Analysis 1

State of Development
In many respects, EMR is in early stages of development, an emerging technology, with respect to real world applications. At the same time, there are many software companies providing solutions for clinics and physician practices. Due to a lack of standards, there is no guarantee that any one of them will be able to support the emerging standards. Also, due to specialized nature of the software, providers are often small and future support is threatened due to the instabilities inherent in small businesses.

Larger companies are geared to providing solutions for larger operations that require sophisticated data storage, customized architecture, and distributed technology. VistA [Hardhats] based solutions seem to be a safe route due to its support by the Veteran's Administration and Medicare. Unlike the majority of players in the EMR market VistA is mature software and has a long track record. At the moment its adoption is somewhat hampered by its use of the little used M programming language and complex installation, though these issues seem to be being addressed. A recent and notable effort is that of Steve Case of AOL fame. He is proposing to revolutionize EMR by providing a Web 2.0 type solution [Clark 2005].

As technology continues to improve and become less expensive it becomes more likely that complete and usable EMR solutions are possible. Wireless networking, portable computers, high resolution displays, and efficient interfaces are near requirements for effective EMR systems. These technologies are becoming easier to use, more secure, and less expensive.

There are an ever growing number of standards that directly and indirectly effect EMR. Currently there are many standards organizations writing standards that compete or overlap with each other [Goedert 2007]. While the situation will improve, this confusing array of requirements makes developing complete and sustainable solutions difficult.