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KLAS Gives athenahealth, Not Epic, its 2013 “Best in KLAS” award

While Epic Systems may still be that the giant in the room, according KLAS, athenahealth is the best overall software vendor for 2013.

athenahealth’s taking first place pushes Epic to second for the first time in eight years. athenahealth got the most positive opinions from the thousands of providers participating in the KLAS poll, notably praise for the usability of its athenaClinicals, athenaCollector and athenaCommunicator products, according to EHR Intelligence.

athenahealth CEO Jonathan Bush was all too happy to take a victory lap. “The old guard of each IT leaders is finally being displaced by more nimble innovative models designed for healthcare’s future – not for its past,” Bush told EHR Intelligence.

Epic still remains in first place as for its overall software suite, reports EHR Intelligence. And it took home multiple prizes this year. But there’s a revolution brewing outside the Epic palace, it would appear. Not one that calls for angry peasants and pitchforks, but clearly some level of entrenched discontent is at work here.

Other well-known vendors of EMRs took their lumps as well. For example, Cerner came in at seventeenth, McKesson at 20th, and Allscripts came in 23rd.

So what to make of all of this? As my colleague John Lynn notes, awards of this kind are best taken with a grain of salt. After all, providers don’t need software that wins popularity contests, they need software which they can afford, which can handily meet Meaningful Use standards and which doctors and nurses and other clinicians can use without a hitch. Being sure their vendors win sexy awards really isn’t on their worry list.

Still, the fact that Epic has been unseated after eight years at the top of KLAS’s best vendor list may mean something. Perhaps Epic’s grip on the market is loosening a bit?

February 6, 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.

KLAS Names Top EMR Vendors For Mid-Sized Practices

A new report by KLAS has designated Epic, athenahealth and Greenway as the top three EMR vendors among mid-sized healthcare practices.  The report, which also identified unpopular EMRs in the space, drew its conclusions based on analysis of ability, workflow and integration capabilities, according to iHealthBeat.

To do the study, KLAS interviewed clinicians and IT personnel at practices with 11 to 75 doctors.

Researchers named the top three mid-sized EMR vendors as Epic Systems, which scored a 85.3 points out of 100; athenahealth, which scored 83.5 points; and Greenway, which scored 81.3 points.

Each of the top three vendors distinguished themselves in unique ways.  For example, researchers found that practices liked Epic’s consistent delivery in large hospital-based practices, athenahealth’s “nimble deployment” and system updates, and Greenway’s exceptional service to smaller, independent practices.

Meanwhile, KLAS noted that Allscripts, McKesson and Vitera had the highest percentage of dissatisfied customers, practices which felt stuck with their current EMR system but would not purchase it again.  Reasons for their dissatisfaction included upgrade issues, lack of support, and a perceived lack of vendor partnership, iHealthBeat said.

When it comes down to it, it’s pretty clear when these practices need from their vendors, and a feeling of partnership and mutual support seems to top the list of matter which researchers is doing the study.  But it’s clear that these characteristics can be pretty hard to come by, even from companies you’d think had plenty of resources to deliver a sense of support and availability to their customers.  Allscripts, McKesson and Vitera (although it is Greenway now) had better get their act together quickly, as mid-sized medical practices are a major market, even if they don’t spend quite as much as hospitals.

January 27, 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.

My #BlueButton Patient Journey: Where Are the Smiley Faces?

Smiley faces and patient payment barriers were on my mind yesterday as I spent a few minutes in the patient portals I use (powered by Cerner, and athenahealth, in case you’re interested). I’ll get to my thoughts on user experience in a sec.

First, an update on the Blue Button Connector, which I may have explained in an earlier post. The Connector is an ONC-powered website that will offer consumers an easy way to find providers, payers and other healthcare organizations that participate in the Blue Button initiative. It will also offer developers a way to access Blue Button + technology, “a blueprint for the structured and secure transmission of personal health data on behalf of an individual consumer. It meets and builds on the view, download and transmit requirements in Meaningful Use Stage 2 for certified EHR technology,” according to the ONC.

