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What if the FDA Started Regulating EHR?

Posted on March 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

In the world of mobile health, we’ve often talked about what will happen if the FDA starts to regulate the various mobile health apps out there. In fact, the FDA has come out with some pretty detailed guidelines on what mobile health applications and devices need FDA clearance. To date, the FDA has stayed away from any regulation of EHR software.

On my ride to the airport after the Dell Healthcare Think Tank event, we had an interesting and engaging conversation about the FDA when it comes to EHR software. Some of the discussion was around whether the FDA would start regulating EHR software.

Shahid Shah suggested that it was extremely unlikely that the FDA would touch EHR software at least until meaningful use was complete and the current President was out of office. He rightfully argues that this administration has hung their hat on EHR and the FDA wasn’t going to step in and stop that program. Plus, Shahid suggested that ONC wouldn’t let the FDA do it either. Janet Marchibroda from the Bipartisan Policy Center was hopeful that Shahid was right, but wasn’t as confident of this analysis.

After hearing them discuss this, I asked them the question:

What would happen to the EHR Market if the FDA started regulating EHR?

Shahid quickly responded that the majority of EHR vendors would go out of business and only a small handful of companies would go through the FDA clearance process. Then, he suggested that this is exactly why the FDA won’t regulate EHR software. FDA regulation of EHR would wipe out the industry.

This is a really interesting question and discussion. The reality is that there are a lot of similarities between EHR software and medical devices. One could make a really good case for why the FDA should regulate it like medical devices. One could make a case for the benefit of some rigor in the development of EHR software. However, there’s no appetite for such a change. In fact, the only people I’ve seen calling for it are those who think that EHR is unusable and potentially harmful to patients. I’m not sure FDA regulation will make them more usable though.

Now, juxtaposition the above conversation with this post by William Hyman titled “A Medical Device Recall of an EHR-like Product” In this case, the FDA announced McKesson’s voluntary recall of it’s Anesthesia Care system. This software was tightly integrated with other FDA regulated medical devices. I wonder what this means for other EHR software that is starting to integrate with a plethora of FDA cleared medical devices and other non FDA cleared medical devices.

I’m personally with Shahid in that I don’t think the FDA is going to touch EHR software with a long pole. At least, not until after meaningful use. After meaningful use, I guess we’ll see what they decide to do.

Epic EMR Training, Glucometer Workflow, New Media Meetup & MU Success

Posted on January 26, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.


I think this is true for all EMR software, but particularly so for Epic. It’s always amazing how many skimp on EMR training and then pay the price for it later.


It’s a little hard to see, but illustrates the challenge associated with connecting these external data devices. It’s going to take a while for this to be commonplace and normal. I do find it interesting that they’re using Direct and the hardest interface to build (sending info to the EHR) is “Out of Pilot Scope.” I guess they don’t want to take on the hard stuff in the pilot.

These next 2 tweets are a little self serving since they point to posts on my EMR and HIPAA site. If you’re not subscribed to that site, you should go and do that now. Plus, one of these tweets is about a party at HIMSS, so I don’t imagine I’ll get any complaints there.


I hope to see many of you at HIMSS 2014!


I appreciate Dr. Webster recognizing this as a good one. While I’m biased, I think it’s a really important topic that needs more discussion. Although, I’m pretty sure it won’t be getting me an invite to any ONC dinner parties.

Consumers Are Ready For Wearable Tech

Posted on January 15, 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.

Though they’re pretty, interesting and fun, I’ve never taken wearable devices that seriously as a force that could have impact on healthcare delivery in the here and now.  Well, it seems that I was wrong.  While it’s not certain that the health system can afford these devices — they don’t exactly come in at an easy consumer price point — it seems consumers are ready to use them if given the chance.

According to a new study by Accenture, more than half of consumers “are interested in buying wearable technologies such as fitness monitors for tracking physical activity in managing their personal health,” according to a report in Health IT Outcomes.

According to Accenture, consumers were primarily interested in devices like smart watches and wearable smart glasses such as Google Glass, even though these devices are not yet available commercially.  Consumers were also very interested in phablets, an emerging device category combining smart phone and tablet PC functions.

