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Study Suggests That Health IT Can Boost Doc Productivity

Posted on November 11, 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.

We’ve all heard stories about medical practices whose productivity crashed when they brought an EMR on board, for reasons that range from workflow problems to training gaps to problems with a wonky system.  But if the following study is right, there’s reason to hope that health IT will actually improve productivity over time, according to a story in Medical Practice Insider.

According to research published in journal Health Affairs, physicians with health IT on board will be able to serve about 8 percent to 15 percent more patients than they could without health IT tools. And in practices where doctors have higher levels of EMR or portal adoption, the spike could be higher, according to the research, whose team includes former national coordinator David Blumenthal.

Meanwhile, practices that adopt emerging technologies such as remote care could allow doctors to perform 5 to 10 percent of care to patients outside of the office visit, and 5 to 15 percent of care could be performed asynchronously, reports Medical Practice Insider.

Another study cited by the article, done by the National Center for Health Statistics, notes that EMRs can offer varied clinical and financial benefits, such as greater availability of patient records at the point of care. And adjunct tools like e-prescribing capabilities and the ability to retrieve lab results can save time and effort, the NCHS study concludes.

These studies are encouraging, but they don’t say much about how practices can manage the workflow problems that keep them from realizing these results. While I have little doubt that health IT can increase productivity in medical practices, it’s not going to happen quickly for most.  By all means, assume your medical practice will eventually leverage health IT successfully, but it won’t happen overnight.

P.S. In the mean time, take a look at this list of factors in creating satisfied EMR users. It might help you speed up the day when productivity climbs.

The Perfect EMR is Mythology

Posted on November 9, 2011 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 don’t know about the rest of you, but ever since David Blumenthal left ONC he’s had plenty of interesting things to say. I think he’s still somewhat cautious, but you can tell he’s given himself more freedom to comment on the state of EHR software and how it could be improved.

One example of this was in Andy Oram’s writeup of David Blumenthal’s speech in Boston a little while back. Here’s one section of Andy’s write up that really hit me (emphasis mine):

Perhaps Blumenthal’s enthusiasm for putting electronic records in place and seek interoperability later may reflect a larger pragmatism he brought up several times yesterday. He praised the state of EHRs (pushing back against members of the audience with stories to tell of alienated patients and doctors quitting the field in frustration), pointing to a recent literature survey where 92% of studies found improved outcomes in patient care, cost control, or user satisfaction. And he said we would always be dissatisfied with EHRs because we compare them to some abstract ideal

I don’t think his assurances or the literature survey can assuage everyone’s complaints. But his point that we should compare EHRs to paper is a good one. Several people pointed out that before EHRs, doctors simply lacked basic information when making decisions, such as what labs and scans the patient had a few months ago, or even what diagnosis a specialist had rendered. How can you complain that EHRs slow down workflow? Before EHRs there often was no workflow! Many critical decisions were stabs in the dark.

Lots of interesting discussion points there, but the one I take away from it is that there’s no such thing as the perfect EMR. Blumenthal is dead on that many doctors have this abstract ideal of what an EMR should be and it will never be that way. Certainly there are benefits to implementing an EMR, but there are also some challenges to using an EMR as well. No amount of programming and design are going to ever change that.

I wish I could find a description I read 4-5 years ago from an EHR vendor talking about the doctors they liked to work with. In it they described that they liked working with doctors who had reasonable expectations of the EHR implementation. They wanted to work with doctors who wanted to go electronic. They wanted to work with clinics that understood that some change was required as part of any IT implementation. From what I can tell, that EHR vendor has basically done just that.

Reminds me of trying to force my kids to do something they don’t want to do. Never seems to end well. Instead, it’s a much more satisfying experience for all when I help them understand why we’re doing what we’re doing. They still don’t like some of the details in many cases, but at least they understand the purpose for what we’re doing.

As long as doctors cling to some abstract ideal of EMR perfection, no EMR vendor will ever be able to satisfy them. A perfect EMR is not reasonable. Just because an EMR doesn’t offer everything that you could dream, doesn’t mean it’s not an incremental improvement over what you’re doing today.

Don’t let the quest for perfection get in the way of incremental improvement. Perfection is more nearly obtained through many incremental improvement than giant leaps.

Costs of Healthcare, Benefits of Healthcare IT and Health Tracking at #chs11

Posted on October 21, 2011 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.

