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HIE Cuts Back On Excess Imaging, But Savings Aren’t Huge

For years now, we’ve been told that HIEs would save money and reduce redundant testing by hospitals and doctors.  Until recently, such has mostly been the stuff of anecdote rather than hard results.  But a new study comparing hospitals on an HIE with those that were not seems to offer some of the hard evidence we’ve been waiting for (though the cost savings it finds aren’t spectacular overall).

According to a piece in Healthcare IT News, a new study has come out which demonstrates a link between HIE participation and the level of imaging performed in hospital emergency departments.

The study, which was done by Mathematica Policy and the University of Michigan, found that when hospitals were joined in an HIE, the number of redundant CT scans, x-rays and ultrasounds fell meaningfully, generating savings in the millions of dollars.

To conduct the study, Mathematica and the U of Michigan compared the level of repeat CT scans, chest x-rays and ultrasounds for two groups.  One group consisted of 37 EDs connected to an HIE; the other group was 410 EDs not connected to an HIE.  Researchers collected data on the two groups, which were based in California and Florida, between 2007 and 2010, using the state emergency database and HIMSS Analytics listing of hospital HIE participation.

The researchers found that hospital EDs participating in an HIE reduced imaging across all the modalities compared with hospitals not participating in an HIE.  For example, EDs using an HIE worth 13 percent less likely to repeat chest x-rays, and 9 percent less likely to repeat ultrasounds.

Ultimately, the study concluded that if all of the hospital EDs in California in Florida were participating in HIEs, the two states could save about $3 million annually by avoiding repeat imaging.  This is just fine, but this translates to $3 million in lost revenue for those hospitals. Once you split up $3 million across that many hospitals, you don’t end up with an impressive amount per hospital, but it’s still a cut to revenues. A cut in revenue isn’t a strong motivator to implement an HIE even if it does help to lower healthcare costs.

This is why it’s a real challenge to get many hospitals on an HIE. When you throw in the technical issues involved in HIE membership, it could be quite some time before the majority of hospitals jump on board without more external incentives.

January 21, 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.

Why Secure Text Messaging Is So Much Better Than SMS

One of my most popular articles of 2013 was titled “Texting is Not HIPAA Secure.” Certainly HIPAA compliance is good enough reason for every healthcare organization to implement a secure text messaging solution in their office. Considering the number of organizations I hear are recklessly sending PHI over SMS, I expect this is going to come back and really hit some organization where it hurts. Plus, you won’t be able to hide since the carriers often save the SMS messages for easy discovery by a legal team (which is another reason why SMS isn’t HIPAA compliant). It might take a major HIPAA violation for the industry to wake up.

HIPAA violation issues aside, there are so many other reasons why a healthcare organization should consider using a secure text messaging solution as opposed to insecure SMS as many do today.

As most of you know, I’m adviser to secure messaging company, docBeat (Full Disclosure). As I’ve worked with docBeat, I’ve been amazed at how much more a secure messaging platform can do beyond the simple messaging that you get with SMS. All of these features make a secure messaging option not just a way to avoid a HIPAA violation, but also a better option than default SMS.

Here’s a look at some of the ways a secure messaging solution like docBeat is better than SMS:

Message Delivered/Read Status – I think this is one of the most underrated features of a secure message solution. With an SMS message you have no idea what’s happening with the message. You have no idea if the message has even been delivered to the recipient, let alone read. We’ve all had times where we receive a SMS message well after it was sent. In the case of docBeat, they have a status indication on each message so you know if the message has been delivered to the recipient and if it’s been read. A simple, but powerful feature.

Secure Text to Groups – While SMS is great for sending a message to one individual, it fails when you want to include an entire group in a conversation. The concept of group messaging is really powerful in so many areas of healthcare. Much like the reply to all in email, you have to be careful not to abuse a group text message, but it’s easier to manage since they’re usually short messages that are easily consumed. In docBeat, they offer this group text messaging to a predefined group of users or to an adhoc group that you create on the fly. I especially like this feature when you need help from any one of many doctors, but you’re not sure which is available to help.

Controlled Message Storage – While this has HIPAA implications, the ability to control and audit the messages that are sent is really valuable for an organization. In the wild world of SMS you have no idea what the carrier is doing with those messages. Once they’re on the phone, there’s not an easy way to wipe them off if something happens to the device. With a secure message solution you can control and audit the secure messages. This might include knowing how many messages are sent, how quickly the messages were read, where the messages are stored, etc.