I can’t help think that this is a very positive trend.  For one thing, consumer wearables can be an important gateway to remote patient monitoring, something that’s less likely with devices that are used and put aside, like wired glucose monitors, pulse oximeters and blood pressure cuffs.

What’s more, wearables can fit into a healthcare ecosystem in which devices talk to one another and other wireless systems (such as their desktop, laptop or smart phone), whereas the other smart devices I’ve mentioned have less flexibility in that arena.

So, who pays for the wearables?  At least at first, it will probably make more sense for providers to invest in these devices and use them to conduct tests of remote patient monitoring and its impact on care.

But as consumers pick up the wearables themselves, providers might want to focus on building a network which seamlessly integrate these devices, as it seems almost a given that consumers will buy them when they’re available and affordable.  It will take years to get that right, so now it’s probably time to start. Get prepared for the Internet of everything!

Forrester’s Take On Computing Trends For Next Year

Posted on 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.

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?

Windows 8 Enables Healthcare Tablet Adoption

Posted on August 20, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 post by Scott Thie, Vice President, Healthcare and Education, Panasonic
Scott Thie - VP of Healthcare and Education at Panasonic
Technology is evolving at light speed, and the way healthcare providers work is changing with it.

Mobile computing technology that was unimaginable five years ago is now commonplace, and has driven efficiency and productivity in healthcare by leaps and bounds. Doctors, nurses and healthcare administrators now have the ability to work from virtually anywhere, storing data “in the cloud” and staying constantly linked to the patient and one another.                   

One of the primary computing devices enabling this mobile evolution has been the tablet – a light weight, powerful and easy-to-use device that has gone from a niche product to widespread healthcare enterprise adoption. Tablets are an excellent way to boost mobility and workflow efficiency, and their role in healthcare continues to grow. Tablets’ portability, flexibility and ease of use have made them a great fit for health business applications of all kinds. In fact, over the next five years total shipments of tablet computers to enterprises around the world are expected to increase at a compound annual growth rate of 48%, according to Infinite Research.

It’s clear that tablets offer improved productivity and mobility, but this technology evolution has not come without its growing pains. In many cases, tablets are so attractive to users that many of them have not waited for their employers to issue them; they’ve brought their own personal devices to work. In other cases, healthcare providers have issued devices to their staff that are better suited for consumer use and lack critical security, durability and functionality features. This has resulted in a fragmented IT management landscape consisting of myriad devices with different operating systems, security challenges and support needs.

Recently, the technology industry has seen a shakeup that could play a large role in addressing this issue. Last fall, Microsoft released Windows 8, the most dramatic overhaul of its operating system since 1995. Offering a redesigned interface and several new features, the operating system is built for mobility, security and manageability. And when paired with enterprise-class hardware, Windows 8 opens the door for healthcare providers to embrace the benefits of tablets, without sacrificing on security, functionality and management capabilities.

Windows 8 Advantages

One of the most obvious benefits of Windows 8 is its redesigned metro interface. Built to take advantage of touchscreen technology, the interface offers enterprise professional users the fast and fluid efficiency and personalization found on today’s popular consumer devices. The operating systems use of swipe, tap and drag gestures allows users to easily switch between applications and multitask. While multitasking is a business reality, it’s a challenge for some tablet operating systems, potentially limiting worker productivity. The Windows 8 interface also includes live updating tiles, which can help business users retain situational awareness.

With the recent boom in mobile devices, many healthcare IT departments have been forced to integrate incoming tablets – with alternative operating systems and potential security risks – into legacy device management, security, and system integration structures. It can be difficult to securely and efficiently integrate mobile devices with newer operating systems like Android or iOS into a legacy Windows IT infrastructure, and often puts healthcare administrators into a “troubleshooting” mode instead of devoting their resources to ensure optimal patient care.

Designed with mobile productivity in mind, Windows 8 allows providers to avoid compromising on mobility, functionality and security by integrating seamlessly with legacy enterprise IT infrastructure. With Windows 8, users have the ability to use the same operating system in desktop and tablet environments. Not only is the IT department supporting a single operating system, users benefit from a seamless and familiar operating environment across all their devices.

Security is a critical need in healthcare technology, and Windows 8 offers several features not found in many other tablet operating systems. Secure Boot, for example, is a boot-up process that helps prevent malware from running at startup. Unlike some mobile app download services, Microsoft vets each app included in the Windows Store for quality and safety before making it available for download.

