USA has Spent Billions to Fix Medical Records, and They’re Still a Mess

We’ve Spent Billions to Fix Our Medical Records, and They’re Still a Mess. Here’s Why. | Mother Jones article gives a critical view on the development of current digital medical record systems.

Judith Faulkner, Epic’s 72-year-old founder and one of just 18 women on Forbes‘ list of self-made billionaires, has a motto: “Do good. Have fun. Make money.” She’s solid on the second two points. Thanks to the White House’s stimulus-era initiative to bring the health care industry into the digital age (“Within five years, all of America’s medical records are computerized,” President Barack Obama announced in January 2009), her company has grown into the country’s leading vendor of software in the $9.3 billion electronic health records (EHR) sector. “Within five years, all of America’s medical records are computerized,” he announced in January 2009.

Epic pulled in $1.8 billion in 2014 and is expanding at a rate of about 1,000 new employees a year. But instead of ushering in a new age of secure and easily accessible medical files, Epic has helped create a fragmented system that leaves doctors unable to trade information across practices or hospitals. That hurts patients who can’t be assured that their records—drug allergies, test results, X-rays—will be available to the doctors who need to see them. Epic is like the Microsoft Office of health care software—more comprehensive than its competitors, even if its individual parts are kind of meh. Doctors are investing the time to input data, but their offices are still having to fax and mail records like they did a decade ago. Epic is not the only barrier to a seamless medical records system. Ecosystem as it is set by Epic and and others is very valuable to the companies taking part in it, and they don’t want to change that.

It is not just in USA, it will also be in use in Finland. Epic Systems Corporation has been selected to supply a new patient data system for the Hospital District of Helsinki and Uusimaa (HUS) and four municipalities. The Apotti project to reform Uusimaa municipality’s patient information systems lurched forward in August. The Apotti project to reform Uusimaa municipality’s patient information systems lurched forward in August 2015. HUS is currently paying 45 million euros a year for the use of its out-of-date patient data systems. The Apotti Programme is estimated to cost a total of 575 million euros over the first ten years. It should be an improvement over the current systems as the usability should be better compared to old systems at least on report on demo. Technically, EPIC, however, is old-fashioned. Its core is written in the Mumps language (technology form 1960′s) which is the current point of view, ridiculous and most of the user interface is the Visual Basic version 6, which is the official support was discontinued in 2008. In principle Epic extensions and further development makes the Epic Systems Corporation of Wisconsin campus in Verona.

Not everybody is happy with the system, so as alternative to it several Finnish software companies have formed a consortium to promote the transparency of the methods used for the health care market and welfare organizations. Companies aim to create an open alternative social and healthcare client and patient information system that will inform the consortium. The consortium is setting up an open developer community, which will be welcomed by all stakeholders.

ASTE (Avoin sosiaali- ja terveydenhuolto = open social and health care) Consortium has been formed to respond to the public sector identified serious software development challenges. The consortium has undertaken to provide a user-driven, based on agile methods, reduce waste and the administrative burden of the application. The aim to to build a modular system where parts can easily communicate with each other. Finland still dreaming of such modularity as in use Estonian ICT architecture -  an XML-based X-Road.

There are also other open initiatives – from them the most promising example, that is, an open source OSCAR-information system (Open Source Clinical Application). That system has about 20% market share in the state of Ontario, Canada, and it is also in use in several countries. OSCAR McMaster is a web-based electronic medical record (EMR) system initially developed for academic primary care clinics. OSCAR has many features which computerize and coordinate the important functions of a medical clinic.