Welcome to EMR and EHR

In addition to what I wrote about in my previous post, Marc Holland also does a pretty detailed analysis of the resources that RECs will have available to help resolve these physician concerns. He estimates in New York (where there are 2 RECs), they will have $4850 per physician available. The Ohio REC has $4750 per physician and the Michigan REC has $3300 per physician.

Of course, this per physician rate is a little misleading since these RECs won’t get their entire grant if they don’t perform. So, depending on how they do, it could be even less.

He also estimated based on the above numbers and the average cost for an EMR consultant that the RECs to break even would be able to provide “roughly two person-weeks in total – for contracting, for site planning, for training, for installation and first line post-implementation support.” Then, he suggested that wasn’t likely enough.

I generally agree that 2 weeks is not enough. However, it depends on the EMR consultants and more importantly, how creative the RECs become in using their EMR consultants and other resources. I’ve implemented in a clinic in two person weeks total spread out over a bit of time. So, it’s definitely possible. However, is that the best use of the resources the RECs have been given?

I personally don’t see the RECs providing this type of “free EMR consulting” services. I think the RECs are going to focus on more broad based strategies. The problem is that if you’re too broad based, then you aren’t that helpful. However, if you’re too focused then you can’t help enough people. Walking this line is going to be an interesting challenge.

Marc Holland, also suggests from the above numbers that the New York RECs alone will have to ramp up staffing to at least 100-120 analysts in the next 60-90 days. For me, that’s just funny to even think about. How many qualified EMR analysts (consultants if you will) are there in the US? And how many of those that are really qualified will want to go and work for a REC?

This is going to be really interesting to watch.

Today I got an email from HIMSS stating that they’ve launched a “complimentary afilliate membership program for RECs.” Looks like HIMSS wants to be able to influence help these RECs with their resources and perspectives. So far they’ve only signed up 10 regional extension centers to the program. Here’s the list that signed up so you can know if you’re REC has joined up with HIMSS:

• HITArkansas
• Colorado Regional Extension Center
• Illinois Health Information Tech Regional Extension Center
• CHITREC
• HealthBridge
• Massachusetts eHealth Institute
• Wide River Technology Extension Center
• Monroe County Medical Society
• North Texas Regional Extension Center
• Michigan Center for Effective IT Adoption

The good news is that this is only 10 of the 60 or so RECs out there. I can’t blame them. HIMSS conference attendance is expensive and free is much better.

I guess I just have a real mixed feeling about HIMSS. As a self proclaimed physican advocate myself, I think that HIMSS has too much EMR vendor influence to be a true physician advocate. I think that being physician advocates is key to successful EMR adoption and will be essential to any REC’s success.

Some of the best and most objective information about EMRs comes from the Center for Health IT at the American Academy of Family Practice. Real doctors who have purchased EMRs rate their EMR in 5 different categories: Quality, Value, Usability, Productivity and Support.

This report is ONLY available to members of the AAFP. I think if the AAFP really wanted to do all of us a big favor, they would release this report to anyone who is interested in seeing it. I don’t understand why they are keeping it secret.

It is going to be very difficult for doctors to find a good EMR because there are so many EMRs and so many “bad” EMRs (hard to use, reduce productivity, expensive). Starting with this survey can help doctors start their EMR search on the right foot.

Contact the AAFP and ask them if you can get a copy of their report.

Center for Health IT

Hopefully they will have our great Healthcare System’s best interest at heart. By making this report available to all doctors, they can help us all get “good” EMRs that are usable and high in quality.

If you are a doctor looking for an EMR, start your search with a few EMRs that get good ratings in this survey.