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EHR Comparison Chart

Posted on March 31, 2011 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.

A little while back I came across this EHR comparison chart on the Amazing Charts website. I was really intrigued. The first thing to note about the chart is that this is a page that’s designed to “sell” the Amazing Charts product. It’s actually a really smart move by Amazing Charts to use these comparisons as a way to increase their profile and compare them against many of the large EHR companies out there.

My biggest problem with an EHR comparison chart like this is that Amazing Charts conveniently decided to list themselves against a whole list of the HUGE and generally legacy EHR software companies. I don’t see the comparison chart including any of the Free EHR vendors. There are no EHR software companies that have come out in the past couple years on that list. There aren’t any of the more nimble EHR software companies that have done similar to Amazing Charts and focused on building an EHR company using revenue instead of outside funding.

Point being that an EHR comparison chart should include more of the 300+ EHR vendors that are out in the market today. If you only compare yourself to the largest and most expensive EHR software, then of course you look a lot cheaper. Plus, it seems they also focused on the most expensive EHR software from the companies that offer multiple EHR software as well.

The other challenge that they note in a footnote is that getting good pricing and EHR market share data is really hard. Most providers don’t publish it and as Dr. K mentions in this well written Future of Meaningful Use piece, “The sum of the number of installed users claimed by each of the top EMR vendors exceeds the number of practicing physicians in the U.S.”

Then, that EHR comparison chart also focuses a bit too much on the various EHR ratings services. I won’t dive into my feelings about the EHR ratings services that exist out there. Let’s just say that I wouldn’t base my EMR selection on any of those ratings services.

If Doctors Bought EMRs Like They Buy Cars…

Posted on March 30, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

You know, when you think about an EMR purchase, it’s obvious that there’s plenty of technical considerations involved.  But the truth is, when it comes down to it, most doctors will never need to know anything about APIs or coding or middleware before they pick out a system. They just want the EMR to work.

The thing is, they’ve already made a big investment in technology before — maybe lots of times — even though they probably know little or nothing about how the gears really mesh. I’m talking about automobile buying, of course.  I sort of doubt a single doctor has ever sat through a Webinar on the difference between anti-lock and regular brakes, the advantages of added cargo room or the physics of improved gas mileage. But they still buy cars, don’t they?

No, like everyone else, I’m sure your average doctor takes in commercials, makes a few mental notes as to how the promised benefits fit into their world, digests the information a bit and then goes shopping. At that point, they’re briefed on what features the car has, and tell the salesperson whether that works for them.  Ultimately, they buy something that fits their budget, their needs and probably, their self-image too.

Now, an EMR isn’t a fashion statement — while cars most decidedly are — but in other ways, the purchasing process should be similar.

After all, the software they’re choosing should be as utilitarian as an SUV. They should come to the buying process knowing what needs they’re trying to address (in a car, say, the ability to haul big objects, or in an EMR, being able to enter patient notes quickly and clearly). Hopefully, they have a sense of how they’re going to use their EMR on a day-to-day- basis, as they obviously do when they’re car shopping.

And with any luck, they’ll also know what ongoing problems they’re trying to solve, be they managing the flow of laboratory results, making sure they’re reminded to follow up on preventive care, looking at the health of their patient population and so on.

If a practice knows these things, they won’t be blinded by a blizzard of technical terms or worry about whether they’re on version 2.15 of the latest build. They won’t have to spend much time debating over whether a SaaS or client-server solution makes more sense. They’ll just want to get the job done.

Unfortunately, it’s hard to get to that point when a technology comes in looking all scary, complicated and expensive.  But as any one who’s ever bought a new car knows, you can always take the damned thing back.

5 Ways Meaningful Use Will Change Your Practice

Posted on March 29, 2011 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 love the title of this post since it uses the word change. People when they see change start to get really concerned. For some reason we don’t generally like change. We often like it after the fact, but rarely want to engage in change. I’ll be the first to tell you that implementing an EMR requires change. Anyone who tells you otherwise probably has something to sell you. Certainly some EMR require more change than others, but they all require a change.

The American Medical News put out an interesting article discussing what they said would be 5 ways meaningful use will change your practice. Here’s their 5 ways and my commentary on each of the items:

Patients will be more involved in their care – Certainly meaningful use has some requirements that encourage the sharing of clinical information with the patient. I expect in future meaningful use stages we’ll see even more sharing of the clinical information with the patient. However, I don’t really see this sharing as translating to a more involved patient. Tons of people miss incorrect charges on their bank account and credit card statements and they have all that information. I’m sure the same will happen as patients get access to this information. Many won’t care to look and many of those that do look won’t have much of an idea what they’re looking at.

With this said, there is a general movement to the active and involved patient. Combine the easy access to health information (good and bad information I might add), the easy social interactions amongst patients (ie. asking your friends on Facebook), and other changes we see in society and the patients will be more involved going forward. I just don’t see meaningful use being a huge driver for this.