Mobile and Web – In a healthcare organization there are often a lot of people you want to message who don’t have a mobile phone issued by the organization. This often means those people start using their personal device to SMS providers (not a good thing) or they just can’t participate in the messaging. docBeat runs on the iPhone, Android and the web. In most cases, the web option is a perfect way for the non mobile staff to participate in the messaging. Try making that a reality with SMS.

Quick Messages for Common Responses – While many people have gotten very fast at typing on their cell phone, it still takes some time. One way to streamline this is to use quick canned messages for responses you give all the time. It’s much easier to one click a message like “I’m on my way. Be there in a minute.” than to try and type that message into the phone.

Scheduled Messages – Considering the 24/7 nature of healthcare, there are often times when someone is working late at night, but the message doesn’t need to be read until the next morning. Scheduled messages are a perfect solution for this problem. You can create and schedule the message to get sent at a reasonable time rather than waking the doctor up needlessly.

Secure Attachments – While MMS mostly works, I’ve seen where some telcom providers don’t support attachments using MMS. Unfortunately, the telcom provider doesn’t tell you this and so you have no way of knowing that the attachment you sent never made it to the recipient. Plus, MMS works best for pictures. It doesn’t support the wide variety of document formats that a secure messaging provider can support.

Ability to Send Location with Text – While you have to be careful with this feature, it can be a really nice added value to your organization to know their location. Are they sending you a message at your hospital or at their kids soccer game? Knowing this little piece of information can change your workflow so the patient gets better care.

Message Expiration – We could call this feature the snapchat feature. As we saw with the popularity of snapchat, there are times when you may want a message to only live for a certain duration. As is the case with most data retention policies in healthcare, some organizations love this feature and some hate it. Of course, each institution can choose how they want to use this type of feature. In the SMS world, you don’t have a choice. You’re at the mercy of the telcom providers decisions.

Automatic Message Routing to On Call Individual – One of the great features of docBeat is the ability to identify the On Call individual in a group. This was originally applied to docBeat’s call forwarding functionality, but they recently applied it to their secure messaging as well. Now you can message a provider and if they’re not around it can be auto routed to the on call provider. A powerful concept that wasn’t possible before.

One Messaging Platform – This is going to take a while to see fully fleshed out, but those in healthcare are starting to get messages from a variety of sources: SMS, phone, EHR, HIE, Patient Portal, medical devices, etc. As it stands today, those messages have to be checked and responded to in a number of different ways and locations. Over time, I believe each of these messages will be integrated into one messaging platform. The beauty of a secure messaging platform like docBeat is that it can handle any type of message you throw at it. We’re not far off from the day where a doctor can check her docBeat message list and see messages from all of the sources above. The idea of a unified messaging platform is really beautiful and can’t come soon enough.

I’m sure I’m leaving off other examples that I hope you’ll share in the comments. As I look through this list of secure text messaging benefits over SMS, I think we’re at the point where many will choose a secure messaging solution in healthcare because of the added features and not just to try and avoid a HIPAA violation.

January 14, 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.

Scanners – The Forgotten Device Series

Far too often in healthcare IT we get so caught up talking about the big projects, big software systems, and huge hardware buys that we forget about many of the little guys that make so much difference in our lives. This isn’t always a bad thing. When $36 billion in government money is available, we should talk about EHR. Although, there are a bunch of little things that can impact an organization as much as the large projects.

In this series of posts, I want to look at the Forgotten Devices that can make or break a user’s healthcare IT experience but we sometimes forget about them. In most cases, these devices are used multiple times a day and can have a significant impact on the happiness of your healthcare organization. In some cases, these devices are hidden from view, but facilitate all of the work done in healthcare.

To start this series off, we’re going to look at: SCANNERS.
DR-M160
Scanners unfortunately seem to be an afterthought in most healthcare organizations. For some reason we have the false perception that once we move to EHR, we’ll be paperless and so the idea of needing a scanner is somewhat foreign. I know in my first EHR implementation I went cheap on the scanners as I underestimated the volume of scanning that would be required post-EHR implementation. I quickly learned post EHR implementation that I better rethink my scanner strategy.

The reality is that paper still plays a key role in every healthcare organization. It’s really romantic to think of the paperless healthcare environment. However, in many respects EHR software are great at printing out reams of paper. Not to mention paper signatures are still required in many environments. Plus, there are waves of paper coming in from outside your healthcare organization which has to be incorporated into your IT systems. A well implemented scanner strategy is the cornerstone to converting this paper into your IT systems.

