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What is Direct?

Posted on June 10, 2014 I Written By

Julie Maas is Founder and CEO of EMR Direct, a HISP (Health Information Service Provider) whose mission is to simplify interoperability in healthcare through the use of Direct messaging EHR integration and other applications. EMR Direct works with a large developer community to enable Direct for MU2 and other workflows using a custom, rapid-integration API that's part of the phiMail Direct Messaging platform. Julie is passionate about improving quality of care and software user experience, and manages ongoing interoperability testing within DirectTrust. Find Julie on Twitter @JulieWMaas.

John’s Update: Check out the full series of Direct Project blog posts by Julie Maas:

The specialist down the street insists he wants to receive your primary care doctor’s referrals, but only if it’s digital: “Sure, I’ll take your paper file referral sent via fax. But the service will cost an extra $20, to pay the scribe to digitize the record so I can properly incorporate the medical history.”

Does it really sound that far off? Search your feelings, Luke…

Will getting medical treatment using paper records soon be like trying to find somewhere to play that old mix tape you only have on cassette?  Sound crazy?  Try taking an x-ray film to a modern radiology department, and see if they still have a functioning light box anywhere to look at it.  It’s all digital now.

There are, of course, other factors.

Because MU2.

Because nobody, and I mean no small company and no large company, wants to be referred to as a data silo anymore.

Direct Exchange is a way of sending and receiving encrypted healthcare data, and certified EHRs must be able to speak it, beginning this year.  Adoption of Direct is increasing rapidly, and its secure transfer enables patient engagement as well as interoperability between systems that were previously dubbed silos.  Here is a brief overview of where Direct is currently required in the context of MU2 (please refer to certification and attestation requirements directly, for full details):

Certified ambulatory and acute EHRs need to use Direct for Transitions of Care (170.314(b)(1) and (b)(2)). They have to be able to Create a valid CCDA and Transmit it using Direct, and they have to be able to use Direct to Receive, Display, and Incorporate a CCDA. In the proposed MU 2015, the Direct piece may be de-coupled from the CCDA piece and modularized for certification purposes, but the end to end requirement would remain the same.

EHRs or their patient portal partner additionally need to demonstrate during certification that patients can View, Download, and Transmit via Direct their CCDA or a human readable version of it.  Yes, you heard correctly, I said patients.  As in patient engagement.

So, how does a healthcare provider get Direct?

1. Get a Direct account through your Direct-enabled EHR vendor

One way HIT vendors offer Direct is through a partnership with one or more HISPs (OpenEMR, QRS, Greenway, and others).  Others run their own HISPs (Cerner, athenahealth, and others).

2. Get a Direct account through an XD* HISP that’s connected to your EHR

HIT vendors alternatively enable access to Direct through an XD* plug-and-play (mostly) connector.  These “HISP-agnostic” EHRs allow healthcare organizations a choice between multiple XD*-capable HISPs when meeting MU2 measures (MEDITECH, Epic, Quadramed, and other EHRs have implemented Direct this way).  EMR Direct, MaxMD, Inpriva, and a few other HISPs offer XD* HISP services; not every HISP offers XD* service at this time.  Of course, there is a trade-off between this flexibility and the extra legwork required of the practice or hospital in setting up Direct.

3. Get a web-based or email client-based Direct account not tethered to an EHR or Personal Health Record (PHR)

 

Direct doesn’t have to be integrated into an EHR to transfer information digitally. Non-tethered accounts cannot attest to the sending side of (b)(2) nor the receiving side of (b)(1) on their own, but they can be Direct senders and receivers nonetheless, participating in Transitions of Care or data transfer for other purposes.  They may also be used to exchange health data with patients, billing companies, pharmacies, or other healthcare entities who are Direct-enabled. In fact, some very compelling use cases involve systems who may not have their own EHR, but want to receive digital transitions of care—one such example is skilled nursing facilities.

By the way, patients are also an integral part of the Direct ecosystem.  Several PHRs are already Direct-enabled, and more are on the way.

So, go digital and get your Direct address, and begin interoperating in the modern age!

HIE Study Finds That Failure To Use Data Cost $1.3 Million Over 18 Months

Posted on March 3, 2014 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.

You can put an HIE in place, but you can’t make doctors drink. That fractured moral was demonstrated recently by an HIE in Western New York, which found that many doctors were failing to use data available in the HIE, and thus ordering CT scans that were unnecessary — wasting about $1.3 million over an 18 month period.

