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EMR Mandate Delay, Patient Focused EMR, and Guaranteed EHR Benefit


This article makes some interesting points about the challenge of EMR. However, I don’t think there’s any shot that the EHR train is going to slow down. At the best there might be a delay in meaningful use stage 2. Although, that could be unlikely as well. P.S. There is no EMR Mandate.


Not true. It takes GREAT EMR design to do that. The regulations are just brutal and don’t focus on the patient.


It’s always beautiful for me to find someone tweeting a blog post I created 4 years earlier. The content is still quite good. Reminds me that I need to finish my EHR Benefits series.

October 27, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

EMR Analysis Detects Childrens’ Growth Disorders

EMRs can be used to detect growth disorders in children, according to new research published in the Journal of the American Medical Association . The study, which was written up in FierceEMR, used a special automated growth monitoring algorithm integrated into an EMR system to track childrens’ growth.

To conduct the study, researchers compared three “control” years to an “intervention” year. An annual average of 33,029 children were screened, according to FierceEMR.

Researchers found that in a control year an average of four children were diagnosed with a growth disorder. During the intervention year, however, 28 new diagnoses of growth disorders were made among 32,404 children, FierceEMR reports.

Looked at another way, the rate of growth disorder diagnoses was 0.1 per 1000 screened children in the control years versus 0.9 per 1000 screened children in the intervention year, FierceEMR noted.

These study results are part of an emerging body of literature suggesting that EMRs to help clinicians detect and manage disease states.

For example, another study appearing in the Journal of the American Medical Association found that EMRs can be associated with a drop in emergency department visits and hospitalizations among diabetics.  That study, which analyzed all of the 169,711 records for patients enrolled in the Kaiser Permanente Northern California diabetes registry during a four-year period, found a 10.5% decline in hospitalizations for preventable ambulatory care sensitive conditions where EMRs were in use.

Another study, which recently appeared in BMJ Quality & Safety, recently concluded that EMRs can help reduce hospital readmissions of high-risk heart failure patients by sorting out high from low risk patients in the ED.

September 16, 2013 I Written By

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

Bill Gates Puts a New Spin on the Great EMR Debate

I heard an interesting interview on NPR the other day with Bill Gates on the subject of polio eradication. The Bill & Melinda Gates Foundation has been working for a number of years now on the effort, and are intent on seeing that no child ever becomes paralyzed as a result of the disease. The interview got me thinking about money, as NPR host Robert Siegel grilled Gates about the cost of this hopefully final vaccination push in the three countries that still show cases of it each year – Afghanistan, Pakistan and Nigeria.

According to Gates, a nice tidy sum of $5.5 billion will be necessary to vaccinate enough children to finally push out the disease. The question arose as to whether or not this money will be spent wisely. Could it be put to better, more effective use fighting other healthcare conditions, such as malaria, that affect greater numbers of people? Gates made the point that once polio is eradicated, the enormous amount of money already being spent on fighting it can then be spent on these other issues – a statement that to me didn’t seem to sit well with Siegel.

Now, if you’re in healthcare, chances are money crosses your mind a few times a day. And if you use an EMR, you’ve likely voiced an opinion or two on whether it has lived up to its promised value. I think Gates’ point above on cost effectiveness of disease eradication – the most expensive disease gets eradicated first to free up its funds for other healthcare causes – can be applied to the EMR ROI debate.

Yes, healthcare is expensive. Yes, current and possibly future EMRs may not have the best interfaces or give the ideal user experience. But, given time (perhaps a lot of time), they will ultimately help springboard immense cost savings throughout the industry. I consider them the backbone of interoperability, especially when it comes to health information exchange and accountable care – two notions that might just become the norm once EMR utilization finally reaches critical mass.

Stage 2 Meaningful Use will likely see a shift in the market, and from what I’ve read thus far, is causing providers to think about Meaningful Use in a new way. It might be a hiccup in this journey to cost savings, but it will likely separate the wheat from the chaff as far as vendors go. Hopefully, only effective products will be left standing, which will in turn make it easier for providers to use EMRs in the most effective way.

