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Epic, Cerner Best For ACOs? Say What?

Posted on September 29, 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.

I don’t know about you, but I’m not exactly sure what an Accountable Care Organization is. In fact, I’m betting nobody is — there’s a bunch of harrumphing and throat clearing out there, but I haven’t seen any crystal-clear descriptions out there.  Shall we say that ACOs are more honored in the breach than in the observance and leave it at that?

Now, we come to the puzzling part of this piece. If nobody’s managed to define an ACO clearly, how can any particular EMR be a better ACO tool than another?  We’ll have to ask KLAS about this one, since they’re the ones that discovered this “fact.”

Today, KLAS announced that it had interviewed 197 providers at 187 organizations to see how ACOs are forming up. A third of the respondents said that they were pursuing a formal Medicare ACO designation, and the majority were felt ACOs were the future, KLAS reported.

Sure, considering that ACOs are just risk-taking organizations with a capitated feel, some people already have a sense of what to expect. But throw an EMR into the mix and we’re in new territory — hopefully good territory, but new nonetheless.

So, tell me how providers know that Epic and Cerner are the most ACO-ready? Apparently, respondents believe that Cerner already has many of the IT pieces needed to run ACOs; moreover, they say Cerner is working closely with providers interested in the ACO model.

Survey takers also gave a nod to Epic, which they see as being close to ready (though behind in analyics and ability to share data with non-Epic users).

Wait a minute — let me get this straight.  Respondents know Cerner has the right pieces, even though the ACO doesn’t exist yet?  They like Epic, even though it doesn’t share data outside of its walled garden?  KLAS is kidding, right?

At this point, I’ll be kind and say that Epic and Cerner users are a bit brainwashed, which I too might be if I’d spent the kind of money those folks have on an EMR.

But the voice in my suggests that KLAS might have had its finger on the scales just a little bit. I will not publicly state that Allscripts, CPSI, GE Healthcare, McKesson, MEDITECH, QuadraMed and Siemens scored worse because they didn’t pay for play…but something sure isn’t right here.

 

 

 

EMR Needs Differ By Specialty – KLAS Doesn’t Differentiate Them

Posted on May 17, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

John’s Note: I got the following message from an EMR vendor a while back. I’ve removed the specific names of the EMR vendors to protect the innocent (and guilty in some cases). Plus, the names of the specific companies are tangential to the issue of ratings services like KLAS.

Many of you know that I’m generally opposed to EHR certification and ratings services are a close second. I don’t think these companies are evil, but I just think they provide very little value to the industry and doctors in particular. The comments below were intended for me and not necessarily as a blog post, but I think they’re worth sharing and considering. Hopefully it will help doctors better understand what they’re getting and not getting.

I’m sure this post will drive some interesting discussion in the comments.

I have been talking with [someone] at KLAS since HIMSS about WHY the KLAS data is either 1) Losing Relevance, or 2) Actually Misleading Providers.

[KLAS representative] told me in April that the average annual “accesses” to the KLAS data was about 17,000, while in 2010, they had over 14,000 through mid-April. Big trend change. ONC-driven, no doubt.

I had a discussion with [KLAS representative] at HIMSS and since, outlining how the KLAS data can and probably IS misleading clients. How? For instance….[EMR Vendor A] gets high marks…almost as high as [EMR Vendor B]
.
They have two “konfidence” checks on their data for the 6-25 provider practice size category (KLAS has 1-5, 6-25, and 25+, I believe as their categories, and vendors must submit their reference accounts in those partitions).

If you are a provider who sees high marks for [EMR Vendor A] in the 6-25 provider space…with all the good supporting comments…..well above the other vendors….you would probably rely on that data to decide they have to be on your short list. But everyone knows that [EMR Vendor A] serves mostly primary care and ob/gyn practices. They have adapted templates and have references for those accounts. What if you are an orthopedist or ophthalmologist…or other specialist. They have almost NO references for that. The KLAS data does not break it out. You may be badly mislead….and find out shortly after spending tens of thousands of dollars…that it wont work at all for you.

