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#HIMSS14 Highlights: the Snail’s Pace of Interoperability

Posted on February 26, 2014 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Ah, HIMSS. The frenetic pace. The ridiculously long exhibit hall. The aching feet. The Google Glass-ers. As I write this, day three for me is in full swing and I’ve finally managed to find some time to reflect on what I’ve seen, which includes a ridiculously long taxi queue at the airport, more pedicabs than I can count, beautiful weather and lots of familiar faces, which is what makes HIMSS so much fun. I’ve heard lots of buzzwords and sales talk, and seen only about an eighth of the exhibit hall, barely scratching the surface of what’s out there on the show floor.

Several common themes stand out based on the sessions and events I’ve been to, and the passions of those I’ve encountered. Whether it’s vendor breakfasts, social networking functions, exhibit elevator pitches or educational sessions, interoperability and engagement are still the buzzwords to beat. This particular HIMSS has given me a different perspective on each, and offered new insight into what’s happening with the Blue Button Connector. I’ll cover each of these in HIMSS Highlights posts over the next several weeks, starting with interoperability.

The industry seems far more realistic this year regarding interoperability – downright frustrated by the slow pace at which such a lofty goal is proceeding. Industry experts Brian Ahier and Shahid Shah perhaps expressed it best during a lively panel discussion at the Surescripts booth:

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Putting vendors’ feet to the fire will certainly initiate a quick and painful reaction, but probably not a sustainable one. True momentum will occur only when providers get singed a bit, too. Panelist comments at a Dell / Intel breakfast on analytics for accountable care brought this into sharper focus for me. The fact that too many disparate EMRs (and thus too many vendors poised to cause inertia) are making it hard for analytics to successfully be adopted and utilized at an enterprise level, highlights a bigger problem related to hindsight and strategy.

From my perspective – that of an industry observer and commentator – it seems many providers felt compelled to purchase EMRs because the federal government offered them money to do so, and hopefully just as many were optimistic about the role technology would play in positively affecting patient outcomes. Vendors saw a great business opportunity and moved quickly to develop systems that met Meaningful Use criteria (not necessarily going for best-fit as related to workflow needs and usability). Neither group truly knew what they were in store for, especially regarding longer term plans for health information exchange.

Providers now find themselves wanting to move forward with health information exchange and greater interoperability, but slowed down by the very IT systems they were so insistent on purchasing just a few years ago. Vendors (some more than others) are hesitant to crack open their products to allow data to truly flow from one system to another, and who can blame them? The EMR market, in particular, is poised to shrink, which begs the question, who will survive? What companies will be around at HIMSS 15 and 16? Those who keep their systems siloed, like Epic? Or those who are trying to break down the silos, such as Common Well Alliance members like athenahealth and Greenway?

It makes me wonder if providers wouldn’t have been better served with just had a handful of EMRs to choose from around the time of HITECH, all guaranteed to evolve as needed and play nicely with each other in the interest of health information exchange. Too many options have caused too many barriers. That’s not just my opinion, by the way. I’m willing to bet that a sizeable chunk of the 37,537 HIMSS 14 attendees would agree with me.

Do you disagree? Are providers (and patients) better served by more IT options than less? Let me know your thoughts, and impressions of interoperability advancement at HIMSS, in the comments below.

Cash for Care a Trickle-Down Effect of EMR Dissatisfaction?

Posted on April 5, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

By now we’ve all heard about or read of the group of dissatisfied EMR users – hospitals and small-practice physicians who bought into the notion of government incentives – and a better way to deliver healthcare with the added benefit of more efficient processing and payment collection from patients and payers – but aren’t seeing the ROI they initially anticipated. Say what you will about this group, but one thing is for sure: Investment in healthcare IT systems like EMRs have led some physicians to turn to hospital employment, others to close up shop, and yet others to turn to more unique business models such as concierge or cash-only practices.

On the flip side of this change in healthcare delivery is an increasing demand from patients to know just what their dollars are paying for, no matter whether those dollars pay into a monthly insurance premium or directly for services rendered. I wouldn’t say we’re yet at the point where this demand is a trend, but I do believe that as more and more mainstream media outlets cover the debate over healthcare costs and price transparency, more patients like you and me will learn how to ask for costs up front, how to shop around, and most importantly, how to determine if what we’re paying for is worth it.