The great part is that scanner technology has come a long way as well and comes in a variety of options. You can buy a scanner like the Canon DR-M160 all the way up to the Canon ScanFront 300P network scanner. All of these can handle the heavy workload that’s required in healthcare at a much more reasonable cost than we have ever had before.

Outside of the daily scanning needs, many organizations also have to apply a scanner workflow to their old paper charts. I won’t dig into all of the various approaches organizations take to scanning old paper charts since we’ve done so many times previously. However, many organizations still opt to scan the old paper charts in house. In fact, many still take a scan as you go approach to incorporating old paper records into their EHR. The same scanner you use to capture the daily paper inflow can also be used for this scan as you go approach. Certainly there are even higher volume scanners that can be used for scanning a whole chart room, but those really aren’t necessary for most healthcare organizations.

The other issue many people forget with scanners is doing regular scanner maintenance. This is not a hard task to do, but it will really impact the scanners effectiveness if you don’t do it regularly. There’s nothing more frustrating for an end user than putting the paper in the scanner and having it jam. You can imagine the frustration a busy nurse experiences when she tries to scan something and runs into a jam in the scanner. With proper maintenance, this issue can be generally avoided.

Another major challenge with scanning is handling the document workflow. Most EHR systems support the standard TWAIN driver that comes with most scanners today. This makes it really simple to scan directly into the patient chart. Otherwise, you can build really advanced workflows that are deeply integrated into the scanner software itself. In healthcare, the former is much more common than the later. However, it will be interesting to see how smart scanners continue to improve the scanning workflow.

As with most technology, you don’t need to focus on scanning every day, but it’s important to regularly consider your approach to scanning and whether it enhances or detracts from your workflow. Scanning will be an important part of every healthcare organization for the foreseeable future. If you don’t keep up with the latest scanning technology and regular scanning maintenance, it can have a negative impact on your end users’ experience. Nothing’s worse than hearing about a bad user experience that could have been avoided.

Sponsored by Canon U.S.A., Inc.  Canon’s extensive scanner product line enables businesses worldwide to capture, store and distribute information.

November 20, 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.

21 Tips to Help Advance Female HIM Leadership

As I mentioned in last week’s post, I had the opportunity to attend several sessions at the AHIMA conference on leadership. These sessions focused on the role of female leaders in the HIM industry, and, more importantly, the need to bolster this demographic up from its currently low numbers.

In her session, “Breaking the Glass Ceiling: Are You Up for the Challenge?” Merida Johns, Principal/Owner at The Monarch Center for Women’s Leadership Development, threw out some interesting statistics:

  • 50% of today’s workforce is female
  • 73% of hospital managers are female
  • 18% of hospital CEOs are female
  • 4% of healthcare vendor CEOs are female
  • 25% of senior healthcare IT positions are held by women
  • 79% of female executives think more female executives are needed in the workforce; but only 42% of men feel the same way
  • 92% of AHIMA members are female; yet only 6% hold an executive position

Johns suggested that in order to raise the bar (or break the glass ceiling) to propel more women into HIM leadership positions, we need to:

Develop Career Clarity

  • identify strengths,
  • develop a personal vision,
  • know your purpose and
  • know what you want

Raise Career Ambitions

  • develop big goals,
  • categorize the goals,
  • break the goals into doable chunks,
  • be specific about when you’ll achieve goals, and
  • develop a vision board

Raise Confidence

  • start success and gratitude journals,
  • sideline the inner critic, and
  • be in the right place at the right time

Promote Yourself

  • accept compliments,
  • use social media effectively,
  • display awards,
  • hone your elevator speech and use it, and
  • develop your brand

Amass Social Capital

  • get a mentor and a sponsor;
  • volunteer, connect and promote;
  • use social media; and
  • provide benefits to others

Being that I’m an avid tweeter at events (and a fan of educating and empowering women in healthcare IT), I threw out several snippets of the sessions I was in, which resulted in an interesting dialogue between myself and several other folks:

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How have you taken the lead and advanced to the next level? Whether you’re in HIT, HIM or HC, how did you position yourself to reach that next career phase? Please share your experiences and advice in the comments below.

November 8, 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.

Will Healthcare.gov Experience Prompt HHS to Delay ICD-10?