Doctors will find it easier to see how they’re doing – Ummm…this seems way off base to me. First, because it’s pretty hard to define “how they’re doing.” So, it makes it hard to talk about. Let’s just focus on the meaningful use measures. Does anyone really think that tracking the meaningful use measures is going to make a doctor better at what they’re doing? Can they really be used to measure how well a doctor is doing? I guess I just don’t think meaningful use is the right “report card” for doctors.

Physicians will collaborate more with other doctors – Stage 1 definitely does little to help this happen more efficiently. We’ll see if stage 2 or 3 takes it much farther. Although, if stage 3 takes it too far, I imagine many will opt out of showing meaningful use for stage 3 since the payouts are so small at the end of the EHR incentive money.

Long term, having an EMR will facilitate collaboration and information sharing amongst doctors. However, we don’t have the highways for that information built yet.

Physicians will pinpoint practice inefficiencies – This feels a little like the second one to me. However, it’s worth also pointing out that I think it would be a very difficult argument to make that meaningful use somehow makes a practice more efficient. I could certainly make an argument (which I’m sure many would love to argue against) that an EMR can make a clinic more efficient, but not meaningful use.

Physicians will need a firmer grip on data security – MU stage 1 has little HIPAA requirements and I don’t expect MU stage 2 and 3 to change that. There are some privacy and security requirements in the EHR certification that try and take data security and privacy in an EMR to the next level. Also, the HITECH act has provided some “teeth” to the enforcement of HIPAA which it never had before. I still think we need a few more clinics to get “bitten” by it to really understand what the requirements are going to be and how they’re going to enforce it.

12 Reasons Why EMRs Improve Patient Care

Posted on March 28, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

While HIT insiders and pundits take it as a given that installing an EMR benefits everyone, it’s not so obvious to some gun-shy practices.   Even researchers like myself switch gears every time I try to explain what EMR technology can do.

That’s why I was pleased to come across the following blog item. This piece offers a very solid list of twelve reasons why EMRs can improve patient care, including the following (in no particular order of importance):

*  EMRs are less subject to physical damage and data loss than paper records, as the data can be backed up and stored elsewhere.

* EMRs reduce wait times for patients, as there’s no need to wait for a receptionist to pull a chart and get it to the treating clinician.

* Data stored in an EMR can be sent more easily to other clinicians than when using a paper record. (This may not be true if the EMR is balky — in reality, only an HIE can really fulfill this promise — but it should be true.)

* EMRs that integrate e-prescribing reduce the risk that a  patient will get the wrong drug/dose, as poorly-written prescriptions stop being an issue.

The piece also notes that with an EMR in place, practices should have neater workspaces to use (no paper accumulation) and have better access to care documentation during emergencies.

Now, to inject a note of skepticism here, it’s unlikely that most practices will realize all of these benefits quickly.

In particular, I highly doubt that practices will be able to cut back on paper quickly, since if nothing else, they’ll have to do something with the reams of letters and faxes that other providers send to them, and possibly images as well. (It’s no coincidence that the author works for an HIT consulting firm.)

Still, it’s good to see a well-rounded wrap-up of how EMRs might support day-to-day patient care.  It’s easy to assume that everyone understands EMRs’ potential — but I’d argue that many clinicians are just beginning to draw these conclusions.

That being said, would you add any clinical care benefits to our blogger’s list? Would you disagree with any of his conclusions?

iPads Could Boost The Value of EMR Installations

Posted on March 27, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I was hanging around the #hcsm (healthcare social media) chat tonight on Twitter, and caught some interesting comments from physicians on how they use tablets.  While it’s hard to tell how unusual this approach is — the #hcsm chat attracts cutting edge types — one physician noted that he shows the patients what he’s doing on his iPad.

Now, in this case the physician said he does so simply to demonstrate that he’s not texting on their time. But that could be just the beginning. As doctors increasingly adopt iPad, Android and other tablets, they’re in a much better position to turn encounters into information sharing moments.

As a patient, I’ve already hit a few practices that have implemented EMRs. While big changes may be happening in the back offices of these practices, things haven’t been much different during my time with the physicians.  Arguably, they’ve seemed a bit better prepared, and in at least one case, they seemed more efficient at note-taking, but it wasn’t some kind of breakthrough moment.

On the other hand, if they used iPhone or Android apps to share key EMR data with me, in real time, it could be a real game-changer.

For example, imagine that you’re a diabetic, and you’ve come in for a regular screening.  Usually, you’ll get some feedback on your overall health status, commentary on test results and suggestions on how to move ahead, but it’s a bit superficial and rushed unless there’s an emergency afoot.

