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AHIMA Plans To Promote Blue Button

Posted on October 31, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

This week, at its annual conference, AHIMA announced that it’s launching a drive to get its members and state organizations to push use of Blue Button technology.  The idea behind the push is to improve consumer access to personal health records, according to a report in iHealthBeat.

For those who aren’t familiar with it, the Blue Button dates to 2010, when the Department of Veterans Affairs launched the tool to help veterans access and share their personal health data in a standardized manner. Consumers who click on the Blue Button get human-readable personal health data in ASCII format.

Since its inception, both private organizations and federal agencies have implemented the Blue Button. According to ONCHIT, almost 500 healthcare organizations have joined the Blue Button Pledge Program, which encourages providers to make personal health records available to individuals and caregivers. Almost 80 million Americans can now access their health information through the program.

Now, AHIMA is encouraging wider expansion of Blue Button use. The association is urging members and state AHIMA chapters to inform employers, families, healthcare providers and other health professionals of the benefits of the Blue Button format, according to iHealthBeat.

This effort should be enhanced as providers move toward Blue Button+, the next generation of Blue Button efforts, which meets and builds on view, download and transmit requirements in Meaningful Use Stage 2.

Neither Blue Button nor Blue Button+ programs magically transform patient data into something everyone can see and use, but they’re steps in the right direction.

So, what’s the next step when Blue Button functionality becomes common?  Will it help patients manage their data, or is it unrealistic to expect them to download and transfer information? I think the jury’s still out on this one.

If nothing else, though, we can look too the Automated Blue Button Initiative, which will probably evolve away from ASCII into more universal standards like XML. I’m keeping my eye on #ABBI to see where that goes, for sure.

Physicians Face Flood of Unsolicited Data

Posted on October 30, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Over the last few years, the sources of information an EMR can contain have exploded. Where it once included only clinical information generated by the provider, these days EMRs may also embrace health information exchange data, input from personal health records, contributions from patient mobile device use and remote monitoring data.

As iHealthBeat writer Michelle Stuckey points out, this information may not have been requested by the provider, but they have to contend with it anyway.  Adapting to these new data sources is possible, but for the near term, it’s likely to disrupt provider workflows and affect the usability of their EMRs.

To combat this problem, AHIMA recently came out with a practice brief which outlines the challenges unsolicited health information can pose for providers. The brief makes several recommendations health organizations should consider in handling the problem, including the following:

  • Develop policies with providers that outline which unsolicited information will be retained
  • Create policies that establish the legal definition of the health record, and which unsolicited information fits the criteria
  • Review the incoming information to determine whether a patient-provider relationship exists, and verify that the information is needed for treatment
  • Develop protocols, by specialty, clinical area or document type which establish which types of information will be accepted into the EMR
  • Provide education to all providers and staff in the health organization on steps to be taken when they receive  unsolicited health records

While it’d be nice, in some ways, for EMRs to remain in silos — at least for those who use them — it simply isn’t going to last. Data is going to come at doctors from every angle, including some we probably haven’t even considered yet.  Forward-looking medical organizations should take a hard look at the AHIMA recommendations before they’re swamped in data they can’t handle.

#AHIMACon13 Should be Called ICD-10 Con

Posted on October 29, 2013 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.

My prediction that the AHIMA Convention would be all ICD-10 all the time was generally true. ICD-10 is on the mind of everyone at the conference. Although, I did hear one attendee that was really happy to find someone that could talk EHR data conversion. They also predicted that next year there would be the year of EHR data conversion. We’ll see how that plays out. I still think next year might be a lot of people complaining about ICD-10.

I’m always impressed by the people I meet at AHIMA. They’re a wonderful group of people that are devoted to the cause of healthcare. These people have some pretty tough and often mundane jobs that often don’t get paid very well, but they do it with such class and dignity. It’s always a pleasure to be around such an amazing group of people.

I’m definitely inspired to do a weekly series of ICD-10 blog posts. I’ll look at starting that next week. Hopefully we can bring out of denial some of the people that aren’t focused on the impacts that ICD-10 can have on their organization. Not to mention the training needs that many have for ICD-10.

I’ve also shot a number of great videos with people I’ve met at AHIMA. They’re short and sweet and hit on a specific subject. I think they impart some good wisdom. Be sure to subscribe to the Healthcare Scene YouTube channel to get the latest video uploads. Plus, we’ll be posting them across the Healthcare Scene network over time.

