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What Software Will Replace EHR?

I’m usually a very grounded and practical person. I’m all about dealing with the practical realities that we all face. However, every once in a while I like to sit back and think about where we’re headed.

I’ve often said that I think we’re locked into the EHR systems we have now at least until after the current meaningful use cycle. I can’t imagine a new software system being introduced in the next couple years when every hospital and healthcare organization has to still comply with meaningful use. Many might argue that meaningful use beyond the current EHR incentive money might lock us in to our existing EHR software for many years after as well.

Personally, I think that a new software will replace the current crop of EHR at some point. This replacement will likely coincide with the time an organization is up for renewal of their current EHR. The renewal costs are usually so high that a young startup company could make a splash during renewal time. Add in a change of CIO and I think the opportunity is clear.

My guess is that the next generation of healthcare documentation software will be one that incorporates data from throughout the entire ecosystem of healthcare. I’m not bullish on many of the current crop of EHR software being able to make the shift from being document repositories and billing engines into something which does much more sophisticated data analysis. A few of them will be able to make the investment, but the legacy nature of software development will hold many of them back.

It’s worth noting that I’m not talking about the current crop of data that you can find outside of the healthcare system. I’m talking about software which taps into the next generation of data tracking which goes as far as “an IP address on every organ.” This type of granular healthcare data is going to change how we treat patients. The next generation healthcare information system will need to take all of this data and make it smart and actionable.

To facilitate this change, we could really use a change in our reimbursement system as well. ACOs are the start of what could be possible. What I think is most likely is that the current system will remain in place, but providers and organizations will be able to accept a different model of payment for the healthcare services they provide. While I fear that HHS might not be progressive enough to do such a change, I’m hopeful that by making it a separate initiative they might be able to make this a reality.

What do you think? What type of software, regulations and technology will replace our current crop of EHR? I don’t think the current crop of EHR has much to worry about for now. However, it’s an inevitable part of a market that it evolves.

April 15, 2014 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.

MinuteClinic Goes With Epic – What’s It Mean?

Retail clinic operator MinuteClinic has decided to purchase and roll out the Epic EMR, upgrading from its home built system it’s used until now.  MinuteClinic, a division of CVS Caremark, expects the rollout to take about 18 months.

This is a big win for Epic.  An estimated 274,000 physicians will use the company’s EMR, and roughly 51% the US population will have a record in Epic when its current customer rollouts are complete.

And MinuteClinic has big expansion plans, which will bring Epic to a wide range of new environments.  According to Andrew Sussman, MD, president of Minute Clinic and senior vice president/associate chief medical officer, CVS Caremark,  the company is expanding rapidly, having added more than 350 clinics in the past three years, and planning to reach 1,500 clinics by 2017.

“EpicCare will take us to the next level by offering enhanced connectivity with other providers, more advanced patient portal capabilities and key analytics to run our practice more efficiently and improve patient care,” Sussman said in a press statement.

What’s particularly interesting about this deal is not just that Epic has racked up another big customer, though keeping an eye on their progress is definitely important. No, what’s more newsworthy is the possibility that epic is slowly but steadily changing its strategy, from selling only to large hospitals to exploring other customer relationships on the ambulatory side.

Not only is Epic rolling out a large ambulatory deal with MinuteClinic, the EMR vendor has struck a deal with the Cleveland Clinic and Dell under which the Clinic and Dell offer providers EMR consulting installation configuration and hosting service for Epic.  Bearing in mind the needs of ambulatory providers, the Cleveland Clinic deal even allows buyers to have the Epic EMR hosted mostly by Dell.

Certainly Epic won’t stop pursuing big hospital deals, but the MinuteClinic and Cleveland Clinic agreements suggest that Epic may be looking for other markets beyond the large hospital market. It looks like ambulatory is on their radar and we know they’ve been working hard to grow internationally.

March 12, 2014 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.

EHR Regulation Vs. Innovation

The following is a guest blog post by Marina Simonian, Product Manager and Jessica Naftaniel, Sales & Marketing Coordinator at gMed. Check out gMed’s whitepaper on Independent Gastroenterology.

