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EHR Stimulus Calculators and Lost Productivity

Posted on March 31, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my post about an EHR stimulus calculator on EMR and HIPAA, a user left an interesting comment that I thought might start some discussion:

Does the calculator account for the 30% loss in productivity that is essentially universal when a group adopts EMR? Most highly productive groups would be better off rejecting the stimulus, especially given the available crop of clickorrhea that passes for an EMR.

NIST EHR Certification Test Plan

Posted on March 28, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed it, I posted on my other site about the NIST EHR Certification testing website. I still haven’t had much time to dig deep into what’s available, but one of my readers sent me the following (excuse the lack of form since they probably didn’t intend it to be published):

Boy, I don’t know what to think. Much of this seems to be piles of words referring to zillions of links.

However, I did find a place where it talks about the “Draft Test Procedures.” Under that heading it lists the “Draft Test Method” for a category such as Maintain Active Medication List. It shows, for instance, that you must be able to enter something like:

RxNormCode Medication Brand Name (generic name) Dose Form Route Frequency DateStarted DateStopped
205875 Diabeta (glyburide) 2.5 mg Tablet By mouth(po) every morning 9/16/09
617314 Lipitor (atorvastatin calcium) 10 mg Tablet By mouth(po) daily 5/5/08

and then modify, and later list. So, I guess if a system didn’t have the ability to enter “route” then does this mean the system fails? Or, does allowing an improper form of “route” for the med make it fail? Unclear. On the other hand, because you can enter and modify all of the above, does it “pass”? What is missing, from my opinion, is the useability factor. My docs, for instance, like to see the history of dispensing of a given medication. Knowing and being able to easily see the various dispensings of amoxicillin is key to practicing good medicine. The Draft does not address that and is, in my opinion, a major missing point. One can have a system where doing anything takes lots of clicks and typing, or common things can be done in a few steps.

The rest of the Draft Test Methods are the same. Enter this, change that, make a list.

It would be nice if someone could tell me what it is I’m missing.

Does anyone else get the feeling that this certification stuff is going to be a mess and add little value for doctors?

Healthcare Reforms Impact on EMR

Posted on March 26, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m out of town now at a leadership retreat. So, I decided I’d pose a question and hopefully a number of people will leave comments with their thoughts on the subject. Now for the question:

What type of impact will the most recently passed “healthcare reform” bill have on EMR adoption and use?

HIPAA Breaches Related to EMR

Posted on March 25, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Someone sent me an email with this link to the list of HIPAA breaches affecting 500 or more individuals. One of my popular searches on EMR and HIPAA is about HIPAA lawsuits, so you can imagine the lawyers are salivating over this list.

In a quick count, I found 31 on the list that were desktop, laptop, or other computer related device. In another quick count, I counted 46 on the list (feel free to correct my counts, but the range is right). The person who emailed me suggested that most of the list was breaches of EMR. I personally don’t think that’s the case.

One thing seems pretty certain. Technology has opened the doors for larger breaches. In the paper world, it’s a little harder to lose/misplace/steal 500 or more individuals information. It happens, but it’s much easier in the digital world. Plus, there’s a lot more vagueness in technology when a breach happens.

In the digital world, it’s often a best guess about what happened during a breach. Most of the time breaches happen in the technical world, they probably didn’t give a rip about the healthcare data. However, there’s the potential that they did, so you get to report it. Enough of that tangent.

One other problem with the assertion that most of this list is from an EMR breach is that I was surprised how many insurance providers were on the list. In fact, it seems like a large portion of the breaches were insurance lists probably. Not sure that’s an EMR breach.

I think it’s also interesting to note that this list of breaches is probably far below the reality. This is just the list of reported cases. I can’t imagine how many breaches happen that go unreported.

Of course, this begs the question of whether we should be moving to electronic records at all if there’s more possibility for breaches. My answer is that of course we should. Although, it should give us real pause as we consider the security of those systems as well. Stuff happens, but we shouldn’t put the possibility of breaches make us set aside the benefits of technology.

One EMR Vendor’s Take on EHR Adoption and Government Intervention

Posted on March 23, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In response to my post on CCHIT’s comments on the EHR Certification criteria, I got an email from Ryan Ricks. Ryan works for XLEMR and shared the following perspective on EHR adoption (or lack thereof) and the effects of the EHR stimulus money on it.

I do not want to delve into politics, but I think this is a classic example of what happens when government intrudes upon the private sector. Rather than speeding up EHR adoption, this whole process has caused the market to grind to a standstill because physicians are waiting for all of the details to become final. I’m sure other small companies have been negatively affected by this, not just us.

It has been very difficult to convince physicians to buy. I think physicians as a group are more concerned with avoiding the risk of purchasing a non-compliant system – rather than motivated by the reward of the stimulus money. Furthermore, we have noticed a significant lack of trust in the government. Many physicians don’t believe the money will be available, or they are worried about the “strings” that are attached. In addition, several physicians expressed a great deal of concern over the interoperability requirement – they want to protect their patient’s privacy.

Sadly, what Ryan describes is basically what I’ve seen happening with EHR adoption as well.