Originally slated for debut in mid-January of this year, ONC has let it be known that it will delay the release so that when it does go live, it will work well. I’m sure I don’t have to point out the recent events that likely prompted this decision. I’m all in favor of delay to ensure everything works well. A beta version is expected to launch just before or at HIMSS. I may have to reach out to the folks at ONC to see about getting an invite to participate. Stay tuned.

Now, back to my user experience with one of my patient portals. I recently logged into the athenahealth-powered portal to cancel an upcoming appointment. It seemed easy enough to schedule a new appointment, but there was no button or quick link to cancel. I sent a secure message through the portal to the appointment department noting my need to cancel. Because it was less than 24 hours until said appointment, I also called the office as a point of courtesy to make sure they knew of my request. The receptionist who answered told me that sending a message to cancel an appointment is the best option through the portal, as that prompts staff to get back in touch with patients to see if they need to reschedule. A valid point, I thought. I realized not long after that call that I’ll need to reschedule an appointment with a different provider, as my current one is during HIMSS. Hopefully rescheduling will be just as painless.

My recent encounter with the Cerner-powered portal was almost just as painless, leaving me with three observations to share. The first being that I messaged my provider and was pleased to get a response back first thing the next morning. The second being that I attempted to look into a payment balance through said portal, but was put off by the fact that the portal directed me to a third-party site for which I have to set up another account. I wonder why the payment/billion function isn’t embedded into the portal. I’m sure there are underlying reasons patients aren’t aware of, but it sure would be a nice value-add. Unfortunately, I’m the type of patient who, when I encounter a barrier to payment, will set the bill aside and let it languish far longer than it needs to.

And the third being that I, as someone with no medical training, would far prefer smiley faces to numbers when it comes to lab results. Let me explain. Here is what I’m greeted with when I first log into the portal:

portalstats

These numbers don’t mean much, as I’m not aware of what levels are appropriate for my age, weight, height, etc. I think it would be much easier to understand if a smiley or frowny face were placed next to each number, with a small link to some sort of resource that could help me better understand each figure. I think perhaps we tend to overcomplicate things since we have so much technology at our fingertips. At the end of the day, as a patient, I want fast access to my portal and easy to understand information within it.

What are your thoughts on patient portal user experience? Have you seen any emoticons used in clinical settings? Let me know your thoughts via the comments below.

January 22, 2014 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.

My #BlueButton Patient Journey – Laying the Groundwork

After taking the Blue Button Pledge, my next step is to get proactive with my medical records. As I may have mentioned in a previous post, I currently see four different doctors throughout the year. Three of those offer a patient portal. Two of them are in the same practice, and therefore use the same portal. Confused yet?

I think the key to being an engaged patient is to first make sure I can log in to each of these portals. I create bookmarks for them as well. I also make sure I know how to navigate through them and that all of my information is correct and up to date. I take care of the first two items by either looking back at papers given to me during my last office visit, or calling my PCP’s office to ask for a pin code.

Once I’ve looked through my information in each portal (powered by Cerner and athenahealth, respectively), I decide to go even further by messaging my PCP to let her know how my visit to a specialist went. If I don’t let her know now, I might forget many of the details when I see her again towards the end of the year. While I’m in there, I decide to look at my past bills to see why I’m still getting one for a balance I’m pretty sure I paid at my last office visit.

bluebuttondownload

Once those details are seen to, I decide to check out the portal used by two of my other doctors because I seem to remember seeing a Blue Button icon on one of the screens during my last log in. Sure enough, there is a link to “View, download or transmit health data.” Clicking this link takes me to a screen where I can “Support the Blue Button® initiative by downloading your health data and storing it in your personal records.”

I hit download and save them on my computer, but then I’m left wondering, “Now what?” I suppose uploading them to a thumb drive and taking them to whatever provider I see next might be helpful. But I have the sneaking suspicion they’d still prefer paper. Since my PCP’s portal doesn’t offer a Blue Button link to download my data, I decide to message my PCP again to let her know I’d like to see this offered. I wonder if she’ll appreciate the comment, and if she’s gotten the request from other patients.

