How can an Electronic Health Solution help Physicians Keep their Doors Open

Shameem C. HameedIn my previous article I started to address the unenviable position that physicians in the United States find themselves, in and how open source solutions can help them keep their doors open. In this article we will address some of the additional business challenges that physician offices and clinics face, and how the Electronic Health Solution (EHS) that we just released can help give them the tools and flexibility to both care for their patients and run a sustainable practice.

This is a critical issue facing the United States today, as tens of thousands of physicians are closing their practices every year, and either retiring or becoming employees of large healthcare corporations. This is having a significant impact on accessibility and affordability of medical care, as fewer doctors are available and people seeking care from  “corporatized” healthcare providers, quickly find out that they have lost a personal relationship with a physician and his staff, in particular the ability to follow up with someone they know, as physicians become just a replaceable employees of a transnational corporation. To add insult to injury, patients suddenly find out they have to pay substantially more for medical care at corporate-run medical facilities.

Why are doctors being forced to give up their practices? Most doctors are small business owners. Not only do physicians have the responsibility of providing care to their patients, but they also have to know a lot about running a profitable enterprise. Many of these providers are not equipped to do so. Apart from all the challenges of POSDCORB (that is short for planning, organizing, staffing, directing, coordinating, reporting and budgeting) functions as a business owner, today’s practice of medicine demands them to be technologists too.

Doctors as Technologists

So let us quantify what physicians are up against as “technologists.” They need to have an EHR system. They need a scheduling system. They need to have medical devices integration, practice management system, e-prescription, lab interfaces, patient engagement, Tele-medicine …. and all these should be secure and HIPAA compliant. And, of course, disaster recovery and business continuity. And their technologies have to comply with tens of thousands of government regulations totaling hundreds of thousands of pages.

Confucius said “Don’t kill a mosquito with a cannon.” You could get all this under one system if you have the money to spend. And there are hospital systems that spend that kind of money. And those systems have sent a few of them into staggering losses:

• Duke University Health system will shell out $700 million
• Tucson area’s largest health network racks up nearly $30 million in losses
• Wake Forest Baptist posts $78.4M operating loss for fiscal 2014
• Maine Medical Center-Epic installation proves more expensive

But it beats me why it should cost so much. I have been in the Hospital Management Systems (HMS) business for 23 years. Back in 1991, I started a company in India which developed and implemented HMS systems. As of today, it is still the leading HMS vendor in South India servicing hundreds of large hospitals across the country as well as countries in the Middle East. Many of the hospitals using this HMS have in excess of 1500 beds. The cost of implementing those solutions is a fraction of the tens of millions to billions of dollars hospitals spend here in the United States for health IT.

When it comes to physician offices, the cost of subscribing to one EHR system is the lease payment of a luxury car. Even if you are able to get a “Free EHR” you still have to pay for the rest of the components. Not to mention that the “Free EHR” bombards you with advertisements. So the physician offices has to pay for the practice management system, the clearing house fees, and the various other systems it needs to get to an efficient solution. Once it has subscribed to these solutions, it has to figure out a way to make these systems talk to each other without having to duplicate time and effort. If something goes wrong the user has may have to call as many as a dozen different providers for their support.

How does a physician manage all this at a cost that is affordable? Should they also go into losses like major health systems?

ERP Systems as Models for Physicians

Many of you have heard about ERP systems or Enterprise Resource Planning. Businesses, especially manufacturing entities, were struggling with a plethora of activities that were needed to run a complicated enterprise. Activities included Accounting, Human Resources, CRM, Sales, Procurement, Production Distribution, and so on and so forth. Until the arrival of ERP, systems entities were struggling with disparate systems to manage these activities at much higher costs.

The physician community needs their own ERP system. A system that has all the technology ingredients necessary for running a practice efficiently. An EHR system is not enough. And we are not talking about the large multi-million dollar behemoths that are driving hospitals to the ground. We are talking about a new generation solution that is user friendly and cognitive. We at ZH Healthcare would like to call this an EHS, Electronic Health Solution.

For a decade we have been the leading commercial implementer of OpenEMR, an open source EHR that has been implemented at sites in 182 countries and it has been translated to 34 languages. The Peace Corps is implementing it in field offices in more than 70 countries around the world. We have gained a lot of knowledge as a result of our extensive experience developing and implementing OpenEMR and being an active member of the open source community.

One of the key lessons we learned was that a high-quality, usable EHR by itself was not sufficient to lift the burden of technologies from physicians practicing in the United States. They needed a complete holistic solution that addressed all of their technology needs. We also learned that they needed a cloud-based solution, so they don’t have to hire IT staff and spend their time supporting a complex computer system. Yet, every physician office is different, so we made sure that the solution retained the key element of customization.

The end result of all these years of work is BlueEHS, which we publicly announced last week. BlueEHS combines Scheduling, Payment Platform, eRx, Labs, Pharmacy, Inventory, Clinical notes, Treatment plans, Practice management, Accounts receivable, Patient Engagement, Telemedicine including video consultation, In-patient systems and more. And we serve it to the care giving community in a multilingual cloud platform that they can use by picking and choosing the components relevant to them. The user interface has been designed by physicians, for physicians, so it does not get in the way of caring for their patients.

This is the power of open source, it has led to a technology solution that makes it possible for physicians to care for their patients while staying in business and making a living.