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Will 2013 Be The Year Of EMR/Device Convergence? Nope.

Increasingly, healthcare organizations are introducing wireless medical devices which can hook up to EMRs.  And this makes a lot of sense, given that data from, say, infusion pumps offers a critical part of a patient’s overall picture and can boost safety as well.  On the other  hand, equipment and integration costs have held back hospitals from widespread convergence.

Given these opposing forces, it it looks like we’re poised at a point where adoption of wireless, EMR-connectible devices could gather momentum or stall out and drag into 2014 or beyond. But don’t get your hopes up for 2013. Here’s some trends that are likely to drag down the progress of medical device connectivity for the coming year:

* Device interoperability not required for Stage 2:  According to one blogger, William Hyman of Medical Connectivity, Stage 2 of Meaningful Use doesn’t directly doesn’t require providers to connect most traditional devices to the EMR. (Imaging and lab systems are exceptions, he notes.)  Well, if Stage 2 doesn’t require smart devices, must less connected ones, it’s hard to imgine CIOs making this a priority.

FCC initiatives to benefit wireless medical device use aren’t mature yet:  The FCC is taking several steps to encourage the use of connected medical devices. These include promoting the use of medical body area networks (MBANs), for which it has reserved spectrum, as well as making frequencies available for medical micropower networks. The agency is also working on making it easier to experimentally license spectrum for wireless health test beds for wireless medical devices.  These initiatives are just getting rolling, however.

Medical devicemakers face big EMR challenges:  As Medical Connectivity’s Tim Gee notes, creating device software that will smoothly pump data into an EMR is actually a pretty big challenge.  Devicemakers will need to export data in digital form, work with a central server aggregating data from your medical devices and translate you device data into HL7 for the EMR. Device vendors face big development expenses if they hope to get this right, he notes.

Will the wireless medical device become a standard part of hospital gear? I’d say it’s only a matter of time. But this year, progress is likely to be slow.

December 31, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

#eHealth100, Single EMR, EMR Adoption, and Wrong EMR Decision

You know what time it is if the post begins with a hashtag. That’s right. We’re taking a quick look at some of the interesting, insightful, fun, entertaining, beautiful or otherwise thought provoking tweets related to EMR and EHR.

We’ll lead off with a tweet nomination to the #eHealth100:


Yes, I was happy that Anneliz thought of me with this tweet nomination. Although, I must admit that I wasn’t sure what I was being nominated for, so I asked and got the following response about the goal of the #eHealth100


I appreciate being mentioned in this group. Considering the many people that make up the healthcare world, I just hope that each day I can make a small difference in people’s lives. It’s a beautiful thing when I can do that and provide for my family at the same time.


I love and hate the sarcasm in Dr. May’s tweet. I love the irony, but hate that it seems to be a major medical breakthrough.


I’m always looking for more numbers on EMR adoption. Although, then I realized that the article is from Venture Beat. Unfortunately, the people at Venture Beat don’t follow healthcare IT and especially EHR very well (they do follow other startups well). This can be seen in their reference to ZocDoc and Castlight as EHR companies likely to go public. They might go public, but they are definitely not EHR companies. I also love that they also have a quote saying that 90% of doctors don’t have an EMR which totally contradicts the CDC EMR adoption numbers they put at the beginning.

The long story short: 1. Don’t read Venture Beat for healthcare IT info. 2. We don’t really know how we’re doing with EHR adoption. We just know EHR adoption is on the rise.


I’ve sadly been predicting major EMR switching for a year or more. There are a number of reasons for this, but I’d say the biggest driver of EMR switching is thanks to the EHR incentive money and meaningful use.