I feel like my next step should be uploading my health data into some kind of personal health record, but which one? Where do I even start when it comes to selecting something like that? Honestly, the data entry involved with PHRs is off putting to me, which is probably why I haven’t created one up to this point.

What has worked for you and your family? Providers, are there PHRs you find easier to work with (assuming you interact with them at all?) I’d appreciate any reader suggestions and advice you’d care to give via the comments below.

January 16, 2014 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.

CommonWell Announces Sites For Interoperability Rollout

Nine months after announcing their plan to increase interoperability between health IT data sources, the CommonWell Health Alliance has disclosed the locations where it will first offer interoperability services.

CommonWell, whose members now include health IT vendors Allscripts, athenahealth, Cerner, CPSI, Greenway, McKesson, RelayHealth and Sunquest, launched to some skepticism — and a bit of behind-the-hand smirks because Epic Systems wasn’t included — but certainly had the industry’s attention.  And today, the vendors do seem to have critical mass, as the Alliance’s founding members represent 42 percent of the acute and 23 percent of the ambulatory EMR market, according to research firms SK&A and KLAS.

Now, the rubber meets the road, with the Alliance sharing a list of locations where it will first roll out services. It’s connecting providers in Chicago, Elkin and Henderson, North Carolina and Columbia, South Carolina. Interoperability services will be launched in these markets sometime at the beginning of 2014.

To make interoperability possible, Alliance members, RelayHealth and participating provider sites will be using a patient-centric identity and matching approach.

The initial participating providers include Lake Shore Obstetrics & Gynecology (Chicago, IL), Hugh Chatham Memorial Hospital (Elkin, NC), Maria Parham Medical Center (Henderson, NC), Midlands Orthopaedics (Columbia, SC), and Palmetto Health (Columbia, SC).

The participating providers will do the administrative footwork to make sure the data exchange can happen. They will enroll patients into the service and manage patient consents needed to share data. They’ll also identify whether other providers have data for a patient enrolled in the network and transmit data to another provider that has consent to view that patient’s data.

Meanwhile, the Alliance members will be providing key technical services that allow providers to do the collaboration electronically, said Bob Robke, vice president of Cerner Network and a member of the Alliance’s board of directors.  CommonWell offers providers not only identity services, but a patient’s identity is established, the ability to share CCDs with other providers by querying them. (In case anyone wonders about how the service will maintain privacy, Robke notes that all clinical information sharing is peer to peer  – and that the CommonWell services don’t keep any kind of clinical data repository.)

The key to all of this is that providers will be able to share this information without having to be on a common HIE, much less be using the same EMR — though in Columbia, SC, the Alliance will be “enhancing” the capabilities of the existing local HIE by bringing acute care facility Palmetto Health, Midlands Orthopaedics and Capital City OB/GYN ambulatory practices into the mix.

It will certainly be interesting to see how well the CommonWell approach works, particularly when it’s an overlay to HIEs. Let’s see if the Alliance actually adds something different and helpful to the mix.

December 13, 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.

athenahealth Partners With Quality Group To Research EMR Patient Safety

While it’s known that EMRs have been involved with, and probably responsible for, patient harm and even death, research is incomplete and sketchy on what risks are the most pressing and how to avoid them. Plus, we’re always balancing these risks with the potential benefits of EMR as well.

One recent study by the Pennsylvania Patient Safety Authority concluded that EMR default settings for medications caused adverse events in more than 3 percent of cases reviewed by the organization.

But that’s just one study, which can only do so much to help on its own. To get a better grip on such issues, EMR and practice management vendor athenahealth has partnered with Patient Safety Organization Quantros to examine the impact that EMRs are having on patient care. The research project is being funded by athenahealth, according to  a piece in Medical  Practice Insider.

athenahealth is offering its national network of about 47,000 providers free access to Quantros’ Safety Event Manager reporting tool, allowing athena’s EMR clients to submit patient safety data directly to the Quantros Patient Safety Center. Delivering the safety data through a PSO like Quantros insulates providers from liability by offering discovery protections when the practices report and analyze a potential issue, Medical  Practice Insider reports.

