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EMR, HIE Use Up Sharply In U.S.

A new survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

May 10, 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.

Pay-for-Play Interoperability, Texting in Healthcare, and Health IT Conferences – #HITsm Chat Highlights

Topic One: Is “pay-for-play” interoperability going to derail CommonWell’s goal of building an industry-wide, interoperable framework?

Topic Two: Will texting in health care become a main driver of #patientengagement? Are iOS iMessage texts HIPAA compliant?

Topic Three: Experts claim data breaches are inevitable for health systems. Agree? What can be done NOW to minimize #healthIT security risks?

Topic Four: What’s the next-best #healthIT event/conference you’re attending? Are there other health IT topics that deserve their own event?

April 13, 2013 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.

EHR and mHealth Successes and Fails: Around Healthcare Scene

Patients are somewhat taught to fear sharing medical data. While privacy is important, especially when it comes to health, being more willing to share medical data can yield great results. The key is knowing who to share information with, and who to avoid. 

EHR vendors can be tricky when it comes to keeping clients around. Sometimes, they don’t really have a choice because the EHR holds client information “hostage” when the client says they are switching EHRs. However, this is a sneaky tactic, and there are many other ways to keep an EHR client longer — most importantly, providing a great product.

While many aspects of HIT have come to a halt, mHealth continues to flourish. There are many things that other parts of HIT can learn from mHealth’s success. First, mHealth doesn’t focus on every patient at once. Next, it is an unregulated industry. And finally, the projects are marketed directly to consumers and paid for by them as well. 

Are you a hospital leader and curious about what technologies you should be watching out for? Well, the ECRI Institute has compiled a list of technologies they feel executives should be looking at this next year. This list includes Electronic Health Records, mHealth, imaging and surgery, and more. 

When an EHR fails to work correctly, how do physicians deal with it? Researchers have observed clinical workflows to answer just that question. The observations concluded that while there was no correct answer, many use paper to record information. Hopefully, this study will show EHRs where their gaps are, and help them to correct them.

There are so many consumer medical devices out there. What makes one stand out from the best? And which one has the best form factor? Wrist bands or chest straps…hand held or pocket stored? Chime in over at Smart Phone Healthcare.

March 31, 2013 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.

Are Cloud-Based Health Record Banks Better Than HIEs?

This week a group of researchers published an opinion in the Journal of the American Medical Association suggesting that cloud-based record banks are a better way to share patient health data than HIEs. I think their view is interesting and sensible, and so here’s a short recap.

The authors argue that cloud-based health record banks are a more logical way to share such data than HIEs, reports MedCityNews. After all, as they note, interoperability challenges make it “inefficient” to share patient data, as every organization has to be able to communicate with every other organization where a patient has been treated.

But cloud-based health record banks wouldn’t pose the same challenges, they note.  These record banks would be more scalable and easier for end institutions to use, according to the authors.  Though local providers could keep copies of a patient’s health record, the electronic health record would be stored in a cloud-based bank in the patient’s community, they say.  When patients moved, their records would travel to a different community health data bank.

This approach isn’t just a theoretical discussion. It’s backed by a group called the Health Record Banking Alliance, which was founded by one of the article’s authors, Dr. William Yasnoff, MD, PhD, FACMI, former senior advisor for the National Health Information Infrastructure. The group has developed white papers outlining a proposed architecture and a business model for community health record banking.

My take on all of this is that the cloud-based community health record bank is a very worthwhile idea. After all, in theory it can greatly reduce the amount of infrastructure build out and interoperability issues providers face in connecting to HIEs.

That being said, the HIE concept is firmly planted in the industry’s mind, and despite all of the issues involved in building out HIE networks, I don’t see providers changing gears to embrace a completely new model. What about you?

March 22, 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.

One Database Has Distinct Advantages for Data

I recently was talking with an EHR vendor and they made the comment that having their EHR all on one database was a distinct advantage over the EHR vendors who install a new database with every new EHR install. I was intrigued by the idea and could easily see some of the benefits of an EHR vendor having all of the EHR data in one database. When you think some of the future quality programs that could come out, I think there could be some advantages there as well.

Considering this advantage, I started to think about ways that multiple database EHR vendors could level the playing field with their single EHR database comrades. One idea I had was using interoperability to level the playing field. If all the EHR vendors have access to all of the data, then not only will single database EHR vendors not have an advantage, but they’ll be at a disadvantage if they don’t work to exchange the EHR data as well.

When I think about this, it makes me wonder why multiple database EHR vendors aren’t accelerating the exchange of health information. This seems like it would be to their strategic advantage to exchange information.

February 18, 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.

EHR Interoperability Benefits Not Related to Physician Data Sharing

I always love when someone can take a subject and expand my thinking on that subject. Whenever I thought about EHR interoperability I always thought about it from the perspective of a physician sharing that data with another physician. In this case it would be one EHR sharing with another EHR (possibly with an HIE in the middle). In a recent post, Dr. Doug Fridsma from ONC, (I love that ONC blogs) expanded my thinking when it comes to the possible benefits associated with data standards and EHR data sharing when he shared the following list:

  • Patient safety advocates may want to use EHR systems to collect patient safety information, leveraging existing standards like the AHRQ “common format” for patient safety reporting
  • Providers and researchers may want to use the EHR systems to collect data for clinical research, including patient-centered outcomes research, and to identify patients who could benefit from participating in a research study
  • Providers may want to give referrals to their patients for community services, like smoking cessation or weight management programs, after discussing these topics with them during an office visit
  • Providers working with disease surveillance case report forms may wish to collect additional information about reportable conditions, such as infectious diseases
  • Provider’s office staff can use EHR’s to gain pre-authorization of certain kinds of medical devices where health payers may want to leverage clinical information collected in EHRs to support additional review of expensive medical equipment.