What if the same diabetic got to see a graph, drawing on data in the EMR, which offered a personalized analysis of how their A1c, glucose levels and other key metrics were trending. The same iPad display could offer a printable list of suggestions, and if you really got tricky, brief educational videos providing more background on each step as needed.

In short, a tablet is more than just a portable physician convenience; it’s a powerful display device which could greatly improve patient/doctor communication.  And if it leverages the well-indexed EMR, that data will be offer more than a recap of the conversation.

Given tablets’ potential for improving clinical encounters, I think practices should plan their EMR and iPad investments in tandem. Tablets can be a doorway to better counseling, education and collaboration with patients.  I hope to see more physicians move in this direction.

PHR Model At Turning Point

Posted on March 26, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

So,  Google is going through some internal upheaval as co-founder Larry Page prepares to take over the reigns as CEO.  According to an piece appearing in today’s Wall Street Journal, Page is aggressively reviewing existing projects and is likely to take an axe to those that don’t seem to be working. Does it surprise any of you that one of the programs facing cutbacks may be Google Health and its faltering PHR?

As HIT expert Shahid Shah notes, Google has created some decent PHR technology — but despite having a vast reach and rich resources, hasn’t figured out how to grow its user community.  Even with its massive bank account, I’m not surprised to see that it hasn’t turned healthcare into a major income source. Google just isn’t that great at going outside of its box.

Then, consider that Microsoft doesn’t seem to be pushing Health Vault very hard these days, and you’ve got to wonder whether the whole “massive tech company builds PHR” thing can possibly work.   Yes, I realize I might get flamed by Microsoft execs saying this, but let’s get real here.  Microsoft isn’t great at connecting to markets it doesn’t monopolize either.

Oh the other hand, evidence is mounting that PHRs may be popular when driven by a provider and its own EMR.  Perhaps the highest-profile example of this may be Kaiser Permanente’s EMR/PHR ecosystem.  Its “My Health Manager” PHR system is closely integrated with its Epic EMR installation and now has millions of users.

Why is Kaiser succeeding at generating PHR interest where Google has failed? It’s largely because rather than offering a mixed bag of apps and options, as tech vendors have been doing, My Health Manager allows patients to securely exchange messages with physicians, refill prescriptions, review test results and schedule medical appointments.  Patients aren’t being asked to become updater and curator of their medical information, but rather, to use it. This just makes sense.

As I see it, the whole notion of a PHR as a freestanding app is basically circling the drain.  Realistically, patients have little incentive to interact with their health data unless it has some immediate impact on their lives.  An EMR/PHR combination, on the other hand, has tremendous potential, as it connects patients to both their providers and their health data effectively.  If I were Microsoft or Google, I’d just throw in the towel at this point.

 

iPad Adoption Slow in Healthcare

Posted on March 24, 2011 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.

At least that’s the case that was made in this blog post on the Software Advice website. The post is a few months old which is centuries in the tech world, but I have to disagree with them on their take that EMR vendors are slow to move their products to the iPad platform. In fact, I mentioned in their comments that I think every single EMR vendor has an iPad strategy.

They do get it right that doctors are adopting the iPad at a really dramatic pace. Here’s my reasons why it’s been so popular:
1. Battery life that lasts a full shift
2. 3G and Wireless Connectivity
3. Intuitive interface
4. $500 price point

We’re still waiting on some enterprise features that it seems like the Blackberry Playbook is trying to implement for healthcare. However, I’m pretty sure they’ll get there in time or someone will create an app that will create those features anyway.

Back to the iPad, the article only states 2 companies that have an iPad EMR offering. There are many more than that. I’ve seen some from Practice Fusion, GE, and VitalHealth to just name a few.

What I haven’t yet seen is how well doctors like the use of their EMR iPad interface. Is it really that usable for a doctor doing his rounds? Does it work well for clinical documentation? Is it a nice compliment to a desktop environment?

Sadly, I still can’t give my first hand account of using an EMR on an iPad. I got my refund from HIMSS since despite all the free iPad giveaways I came home without one. Oh well, the iPad 2 is out now and it would have been a shame to only won a first generation iPad. I’m told by Christmas there may even be an iPad 3, but I digress.

What might even be more interesting than EMR use on an iPad is the other creative ways that people are using iPads in healthcare. For example, I’ve heard of people using an iPad as a check in device for their clinics. There’s something cool about handing over an iPad instead of a clipboard for your patients to fill out their paperwork. I’m sure some patients would hate it, but I for one would be much happier feeling out the stack of paperwork electronically.

Physician Social Media Use And EMR Adoption: Held Back By Similar Forces

Posted on March 23, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In a recent blog post, Dr. Jeffrey Benabio argues that generally speaking, there are two simple reasons why many physicians haven’t spent more time digging into social networking:

*  Fear of liability

*  Lack of compensation for time invested

I’d argue that these two forces are holding back much of physician EMR adoption as well.  Sure, many practices dislike having to spend on an EMR solution, and may find technology overwhelming, but I’d argue that the two concerns  above are far more powerful.