As one might expect, athena is mounting the experiment to find out when use of its EMR might have contributed to a  potential adverse event, such as, for example, when the EMR fails to warn a physician that a prescribed drug would interact with a drug the patient is already taking.

The bottom line, for athena, is to analyze the data for patient safety trends, and use it directly to improve its technology, said Tarah Hirschey, athena’s senior manager of patient safety, to Medical  Practice Insider.

November 15, 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.

Big Healthcare Companies Won’t Disrupt Themselves

I’ve been really interested in something Jay Walker, curator and chairman of TEDMED, told me at Xerox Healthcare event at CHIME. I’m not exactly sure how we got into the conversation, but Jay made the comment that “big companies never disrupt themselves.”

I’d love to have had a chance to dive in more to what Jay Walker was really thinking on this subject. No doubt I could tell he’d given it a lot of thought. However, the concept is incredibly intriguing to me and the more I dig into it I realize that Jay is really on to something.

There are so many reasons why a big organization won’t or can’t disrupt itself. This isn’t to say that big companies aren’t without their value. It turns out that large organizations are really really good at optimizing existing business, services and processes. They can squeeze the value out of a current business like no other. However, optimizing your current business is very different than disrupting your business and changing a market. There are just too many incentives for a large healthcare organization to not disrupt themselves.

When it comes to healthcare IT, I think we will see this same concept play out as well. We can look to the large healthcare IT organizations to see how something is going to be optimized, but we shouldn’t expect any sort of disruptive innovation to come from these larger healthcare IT companies. They have so many reasons not to disrupt themselves.

I give Jonathan Bush, CEO of athenahealth, a lot of credit when it comes to understanding this. He literally built a program at athenahealth that he calls “More Disruption Please.” My take on it is that Jonathan Bush wanted a way to spend a bunch of money on things that could disrupt the athenahealth business. This program would allow him to do just that without having to explain that spend to the public markets. When they ask why he spend millions of dollars on these disruptive companies, he can just say “That’s what I told you I was going to do. It’s called More Disruption Please for a reason!” I think it’s pure genius.

Although, even this effort which I call genius really just highlights that the disruption to healthcare is likely going to come from outside large companies. If anything, this program is a way for athenahealth to tap into that disruption so that they’re well positioned to ride that wave of disruption which will surely come.

What disruptions do you see coming to healthcare? And if you tell me it’s coming from a big company, I’ll take a look, but now you’ll know I’m skeptical. Although, I’m certainly happy to be proven wrong.

November 7, 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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. Healthcare Scene can be found on Google+ as well.

Engagement via EMRs, CRMs and State Fairs

Do Your Bottom Line a Favor – Don’t Ignore Social Media
Following up on last week’s post, I’ll give some airtime to a new development from athenahealth, which in my mind further connects the dots between Stage 2 Meaningful Use and social media. The company recently announced that it will now offer Demandforce automated marketing, communication, and reputation building software as part of the athenahealth Marketplace. “Social media has clearly arrived and is not going away. The fact is that our patients are on these platforms with or without us and there’s incredible value in being able to connect with them online,” said Anthony Cerullo, Founders Family Medicine and Urgent Care, in a press release announcing the new offering. “Navigating the waters of patient engagement is challenging in traditional settings, let alone the world of social platforms.”

While he doesn’t mention Meaningful Use specifically, I get the impression that social media is a component of the patient engagement efforts his practice has adopted. A reader’s comment on my last blog post took me to task for assuming providers can even find the time to partake in social networking on behalf of their practice. They lamented that it’s just one more thing to do in a provider’s already too-busy day, and often doesn’t warrant attention because there is no definable ROI.

When a company like athenahealth decides to offer a service like Demandforce, it makes me think that providers might end up shooting themselves in the foot if they willfully ignore the brand reputation opportunities social networking can bring. I’d love to hear more opinions on this in the comments below.