The HIE, HEALTHeLINK, recently conducted a study intended to put a specific value on how many potentially unnecessary duplicative tests were being ordered by providers in its region, as well as a potential savings to the health system.

The sample audience was comprised of patients who had received more than one CT scan within a six-month period on the same part of the body. Scans were then sorted into the three most common categories of CBT groupings — head and neck, chest, and abdomen.

The duplicate scans were divided into three separate categories: 1) studies in which the CT report clearly reference to previous CT scan, 2) inconclusive studies in which researchers were able to tell if the previous study was known prior to ordering the scan and 3) unknown studies in which the CT report clearly stated that no previous study was known of.

Some findings include the following:

* During the 18 month study, which drew on claims data from three major insurance carriers in the area, researchers found about 2,763 CT scans which were considered to be potentially unnecessary.

* About 90 percent of the potentially needless CT scans were ordered by physicians who never or infrequently used the HIE. And more than 95 percent of the identified potentially unnecessary CT scans were done in a hospital,

* About 50 percent of the patients who had a duplicate CT scan had already consented to have their data accessed (so patients weren’t the obstacle).

While the analysis is complex, the lesson seems to be fairly simple. HIE’s are missing out on producing cost reductions when doctors aren’t accessing them prior to ordering tests.

#HIMSS14 Highlights: the Snail’s Pace of Interoperability

Posted on February 26, 2014 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.

Ah, HIMSS. The frenetic pace. The ridiculously long exhibit hall. The aching feet. The Google Glass-ers. As I write this, day three for me is in full swing and I’ve finally managed to find some time to reflect on what I’ve seen, which includes a ridiculously long taxi queue at the airport, more pedicabs than I can count, beautiful weather and lots of familiar faces, which is what makes HIMSS so much fun. I’ve heard lots of buzzwords and sales talk, and seen only about an eighth of the exhibit hall, barely scratching the surface of what’s out there on the show floor.

Several common themes stand out based on the sessions and events I’ve been to, and the passions of those I’ve encountered. Whether it’s vendor breakfasts, social networking functions, exhibit elevator pitches or educational sessions, interoperability and engagement are still the buzzwords to beat. This particular HIMSS has given me a different perspective on each, and offered new insight into what’s happening with the Blue Button Connector. I’ll cover each of these in HIMSS Highlights posts over the next several weeks, starting with interoperability.

The industry seems far more realistic this year regarding interoperability – downright frustrated by the slow pace at which such a lofty goal is proceeding. Industry experts Brian Ahier and Shahid Shah perhaps expressed it best during a lively panel discussion at the Surescripts booth:

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Putting vendors’ feet to the fire will certainly initiate a quick and painful reaction, but probably not a sustainable one. True momentum will occur only when providers get singed a bit, too. Panelist comments at a Dell / Intel breakfast on analytics for accountable care brought this into sharper focus for me. The fact that too many disparate EMRs (and thus too many vendors poised to cause inertia) are making it hard for analytics to successfully be adopted and utilized at an enterprise level, highlights a bigger problem related to hindsight and strategy.

From my perspective – that of an industry observer and commentator – it seems many providers felt compelled to purchase EMRs because the federal government offered them money to do so, and hopefully just as many were optimistic about the role technology would play in positively affecting patient outcomes. Vendors saw a great business opportunity and moved quickly to develop systems that met Meaningful Use criteria (not necessarily going for best-fit as related to workflow needs and usability). Neither group truly knew what they were in store for, especially regarding longer term plans for health information exchange.

Providers now find themselves wanting to move forward with health information exchange and greater interoperability, but slowed down by the very IT systems they were so insistent on purchasing just a few years ago. Vendors (some more than others) are hesitant to crack open their products to allow data to truly flow from one system to another, and who can blame them? The EMR market, in particular, is poised to shrink, which begs the question, who will survive? What companies will be around at HIMSS 15 and 16? Those who keep their systems siloed, like Epic? Or those who are trying to break down the silos, such as Common Well Alliance members like athenahealth and Greenway?

It makes me wonder if providers wouldn’t have been better served with just had a handful of EMRs to choose from around the time of HITECH, all guaranteed to evolve as needed and play nicely with each other in the interest of health information exchange. Too many options have caused too many barriers. That’s not just my opinion, by the way. I’m willing to bet that a sizeable chunk of the 37,537 HIMSS 14 attendees would agree with me.

Do you disagree? Are providers (and patients) better served by more IT options than less? Let me know your thoughts, and impressions of interoperability advancement at HIMSS, in the comments below.

