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Meaningful Use Payouts Hit $19 Billion

Posted on February 12, 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 @annezieger on Twitter.

The pace of meaningful use payouts has stayed strong of late, with CMS disclosing that it has disbursed more than $19 billion in EMR usage incentives. While hospitals have been particularly prone to stay on the meaningful use train, eligible providers are collecting their payouts too, according to Healthcare IT News.

According to CMS data, there were 440,998 registered providers participating in the federal EMR incentive program as of the end of 2013, who have to date received 19.2 billion in incentives.

About 88 percent of all eligible hospitals have been given EMR incentive payment so far, according to CMS officials.  Also, about 60 percent of Medicare eligible providers are meaningful users of EMRs, the agency reports.

And the meaningful use programs for Medicare and Medicaid are both active, with more than 340,000 eligible providers having received an incentive payments to their program. Medicaid eligible providers are distinctly less likely to be involved in the meaningful use program; only 20 percent of Medicaid EP’s are meaningful users.

What the Healthcare IT News article doesn’t discuss, but ought to, is that there is considerable evidence that many doctors are not willing to push beyond Stage 1 of meaningful use. Stats suggest that these doctors have little financial incentive to move ahead with Stage 2, and can’t afford the time or money to push through the MU 2 obstacles.

In other words, before CMS runs a victory lap, it might do well to see what’s happening with the doctors walking away from the program.

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 @annezieger on Twitter.

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.

Study: Opportunities Still Available For HIT Vendors

Posted on October 28, 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 @annezieger on Twitter.

Not long ago, my colleague John Lynn wrote a piece arguing that the era of easy EMR money and abundant customers is over. In that post, he contends that the “Golden Age of EHR Adoption” has fled, leaving vendors with the unenviable task of attracting the late adopters to the table.

Well, at least one research firm seems to disagree. According to a trend report from Berkery Noyes, there are still many openings in the HIT marketplace for entrepreneurs who can address pain points, Healthcare IT News reports.

The Berkery Noyes report analyzes M&A activity in the healthcare sector taking place during the first three quarters of 2013, and compares it with data from 2012.  Markets covered include information and technology companies servicing the pharmaceutical, payer and provider sectors.

At present, the researchers say, the healthcare market is highly fragmented, offering many opportunities for entrepreneurs that find areas of need.  These opportunities include healthcare IT startup, the researchers say.

The market clearly seems interested in HIT plays. Healthcare IT dealflow is strong, seeing a 56 percent volume increase on a quarterly basis, according to Healthcare IT News. HIT deals also accounted for almost half of the industry’s aggregate M&A volume, as opposed to just 31 percent in the previous quarter.

In fact, the standout deal of the quarter. booking the overall industry’s highest value, was Vitera Healthcare Solutions’ planned $644 million acquisition of EMR vendor Greenway Medical Technologies. And this may not be this year’s biggest deal; researchers note that “large strategic buyers” are looking to buy unique content/software solution in the healthcare market.

All that being said, it’s worth noting that it’s not as though every promising healthcare technology company has suitors at the door.  Buyers want companies with proprietary technology/content, scale in their markets, high (double digit) revenue growth, a high percentage of recurring revenue and a large total addressable market opportunity, noted Tom O’Connor, managing director at Berkery Hoyes, in a recent press release.

So, net net, it looks like there’s money out there for the right health IT play, but not so much for startups early in their growth path, or health IT players struggling to capture the rapidly shrinking Meaningful Use-fueled market. So I’d argue that the report’s enthusiasm for entrepreneurial opportunities should be qualified a bit. Still it’s good to know that investors are bullish on health IT generally.

Doctors: EMRs Can Be Quality Obstacles

Posted on October 15, 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 @annezieger on Twitter.

Many doctors believe that today’s EMRs are difficult to use and stand in the way of quality care at times, according to a new RAND Corporation research report covered by Healthcare IT News.

The RAND report comes from a project, sponsored by the American Medical Association, which was designed to identify what influences doctors’ professional satisfaction.

To research the report, RAND surveyed 30 physician practices in six states–Colorado, Massachusetts, North Carolina, Texas Washington and Wisconsin. RAND researchers also visited each of the practices on site, conducting in-depth interviews with 220 doctors, medical administrators and allied health professionals to see what drives doctors’ satisfaction with their work lives.

One key finding of the report was that being able to provide high-quality care is a primary factor in job satisfaction for physicians — and that anything which hinders them from doing so is a source of stress. And one critical factor that doctors feel impedes their ability to deliver good care is the requirement to use EMRs, Healthcare IT News notes.

Doctors who responded to the survey told RAND that current EMR technology gets in the way of face-to-face discussions with patients, demands that physicians spend too much time on clerical work and lowers the accuracy of medical records by encouraging the use of template-generated notes, according to Healthcare IT News.

What’s more, doctors told RAND that they’re unhappy that EMRs have been more costly than expected, and that the lack of interoperability between various EMRs has been a major frustration, as  it keeps them from easily sending patient data where it’s needed and when it’s needed.

