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What Would You Do If your EHR Vendor Shut Off Access to Your EHR?

Posted on September 25, 2014 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.

Anne Zieger at Healthcare Dive has an interesting summary of a practice who just had their EHR access shutdown by an EHR vendor. Here’s the summary of what happened:

*A small medical practice in northern Maine has been blocked from accessing patient medical records because its EMR vendor has shut them off.
*Vendor CompuGroup says the practice, Full Circle Health Care, won’t get access to its records back until it pays $20,000 in overdue charges to the vendor.
*The medical group acknowledges that it stopped paying CompuGroup $2,000 per month in monthly fees 10 months before the July shut off, but said that was after months of attempting to address what the practice considered to be exorbitant, unexpected maintenance fees and charges for hardware that didn’t arrive.

This is a really challenging situation. No doubt the vendor wants to make sure it gets paid and needs some sort of recourse. Although, if you’ve ever had an EHR on which you relied, you know how important it can be to the care you provide. Just ask anyone who has had their EHR go down. Unless you have great EHR downtime procedures it can get a little crazy. Now just imagine that your EHR was taken down with no sign of when it will be back up.

Of course, we’re a little short on the exact details of what happened with Full Circle Health Care and CompuGroup. I’d love to know how many warnings CompuGroup gave Full Circle Health Care before they turned it off. If they gave them the right number of warnings over a certain period, then I don’t begrudge them for making the decision they made. If they just pulled the plug without very specific warnings about what was going to happen, then CompuGroup should get some of the blame.

This would make for an interesting court case. I imagine there’s previous case law from other industries that would illustrate what would happen. Although, in healthcare we’re not just talking about lost business and financial impact. Turning off someone’s EHR could literally kill someone. That’s pretty scary to consider.

I’m surprised that CompuGroup hasn’t gotten ahead of the story. That’s what I’d want to do if I were in their shoes. Unless the facts don’t put CompuGroup in a very nice light. However, it’s hard to put them in a worse light than they already are in with the story above.

Do you think it’s ok for an EHR vendor to turn off someone’s EHR if they stop paying? Should there be laws that say that an EHR vendor can’t do that? What would you do if you were in this practice’s situation?

For me this is really hard to think about, because if I were at that practice I would never let it get to this point. I’ve heard of a few cases where EHR vendors have become a black hole of unresponsiveness. However, that’s really rare and usually only happens when other really major and scarier things are happening at the company.

If You Were an EHR, Which Would You Be?

Posted on August 6, 2014 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.

I was recently watching a video of Derek Hough, Dancer on Dancing with the Stars (and much more). In the interview Derek was asked which dance best fit various periods of his life. As an #HITNerd, I thought we could do something similar with EHR vendors. So…

If You Were an EHR, Which Would You Be? Are you…

Epic – Single minded, focused and dominating in their sphere. Closed to outside discussions, but very thoughtful and caring of those in your inner circle. A bulldog if someone comes after something you consider important. Built on an aging system that’s done well, but many question how much longer they can be successful on top of such an old platform.

Cerner – The second child who’s done really well for themselves, but wonders why the older brother gets all the attention. They’re successful, well educated, built on a strong foundation, open to improvement. They’ve recently taken on a little bit of baggage. They decided to marry someone who’s been divorced and has four children. We’re not sure how this new marriage is going to work out and how it’s going to impact the family structure.

MEDITECH – This is the middle child. Ahead of their time, but no one notices them anymore. They’re quiet and mostly stay to themselves in their corner. Sure, they’d like to be noticed and get more attention, but they don’t mind too much since they’ve been so successful.

Allscripts – Flashy. Exciting and unpredictable. They’re the one that wears the flashy green jacket to the party. They’ve worked on so many things in their life that it’s hard to really place who they are and what they do. They’ve seen a lot of success, but don’t make us predict what they’ll do next. They seem to have a clear vision of where there going (albeit different than it was 2-3 years ago), but that could change so you have to stay on your toes.

athenahealth – Despite some ADD tendencies, they’ve largely stayed the course on what they want to do and what they want to become. They’re always interesting to be around, because they’re never shy to say what they think or feel about anything. While not as successful as some other people, they still have a lot of potential that could blow up for good or bad. If nothing else, they’re the life of the party and always keep things interesting.