Are you ready for ICD-10? Are there ICD-10 topics you’d like to see covered in the future? I’d love to hear your thoughts about it in the comments.

Study: Opportunities Still Available For HIT Vendors

Posted on October 28, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, my colleague John Lynn wrote a piece arguing that the era of easy EMR money and abundant customers is over. In that post, he contends that the “Golden Age of EHR Adoption” has fled, leaving vendors with the unenviable task of attracting the late adopters to the table.

Well, at least one research firm seems to disagree. According to a trend report from Berkery Noyes, there are still many openings in the HIT marketplace for entrepreneurs who can address pain points, Healthcare IT News reports.

The Berkery Noyes report analyzes M&A activity in the healthcare sector taking place during the first three quarters of 2013, and compares it with data from 2012.  Markets covered include information and technology companies servicing the pharmaceutical, payer and provider sectors.

At present, the researchers say, the healthcare market is highly fragmented, offering many opportunities for entrepreneurs that find areas of need.  These opportunities include healthcare IT startup, the researchers say.

The market clearly seems interested in HIT plays. Healthcare IT dealflow is strong, seeing a 56 percent volume increase on a quarterly basis, according to Healthcare IT News. HIT deals also accounted for almost half of the industry’s aggregate M&A volume, as opposed to just 31 percent in the previous quarter.

In fact, the standout deal of the quarter. booking the overall industry’s highest value, was Vitera Healthcare Solutions’ planned $644 million acquisition of EMR vendor Greenway Medical Technologies. And this may not be this year’s biggest deal; researchers note that “large strategic buyers” are looking to buy unique content/software solution in the healthcare market.

All that being said, it’s worth noting that it’s not as though every promising healthcare technology company has suitors at the door.  Buyers want companies with proprietary technology/content, scale in their markets, high (double digit) revenue growth, a high percentage of recurring revenue and a large total addressable market opportunity, noted Tom O’Connor, managing director at Berkery Hoyes, in a recent press release.

So, net net, it looks like there’s money out there for the right health IT play, but not so much for startups early in their growth path, or health IT players struggling to capture the rapidly shrinking Meaningful Use-fueled market. So I’d argue that the report’s enthusiasm for entrepreneurial opportunities should be qualified a bit. Still it’s good to know that investors are bullish on health IT generally.

EMR Mandate Delay, Patient Focused EMR, and Guaranteed EHR Benefit

Posted on October 27, 2013 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 article makes some interesting points about the challenge of EMR. However, I don’t think there’s any shot that the EHR train is going to slow down. At the best there might be a delay in meaningful use stage 2. Although, that could be unlikely as well. P.S. There is no EMR Mandate.


Not true. It takes GREAT EMR design to do that. The regulations are just brutal and don’t focus on the patient.


It’s always beautiful for me to find someone tweeting a blog post I created 4 years earlier. The content is still quite good. Reminds me that I need to finish my EHR Benefits series.

What Our Kids Can Teach Us About EMR Implementations

Posted on October 25, 2013 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.

I occasionally help out in my church’s children’s worship and education areas, and so sometimes receive emails with helpful articles and words of advice from the children’s ministry. These usually focus on how to best interact with kids who are not shy about asking big questions that often leave even senior pastors stumped.

The most recent email had to do with “How welcoming is your ministry to children and their parents?” As I read through the message, I realized much of it could be applied to the healthcare setting, particularly an EMR implementation. With the switch of a few words, the headline could read, “How welcoming and inclusive is your EMR implementation game plan to your end users?”

Tips on being welcoming include:

1. Build Communication: Sometimes what scares kids is other kids. They need to learn how to talk to one another. By playing simple icebreaking games and including time for conversation, you’re fostering friendship and a sense of community.

The EMR Implementation Twist: While I can’t speak to what individual participants in an EMR implementation team might be scared of (each other? Higher ups? The EMR itself?), I can get behind the need for communication. Simple icebreaking exercises and time for conversation seem like great first steps in building a cohesive team looking to be able to successfully get through a go live.

2. Ownership: Allow kids to take ownership of their ministry. Give them jobs and responsibilities they enjoy. Letting kids form a welcoming team or allowing them to help set up for snack are simple and easy ways for them to be a part of the team.