Focusing on the Right EMR Goals

Posted on March 22, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve preached this point many times since we heard about the EMR stimulus money, but I can’t help but repeat it over and over so that as many doctors as possible will get the right message. Bill Karmis from Media Spider left the following comment which aligns pretty well with my thoughts on EMR selection:

As you have seen in many of my posts, I believe the real reasoning behind choosing a method and using it should not be based on recovering money for doing so. It should be done for the core reasons that EMR EHR systems were invented.

1 To be more efficient in the workplace.
2 To more effectively collaborate with your peers.
3 To be responsible for the information you are to maintain and a physician.
4 Reclaim valuable office space.

In either case, the stimulus money is a carrot being dangled my our government. The same government that is probably 10 years behind the average technological curve.

The same government that we know puts more spin on everything they get involved with than any individual would be allowed to do.

EMR Selection e-Book

Posted on March 21, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you don’t read my other blog, EMR and HIPAA, I released my first e-Book. This book focuses on EMR selection. So far I’m quite happy to report that a bunch of people have bought the book.

Shahid, the healthcare IT guy, wrote up a full review of my EMR selection e-book. Here’s just a few of his comments [emphasis mine]:

“I now recommend it as a must-read for anyone that’s looking to purchase an EMR and wants to know how to make sure they don’t get sold a lemon by a vendor.”

“The final selection guidelines and the contract negotiation section itself is worth the price of the book alone.”

“If you’re looking to select an EMR, this is a great book to start with. No fluff, just sound advice and a “how to” guide that you can trust to get you to a good selection and purchase decision.”

I look forward to hearing more feedback on the book.

Guest Post: EHR Certification Does Not Equal Meaningful Use

Posted on March 19, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

EMR Stimulus Myth #2: “I have a CCHIT certified EHR so I am good to go for meaningful use”

It is likely that CCHIT will be one of the accredited certification body under the EHR incentive program. HOWEVER, given that there is no formal EHR certification program available from ONC yet, no existing certification, including from CCHIT, means much towards meaningful use.

As I covered in EMR Stimulus Myth #1, even if you implement an ONC certified EHR (when the certification program is finalized), it does not get you to meaningful use. Providers have to meaningfully use the certified EHR and report on defined clinical qualify measures over a set reporting period to meet meaningful use. Given that no EHR today is certified, how should you proceed with EHR purchase decision?

If you are making the decision to buy an EHR now, YOU MUST VETT THE EHR VENDOR prior to purchase so that you minimize the risk of buying the wrong EHR. Vetting should include the assessment of EHR against the current definition of certified EHR from ONC plus the match of EHR to the makeup of your organization. Of course, any promises of future from the vendor should be baked into the contract you are executing with them. EHR needs of a solo or a small practice group is much different than a larger group/clinic/hospital.

People often find real value in getting the assistance of a meaningful use expert for this assessment. The pitfalls avoided make it worth the investment. You don’t want to purchase and implement an EHR and then find out your EHR won’t meet the meaningful use requirements. That would be a depressing realization.

About David:
David Lee is the Principal at eRECORDS, Inc.  David has provided successful healthcare technology, CRM and financial product consultancy for the past two decades and most recently, guiding healthcare organizations to “meaningful use”.   You can reach David at david.lee@eRecords.com or visit www.eRecords.com.

Quest Launches Care360 EHR

Posted on March 18, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I meant to post this a long time ago and never got around to it. Although, I think it was one of the really interesting announcements at HIMSS. Here’s a portion of the press release from Quest about their EHR offering:

“Quest Diagnostics is making broadly available a Web-based EHR that helps physicians embrace digital healthcare one step at a time, connect easily with their peers on patient care, and achieve meaningful use that allows them to qualify for government incentives,” said Richard A. Mahoney, Quest Diagnostics’ vice president of Healthcare Information Solutions and president of its MedPlus healthcare information technology subsidiary. “We value the longstanding trust physicians have in our company, and we are proud to answer physicians’ needs with a modular technology that will truly help drive meaningful improvements in quality of care.” MedPlus develops the technologies that power the Care360 suite of physician offerings.

Each week I’m introduced to another interesting type of organization that’s trying to use their connections and relationships with doctors to sale an EHR. Who’s connections are going to win?

Of course, one question that will be interesting for Quest is how they’ll handle interfaces between their Care360 EHR and other vendors. I assume you’ll have to have a Quest lab interface as part of the deal. Does that mean all other labs are shut out? I can imagine that many doctors will be reticent to go with a Quest EHR if it basically locks them into a relationship with only Quest. It’s going to be interesting to see how this plays out.

Interview with Glen Tullman, CEO of Allscripts

Posted on March 17, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Matthew Holt of the healthcare blog always does a nice job with his interviews. This is a pretty interesting one with Glen Tullman, CEO of Allscripts. Like it or not, Allscripts is going to play a big part in the EMR/EHR space. So, it’s worth listening to Glen to hear what he has to say about the industry.

One part that I found especially interesting was when he calls out Epic for not working on EMR interoperability. What’s interesting is that Glen really did look sincere in his desire for Allscripts to be inter operable. The problem is that I haven’t seen enough action in implementing those solutions.

Lots of other goodies in the video as well. Nice work Matthew.