I don’t think it will be news to anyone reading this that HHS is getting hammered for their implementation of Healthcare.gov. Sebelius congressional testimony was brutal. Certainly the botched implementation of Healthcare.gov will have long lasting impacts on all future HHS IT projects.

While not purely an IT project, I wonder if the experience of Healthcare.gov will have an impact on the ICD-10 implementation. Will HHS be gun shy after the Healthcare.gov debacle that they’ll delay ICD-10 to avoid another one?

My gut reaction is that I don’t think this will happen, but it’s worthy of consideration.

On October 1, 2014, HHS’s IT isn’t ready to accept ICD-10, then you can read the headline already: “HHS Botches Another IT Project.” For those of us that work in healthcare IT, we know that ICD-10 has deep IT implications. Not the least of which will be CMS being ready to accept the ICD-10 codes. While you’d think this is a simple change, I assure you that it is not. Plus, if CMS isn’t ready for this, a lot of angry doctors and hospitals will emerge. It will be a major cash flow issue for them.

We still have almost a year for HHS to get this right. Plus, HHS has had years to plan for this change so they shouldn’t have any IT challenges. Although, if they do have IT challenges this extended time frame will damage them even more. The article will say they had plenty of time and they still couldn’t implement it properly.

With the comparison, there are also plenty of reasons why ICD-10 is very different than Healthcare.gov. In many ways, ICD-10 is a project implemented by companies outside of HHS as opposed to a project run by HHS. First, I think it’s unlikely that HHS won’t have their side ready for ICD-10. Second, their part of ICD-10 is very little compared to what has to be done by outside payers, hospitals, and doctors offices.

If ICD-10 has issues it will likely be seen as the payers or healthcare organizations not being ready as opposed to HHS. That’s not to say that HHS won’t have some damage if they force an ICD-10 mandate and people aren’t ready. They could have some collateral damage from it, but not the same as Healthcare.gov where the product is really their own product.

Plus, if ICD-10 goes bad, consumers/patients won’t know much difference. No patient cares if you code their visit in ICD-9 or ICD-10. They’ll still get the exact same care when they’re visiting the doctor. If ICD-10 goes bad, it will be doctors and hospitals that suffer. That’s a very different situation than Healthcare.gov which was to be used by millions of Americans.

I hope that HHS doesn’t delay ICD-10 based on their experience with Healthcare.gov. If HHS becomes gun shy about any project that IT touches, nothing will ever get done. That’s a terrible way for an organization to function.

November 4, 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.

DoD, VA Move Closer To Joint EHR

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!

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 @annezieger on Twitter.

Leadership Discussions at Healthcare CIO Conference

This week I get to enjoy the company of 750 attendees at the healthcare CIO conference organized by CHIME (officially called the CHIME Fall CIO Forum). It’s always an amazing experience to break bread and learn from people who are dealing with some of the hard challenges of healthcare IT.

One topic that’s always present at CHIME events is a discussion of leadership. So, it was extremely appropriate that Jim Collins was the opening keynote. The guy just exudes leadership. Here’s some of the tweets I sent out during his keynote.

October 9, 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: EMR Default Med Settings Can Cause Harm To Patients

EMR default settings for medications caused adverse events in more than 3 percent of cases reviewed by the Pennsylvania Patient Safety Authority in a recent study, reports Healthcare IT News.

Researchers with the PPSA analyzed 324 EMR default values (preset medication, dose and delivery) that led to adverse events, in an effort to provide the state’s healthcare facilities with data that could help them avoid such problems. Of the total, six errors were led to what were deemed “unsafe conditions”, while 314 events were reported which generated no known harm to the patient.

Researchers found that the most commonly reported error types were wrong-time errors (200), wrong-dose errors (71) and inappropriate use of an automated stopping function (28).

In theory, default values are there to make medication dosing more standardized and efficient in hospitals. But there are situations in which presets can actually cause harm if they’re not used properly, Healthcare IT News said.

For example, in one report, a patient’s temperature shot up after a default stop time automatically cancelled an antibiotic. In another case, a patient’s sodium levels kept rising because a default note to administer an antidiuretc was marked “per respiratory therapy”; nurses, in response to that note, failed to administer the drug since they incorrectly believed that respiratory therapy was giving the patient the drug.

Another two reports involved temporary harm that called for treatment or intervention by clinical professionals. In one case, a patient got a muscle relaxant dose much higher than intended, and another involved administration of an extra dose of morphine too close to the patient’s last dose.