Seems like people really liked my tweets from yesterday at the Connected Health Symposium. So, I thought I’d do it again today. Here’s some of the interesting tweets I saw and wrote during the Connected Health Symposium.

The cost of healthcare was a major theme throughout the entire conference. I agree completely that as patients start to pay more of their healthcare, they need more information and make better decisions.

I found this really interesting. Twitter (and even this blog) doesn’t quite capture the irony of the statement. Basically, Dr. Tippets from Verizon really highlights how if we did IT right in healthcare we have the potential of saving lives and live longer. Both noble goals.

I think Blumenthal might have actually said Healthcare IT instead of EHR, but there’s a lot of overlap in this. I agree with Blumenthal that the media and even blogs like mine love to write about the negative more than the positive. It makes for a compelling headline. Maybe the people behind the good research studies need to promote themselves more too.

This kind of hit me on multiple levels. First, I found it interesting that 15% are tracking their weight and exercise. Is that too low? It’s probably the highest level of any other healthcare data tracking app. I wonder where the rest of the apps stand. The second thing that hit me was the fact that doctors aren’t using this data. Finding some way to make it easy and useful for doctors to use all this collected information is going to be a challenging, but important next step. I’ll be interested to see how EHR companies work through the process of taking that data and integrating it into their EHR software. It won’t be easy, but I believe patients will love this type of integration. Plus, it would encourage many others to start using these medical devices.

David Blumenthal Addresses Disparity in EMR Adoption In Minority Communities

Posted on October 18, 2010 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.

David Blumenthal, National Coordinator for HIT, published a letter today calling on the EMR vendor community to provide EMR opportunities to physicians and other healthcare providers “working within underserved communities of color.”

Dr. Blumenthal also says:

We are writing to solicit your assistance in making sure that we are not creating a new form of “digital divide” and want to make sure that health IT vendors include providers who serve minority communities in their sales and marketing efforts.

I must admit that I’d rarely considered the idea of EMR adoption being a racial issue. I’d certainly put some thought into the community health care initiatives that serve poor communities. I’ve given some thought to the challenges of EMR in a rural health setting. I haven’t given much thought to it being a racial issue. Now that I’ve read this, I’ll certainly be considering this possible “digital divide” more.

My initial reaction is to question why there’s this disparity. I know a lot of EMR vendors and I’m quite sure that they’d be MORE than happy to sell their EMR software to a clinic with no regard to their color or ethnicity. I think it’s reasonable to say that most EMR software companies aren’t deliberately choosing not to serve these “communities of color.” So, it begs the difficult to answer question of why these communities aren’t seeing the adoption of EHR at the same level of other communities.

The other question worth considering is if EMR vendors are missing out on a real opportunity to grow their business if they focused their sales and marketing efforts on these minority communities.

These are definitely not easy questions to answer, but I’m glad that Dr. Blumenthal started the discussion. I know it will be on mind more now.

Number of EHR Certifying Bodies Continues to Increase

Posted on July 21, 2010 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.

An article by Government Health IT’s Mary Mosquera has some interesting data from ONC about the number of EHR certifying bodies there might be available to EHR vendors. Here’s the most relevant section:

So far, ONC has received six or seven completed applications out of the 30 it sent to organizations that have requested them since July 1, said Dr. David Blumenthal, the national health IT coordinator, at a meeting of the advisory Health IT Policy Committee.

ONC released in June its final rule for the temporary certification program, which lays out steps organizations must take to be authorized by ONC to both test and certify that EHRs can perform the functions required for meaningful use.

“We are optimistic that we will have a new landscape in the certification realm in which, instead of having a single certification body, there will be more opportunity, a broader pipeline for certification, hopefully more price competition and shorter waiting times to get certification,” Blumenthal said at the committee meeting July 21.

6-7 applications to certify EHR software and 24 more out there that could come in. That sure blows the initial projection of 5 EHR Certifying body applications out of the water. I’m not really sure the business model for these organization. The customer base is about 300 EMR companies. That’s a pretty small market for these organizations to share.

I imagine this is really bad news for those people at CCHIT too. Mostly because CCHIT’s only product is certifying EHR software. At least other organizations like the Drummond Group do a number of certifications. Who would have guessed that the ARRA EMR stimulus money that looked so promising for CCHIT could become the legislation that drives them to irrelevancy?

