Wednesday, March 20, 2013


By now, the majority of America has noticed the new Windows 8 advertisement with young hipsters clicking iPad-like computer screens to a keyboard computer base: touch screens, magnetic attachments to computer bases, pretty colors with cool graphic user interfaces.  It all looks so cool, so hip.

But doctors should forget these things for the Electronic Medical Record of tomorrow.  After all, our biggest EMR, EPIC,  has been developed and tested with Windows XP or Windows 7 and it uses the MUMPS programming language.

I wonder, how long will the our next Windows platforms remain backwardly compatible to support our expensive EMRs?  How long will a non-graphic and cumbersome user interface MUMPS survive in tomorrow's graphical computer world?  More to the point: how much would updating to a more current operating system cost in the future?

Yeah, we're stuck with what we've got for a very long time.



Anonymous said...

Really? Who's in charge of purchasing these things?

Why would such as person even consider something that isn't platform independent? The motto should be 'Use our EMR, securely, when you want, where you want, on your terms'.

Technologically, it's not hard. We've been doing it for years.

I know, HIPPA and all the other excuses for why big medicine has such a hard time solving problems that other industries conquered long ago.

Consider this, I can trade $100,000 of equities instantly, on any computer, tablet, smartphone, or ...gasp... telephone that I want to. Financial services are a highly regulated industry where security, privacy, and record keeping are paramount. As screwed up as that industry is, they solved platform dependence years ago.

I imagine a gathering of EMR salesmen, laughing, at the crap they sell to hospitals and practices for such big money. Laughing...all the way to the bank.

Who's falling for this stuff?

Dave said...

I don't think the previous poster quite realizes how EMR's (particularly EPIC) are implemented. Rarely are you running the EMR natively on your machine. Rather you are utilizing a remote desktop program (Citrix is very popular) which connects to a centralized server that is running a virtual instance of windows XP (or windows 7). Thus you are often in the situation of running a virtual instance of windows, while concurrently running windows.

So yeah, you can access the EMR from any computer/android tablet/ipad/phone/etc provided things are set up correctly. The utilization of virtual machines is pretty common across multiple industries, so this isn't that egregious of a situation.

The problem is is that the way the data is stored is proprietary. You can't simply replace the EPIC program with another to read a patient's file; which is flat out wrong. The government needed to put in place a standard file format for health records, but due to industry lobbying that'll never happen.

Anonymous said...

Isn't it the hospital IT managers responsibility for making sure the associated data on the system they manage is forward looking? 20 years ago I worked with 9-track tape in the graphics industry and in order to serve our customers and keep the legacy data we needed to make sure it was available at all times, over time. Where are the plans to migrate the O/S? Windows XP... not supported any longer...