I could keep going, but that’s a good start using a few of the larger or more well known EHR vendors. Which one is most like you? Also, I really hope that many of you will join me in the comments and revise/improve upon what I’ve written or do something similar for another EHR vendor. Let’s have some fun and learn about people’s perceptions of these companies in the process.

Note: Cerner is an advertiser on this site.

Have You Ever Tried to Cancel an EHR?

Posted on July 15, 2014 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.

A caller’s attempt to cancel their Comcast service is going around the internet. About 10 minutes into the call, the husband got on the line and started recording the call for all of us to see how the Comcast retention rep acted. You can listen to it embedded below.

I imagine most of us have had an experience trying to cancel our service at one time or another. It’s not a fun experience. Although, I know some people who call to cancel their cable service every 3 months in order to have the customer retention representative give them a lower cost deal. You know that offering you a 3 month lower cost (or something like that) is one way they try to retain you as a customer.

As I listened to the call, I was thinking about some of the experiences I’ve read and heard about clinics cancelling their EHR service. Unlike a cable or TV service where it’s quite easy to switch services, switching EHR software is a much more involved process. In many cases EHR vendors hold you “hostage” more than the Comcast retention rep above.

In most cases, the EHR vendor will go radio silent on you or responses to your inquiries will take a really long time. Plus, when you ask for access to your EHR data, you’ll often get hit with a hefty price tag. It’s a shameful practice that many EHR vendors employ to try and lock their customers in and prevent them from switching EHRs. We’re entering the era of EHR switching and this is going to impact a lot of practices going forward.

I’ve debated for a while now creating an EHR “naughty” and “nice” list which outlines the good and bad business practices by EHR vendors. One of the challenges is defining what’s naughty and what’s nice. There’s a lot of grey area in the middle. Although, I think that aggregating this type of information would be really valuable. I’m just afraid that many EHR vendors won’t want to share.

I’ve written posts before about why I think holding a practice’s EHR data hostage is a terrible business practice. The medical community is small and an EHR vendor that tries to do this will definitely suffer from negative word of mouth. What do you think? Should we create a list of EHR vendors and their policy on EHR cancellations?

Physician Designed EHR, EHR MU Documentation, and Top EHR Ratings Lists

Posted on March 16, 2014 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.


I really hate this discussion. It reminds me of the republican-democrat debates. They always go too far and both sides (in this case Physicians and EHR vendors) often only see their side and miss the opposite viewpoint. It’s very polarizing. The best situation is the mix of both sides of the equation. Plus, you usually need someone who can help translate and moderate between the two viewpoints. That’s much easier said than done. You can definitely learn a lot about an EHR vendor when you learn if they’re more physician designed or tech designed.


Many people unfamiliar with these standards probably don’t undstand this tweet from Mandi since they assume it’s a standard and so the ONC documentation should be good enough, no? The reality is that every implementation of the ONC standard is different and you have to have documentation of how that EHR vendor implemented the standard.


I appreciate Chandresh’s tweet more than most. I’ve often considered the idea of starting an EHR rating site. They are a dime a dozen and I don’t think any of them are very good. The best ones use some high level filters to help you narrow the search. This has some value, but isn’t really an EHR rating site. The problem with an EHR rating is the sheer scale of responses that you need to collect for it to be valuable. There are 300+ EHR vendors. There are 40+ specialties. There are practices from solo doctor up to hundreds in a multi specialty clinic. There are 50 states. There are hundreds of insurance plans. You get the picture. The number of randomly collected quality ratings you would need is impossible. I enjoy a good list as much as the next person, but just remember what I mention above when you see the next list of Top EHR vendors.

Then again. Maybe Chandresh and I should get together and do an EHR rating service based on if the EHR was a physician designed or tech designed EHR.

Homegrown EMRs with Joel Kanick, InterfaceMD

Posted on December 10, 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.

I had a chance to sit down with Joel Kanick, President and CEO of Kanick And Company and Lead Developer and Chief Architect of interfaceMD. In this video we discuss the story behind interfaceMD and their custom EHR solution. We talk about meaningful use and the EHR incentive money. We also talk about healthcare interoperability and exchange of patient data. Joel and interfaceMD have a really unique approach to EHR that I think many will find interesting.