Meaningful Use Final Rule Links

Posted on July 15, 2010 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.

Today, I thought it would be interesting to list the meaningful use final rule comments that I know of and to invite my readers to tell me about other meaningful use final rule commentary that they know about. Just reply in the comments of this post or on the EMR and EHR contact us page and I’ll update this post with all the meaningful use final rule resources we can find.

Full Meaningful Use Final Rule, Press Conference Video and EMR and HIPAA MU Thoughts
Comparing the Preliminary Meaningful Use Rule to the Final Meaningful Use Rule Done by Inga from HISTalk and a great resource.
List of Meaningful Use Webinars – Done by EMR and HIPAA
Everything HITECH Analysis of Meaningful Use
Advice on Addressing Meaningful Use – Good advice from the Healthcare IT guy on not being in a hurry to address meaningful use.
Interview with David Blumenthal About Meaningful Use
Mr. HISTalk and John Glaser Reactions to MU (have to scroll down a bit to see the obligatory meaningful use section)
Meaningful Use and It’s Impact on Physician Productivity
HISTalk Initial Comments and Reactions to MU – Just read the comments on this one.
Summary of Meaningful Use Announcement and Rule
CMS Page on Meaningful Use
Meaningful Use Final Rules Are a Big Deal – Wm. T. Oravecz Take on Meaningful Use Final Rule on HITECH Answers
David Blumenthal’s Thoughts on Meaningful Use
John Halamka’s Summary of Meaningful Use Final Rule Changes
Halamka’s Presentation on the Meaningful Use Final Rule
Summary and Other Meaningful Use Documents – The Summary Chart that’s embedded on this is an interesting one. Too bad it’s partially cut off on my screen.
Summary of the 2 Reginas and Meaningful Use – Matthew Holt talks about the 2 Reginas that spoke about Meaningful Use of an EHR
Chilmark Research Quick Meaningful Use Analysis – An always insightful look at healthcare IT
The Fox Group’s Thoughts on Where to Go from Here

I’m sure that there are plenty more. If you know of some good ones, let me know and I’ll add them to the list.

Final Meaningful Use Rules Released Tuesday at 10 AM EDT

Posted on July 12, 2010 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 just came in. The wait is finally over. I guess I know what I’m doing tomorrow.

CMS AND ONC TO ISSUE FINAL RULES ON MEANINGFUL USE AND STANDARDS AND CERTIFICATION FOR ELECTRONIC HEALTH RECORDS INCENTIVE PROGRAM

WHAT: CMS and ONC will host a press briefing to announce the final rules on Meaningful Use and Standards and Certification under the HITECH Act’s Electronic Health Records (EHR) incentive program.

WHO: Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services
Donald Berwick, M.D, Center for Medicare & Medicaid Services, Administrator
David Blumenthal, M.D., M.P.P., National Coordinator for Health Information Technology
Regina Benjamin, M.D., M.B.A, Surgeon General

Dial In: Call in: 800-857-6748
Verbal Passcode: HHS

To watch the webcast live visit www.hhs.gov/live

Relaxing of Meaningful Use Final Rule

Posted on June 25, 2010 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.

There’s a lot of interesting speculation going on right now around what HHS is going to do in regards to meaningful use. There’s no doubt that a lot of the feedback given to HHS on meaningful use surrounded the idea that it was too much and had too many objectives. The question remains, what will HHS do with this feedback?

A number of people have suggested that the meaningful use objectives will be relaxed. In this company is past healthcare IT czar, David Brailer. The interesting part of this chorus is that it includes a large number of providers that say it’s going to be relaxed. Then, they follow up that statement with something like, “If it’s not relaxed, then doctors won’t show meaningful use and will not worry about the EMR stimulus money.” Basically, it will become a failed government initiative if the meaningful use bar is too high.

Other people are suggesting that meaningful use is going to stay the same. Carol Flagg of HITECH Answers quotes the following from David Blumenthal as indication that meaningful use will not substantially change:

“Introducing change in health care is never easy. Historically, adopting our most fundamental medical technologies, from the stethoscope to the x-ray, were met with significant doubt and opposition. So it comes as no surprise that in the face of change as transformational as the adoption of health IT – even though it carries the promise of vastly improving the nation’s health care – some hospitals and providers push back….The question health care providers are facing today is whether we are pushing too hard, too fast to make this important change. I respectfully submit, no. In turn, I ask, ‘Can we make these changes expeditiously enough?… Every provider, every patient throughout our nation will benefit from the goals envisioned by the HITECH Act. Yes, this will be a challenge. While large hospital networks and smaller providers may be stretched to meet national health IT goals, it is not beyond their capacity for growth.”

