Building an Electronic Health Record That Won’t Make You Pull Your Hair Out with Dr. Richard Sztramko

If you want to get a doctor's blood pressure up or make her sweat, just tell her that you have a great electronic health record (EHR) to use. EHRs are the bane of a physician's life because they don't work well with your work flow, create extra work and inefficiencies, and cost a ton of money. That's why I spoke to Dr. Richard Sztramko of Hamilton, ON who is co-founder of Arya health technology company that has designed a new EHR.

To this American, I found it very surprising that an innovative EHR product would ever be developed in Canada with a nationalized health care system. The secret is that Canada's health care system isn't that different than ours in many ways. You can catch other episodes where we spoke about EHRs and why we hate the ones we use here, here, and here.

Canadian Docs Have Private Practices

Much like the United States, the Canadian health care system is made up of private practices for generalists and specialists. They bill in a manner very similar to US doctors except that their payors are just governmental. They still have to collect billing information, diagnostic coding, visit or procedure types, and time spent with the patient. It would be very similar to if every service in our country went through with Medicare and Medicaid.

Not all Canadian physicians are in private practice, many work in academic settings, like Dr. Sztramko, where they are employed and have the private non-profit hospitals employ them and provide the personnel to run their clinics and practices. This leaves the country with a non-uniform, disjointed medical system with software that doesn't communicate with each other and is often expensive to operate. The computer systems are the same as in the US in that it is becoming dominated by Cerner and Epic. Ultimately, our medical systems look very similar in their dysfunction for clinicians.

What Makes a Good EHR?

A good electronic health record is hard to find in the marketplace. But what constitutes qualities that make an EHR good?

1. It maximizes your revenue capture. This is important that you get paid in a timely fashion by collecting all the coding information to get prompt payments and minimizing collection work.
2. Improves daily workflow. A good EHR will make things more efficient from a scheduling standpoint and allow you to see more patients and get to the solution faster.
3. Decrease time charting. The EHR should be quick and make charting even faster than it is on paper.
4. Information should be easily accessible. Most EHRs make finding simple questions complicated. They aren't intuitive or they can only be found after multiple clicks
5. Help your bottom line. The cost of the EHR should be easily outweighed by the increased efficiency and revenue that you bring into your practice.

Does Arya Pass the Test?

Not surprisingly, Dr. Sztramko feels that his new EHR product does what most do not. It is relatively inexpensive (only $300/user/month), intuitive, and actually decreases the time necessary to actually do your charting. One of the biggest benefits according to Sztramko is the fact that the program is so intuitive that training is very easy. He reported that in contrast to EPIC and Cerner training which takes days or even weeks to be a super user, Arya training is so easy that doctors usually only need an hour or just to watch the short introductory training video.