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Electronic record system results from frustration: Doctor, partner hawking technology they developed

May 26, 2008

For Dr. Tim Story, frustration was the mother of invention.

The Carmel internist didn't like the cost or complexity of the electronic medical record systems he had seen. So he created his own.

And now he's trying to sell it to other doctors.

"I wanted an EMR that I could use, that I could understand," said Story, 55, who also chairs the largest group of physicians at Clarian North Medical Center.

Story is by no means alone. Hundreds of doctors across the country have created their own electronic medical record systems and tried to sell them to other doctors. But almost all have failed, said Dr. Thomas Handler, a physician informatics researcher at Connecticut-based Gartner Inc., a technology research firm.

"It's a hugely common story of a doctor who creates a system for himself and then tries to market it," Handler said. "I'm not aware of any that have actually succeeded."

Doctor-developed systems face brutal competition from far larger companies, such as GE Healthcare, McKesson and Siemens. Four companies accounted for 60 percent of all medical record system installations last year, according to data from HIMSS Analytics. Self-developed systems accounted for 3 percent.

But Story and his business partner, Mike Sanders, think they have advantages not all doctors have had.

Sanders ran Story's conceptual design through the software programmers and creative types employed at his firm, The Sanders Group, which is an Indianapolisbased advertising and media production agency.

Now, Sanders' wife Pam, a former mortgage lender and broker, has built a marketing campaign to push the product, which is called Office Visit Complete. Next month, she will start sending advertisements to nearly 500 general practice doctors in central Indiana.

"They didn't really have the finances or resources to market a product," Sanders said of other doctors who invented their own systems. "At The Sanders Group, that's what we do."

Story and Sanders certainly have a big market to tap. More than 70 percent of office-based physicians have yet to adopt electronic medical records, according to a 2006 survey by the Centers for Disease Control and Prevention. For physician practices with fewer than five doctors, even more have yet to switch their patient files from paper charts and manila folders to central servers and laptop computers.

Yet nearly all health care policy experts say the adoption of electronic medical records is vital to improving quality and reducing spiraling costs in the national health care system.

But doctors won't buy computerized record systems, Story said, if they cost too much in money and staff training time, due to their complexity.

He criticized as overly complex the electronic medical record system used by Clarian North. And he said many doctors there agree.

"It's about as popular as malaria," Story said of Clarian's system, which is made by Missouri-based Cerner Corp. Cerner has 6,000 clients worldwide, ranging from large hospitals to small doctor practices.

He contends Office Visit Complete solves the problems of both cost and complexity.

The Web-based system can work on computers most doctors already have. In a demo on the product Web site, ovcemr.com, Story says training takes "minutes, not hours or days." The marketing materials created by The Sanders Group call the product "the point-and-click EMR."

Office Visit Complete costs $5,000 for one doctor and $3,000 for each additional doctor. Doctors also must pay a $200 monthly server fee. But training is free.

Pediatrics Associates, a two-doctor practice in Avon, paid $55,000 for its electronic medical record system in 2004. Unlike Office Visit Complete, the system also includes billing and scheduling programs.

Dr. Donald McIntire and his partner pay more than $5,000 a year in maintenance and licensing fees to local vendor RANAC Corp. and Iowa-based MediNotes Corp., which makes their system.

Having a system designed by a doctor doesn't appeal to McIntire. He said that because each doctor practices differently, he wanted a system that allowed for easy changes and customization.

"Physicians do different things in their offices and some physicians would put things in the system that other physicians would go, 'I don't know why I need that,'" McIntire said.

In fact, a lot of doctors feel the same, which is the biggest reason doctor-developed systems fail, said Handler, the Gartner researcher.

Also, doctor-developed systems often do not offer tools that Handler thinks will become vital as the practice of medicine becomes more complex. For example, he said, electronic prescribing and computergenerated reminders to help doctors make decisions.

"I think [doctor-developers] greatly underestimate the complexity of what these systems should be doing," Handler said.



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