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The Effect of Dropping an iPad

Posted on May 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.

This is a little off topic, but not really since the iPad craze in healthcare is so big. Because of this fact, I was quite interested in this video I found which tests out what would happen if an iPad was dropped. They actually drop 2 iPads. One with a smart case and one without a case. They start off first dropping it from waist level and then shoulder level.

Yes, this is a little hard to watch a2 perfectly good iPads get destroyed, but it is interesting to see what might happen if a doctor were to drop their iPad on their rounds.

Yes, it is worth noting that it’s unlikely that the iPad would drop straight on its face like in this video. It’s also worth saying that there are even more durable cases available for those that are concerned about iPad’s being dropped. Although, I have to admit that I’m amazed that the Smart Case did as well as it did after being dropped.

Using PIMSY EMR on an iPad and Android Device

Posted on May 30, 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.

One of the regular EMR and EHR readers, Judy, recently took up the challenge I posed in my previous post about Every EMR Vendor available on the iPad. She downloaded the LogMeIn Ignition app that I mentioned in that post and tried out her PIMSY EMR software on it. Thanks to Judy for sharing her experience.

The following is her experience and review.

I tested the new LogMeIn app to see if I could access PIMSY EMR from my older Droid and from an iPad. It takes a little getting used to: you have to familiarize yourself with how to navigate on the screen and how to change the size to get the screen view that works for you. Once you get that done you are good to go. That said, there are 2 ways to change the size: a magnifying option at the bottom of the screen or a zoom in bar on the right hand side; you can enlarge as much as needed. There are also 2 options for moving around: you can move the screen with your finger (the cursor stays put) or you can move the cursor like a regular mouse; I prefer navigating around the cursor. Both options make it simple to maneuver.

If you’re used to texting and typing on a smaller keyboard, it will be easier to adjust. The app itself gives you a keyboard that takes up approximately half the size of the screen, so larger phone screens like Droid 2 or iPhone would have a bigger keyboard than a regular Droid, and the iPhone keyboard was comparable to a regular size. For those who aren’t used to navigating and typing on a phone screen, there will be an adjustment period. If you’re connected to dual monitors, you can easily switch to either one, and I was able to watch a video.

The speed is slightly slower from phone or iPad to computer but very good from computer to computer. The app is not offered on a Blackberry. I would highly recommend this app to anyone who wants to connect to their desktop remotely; it worked great to get into PIMSY. Well worth $29.99.

Proving EMR ROI IS Still Tough, So Buying Takes A Leap Of Faith

Posted on May 29, 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.

Folks, if you’ve worked or presently live in the enterprise software world, you know that proving that you system generates a worthwhile return on investment is tricky.  Sure, vendors sales staffs usually offer some neat calculators that prove you’ll see 1000% return by next Tuesday, but internally, even they admit that making such estimates is more black magic than science.

While some of you may have different experiences, it seems to me that proving that an EMR can generate a return on investment reasonably soon is particularly difficult. Sure, most hospitals and medical practices know their annual revenue run rate, and have a good breakdown of their expenses in hand, but are they set up to detect the effects going electronic can have?

After all, while some enterprise software directly helps companies generate revenue — most obviously, lead-generation monsters like Salesforce.com — others earn their keep but preventing problems from happening or improving quality. And if a provider organization doesn’t know what their mistakes are costing them, and doesn’t pay a direct price when patients fare poorly, how can they pin down how much financial benefit their EMR produces?

 

Admittedly, as the quality data reporting bandwagon continues to roll faster, everyone from small practices to giant hospital systems are likely to have a better idea of where they’re slipping — they can’t afford not to, as they’re likely to forfeit incentives paid by Medicare or private insurers.  And most cases, it will take an EMR to organize, analyze and report out that data effectively.

Unfortunately, providers can’t expect huge bonuses just for buying an EMR. (OK, let’s be honest and admit that HITECH dollars are nice to have but not enough to make  or break a viable business.) So they’re having to make a leap of faith and invest in a system, sometimes a very expensive one, on the still-unproven assumption that it will offer tangible financial and organizational benefits in the near future. That’s gotta hurt.

