Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why EMRs require cloud-based solutions

Tashfeen Ekram, MD
Tech
December 4, 2015
Share
Tweet
Share

In a recent post Rocky Bilhartz outlined some of the challenges health care providers face when working with software. Health care providers are spending more time in the digital world and less time interacting with patients. The problem of less patient contact, in part, accounts for their complaints leading to the desire to streamline repetitive tasks so they can get back to why they really choose to be in medicine.

However, the nature of large organizations is to move slow, which is what often leads to the experience in Dr. Bilhartz’s post where it took two years to get a response to a feature request.

In the early 2000s, the University of Michigan Health Care System was still using a homegrown web-based EMR (CareWeb) which functioned very well for a fairly large system consisting of 3 hospitals, 120 clinics, and an operating budget greater than $3 billion. However, it became clear that an in-house effort could not keep up with changing needs, particularly around government incentives connected with certified technology use. They purchased Epic.

This was certainly the right decision at the time, but looking at other industries, this is a very early 2000s attitude. This forces customers to run the software onsite and have onsite support. Software like these are not typically built to be upgraded in a facile manner. New feature releases, security patches, etc. come in bunches and often lead to downtime. My home institution just upgraded our EMR, and we were without a usable EMR for 12 hours. Often, maintenance is an in-house effort by folks that are also supporting several other systems; thus, they are short staffed and generalists in several different systems. This is an inefficient and expensive effort.

Let’s fast forward to 2015 to another industry. British Airways (BA) is representative of a well-established company not known to take excessive risks. Like many other corporations of their size, they ran communication services internally by buying Microsoft products and having IT staff internally to maintain them. More recently, they opted to buy this as a service from Microsoft in order to not have to worry about maintaining it or upgrading it. This is slowly becoming the standard as companies providing such services are seeing tremendous growth.

The important point about this trend is that it allows companies like BA to become more lean and focus on their core business. This holds an important lesson for health care particularly given that technology is becoming an increasing cost. Rather than having dedicated staff at every institution maintaining the same software that runs on the inside separately, we could follow the paradigm switch of buying software as a service and relying on dedicated, experienced staff at a central location. At a global level, imagine if we could reduce the internal IT staff as means of reducing costs. There is of course over simplification as there are many factors involved in making such a switch including patient data safety, uptime of the service, site-specific implementation, etc.

But more importantly for the end users, this would mean the software would never seem stagnant. When software is built with the intent of selling it as a service, it is designed to be updated constantly which translates to the software staying fresh while minimizing downtime and allowing doctors to return their focus on their patients.

Tashfeen Ekram is a radiologist and co-founder Luma Health. He can be reached on Twitter @tashfeenekrammd.

Image credit: Shutterstock.com

Prev

How a pediatrician won social media and defined his online reputation

December 4, 2015 Kevin 0
…
Next

The general radiologist is still valued. Here's why.

December 4, 2015 Kevin 1
…

Tagged as: Health IT

Post navigation

< Previous Post
How a pediatrician won social media and defined his online reputation
Next Post >
The general radiologist is still valued. Here's why.

ADVERTISEMENT

More by Tashfeen Ekram, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Help your radiologist out and provide as much history as you can

    Tashfeen Ekram, MD

Related Posts

  • The expanding role of specialists in value-based care

    Martin Lustick, MD
  • Lessons from the meeting of different value-based concepts

    Joshua Liao, MD
  • Behavioral health providers face challenges in value-based care

    Martin Lustick, MD
  • Considering the recent setbacks of evidence-based medicine

    Kenneth Lin, MD
  • Market-based approaches solving the opioid epidemic

    Julie Craig, MD
  • Primary Care First: CMS develops a value-based primary care program for independent practices

    Robert Colton, MD

More in Tech

  • How I stopped typing notes and started seeing my patients again

    William S. Micka, MD
  • How AI is reshaping preventive medicine

    Jalene Jacob, MD, MBA
  • Why clinicians must lead health care tech innovation

    Kimberly Smith, RN
  • Why medical notes have become billing scripts instead of patient stories

    Sriman Swarup, MD, MBA
  • a desk with keyboard and ipad with the kevinmd logo

    AI in health care is moving too fast for the human heart

    Tiffiny Black, DM, MPA, MBA
  • Why AI in health care needs the same scrutiny as chemotherapy

    Rafael Rolon Rivera, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 25 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why EMRs require cloud-based solutions
25 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...