I was really interested to hear the story behind how interfaceMD came to be. I wonder if people would be interested in a whole series of videos with EHR founders that cover the background story of EHR companies. Let me know in the comments.

Learning about HealthFusion and MediTouch EHR

Posted on November 26, 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.

The following is an interview with Dr. Seth Flam, Co-Founder and CEO of HealthFusion. If you’d like to hear more from Dr. Flam, he’s doing a Meaningful Use stage 2 webinar today at 9:15 PST (12:15 EST).
DrSethFlam
Tell us a little bit of the history of HealthFusion.

HealthFusion was founded in San Diego in 1998 by two primary care physicians. The company started out as a clearinghouse, but has since evolved into a fully integrated software suite – including MediTouch EHR (Electronic Health Records and Patient Portal) and MediTouch PM (Practice Management and Claims Clearinghouse).

What differentiates the MediTouch EHR from the other hundreds of EHR software out there?

First of all, even though the iPad has been part of our culture now for over three years, there are still very few pure cloud EHRs that work natively on the iPad browser. Native is important because with MediTouch, every EHR function that can be performed on the desktop can also be performed on the iPad. Our product was developed from the ground up for the iPad, so the interface is not a “retrofit” from an older legacy desktop one. Instead the interface is a set of buttons that are sized perfectly for fingertip and even work well on the iPad mini.

Now if you couple that with Meaningful Use 2014 certification, I challenge you to find more than a handful of products that meet this profile. But that is just the tip of the iceberg. We are consistently rated by users on average at around 4.5 stars out of 5, so our doctors love us. Because we are an early adaptor of new technology we have the time to not just present new technologies such as the ones required in Meaningful Use 2014, but we have the time to hone those new technologies and make them usable.

It seems that HealthFusion’s MediTouch EHR has been designed for every specialty, but are there certain specialties where it really excels?

Primary care is of course a focus. We are poised to release our comprehensive Patient Centered Medical Home module this month. Our commitment to Medical Home is very strong and I don’t know of any software that makes becoming a tier three medical home easier. Speaking of primary care, we do great with OB/Gyn and Pediatrics – in fact, Miami Children’s Hospital has selected MediTouch as their exclusive private label solution for their hundreds of admitting providers. For Pediatrics, that’s the best validation of our product, especially since MCH is known as the technology leader among pediatric hospitals.

We service most all of the internal medicine specialties, many of the surgical specialties and some niche providers such as pain management specialists. We are the exclusive EHR vendor for the American Osteopathic Association (AOA) and the first cloud-based endorsed by the American Podiatric Medical Association (APMA ). Needless to say, we are very strong with the Osteopathic doctors from all specialty types and simply the best choice for podiatric physicians. And it’s not just us saying that – we have the endorsement of those associations to back it up.

What’s been HealthFusion’s approach to meaningful use?  Are you ready for meaningful use stage 2?

HealthFusion’s MediTouch was actually one of the first 5 pure ambulatory EHRs to achieve Meaningful Use Stage 2 certification. Our whole system was designed with the government standards in mind, which means Meaningful Use is incorporated into the daily workflows of our EHR.

As an additional resource, we recently started hosting webinars on Meaningful Use. The next one is scheduled for November 26th, and will offer a “deep dive” into Meaningful Use Stage 2.

Most EHR vendors that were certified for 2011 have not achieved Meaningful Use 2014 certification. Buyers should be leery of EHRs that cannot meet government compliance standards. We are beginning what I call the “Great American EHR Consolidation.” Simply stated, if your EHR can’t meet Meaningful Use 2014 by the end of this year, you are at a disadvantage heading into 2014. Remember, 2014 is not just about Meaningful Use – ICD- 10 begins in the fourth quarter. Providers need time to prepare for ICD-10, it is even more important than Meaningful Use since it impacts every dollar. Because Meaningful Use 2014 compliance is behind us, we have been able to focus on developing all of the tools providers will require to make their transition to the new diagnosis coding system easier. A simple list of ICD-10 codes just won’t cut it – the tools need to be more sophisticated and we have them today.

