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Ice Storms and The Benefit of a Connected EHR

We’ve often heard the good and bad stories that come out of disasters like Hurricane Katrina or Superstorm Sandy. In some cases, the EHR is a savior and is able to get the doctor the data they need because the EHR is still up and running and can be accessed remotely. In other cases, the power supplies are flooded and the EHR is down for the count (check out this video interview where I discuss why Las Vegas data centers don’t have these natural disaster issues).

A similar story hit my inbox right before HIMSS that looked at the benefits of having an EHR during all the ice storms (#Snowmageddon as Jennifer Dennard called it).

What happened in this story is that hundreds of patients and medical people were stuck at the physician office because of the storm (ironically this was at University of Alabama – Birmingham health system, the same place that brain surgeon walked 6 miles in the storm to do surgery). No one brought their medications, since they assumed they’d go in for a 15 minute appointment, then go home for the day. This left the patients and the practice in a challenging situation.

The good part is that the Kirklin Clinic, where this occurred, was on the Cerner EHR which had ePrescribing and access to the patients prescription history. Plus, there was a pharmacy a few minute walk away from the clinic.

This is a pretty small example, unless you’re the patient trapped in the clinic and needed access to your meds. Then, the fact that the clinic could quickly access your med history and write a prescription for you to get your medication while you waited out the storm is literally a life saver.

The problem with stories like this is that they’re hard to add in to an EHR ROI calculation. I believe there are hundreds of small examples like this where a connected EHR with your medical history can not only provide better patient care, but also save lives. There’s just no good way to put a possible saved life on an ROI calculation.

March 6, 2014 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.

New Telemedicine Stats Bode Well for EMRs

With the recent projection that telemedicine will reach 1.8 million patients worldwide by 2017, I think it’s fitting to continue the discussion I started last week pertaining to the current ROI of EMRs. While current utilization based on scrambling to meet Meaningful Use for federal incentives may not be all it’s cracked up to be, I do believe EMRs will ultimately provide a fiscally sensible return on investment, especially if telemedicine technology becomes part of any given vendor’s standard EMR package/offering.

I decided to bounce the idea off Sande Olson, a Twitter friend (@sandeolson) and Senior Healthcare Consultant at Olson & Associates. Being a healthcare professional that has worked in telemedicine long enough to witness its evolution, Olson seemed a fitting expert to speak with on the subject of EMRs, telemedicine and the bottom line.

How have you seen the telemedicine landscape change over the last few years?
Olson: Until recently, telemedicine has been a niche industry. Early users recognized the potential value of telemedicine, but successful business models (showing a viable ROI) didn’t exist, and technology was costly. The challenge was reimbursement; who was going to pay for it?  Without reimbursement or a viable business model, telemedicine could not go viral.

The telemedicine landscape began to change with advancements in information and communication technology on the heels of The Affordable Care Act. The push for healthcare reform provided financial incentives to “nudge” healthcare providers towards EMRs. Reform mandates and the availability of government funding created new opportunities around technology. Telemedicine, a valuable if fledgling technology, became a buzzword around technology and healthcare reform.

Industries saw business opportunity as solution providers for an “industry poised to undergo radical change.” Entrepreneurs, inventors, investors and healthcare visionaries followed new and sometimes disruptive ideas. Care delivery tools moved from PCs to tablets, along with mobile apps.

The confluence of all these influencers is creating a potential tipping point for telemedicine; it only needs wider reimbursement and licensure portability. Our aging population and forecasted physician shortage will help continue to thrust telemedicine into the forefront of change. Telemedicine is already being used successfully; reimbursement is still a challenge. But, healthcare innovation is just getting started. We have challenging times ahead, but this is also the most exciting time to be in healthcare ever!

Do you think there’s been a trickle down effect from the Affordable Care Act in terms of increasing interest in and adoption of telemedicine?
There has been a trickle-down effect on telemedicine. The Affordable Care Act has increased interest in exploring the possibilities of telemedicine outside of previous niche markets. As I noted, it is the confluence of influencers around healthcare reform that continues to push the tipping point for telemedicine.

Do you think EMRs will prove their worth in the coming years by better facilitating more novel methods of healthcare delivery, like telemedicine, or integrating with consumer-friendly mobile health apps?
Will EMRs prove their worth? Well, data silos do not support healthcare’s philosophy of providing a continuum of care from cradle to grave. And, you cannot provide care without a medical record; you can’t measure outcomes. So, interoperability– across all silos– is critical to successful healthcare reform. EMRs today may fall a bit short, but they will create efficiencies and improve patient outcomes. They will get simpler to use. EMRs will assist in improving reimbursement and revenue cycles. And, future EMRs will push and pull data from HIEs, PHRs and mobile health apps; we are just not there yet.

January 24, 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.

Disaster Planning, Horrors of Generic HIT Training, and Snap.MD: Around Healthcare Scene

EMR and HIPAA

Disaster Planning and HIPAA

Unfortunately, it appears that far too many healthcare providers don’t follow this rule. There aren’t very many that even have an emergency plan in place. However, this will soon need to be remedied. HIPAA security general rules state that not only must a patient’s privacy be protected, but the ePHI is available at all times — even in the case of an emergency. All healthcare providers, regardless of size, will need to implement some kind of disaster planning, regardless of their situation, in order to be in compliance with these regulations.

