Examples of physician engagement?

I totally agree that it does not take a village to accomplish a lot. The problem is that most physicians are stuck with what ever vendor they have and the vendors are not listening. In my experience vendors in their early days listen attentively and implement things quickly. But after 2-3 years and when they have a bit of an established user base they stop listening. My concern is that vendors are more interested in a 'minimal viable product' that typically gets changes to the fringes of the product and things that would help introduce significant changes like clinical decision support remain on the back burner for many years. The excuse is that physicians are not asking for those features. The physicians that do ask for these things are marginalized and there is no venue where these vital changes can be brought forward and then put to the vendors as necessary components of an EMR.

I saw Rick Marshall (www.linkedin.com/in/rick-marshall-9662237/) evangalize the "golden pair"; a proven model of health software design where a clinician with deep understanding of needs pairs with a software designer with a deep understanding of an open source health software platform. By working closely together (deep and long), they can acheive remarkable success designing user centered systems based on actual needs and with a rapid design cycle. Beyond "agile", the Golden Pair provides continuous product development and mutual insight. I've used Open Source OpenEMR (GPL 2 licensed) and worked closely with one of many community members of what I consider the "best in class" OS EMRs. I would recommend a similar model for anyone looking to develop a better model for interoperability.

Over the past 20 years there has been very little physician/clinician engagement. I have been involved with quite a few Infoway projects. There are only a couple of physicians that have continued to be involved over the years. It seems that most of the time physicians seem to be involved for a very short time and projects keep starting with a blank slate and include physicians that have expressed interest but typically have no deep understanding of the issues. There was one Infoway project I was involved nearly 20 years ago that had over 20 clinicians that produced a unanimous recommendation that after all this time continues to largely be ignored by EMR vendors. Physicians continue to be stuck with using 45 year old reference lists. I keep hoping that pointing out things like this that it would ignite some activity.