After just publishing my recent post about The Coming Physician EHR Revolt, I can’t help but ask what any of the above items do to help a doctor. The last one could help a physician’s workflow, but the rest of them have limited specific value to a physician. This is one of the challenges with EHR data sharing. Doctors don’t buy and implement an EHR because they want to give better referrals to their patients for community services. There’s a mismatch between providers’ needs and healthcare data exchange desires.

February 5, 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.

Health IT Doesn’t Save As Much As Hoped Due To Interoperability Failures

Does health IT actually save money for health organizations?  That’s a billion-dollar question — one which the whole Meaningful Use program rises or falls, I’d argue — but it still hasn’t been resolved. For what it’s worth, though,  here’s some thoughtful input on the subject.

According to a new study appearing in the journal Health Affairs, always the class act of the health policy game, health IT isn’t generating cost savings because of slow adoption and limited interoperabilityiHealthBeat reports. The research was conducted by the RAND Corporation.

Specifically, RAND researchers say, the productivity and cost benefits of health IT have been held back by:

* Slow adoption
* Reluctance of many clinicians to burn the midnight oil needed to truly master such systems
* Failure of the healthcare system as a whole to implement process changes needed to realize health IT system benefits

Another big issue is lack of interoperability between many health IT systems, the RAND researchers said. They note that previous predictions about health IT savings assumed that systems would be connected, thereby increasing efficiency.

To get savings from health IT, the U.S. healthcare industry needs to do the following, RAND says:

* Patients should be able to access their electronic health data and share those records with other health care providers
* Health care providers should be able to easily use health IT systems across different health care settings
* Health information stored in one IT system should be retrievable by health care providers that are part of other health care    systems
* Health IT systems should be set up to support — rather than hinder — the work of clinicians

No one of these points should come as a surprise, but given the stakes involved, it doesn’t hurt to hammer them home again. The whole interoperability “thing” isn’t going away…

January 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.

EHR Holiday Giving, Teen EMR, and Doctor Emails

We’ve got some really power packed tweets this week. Some really important and terribly challenging topics. Although, first let’s begin with a holiday season EHR tweet:


I always love when EHR is given to clinics for free. As long as they don’t blind side them with support fees. I’ll assume that TECNEX is doing it the right way. I’d love to hear what other healthcare IT vendors are doing to help others this Holiday season.


Sticky doesn’t even begin to address the issues associated with a teen’s patient record. This is a HUGE problem for HIEs as well. This deserves its own post, but answering the question of who controls a teen’s patient record is ugly and complicated in our current cultural climate.


Elin is definitely not alone in this. Very few docs email their patients. This likely won’t drastically change until reimbursement becomes available for that type of communication. Although, if we can simplify the secure email connection enough to help doctors avoid phone calls they’re currently making, we could make some headway. I’m partially working on this problem in my new company Physia. We don’t have the details on the website now, but I’d love to talk with some doctors, practice managers, or hospitals about what we’re working on if you’re interested. Just drop me a note on the EMR and EHR contact page.

December 16, 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.

Motivating Factors for Doctors and Hospitals to Participate in HIE

While attending the Digital Health Conference in New York, I had the chance to sit down and talk with Paul Wilder, Director of Product Marketing and Adoption for the New York eHealth Collaborative (NYeC). I was really impressed by Paul’s understanding of the benefits and challenges of an HIE. He knows them first hand with NYeC’s SHIN-NY project which is connecting all of the various HIE’s and RHIO’s in New York.

I pulled out my camera and asked Paul to talk about the motivating factors for doctors and hospitals to participate in an HIE. I think you’ll enjoy Paul’s answer in the video below. He brings up some ideas related to HIE that I hadn’t heard articulated that way before.

November 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.

From #AMIA: Interoperability Held Back By Politics

When a recent AMIA panel was asked why health IT interoperability was still in its infant stages, members’ responses were the same we’ve been hearing for, I don’t know, a decade or more.  Let’s say that there didn’t seem to have been a lot of hope in the room.

According to Healthcare IT News, true interoperability between health systems is still beyond us due to the same-old, same-old reasons:  Hospitals with hundreds of systems, vendors with proprietary databases, varied standards, health systems that don’t want to share data and a lack of interoperability support from policymakers.

Ultimately, the fact that these obstacles haven’t been overcome is as much a matter of politics as integration problems, the magazine reports:

Charles Jaffe, MD, CEO of standards development organization Health Level Seven International (HL7) described a “circle of blame” involving government agencies and regulators, hospitals and healthcare systems, technology vendors, clinicians, academicians like those at AMIA and, yes, standards development organizations (SDOs), such as HL7. “The policy always preempts the technology,” said Jaffe.

My feeling is that this circle of blame would dissolve in a millisecond if a compelling financial case could be made for interoperability.  Anything might help at this point.

Hey, just prove that interoperability saved a health system $2 a patient somehow, and they might be made to invest in needed changes. Or convince vendors that they’d move even a few units of their product if their systems were freely interoperable, and they’d probably be more cooperative.

At this point though,  you’ve got cross-cutting turf wars going on, with vendors and health systems and standards organizations each pursuing an agenda of their own. And honestly, why shouldn’t they?

With plenty of financial and institutional risk involved, and questionable rewards, I’m not sure how gung-ho I’d be on interoperability if I were a healthcare CIO or vendor exec.

Bottom line: If you want interoperability, it’s got to have a more tangible payoff for everyone involved.

November 12, 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.