Athenahealth | EMR and EHR

KLAS: Strong Support Distinguishes Top EMR Vendors

Wth EMR usability still shaky at best, it’s the developers that offer hands-on support that score highest when EMR usability gets rated, according to HIT researcher KLAS Enteprises, reports Modern Healthcare.

KLAS, which just completed its report “Ambulatory EMR Usability 2013, More Nurture than Nature,” spoke with 163 providers, specifically leaders of practices with more than 25 physicians. In nearly every case, the magazine said, providers’ greatest frustration was related to vendor relationships, not the software itself, KLAS told MH.

As part of its research, KLAS ranked nine vendors on how well “the typical physician” could efficiently and effectively perform six common EMR tasks/functions, including e-prescribing, medication reconciliation, physician documentation, problem lists, viewing patient information and supporting mobile devices.

Coming out on top was athenahealth, a Web-based vendor, which topped the list for getting providers to usability at first use, and second for having strong handholding relationships with customers.

Epic, which came up second in the overall composite ranking, was number one when respondents asked whether their vendor gave them good support in guiding them to usability. This was true despite the fact that Epic is also well known for usability complaints by physicians, and that Epic is built on configurable modules that lead to a steep learning curve.

GE Healthcare and Greenway Medical Technologies tied for third in the composite scoring.

Meanwhile, Allscripts’ Enterprise EHR and McKesson Corp.’s Practice Partner got low scores for initial usability, the magazine said. Allscripts got higher grades for getting customers situated over time; 74 percent ranked the vendor good or okay as compared with 54 percent of McKesson customers.

McKesson had the most customers of any vendor in the survey reporting that the company was “not good” at helping users with its technology.

So, we have an interesting conclusion here: even if vendors turn out a difficult-to-use product, strong customer support can largely erase that disadvantage. Now, let’s see what happens when a big vendor turns out a product which is easy to use without a lot of handholding…

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June 12, 2013 I Written By Anne Zieger

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.

Tags:Allscripts Enterprise athenahealth Epic Systems GE Healthcare Greenway Medical Technologies McKesson Corp. Practice Partner

EHRs Don’t Support Key Parts of Practice

Ideally, EHRs make the clinical exams more efficient and effective, ultimately saving or even making more money for medical practices. But the reality is that they bypass other parts of the patient encounter where much of the costs and inefficiencies are generated, according to a whitepaper by athenahealth, “The Economics of Patient Workflow: Cracking the Code of Successful EHR Design.”

As the paper notes, 100 percent of practice revenue is generated by the patient exam. Other stages of managing a practice, such as orders and results management, generate 30 percent to 40 percent of costs but no revenue at all. So having an EHR in place which does little to improve exam efficiency — or actually reduces it — is a dangerous thing to do to a practice.

Worse, as the paper points out, there are some major flaws with typical, software-based EHRs:

* They’re too expensive: Typical cost is $33,000 per physician plus $1,500 per doctor per month for maintenance.

* They don’t save money because they slow doctors down: Most EHRs force physicians to do a lot of data entry, much in time-consuming, structured formats.

* They aren’t designed to manage the P4P cycle seamlessly: With most EHRs, doctors have to dig out the data needed to create pay for performance reports.

* They usually don’t offer an efficient, closed-loop solution to the problem of monitoring paper and electronic orders and results: Remember, orders and result management generates as much as 40 percent of practice expenses. EHRs’ failure to make such tracking efficient is a major obstacle for medical practices.

* Few EHRs support follow-up work from orders and results effectively: Most EHRs don’t include built-in management and tracking of patient communications, forcing providers to do inefficient and potentially risky manual follow-up.

The white paper goes on to make the argument that there are several reasons why Web-based EHRs solve these problems, largely by requiring no up front cost, using up less physician time on data entry, optimizing collection of data for P4P programs, digitizing all paperwork and tracking practice results.

