EHR Lessons Learned: Week 6

Posted by: Navy Capt. Michael Weiner
DHIMS Deputy Program Manager and Chief Medical Officer

Wednesday, May 05, 2010

During the last month or so, I’ve been blogging about the lessons learned by the Military Health System in information technology and information management regarding electronic health records based on my experience as a military physician. The workflow is high on the list of priorities, as is training, but getting to the speed and ensuring our medical providers have the right information at the right time is imperative because health care is local, but the information is global.

Web Hosted Solutions Make Sense for Speed and Redundancy

As Internet connections become faster and more, it may be efficient to have a third party vendor host an EHR for the private sector versus running it from a server located within the organization. Every need is different. The Department of Defense hosts information on its own servers to protect national security and because of the volume of the people we serve. In MHS, we serve 9.6 million beneficiaries so it makes fiscal sense for us to do our own hosting. However, when the military’s EHR was first conceptualized as a dream and a contract, Web hosting wasn’t even an idea people could consider. Now, we wish it had been because our system was developed as a desktop application.

The lesson I’ve learned regarding EHRs and the power of the Web is that Web hosting increases speed, allows for better redundancy and increases reliability. A centralized server eliminates the need for constant upgrades to servers at the local level. Web-enabled solutions allow upgrades to occur faster, and issues to be mitigated more quickly than desktop based systems. Some of the virtualized solutions on the market today also provide the look and feel of a Web-based product and many companies are now making their EHR solutions available through virtual desktops. Of course, the off-the-shelf models are not yet, to my knowledge, scalable for a global enterprise such as the MHS. However, if I were to retire today and go into civilian private practice, I would be exploring those Web options myself.

The availability of easily accessed Web-based applications has spoiled us as a nation, and we now expect no less in our EHR capabilities. The point is that EHRs are Web-based, or accessible to the medical provider and patient at all times. Even a Web-based system will be constrained if the medical providers are hindered by cords and wires. Next week, I am going to look at the benefit of cutting the wires that constrain the providers.