EMR Add-On’s that Provide Physician Benefit

MedCPU is a part of the inaugural NYC Digitial Health Accelerator class. They have developed a new concept that will likely to very helpful to many. It analyzes free text notes and structured data, and checks for compliance with rules and to identify any deviances. The company described one hospital using the services the company provides as a benefit given to doctors who use EHR. This is just one of many add-ons available, but some are seeing them to be a large reason why some doctors want to adopt EMRs.

Hospital EMR and EHR

Video: The Horrors of Generic HIT Training

Need a break from the day-to-day monotony? Be sure to check at this video on the horrors of generic HIT Training. It “offers a wry take on what happens when EMR training isn’t relevant for the doctor who’s getting the training. In this case, we witness the plight of a heart surgeon who’s forced through a discussion on primary care functions that she neither wants nor needs.”

Study: EMR ROI Stronger In Low-Income Setting

A recent study revealed something interesting. Hospitals in low-income areas actually may have a decent return on investment when an EMR is integrated. Three different areas were looked at and analyzed, and it was found that after five years of having an EMR, the hospital examined had a net benefit of over $600,000. Not all hospitals will benefit this much, but it’s encouraging to see more EMR success stories popping up.

Smart Phone Healthcare

Get Peace of Mind and Avoid the ER With Snap.MD

It’s the middle of the night, and your child breaks out in a rash all of his or her body. The doctor’s office doesn’t have middle of the night, on-call doctors, so the only option is the ER, right? Maybe not for long. Snap.MD, a new telemedicine system, may help parents decide if the Emergency Room is the best course of action. Parents of pediatric patients are connected to physician, who will help evaluate the situation via video conferencing.

November 25, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Proving EMR ROI IS Still Tough, So Buying Takes A Leap Of Faith

Folks, if you’ve worked or presently live in the enterprise software world, you know that proving that you system generates a worthwhile return on investment is tricky.  Sure, vendors sales staffs usually offer some neat calculators that prove you’ll see 1000% return by next Tuesday, but internally, even they admit that making such estimates is more black magic than science.

While some of you may have different experiences, it seems to me that proving that an EMR can generate a return on investment reasonably soon is particularly difficult. Sure, most hospitals and medical practices know their annual revenue run rate, and have a good breakdown of their expenses in hand, but are they set up to detect the effects going electronic can have?

After all, while some enterprise software directly helps companies generate revenue — most obviously, lead-generation monsters like Salesforce.com — others earn their keep but preventing problems from happening or improving quality. And if a provider organization doesn’t know what their mistakes are costing them, and doesn’t pay a direct price when patients fare poorly, how can they pin down how much financial benefit their EMR produces?

 

Admittedly, as the quality data reporting bandwagon continues to roll faster, everyone from small practices to giant hospital systems are likely to have a better idea of where they’re slipping — they can’t afford not to, as they’re likely to forfeit incentives paid by Medicare or private insurers.  And most cases, it will take an EMR to organize, analyze and report out that data effectively.

Unfortunately, providers can’t expect huge bonuses just for buying an EMR. (OK, let’s be honest and admit that HITECH dollars are nice to have but not enough to make  or break a viable business.) So they’re having to make a leap of faith and invest in a system, sometimes a very expensive one, on the still-unproven assumption that it will offer tangible financial and organizational benefits in the near future. That’s gotta hurt.

Aggressive providers have been taking this risk for years now, and many have been very glad they did.  Not only have there been some nice examples of how hospitals and health systems have benefitted by their EMR investment, I’ve met doctors in small practices who absolutely rave about how productive their shift to EMRs has been. So there’s at least anecdotal evidence to support EMR buy-in.

Still, it sure would be nice if there was a one-size-fits-all ROI we could offer providers, or even a decent series of estimates. Right now, many are just going to have to fly blind.

May 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.

EMRs, Small Business and Universal Coverage

I turned on the radio on Monday and they were talking about Healthcare again. Universal coverage, the August recess, the “blue dog” democrats.

I keep thinking about how EMRs fit into all of this. Obama thinks that EMRs are going to make care better, more efficient and less costly. I think he is right about the first two (if we install EMRs that are usable and bring value to doctors and patients), but not necessarily about the third. EMRs may not reduce costs!

As Obama takes our economy (and our healthcare system) away from the small business model to the big government/big business model, I wonder how EMRs fit into all this. Investing in an EMR is a big deal for most physicians because we are a small business that provides medical care. Spending hundreds of thousands of dollars on an EMR which may not bring return on investment (ROI) while potentially reducing our productivity is a big risk. At the same time, if reimbursement are reduced or the system becomes Universal, the stakes are higher and the risks are greater.

Everyone (individuals and small business) is struggling with our current economy. Small businesses are at risk (many are closing their doors). Physicians are working hard to pay the bills, make payroll and have a little left over to take home to the family. The EMR issue has to be handled correctly or it could have dramatic effects on our healthcare system. The EMRs have to be effective and efficient. Doctors have to like them and be satisfied with their utility and performance. EMRs have to help us take care of patients more effectively and efficiently. Anything less than this throws more sand into the cogs of the healthcare machinery and amplifies the risks of all the other changes occurring at this time.

July 28, 2009 I Written By