Aggressive providers have been taking this risk for years now, and many have been very glad they did.  Not only have there been some nice examples of how hospitals and health systems have benefitted by their EMR investment, I’ve met doctors in small practices who absolutely rave about how productive their shift to EMRs has been. So there’s at least anecdotal evidence to support EMR buy-in.

Still, it sure would be nice if there was a one-size-fits-all ROI we could offer providers, or even a decent series of estimates. Right now, many are just going to have to fly blind.

How will Healthcare IT and EMR save on Medicare costs? – EMR Video Series

Posted on May 28, 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.

Ok, so this was the first video that I made in the EMR video series (see the other video I posted on EMR data sharing). So, I stumble around a little bit on the video, but I think I provide some interesting answers to the question. Although, I’ll admit that it’s a really hard question to answer.

Here’s the question I try to answer in this video:
How will Healthcare IT and EMR save on Medicare costs?

Let me know if you like these videos. Also, let me know what I might have missed in this video.

AMA’s Health IT Portal: Will Doctors Bite?

Posted on May 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.

Last month, the AMA announced that it was launching a health IT portal for doctors.  The AMAGINE platform includes a fairly robust range of products, including three EMRs, and its price range seems pretty reasonable. Still, I’m somewhat skeptical it will be popular. Lest I be accused of being arbitrary, let me explain.

On the surface, the idea or and product line sound great. In addition to the EMRs, the lineup includes e-prescribing, claims management and clinical support systems as well as reference tools. Vendors involved include Allscripts, CareTracker, Quest Care360, NextGen and DocSite.

Subscriptions to the surface range from $20 per month for e-prescribing to $300 per month for the EMR options, numbers that aren’t likely to send most practices into shock.

Not only that, the AMA seems to have preliminary evidence that this approach works. The trade group pilot-tested the AMAGINE on Michigan doctors for about two years prior to going national, and has to assume that the physician association would have pulled the plug if the pilot went badly.

All that being said, I’m still pretty skeptical that the approach will work, for reasons including the following:

* Despite its being the best-known and largest physician group in the U.S., the AMA doesn’t have a great reputation with up-and-coming young physicians who are first to adopt health IT

* It may sound counterintuitive, but I don’t think doctors want the AMA or anyone else to narrow down their EMR choices. Given the stakes involved, my sense is that physicians want to do a lot of exploring before they commit their lives and workflow to a new system.

* While a best-of-breed portal approach may actually be a good idea, I have a gut feeling that it might actually overwhelm or confuse some physicians. (If it were me, I’d be thinking “One decision at a time please!”)

* Say what you like about vendor technical support, but I bet any decent player would offer better technical support, education and training than an AMA venture.

So, what do you think? Am I off base here, or is AMAGINE going to face an uphill battle?

 

 

EHR Question and Answer Video: EMR Data Sharing

Posted on May 26, 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.

Yesterday I started testing out a new idea where I’d film some original EMR and EHR videos where I answer questions about healthcare IT and EMR that people have sent to me. I’ll post the first video here and possibly another one this weekend. Then, I’ll probably start posting the videos on my new EMR and EHR video website. Although, I may do some updates with links to the latest videos that are posted.

It’s a low budget production as you can imagine. I also was streaming it live on the internet, so you’ll see me look down a number of times to check how many were viewing it live. Those things aside, hopefully you’ll find the content of the video interesting and useful.

This first video tries to answer the question:
Does the EMR allow data sharing with the patient’s PHR and/or Social Net account(s)?

As always, I’m interested to hear your thoughts on the subject as well. Was there anything I missed? Was I wrong about anything? What else is important about EMR data sharing? Should we be able to share our EMR data with social networks like Facebook, Twitter, etc?

Also, if you have other questions you’d like me to answer in a future video, be sure to leave a comment or let me know on the contact us page.