December 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

11 Reasons Why Healthcare is So Screwed Up

If you don’t read the GetReferralMD blog, you should go and check it out now. It is always chock full of strong opinions and thoughts on healthcare that will make you take a step back and consider what’s really going on in healthcare. This post I found on the 11 Reasons Healthcare is Messed Up is a good example. Here is the list of 11 reasons for those that don’t want to go read the full post:

1. Insurance Companies
2. Excessive Regulation
3. Shortage of Doctors
4. Medical Advances
5. Paper
6. Ignorance
7. Choice to Die
8. McDonalds
9. Cluster $#@! Of EMR’s
10. Healthcare Vs. Military
11. Pharmaceutical Companies

Of course, you should click over and read the full post. It’s chock full of commentary and explanation for each post. He basically brings out the big guns and says what a lot of people don’t say about healthcare. I don’t necessarily agree with all of them, but he does provide something interesting to chew on. Although, I do particularly like his call out of paper and the fax machines that continue to print out that paper at an extraordinary rate in healthcare.

As an entrepreneur, I also look at this list and think that it’s the perfect time for some companies to come and disrupt the current model. Any time there is pain in a system, there is also opportunity to relieve that pain.

December 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Christmas Scavenger Hunt Inspires EMR Wish List

Happy holidays, dear readers! I hope my latest blog post finds you well, resting comfortably away from your usual place of employment, and not tied to a device despite being “on vacation” or attempting to take “time off.”

My family and I are a bit further South than usual, visiting family in Jacksonville and engaging in a time-honored tradition in nearby St. Augustine – the Holly Jolly Trolley. Never was there a better excuse to turn Christmas lights into a 3-D psychedelic experience.

We turned our annual light-seeing drive through the Blackhawk Bluff neighborhood into a Christmas lights scavenger hunt, checking off images from our list as we came across them during our drive. Suitable for the younger crowd, our checklist had images of traditional holiday décor – snowmen, stars, candy canes, candles, etc. The gingerbread man gave us the most trouble, and eventually we had to settle for seeing a gingerbread man windsock.

Driving home I got to thinking about what a similar hunt would look like, say, at HIMSS next year. Gather a group of providers, give them a list of EMR attributes and set them loose in the exhibit hall to find as many as possible within a certain amount of time. I wonder how many vendors/booths they’d have to stop at before they checked everything off the list.

For that matter, it would be interesting to turn the check list into a wish list – pinpoint a number of features providers most want in their EMR and see which vendor offers the most in one package. This would then of course lead to a comparison of price and customer reviews, but that’s another blog entirely.

What would such a check list / wish list look like? Based on the major healthcare trends that have come to light over the last year, I’m willing to bet these features (however pie-in-the-sky they might be) would be included:

  • Guaranteed security / protection, especially with regard to mobile EMR applications
  • Innate knowledge of ICD-9 to ICD-10 code translation
  • Ability to connect to any HIE at the click of a button
  • CPOE
  • Pop-up that suggests, on a patient-by-patient basis, how best to digitally engage with that particular person based on their preferred method of communication
  • Suggested protocols culled from evidence-based medicine analytics

What other features would likely be included? What vendors already offer a majority of these features? Do they exist, or will tomorrow’s start up be next year’s true game changer when it comes to success in the EMR marketplace? Please share your thoughts in the comments below.

December 27, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

HealthCare.gov

If you haven’t been to HealthCare.gov for a while, go and check it out. If you didn’t know better, you’d think that HealthCare.gov was built by a company and not the government. This is true all the way down to the HealthCare.gov Blog featured on the home page. I applaud Todd Park and the others at HHS who took a different approach to how a government website should look and feel. They even have a scrolling set of stories about patients and benefits. You’d think they have something to sell us.

Well, I guess they do have something to sell. They are definitely trying to sell us on ACA (aka Obamacare) and the benefits that come from Obamacare. Although, the tools that I found most interesting were the Insurance Options Wizard which walks you through all the options you have to getting insurance. Not to mention a whole set of tools to try and help people understand using insurance. Although, I’m pretty sure most of that’s not going to be read. So, hopefully it’s got a good dose of search engine optimization applied so that it will show up in search engines where it might get a chance at being read.