HIE Cuts Back On Excess Imaging, But Savings Aren’t Huge

Posted on January 21, 2014 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.

For years now, we’ve been told that HIEs would save money and reduce redundant testing by hospitals and doctors.  Until recently, such has mostly been the stuff of anecdote rather than hard results.  But a new study comparing hospitals on an HIE with those that were not seems to offer some of the hard evidence we’ve been waiting for (though the cost savings it finds aren’t spectacular overall).

According to a piece in Healthcare IT News, a new study has come out which demonstrates a link between HIE participation and the level of imaging performed in hospital emergency departments.

The study, which was done by Mathematica Policy and the University of Michigan, found that when hospitals were joined in an HIE, the number of redundant CT scans, x-rays and ultrasounds fell meaningfully, generating savings in the millions of dollars.

To conduct the study, Mathematica and the U of Michigan compared the level of repeat CT scans, chest x-rays and ultrasounds for two groups.  One group consisted of 37 EDs connected to an HIE; the other group was 410 EDs not connected to an HIE.  Researchers collected data on the two groups, which were based in California and Florida, between 2007 and 2010, using the state emergency database and HIMSS Analytics listing of hospital HIE participation.

The researchers found that hospital EDs participating in an HIE reduced imaging across all the modalities compared with hospitals not participating in an HIE.  For example, EDs using an HIE worth 13 percent less likely to repeat chest x-rays, and 9 percent less likely to repeat ultrasounds.

Ultimately, the study concluded that if all of the hospital EDs in California in Florida were participating in HIEs, the two states could save about $3 million annually by avoiding repeat imaging.  This is just fine, but this translates to $3 million in lost revenue for those hospitals. Once you split up $3 million across that many hospitals, you don’t end up with an impressive amount per hospital, but it’s still a cut to revenues. A cut in revenue isn’t a strong motivator to implement an HIE even if it does help to lower healthcare costs.

This is why it’s a real challenge to get many hospitals on an HIE. When you throw in the technical issues involved in HIE membership, it could be quite some time before the majority of hospitals jump on board without more external incentives.

CommonWell Announces Sites For Interoperability Rollout

Posted on December 13, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Nine months after announcing their plan to increase interoperability between health IT data sources, the CommonWell Health Alliance has disclosed the locations where it will first offer interoperability services.

CommonWell, whose members now include health IT vendors Allscripts, athenahealth, Cerner, CPSI, Greenway, McKesson, RelayHealth and Sunquest, launched to some skepticism — and a bit of behind-the-hand smirks because Epic Systems wasn’t included — but certainly had the industry’s attention.  And today, the vendors do seem to have critical mass, as the Alliance’s founding members represent 42 percent of the acute and 23 percent of the ambulatory EMR market, according to research firms SK&A and KLAS.

Now, the rubber meets the road, with the Alliance sharing a list of locations where it will first roll out services. It’s connecting providers in Chicago, Elkin and Henderson, North Carolina and Columbia, South Carolina. Interoperability services will be launched in these markets sometime at the beginning of 2014.

To make interoperability possible, Alliance members, RelayHealth and participating provider sites will be using a patient-centric identity and matching approach.

The initial participating providers include Lake Shore Obstetrics & Gynecology (Chicago, IL), Hugh Chatham Memorial Hospital (Elkin, NC), Maria Parham Medical Center (Henderson, NC), Midlands Orthopaedics (Columbia, SC), and Palmetto Health (Columbia, SC).

The participating providers will do the administrative footwork to make sure the data exchange can happen. They will enroll patients into the service and manage patient consents needed to share data. They’ll also identify whether other providers have data for a patient enrolled in the network and transmit data to another provider that has consent to view that patient’s data.

Meanwhile, the Alliance members will be providing key technical services that allow providers to do the collaboration electronically, said Bob Robke, vice president of Cerner Network and a member of the Alliance’s board of directors.  CommonWell offers providers not only identity services, but a patient’s identity is established, the ability to share CCDs with other providers by querying them. (In case anyone wonders about how the service will maintain privacy, Robke notes that all clinical information sharing is peer to peer  — and that the CommonWell services don’t keep any kind of clinical data repository.)

The key to all of this is that providers will be able to share this information without having to be on a common HIE, much less be using the same EMR — though in Columbia, SC, the Alliance will be “enhancing” the capabilities of the existing local HIE by bringing acute care facility Palmetto Health, Midlands Orthopaedics and Capital City OB/GYN ambulatory practices into the mix.

