“Epic is dead, Cerner is dead, in their current form. It’s only a matter of time,” Dr. James said at a NEJM Catalyst event this summer held at Intermountain.
Though the original design of EHRs was not financial, their current use is to generate fee-for-service billing, which is why physicians spend two hours on computer entry tasks for every hour they spend with patients, he explained. Dr. James said at this point, EHRs have turned physicians into “a bunch of very expensive financial clerks.”
Around 80 percent of an EHR’s functionality is commodities, he claimed. This includes patient identification, data storage, security features and order processing. His idea is to build a layer on top of that, which would allow clinical teams to have complete control over it and define their own work environment.
Dr. James described Intermountain’s experimental EHR that uses an activity-based design. “We were looking for the ideal system to support clinical decision support,” he said. “It gives a nice granular content to your data. It’s clinically natural — it’s the way you think about it, the way we think about it as doctors. And you can define it, change it. But it gave so much structure to the clinical environment that natural language processing began to work.”
He added that other next-generation EHRs are showing potential, too, though did not cite any vendors by name. “When you see those, you realize you’re seeing our future, and it’s a great future. And it can’t come soon enough.”
Click here to listen to Dr. James’ full remarks.
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