I’m a Consumer. Engage Me!
The North Georgia State Fair will soon open its gates, and while I don’t have plans to attend this year, I wonder if payers in the Peach State would do well to follow in the footsteps of Blue Cross and Blue Shield of Minnesota, which handed out 4,000+ vouchers for free e-visits with providers at the Minnesota state fair. I’m a big fan of engaging with consumers where they already are, rather than taking them/us out of comfort zones in order to gain our business.

flyer

That being said, I feel like my local health system, WellStar, missed out on a great marketing opportunity with their recent mailer for the semi-new urgent care center. I would tape this to my fridge if it offered a $10 discount on my next visit. What consumer doesn’t like saving money, especially when it comes to unanticipated visits to the doctor?

September 12, 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.

Does EHR Help or Hurt Doctors Wanting to Stay Independent?

I’ve been hearing more and more people talk about the challenges that small independent doctors are having in this ever changing healthcare environment. In fact, I’ve heard a number of people proclaim the death of the small physician practice. I’m not ready to carve the gravestone of small practices, but there’s little doubt that the small physician practice is facing a lot of challenges from a lot of different angles.

athenahealth recently did a profile of whe Wilson Stream Family Practice’s challenge to stay independent. It’s a common case that many of us have no doubt seen. Although, what I found really interesting in the profile was they made the case that athenaCollector and athenaClinicals was key to them staying an independent practice. It’s only a two page profile, so check it out to see what I mean.

I found this a really interesting topic of discussion. Does an EHR help a practice stay independent?

As usual, the answer is that it depends. A poorly implemented EHR can put an independent practice out of business. However, the opposite can also be true. I’ve seen a well implemented EHR help a lot of practices get the business of their practice in order. I think an EHR will become even more valuable to an independent practice as the billing and coding rule complexity continues to increase.

One aspect of that reimbursement complexity revolves around the move to accountable care. Many indepents are selling off to hospitals in anticipation of this change, but there is a case to be made for Clinical Integration with your hospital system as opposed to a full on physician acquisition. However, a practice without an EHR won’t have the clinical integration option available to them. A hospital won’t be clinically integrating with a paper practice.

We’ll see what other forces start pressing down on doctors, but an EHR will be a required part of practicing medicine whether your practice remains independent or is acquired by a hospital.

September 11, 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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. Healthcare Scene can be found on Google+ as well.

EMR Costs Outweigh Benefits, Physicians Say

Nobody likes paying for something that’s expensive but not that valuable. But that’s the position many physicians feel they’re in when they buy an EMR, FierceHealthIT reports.

A new study by athenahealth concludes that while physicians do feel EMRs deliver benefits, the expense they have to take on outweigh the benefits EMRs deliver. The EMR vendor surveyed 1,200 physicians, 70 percent specialists and 30 percent primary care doctors to learn more about their attitudes toward EMRs, FHIT said.

The study wasn’t all bad news for EMR use. Thirty-eight percent of doctors had a “somewhat favorable” opinion, and 31 percent had a “very favorable” opinion of EMRs. That being said, 51 percent of responding physicians said that the financial benefits of EMRs don’t outweigh the cost, athenahealth found.

The study found that physicians were more familiar with EMRs than they were when athenahealth did its 2012 Physician Sentiment Index. But doctors’ willingness to buy an EMR  has actually fallen, probably because those who haven’t done it at this late date are particularly resistant. Meanwhile, one thing that hasn’t changed since last year is that doctors don’t think EMRs are made with their practice needs in mind.

Sadly, these results aren’t much of a surprise. While some doctors are adapting to their EMR installation, they’re still struggling with clunky interfaces and questionable vendor support.  Some practices have spent years waiting for their pre-EMR productivity to come back, and have found that it just isn’t happening.

But here and there there are some signs that vendors are “getting it.” For example, I really liked a story John wrote about how EMR vendor Elation requires programmers to shadow a physician as part of the hiring process. To my mind, this kind of thinking is far more likely to bear fruit than the existing system, which puts programmers at a considerable remove from their product’s end users.

The truth is, we’re never going to reach the point where all physicians are EMR boosters, but it’d be nice if we at least reached a point where most saw EMRs as being worth the (big) pricetag.

August 21, 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.