It’s About Time: Government Workshop Will Address EMR Usability

Posted on May 25, 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.

As you may know, not long ago I wrote up a rant slamming awkward-to-use EHR interfaces, an article which has drawn plenty of reader debate and discussion.

Today, I learned that the government is paying attention to this issue as well (and not a moment too soon).

The National Institute of Standards and Technology (NIST, to its friends and relations) announced that it would be holding a free workshop on EHR usability intended help all sectors of the industry collaborate on the problem. NIST hopes to attract industry players, academics, government officials and healthcare providers to the same table.

The workshop, which will take place on Tuesday, June 7 on NIST’s Gaithersburg, MD headquarters, will focus on four key questions:

  • What facets of usability should be measured?
  • What measurement methods and protocols should be used to do this?
  • What are some of the challenges to rigorous measurement and how can they be addressed?
  • How can measurement results stimulate a market and support improved usability?

Call me a cynic, but I don’t see participants making a lot of progress on these questions in a single day. Heck, you could spend weeks or months on any of these issues and still end up spinning your wheels.

That being said, it’s always good to see the bureaucrats pay attention to an issue like this. Why? Because if bureaucrats have any virtues, one is that when they grab an issue, they tend to stick to it. (I’d rather see CMS dig into this topic, but hey, NIST’s a start.)

With hundreds of EHR vendors competing for mindshare out there, it’s not likely they’ll come together to set usability standards on their own. But if pesky government types — from both the policy and tech sides — decide to dig their teeth into the usability problem, it’s probably a good thing.

I don’t know about you, but I think attending is a great idea. If any of you make it, please feel free to let us know what you learned. It should be an interesting session.

EVERY EMR Software Available on the iPad

Posted on May 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.

I’m about to make a big announcement about the iPad. Something that every iPad loving doctor will be happy to know about. It’s a simple announcement, and something many of you probably already know: Every EMR software vendor out there is now available on the iPad.

That’s right, you can pretty much run any and every of the 300+ EMR companies software on an iPad. All it takes is an iPad, a cell or WiFi internet connection and some form of remote desktop application. There you go, I solved all the EMR companies iPad strategy problems.

Practice Fusion sent out a press release recently about support of the iPad for their Free EHR. In the press release they highlight a number of the benefits of access to an EMR on the iPad and they describe the use of the EMR iPad model that I talk about above. They use the remote desktop app for mobile devices called LogMeIn Ignition. $29.95 and you can connect to your computer from your iPad. Not to mention that it also support Android and Windows. Yes, that’s right, I guess we could also say that every EMR software is available on Android and Windows phones and tablets as well. Of course, there are also some free RDP options as well, but probably aren’t quite as easy to configure.

Now, I’m sure the purest out there are going to come and say that there’s a lot of difference between a remote session to your computer than a native iPad EMR application. They’re right. In some ways, the remote connection to your computer is better. There’s no new EMR interface you have to learn. You have remote access to all the files and programs on your main computer. You have all the preferences you’re use to having at your desk. I could go on, but there’s certainly some benefits to remotely accessing your computer on an iPad.

Some might argue that the latency (Translated: slowness) of a remote session could be a major issue. I think these comments are from people on super slow connections and/or people who haven’t used the latest remote desktop sessions. Remote access has come a long way and the experience of using a computer remotely is almost as good as being at the computer itself.

The more important argument that I’ve left out is actually the EMR user interface. The problem with most EMR user interfaces is that they were designed with a mouse and keyboard as the input devices. The keyboard can generally be overcome with good templates, voice recognition, the iPad keyboard, etc. However, the mouse is a more difficult challenge since the precision of the mouse is so much better than your finger (This is the true fat finger issue).

Point being that while you can certainly access your EMR remotely on the iPad, it’s going to be important to know how well your EMR software is designed for a touch screen interface. Spacing of elements in your EMR, size of buttons and a number of other design elements can drastically change your experience using a touch screen interface. Plus, that doesn’t even cover the unique touch screen gestures that are available like swiping, 2 finger taps, etc.

