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Will EHR Vendors Become Service and Consulting Companies?

Posted on October 14, 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.

This is the topic of a really interesting LinkedIn discussion: Will EHR Vendors Become Service and Consulting Companies?

I think this is a really great question and one that’s worthy of serious consideration. I think we’ve seen this happen time and time again in the IT industry. Some of the best examples are IBM, HP, and Dell. As their IT hardware and software becomes a “commodity” then they leverage their relationships and domain expertise to change into a service and consulting company. Usually this also involves them spending their extra cash to acquire the leading consulting company (or companies) in the industry as well.

In some ways we’re already seeing this happen. Epic announced a consulting division of their company in order to retain their senior staff. Cerner’s always made a good chunk of their money from consulting services.

Of course, thanks to meaningful use incentive money and some still massive upgrade costs, EHR vendors haven’t needed to shift their business model to a service and consulting model yet. There’s still plenty of money to be made just selling the software, training, etc.

What will also be interesting to watch is whether the large service and consulting companies like Accenture, IBM, HP, Dell, etc. will eat up the market share so that the EHR companies don’t have as much of an opportunity to grow a service and consulting business. No doubt it will be a big dog fight. Not to mention many of the current EHR consulting companies (although, you could see many of these getting acquired by the EHR vendors).

I guess my short answer to this question is: In the short term, we’re not likely to see a massive shift towards services and consulting, but long term it’s very likely to happen. What are your thoughts?

Many US Consumers Would Switch Doctors To Gain EMR Data Access

Posted on September 17, 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.

Evidence continues to mount that consumers not only accept EMRs, but want to have access to the data they contain. The latest on this subject comes in the form of a new Accenture survey, which concluded that 41 percent of US consumers would be willing to switch doctors to obtain online access to their EMR data.

To get a sense of how consumers are responding to the EMR revolution, Accenture surveyed more than 9,000 people in nine countries.  The survey sought to assess consumer perceptions of their doctors’ electronic capabilities across nine countries: Australia Brazil, Canada, England, France, Germany, Singapore, Spain, and the United States. (The survey included 1,000 US consumers.)

Researchers with Harris interactive, which fielded the study, found that at present, roughly one third of US consumers (36 percent) have full access to their EMR. However,  57 percent of consumers surveyed are self-tracking their personal health information, keeping data on items such as their health history (37 percent), physical activity (34 percent) and other health indicators such as blood pressure and weight.

Other survey results suggest that consumers on something of a collision course with doctors when it comes to access to medical data. While roughly four out of five consumers (84 percent) believe they should have full access to the EMR data, only one third of doctors (36 percent) agree.  The same study found that the majority of US doctors (65 percent) believe patient should have only limited access to their records.

These results strongly suggest that sharing full EMR data with patients is likely to become common practice in the future. After all, it seems that engaged patients are most of the way there already, and will continue to put pressure on doctors to open up the kimono for the foreseeable future.

P.S.  This data dovetails nicely with another recent report by independent research firms Aeffect and 88 Brand Partners which concludes that almost 50 percent of patients take EMR access into account when they consider choosing a  healthcare provider.

EMR, HIE Use Up Sharply In U.S.

Posted on 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. Contact her at @annezieger on Twitter.

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.

Doctors Want Patients To Update, But Not Have Full Access To EMRs

Posted on March 12, 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.

So, it seems that doctors are willing to open up the kimono, but only so far. A new Accenture study has concluded that while most U.S. doctors surveyed are ready to have patients update their electronic health record, only a minority believe patients should have access to their full record.

Accenture, which announced these results last week at HIMSS, did an eight-country survey of 3,700 doctors cutting across Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.

When it came to U.S. doctors, 82 percent reported that they were comfortable having patients update their own EMR data. But when asked, less than a third (31 percent) felt that patients should have access to their full record. Sixty-five percent felt that  patients should have limited access and 4 percent no access at all.  (Interestingly, the results were similar across all eight countries, Accenture reports.)

Breaking things down further, while almost half (47 percent) of U.S. doctors surveyed felt that patients should not be able to update their lab results, most said patients should be able to update several types of information, including:

* Demographics (95 percent)
* Family medical history (88 percent)
* Medications (87 percent)
* Allergies (85 percent)

Most doctors (81 percent) also believe patients should be able to add clinical updates to records, specifically self-measured items like glucose and blood pressure levels or new symptoms.

On the other hand, only 21 percent of doctors surveyed currently allow patients to have online access to their medical summary or patient chart, despite the fact that 49 percent believe that giving patients access to their records is crucial to providing effective care, Accenture said.

Doctors Dump Small Practices To Join Large Providers

Posted on November 5, 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. Contact her at @annezieger on Twitter.

Intimidated, in part, by the health IT expenses they’re expected to bear, doctors are leaving private practices to seek jobs with large healthcare organizations, according to a new study by Accenture.  The need to purchase EMRs certainly isn’t the only reason doctors are jumping ship, but it is one of the most important reasons, the firm found.

Accenture interviewed 204 doctors in May, drawing from an even mix of primary care docs and specialists across equally-divided sections of the U.S.

The study results projected that only 36 percent of doctors will remain part of an independent practice by 2013, down from 39 percent this year and 57 percent in 2000. (I knew doctors were streaming into integrated health systems but that blew my mind.)

According to the Accenture survey, 53 percent of doctors responding said that EMRs requirements drove them to look for employment with big health organizations.

Doctors are also spending big on updated practice management, billing and scheduling applications. My guess is that in some cases mobile health spending is beginning to rear its head as well, even in smaller practices. After all, while doctors generally bring their own devices to the party, practices may see it as in their interest to own mobile gear and applications as they become more central to care delivery.

On the other hand, health IT may also be the saving grace for some. Doctors who do remain independent are likely to offer telemedicine or online consultations to help keep their profits at an acceptable level, researchers found.

Readers, I doubt any of you are too surprised by Accenture’s findings. I doubt public policy planners are either.

Given these realities, I’ve always wondered why no one has proposed re-structuring Meaningful Use for smaller organizations to account for the disproportionate effect such investments have on the smallest practices, say those with five doctors or less.  Incentives are all well and good, but if we don’t want to see independent practice all but wiped out, perhaps some up-front grants are in order.

Many Hospitals May Not Meet MU Goals By 2015

Posted on January 25, 2011 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.

John’s Note: I’d like to welcome accomplished healthcare journalist, Anne Zieger, to EMR and EHR. Anne has a long history in the healthcare IT space and I’m really looking forward to her contributions to EMR and EHR. I’ll still be posting on EMR and EHR as well and of course on EMR and HIPAA. However, I’m excited to bring another voice to EMR and EHR. Welcome Anne!

Nobody said that meeting Meaningful Use standards for EMRs would be easy, but if a new Accenture study is any indication, things are even worse than they seem out there.

Accenture argues that hospitals have a a staggering amount of work to do, and that few are ready. If they hope to get to MU compliance by 2015, hospitals going to have to think differently about change management, plan for a long, tough project, spend heavily and find qualified new personnel.

According to the study, less than 1 percent of health systems were mature EMR users in 2009.  What’s more troubling is that if Accenture is right, only half of U.S. hospitals will meet MU criteria by  2015. That could mean penalties of $3 million to $4 million per year for a 500-bed hospital, the consulting firm estimates.

Why are hospitals and health systems lagging behind?  They’re underestimating how hard the MU compliance job is — and getting blindsided what can be an 80% jump in costs during the transition.

My question:  are these massive transformation headaches and eye-popping costs are inevitable if you want to prove Meaningful Use of an EMR?  Or will hospitals that run lean IT and plan well enjoy a smoother ride?