We’ve written about the “Comparing Care Providers” part of HealhCare.gov before. It’s pretty gutsy for a government organization to go there at all. Certainly they are taking a pretty high level approach to their “comparison” but we’ll see how much they dig into it going forward. Will those doctors that are part of an ACO that’s striving to be reimbursed on the quality of care be listed different than other doctors? It will be interesting if tools like these start to differentiate which patients go to which providers.

I do wish that the website did more to get patients involved in their healthcare. Here’s what I said in my “All I Want for Christmas…” post on EMR & HIPAA:

More Empowered and Trusted Patients – Imagine where the patient was a full participant in their healthcare. That includes being trusted and listened to by their doctor and a patient who thoughtfully considers and listens to their doctor. This is not a one sided issue. This is something that both patients and doctors can improve. There are as many belligerent patients as their are arrogant doctors. We need a good dose of humility, care and trust re infused into healthcare. I think they only way we’ll get there is for the lines of communication to open up on an unprecedented level.

Seems like HealthCare.gov is one place that could help reach this goal. I guess in some ways the physician comparison engine could work towards this. How cool would it be if they listed which of the physicians used EHR and which EHR that physician used? Reminds me of “Got EMR?” ad campaigns I first wrote about about 6 years ago.

EMR or Not, we’re quickly heading to a world where doctors are differentiated on the technical services they provide their patient. Doctors are starting to be judged by their medical website and the services they provide on that website. Do they accept online appointment requests? Do they accept online payments? Can the patient communicate electronically with the clinic? Can the patients receive their patient records electronically?

It will start with a handful of doctors and then start to spread. Plus, it will be accelerated if HealthCare.gov or some other website starts to highlight those doctors who offer these type of services and those that don’t.

December 26, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

AAFP EMR Survey Offers Food For Thought

Even the authors admit that the following study has got flaws, given that respondents weren’t randomly selected and some vendors screened out by its design.  Nonetheless, new EMR satisfaction research by the American Academy of Family Practice gives us some interesting stats to consider.

The study, which was published in the November/December issue of its Family Practice Management  journal, draws on 3,088 responses from AAFP members, who responded to a series of questions regarding which EMRs they used and how comfortable they were with those EMRs.  Respondents reported using a total of 160 named EMRs, but the study dropped 129 which were used by 12 or fewer practices in an effort to simplify the results, leaving 31 systems for analysis.

The systems with the strongest satisfaction ratings, ranging from roughly 80 percent too over 50 percent, were Praxis, HealthConnect, MEDENT, Amazing Charts and SOAPware. eMDs,  Practice Fusion, Point and Click EHR, EpicCare Ambulatory and Vista CPRS followed closely, with scores clustered around 50 percent.

Not too surprisingly, EMRs that were ranked easy to use were largely the same ones which got high satisfaction ratings. Topping that list was Point and Click EHR at nearly 80 percent, followed by Amazing Charts, Practice Fusion, Praxis, SOAPware, Aprima, MEDENT,eMDs, HealthConnect, Vista CPRS, with Care360 EHR rounding out the bottom of the top 10 at roughly 47 percent.

The only surprise the authors highlighted came in response to a question asking which EMRs helped doctors see more patients or go home earlier than they could with paper charts. In that case, Praxis stood out, with doctors who agreed hitting about 80 percent. The number who agreed for the next on the list, SOAPware, fell immediately to just over 40 percent, with the other players falling even lower on the scale.

Even with its deliberate statistical laxity — authors described their intent as being more of an “advice from colleagues” format — this certainly offers some stats to chew on. In particular, I’d love to know what Praxis is doing right. After all, when it comes right down to it, productivity is king.

December 24, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

The Fiscal Cliff of Primary Care and Jubilee Health Community – Around Healthcare Scene

EMR AND HIPAA

The Fiscal Cliff of Primary Care

Everyone has heard about the Fiscal Cliff that is currently being talked about at the White House, but have you heard about the fiscal cliff of primary care? The Hello Health Blog posted some interesting facts about what they refer to as the fiscal cliff of primary care. At the core of the discussion is whether or not EHR software is a financial win or loss.