The EMR Implementation Twist: The takeaway here is that team members need to feel valued, which will likely engender pride in the implementation. Many of you have heard of the need for physician champions during times of HIT implementation; these are the types of team members that can be tapped to take ownership of the project and share their enthusiasm with less-involved (or downright stubborn) colleagues.

3. Get to Know Your Kids: All of them. Make them feel loved. Not just with a prize or a piece of candy for coming. Get down on their level and talk with them. Let them know that you’re their friend. It sounds simple, but for a kid who feels like an outsider, this could mean the world.

The EMR Implementation Twist: Get to know your teammates. All of them. Make them feel appreciated. If you’re a project leader, make a point to check in with them every so often, and not just about the implementation. It could be via email or text, but a phone call or quick chat in the hallway might make more of an impact. Let everyone know that the lines of communication are always open. An open door is even better.

I have to add a fourth tip: Give thanks. Everyone likes to feel appreciated. Kids light up when I tell them, “I’m so glad you’re here!” Frankly, I’m not that much different. Remember to take the time to thank your teammates for the job they are doing, even though it may be bumpy at times.

These are obviously simple tips, but sometimes we need to take a step back and reassess the fundamentals before moving on. Are there any additional tips you’d like to share? Know of an effective way to put team members in time out? Let me know via the comments below.

DoD, VA Move Closer To Joint EHR

Posted on October 24, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

It looks like the DoD and VA may yet again be making  progress toward creating an integrated health record, after a long stretch when it looked like the project was dead, according to Healthcare IT News.

This is a gigantic effort, and expenses for executing it are gigantic too. In September 2012, the Interagency Program Office estimated the final costs for the iEHR at between $8 billion to $12 billion.

The course of the project has been bumpy, with key players shifting direction more than once. Most recently, the DoD had announced in May that it was looking for an EHR on the commercial market, seemingly dropping plans for creating an iEHR with the VA. But now the two agencies have awarded a re-compete contract for creating the iEHR, HIN reports.

Last week, the Interagency Program office said that Systems Made Simple had won the contract, under which the company would provide systems integration and engineering support for creating the iEHR.  SMS had previously won the contract in 2012, but that contract called for it to bid again in a competitive process.

The idea behind the iEHR has been and continues to be creating a system that can present a single record for each military veteran, complete with all clinical information held by the two giant agencies.

However, for a time it looked like the iEHR project was dead, when the two organizations announced that they were shifting their approach to buying technology from an outside vendor. Critics — including myself  — sharply scolded the agencies when these plans came to light, with most suggesting that the new plan was doomed to fail.

Now, the integration game is on. SMS’s three main focus areas will be to establish data interoperability between the VA and DoD systems, plan a service-oriented architecture for the integration, and create terminology translation services that deliver data to users in a shared format, notes HIN.

With these goals met, SMS plans to “create data through a single, common health record between all VA and DoD medical facilities,” the company said in a statement.

Now, let’s hope that nobody in the agencies switches direction again. Let’s give this thing a chance to work, people!

Non-Profit Achieves Meaningful Use For In-House EMR

Posted on October 23, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Most organizations hoping to achieve Meaningful Use milestones buy their way in, by acquiring certified technology from an established EMR vendor. However, there are still some organizations that are working to create in-house technology that meets Meaningful Use standards.

One such organization, the Massachusetts eHealth Collaborative (MAeHC), recently achieved a nice win by meeting all three Meaningful Use Stage 2 requirements for its in-house-built EMR module, according to a report in Information Week. To meet certification criteria, modular EMRs must use the Quality Reporting Document Architecture Type 1 document to capture and input the data electronically.

MAeHC, a not-for-profit health IT organization, has created a modular EMR for clinical quality measurements (CQM) reporting, which the CCHIT certified to support Meaningful Use Stage 2, IW reports. The MAeHC product, which is hosted in the cloud, integrates with stand-alone EMRs and can span across multiple EMR platforms.

Getting certified was partly a matter of interpreting the criteria for Stage 2, which include capture and export, import and calculate and electronic submission, MAeHC execs told IW.

From the get-go, for example, the first criterion was problematic, as “capture and export” require EMRs to electronically record data and export it using established standards. MAeHC’s EMR has no user interface to manually key in data.

But the group’s leaders were determined to meet all three criteria, and they managed to get all of their issues sorted out. The MAeHC system is now certified for eligible providers and should be certified for eligible hospitals within the next few weeks, according to IW.