It will certainly be interesting to see how well the CommonWell approach works, particularly when it’s an overlay to HIEs. Let’s see if the Alliance actually adds something different and helpful to the mix.

One-Third of Chicago-Area Hospitals Come Together Into HIE

Posted on December 4, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Thirty-four Chicago hospitals have decided to come together into a health information exchange, with plans to begin exchanging data early next year, according to a story in Modern Healthcare.

The group, which calls itself MetroChicago HIE, considers itself to have critical mass, given that it embraces about a third of the region’s 89 hospitals.

To exchange data, the HIE is using Direct protocols permitting basic, encrypted clinical messaging, such as the transmission of referral letters between providers which have established authentication and business relationships, Modern Healthcare notes.

Even with Direct protocols in hand to streamline data sharing, the hospitals will face significant challenges in tightening communications between their various EMRs, which include a number of Epic and Cerner installations, as well as a few Meditech shops. Planners will also face issues when they set out to link the HIE to office-based physicians.

To address the problem of communicating between multiple interfaces, the HIE has hired technology firm SandLot Solutions, a company launched by North Texas Specialty Physicians.

To date, many hospitals have been reluctant to sink big bucks into HIE development. But participating hospitals in Chicago seem confident that there is a business case for spending on an HIE.

The truth is, this may just be a tipping point for hospital-run HIEs generally. For example, a recent study by HIMSS Analytics and ASG Software Solutions concluded that almost 70 percent of the 157 senior hospital IT execs surveyed were involved in HIE efforts.

Now, let’s see how these Chicago hospitals handle data exchange when they move beyond Direct into more advanced sharing. That will really be where the rubber hits the road.

Hospitals Still Struggling With HIE Data Sharing

Posted on September 30, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Hospitals are trying hard to make HIEs work, but establishing robust data exchange remains a major challenge, particularly given the difficulty involved in processing paper records, a new study by HIMSS Analytics suggests.

The report, sponsored by ASG Software Solutions, draws on a survey of 157 senior hospital IT executives.

More than 70 percent of respondents to the survey reported that they participated in an HIE with other hospitals and health systems.

The thing is, the facilities reported that they’re having difficulty exchanging patient information in meaningful, powerful ways. Also, survey respondents noted that sharing information outside of HIEs is held back by budget concerns and staffing problems.

Juggling electronic and paper-based data is still a major issue, the study suggests:

* 64 percent of health information organizations reported that they shared data with nonparticipating hospitals via fax
* 63 percent of the same organizations converted faxed information into digital form via scanning
* 84 percent of respondents integrated their output/print environment directly into their EMR/HIS system
* 42 percent of survey respondents said their output/print environment was “high effort”

Unfortunately for HIE fans, coordination and management of paper records is far from the only issue standing in the way of making them work acceptably in a hospital environment.

According to a study by Chilmark Research, the focus of most HIEs is still on secure clinical messaging, which doesn’t do the job for cross-enterprise care coordination. The Chilmark research estimates that queries of databases for patient information needed at the point of care account for just 2 percent to 10 percent of HIE transactions overall.

As Chilmark CEO John Moore recently told Information Week, the problem is particularly acute in ambulatory care. Most ambulatory EMRs haven’t been able to generate CCDs that other EMRs can consume or execute queries using a record locator service. This is a pretty serious weakness in the HIE space, given that 80 percent of care takes place in ambulatory setting.

Given their importance, it’s troubling to see how many obstacles remain to robust HIE use by hospitals and physicians. Let’s hope the next 12 months see some breakthroughs.

HIEs Unable To Keep Up With User Demands

Posted on August 7, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While HIEs are expanding their offerings to include analytic and care coordination functions useful for population health management, they aren’t doing it quickly enough to meet market demand, according to a piece in Information Week.

The IW story, which outlines the conclusions of a new report from Chilmark Research, notes that the focus of most HIEs is still on secure clinical messaging, which is not adequate for cross-enterprise care coordination. The Chilmark report estimates that queries of databases for patient info needed at the point of care account for just 2 percent to 10 percent of HIE transactions overall.

Information Week also drew attention to a study appearing in Health Affairs noting that the most common functions of the 119 operational public HIEs were transmitting lab results, clinical summaries and discharge summaries. While there’s been a large increase in the number of HIEs that can exchange Continuity of Care Documents, few EMRs can integrate the data components of CCDs in to structured fields, the Health Affairs piece noted.

