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“If You Could Tell Your CIO …”

Posted on March 7, 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 the first part of this blog series, I outlined the increasingly important role CMIOs are playing in the hospital ecosystem. They are bridging the gap between the world of clinical and IT, bringing a spirit of impartiality to HIT implementations that often makes the acceptance of impending workflow upsets a little bit easier to swallow.

This second part will focus on the specific challenges CMIO panelists at a recent Georgia HIMSS luncheon were particularly vocal about:

* Taking an EMR implementation from grumbles to growth;
* Data and its potential impact on establishing or refining best practices;
* Patient engagement; and
* “If You Could Tell a CIO.”

From Grumbles to Growth
All the panelists shared their “secret ingredients” for EMR implementation success. Roland Matthews, MD, physician champion at Grady, stressed that the hospital chose to implement an EMR not for the Meaningful Use incentives, but to ultimately improve quality over the long term. Despite recent EMR backlash, Matthews is a firm believer in the benefit they will ultimately bring to patient care.

That being said, he believes that simpler, easier-to-use systems are the best choice when it comes to gaining full adoption amongst clinicians. His statement echoes the increasingly loud call from clinicians for better user experience. Involving all departments in the selection and implementation process from the very beginning is also essential, according to Matthews, and serves as a testament to good leadership.

The best user experience won’t take physicians very far, however, if infrastructure is too unreliable to sport it. While he didn’t claim to speak from personal experience, Matthews also pointed out the latest and greatest EMR may never be used to its fullest potential if the platform on which it stands is down half the time.

Steve Luxenberg, MD, CMIO at Piedmont Healthcare, made sure to point out the full value of an EMR can only be realized if clinical and IT work together to maintain, optimize, and grow the product from within.

This takes us to conversation points about extracting data to create or refine best practices in an effort to drive quality initiatives.

Digging Out Data to Increase Quality
“It’s not an EMR for the sake of an EMR,” Luxenberg emphasized. “It’s about the data we can pull out, interpret and impact outcomes with.”

Daniel Wu, part-time CMIO at Grady, echoed Luxenberg’s comments: “The EMR has opened a door to allow us to collect data as we’ve never been able to do before.” The panelists all agreed on this point, and now it seems as if they are tackling the issue of interpreting the data to enable better outcomes and quality.

Matthews insisted that collecting the data is really all about quality, and suggested that the EMR should guide standards, which the panelists referred to in the same context as best practices.

Wu made the point that if providers don’t control what designates quality care, or best practices, then the government will come along and regulate it for them. (I’m fairly certain this echoes what Farzad Mostashari has tweeted about in the recent past.)

Luxenberg again emphasized the impartiality CMIOs must take when dealing with clinical and IT staff. He noted the CMIO’s role is to bring the two groups together for consensus on what best practices are and how to put those into the EMR, and added this becomes more challenging when working in a multi-facility healthcare system.

Patient Engagement
Patient portals were on the tips of all the panelists’ tongues when it came to patient engagement. Julie Hollberg, MD, CMIO at Emory, is in the middle of rolling out a portal right now. Her team is finding the most challenging part of that implementation to be educating Emory patients on what benefits the portal offers. Luxenberg was a bit lukewarm with regard to patient portals. He’s seen several come and go and has found that only a certain set of patients is apt to use them.

Wu, who has helped implement Epic’s MyChart at Grady, was firm when he said that patients have the responsibility in their court now. Patient kiosks are helping in that effort, too.

What Would You Like Your CIO to Know?
Wu’s big point was that if CMIOs and CIOs can’t communicate, each is doomed to fail. He said it with a smile, of course, as his CIO, moderator Debbie Cancilla from Grady, was standing right next to him.

Other insights included:

* Keep IT simple for the clinicians.
* Just because you can do it doesn’t mean you should.
* Always keep in mind what’s best for the patient, and what’s the simplest way to get that done.
* It’s always a good idea to have IT folks shadow clinicians and vice versa. The CMIO’s job is to help facilitate this type of partnership.

How have CMIOs brought your clinical and IT teams together? Please share anecdotes and more best practices in the comments below.

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.

gahimssCMIOpanel

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.

EMRtweet2

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

EMRtweet3

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.

MyPassport, Transcription Costs, and CDC App — Around Healthcare Scene

Posted on January 20, 2013 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.

Hospital EHR and EMR

Hospitals Beware: EMR Copy and Paste Common

EMR Templates can be helpful, but also makes life harder as well. A recent study found that 82 percent of progress notes by residents had 20 percent or more copied and pasted material. This function is tempting for physicians who need to cut time somewhere, but its something that needs to be watched out for and prevented.

iPad App Helps Patients Understand Inpatient Care Process

In an effort to eliminate confusion that often comes during an inpatient stay, Boston Children’s Hospital has developed an iPad app. The app, called MyPassport, helps patients understand more about what is going on during their stay. It displays photos of doctors and nurses, others involved in care, as well as lab results that have been condensed to patient-friendly terms.

EMR, EHR, and HIPAA

EHR Benefit — Transcription Costs Savings

This is the next part of the EHR benefits series. Many doctors were thrilled to give up their transcription for an EHR in hopes of saving costs. However, some are feeling that their EHR may not be the best solution after all. Because of this, some are wanting to implement transcription services again. So, for some, eliminating transcription may not have saved as much money as some had hoped.

Mixing Physical, Mental Health Data Lowers Readmissions

Physicians aren’t often given access to the psychiatric records of patients they are treating. However, a study by Johns Hopkins found that perhaps they should be. The study showed that a signficant percentage of patients whose physicians had access to both physical and mental health data had a smaller readmission rate than those whose mental health records weren’t available.