Little by little I’m leaning this direction. I’m not sure exactly why, but I’m getting the feeling that HHS either can’t or won’t change the meaningful use criteria. It’s basically going to be similar to what we have now with maybe one or two items of note.

What do you think? What will happen with the MU final rule?

Blumenthal HIMSS Address Should Prove Meaningless

Posted on February 7, 2010 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’m preparing for my time at the HIMSS conference. I can tell that the conference is going to be incredibly busy. Plus, I don’t want to over schedule my time since I want to make sure I spend plenty of time discovering new things and smaller companies that are doing really interesting things. Specially related to EMR is best, but even the technologies that make EMR better are great too.

Well, I got an email from HIMSS about one of the keynote speakers. When I looked at the subject line I read “Blumenthal HIMSS Address Should Prove Meaningless.” At first I didn’t realize the email was from HIMSS. I then came to the email again and realized that I’d misread it. The email actually said, “Blumenthal HIMSS Address Should Prove Meanignful.”

Well, I couldn’t help the irony of the misread. Blumenthal has a chance on a pretty large stage to make some important statements. I am interested to hear what he says. I have a philosophy to listen to smart people when they talk. That’s why I loved the chance to hear Marc Probst (HIT Policy Committee and CIO of IHC) and that’s why I plan to listen to Blumenthal. In many respects, Blumenthal holds the keys to billions of dollars in EMR stimulus money. Let’s hope he will provide something meaningful, but I’m not holding my breathe.

As a side note, I’ll be covering my time at HIMSS on this site and on EMR and HIPAA. I’m also hosting a couple meetups at HIMSS which I’ll be announcing tomorrow or the next day.

David Blumenthal on Meaningful Use, Nationwide Health Information Network and CCHIT

Posted on January 27, 2010 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 just found this really nice interview by InformationWeek with David Blumenthal, Health IT Czar. Here are a few snippets of what David Blumenthal said with my own commentary in italics.

Congress set very ambitious goals for the HITECH legislation. The concept of meaningful use is novel, and a very powerful and important concept. The process of defining meaningful use has gone through many months, through many public hearings.

I think David Blumenthal realizes that meaningful use is going to be a major problem for many doctors offices. I think we’re going to hear him blaming Congress for the “ambitious” HITECH legislation which has his hands tied. It probably does, but it’s too bad he can’t just say it that way if it is the case.

The Office of National Coordinator is still committed to developing the Nationwide Health Information Network. Many of our federal colleagues and quite a number of larger healthcare organizations are on the verge of using NHIN as it was originally conceived and configured for their own purposes, and we’re continuing to invest in it.

At its last meeting the HIT Policy Committee adopted recommendations that they have not yet formally transmitted to me to encourage the development of a more flexible, adaptable, less complicated method of health information exchange than the Nationwide Health Information Network. And that’s something that we’ll be studying.

I think this is a good move. This national network in its current state just doesn’t seem like it’s going to have much affect on small doctors offices, which last I checked make up a large part of our healthcare system. I think in politics they call this move taking it to the people.

InformationWeek: Once you get clinicians using e-medical records, who pays to maintain the exchange infrastructure?

Blumenthal: It’s a short-term issue. Long term it’s going to become an expectation on the part of the clinician and patient that information is going to be exchanged. And I think it will become a cost of doing business in the healthcare sector just as physicians and nurses consider it a cost of doing business to buy stethoscopes and run an office.

Doctors will hate to hear this quote. Although, they shouldn’t be too upset. In reality, they’ll be passing this cost on to the consumers. Now how we get to the point Blumenthal talks about is beyond me. That’s a huge gap to cross.

InformationWeek: Will the Certification Commission for Heath IT–CCHIT– remain the organization doing these certifications, or will there be others?

Blumenthal: We’ll have to see what the regulation actually is and see where CCHIT fits in. CCHIT is clearly going to have the option to participate in certification going forward, but I can’t tell you what role exactly it will play.

Translation: I don’t care about CCHIT. If they want to participate great, but I’m playing no favorites here.