Shopping for Health Software

Some Doctors Get Buyer’s Remorse

By D. Kellus Pruitt; DDS

Dear Huffington Post Investigative Fund

As a dentist, I read Emma Schwartz’s “Shopping for Health Software, Some Doctors Get Buyer’s Remorse” with interest.

It was like watching a slow, grinding train wreck from a still safe, but shrinking distance.

http://www.huffingtonpost.com/2010/01/29/shopping-for-health-softw_n_442651.html

Duped Physicians 

The numerous stories about physicians who lost hundreds of thousands of dollars because of bad software purchases – including the case where some doctors alleged they were locked out of their patients’ medical records – is awe inspiring if one isn’t mandated to live the misery. I hope it’s a long, long time before paper dental practices are outlawed. If as Ms. Schwartz describes, broad-band interoperability fails to save money for physicians where it makes sense, I promise that dentists will never invest in interoperability beyond occasionally purchasing a new fax machine, telephone, or postage stamps. Dentistry simply isn’t emergency room medicine, and non-productive technology is especially costly if it fails to function properly.

A Volatile Industry 

Steven Lazarus, president of consulting company Boundary Information Group, was quoted:

 “This is a very volatile industry. Any product doctors buy could be bought or changed within two years.”

You want to see volatile? Try explaining that to thousands of disappointed dentists in solo practices – one disagreeable SOB at a time.

A Canadian Illustration 

Believe it or not, there’s still more kinetic energy behind the train wreck – even without mentioning data breach bankruptcies. As illustrated by Schwartz’s example of Canada-based MedcomSoft, even if a company’s EHR system is CCHIT-certified, bankruptcy can occur unexpectedly – again leaving doctors holding the bag. To stay in business, providers who lose money on EHRs either must cut corners or increase fees to cover the loss … volatile!

A Dentist’s Question 

Why, oh why, would a dentist want to spend $40,000 on software including thousands of man-hours in transition, just to risk pulling this tangled, expensive mess down on top of one’s practice? And – for what? There is no return on investment beyond the stakeholders in the EHR industry – which is ultimately paid by unrepresented patients through their healthcare in higher medical fees. As one can imagine, dentists are staying away from EHRs in droves.

For example, what does it mean that there are few if any advertisements for electronic dental records in industry journals, junk mail ads or Internet venues? I think it means that the Father of Economics Adam Smith is quietly warning ambitious, would-be dental software salespeople that their dangerous and expensive products will get them thrown out of dental offices.

The ADA 

But then again, I could be wrong. Here is what Dr. John Findley, the immediate past president of the American Dental Association, told ADA Reporter Judy Jakush in a September 2008 interview a month before taking office:

“The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’ That’s why we absolutely need the profession to be represented in the discussions about EHR to make sure our ideas are enacted to the greatest extent possible.”

To me, that’s scary. It smells a lot like tyranny.

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