Yes, it is fair to say that EVERY EMR software out there can be run on an iPad. However, that definitely doesn’t mean that you will want to run that EMR software on the iPad. The good thing is the cost to try your EMR software on the iPad is really low. Once you’ve tried it out, let me know your experience so that others can learn as well.

Reader Says EMRs Too Rigid For Most Doctors

Posted on May 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.

My post on lousy EMR interfaces continues to stir reactions among EMRandEHR readers.  Those responses include the following, from reader Bret Shull:

Thank you for bringing up yet another important matter in the never-ending drama that is EMR.  Until a merger in Dec. 2009, I owned and served as administrator for a  4 physician diagnostic clinic in southern California.  While marketing our professional and clinical services over the years, I consulted with hundreds of practices and physicians regarding various practice management issues.  Based upon my inquiries, the vast majority of the providers who have deployed  EMR revert back to paper SOAP notes within a few months.

When asked why they go back to paper, they confess that they find EMR’s very rigid; the logic forces them into a completely unfamiliar (and often inferior) approach to their patient encounter. Subsequently, the physicians either stay after hours to type and click their notes into the EMR or delegate the arduous task to a staff member.  The comments I’ve heard from my referring physicians follow along these lines:

  • “I’ve been practicing medicine for 20 years… What do the people who designed this software know about practicing medicine that I don’t?”
  • “Why can’t an EMR learn how I practice instead of forcing me to assess my patient its way?”
  • “It seems the more we customize the templates, the more pull-down screens we create, making the system even more cumbersome.”

Even with the HITECH incentives in place, many physicians are still hesitant to “take the plunge”.  At the risk of stating the obvious, I personally believe the cumulative effects of these negative experiences throughout the market have served to stifle EMR adoption.

As it turns out, Shull did find a platform he liked eventually. He’s a big fan of the Praxis EMR, which he says works far more intuitively than the other systems he tried.

I can’t vouch for Praxis — or any EMR for that matter — but it’s great to hear that Shull’s was happy with what he found.  Has anyone else found a system they believe doctors will actually  use?

HIEs Still In Shaky Condition

Posted on May 22, 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.

For several years, I’ve been citing dismal statistics on the growth of health information exchange networks. Perhaps, back then, I was too hard on them. After all, fledgling, starry-eyed HIE groups were facing tough odds, given how few physicians and hospitals were even wired enough to support their efforts.

Fast forward to today, and it seems little has changed. Though hospitals and medical practices are going online in large numbers, the HIE business model still seems to be shaky.  The latest evidence of this comes from a study from the Harvard Business School, which concluded that — surprise, surprise — that most HIEs still aren’t financially viable.

The study, which collected survey results from 165 HIE groups, concluded that just 75 of these organizations were actually up and running. Those 75 groups are probably working very hard, but still only reach 14 percent of U.S. hospitals and three percent of smaller medical practices. And get this: only three of the 75 groups offer a data exchange model which supports Meaningful Use standards. Wow.

Not only that, most of the HIEs studied don’t seem to have a sustainable business model. Two-thirds of the operating HIEs ended up in poor financial shape once they burned through initial hospital and physician funding, the study’s authors found.

Now, it’s worth noting that the study’s authors collected their data in late 2009 and early 2010, and heaven knows EMR penetration, interoperability and health data exchange are moving targets. If HIEs were just starting out now they might have had more momentum.

The unfortunate truth is, however, that HIEs have faced a nasty chicken-and-egg problem; if they wait for providers to get up to speed they’dllnever get rolling, but they’re having trouble making it without enough provider support.

At some point, the provider community’s going to have to decide how serious it is about data sharing, and whether leaders are willing to invest in this model over the long term.  Waffling, posturing and playing chicken (i.e. “let’s see if anyone else is willing to spend money on this”) obviously aren’t going to work.