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Poorly Done Report that Physicians Lose 48 minutes a Day to EHR

Posted on October 1, 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.

There’s been a study that’s been pandered around making the assertion that Physicians lose 48 minutes a day to EHR. This story in Medical Economics is just one example of many. A comment on that story from Dr. Rah describes generally my feelings about the study:

I find it disappointing that such drivel is even reported. #1. A 2012 survey! Data is > 2 yrs old. #2. 411 respondents is a very small N; hardly significant in that there are at least a million users now of EMRs. #3. You can do better–why report such meaningless info??

Of course, this only begins to describe the flaws in this study. First, they were just asking physicians for their perceived views on how long something took with the EHR as opposed to actual time. As humans, we’re really bad at judging the amount of time that’s passed. Not to mention that many of the respondents were trainees who had no history with which to compare. I could go on and on, but I’ll stop there.

I’m not arguing whether EHR saves doctors time or whether it takes more time. I’ve seen places where both sides of the coin have occurred. So, I think that you could write an article that EHR saves doctors time and another article that talks about how EHR takes more time. You can find both experiences out there. There are hundreds of factors at play that influence the answer to this question.

One thing I don’t think anyone would disagree with is that meaningful use has required a lot more time from doctors. So, when you layer on a new EHR with the meaningful use requirements, then you’re probably going to be spending more time documenting in the EHR. Although, is that the EHR’s fault or meaningful use?

It would be nice for someone to do a high quality study on EHRs and the time a doctor spends. However, when you think about the factors that could influence the time spent: EHR software, specialty, location, tech skill of doctor, meaningful use, not meaningful use, etc etc etc, you can see why we haven’t seen a proper study on the impact of EHR on efficiency. There are too many variations for which you’d have to test.

What Really Differentiates EHR Companies?

Posted on February 8, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My post yesterday on EMR and HIPAA called “Does Spending More on EHR Mean You Get More?” started me thinking what does differentiate one EHR company from another. I think there’s a real disconnect between what most people selecting an EHR use to differentiate EHR companies with what really matters to the users of an EHR.

First let’s take a look at some of the many ways that I see doctors and hospital CIO’s using to differentiate EHR companies. Many use price as an indicator of quality. Hopefully this post puts that to bed. Price matters, but it’s not a great indicator of EHR success. Many are swayed by great sales and marketing by EHR companies. It’s hard to deny that seeing an EHR vendor with a full HIMSS booth doesn’t have some effect on what you think of that EHR vendor. Going along with this is having the big, well branded name recognition. Although, what’s in a name if the EHR software doesn’t meet your specific needs?

Another differentiator that many use is KLAS or other ratings. When I’ve dug into all of the various EHR rating and ranking systems, there are flaws in all of them. Some lack enough data to really draw conclusions. Some use bias methods for collecting data. Some EHR ranking services don’t use data at all. It’s amazing how interested we get in a list that may or may not have any legitimate value. Every EHR vendor has some flashy numbers to share with you. Just remember that numbers can lie. You can make them appear any way you want.

I’m a little torn on the idea of EHR certification and access to EHR incentive money being a point of differentiation for EHR vendors. There are so few that can’t get you there, that it’s almost a non-issue. Sure, if you really want to get the EHR incentive money, you could and should talk to the users of that EHR that have gotten the EHR incentive money. However, because almost every EHR vendor is a certified EHR that can get you to meaningful use, not being certified might actually be a more exciting. The story is reasonable: our EHR focused on what doctors care about in an EHR as opposed to some random government requirements. Could be a compelling message. Especially for those doctors who don’t qualify for the EHR incentive money.

What should be used to differentiate EHR companies?

The number one thing that I think doctors should look for in an EHR is efficiency. A large part of the coming Physician EHR revolt is due EHR software’s impact on physician efficiency. Yet, most doctors selecting an EHR pay little attention to the effect of an EHR on efficiency. This data is harder to get, but a good survey of existing EHR users can usually get you some good information in this regard.

Another area of differentiation with EHR companies should be around their EHR support and training. How quickly an EHR vendor answers support requests and how well an EHR gets you up and running on an EHR is extremely important. As someone on LinkedIn mentioned today, EHR is not plug-n-play software. There’s more to an EHR implementation than just plugging it in and going. It requires some configuration and learning in order to use an EHR in the most effective way.

How come we don’t use the quality of care that an EHR provides as a method of differentiating EHRs? The answer is probably because it’s a really hard thing to measure. I wonder if any EHR has found a way to show that their EHR provides better care. There’s plenty of anecdotal examples, but I wonder if anyone has more data on this.

Another point of differentiation that I think matters is how an EHR company approaches its relationship with the users. Does the doctor, practice and hospital feel like a partner of the EHR company or are they a distant customer. You can imagine which situation is better than the other. This relationship will matter deeply as you run into problems that are unique to your environment. I assure you that this problems will come.