Entrepreneurs didn’t take long to catch wind of this, and as a result we’re seeing a number of consumer-friendly healthcare businesses pop up. Take Healthpons, for instance. I came across mention of this company a few weeks ago, and was intrigued by its Groupon model for healthcare services. The company offers one line of service for providers, and another for patients. According to its website, Healthpons offers a free portal that allows physicians to market their services at a cash price so that patients can quickly search for said practice and service by city, state, zip, specialty or symptom checker; purchase services and set appointments online. Patients, in turn, can use the portal to search for providers, find the one with the best price, and use a Healthpons discount to pay in advance and make an appointment at the same time.

I chatted with Healthpons co-founder Patty Everette, to learn more about the business:

How do you qualify providers to participate in the program?
We have a system, similar to an insurance company, to review and verify credentials of all providers. This is why we are in a pre-launch phase to validate providers prior to posting their information.

How many providers have signed up?
We have validated about 6,000 providers and many more have enrolled.

The website mentions the patient portal will go live in all 50 states in 2013 – can you give us a more exact timeline?
June 2013 is our target launch. All validated providers will be posted, however, there are certain geographic areas that have a higher concentration of providers, such as the Southeast, Northeast and California. Each month we will continue to add providers as they enroll and are verified.

What types of providers is healthpons best suited to (primary care docs, dermatologists, cosmetic surgeons, etc.)?
The first provider registered was an ENT. We have pediatricians, surgeons, primary care, orthopedic, ENTs, family medicine and more. It is best suited to any provider willing to provide reasonable cash prices, willing to share content and to help people become more informed about what they do and how they are qualified to do it. Our focus is on transparency – and developing relationships.

How are you going to avoid the Groupon problem of too many vouchers sold, and providers subsequently becoming overrun with customers they are inadequately staffed to handle (typically resulting in poor customer service and no repeat patients)?
Our business model is not like Groupon. We make money primarily from any upgraded, subscription-based services or advertising.

All providers control the number of visits they can sell per service. We provide a guide to each provider as to what is recommended to sell. The consumer can see the provider’s availability prior to purchasing a visit. Also, we will monitor their sales and service comments to ensure quality and service is maintained.

I know there is more to share as Healthpons is developed with great depth. We have used multiple panels of providers and their office managers to preview our systems as we have developed. We took an idea we had and asked providers what they thought – what they wanted – then we asked our customers (patients) what they would like to get out of our platform. We bridged the concepts to bring doctors and patients together for an online network marketing experience to de-mystify medical services and pricing.

CMIOs Bridge the Clinical & IT Gap

Posted on February 27, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

It’s been interesting to see the evolution of conversation around healthcare IT at the provider-focused events I’ve attended over the last two years. Panels of hospital executives at first spoke about the benefits they were likely to see as a result of the HITECH Act and their facilities’ subsequent plans for EMR implementation. One-year later, it was all about best practices for go lives. Today, conversation has reached the “now what?” phase.

This was definitely top of panelists’ minds at the recent Georgia HIMSS Lunch & Learn, which offered attendees a hearty Italian meal and the chance to hear area CMIOs converse around the topic of “CMIO 2.0 – Leading Healthcare Transformation.” While “transformation” tends to be a bit overused, I think it was an apt word based on the remarks from moderator Debbie Cancilla, Senior VP and CIO at Grady Health System; Julie Hollberg, MD, CMIO at Emory Healthcare; Daniel Wu, part-time CMIO at Grady; Roland Matthews, MD, physician champion at Grady; and Steve Luxenberg, MD, CMIO at Piedmont Healthcare.

I hate to play favorites, but Wu was my favorite panelist. Calling himself the “least tech savvy CMIO in the country,” he was engaging and a good sport when it came to verbal sparring with his Grady colleague, Cancilla. No one in the audience was fooled by his self-deprecation, of course. Wu, who is also Assistant Medical Director at Grady’s Emergency Care Center, and Assistant Professor of Emergency Medicine at Emory University’s School of Medicine, knows a thing or two about healthcare IT, having put in an EMR for Grady’s emergency department. He continues to serve as a physician champion for the hospital.