Mobile Health Trends and Technology

This post features videos that were taken at the mHealth Summit in Washington D.C. The videos are interviews with various people and describe some of the up and coming mobile health trends and technology. David Collins and Jonathan Dreyer talk about different trends they have seen, and provide a perspective on health applications.

Hospital EMR and EHR

Impossible to Say “Wrong EHR”

The title of this isn’t always true — it is possible for a hospital to have implemented the wrong EHR. However, it’s a hard mistake to admit. Especially with EHRs like Epic, which are highly selective and cost so much money.

Oops! Community Hospitals Unhappy with EMR Purchase

The latest KLAS reports revealed that many community hospitals are disappointed with their EMR, and questioning the purchase. Some of the hospitals are even pulling the systems completely from their practice. This may not be the best solution, but some of these hospitals don’t feel like it is worth the time and effort.

Smart Phone Health Care

Jubilee Health Community and NoMoreClipboard Combine Forces To Help Diabetes Patients

Diabetes is very prevalent in the United States today, and it can be difficult to manage. Jubilee Health Community provided NoMoreClipboard with someone of their diabetic patients to help treat and manage their diabetes. After a year, some interesting results were found. In some cases, the health of a patient who actively used the system increased.

December 23, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

#HITsm and #hcsm Highlights Around Twitter – Healthcare and Social Media

If you are avid follower of the #HITsm Chats, you probably noticed it was MIA this week, and also will be next week. So, instead, here are a few interesting tweets I found from doing a search for #HITsm and #hcsm on Twitter. I highly recommend doing that every once in awhile…there’s some pretty interesting information to be found. With that, here are some of the highlights I found from those searches (it was hard to pick just a couple!) I saw a lot about social media, so I thought I’d focus on that today.

This is a really fascinating article. Did you know that 90 percent of people ages 18-24 trust health information found on social media? Kind of scary in some ways, since, well, there’s definitely some incorrect information out there. It also puts a lot of weight on the shoulders of those that do provide the information, to make sure it’s accurate, up-to-date, and informative. To be honest, I sometimes trust sites like WebMD more than my own doctor! Social media and mobile devices are here to stay in the healthcare world, that’s for sure. I think this article gives some good information on the pros and cons, as well as how healthcare providers can benefit, which brings me to the next post…

Well, this is the opposite of what I read (and preach) a lot. A waste of time? The previous article talked about how it can be very beneficial for healthcare providers. The main arguments are that there is no return on investment (ROI), it can be dangerous when it adds to the likelihood of a doctor being burnt out, and it’s just a fad that is going to blow over and isn’t worth investing time, unless you have a lot of time and want it to be a hobby, or your company has products and services the customer pays for. I don’t agree with these statements, and believe that it is worth putting the time and effort into…but I suppose only time will tell which side of the fence is correct.

Aren’t patients the most crucial aspect to any healthcare provider? So empowering them is so important, and this article talks about how social media is doing just that. It has five ways it empowers patience, which, in a nut shell, are:

  1. Connecting people suffering from a disease or ailment with others…so basically, helping people not feel so alone in their health struggles, and get support from others that “get it.”
  2. Patients can learn about different treatment options and about medical devices more easily. When a person just relies on their doctor for information, some of these options can be overlooked (and often are.)
  3. Patient’s who like being self-advocates are likely to become community advocates as well
  4. Patient’s are given a “voice” to talk about their experiences and thoughts
  5. There are social networks dedicated to certain diseases or conditions.

And finally, this doesn’t have anything to do with the other tweets I’ve mentioned, but it made me laugh. The sledding blogger on the far left looks familiar, doesn’t he?