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June 3, 2013 I Written By Anne Zieger

Filed Under: EHR Electronic Health Record Electronic Medical Record EMR EMR Technology Healthcare Healthcare IT Pay for Performance Revenue Cycle Management

Tags:athenahealth EHR Data Entry EHR Design EHR Failure P4P Patient Communication Pay for Performance

EMR and EHR Whitepapers

For a while I’ve been considering how the Healthcare Scene network of blogs can provide an EMR, EHR and healthcare IT whitepaper service. Over the many years I’ve been blogging about EMR and EHR, I’ve seen a lot of really valuable whitepapers created by the various EHR vendors. The time required to create a whitepaper is lengthy and for someone looking for an in depth look at a subject, a whitepaper is a nice option.

With that in mind I recently launched a new EMR, EHR and Healthcare IT whitepaper portal. We’re just getting started with the healthcare whitepaper portal, but we’ll be growing the content that’s available there over time. We’ll also be including a nice sidebar widget for those interested in the latest whitepapers we have to offer and we’ll embed a list of whitepapers in the email subscription as well.

We already have a number of great whitepapers available. For example, athenahealth created this whitepaper on Making the Switch: Replacing Your EHR for More Money and More Control. We’ve often talked about EMR switching becoming a very popular and important topic. This whitepaper helps a practice considering the EMR switch to go through an analysis of why to switch EMR or not.

Another whitepaper by NextGen is called The tips and tools to help you on the path to MU (Meaningful Use) and beyond. Considering less than 50% of providers have attested to meaningful use, this could be useful to many. It contains a lot of great resource links and some tips on how to approach meaningful use. If you’re looking at meaningful use stage 2, check out this one from AdvancedMD called Achieving Stage 2 Meaningful Use in Private Practice.

Those are just a few examples. You can find many more of them on this EMR and EHR whitepaper library page. I look forward to adding a lot more interesting whitepapers in the future. Hopefully you’ll find the content valuable.

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April 23, 2013 I Written By John Lynn

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.

Filed Under: ARRA EHR Electronic Health Record Electronic Medical Record EMR Healthcare IT Research

Tags:AdvancedMD athenahealth EHR Whitepapers EMR Whitepapers Meaningful Use Meaningful Use Stage 2 NextGen

Big EMR Vendors Agree To Interoperability Scheme

John’s Comment: See my coverage of the CommonWell announcement on EMR and HIPAA.

Could it be that real interoperability between vendors is on the way? Five big EMR vendors — including three hospital-oriented giants and two doctor-focused players — have come together during HIMSS to announce plans to create common standards for health data sharing, reports Forbes.

Cerner, McKesson, Allscripts, athenahealth and Greenway Medical Technologies have joined to create a new non-profit called the CommonWell Health Alliance. (As most wags have noted, Epic is conspicuously absent from the mix.)

The partners haven’t disclosed a lot of detail as to how they plan to achieve interoperability amongst themselves, but the scheme seems to rely on creating a unique national ID. “Without a national ID and the ability to create true data that can be safely and securely sent between individuals, we are going to introduce new systemic risk back into the system,” Neal Patterson, founder, chairman and chief executive of Cerner told Forbes.

Patterson, public citizen that he is, said that the CommonWell Alliance isn’t a commercial effort but “an obligation.” That certainly sounds lovely, but with five hyper-competitive public companies forming up this effort, I’m skeptical to say the least. Besides, if it’s an obligation, why isn’t Epic so obligated?

John Halamka, Chief Information Officer of Beth Israel Deaconness Medical Center in Boston, has probably sniffed out more of partners’ true motivation. “They’re thinking of it as an enabler for new technologies,” Halamka suggests to Forbes, a move which can “raise the tide for all boats.”

Whether it raises any boats or not, creating interoperability links between these vendors certainly can’t hurt. After all, the more data sharing the better, particularly by major players with significant market share.

That being said, there’s still the matter of Epic being out of the picture, not to mention other major EMR players. How much of a practical difference the CommonWell Health Alliance can make is very much in question.

EMR Vendors Want Meaningful Use Stage 3 Delay

A group of EMR vendors have joined the chorus of industry organizations asking that Meaningful Use Stage 3 deadlines be moved up to a later date. The vendors also want to see the nature of Stage 3 requirements changed to put a greater emphasis on interoperability, Information Week reports.

The group, the HIMSS EHR Association (EHRA), represents 40 vendors pulled together by HIMSS. Members include both enterprise and physician-oriented vendors, including athenahealth, Cerner, Epic, eClinicalWorks, Emdeon, Meditech, McKesson, Siemens GE Healthcare IT and Practice Fusion.