Several telling themes emerged from panelists’ comments and audience questions, which I’ll share in part 1 of this post. I’ll cover challenges specific to each panelist and their facility next week in part 2.

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Left to right: Julie Hollberg, MD, CMIO, Emory Healthcare; Roland Matthews, MD, Physician Champion, Grady Health System; Steve Luxenberg, MD, CMIO, Piedmont Healthcare; Daniel Wu, part-time CMIO, Grady; and Debbie Cancilla, CIO, Grady. Photo courtesy of Georgia HIMSS

Shining a Light on CMIOs
This was the first all-CMIO panel I’d ever seen, which may be indicative of their general reluctance to be put in the spotlight, and perhaps the increasingly important role they play in HIT implementations of all kinds. (I also wonder if the title of CMIO is growing. If anyone has statistics on that, please share.) Cancilla noted it was time for CMIOs to get in the healthcare transformation conversation, and while these four seemed at no loss for stories to tell and pain points to share.

CMIOs Don’t Play Favorites
When it comes to the clinical side of the house versus the IT side of the house, the panelists agreed that sometimes the two just don’t understand each other. And that’s where the CMIO steps in, acting as interpreter, smoother of ruffled feathers, and occasionally spokesperson for both departments to the higher ups. In describing his role, Luxenberg described himself as an objective third party, coming in to finesse sticky situations between clinical and IT staff. I got the impression from him that CMIOs often have more success in resolving disputes because they don’t have allegiance to one particular department, but rather the hospital as a whole.

(Sidenote: Wu mentioned a hilarious cartoon by Atlanta-based anesthesiologist Michelle Au that highlights the delicate verbal dance CMIOs must do when talking with various medical specialties. Check out “The 12 Medical Specialty Stereotypes.” It’s worth noting Wu would be considered a “cowboy.”)

Getting it Done for the Patient’s Benefit
Because they represent the interests of the hospital, these CMIOs ultimately hold themselves accountable to the patient, and benefiting the patient is a big part of the message they have to convey to clinical and IT folks, especially during times of implementation. Luxenberg noted that he gets better EMR buy in from different departments when he highlights the benefits to patient care, rather than focusing on details specific to one department in particular.

Talking with different departments does mean, however, that CMIOs must step out of their comfort zones and really get familiar with the pressures of each area within their facility. Conveying this information is where a great relationship with the CIO comes in. For the CMIO’s objectivity to truly be valuable, that assessment must be meaningfully discussed with the CIO. As Cancilla mentioned, CIOs need to step up and strengthen relationships with their CMIOs. All the panelists and Cancilla agreed the communication from the top down and bottom up is key to successful adoption of healthcare IT.

Breaking up with Your EMR is Hard to Do

Posted on February 13, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

In light of this week’s “holiday,” I thought I’d take a look at the current love/hate relationship the healthcare industry seems to have with electronic medical records and Meaningful Use.

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Thanks are due to @mdrache and @EHRworkflow for their inspiration for the title of this week’s post: EMRtweet1

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The nay sayers seem to have become especially vocal lately, which may be due in large part to the passing of time. Those that have implementations under their belt now feel qualified to talk about the efficacy of the solutions they selected. Negative EMR press may also have bubbled up to the service in light of the recent RAND report, which backpedaled on previous predictions of cost-savings associated with healthcare IT adoption. That study broke the ice, so to speak, and perhaps made providers more comfortable with voicing their discontent.

In any case, if current healthcare IT press is any indication, EMR technology currently on the market has often left providers dissatisfied for a number of reasons. No doubt this dissatisfaction will be a subject of many show-floor conversations at HIMSS in a few weeks. I wonder how EMR vendors are preparing their responses. What will be their top three talking points when it comes to EMR benefits? It seems Meaningful Use incentives have lost their luster, and in fact have left many providers disenchanted with healthcare IT in general.

John Lynn posted a very telling reader comment over at EMRandHIPAA.com from a provider who used his Meaningful Use malaise to create a new independent practice business model. Is this an indication that more providers may “revolt” against Meaningful Use and the trend towards hospital employment? If so, what will the private practice landscape look like in three to five years?