We have asked them to break out the data by specialty… they know who they are talking to. They know what each practice is. Not hard to add the question…so the data can be sliced that way. Tremendous value-add for ALL practices to know how the vendors break out. Guess what they are going to find out when they do that? And by the way…they ONLY gather data from accounts that have been installed and live for a certain period of time….no data on failed attempts or those that gave up using products.

KLAS agreed in principle it was a good idea to add specialty to their data. They even agreed to start doing it with the last reporting cycle, but didn’t have much time. All the data they have….not normalized by specialty.

LIKE THE GOVERNMENT, THEY ARE ASSUMING ALL SPECIALTIES CAN BE TREATED THE SAME AS FAR AS EMR ADOPTION GOES. Why do they think there is a 50-83% failure rate in the industry? Why has “meaningful use” not been defined for specialties before “certification” of a product can be decided? Does an orthopedist who does hip replacements, rotator cuff surgery and meniscus revisions…..report the same thing as doctors who treat diabetes, liver disease or other costly chronic-care conditions? Heck No.

I don’t think the market fully realizes how “homogenized” the KLAS data is….after all, if the average depth of the Mississippi River is only three feet…..why are there so many different size boats—-barges to sailboats—sailing in it each day?

EMR and EHR Ratings Confusion

Posted on October 30, 2010 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 got a comment from Tammie on my post about EMR and EHR rating websites. Here last line really hits home:

If we cannot trust the reliability of web published EMR/EHR ratings, then are we not to trust the surveys and polls conducted by the professional organizations or the selections by the Regional Exchange Centers either? I can’t recall ever researching something so thoroughly and have so much information available to me and yet be still so utterly confused.

It’s a definite challenge. I’d suggest going through a methodical process that’s described in my free EMR Selection e-Book. Still a challenge, but this approach helps.

EMR and EHR Rating Websites

Posted on October 20, 2010 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.

There are a number of EMR and EHR rating websites out there. The problem that I have is that none of them are really very good at all. They all have MAJOR weaknesses and some are just completely and utterly flawed. Some require the EMR and EHR vendors to pay them to be rated. Doesn’t that just wreak of conflict of interest?

There’s just so many ways to have the ratings of EMR and EHR vendors be skewed. Dr. Oates, Founder of SOAPware, recently wrote a blog post about the problems with many of the EMR and EHR rating websites and reports. Certainly he has a vested interest in his EMR software to be ranked highly, but this part aside he raises some very important questions about the accuracy and value of these various ranking systems.

Here’s one sample of the challenge of ranking and rating EMR and EHR vendors:

In addition to accepting user evaluations, many of the ranking systems require that vendors also fill in yes/no to a large list of features. Historically, many vendors have demonstrated tendencies to answer “yes” to functionalities to which a “no” would have been more accurate. Because we tend to answer honestly, we have sometimes ended up inaccurately appearing to be less functional than some others.
There are inherent problems with each of these surveys in that the survey results can, and often are, manipulated by the vendors who are paying a the most of attention to them. Because these surveys are the result of users offering information, some vendors will expend great effort to be certain that many, mostly happy users of their product are in some fashion encouraged to participate in the surveys. SOAPware has typically avoided such activities, because it ends up being a game to see who can motivate the most satisfied users to engage the ranking system.

This is just a small sample of the challenges of trying to honestly and effectively get quality ratings and reviews of EMR and EHR vendors. Yet, providers and practice managers have an insatiable appetite to try and get information on the various EMR and EHR vendors.

Trust me, this is not an easy issue. If I knew the solution, I’d have already done it myself. I write about this since I think it’s a valuable and important message for doctors to be very very careful trusting any of the data coming out of these EMR and EHR ratings websites. Instead, go download the Free copy of my EMR Selection e-Book and do the work necessary to rate them based on your specific practice needs.