In comments submitted to HHS, the vendors argue that MU Stage 3 requirements should not kick in until three years after a provider reaches Stage 2, and start no earlier than 2017. But their larger request, and more significant one, is that they’d like to see Meaningful Use Stage 3′s focus changed:

“The EHRA strongly recommends that Stage 3 focus primarily on encouraging and assisting providers to take advantage of the substantial capabilities established in Stage 1 and especially Stage 2, rather than adding new meaningful use requirements and product certification criteria. In particular, we believe that any meaningful use and functionality changes should focus primarily on interoperability and building on accelerated momentum and more extensive use of Stage 2 capabilities and clinical quality measurement.”

So, we’ve finally got vendors like walled-garden-player Epic finding a reason to fight for interoperability. It took being clubbed by the development requirements of Stage 3, which seems to have EHRA members worried, but it happened nonetheless.

While there’s obviously self-interest in vendors asking not to strain their resources on new development, they still have a point which deserves considering. Does it really make sense to push the development curve as far as Stage 3 requires before providers have gotten the chance to leverage what they’ve got? Maybe not.

Now, the question is whether the vendors will put their code where their mouth is. Will the highly proprietary approach taken by Epic and some of its peers become passe?

EMR Vendors Buying Physician Market Share

Here at EMRandEHR.com, as well as in blogs across the web, we’ve been predicting that this will be the time when the EMR vendor market will begin to consolidate. I stand by that prediction. But I have to admit that the first couple of deals I’ve tracked have turned out differently than I had expected.

Consider the acquisition of Amazing Charts by Pri-Med, a provider of professional medical education to more than 260,000 clinicians. I would have assumed that Amazing Charts would be acquired by a larger EMR vendor to fill out its offering physicians, but instead, Amazing sold to a publishing company with a huge physician base. In retrospect, it makes plenty of sense, but for some reason I didn’t see it coming.

EMR vendor athenahealth pursued a similar strategy recently when it signed a definitive agreement to buy Epocrates, perhaps the most popular mobile application used by physicians today. athenahealth agreed to pay almost $300 million in cash for Epocrates, 22 percent more than what the mobile app vendor’s’ stock was worth on the day in question, in a move that the EMR company concedes tapped out its credit line.

But costly though the deal might have been, athena is getting a lot for its money. Buying Epocrates adds another one million physicians to its comparatively small provider base of 38,000. If you consider the app itself plus the physician users, athenahealth’s investment seems pretty reasonable. When you consider how costly it is to acquire physicians as customers, a deal valuing them at $300 a physician doesn’t sound astronomical to me.

What I’m getting at, bottom line, is that other EMR players are likely to follow the model established by the Amazing Charts and athenahealth deals. I think this approach — buying, rather than begging for, new physician relationships — makes a great deal of sense. What about you?

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January 9, 2013 I Written By Anne Zieger

Filed Under: EHR EHR Market Electronic Health Record Electronic Medical Record EMR Healthcare IT Market

Tags:Amazing Charts athenahealth EMR Acquisitions EMR Consolidation EMR Mergers Epocrates Pri-Med

Farzhad Uses Twitter to Call Out EHR Vendors

When it comes to ONC, I think a few things have always been clear:
1. ONC has its heart in the right place.
2. ONC hates the government restrictions that have to work within as much as the rest of us.

If you’ve ever had a chance to meet with someone from ONC in person, then you know the first item to be true. They really do have a sincere desire to improve healthcare in America through the implementation of IT. Not only do you see that in person, but their actions compliment this as well. In fact, I’d say that they’re some of the most sincere parts of Washington DC that I’ve ever met.

The challenge comes with the second point. ONC has to work within the legislation and government regulations that they’re given. I once posted about Blumenthal’s HIMSS adress as being meaningless. Someone at ONC found it and asked what they could do to make his address more meaningful. I told them nothing, because he was subject to the government muzzle. I think they’re reply was something like, “Many of us here don’t like the government muzzle either.” Another simple example of how they are very sincere people at ONC. I wonder if Blumenthal could offer a non-muzzled speech now.