Just how easy is it for providers to truly “break up” with their EMRs? We’ve all read the multi-million-dollar rip-and-replace horror stories – talk about a bad breakup. And then there are the providers that stay in dysfunctional relationships with their EMRs because they can’t afford a new one, instead developing copious amounts of workarounds potentially at the expense of clinical care and accurate reimbursement.

As of last summer, KLAS reported that a whopping 50% of providers were looking to replace their ambulatory EMRs, compared to 30% in 2011. A recent Health Data Management webinar noted more than 30% of ALL new EMR purchases are made to replace an existing EMR.

To me, these numbers beg a number of questions. Were first- and perhaps even second-generation EMRs just not mature enough for providers’ needs? Did providers simply not do enough due diligence before making their purchases? Will these impending replacement EMR purchases stick? If you have updated EMR breakup statistics or a crystal ball, please send them my way.

“Fat Finger Syndrome” Not Just a Google Problem

Posted on December 19, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

In trying to keep things light this week, I’ve taken inspiration from two very different sources – NPR and Homer Simpson. A recent Morning Edition piece on “Fat Fingers Blamed for Mobile Ad Clicks” highlights the problem many smart phone users face –  large fingers on a small screen usually result in the occasional misspelling, accidental click on a field or image, or unintended dial.

The story concentrated on “Google’s launch of a new type of mobile ad that aims to combat the ‘fat finger’ problem. As the smart phone market grows, mobile ads have become more important to the tech giant, which makes most of its revenue through advertising.”

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Listening to the piece, which started off with a hilarious sound bite from the Simpsons, made me wonder if EMR developers face this same type of problem when developing their software for mobile devices. What sort of consequences do providers face as a result of unintended clicks or incorrect data entry?

I polled a few friends who work in healthcare IT user experience (coincidentally, a topic that I heard come up quite often during the fall conference season), and they brought up numerous cases – some with dire consequences – of mistaken medication administration because of very similar patient names.

I also came across the ubiquitous drawback of using tablets in healthcare: “The iPad is difficult to type on, [one provider] complains, and his “fat fingers” struggle to navigate the screen,” according to a Kaiser Health News story last year.

But, providers, as they so often do, are creating workarounds. One family practice in particular has “introduced a stylus since some people occasionally suffer from ‘fat finger syndrome’ (some people just have an innate ability to miss the buttons in the questionnaire when they use their fingers).”

How have you, your practice or your colleagues dealt with pleasantly plump pads of the finger? Please share your anecdotes in the comments section below.

Will Meaningful Use Affect M&A In The EMR Space?

Posted on November 19, 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.

As some of you may recall, Allscripts is said to be floating the possibility of selling out to a venture capital firm. This follows several months of tumult at the board level, including some who might have been helpful in keeping its merger with Eclypsis moving forward.

I’ve been thinking about this deal for a while, wondering whether it would come to fruition and if so, what would make it happen. And I’ve realized an Allscripts deal, or other EMR company sale, might give us a window into just how valuable Meaningful Use criteria have proven to be. Let me explain.

If I was a EMR vendor looking for an acquisition or merger, I’d certainly look at the usual metrics, including the customer list, code base my target had in house, maturity of the product line, the extent to which in-house programming talent could support the roadmap and so on. (Naturally, I’d go over its books in depth too.)

But that’s not all. These days we have some new perspectives from which to evaluate the success of EMR vendors, a set of standards which are fairly unique in the software business.  Two important examples: We can look at how successfully a vendor’s customers have been able to meet Meaningful Use goals to date, and how far along the HIMSS EMR Adoption Model customers are as well.

While both are interesting, Meaningful Use is more important, as it’s such a politically fraught, complicated and rapidly evolving set of standards. In short, I’d argue that if a vendor’s customers are doing well with MU, then it’s likely the vendor is doing something right.

Now, you can’t draw a straight line between the quality of a vendor’s product and how well its customers  have done in qualifying  for Meaningful Use. Implementation is ultimately the hospital or doctor’s responsibility, even if the provider pays for EMR vendor consulting to get things going. And there’s lots of ways things can go wrong that have little or nothing to do with the product.