Looking at the challenges faced by those that blaze their own EMR trail, it’s interesting to note that two years ago, Beth Israel Deaconess Medical Center became the first hospital to have its entire home-brewed EMR certified as “complete” by the CCHIT. Considering the resources required, and the tough problems a group like MAeHC faced just to create one module, I’m not surprised that most of its hospital brethren have gone with packaged solutions instead.

Healthcare Standards – Opportunities and Challenges Remain for SNOMED CT, RxNorm and LOINC

Posted on October 22, 2013 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.

The following is a guest blog post by Brian Levy, MD, Senior Vice President and Chief Medical Officer for Health Language.
Levy Low Res

Health IT standards and interoperability go hand-in-hand. Going forward, the success of the industry’s movement towards greater health information exchange (HIE) will hinge on the successful uptake and adoption of standards that will ensure reliable communication between disparate systems.

Progress is being made in this area through both messaging and coding standards introduced as part of Meaningful Use (MU). Specifically, MU coding standards that draw on such industry-respected clinical vocabularies as RxNorm, SNOMED CT® and LOINC® have the potential to drive more accurate, detailed sharing of patient information to promote better decision-making and patient outcomes.

Effectively deploying and adopting these standards is a huge undertaking with responsibilities falling to both vendors and providers going forward. To survive in future of healthcare, EMR vendors will have to evolve to support current and future industry standards. Providers will also have to grow their knowledge base and become more aware of how standards impact care delivery—instead of simply relying on vendors to pick up the slack.

The ability to “normalize” data to support all of these standards will be critical to advancing interoperability and communication between healthcare providers. With so many federal health IT initiatives competing for resources, the integration and use of terminology management solutions will become an important element to any data normalization strategy.

As providers assess their current needs and vendors move towards more enhanced offerings to align with new standards, the combined effort should produce significant progress towards improved information sharing. In the meantime, many challenges and opportunities exist along the roadmap to full implementation and adoption.

Vendor Readiness

While the EMR vendor market hit $20 billion in 2012, recent surveys suggest that many will not have staying power for Stage 3 MU. And one of the primary reasons, according to a 2013 Black Book Market Research report, is lack of focus on usability. An earlier report also pointed to 2013 as the “year of the great EHR switch,” pointing to provider frustrations that their current EMRs do not address the complex connectivity and sophisticated interface requirements of the evolving regulatory landscape.

Stage 1 MU created an artificial opportunity for many vendors to enter the market through government incentive grants. Because most initial EMR systems were not designed with Stage 2 requirements for HIE standards in mind, many vendors may find that they are not in a position to fund the infrastructure advancements needed to support future interoperability.

For instance, many EMRs support ICD-9 or free text for the development of problem lists. Under Stage 2 MU, problem lists must now be built electronically using SNOMED CT, requiring EMR vendors to develop and put out new releases to support the conversion. In tandem with this requirement, EMRs will also have to be designed to support RxNorm and LOINC.

It’s a time of upheaval and financial investment in the EHR industry, and when the dust settles, healthcare providers will have designated the winners. The end-result will ultimately include those players that can support the long-term goals of industry interoperability movements.

Minimizing Workflow Impacts

In existence since 1965, the SNOMED CT code set has a long track record of success and international respect. A comprehensive hierarchical system that includes mappings to other industry terminology standards, the code set enables computers to understand medical language and act on it by organizing concepts into multiple levels of granularity.

Few would dispute the potential of SNOMED CT to enhance accuracy and address the detail needed to promote enhanced documentation practices, but the expansive nature of the code set is still not exhaustive. Searching and finding the SNOMED concepts to include in Problem lists often requires further expansion of synonyms and colloquial expressions commonly used in clinical practice.  In addition, an accurate SNOMED code may not equate to a billable ICD-10 code, potentially requiring clinicians to conduct multiple searches if EMR workflow is not carefully planned.

The challenge for healthcare organizations is two-fold when it comes to the complicated SNOMED CT conversion process. First, the conversion represents one more complex IT project that healthcare organizations must undertake  amid so many other competing initiatives. Second, the success of implementations will be diminished if clinician workflows are negatively impacted. With EMR documentation practices already requiring more time from a clinician’s day, the situation will only be exacerbated if multiple code searches are required to ensure regulatory compliance for MU and ICD-10.