From an IT management perspective, a key benefit of Windows 8 is its ability to work with existing software and hardware. Many business-critical applications, especially in the healthcare segment, are designed to run on Windows. It’s also integrated into the enterprise in other ways, such as the many third-party cloud and software-as-a-service providers using Active Directory for identity management. Windows 8 works with mobile device management (MDM) systems as well, including offering features to secure devices from unauthorized use.

Choosing the Right Device

Equally important as the operating system is the right hardware. Purpose-built tablets, designed specifically for challenging environments, offer the durability, ease of use and warranty support that healthcare providers require, without compromising on security or manageability.

Before investing in a tablet deployment, verify that the device will offer the features your care providers and healthcare facility demand. Something as simple as a user-replaceable battery, which many consumer devices lack, could be a potential life-saver for doctors and nurses remotely accessing critical patient data. In other cases, it may be as simple as a tablet with a daylight-viewable screen, which ensures a clinician can work efficiently regardless of lighting challenges. Some hospital workers may need a device that can be used with a digitizer pen for signature capture or an all-touch interface for easy manipulation of medical images or text.

The most common causes of mobile computer failures are drops and spills. These dangers are magnified for healthcare mobile workers. Tablets should be engineered to be rugged enough to withstand a fall to a hard surface, sealed to withstand spills and dust, and easily sanitized help to ensure reliable operation.

With computer hardware such as tablets, it’s also important to understand the difference between price and cost. Even at an enterprise level, it’s natural to gravitate toward the lowest sticker price. However, if that device has a high failure rate, hinders productivity, lacks enterprise-level support or has a short standard warranty, it will end up costing more in the long run – not just in replacement costs but also labor costs, inefficiency, the loss of critical data, reduced patient satisfaction and more. Think about products in terms of their total cost of ownership in order to get the most for your money.

Tablets represent a turning point for the healthcare industry, with the promise of new efficiencies, methods of decision-making and competitive advantage. By making the right technology decisions, healthcare providers can ensure their physicians, nurses and medical staff are equipped to take advantage of these gains without compromise.

Scott Thie is Vice President of the Healthcare & Education Sectors for Panasonic System Communications Company of North America (PSCNA). He is a 24 year veteran of the technology industry and has been with Panasonic since 1998.

Scott began his career at Panasonic as an Area Sales Manager. He was promoted to Regional and then National Sales Manager before his current position. Scott has been recognized several times with awards including Rookie of the Year and Area Sales Manager of the Year. He successfully developed Panasonic’s Field Service Vertical and managed its growth for five years. During his career, he has held positions in sales and sales management, as well as management of marketing, business development and sales engineering. Scott’s current challenge is driving growth and extensively expanding PSCNA’s Healthcare Sector. Before joining Panasonic, Scott was District Sales Manager at Alps Electric, a company specializing in printers and OEM PC components. He was also Regional Sales Manager for Philips Electronics. Scott holds a BS degree in marketing with a minor in sales management from Ferris State University.

Developing Safety Critical Healthcare Software

Posted on June 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 Healthcare IT Guy, Shahid Shah, has a great post up on his blog about writing safety critical software using an agile, risk-based approach. Here’s a portion of the blog post where Shahid really hits the nail on the head:

Much of that [every software being custom] changed in the 90’s and then upended even further in the early part of the 21st century; we should no longer weighed down by the baggage of the past.These days even our hardware is agile and extensible, real-time operating systems are plentiful, software platforms are malleable, mHealth is well established, and programming languages are sophisticated so we need to be open to reconsidering our development approaches, especially risk-based agile.

Why should we use “risk-based” agile? Because not every single line of code in software can or should be treated equally – some parts of our medical device software can kill people, many parts merely annoy people, but most other parts simply aren’t worth the same attention as the safety-critical components. When you treat every line of code the same (as is often true in a plan-driven approach) and you have a finite amount of resources and time you end up with lower quality software and less reliable medical devices. It’s not fair to blame the FDA for our own bad practices.

I’m always amazed by Shahid’s knowledge and ability to describe something in simple terms. I should know since I’m often on calls with Shahid since he’s my partner in Influential Networks and Physia.