How have your doctors and other doctors responded to meaningful use from your experience?

Meaningful Use and other government compliance programs are here to stay. Sticking your head in the sand simply won’t work. In fact, we would not be surprised if the federal government standards that define Meaningful Use spill over to private sector. I think providers liked getting the front loaded incentive dollars but I don’t think they like some of the compliance requirements, and they definitely don’t like the threat of an audit. I am certain that they will find Stage 2 harder, and that is why they need committed technology vendors to help simplify workflows for them. Patient Engagement requirements such as a Meaningful Use compliant patient portal can simplify Meaningful Use, and of course that should be part of the buying decision for physicians.

How are you approaching interoperability?  What will be the key to cracking the interoperability challenge?

With interoperability, the problem isn’t with the sophisticated EHRs, instead it is with the lack of mandated standards and the adoption of those standards. MediTouch responds quickly when faced with a new standard, a good example is Direct Secure Messaging. This is the new standard for secure email. It’s crazy, we adopted the standard in June and our providers have secure email addresses but hardly anyone to exchange mail with today. In the coming months we hope that will change as more EHR vendors implement this standard.

The government makes interoperability challenging because as an example they use HL7 standards alone to define a way to exchange data, but HL7 is at best a “suggestion, not a standard.” What I mean is that there is too much room for interpretation within the HL7 guide to permit seamless interoperability across multiple exchange points. A good example is the immunization registries that are run by state or regional entities. I like to say, if you connected to one state you connected to one state. The work required to maintain and manage 50-60 connections and standards is wasted time that could be spent on better projects. It would have been simple for the government to tighten the requirements so that there was less variation between states, or to consider a national immunization registry with a single standard and connection.

Are you getting many requests to incorporate accountable care (ACO) features into the EHR?  What’s your thoughts on the future of ACOs in healthcare?

First of all, I hope they work. Sharing savings is not a new concept and there have been failures, occasions where quality was sacrificed for short-term financial gain. With EHR technology, we think that there is enormous promise and it starts with great Patient Centered Medical Homes (PCMH). It will take a new breed or a transformed primary care doctor to really make PCMH work because it changes the role of the primary care doctor significantly. Managing patient populations is different than managing individual visits. MediTouch software is committed to making PCMH work for primary care practices so we expect to play an important role in the interplay between primary care medical homes and the ACOs they relate to. The truth is that without great EHR software that supports PCMH, the ACO initiative will fail and therefore we understand that the effectiveness of our software will contribute to better population management, and ultimately the success of ACOs.

Where is Health Fusion heading 5-10 years from now?

We have a nimble group of engineers and we have found that meeting government mandated compliance standards has not been an obstacle that we cannot easily overcome. By complying with Meaningful Use 2014 early we now have time to do what we love and that is innovate. Our innovation process is simple – we listen to our users. As a physician I know that it is difficult for engineers to understand the complex workflows required to manage just a single day in a doctor’s office, and our culture is built on listening closely to the end user – the medical practice.

There are times though that we innovate or create new features that were never requested by a medical practice. Remember, we were designing an iPad EHR solution one year before the iPad was released, clearly that was way before any physician would have requested a system like the one we designed. Steve Jobs invented the iPad even though there was no market for the device prior to its release. A great EHR combines features that are a reach (like the example of the invention of the iPad) with more everyday solutions that refine everyday workflows. Remember, each year the practice of medicine requires more attention to administrative and compliance issues – our job is to innovate at a faster rate so that provider workflow is continually enhanced, and to make sure that patient care is still rewarding for our docs.

Full Disclosure: HealthFusion is a sponsor of EMR and EHR.

One Database Has Distinct Advantages for Data

Posted on February 18, 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.

I recently was talking with an EHR vendor and they made the comment that having their EHR all on one database was a distinct advantage over the EHR vendors who install a new database with every new EHR install. I was intrigued by the idea and could easily see some of the benefits of an EHR vendor having all of the EHR data in one database. When you think some of the future quality programs that could come out, I think there could be some advantages there as well.