In the past few years EHR technology vendors and healthcare providers alike have struggled with a myriad of regulatory requirements, from PQRS and eRX incentive programs, to ASC quality reporting, to Meaningful Use, ICD-10 and beyond. The next few years are set to bring even more challenging requirements for interoperability, patient engagement, quality metrics and clinical decision support. Being a technology and services vendor, we always strive to provide the most efficient, innovative and high quality products to our clients.

But how innovative can you get in this era of regulatory overload?

On one hand, innovation on a deadline is almost an oxymoron. Especially with such restrictive guidelines. One could only imagine what type of innovative, amazing solutions could be developed with the amount of time and resources that have been thrown in to meeting regulatory requirements.

On the other hand, necessity is the mother of invention.

As a direct result of numerous new regulatory measures and government requirements, many EHR providers are simply throwing components together to meet requirements and pass a certification.  Features which are put together hastily may make life more difficult for the people using their products, and might not last long on the market.

However, keeping your eye on the long term goal and looking beyond regulation helps to see some of the great benefits that can still arise from this race. When, for example, the DirectTrust and similar organizations come together to facilitate sharing of patient information securely across various healthcare entities, this may be a huge step to, perhaps, someday in the future, being able to tap into a centralized patient record and get the data you need, exactly when you need it, regardless of your location or affiliation.

And while for some vendors it makes perfect sense to focus on a limited number of features and bring value with those few, there are some others who choose to bring the value of integration and are a one-stop-shop for all of their users’ Electronic Health Record software needs. It is not an easy task by any means. And the best attestation to that is in the astounding difference in complete certified EHRs between 2011 and 2014.  In the end, whichever path one chooses, only those who are able to keep the long term focus on innovation above regulation, to put efficiency and ease of use above merely meeting a requirement, and to remember that improvement of patient care and overall population health is the ultimate goal, will be able to withstand the regulatory storms.

For more information on gMed’s innovative technology, visit us at gmed.com. gMed provides the gastroenterology industry with a fully integrated platform consisting of an Electronic Health Record, Endoscopy Report Writer, Practice Management solution, Patient Portal and a Data Analytics tool. Fully scalable through the cloud or using an on-site server, gMed’s products are all Meaningful Use Certified and ICD-10 ready.

Full Disclosure: gMed is an advertiser on this site.

February 19, 2014 I Written By

KLAS Gives athenahealth, Not Epic, its 2013 “Best in KLAS” award

While Epic Systems may still be that the giant in the room, according KLAS, athenahealth is the best overall software vendor for 2013.

athenahealth’s taking first place pushes Epic to second for the first time in eight years. athenahealth got the most positive opinions from the thousands of providers participating in the KLAS poll, notably praise for the usability of its athenaClinicals, athenaCollector and athenaCommunicator products, according to EHR Intelligence.

athenahealth CEO Jonathan Bush was all too happy to take a victory lap. “The old guard of each IT leaders is finally being displaced by more nimble innovative models designed for healthcare’s future – not for its past,” Bush told EHR Intelligence.

Epic still remains in first place as for its overall software suite, reports EHR Intelligence. And it took home multiple prizes this year. But there’s a revolution brewing outside the Epic palace, it would appear. Not one that calls for angry peasants and pitchforks, but clearly some level of entrenched discontent is at work here.

Other well-known vendors of EMRs took their lumps as well. For example, Cerner came in at seventeenth, McKesson at 20th, and Allscripts came in 23rd.

So what to make of all of this? As my colleague John Lynn notes, awards of this kind are best taken with a grain of salt. After all, providers don’t need software that wins popularity contests, they need software which they can afford, which can handily meet Meaningful Use standards and which doctors and nurses and other clinicians can use without a hitch. Being sure their vendors win sexy awards really isn’t on their worry list.

Still, the fact that Epic has been unseated after eight years at the top of KLAS’s best vendor list may mean something. Perhaps Epic’s grip on the market is loosening a bit?

February 6, 2014 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.

Should Doctors Say Goodbye To Meaningful Use?

