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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 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 81-85

Posted on August 2, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Time for the second entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

85. Test, retest, and test the network and wireless
Far too many EHR implementations fail because of basic technology issues. Of course, the blame usually gets placed squarely on the head of the EHR company. However, in many of the cases, the EHR company has no control over the issues you have. Your local wireless and network is one place where you can doom an EHR installation and the EHR company can do nothing about it. If you want to have a great EHR installation make sure you have a great network and/or wireless infrastructure set up and tested.

84. Have ONE number to call
This recommendation applies more to large EMR installations than it does to small ones. The basic suggestion is not to give one phone number for EMR issues (ie. I can’t login) and another for technology related issues (ie. my PC crashed). The problem with multiple lines is that people don’t generally know the difference between an EMR issue and a PC issue. At the end of the day, they’re likely to consider almost everything an EMR issue. So, they’re going to call the same number anyway. You might as well just have one number that knows how to triage the issue well and direct them to the right support resource.

83. Remember who the support team’s customers are
Another recommendation for hospital EHR support. It is a great idea to remember that the support team’s customers are the clinicians that are calling for help. Prepare them for the calls they’re going to get. While clinicians are highly educated, that doesn’t guarantee that their education included even basic computer skills. You’ll be surprised how many of the issues have to do with basic computer skills as much as any EMR specific support.

82. Have a communication strategy for when things go wrong
Things are bound to go wrong. So, be ready to communicate those issues. Don’t sweep the issues under the rug either. Communicate more than is necessary. It won’t hurt as much to over communicate as it will to not communicate something important.

81. Make all of your planning very public within your organization
The fastest way to get buy in for an EHR project is to involve your organization in the planning process. Yes, that means that you’re going to hear some harsh feedback from people about what you’ve planned. Be grateful that you’re hearing the feedback during the planning stage when you can work to do something about it. That’s much better than being half way through the project and hearing the harsh criticism of your project.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 91-95

Posted on July 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Time for the second entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I hope you’re enjoying the series.

95. Background check the vendor’s support team
This is such great advice. You’re guaranteed to have to call your EHR’s support number. You want to know what kind of answer you get. Certainly this can be learned by asking current clients of the EHR vendor. Although, don’t just ask the clients the EHR vendor gives you. Also, be sure to call other users of that EHR system to understand what kind of support they get when they have an issue.

Online forums are also a great place to learn about support. Just be aware that online you’re likely only going to read about the best and worst experiences that people have had with an EHR vendor. Of course, you can also always just give their support number a call and see what happens. Cold calling their support could teach you a lot about the type of service they provide.

94. Ask how the vendor ensures disaster recovery and business continuity
This is particularly important when you’re dealing with a SaaS EHR vendor. Don’t be shy asking them for details of how they’re doing this. In fact, if I were an EHR vendor I’d have a nice detailed explanation of how we’re doing it. If they’re doing it right, they’ll be happy to talk through the details.

If you’re considering a client server based EHR software, then some of this will fall to you and your IT team. However, your IT team can often only implement certain disaster recovery and business continuity features if your EHR vendor supports those features. So, be sure to have a competent IT person look over the EHR vendors capabilities. Plus, you might want to put these capabilities in your EHR contract since they often say one thing about disaster recovery and then deliver another.

93. TRY to use a vendor that actually has standards in their system I find this point from Shawn interesting. My first problem with it is that unfortunately we don’t have great standards in healthcare IT (yet?). However, a few that are easily recognized are HL7 and CCR/CCD. I honestly can’t say I’ve seen any vendor that doesn’t support HL7 though. So, since they all do it, that won’t help you much.

The other side of this coin is the various systems that an EHR vendor uses. Do they use a standard SQL database and a common programming language or do they use a proprietary database and programming language? I’m not sure this should be a complete deal killer, but there is some benefit to choosing an EMR system that uses a standard SQL database. Particularly if we’re talking about a client server EMR system. However, for most people this won’t likely have much impact on them. The only exception being that the language and/or database they use might be an indication of how “legacy” their EHR software is.

92. Google “product name + support forum”
There’s some real value for an EHR vendor to have an online support forum. In some cases, EHR vendors have support forums that are run by a third party. I think we can all see the value in sharing experiences using a specific EHR software with someone else who uses that same software. A lot of learning can happen that way. You’ll be amazed at how creative some people are and how vastly different they might use the same software.

My only problem with some of these third party online forums is that it can often mean that the support from that EHR vendor isn’t very good. Why do I say this? Because if the EHR vendor support was better, people wouldn’t have had to turn to these third party forums to get support. You can usually see if this is the case by browsing the threads of the forum and see how many complain about not getting support from the vendor and so that’s why they found the online forum.

I wouldn’t say an online forum is absolutely essential for an EHR company, but if they have one you should know about it and see what it’s like before you buy.

91. Google “product name + Twitter / Facebook / etc…
It seems that I wouldn’t knock an EHR company as much as Shawn does when it comes to an EHR vendor’s presence on things like Twitter and Facebook. Shawn says that it could be a sign that they’re stuck in the past. While this could be true, it could also just mean that they’ve chosen other forms of marketing that fit their skills and abilities.

While I don’t necessarily count lack of social media presence as a huge minus, it can be a huge plus. Twitter has become a great way for me to get support. For some reason companies like to listen more when I broadcast my need in a public forum. So, EHR companies that listen on the likes of Twitter might be a benefit for you when you’re not getting the support you need. Plus, an EHR vendor’s Twitter, Facebook and blog can tell you a lot about the personality of an EHR company. Something that can be really important in your assessment of the company.

If you want to see my analysis of the other 101 EMR and EHR tips, I’ll be updating this page with my 101 EMR and EHR tips analysis. So, click on that link to see the other EMR tips.

Providers Aren’t Taking EMR Training Seriously Enough

Posted on February 16, 2011 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As we noted in a previous post, the latest group of EMR buyers have gotten savvy about support.  As a new study suggests, more than ever, providers are choosing vendors who offer a great deal of handholding.  And that’s probably a good idea, according to Michael Patmas of the American College of Healthcare Executives.  Below,  here’s some of his thoughts on EMR and CPOE project failures.

I have had the unfortunate experience of being in two organizations that had EMR and / or CPOE implementation failures as well as one organization that was successful. A key learning for me was the need to adequately fund training and support. Too often, implementation plans are driven by the vendor who tend to under emphasize the training needs. Simply providing a few hours of hands on training for the physicians is not enough. The real training begins after one flips the switch and providers have to actually work with the system in real time during clinical encounters. That’s when having trainers available to sit with and coach the providers is essential. In every implementation failure I have seen, the organizations under-invested in training and ongoing support.

Sadly, though, many providers seem to cross  their fingers and hope a little training will somehow diffuse automatically into the organization.  This is a dangerously irresponsible stance, but it’s all too common.

In fact,  at three separate community hospitals, I’ve personally witnessed doctors and nurses huddled together over an EMR workstation trying to teach each other how to use the system.  If it made me squirm — under these circumstances, serious  errors like misdocumenting drug allergies are all but inevitable — hospital leaders should be terrified, shouldn’t they?