The irony is that in the EHR and mHealth world you could argue that many have taken too much of a lean approach to building their applications while the medical device world treats every part of the software as a patient safety issue. Now if we could just bring the two together into a more reasonable balance of what’s important from the safety side and what’s not.

As far as I can tell, the FDA is planning to mostly stay out of regulating the general mHealth and EHR side of healthcare IT and will stick to the medical devices and mHealth devices that fit under the medical device term. I think this is generally a good thing for a number of reasons. Not the least of which is that the FDA doesn’t have the expertise needed to regulate EHR software. However, I wouldn’t mind a touch more patient safety concern from EHR vendors. Maybe the EHR Code of Conduct will help add a little more to this concern.

Of course, as Shahid points out, you don’t have to sacrifice agile software development to develop safety critical software. This is true in medical device development, EHR development, and even mHealth development.

eHealth Pilot Helps Chronically Ill

Posted on May 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.

An 18-month pilot in one of Rio de Janeiro has demonstrated that even a small amount of health IT tools, applied to the right population, can have a significant effect on targeted patients’ health.

To conduct the pilot, the New Cities Foundation and GE Healthcare set out to test out a model which would improve access to primary care in a poor urban community, reports PMLive. (Note: The New Cities Foundation was established by GE, Cisco and Ericsson.)

The partners gave a clinic in the Santa Marta favela in Rio a GE-created eHealth kit, capable of fitting in a backpack, which contained a set of tools to measure key health indicators.  The materials in the kit, if purchased by outside parties, would usually cost about $42,000.

Clinic staff used the portable set of tools to visit 100 elderly patients living with chronic illness and mobility issues, in an effort to offer these patients a comprehensive diagnosis, the publication said.

According to a report created on the project by the Foundation, the results were substantial. Cost savings due to avoiding adverse clinical events included $4,000 (heart failure) to $200,000 (kidney failure) per 100 elderly patients.  Meanwhile, the pilot saved $136,000 per 1,000 patients by avoiding hospitalizations of those with cardiovascular diseases.

Time and time again, research shows that proactively providing preventive care takes costs out of the health system. This model, which seems like it could be duplicated easily in the U.S., should be tested widely in urban “health deserts” here. Any approach which brings primary care to where the frail, immobile elderly are seems almost guaranteed to be a winner.

EMR Ready: The Smartphone Physical

Posted on April 9, 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.

Here’s the kind of thinking that makes me wish I was going to TEDMED 13 (John Lynn will be there if any other readers are attending.).  At this years’ show, a team of current and future medical professionals plan to do a complete “smartphone physical” for attendees, using a bunch of devices that appear to be compatible with an iPhone. Not only is the data immediately readable as the testing goes on, it’s EMR-ready, too, both pretty neat features.

Check out just how thorough the physical is going to be (courtesy of the TEDMED blog):

• Body analysis using an iHealth Scale.

• Blood pressure reading using a Withings BP Monitor.

• Oxygen saturation/pulse measured simultaneously with blood pressure, using an Masimo iSpO2 placed on the left ring finger.

• Visual acuity via an EyeNetra phone case.

• Optic disc visualization using a Welch Allyn iExaminer case attached to a PanOptic Ophthalmoscope.

• Ear drum visualization with a CellScope phone case.

• Lung function using a SpiroSmart Spirometer app to conduct a respirometer test.

•Heart electrophysiology using the AliveCor Heart Monitor.

•Body sounds: A digital stethoscope from ThinkLabs auscultates and amplifies the sounds of a patient’s lungs and heart.

• Carotid artery visualization using a Mobisante probe.

Participant Shiv Gagliani, a Johns Hopkins medical student, tells TEDMED that the smartphone physical can improve doctor-patient relationships, as the real-time, audible and visual results help connect patients to the tests and increase their understanding of their bodies.  Not only that, the patients can help gather the data themselves, increasing their engagement with their care.

And of course, the devices that make the smartphone checkup possible are also very portable, making it possible for doctors to take them wherever they go, be it down the street or across the globe.  What’s more, less-trained global health workers will be able to use these devices to gather baseline readings and via telemedical links, get instructions on how to treat patients. This device connectivity is part of what John suggested was needed for successful Telehealth.