December 22, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Hardest Meaningful Use Measure

There was a great piece a while back by Benjamin Harris that looked at the 5 not-so-easy pieces of meaningful use stage 2. In the article he suggests the following 5 challenges:

1. Structured Lab Results
2. Patient Access to Health Information
3. Ongoing Submission to Registries
4. Computerized Order Entry (CPOE)
5. Summary of Care Referrals

I started asking around my network to see what readers of my site and those in my social media groups thought was the hardest meaningful use measure for them. Some of them match the list above, but I thought I’d highlight a few of them I found interesting.

One person told me that the multi-lab scenario might be one of the most challenging parts of meaningful use and one that doesn’t get talked about much.

A CIO named Renee Davis told me that ePrescribing and monitoring compliance were the hardest meaningful use measures. I think the ePrescribing part can be a huge challenge depending on your EHR vendor, your physician users, and your location (ie. Do your local pharmacies participate?). Plus, any CIO will definitely have challenges with compliance.

Patty Houghton suggested that Clinical Summaries and Problem Lists were her hardest meaningful use challenges.

Obviously when you say the word “hardest” it’s something that’s unique to an individual practice or institution. With that disclaimer, from the large number of people I’ve talked to I think that most people consider the 60% CPOE meaningful use measure the hardest.

I still remember the day when I heard Marc Probst, CIO of Intermountain Healthcare (IHC), say that IHC was doing ) CPOE. This was when he was first working on the committees in Washington to create EHR certification and meaningful use requirements. It was a shock to me that IHC, who is touted for its use of IT in healthcare, could have 0 CPOE (I think Meaningful Use has helped encourage them to remedy this number). It illustrated well how much of a challenge CPOE will be for many institutions.

What’s your experience and the experience of the doctors and hospitals you work with? Which meaningful use measures are most challenging?

December 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Some Interesting EMR Usability Ideas

Not long ago, I wrote a piece slamming the lack of EMR usability standards out there today, arguing that the industry was pretty much going to stay in a rut until we got some.  One of our readers, Prasad Patankar, posted a very thoughtful response which I felt deserved more exposure and discussion.

Here’s his ideas, in italics, with my comments interspersed:

* EMR systems should have a consistent hierarchy for navigation so
  that it is easy for users to locate information.

This is hard to argue. Unfortunately, given the vendor turf wars going on out there, I think we’re going to be stuck with proprietary systems and proprietary hierarchies for some time to come.  But what Prasad suggests here is just common sense, not that we can expect to see a lot of that on display.

* Error messages should be clear. They should explain why the error
  occurred and explain what the users should do next. Definitely not
  any programming language errors.

Again, I agree with Prasad here. This kind of consistency would do much to orient users. The problem is, these systems are still driven largely by developers, who best understand the nasty programming language error codes.  Expecting them to make their EMR products speak plain English is a bit of a stretch, sadly.

* For screens that contain too much information, there should be an
  option available for the users either to see the summary or a
  detailed drill-down capability. Some EMR vendors have started
  incorporating this functionality into their reporting modules.

Beautiful — a function vendors already understand. That’s enough to sell me on the notion that it can be more widely implemented, and soon. In this case, there’s no excuse for vendors to obfuscate;  just go ahead and make the data easier to read already!

* Consistency should be followed in displaying allergies and current
  medications in one single location. Users should not have to click
  multiple windows to get to this. This also applies to past
  encounters(progress notes) which have been migrated prior to
  implementation of the new EMR system.

This is a very good idea. When Your Editor recently read up on research into errors made using EMRs, medication slip-ups were by far the most common event. (And the only event that created serious harm was administration of a drug to which the patient was allergic.  Past notes might not be as urgent, but useful, definitely.

* It would also be interesting to see if EMR vendors could incorporate
  the cultural context and meaning of a color in that context before
  they use the entire color palette in their software.

This is an intruiging idea, though I can’t imagine the big enterprise vendors giving it much thought.  Perhaps if Apple designed their interface… But that’s a tale for another day.

December 20, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.