Still, I predict that Meaningful Use success is going to become a more important metric in EMR vendor M&A as time goes by. After all, the more bragging rights a company has regarding Meaningful Use success, the more they can improve the acquiring vendor’s profile. That’s gotta matter.

EMR Value Diminished If Patients Can’t Access Care

Posted on November 16, 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.

A new study from the august Commonwealth Fund has just come out, offering a portrait of primary care practices in ten countries. The study had a lot of interesting data to offer, including news of primary care reforms to meet the needs of aging populations and improve chronic disease care.

One of the key data points drawn from the CF study was that two-thirds of U.S. PCPs reported using EMRs in  2012, up from 46 percent in 2009. That’s obviously a big improvement, though the U.S. still lags behind the U.K.,  New Zealand and Australia in EMR implementations and use of IT generally.

At the same time, it seems that U.S. citizens still face serious financial obstacles in getting primary care. Fifty-nine percent of U.S. physicians surveyed said that their patients often have trouble paying for care. That’s a big contrast with other countries included in the study, including Norway (4 percent), the  U.K. (13 percent) and Switzerland (16 percent). These numbers make sense when you consider that the U.S. is the only country surveyed that doesn’t offer universal health coverage.

Putting aside humanitarian reasons to be troubled by money obstacles to PCP access, there are other issues to consider. To me, the most obvious is the selection bias imposed by financial barriers to care.

Consider one of the big goals a medical home hopes to accomplish, managing chronic conditions effectively across the primary care practice’s population.  PCPs can make great use of an EMR to work on such goals, from issuing reminders to get preventive care to tracking patient progress across different demographics to test the impact of new interventions.

The thing is, the power that is a well-tuned EMR is not at its best if the interventions are mostly aimed at those who fit a certain socio-economic profile.

Admittedly, few small PCPs need to be worried about selection bias from a scientific standpoint, as they’re seldom gunning for the next journal article presentation, but looking at the country as a whole, we’re missing out on the collective learning we can generate with clinical data analytics.  It seems to me that we’re going to have to address this problem directly if we want to leverage EMRs for the greater public good.

Could Patent Conflicts Choke mHealth Growth?

Posted on November 2, 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.

This week I caught a very interesting piece in MobiHealthNews which took a look at the possibility that the mHealth world is ripe for patent clashes.

Orion Armon, an attorney with Cooley LLP’s IP litigation practice, notes that companies in medical device, computer, networking and communications markets are busily patenting mHealth innovations, and that sooner or later, these patents will overlap.  The result: nasty turf battles which cost everyone involved boatloads of time and money.

While the number of patent lawsuits currently being filed in these industries is nowhere near the levels seen in say, the smartphone and computer  business, a few significant cases have emerged, Armon reports:

  • CardioNet filed lawsuits against MedNet Healthcare, MedTel 24, Rhythm Watch, AMI Cardiac Monitoring, ScottCare, and Ambucore Health Solutions;
  • Robert Bosch Healthcare filed lawsuits against ExpressMD, MedApps, Waldo Health, and Cardiocom; and
  • BodyMedia filed a lawsuit against Basis Science.

But that’s just the tip of the iceberg. Consider the patent ambitions of Airstrip, a tech vendor offering a mobile patient monitoring platform. The company’s President and Chief Medical Officer, Dr. Cameron Powell, told MobiHealthNews that his company’s patents cover “taking any type of physiologic data—whether that’s from a sensor in the shoe, a home monitor, a blood pressure cuff, or a monitor in the hospital—and then re-rendering it on a native or HTML5 application on a mobile device.”  (My jaw dropped when I read that one.)

Since that interview, Airstrip has filed a lawsuit against mVisum Inc. alleging that four of the other vendor’s products infringe its patent.  It’s asking the court for an injunction barring future infringement, treble damages and attorneys’ fees.  These are standard provisions in a patent lawsuit, but from where I sit they’re pretty intimidating, and if the injunction is ordered mVisum has a heck of a battle on its hands.

As provider interest in mHealth applications continues to expand, I can only imagine that the patent battles are going to get uglier and more widespread.  It’s only logical, given the explosion of innovation we’re seeing in this space. But I do hope that patent wars don’t slow the introduction of new products too much at such a critical time in the mHealth industry’s growth.