I say all of this as background for a tweet that Farzad Mostashari sent out to EHR vendors. The thing I love most about this tweet is that Farzad is using the farthest extent of his power possible to push forward health IT within the government framework. This is no easy task, but I think Farzad’s tweet is brilliant:

Hey, EHR vendors! tweet a pledge to do View/ Download/Transmit in 2012. Will shout out on Monday. #ONCPledge #VDTnow #HealthIT4U

— Farzad Mostashari (@Farzad_ONC) September 7, 2012

I think the ONC pledge is still being considered by many EHR vendors. I know how EHR companies make decisions and so this won’t be any different. However, Farzad already posted this tweet with EHR companies that have made the pledge:

Have pledged to let patients view/download/transmit by @himss: @eclinicalworks @athenahealth @soapware @greenwaymedical #ONCPledge #VDTnow

— Farzad Mostashari (@Farzad_ONC) September 8, 2012

I’ve also seen tweets from NextGen and Azzly. We’ll see if others pop up on the #ONCPledge hashtag.

Oh the power of a tweet! Can you imagine how simple, but powerful Farzad’s request could be? No complicated legislation. No expensive stimulus. No mind numbing regulation. Just good old fashioned public pledge to do what’s right. I wonder how else this could be used.

EMR Note Cloning, Meaningful Use, and Doctors Entering the Social Media World: This Week in Healthcare Scene

EMR and HIPAA

Understanding Meaningful Use Stage 1 and Stage Deadlines — Meaningful Use Monday

Zub Emsley, CEO of ChartLogic, Inc., was a guest poster at EMR and HIPAA last week. He talks about the different stages of Meaningful Use, upcoming deadlines, and the potential penalties for missing them. The “tipping point” for EHR adoption has been reached, and Emsley discusses some important topics for anyone involved in EHR adoption to hear about.

Are We Ready For ACOs? Security, Process Issues Abound

The EMR industry is continually growing. With more medical technology being developed as well, this growth probably won’t be slowing down anytime soon. Katherine Rourke predicts that EMRs will look different just 18 months from now, and describes her feelings in this post.

Wired EMR Doctor

EMR Note Cloning is Scarier Than I Thought

One issue that occurs with using EMR is cloning. While some doctors try hard to avoid cloning as much as possible in clinic notes, it sometimes happens accidentally. Dr. Michael Koriwchaz describes some of his “accidental cloning” and how it sometimes can be difficult to avoid cloning in certain situations. He talks about how these experiences made him realize how cloning is “scarier” than he thought.

Smart Phone Health Care

Is Meaningful Use Slowing the Growth of mHealth?

As David puts in this post, “mHealth is cool.” Unfortunately, it appears that many doctors and hospitals aren’t using all this new technology as much as they ought to. The monetary incentive to implement EHR/EMR in practices seems to be the main catalyst for doctors. David explores some of the reasons why mHealth isn’t growing as quickly as it it could be.

Tips for Doctors Entering the Social Media World

As the world of social media and health care merge, doctors are finding it more necessary to become involved. However, it may not be as easy as one might think. It involves a lot of time and patience, but the benefits are great. Find out some great tips, reasons to become involved, and discover 10 doctors who have embraced social media successfully.

EMR and EHR Videos

Attaining Meaningful Use with athenahealth

ateneahealth, a distributor for medical billing, practice management, and EHR services, are “dedicated to liberating doctors and patients from the administrative expense and stress of the health care system,” according to the company website. The company’s co-founders, Tood Park and Jonathan Bush, pride themselves in knowing how hard those in the medical field work because they ran a medical facility at one time. Because of their dedication in helping others be successful in meaningful use, they have helped 85% of their providers get paid for it. In this video, atenahealth explains how they did that and gives encouragement to those hoping to attain meaningful use.

Health 2.0 Boston

I’m in Boston enjoying meeting with a lot of really smart people at Health 2.0. As usual, the biggest value of the conference is the people you meet and the hallway conversations you have with those people. I’ll certainly be doing posts over the next couple weeks related to those conversations.

The other highlight of Health 2.0 was hearing Jonathan Bush speak. He was in true Jonathan Bush form and he’s great because you can guarantee that he’ll never give the same speech twice. As one person said in the hallway, the connection between him thinking it and him saying it is very short. It’s so short that it has no filter. My biggest complaint with Jonathan Bush’s talk was that they only gave him 20 minutes on stage. Not nearly enough.

