Being a newbie to healthcare informatics I sometimes find myself making pre-assumptions about the state of the art in healthcare IT. A few months ago I began the process of learning what the EMR is today, its past and its future. Through my readings I came to realize that for as long as the EMR concept has existed it has not yet been fully standardized and I wondered, why that is. Why is it that this data structure is not completely defined and regulated by our government whom is spending an incredible amount of money and resources to bring the healthcare system into the 21st century? Why has this not been done prior to mandating that all physicians begin to use an EMR? Is the government, once again, putting the cart before the horse?
My original position as to why the EMR is not yet completely standardized was very critical of both the healthcare industry and our government. Having had some time to enlighten myself in regards to the complexity of the problem, industry environment and its current state I now find myself understanding the current state and even in agreement with its lack of complete standardization at this point in time. In a recent article posted on medcitynews.com Dr. David Blumenthal, the National Coordinator for Health Information Technology, was quoted as saying:
“There is a raging debate in the computer science world, which I have only lifted the lid on because I’m not a computer scientist, but it goes basically like this: Do we want a world where somebody sets very detailed standards for what computers have to do in order to create interoperability? Or do we want a world that’s a little bit more like the Internet, where a minimal set of standards was created and an enormous, vibrant competition and spontaneous growth occurred?”
I would have to side with the latter view. Not only will there be spontaneous growth but also that spontaneous growth will allow for the evolution of a much better solution than one developed by committee. Furthermore by allowing the solution to evolve there is the opportunity for financial success by many rather than just a few. Not to mention innovation of unforeseen solutions.
In closing, I now am in support of an evolving EMR which will be allowed to grow and adapt as nature dictates. I now support an EMR solution that is never completely standardized and will always possess a fuzzy definition in certain areas.
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