Is Modular EHR Technology a Viable Option? Harvard’s SMArt Research

A very interesting concept is that of modular EHR technology. Earlier this year, ONC awarded four Strategic Health IT Advanced Research Project (SHARP) grants. A Boston based research group was one of the successful recipients. A blog excerpt is provided below describing how the modular EHRs could work.

Kibbe & Klepper – Oct 5, 2010 …One of these grants was awarded to a Harvard group led by Drs. Ken Mandl and Isaac Kohane, based in Children’s Hospital Boston and Harvard Medical School. This research team is tackling the problems associated with developing an ecosystem of modular, plug-and-play medical applications, what we have referred to as Clinical Groupware. (Disclosure: DCK is on the Harvard SHARP grant’s advisory board.)

The research is aimed at creating a “medical apps store” based on the iPhone/iPad model of substitutable applications running on a device or platform. The name of the project, SMArt, stands for “Substitutable Medical Applications, re-useable technology.” The approach could impact both the EHR industry and the federal regulatory and standards process, possibly within a relatively short period, i.e., 1-3 years, so we think it merits your attention. First, the problem.

The dependence on monolithic EHR products – with pre-defined features that are presumably comprehensive – has kept health care IT expensive, difficult to implement, use, and maintain.

This approach has impeded innovation, and has helped to perpetuate a fragmented health system with many disconnected “silos” and “data islands.” A vibrant, evolving health care system requires an IT infrastructure that is more like the iPhone and its app store. In other words, we believe that a more practical, contemporary approach involve general purpose platforms designed for communications and data sharing, able to support any number of simple applications, each doing a small set of tasks consistently and reliably.

Read the full posting

What are your thoughts? Do you think we should have a modular platform? How could we maintain quality and usability? EHRs are mission critical applications that need to work 100% of the time. Would clinicians tolerate applications that did not work properly vs. the .99c app from the App Store that did not work and was simply deleted from one’s phone or computer?

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This post is the personal opinion of
the author and does not necessarily reflect the official policy or
position of the American College of Physicians (ACP). ACP does not
endorse a specific EHR brand or product and ACP makes no
representations, warranties, or assurances as to the accuracy or
completeness of the information provided herein.

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