Tens of billions of dollars paid out by the federal government for the purchase of healthcare information technology enabled our industry to stay addicted to its current solutions. With no incentive to change behavior or innovate, why should the major HIT vendors bother to do so?

Even if vendors wanted to innovate, the new requirements for ICD-10-CM and meaningful use consume resources that might otherwise be used to improve clinical usability of their products.

To make matters worse, those very requirements are daunting enough to spur physicians to sell their practices to enterprises dominated by hospitals, where they become employees with little influence over how systems are designed. Clinicians can complain about usability all they want but they have little power to do anything about it.

In some cases, even when an enterprise does decide to listen to its clinicians and provide something that they actually want to use, their vendor may decide it is not worth its while to participate. After all, addicts don’t change behavior until they hit bottom, and our industry is still riding high on the federal dollars.

A case in point is Phoenix Children’s Hospital (PCH).

PCH was not getting what was needed from its HIS vendor in terms of clinical usability for ambulatory physicians. The physicians at PCH met to determine what was needed, and PCH presented these requirements to the vendor. When PCH did not see a path to getting what their physicians wanted, they discovered a clinical documentation solution that could be integrated with their existing HIS and that met their needs.

The HIS vendor decided not to integrate this solution into its own product, but allowed PCH to do so itself. Within nine months they went live. Today they report that ambulatory physicians are seeing 30% more patients per day, quality and compliance has improved, and the doctors love it and are getting home earlier.

Even though we are supposedly in the “post-EHR world,” I think you will start to see more of this, where capabilities will be added to existing systems to address clinical usability.

It may not come from the HIS vendors, though, as long as the federal dollars enable them to sustain their addiction.