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The Search for the Holy Grail - 'Clinically Seductive Software'

Posted Oct 30 2008 3:22pm

Earlier this week I attended an Infoway sponsored conference in Quebec entitled 'Beyond Good Intentions'. The title of the conference was extremely apt. Every attendee was there with the intention of facilitating the adoption of electronic health records in Canada. The conference was a mix of international and Canadian speakers and the audience ranged from physicians in primary care to deputy ministers of health.

Sir Nigel Crisp, the previous Chief Executive of the Department of Health and the NHS talked about the challenges facing England as the NHS goes through a significant redesign and IT upgrade. He highlighted the fact that clinician acceptance and the identification and support of clinical champions has been a major challenge in England. It is clear from international experience that it is not possible to acheive success without the support of physicians. Ergo - physicians now enter the arena. The infrastructure is being built, systems are being tied together and the last, but most critical component is engagement of the end user.

Another point that struck me was mentioned by Dr. Mike Stein, medical director for the Map of Medicine. He stated that the inability to engage physicians is directly a result of a lack of availability of 'Clinically Seductive Software'. So, what is this elusive thing called clinically seductive software? Clearly this term could be applied to Electronic Medical Record systems that currently exist in the market place today. Dr. Bill Clifford, a physician in the Northern Health Authority in British Columbia designed and built an Electronic Medical Record system. The majority of the physicians in Northern Health Region use this application. What is more important is that fact that in a country in which adoption rates for electronic medical records are somewhere in the range of 20% - 25%, in Northern Health Region, 50% of physicians were using an EMR even before a funding deal was announced in British Columbia.

So why the aberration? I believe that what Dr. Clifford has done is create 'Clinically Seductive EMR Software'. His system was designed to solve clinical problems and produce data in a way that physicians could examine populations of patients in order to deliver more optimal care. This is a signficant driver and one not be underestimated by the creators of EMR applications. (Please note - It is not my intention to debate the merits of any individual software application or endorse any specific product, simply to point out a phenomenon.)

It is more important that Dr. Clifford has been able to construct a seductive application. This phenomenon needs to be better understood. Epocrates is a clinically seductive application for the PDA - it launched a whole industry of handheld based drug interaction programs. Perhaps we need a new category of consultant in Canada, a 'Clinical Seduction Expert' or CSE. Each project to be used by clinicians would then be evaluated by the CSE before being unleashed.

Share your experiences. Have you used a clinically seductive EMR application or medical software tool? What should we avoid? How important is this phenomenon?

To share your experiences, click on the 'Comments' link.

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