For those who couldn’t make it, here’s the main points that Jonathan Bush provided:
1. “Don’t bite off more than you can chew.”
2. “You need your partner’s ‘id’ as well as their signature.”
3. “Culture trumps capability.”

This is all really good advice for healthcare startup companies. One other thought from Jonathan Bush:

.@Jonathan_Bush compares entrepreneurial survival to paramedics’ attention to the ABCs…focus on first things first. #health2con #EMS

— Carissa O’Brien (@CarissaO) May 15, 2012

Here are some other good takeaways from Health 2.0 Boston that were tweeted out:

Steve Krein: Introductions are easy, being prepared for the meeting and what follows is hard #health2con

— Matthew Holt (@boltyboy) May 15, 2012

Very good advice and appropriate at Health 2.0 Boston since the focus of it is about partnerships.

The core problem is “uncompensated care.”#health2con

— EMR, EHR and HIT(@ehrandhit) May 15, 2012

There’s a compelling story if you look at how much uncompensated care physicians provide.

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May 15, 2012 I Written By John Lynn

Filed Under: Healthcare Healthcare IT mHealth

Tags:athenahealth Carissa O'Brien Health 2.0 Health 2.0 Boston Healthcare Startup Companies Jonathan Bush Startup Companies Steve Krein Uncompensated Care

Do Privately-Owned EMR Vendors Offer Better Customer Care?

When a company like Greenway Medical Technologies (NASDAQ: GWAY) goes public, most of the post-IPO talk centers on what its leaders will do with the money.

Ideally, the newly-rich EMR vendor will do customer-friendly stuff like improving their product and strengthening their technical support organization. In reality, though, public companies have a different focus; their job is keeping the Wall Street folks who own their shares happy.

Since happy largely means only one thing — increasing profits and earnings per share — that vendor isn’t likely to take on new expenses. No, it’s more likely to find ways to charge more and sell more, rather than doing a better job of showing love to its existing customers.

SRSsoft’s Evan Steele has shared a nice analysis of how KLAS customer support ratings (for companies serving the 6 to 25 physician practice) compare with the vendor’s financial status. While they’re not exactly scientific, Steele’s conclusions are still striking; he concludes that five of the top six vendors are privately owned.

Now, I’m not sure how that correlates with another KLAS data point, in which publicly-held EMR/practice management vendor athenahealth (NASDAQ: ATHN) was named as top-ranked provider for its cloud-based EHR in December. Its stock has also been on a generally upward climb for the past 12 months, ranging from $39.87 to $72.70 per share.

Is it possible athena is managing to please both its customers and its investors? Well, if the typically nasty gossip you see on athena’s discussion board is any indication, no. It looks like grouchy insiders are shorting the stock, which some expect to plunge below its starting price to $30/share or so fairly soon.

That being said, one particularly intriguing comment suggests that Cerner (NASDAQ: CERN) is eyeballing athena, which observers think would be a good fit.

Cerner fits the profile I’ve outlined: it’s huge, profitable and what’s more, in need of a product to fill the physician niche it doesn’t own. If you think Cerner could just build its own physician presence, look at GE’s decision to drop doctor-oriented Centricity Advance. Clearly getting doctors to buy was much harder than it looked at first glance.

Cerner doesn’t need athena to build its margins: analysts expect it to see sales growth of 13+ percent this year, to $2.5 billion or so. It should also see earnings growth of 22+ percent to $2.25 per share.

Buying athena would give Cerner a critical medical practice presence, and at the same time, let athena keep its customers happy without forcing it to play only for a Wall Street audience. In this situation, at least, maybe an EMR vendor can have its cash and eat it too.

KLAS: Strong Support Distinguishes Top EMR Vendors

EHRs Don’t Support Key Parts of Practice

EMR and EHR Whitepapers

Big EMR Vendors Agree To Interoperability Scheme

EMR Vendors Want Meaningful Use Stage 3 Delay

EMR Vendors Buying Physician Market Share

Health 2.0 Boston

Do Privately-Owned EMR Vendors Offer Better Customer Care?

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