I also see technology approach as a really important factor for EHR companies. When I say this, I think most people start to think about SaaS EHR vs Client Server EHR. Certainly that is one major component to this idea, but it should go much deeper. You can tell by the way an EHR’s technology approach if they’re focused on the right things. Do they take shortcuts when they implement technology? Are they thoughtful about what really matters to the EHR user? Do they implement something on a whim or do they think deeply about the impact of a feature? While every EHR company has limits on what they can put out in a release, they can still provide a great roadmap of the current release and their plans for future releases which shows that they understand the needs of the users.

I’m sure there are many more good ways to differentiate an EHR company. I look forward to hearing more of them in the comments. We just need to expand the discussion to things that really matter as opposed to basing our EHR decisions on vanity metrics.

An Interview with Dr. Nan Nuessle (@DrNanN) – #HITsm Spotlight

Posted on October 31, 2012 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.

For the past few months we’ve been doing a summary of the #HITsm chats that happen each Friday. I once heard Michael Gaspar, who does social media at HIMSS, describe Twitter hashtags as a community of users. I think this is definitely true when it comes to the #HITsm hashtag. With that in mind, I thought it would be interesting to learn more about the members of the #HITsm community and to learn from the members of the #HITsm community.

The first in this series of #HITsm spotlights is with @DrNanN (Nanette Nuessle, MD). She gives some amazing insights. Enjoy!

When did you get involved in social media? What got you started with it?
I got started in social media 2 years ago. I was at a national meeting of pediatricians. One of my colleagues said I needed to be on Twitter. I told her I didn’t know anything about it. She grabbed my phone, asked how the kids in my practice address me, then handed the phone back and said, “you’re on twitter.” I didn’t do anything but follow for 2-3 months. I didn’t really try to build a following until about 18 months ago. Now, I have nearly 4,000 followers.

What benefits have you received from social media?
Social media has given me a way to talk with patients outside the 10-20 minute office visit. I can post information that is specific to my practice, or tell them of late-breaking news. It gives me a vehicle for discussing that late-breaking news with other professionals. My attention to these 2 things has greatly improved my ongoing education. Finally, it has opened career paths that allow me to help other physicians who are transitioning to the use of electronic health records and social media.

Looking at the world of healthcare IT, what do you see as the most important things happening today?
The single most important thing in healthcare today is the budding widespread use of electronic health records. We must remember that this practice is in it’s infancy. It is still the most powerful tool to reach physicians since the development of the stethoscope.

As a doctor, what’s your view of the current EHR world?
The EHR world is in it’s infancy. I have been sending prescriptions electronically since 2005, and using electronic health records for even longer. Many providers are just starting into this world. The potential to change the face of medicine is obvious. We can get the record of a walk-in patient before the front desk finishes registering them for their visit. We have access to all visits and all studies done in-house at all times. However, there are still kinks being worked out that will improve efficiency for providers. This includes day-to-day ease of using an ehr, as well as sharing between different clinical entities (interoperability).

What is the most promising technology for pediatricians?
We live in a mobile society. Most adults don’t live in the same neighborhood or town where they grew up. Most children don’t stay with the same pediatrician from birth to their 18th birthday. For the pediatrician, the HIE is going to be crucial. This will allow us to track immunizations and routine labs for all children as they move through their childhood.

If you could wake up tomorrow and have one part of healthcare solved, what would it be?
I have 2 wishes, Magic Genie. One is to solve interoperability. The other is to see prenatal care and immunizations made free for all people living in the US. The first will revolutionize healthcare in the US, the second will revolutionize health itself.

What health IT issue do you see out there that not enough people are talking about?
Efficiency. Everyone is talking about Meaningful Use and Interoperability. These are certainly important issues. However, without efficiency, providers are going to continue to fight the use of ehrs. Before using an EHR, I routinely saw 30-32 patients a day. Now, I am exhausted at 20-25, depending upon the EHR. My staff complain that it takes over 10 minutes to “room” a new patient because of all the data entry involved. Rooming a new patient used to take 2-4 minutes. Consequently, we are working harder but seeing fewer patients. This translates to less money. Unless we address the issue of efficiency, EHRs will never reach their full potential.

Where or to whom do you look in order to stay up with all that’s happening in healthcare IT? What’s part of your daily routine?
I keep up with healthcare IT in 2 ways. One is by reading daily electronic newsletters, particularly HealthCareITNewsDay.The other is by networking with others in the field.

Any final thoughts?
Electronic health records are in their infancy. For them to grow, we need to nurture providers into this field. There has to be more dialogue between physicians, nurses and IT professionals. We speak different languages. We need to sit down at the table together and share our thoughts without letting our personalities get in the way. I think if this is done the potential in the field of healthcare IT is limitless.