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Finding the Silver Lining in EMR Investment

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.

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 its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

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.

Wireless Healthcare IT Could Hold the Key to Preventable Readmissions

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.

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 its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

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.

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

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.

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.

EMR Value Diminished If Patients Can’t Access Care

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.

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.

ACA Implications, Hurricane Sandy, and Interoperability — #HITsm Chat Highlights

Topic One: Obama’s re-election secures the future of the #ACA, but what changes/concessions are we likely to see during its rollout?

Topic Two: What #healthIT strengths and weaknesses did Hurricane Sandy expose?

Topic Three: What business continuity/disaster recovery strides do health providers still need to make?

 

Topic Four: A national #HIE would have come in handy during #Sandy, so why does the industry still fail to embrace interoperability?

 

 

November 10, 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.

Could Patent Conflicts Choke mHealth Growth?

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.

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.

Clinical Data Access, New Open Source EHR, and Striiv – Around Healthcare Scene

Hospital EMR and EHR

Call Me Maybe at #CHIME12

One of the most popular songs among teens recently is “Call Me Maybe.” Well, at CHIME 2012, a music video of this song was created, featuring many of the participants in #CHIME12. It’s a fun little video, and the song sure is catchy.

Senators Join Initiative to Scrutinize Meaningful Use

After four GOP leaders have demanded that HHS Katherine Sebilus account for “failures” they found with Meaningful Use. Recently, a few senators have joined in the fight as well. Several questions were raised about EMRs, Medicare, and Meaningful Use. Is this the push that was needed in order to get Congress interested in the future of EMRs?

EMR and HIPAA
SXSW Accelerator Event for Health Startups

SXSW has long been known as an amazing music, film and now IT event. In fact, many people laud the event as a great place where creative people from all industries come together. This year SXSW has a whole health IT campus and a section of their Startup Accelerator competition that’s just devoted to healthcare IT startups. It will be a great place for healthcare IT to mix with the rest of the IT startup world. Plus, I expect a number of very interesting health IT companies to launch in the SXSW accelerator.

Access to Clinical Data Too Easy Via Phone

Most doctor’s offices will verify information by asking for a name and birthdate. However, this system could easily be compromised. Is there a better way to verify this type of information, before discussing medical issues? This post talks about different ideas, and how patient portals might be the solution.

New Open Source (Free) EHR Offering Developed by A Doctor

A new open source EHR is about to be released. And it was developed by a physician. Michael Chen, MD,  the doctor behind it, was interviewed on EMR and HIPAA. He discusses why he wanted to create an open source EHR, future plans, and any challenges that might be associated with it in this post.

Happy EMR Doctor

EMR Use Improves Primary Care: New Study

While there has been some debate about if EMR improves patient care, a recent study indicates that it does; at least in some health specialties. Over 7000 patients with coronary artery disease and diabetes were studied over the course of nine months, and the results ruled in the favor of EMRs. Dr. Michael West has found in his own personal observations, EMR does indeed improve patient care as well.

Smart Phone and Health Care

Five Challenges of mHealth

While mHealth has many advantages and has improved health care in many ways, there have been some challenges that have come about. These challenges include privacy, data security, and funding.

Striiv Ups the Standard for Pedometers — Games, Challenges, and Charity Incorporated

A new generation for the classic pedometer has been created. Striiv recently released a $99 pedometer that really gives the old kind a makeover. It incorporates fitness games, goals, and a charity to convince people to get walking. For those that don’t want to spend $99 on a pedometer, the (free) mobile app is available for the iPhone, and has a lot of the same functions.

October 28, 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.

Meaningful Use and Big Data, Payment Reform, and Evidence-Generated Medicine – #HITsm Highlights

Topic One: Is Meaningful Use enabling big data in health care? Why or Why Not? #bigdata

Topic Two: Will payment reform make data sharing a strategic imperative? Why or Why Not?

T3: What are the most underutilized sources of data in health care? #bigdata

Topic Four: What data might be used for evidence-generated medicine?

October 27, 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.