Heathcare stimulus: Increasing EMR liquidity

I was having a discussion with the new MD in the practice today and we were discussing Ankhos, and how it compared with what he has seen at other oncology offices.


I described how things are going very well and that we are slowly but surely adding new functionality and refining existing features. I told him that the biggest issue  we have is getting data from the previous EMR.


He suggested that, maybe, the real way to promote competition in the EMR field was not to mandate that all doctors/hospitals have EMR software, but to mandate that if a practice requests it, an entire data dump must be provided in an electronically-parseable format by the EMR vendor.


This would light a fire under the butts of many of the old EMR vendors whose strategy has revolved around vendor lock-in and would allow for practices and hospitals to incur less risk when deciding on an EMR vendor.


Doctors and hospital admins are not stupid; they are not categorically computer-averse.  A mandate is not magically going to make medical software worth a doctor’s time. Forcing immature/unwanted software into the medical field is a recipe for disaster.


If it is impossible to shop around and take your data with you, all the choices in the world are not going to help.  We need EMR liquidity.

4 Responses to “Heathcare stimulus: Increasing EMR liquidity”

  1. kd4ttc Says:

    I commend the thought. However all emr’s are
    Electronically parseble. The problem is the cost of parsing. In particular, a relational database is easy to parse table by table, but rearranging the data for importing into another database can be extraordinarily complex.
    Mandating a specific database organization would be a poor choice because architectural choices affect performance, and different practices have different performance requirements.

  2. orlowski Says:

    Yes, by the nature of an EMR, the records are electronic. However, this does not mean that a vendor must supply the data contained within the system in an electronic format.

    One of the challenged I faced is that our current EMR does not even allow copy and paste from their interface. It is clear that the vendor wishes to convert such requests to an ‘interface request’, where they can charge $3,000 to give you parseable access to your own data.

    This is not an issue of database design, it is an issue of information access and vendor lock-in.

  3. kd4ttc Says:

    Oh, that’s just plain rude. I have a billing system called MacPractice. I made sure it used an accessible SQL server model. In my case, MySQL. That let me leverage address data and scheduling info which I could use to create useful programs for schedule display over the internet and automate procedure documentation. But preventing cut and paste is way over the line in a system preventing you from using your own data.

    EMR vendors have always told me that I would own the data in any system that I purchased. If you cannot read it you eally don’t own it. You might look over the user agreement to see if there is a clause about the data being yours. You might be able to pressure them into allowing access. Since it is an EMR that uses multiple terminals it is probably a client/server model. Not many apps do their own database anymore, so there may be a port that will accept SQL requests on the server. I’m sure you’ve looked at the backup files. No hints there, either?

    So, the legacy system doesn’t do copy and paste. Does it have any sort of export option?

  4. orlowski Says:

    Yes, we have a few options, and are not dead in the water. I did contact them directly to discuss and they replied with a service quote.

    These types of things are what give EMR systems a bad name.

    Just “Don’t be evil.”

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