Money will of course be on everyone’s minds at the upcoming HFMA ANI show in Orlando. This has got to be one of my favorite events as it is smaller than HIMSS but still has that bustling, breaking news vibe. I’ll be interested to hear from providers their opinions on the recent push for greater price transparency when it comes to hospital costs, and how they are feeling about EMRs as of late. It will also be interesting to see how vendors are helping these providers meet Stage 2 and patient engagement head on.

Will you be at the ANI show? Drop me a line in the comments below and let me know what you’re looking forward to learning about or seeing the most.

May 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.

EMR A Disappointment In The US?

Twitter has been circulating tweets discussing whether EMR is a disappointment in the USA. I find the question really intriguing. I’m sure the doctors who have their EMR and love the benefits they’ve gotten from EMR think its far from a disappointment. The doctors that have an EMR forced on them or select one that kills their workflow likely see EMR as a huge disappointment. Whether EMR is a disappointment in the US starts with which group you think is larger.

My personal gut feeling is that it’s likely split somewhere down the middle. About half of doctors are satisfied with their EMR, and half of doctors are unsatisfied (some might use a much harsher word) with their EMR software.

Does that mean that EMR is a disppointment in the US? I’d have to say it does.

Although, I think that disappointment is the right word. It’s not that I think we shouldn’t be doing EMR. We absolutely should be making physician documentation electronic. As I’ve been starting to highlight in my EMR Benefit Series on EMR and HIPAA, there are some major issues with paper charts that are easily solved with EMR.

The reason EMR has a been a disappointment to date is that EMR implementations can be so much better than they are today.

I believe we are sitting on so much possibility when it comes to how healthcare IT can transform healthcare. For a myriad of reasons, we’re not seeing that potential and quite frankly that’s disappointing.

January 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Study: EMRs Improve Ambulatory Care

A new study done by researchers from the Weill Cornell Medical College has concluded that community-based physicians who move to EMRs can improve care meaningfully.

The study, which was done in collaboration with New York’s Health Information Technology Collaborative, gathered baseline year data gathered from 500+ physicians in ambulatory practices and 75,000 patients with five different health plans in New York’s Hudson Valley.  They then compared quality scores for EMR-using physicians and those without EMRs.

Researchers concluded that 56 percent of physicians who were using EMRs scored significantly higher on quality of care provided, particularly in managing chlamydia, diabetes, colorectal cancer and breast cancer.  A combined score across nine quality measures also also suggested that EMRs helped generated better care than paper-based records overall.

What made the study results particularly interesting, researchers said, was that the physicians using EMRs used off-the-shelf systems which hadn’t been specialized to achieve these kind of results.

Researchers seem to think that the improved ambulatory results are just the tip of the iceberg:

EHRs may improve the quality of care by making information more accessible to physicians, providing medical decision-making support in real time and allowing patients and providers to communicate regularly and securely,” says Dr. Rainu Kaushal, director of the Center for Healthcare Informatics and Policy and the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell. ”However, the real value of these systems is their ability to organize data and to allow transformative models of health care delivery, such as the patient-centered medical home, to be layered on top.” 

Interesting. I would have assumed that reminders and warnings had generated , as they certainly help doctors make sure overworked doctors are on target with tests, avoid drug interactions and the like. But researchers like Dr. Kaushal and her colleagues seem to think that the big EMR payoff will come as EMR systems change the core models doctors use to deliver care.

Given that new models are all but inevitable at this point, I guess we’ll get to find out!

October 30, 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 @annezieger on Twitter.

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

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

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

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

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

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

October 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Does an EMR Improve Patient Care?

Everyone probably realizes by now that I love to read first hand experiences with EMR and EHR. I guess I’ve always loved stories and I’ve always loved to tell stories, so maybe that’s where that comes from. I guess this is why I loved Katherine Rourke’s post called “Would An EMR Have Improved My Son’s ED Care?” on the Hospital EMR and EHR website. It’s a great read if you love first hand experiences with EMR as I do.

Katherine does raise a challenging question, “Does an EMR improve patient care?”