Smart Phone Healthcare

CDC Launches New Mobile App

The CDC is getting into mHealth with the recent release of their mobile app. The app has many different features, such as health articles, quizzes, and a news room with information outbreaks or other pertinent information. The app is free and definitely one that should be downloaded if you enjoy hearing about health news.

Google Gets Into Activity Tracking

After the failure of Google Health, Google is making an attempt to get into the activity tracking world. “Google Now” basically turns the phone into a personal tracking device, including for fitness. It isn’t as accurate as some of the more sophisticated tracking devices out there, but it is a lot easier to use because it is embedded into the phone. It may make it easier for people to

Finding the Silver Lining in EMR Investment

Posted on January 17, 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 a week of doom and gloom news as far as healthcare IT goes. Apparently, providers aren’t seeing the ROI they’d hoped for from EMRs, and as I’m sure you’ve heard, RAND researchers have found that, despite predictions to the contrary some years ago, healthcare IT does not actually save money. Couple these with the 2% hike in social security tax everyone is seeing in their paychecks this month, and it’s easy to understand why the healthcare community might be a bit grumpy.

I’m here to propose that providers try to look on the bright side when it comes to recouping some of that EMR investment. Telemedicine programs may hold a ray of hope for providers looking to find additional value in their EMR. These programs, in my opinion, have gained a strong foothold in the healthcare industry – providers, payers and patients are certainly showing interest, especially given the industry’s stance on readmissions these days; the government seems supportive; and vendors are always eager to provide more product to willing customers.

Here are just a few of the telemedicine highlights I’ve come across in the last few weeks:

* A proposed bill in the House backed by the American Telemedicine Association – The Telehealth Promotion act of 2012 – would potentially expand telemedicine programs in Medicaid and Medicare programs, federal health employee plans, the VA, and others

* The federal government has set aside $1.9 million as part of its Telehealth Resource Center Grant Program in the hopes of expanding its current network of 14 centers to 20.

* The FCC will offer qualifying healthcare facilities up to $400 million annually as part of its Healthcare Connect Fund, which seeks to accelerate development of broadband networks in rural areas.

My thinking is that we’ll see these telemedicine initiatives grow as physicians become more scarce (at least in non-metropolitan areas), coordinated care programs increase, payers look to play a part in wellness programs and preventing readmissions, and everyone continues to look for ways to drive down costs. And from what I’ve read, I don’t see how a hospital or physician’s practice can successfully or meaningfully (pardon the pun) participate in a telemedicine program without an EMR.

Which brings us back to the bad news above. EMRs in recent years have mostly been designed with Meaningful Use measures in mind, not telemedicine, and so might not be adequately equipped to integrate data from teleconsultations. This is where vendors come in. If BCC Research’s prediction of the telehospital market growing to $17.6 billion in 2016 is true, they’ll come in droves. They’ll get to that value by working with hospitals and physicians that want to further their telemedicine programs, and will likely be looking for ways to increase the functionality of their EMRs as a result.

As many of us head to HIMSS in a few weeks, it will be interesting to see if providers really are as disgruntled with HIT expenditures as the media would have us believe, and how much play is being given to telemedicine in the educational sessions and on the show floor.

What is your opinion? Do you currently participate in any sort of telehealth program? Do they have the ability to make EMRs more useful? Please share your thoughts in the comments below.

EMR A Disappointment In The US?

Posted on January 15, 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.

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.

Wireless Healthcare IT Could Hold the Key to Preventable Readmissions

Posted on December 12, 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.

As I mentioned in my last blog post, CardioMEMS was the winner of this year’s Intel Innovation Award, presented at the Health IT Leadership Summit earlier this month. CardioMEMS has a number of development firsts to its credit, bolstering its recent claim to innovation fame:

  • First wireless communication system for the human body
  • First medical implant completely wafer fabricated
  • Only FDA-approved, permanently implanted wireless sensor

Essentially, the company has developed a first-of-its kind wireless (and battery-less) heart failure monitoring system. As Richard Powers, Vice President of Information Systems, explained to me on my field trip to CardioMEMS’ relatively new offices in Atlanta, the company has figured out a way to, in the least traumatic way possible, implant a cardiac sensor that monitors pressure and wirelessly transmits that data directly to a patient’s physician via a Web-based portal.

When I first came across the company nearly two years ago, the term “Big Data” hadn’t quite gained the buzzy reputation it has now, so I feel confident in saying that CardioMEMS’ analytics team were a bit ahead of the game – not surprising, given that the company was founded by Dr. Jay S. Yadav, its current CEO and still a consulting cardiologist.

In talking with Yadav, I realized he and his colleagues recognize not only the importance of back-end data, but also the value of simplicity.  As Powers pointed out, the sophisticated technology isn’t in the device itself, but comes after on the receiving end. Ideally, physicians will use data transmitted from the sensor to gauge cardiac pressure changes and adjust medication accordingly.

The timing of this technology couldn’t be better, in my opinion, since so much attention is being paid to preventing readmissions, increasing quality outcomes and improving patient satisfaction scores. Benefits of the sensor in clinical trials include fewer hospitalizations, lower cost of care and an increase in quality of life. And I do believe the CardioMEMS team has even figured out the reimbursement angle with CMS, which should make provider adoption of the devices that much more likely.

Pending FDA approval is the only thing holding up a full-court product marketing press, which may, when that approval comes, be aided by partnership with a select provider organization.

I couldn’t leave the CardioMEMS offices, of course, without asking about its plans to integrate into an EMR. According to Powers, integration of the physician portal into an EMR is in fact on the drawing board yet. They are also looking at ways to pull a patient’s EMR data into the CardioMEMS portal. The company is currently working with the Enterprise Innovation Institute at Georgia Tech to look into EMR interoperability.

I’m confident we’ll be seeing some really interesting developments from this company in the near future.

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

Posted on 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.

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.

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.