The problem is particularly acute in ambulatory care. As Chilmark CEO John Moore told Information Week, most ambulatory EMRs haven’t been able to generate CCDs that other EMRs can consume or do queries using a record locator service. “The value that HIEs provide to the ambulatory sector, where 80 percent of care takes place, is pretty limited,” Moore told IW.

Still, despite their weaknesses, public HIEs continue to hold onto life. For example, as various industry stats have shown, hospital CIOs increasingly see participation in an HIE as a key initiative, if nothing else because Meaningful Use will eventually demand interoperability.

But as the Chilmark study emphasizes, HIEs have a long way to go before they’re making a major contribution to patient care. And getting enough momentum to address these problems seems elusive. All told, while HIEs are clearly an important movement, getting them to the point of true usefulness could take years more.

Health IT Costs, Health IT Adoption, HIE and CommonWell – Pre #HITsm Thoughts

Posted on June 28, 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.

Last week I took the #HITsm Chat topics and created a blog post about Healthcare Unbound. I enjoyed creating the post so much that I decided to do it again this week. Not to mention I’ll be on the road to Utah during this week’s chat and won’t be able to participate. (Side Note: If you live in Utah and want to do lunch, I’d love to meet and talk EMR or health IT. I’ll be in Hawaii in July if you want to do the same.)

The chat topics make perfect discussion items. Plus, I love that I have more of an opportunity to really dig into the topics in a blog post. You can’t dig in quite as much in 140 characters.

Topic 1: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?
We’ve seen an enormous shift in the cost of healthcare IT since I first started blogging about EMR 8 years ago. Cost use to be a much bigger issue when the cheapest EMR software you could find was about $30,000+ per doctor (in the ambulatory space). Plus, they expected you to pay the entire lump sum payment up front (many did offer financing). These days the cost of EMR software has dropped dramatically and fewer and fewer EHR vendors are using the lump sum payment model. This change means that costs are much more in line with a practice’s revenue.

These days, I’d say that those who use cost as the reason for not adopting health IT are really just using it as an excuse not to do it. There are a few rural providers where cost is more than just an excuse, but those are pretty few and far between. I’m not saying that cost isn’t an important part of any health IT project, but I’ve most often seen cost used as a mask for other reasons people don’t want to implement health IT. The most common reason is actually just a general resistance to change.

Topic 2: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?
If providers could be reimbursed for telehealth, adoption would be high.

It is ironic that doctors don’t really get reimbursed for ePrescribing, but they do it at a high level. Although, the doctor does get reimbursed for the visit that generates the need for the prescription. A deeper investigation of why ePrescribing has had good adoption would be interesting. Certainly there are many doctors who miss their sig pad. However, once you have to record the prescription in the EHR, you might as well ePrescribe it.

Plus, there are some obvious reasons why ePrescribing is better. Whether it’s replacing the unreadable prescriptions or the drug to drug and allergy interaction checking that’s built into every ePrescribing platform, the benefits can be understood quickly.

The sad thing is that the benefits of Telehealth can be seen quickly as well, but you can’t get paid to do it.

Topic 3: #HIE as a noun or a verb? Does negative press for HIE org$ hinder health data exchange as a whole?
HIE is currently more of a noun than a verb. Verbs require action and we’re not seeing enough HIE action.

In some ways negative press could discourage healthcare organizations from participating in an HIE organization. However, negative press about HIE’s weaknesses can also put pressure on healthcare organizations to finally step up to the plate and have more HIE action and less HIE talk.

The biggest hindrance to HIE is business model, and good or bad press won’t do much to change that.

Topic 4: Is #CommonWell just a bully in a fairy godmother costume?
I love this question mostly because I sent the tweet that inspired it. Although, a smart health IT PR/marketer was the one who said it to me.

It’s a little too early to tell if the fairy godmother costume that CommonWell has on is real or fake. I think there path is paved with good intentions, but will the almighty dollar get in the way of them realizing these good intentions? I don’t know. I’m hopeful that it will be a success. I’m also glad that at least the conversations are happening. That’s a step forward from where we were before CommonWell.

Topic 5: Open forum: What #HealthIT topic had your attention this week?
There are so many topics that I discuss each week, but I think I’m most excited by the project announced this week to create a Common Notice of Privacy Practices. I hope their crowdfunding is successful and they get a lot of great healthcare organizations on board with what they’re doing. I also found the Vitera Healthcare acquisition of Success EHS quite interesting. EMR is slowly but surely consolidating.

Bill Gates Puts a New Spin on the Great EMR Debate

Posted on 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.

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.