Honestly, I think complaints about EMR costs have been exaggerated.  EMRs aren’t necessarily a big expense for a healthy practice, especially given that hosted solutions are getting more affordable by the day.  I’m not saying the cost is trivial, but it can be managed.

And I don’t think physicians, especially young ones, are stone-cold terrified by the idea of bringing more technology into the practice. They may not be thrilled by changing their workflow, but they’re intelligent adults who have doubtless used computers to perform many other types of work in their time.  Buying an EMR is a stretch, but not the biggest hurdle they face.

No, I think that fear of liability — in this case, mistakes made due to EMR misuse — and of sinking countless hours into learning the new platform are the biggest inhibitors to physician EMR implementation.  Both of these fall into the “fear of the unknown” category which derails so many new technologies.

If I’m right about this, the best way to boost medical practices’ EMR adoption rates may be to help address these fears. CMS, the courts and leading attorneys need to nail down what liability doctors face when working in this new environment, and vendors need to find better ways to assure doctors they’ll be productive quickly.

Let’s get right down to it and help doctors cope with their real concerns. Otherwise, we’ll wait in frustration as consultants and policymakers swing and miss.

Fair Healthcare Prices

Posted on March 22, 2011 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.

As most of you know, I’m a tech person by background. So, most of my focus on my blogs is about EMR and other healthcare IT related technology. However, every once in a while I like to point out interesting uses of technology in healthcare.

One example of this was this interesting website called FairCare MD. They call themselves The New Healthcare Marketplace. Essentially if you’re a patient looking for a certain treatment or other healthcare need, you can search for a qualified doctor in your area using their system. As a doctor you can list your services and the prices for your services.

One of the challenges of a service like this is the chicken and the egg problem. You need enough doctors to make the service useful for patients, but doctors don’t want to use the system until there are patients searching the website as well. I’m not exactly sure how they plan to solve it.

Plus, it seems like they need to work on their search algorithm some more too. I searched for Acne Treatment and it returned a bunch of results for Orthodonic Treatment. Not a very good match.

While there technology and database is still in need of work, I find the concept of a healthcare marketplace really intriguing. The idea that I could go online and search for similar healthcare services like I might compare prices for a computer online is interesting. There are definitely differences in how you should search. FairCare MD will also need to really invest in a way to differentiate the good doctors from the bad ones. That’s just much easier said than done.

I also found this blog post they did which addresses what they call a Win-Win-Win-Win Situation for Healthcare. They were appropriately concerned with how their service would be seen by insurance companies since it kind of cuts insurance companies out of the loop. However, he describes some possible benefits to the insurance companies of this approach. I’m not as rosy on a service like this being a nice win for insurance companies, but if this type of service takes off, there’s no doubt that it could have an impact on healthcare and healthcare prices. Isn’t it beautiful what the power of the internet can make possible?

Either way, I love their mission of Fair Healthcare Prices.

Establishing A National HIE On One Platform May Be A Good Idea

Posted on March 21, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

When you read this statement from HIT vendor Orion Health, it sounds oh-so-simple: why not establish an entire county’s HIE network on a single connecting platform?  Given the country’s already high EMR adoption rate — about 80 percent of GPs had one, as of March 2010 — New Zealand’s already part-way there.  Just knit offices up together and you’re ready to go.

Orion, of course has its own technology in mind, naturally. But whatever vendor you use, they may be onto something. I’ll pause here to say that the following proposal could incite a riot at a HIMSS floor full of competing vendors, but hey, ideas are harmless, aren’t they?

What if CMS decided that it would pay incentives not just to meaningfully, sensitively, insightfully install EMRs, but to connect them to an overall HIE?  And to take the thought into more controversial territory, what if it had a vendor or two of choice which doctors and hospitals had to use if they wanted the dough?

As we all know, the value of EMR installations isn’t just in automating, error checking and (hopefully) streamlining workflow in practices. The data is infinitely more valuable when it can be aggregated, shared, cross-checked and mined for best practices.

What are the odds of that, however, if you have an outbreak of regional and state projects using technology from a multitude of vendors?  You can talk standards all you want, but true interoperability isn’t going to happen anytime soon this way.  National connectivity?  Well, give me a couple of decades and let’s see how far that’s gotten.

On the other hand,  if CMS signed contracts with HIE technology vendors, and demanded that they give preferred pricing to those work with them, you’d see a rash of connectivity unrivaled since the invention of the telephone.  Before you scream that this just isn’t fair, doesn’t this kind of thing happen every day in, say, military contracting?

I know, I know, this may not be practical. But you can’t argue that It’d be interesting to see how the HIE and EMR market gelled if CMS took a strong lead.