According to a PPSA statement cited by Healthcare IT News, many of these error reports involved a source of erroneous data, most commonly failure to change a default value or user-entered values being overwritten by the system. Errors also took place when a user failed to enter information completely, which caused the system to insert information into blank parameters.

As useful as these observations are, they just scratch the surface of what can be done to improve EMR safety. Hopefully, the new HHS Health IT Patient Action and Surveillance Plan will address and even cure issues that lie beyond the scope of Pennsylvania’s efforts.

September 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. Contact her at @annezieger on Twitter.

Is Remote Monitoring Data A Blessing, Or A Distraction?

This week, Venture Beat reported on some growing remote monitoring efforts in which a handful of Massachusetts hospitals are working to pull the data into their EMR. The hospitals are hoping to get their arms around a growing body of data which increasingly lives not only in wireless medical devices (such as glucometers and pulse oximeters) but also smartphones, smart wristbands, FitBit devices and other health-tracking technology.

One of the players involved in the new effort is Partners HealthCare, whose Center for Connected Health is focused on collecting and making use of such data. Its latest initiative sweeps patient data collected at home — such as blood pressure, weight and blood glucose — into the Partners EMR, making it accessible as part of routine clinical workflow. (The data collected by patients is transmitted wirelessly and automatically subsumed into the EMR.)  Patients can also review the data through a patient portal known as Patient Gateway.

According to Partners, this process is designed to change care delivery by allowing doctors to keep a close watch on patients when they’re not in the hospital or doctor’s office.

This is all well and good, especially for monitoring the chronically ill, whose condition may fluctuate dangerously and require timely intervention. But the question is, is this new flood of data going to be manageable for doctors?  Can a physician managing thousands of patients really give appropriate attention to every data point a FitBit or smartphone produces?  Certainly not.

Perhaps that’s why Kaiser Permanente recently told a conference that it was going to be rather picky as to what data flows into its EMR. According to Lead Innovation Designer Christine Folck:

“Don’t come to us telling us you can upload [data] into our electronic medical record. We don’t necessarily want it there. We have too much information in our electronic medical record. Kaiser Permanente was one of the first to go nationwide with our electronic medical record, we are fully integrated, but the problem is now everybody wants to upload into it. Our physicians don’t want it all there. They really don’t need to know how much exercise each of their patients is getting on a daily basis; they just don’t have time to process all of that.”

So, while there’s clearly benefit to tracking chronic conditions via remote monitoring, it seems clear that there will be some pushback from doctors, who can’t possibly absorb all of the data the healthier “quantified self” types are producing.  It looks to me like we’re going to have to narrow down what categories of data are actually helpful in an EMR and which aren’t.

August 1, 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.

EMRs Slow Rise In Outpatient Medical Costs

EMR use can slow the rise in outpatient medical costs by about 3 percent, according to a new study done by the University of Michigan.

The study examined more than four years of healthcare cost data in nine communities, including doctor’s visit fees and services typically ordered in labs, pharmacy and radiology.

The cost data, which encompassed 179,000  patients, was drawn from the years 2005 to 2009.    Researchers studied three Massachusetts communities that adopted an EMR during this period and six other communities to serve as a control group.

All of the communities, including the three communities that adopted EMRs  – Brockton, Newburyport and North Adams — were participating in the Massachusetts eHealth Collaborative pilot which funded entire cities’ worth of doctors’ offices. The eHealth Collaborative pilot was testing the premise that converting entire communities to EMRs generates the best results.

After analyzing 4.8 million data points, breaking costs down by hospital care and outpatient care, the researchers concluded that the communities which had an EMR in place saved $5.14 per patient per month on outpatient services.

Most of the savings came from radiology. Research leader Julia Adler-Milstein speculates that the presence of EMRs may have led to the ordering of fewer imaging studies because doctors had prior images and full medical histories available to them in the EMR.

Researchers found no reductions in total cost or in hospital costs, a result Adler-Milstein attributes to the fact that community doctors, not hospitals, were taking part in the pilot study.

All told, this is interesting but perhaps not a huge deal. While a 3 percent savings is all well and good, I’d rather see results along the lines of what Canadians have seen. (A recent Pricewaterhouse Coopers study found that EMRs have saved the Canadian health system $1.3 billion since 2006.)

That being said, you can’t fix what you don’t understand. Let’s hope more serious academic attention is given to the problem of how and when EMRs can begin to bend the cost curve in a favorable direction.

July 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 @annezieger on Twitter.