Of late there’s been a lot of concern about doctors exiting the Meaningful Use program, with many saying the financial reward was simply not worth the trouble. This trend, of course, has the medical world abuzz with discussion as to what will happen if doctors drop Meaningful Use like a stone.

Meanwhile, a few months ago, an EMR vendor brought the discussion more heat when it announced that it would no longer be Meaningful Use certified. ComChart Medical Software said, in a letter to the EMR community, “unfortunately, will not be able to meet the Stage 2 (or greater) Meaningful Use certification requirements as its requirements are technically extremely difficult to implement.”

If I were running a medical practice, and my vendor took away from me the choice of complying with Meaningful Use or not, I might be angry, but I might breathe a sigh of relief.  After all, complying with Stage 2 will be a major accomplishment for virtually any practice, and if my vendor takes the choice of complying or not complying with Meaningful Use out of my hands, I won’t have people breathing down my neck saying I’m not a team player.

But even if my vendor continues to support a certified EMR for now and into the future, it’s still worth wondering whether it’s worth the trouble for doctors, half of whom are in smallish practices that don’t have much of an IT budget.  After all, if my practice has completed Stage 1 I’ve already realized most of the financial benefits the program offers, notes Modern Healthcare.

So what do you think readers? Do the next stages of Meaningful Use pay off in other ways that make the struggle for compliance worth the trouble?

January 7, 2014 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.

Forrester’s Take On Computing Trends For Next Year

Recently, Forrester Research’s J.P. Gownder released a list of six broad tech trends he feels will dominate 2014. While they’re not healthcare-specific, I thought our readers would appreciate them, as they are relevant to the work that we do.

Mobility:  Gownder is arguing that this year coming will see a “sustained mobile mind shift.” He argues that customers and employees are beginning to expect that the data they touch will be available to them in context on any device at the exact what would’ve need. He argues that customers will actively shun businesses that lack mobile applications.

Fragmentation:  While vendors would like to see us, as consumers, stick to one vendor and operating system, Gownder argues that just the opposite will happen in 2014, with people trading off between multiple devices and thriving across operating systems. This movement, driven by the seeming infinity of new mobile devices, makes things more difficult for health IT administrators, to be certain.

Wearables:  While the wearables devices your editor has seen strike her mostly as toys, Gownder is far more enthusiastic. He argues that next year will see commercial availability of a range of once theoretical wearables — and that enterprise wearables have a particularly rich future ahead of them.

Intelligent assistants:  For me, services like Siri and Samsung’s S-Voice are entertaining, but hardly add anything to the mix when it comes to what your phone tablet or PC can do. Gownder, however, believes that intelligent assistance will rise to prominence in 2014 as they become more sophisticated, interesting and useful.

Gestural computing: Expect to see new applications and scenarios for gestural computing this year, Gownder predicts, driven by phenomena like the presence of XBox Kinect in tens of millions of homes, the emergence of Leap Motion and the emergence of a new device known as Myo from Thalmic Labs. In this case he isolates healthcare specifically as a strong use case, in which professionals manipulate and navigate medical imaging using gestures.

Stores recognize you: Here’s one I can see direct healthcare applications for; next year, Gownder predicts, will be the year in which you walk into a store and the store “recognizes you” and tailors your experience accordingly. I can see this being relevant in virtually any public-facing healthcare setting, including the ED, medical clinics and perhaps even EMT settings. Sounds very much like John’s description of a “biometrically controlled healthcare system.

So which of these trends do you think will be the most important next year? How are you adopting them, if at all, in your healthcare organization?

December 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 @annezieger on Twitter.

Helping the Small Practice Physician Survive with Dr. Tom Giannulli

In case you haven’t seen, I’ve been doing a whole series of video interviews over on EHR Videos. There are some really great videos in the series chock full of insights into what’s happening in the world of EHR and Healthcare IT.

The following video is an example of the type of great video interviews we’ve been doing. In this interview, I talk with Dr. Tom Giannulli, CMIO of Kareo about how a well done EHR vendor can help a small practice physician survive. This has become a really popular topic for a number of ambulatory focused EHR vendors. Along with these topics, I ask Dr. Giannulli about the former Epocrates EHR he helped create which is now owned by Kareo and is offered as a Free EHR.