In past presentations, I’ve always put the idea of an EMR improving patient care under the “possible EHR benefits.” (See a full list of EMR and EHR Benefits) As many things in life there’s a big “Depends!” that is the b est answer to that question. The answer to this question depends on what kind of care you were offering previously, the type of care you offer, the EMR you chose, the features you chose to employ in that EMR, the match between your workflow and the EMR workflow, and I’m sure another dozen other depends as well.

What’s more important to point out is that an EMR can improve patient care. I certainly can’t guarantee that an EMR will improve patient care in your clinic, but I’ve seen many cases where it has improved patient care and so I know it’s possible. The biggest determining factor in whether an EMR will improve patient care in your clinic is your desire to have it do so.

Many times in life, you get what you want. Do you want an EMR to improve your patient care? Or were you too focused on wanting to get the EHR Incentive money? Not that these and other benefits are mutually exclusive, but the focus of your EHR implementation matters a lot. Make sure you’re focused on the right things and your EMR selection and implementation will go 100 times better. In fact, it will even improve patient care if you want it to.

September 16, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Will EMR Vendors Cut Through The Noise This Year?

Folks,  as an editor covering this industry I’ve read more EMR vendor news, pored over more of their press releases and taken in more their advertising pitches than most.   Despite that, I’ve seldom walked away with a clear sense of why that vendor was truly special.

While that’s never a good thing for any vendor, it’s a particularly bad problem in 2011, which, I predict, will make or break many smaller EMR developers.  If it was hard to get buyers’ attention over the last two years — especially that of fearful physicians — it’s going to be a Herculean challenge this year.  The noise level is higher than a pack of screaming fans at a Metallica concert.

I’m not suggesting that EMRs have become a commodity like John suggested was a possibility (the real problem is how diverse they are, in fact!) but I am saying that many are still doing a terrible job of setting themselves apart.  Too much of the content churned out by EMR vendors makes appallingly broad generalizations or strings together a list of “me-too” features.

I do sympathize, tremendously, with the struggle health IT marketers go through in trying to sell such a complex product in a way which clearly communicates:

*  Affordability
*  Easy maintenance
*  Easy-to-establish productivity
*  Reliability

and in the case of selling to larger entities like hospitals:

*  Interoperability
*  Data integrity
*  Intelligently designed infrastructure
*  Scalability
*  And much, much more!

Still, there’s no getting around the fact that they’ve got to get the job done.  This year, if an EMR vendor seems like a me-too, they’ll be history in 18 months, tops.   Like it or not, the time has come to put up (a clear message) or shut up.

February 25, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

What are the Benefits of EMR?

I’ve always loved the discussion on benefits of an EMR. There are a lot of interesting possibilities. It’s certainly a hard thing to measure since you’re often comparing apples and organes, but there’s certainly some interesting possible benefits. Looks like the video got most of my list of EMR benefits. Enjoy!

December 31, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

EMR Stimulus Concerns

I just read one of the best posts I’ve read in quite a while by Marc Holland, CEO of System Research Services about HI(TECH) Anxiety. One of the best parts of the post was a list he did of the concerns physicians and their staff have about the EMR stimulus:

  • I don’t have enough Medicare revenues to qualify
  • I don’t have enough of a Medicaid patient volume to qualify
  • I’m reluctant to shop, let alone buy, until I know what criteria I must meet for my usage to be considered “meaningful”
  • The vendors I have spoken with don’t offer a version suitable to my specialty; a general purpose EMR simply doesn’t meet my needs
  • I have no personal capability or interest in becoming my own IT department and I don’t have the luxury of staff with the necessary skills
  • I haven’t begun to shop and don’t know where to start
  • The software I have seen doesn’t match my needs; usability is a key concern
  • I’m concerned about sharing my patient information with competitors and with the government, how do I preserve the confidentiality of my patient information?
  • How do I obtain and manage patient permissions?
  • I need help; lots of help

These concerns really aren’t new. Plus, none of them are really all that significant. It’s just the learning curve that’s required to implement an EMR. Sadly, I think that far too much focus has been on shoving the EMR down people’s throats instead of educating them properly on EMR and the inherent benefits of those EMR.

June 7, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.