To learn more about this project, visit http://www.smartphonephysical.org/. I’d definitely take a look; it seems to me that this type of mobile health technology is here to stay.

Keys to Successful Telehealth

Posted on April 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

Rob Sobie wrote a nice post on the Point of Care Corner blog about the 4 Keys to a Successful Telemedicine Launch. These are the 4 keys he offers:

  • Reliability
  • Ease of Use
  • Mobility
  • Flexibility

Most of the ideas are pretty self explanatory, but check out the full post for his explanation of each item. I agree with each item, but I think there are a number of other things that are needed for successful telehealth as well.

Multiple Application Support – While we’d love to have the entire Telehealth experience on one application, it’s unlikely to ever happen. While doing a Telehealth visit, the doctor is going to need access to a number of other applications such as their EHR. This is where the dual monitor Telehealth setup is so beneficial. They can have the Telehealth visit up on one screen while they browse their EHR or other health application on the other screen.

Telehealth Reimbursement – I recently asked an insurance company executive about Telehealth and if they’re really start reimbursing for it. He said they were happy to reimburse a Telehealth visit, as long as they had a way to know that there was indeed a visit that justified payment. You can see where they’re afraid of Telehealth reimbursement fraud. His solution to that was reimbursing Telehealth systems that were their trusted partners. With this in mind, you want to make sure whatever Telehealth solution you use is trusted by the payers so that you get paid.

Device Connectivity – One of the challenges of Telehealth is the ability to get device information from a patient. There’s a new wave of Telehealth technologies that are incorporating medical devices into the Telehealth experience. Integrating Telehealth and devices really takes Telehealth to the next level and since the cost of devices is dropping dramatically we’re going to see more and more integrations. Just be careful because many Telehealth platforms won’t have the forethought to do this type of device integration.

I’m sure there are other keys to Telehealth success. I’d love to hear your additional ideas in the comments. Where are you seeing it implemented? What’s been most successful?

I believe the Telehealth market is set to grow like it’s never grown before. The technology and infastructure are in place for it to become a reality. Things like shared savings will drive adoption of Telehealth as a way to lower costs. The article linked above says that Telehealth is projected to be a $27.3 billion industry in 2016. I’m personally looking forward to the shift to Telehealth.

One Doctor’s EMR Usability Wish List

Posted on March 18, 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.

In this space, we talk a lot in the abstract about how physicians feel about EMR usability. Today, though, I wanted to share with you some great observations from a KevinMD.com piece by an angry anesthesiologist who lays out her own usability wishlist for EMRs and health IT generally.

In the piece, Dr. Shirie Leng fumes over the sheer work it takes for her to negotiate the systems she uses at her hospital. She notes that over the course of doing eight cases during a day, she’ll a) sign something electronically 32 times, b) type her user name and password into three different systems a total of 24 times and c) generate about 50 pages of paper given that the the computer record must be printed out twice.

To Dr. Leng, there’s ten steps institutions can take to eliminate much of the hassle and waste:

1. Eliminate user names and passwords:   She suggests using biometric sign-in technology.

2. Eliminate the paper:  Why print data that’s already entered into the system, she asks?

3. Make data systems compatible and 4. Make everyone statewide use the same system:  Dr. Leng says it’s crazy that we don’t have interoperability within hospitals or between different institutions.

5. Don’t make her turn the page:  “All the important information about a patient should be on the first page you open when you look at a patient,” she says. “I shouldn’t have to click six different tabs.”

6. Don’t make her repeat herself: If she does several cases the same way, with the same documentation each case, don’t make her re-enter it every single time.

7. Invest in voice-recognition software:  During patient interviews, Dr. Leng notes, she wants to look at patients and talk, not hunt and peck at the keyboard or worse, spend hours later typing in data or clicking checkboxes.

8. Go completely wireless:  Not an EMR point, but a good one nonetheless: why make doctors untangle cords and monitoring wires?

9. Hire a typist if you need one:  Don’t turn nurses into data entry clerks, she argues. Right now they have massive amounts of data entry piled onto their plate.

10. Triple back-up the system:  Paper doesn’t crash but computers do, she notes.

So there you have it, a list of EMR and health IT concerns straight from a practicing physician. I think all her points deserve attention.