Considering this advantage, I started to think about ways that multiple database EHR vendors could level the playing field with their single EHR database comrades. One idea I had was using interoperability to level the playing field. If all the EHR vendors have access to all of the data, then not only will single database EHR vendors not have an advantage, but they’ll be at a disadvantage if they don’t work to exchange the EHR data as well.

When I think about this, it makes me wonder why multiple database EHR vendors aren’t accelerating the exchange of health information. This seems like it would be to their strategic advantage to exchange information.

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.

EMRs Investors Stuck In Old Patterns

Posted on November 7, 2012 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.

Today I read an intriguing piece in The New York Times which looked at different ways capital can be invested, and how over-reliance on one style may be cramping our economy.

In the piece, Harvard professor Clayton Christensen asserts that there are three main models for investing in innovation:

Empowering: These innovations “transform complicated and costly available to a few into simpler, cheaper products available to many,” Christensen says.  Obviously, the reduction of the mainframe into consumer desktops is one example.  These products open up new markets.

Sustaining:  These innovations replace old products with newer ones that improve on the old (his example: The Toyota Prius hybrid).  They don’t necessarily open new markets, as people often buy the improved model instead of the previous version, but they do keep the market moving.

Efficiency:  These innovations reduce the cost of making and distributing products and services, making capital available to keep the improvement process. They generally don’t expand markets at all.

In Christensen’s model, industries cycle through each of these stages and create new markets and jobs in the process. But that engine seems to be stuck in neutral of late, he suggests.

At this point, he argues, VCs and companies with excess cash are focused on a new finance model which discourages investment in brand new, empowering innovations. Capitalists want to make big money but are being channeling into spending only on the third stage of the cycle.

So, why all of this economic analysis in an EMR publication?  Well, because I’d argue that the EMR business has already fallen into just such a stall.  Rather than come up with paradigm-shifting innovations which really empower doctors, vendors are falling over themselves to create more efficient models of the same basic thing.

Not only is that bad for the health IT economy, it’s bad for end users, few of whom are rapturously happy with the basic EMR paradigm.  It discourages innovations that are patient-facing — such as a fascinating three-dimensional avatar I just heard about which can be used as a PHR — since there’s little if any funding for such projects.

Worst of all, focusing on efficiency doesn’t inherently improve patient care either, something we’d hope would be the fundamental goal of any EMR.

Given the stakes involved, let’s hope investors decide that chasing efficiency by reworking old models isn’t the best way to keep the EMR business alive.  Otherwise, we may stay bogged down for many years to come.

EHR Vendors Using EHR Certification Excuse

Posted on October 11, 2012 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.

As most of you have probably figured out by now, I’m not really a fan of EHR certification because I believe there is very little value provided by EHR certification. An interesting additional problem that comes from EHR certification and meaningful use has to do with how EHR vendors are using this as an excuse for why their EHR sucks doesn’t work the way doctors want it to work.

Don’t just think that I’m making this idea up. I first thought about this idea when a doctor wrote me about his experience with an EHR vendor that used EHR certification as an excuse for why their EHR software’s workflow was terrible.

The interaction went something like this:
Doctor: Why do I have to do these extra 5 clicks?
EHR Vendor: That’s required by EHR certification.
Doctor: That provides no value to the care I provide a patient.
EHR Vendor: Sorry, we have to do that for EHR certification.
Doctor: What about this other prompt I get in your EHR? Why does that come up and disrupt my workflow?
EHR Vendor: That’s another EHR certification and meaningful use requirement.

You’ll notice that I made the complaints generic, because they likely could apply to almost any measure in meaningful use and EHR certification requirement.

I’ve seen first hand the efforts that some EHR vendors have put forward to try and make sure that their doctors don’t have this discussion with them. You can be sure it takes a lot of time, energy, and skilled professionals to make meaningful use and EHR certification a seamless part of a practitioner’s EHR experience.

The problem is that many many EHR vendors just ran the EHR certification race and in an attempt to win that race they just slapped something together to meet the requirements. This I want to be the “first” EHR vendor certified mentality is causing many doctors to pay the price today.

Is it any wonder that many doctors look at meaningful use and are upset by the way it’s changing the way they practice medicine?