What do you think about Dr. Giannulli’s comments about helping the small practice physician survive? Will EHR vendors play an important role in making this happen? I look forward to seeing your thoughts in the comments.

November 19, 2013 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.

Study: Opportunities Still Available For HIT Vendors

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.

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 @annezieger on Twitter.

Does EHR Have an Image Issue?

I was incredibly struck by a comment Tom Cox, MD made in reply to Katherine Rourke’s post about “Teaching to the EMR Template.” Here it is in case you missed it:

Of course this is happening. And, physicians in practice see it happening. But, we are powerless to change the system as many of us are held captive by our employer’s choice of EHR. EHR’s are less about health care and more about monitoring of healthcare. So, whether or not the ‘note’ is helpful to others is not important.

We’ve certainly written about EHR backlash a number of times before including my prediction of a coming Physician EHR revolt. However, Dr. Cox’s words about being powerless are quite a challenge and frankly scary.

What’s even more disheartening for me is that EHR doesn’t have to be this way. Sure, billing requirements are onerous and do put some pressures on doctors that do nothing to improve healthcare. The same could be said for meaningful use. However, there are plenty of EHR benefits to consider as well. Unfortunately, I think most of those are getting overwhelmed by some of the bad stories (and there are bad stories).

Many like to blame the news outlets for only covering the bad EHR examples. Certainly I won’t be arguing against laying some of the blame on those of us covering EHR. A disaster can often be easier to write about than an EMR success story. Plus, they’re easier to find. Not to mention readers can’t help but read it. However, I believe there’s something more happening here.

There’s plenty of blame that can be placed on the EHR vendors who do a shoddy job. We can throw some blame on doctors who don’t go through a rigorous EHR selection process or who skimp on EHR training. There’s certainly plenty of blame to go around for why EHR needs an image overhaul.

The challenge with the image of something like an EHR is that there’s no one person that holds responsibility for that image. There’s an entire industry that shapes the image of EHR. The only way to change it is for the industry to change. I only hope the fact that EHR is nearly a requirement for practicing medicine today won’t mean that bad actors will continue to scar the EHR image. My hope is renewed when I meet with EHR vendors who do have the physician and patients best interest in mind.

Maybe all of this is just the reality of the post EHR golden age environment.

October 17, 2013 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.

Investors To Take Greenway Medical Private

Health IT vendor Greenway Medical Technologies has agreed to be taken private by investment firm Vista Equity Partners for $644 million.  The deal, which comes less than two years after the company went public, will roll up Greenway with Vitera Healthcare Solutions LLC, a privately-held EMR vendor which is owned by Vista Equity, Reuters reports.

Vista has agreed to pay $20.35 per Greenway share, about 19 percent more than the stock’s Tuesday close of $17.13 on the New York Stock Exchange. The price is more than the Greenway shares have seen through its existence as a public company. (According to Reuters, the shares saw a lifetime high of $19.44 in November.)

Greenway has said that stockholders owning about 50.9 percent of its shares have agreed to tender in their holdings and vote to push the deal through. All of Greenway’s directors and some of its executive officers have also agreed to do so, according to the Reuters report.

Vista must have seen tremendous value in hooking up Vitera with Greenway. After all, it’s willing to take on a financially wobbly company that lost $5.1 million in its 2013 fiscal year ending June 30 and pay a premium for it. Although Greenway has regularly commented that many of their revenue issues stem from their move to a monthly revenue model.

If nothing else, the deal bulks up both sides to a level that can only help during an era of EMR consolidation. According to the two companies, the combined entity will serve almost 13,000 medical organizations and 100,000 providers. The new health IT company will be marketed under the Greenway brand.

This transaction made me think about a recent post by my colleague John Lynn regarding the status of the EMR vendor marketplace. It’s his view that we’re past the “Golden Age of EHR Adoption” and that things will be tougher for vendors than ever before. Assuming he’s right — and his thesis is pretty hard to argue — we should see a lot more consolidation deals taking place in the near future.

October 14, 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 @annezieger on Twitter.