What Your EMR Would Say If It Could Talk

Posted on October 25, 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.

In this column we spend a lot of time talking about EMRs, but do we ever listen to them?  Maybe it’s time for an “EMR Whisperer” to turn up and tell us what EMRs are trying to tell us. Or since I don’t know where to find one, I’ll do some listening myself.

Here, for your consideration, are some messages EMRs are trying to share. Don’t take offense…they’re only trying to be honest.

-Anne

* Too many clicks?  I’ll bet you never say that to your World of Warcraft host.

* There’s not enough expansion slots in all of China to integrate that mess.

* So, I went down for a few hours.  Don’t I deserve a break now and then?

* Don’t lie — you’re planning to tear me out and replace me with a younger upgrade.

*  I wish you’d stop telling me F/U.

*  I’m not user-friendly?  What about that smiley I put at the end of that 600-page data dump?

* I thought you loved me for my intelligence, not my interface.

* Your doctors have been saying mean things about me. My feelings are hurt. :-(

*  Sure, I interoperate, but I always come back to you…

Getting Personal with EMRs and Women’s Health

Posted on October 18, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

It’s that time of year again. Like my mother, I’ve taken to scheduling any sort of annual event around the time of my birthday. So, now my birthday cake is accompanied by a trip to get my emissions done, a jaunt to the tag office, and a visit to my primary care doctor for an annual physical and any other female-related health services I might need. (Timely, considering that October is also Breast Cancer Awareness Month.)

I tend not to schedule my well visits months in advance, and so was a bit apprehensive earlier in the week as I dialed in to get an appointment. I’ve read quite a few patient horror stories lately of appointments not being available for months due to lack of staff. Thankfully, this was not my experience. I was able to pick the date and time of my choosing, with the only insurance-related caveat being that I had to wait until one day after the date of my exam in 2011.

When I was at the doctor’s office last year, they were in the process of launching a patient portal. Digging around on their website while speaking with their receptionist, I noticed the portal is indeed available. The patient-centric portal offers online bill pay, appointment scheduling and pre-registration services and a personal health record. I’ll be interested to see if they mention its availability when I am seen in a few weeks. I’ll definitely ask who was involved with the implementation, and if they’re looking to Stage 2 Meaningful Use quotas when it comes to electronic patient engagement.

But enough about me. The reason I bring all this up is because the Journal of the American Medical Informatics Association recently made available research on “The effect of electronic medical record system sophistication on preventive healthcare for women.” A quick look at the abstract relates that 29.23% of providers (culled from those in the National Ambulatory Medical Care Survey from 2007-08) had no EMR system, 49.43% had minimal EMRs, 15.97% had basic EMRS, and 5.46% had fully functional EMRs.

“For breast examinations, pelvic examinations, pap tests, Chlamydia tests, cholesterol tests, mammograms, and bone mineral density tests, an EMR system increased the number of these tests and examinations,” according to the abstract. “Furthermore, the level of sophistication increased the number of breast examinations and pap, Chlamydia, cholesterol and BMD tests.”

The JAMIA’s point being that “the use of advanced EMR systems in obstetrics and gynecology was limited. Given the positive results of this study, specialists in women’s health should consider investing in more sophisticated systems.”

I’m going to play devil’s advocate here for a minute.

First of all, the fact that not even 5.5% of providers surveyed had a fully functional EMR is dismaying, but perhaps I don’t understand the underlying financial reasons for their lack of adoption. And the fact that the survey was taken more than four years ago could play a part. It would seem to me that there would be much to gain clinically and financially in having a fully function EMR especially in obstetrics, where women are often seen at a number of facilities throughout their pregnancies.

And finally, I have to take issue with the “positive results” the JAMIA concludes the study to have had. To me, “positive” connotes “successful,” so I wonder if there’s a hidden conflict of interest here. Increased sophistication of EMR systems would seem to equal more tests, according to the study, but no mention is made of if those tests lead to better outcomes (a win for patients) or higher reimbursements (a win for providers). I know we walk a fine line when talking about EMRs, tests and money, and that it often ends up being a chicken-and-egg situation, but it’s still a debate that needs to be had, especially in the area of women’s health.