Terminology conversion tools that leverage provider-friendly language can be a great asset to easing the burden by providing maps between ICD-9 or ICD-10 and SNOMED CT problems. Physicians search for the terms they are accustomed to using in the paper record, and terminology tools convert the terms to the best SNOMED CT and ICD-10 codes behind the scenes.

For example, a clinician may add fracture of femur to a problem list, but ICD-10 requires documentation of whether the fracture was open or closed, the laterality of the fracture and whether the fracture was healing. Provider-friendly terminology tools provide prompts for the additional elements needed and guide clinicians to the most appropriate choices without the need for multiple searches.

Improving Mapping Strategies Internally and Externally

Industry crosswalks and maps exist to help ease the transition to new standards like SNOMED CT, RxNorm and LOINC. While these tools provide a good starting point in most cases, there is simply not a gold standard map that will work for every case.

Consider RxNorm, a naming system that supports semantic interoperability between drug terminologies and pharmacy knowledge base systems. Working in tandem with SNOMED CT to improve accurate capture of patient information from external systems, RxNorm codes are now required as part of the CCD (Continuity of Care Document) and HL7 messages for capture of medication information.

While designing EHRs with the capability to send and receive RxNorm codes is the first step, healthcare providers will still require a method of converting codes from RxNorm to internal medicine systems and drug information and interactions databases like Medi-Span, First Databank, Micromedex and Multum. Another challenge to standardizing medication information is the use of free text. Many healthcare providers receive drug information that is not coded at all, requiring a specific, customized mapping.

LOINC, a universal standard for identifying medical laboratory observations, is particularly challenging in this arena. Because the industry is home to hundreds of local lab systems and thousands of local lab codes, creating a single industry mapping solution is nearly impossible. The process often requires that sophisticated algorithms be built by performing an analysis of individual lab tests that are conducted in a particular hospital.

By leveraging the expertise and sophistication of a terminology management solution, healthcare providers can more easily automate and customize mapping of patient data to standardized terminologies. Otherwise, IT departments must expend valuable staff time to build complex mapping systems to address the myriad of needs associated with an influx of new standards.

Conclusion

The healthcare industry has identified use of a common medical language as a key foundational component to advancing information sharing capabilities. By designating such standards as SNOMED CT, RxNorm and LOINC as MU requirements going forward, the industry is taking a progressive step forward to ensuring clinicians have more efficient access to better patient information.

It’s a critical step in the right direction, but the road to success is complex. Healthcare organizations that draw on the expertise of terminology management solutions will be able to achieve the end-goals of this movement much quicker and with fewer headaches than those trying to implement these complex standards on their own.

Use Of Surescripts E-Prescribing Up Dramatically

Posted on October 21, 2013 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

E-prescribing has become almost commonplace, if not universally used, among providers with EMRs during the last four years, a new study concludes. The study, which was published in The American Journal of Managed Care, was conducted by a team led by ONCHIT’s Meghan  H. Gabriel, PhD.

Researchers found that between 2008 and 2012, the total number of e-prescribers using Surescripts shot up from 7 percent (47,000 providers) to 54 percent (398,000), according to a report in EHR Intelligence.

As EHR Intelligence notes, these numbers didn’t just appear out of nowhere. Part of the reason e-prescribing has gained so much ground is that 94 percent of pharmacies are now able to accept e-prescriptions, up from 61 percent in December 2008.

It’s a good thing pharmacies are on board. E-prescribing must be in place  — specifically, certified EHR technology (CEHRT) — to meet one of the requirements of Stage 2 Meaningful Use. The requirement is that eligible providers need to transmit more than 50 percent of “all permissible prescriptions” via their CEHRT, EHR Intelligence points out, 10 percent higher than the Stage 1 requirement.

Side note: CMS seems happy with e-prescribing progress to date. According to the agency, more than 190 million electronic prescriptions had been sent by doctors, physician’s assistants and other healthcare  providers using EMRs. That 190 million is the cumulative total sent since the inception of the Meaningful Use program in 2011.

But from my way of looking at things, it isn’t completely kosher that e-prescribing by providers is barely over the half-way mark, despite representing considerable improvement over the years. While 54 percent is a nice round number, it still suggests that nearly half of providers are not equipped to achieve compliance with Meaningful Use Stage 2, an undesirable situation at best.

No, despite the improvement in e-prescribing uptake, to me the current stats actually look like a problem, not a win at this stage. The 46 percent of providers not online with e-prescribing had better get their act together.