“No one’s talking about the legacy problem with Information Technology systems,” he said.
“What do you mean?” I asked.
“While every one’s talking about developing a fully-integrated nationwide electronic medical record, no one give a damn about the old systems that exist out there. They’re not worth supporting. No one cares about the data they contain, even though for the doctor, they contain critical documentation about patient’s prior health care and are vital documentation to prevent litigation.
He continued, “I was in an eight man group in 1995. We were very cutting-edge. We bought the latest and greatest software that printed out fully legible prescriptions in the patient’s exam room using personalized prescription pads. It organized our clinic visits – helped with scheduling and documentation of the examination – the works. Our first problem was when Windows NT shifted to Windows XP, we found the had to pay for the upgrade because Microsoft stopped supporting the old system. We quickly discovered that the printers we used to print our prescriptions didn’t work. Why? Because printer drivers for our older specialized printers weren’t available for the new operating system. The printers became useless. Who could I pay to develop these drivers?
But it didn’t end there. For other reasons, our group split up. Our eight-man group became four, and eventually over the next several years, two. We simply could no longer afford the maintenance on the fancier medical record system, so we bought a simpler one that was much less expensive to maintain but found that the data from the older system could not be imported into the new system.
What to do?
We couldn’t get rid of the old system for it contained all of the documentation on patients from the recent past. We had to pay to have it maintained while working to re-create patient data on a new system. Eventually, as time went on, fewer and fewer people knew how to support the old system, the hardware became obsolete, and finally I just stopped paying the maintenance fee. I went “naked” without archived medical records. What choice did I have?
So I ask you, when the government decides on a single electronic medical record system that suits their needs and is all-encompassing, what’s going to happen to all the data on the other systems? I bet every one's going to experience the same problems I did.”
Image reference: Andrew* on Flickr via a Creative Commons license.