When marketing people are left unchecked, they often get creative by inventing terms and reinventing them. In the world of health information technology, marketing people have awakened to a new opportunity. They've borrowed a term made popular by the auto industry, and are using to pimp their products.

A Hybrid EMR is a much better marketing term than its predecessor, "the Anti-EMR". It turns out that the company that tried to be the Anti-EMR had some difficulty gaining traction with this term. They then brought in the big guns, and shifted to a better strategy.

EMR stands for Electronic Medical Records. This is a piece of software that allows a doctor to store their patient charts - documentation about what happens at each patient visit and exam - electronically. The first EMRs started about 15 years ago, as Microsoft Windows 3.1 was gaining traction in replacing MS-DOS. Granted, there were systems earlier than that, but like these very first Windows EMRs, they didn't really solve real world problems. Technology nuts would tinker with systems and try them out.

The winds started changing with the next Windows EMRs. The EMR would allow a medical provider to document their patient encounter note using the computer. Prior to that, they hand-wrote a note or dictated into a recorder and had a transcriptionist type out the note. These early charting systems, then stored the record electronically, eliminating the old paper storage system. Over time these systems evolved into solving each manual process in the practice, including prescription writing, clinical orders, messaging, reporting, and document management.

However, with increased sophistication came increased complexity. Doctors overwhelmingly chose not to adopt the technology, as it slowed them down. While this was becoming painfully obvious, 300 competing products entered the marketplace, all trying to get the doctor to fully adopt the complicated technology.

The Anti Accident

How do you get a doctor to adopt your technology, when they overwhelmingly are saying "No!"? One company brought their document storage system into play as the "Anti-EMR". This meant that you could have an electronic medical record, without changing your current charting methods. The doctor could complete his note using his old methods, and have a staff member enter it into the digital chart.

No surprisingly, when you try to enter the marketplace, associate yourself with an existing product type, all while disparaging the concepts behind it, you don't succeed. With any new product launch, you must decide one of two major launch strategies. Do you educate the marketplace about your new widget, or do you use an associated product and educate the marketplace about how your new widget is the same as, but different than the comparable widget.

This company launched their document management widget, but didn't have the marketing dollars to educate the entire marketplace about the new widget. As such, they associated their product to the older 300 widgets, while trying to differentiate. However, in differentiating, they went too far for their own good. You can't say that EMRs don't work, all while saying you're an EMR.

The Birth of the Hybrid

They apparently had an epiphany. They started calling themselves a Hybrid EMR. They still talked about how EMRs didn't work, and tried to differentiate. However, because they changed the name, and because they changed the tone of the conversation, it worked. They started gaining some traction.

But what is the Hybrid? Well, the initial term was somewhat closer to reality. The Anti or Hybrid EMR is a document storage system. Basically, it doesn't include a charting system, the core of most EMRs. However, it does do a lot of the fringe features such as prescription writing.

Does the Hybrid Have Both a Gasoline and Electric Engine?

There are now other players in the Hybrid market. But the question remains, is Hybrid the correct term? No. For most of these companies, the Hybrid is actually simply an electric car. It has limited range, a maximum speed limitation, and a limited return on investment. That doesn't mean it is valuable. However, it may have a government induced dead end, as the government will likely require electronic charting and data mining that isn't available with a document storage system.

To continue the bad analogy, a true Hybrid would allow the electric engine to run until you got to the freeway, or until the battery got low. Then, the gasoline engine would take you the rest of the way. The equivalent in EMR is a document management starting point (the electric engine). However, when you want to (or are required to) switch to the gas engine, you can upgrade to the full EMR charting system.

However, with a dead-end document management system, you'd have to buy a whole new car if you want the gasoline engine. That means a new investment, a new product to learn, and more down time.

Luckily, one of the companies has addressed this with a true Hybrid EMR. According to their press release, if you want to go document management only, that's OK. When you want to go to the full charting EMR, you don't have to buy a completely new system and relearn it. Check it out at www.chartlogic.com/company/news/pr_11_24_08.php.