Medical practices are trying to reduce doctor frustration by hiring staffers to perform many tasks involved in maintaining electronic records. And practices are attempting to improve physician satisfaction in other ways, such as giving them more independence in structuring clinical activities and allowing more control over the pace and content of the care they provide.

Still, it’s telling that as many as one-fifth of practices might switch EMRs, searching for an system that solves problems rather than creating new ones.  Whatever practices are doing to help physicians achieve satisfaction with their current EMR, it doesn’t seem to be working very well.

Dilbert Digital Health Cartoon

Posted on August 18, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

How can you not love Dilbert? I once heard Scott Adams speak at a conference and it was spectacular. I laughed the whole time and left with an important message. Neil Versel says he spoke at HIMSS in 2005. I can only imagine what he’d say about Healthcare today.

Oh yes, you probably want to see the Dilbert Digital Health cartoon. I’d put it here, but it seems right to have you click the link and check it out on Meaningful Healthcare IT News since he found it.

I love digital sensors. There’s certainly plenty of FUD around them, but for every bad thing there’s a handful of great benefits.

I hope you enjoy a little weekend humor.

EMR, HIE Use Up Sharply In U.S.

Posted on May 10, 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 @annezieger on Twitter.

A new survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

Hardest Meaningful Use Measure

Posted on December 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

There was a great piece a while back by Benjamin Harris that looked at the 5 not-so-easy pieces of meaningful use stage 2. In the article he suggests the following 5 challenges:

1. Structured Lab Results
2. Patient Access to Health Information
3. Ongoing Submission to Registries
4. Computerized Order Entry (CPOE)
5. Summary of Care Referrals

I started asking around my network to see what readers of my site and those in my social media groups thought was the hardest meaningful use measure for them. Some of them match the list above, but I thought I’d highlight a few of them I found interesting.

One person told me that the multi-lab scenario might be one of the most challenging parts of meaningful use and one that doesn’t get talked about much.

A CIO named Renee Davis told me that ePrescribing and monitoring compliance were the hardest meaningful use measures. I think the ePrescribing part can be a huge challenge depending on your EHR vendor, your physician users, and your location (ie. Do your local pharmacies participate?). Plus, any CIO will definitely have challenges with compliance.

Patty Houghton suggested that Clinical Summaries and Problem Lists were her hardest meaningful use challenges.

Obviously when you say the word “hardest” it’s something that’s unique to an individual practice or institution. With that disclaimer, from the large number of people I’ve talked to I think that most people consider the 60% CPOE meaningful use measure the hardest.

I still remember the day when I heard Marc Probst, CIO of Intermountain Healthcare (IHC), say that IHC was doing ) CPOE. This was when he was first working on the committees in Washington to create EHR certification and meaningful use requirements. It was a shock to me that IHC, who is touted for its use of IT in healthcare, could have 0 CPOE (I think Meaningful Use has helped encourage them to remedy this number). It illustrated well how much of a challenge CPOE will be for many institutions.

What’s your experience and the experience of the doctors and hospitals you work with? Which meaningful use measures are most challenging?

From #AMIA: Interoperability Held Back By Politics

Posted on November 12, 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 @annezieger on Twitter.

When a recent AMIA panel was asked why health IT interoperability was still in its infant stages, members’ responses were the same we’ve been hearing for, I don’t know, a decade or more.  Let’s say that there didn’t seem to have been a lot of hope in the room.

According to Healthcare IT News, true interoperability between health systems is still beyond us due to the same-old, same-old reasons:  Hospitals with hundreds of systems, vendors with proprietary databases, varied standards, health systems that don’t want to share data and a lack of interoperability support from policymakers.

Ultimately, the fact that these obstacles haven’t been overcome is as much a matter of politics as integration problems, the magazine reports:

Charles Jaffe, MD, CEO of standards development organization Health Level Seven International (HL7) described a “circle of blame” involving government agencies and regulators, hospitals and healthcare systems, technology vendors, clinicians, academicians like those at AMIA and, yes, standards development organizations (SDOs), such as HL7. “The policy always preempts the technology,” said Jaffe.

My feeling is that this circle of blame would dissolve in a millisecond if a compelling financial case could be made for interoperability.  Anything might help at this point.

Hey, just prove that interoperability saved a health system $2 a patient somehow, and they might be made to invest in needed changes. Or convince vendors that they’d move even a few units of their product if their systems were freely interoperable, and they’d probably be more cooperative.

At this point though,  you’ve got cross-cutting turf wars going on, with vendors and health systems and standards organizations each pursuing an agenda of their own. And honestly, why shouldn’t they?

With plenty of financial and institutional risk involved, and questionable rewards, I’m not sure how gung-ho I’d be on interoperability if I were a healthcare CIO or vendor exec.

Bottom line: If you want interoperability, it’s got to have a more tangible payoff for everyone involved.

EMR and Healthcare IT Article Run Down

Posted on May 19, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

I imagine most of my readers know that I’ve launched the Healthcare Scene blog network. EMR and EHR is one member of the blog network along with 7 other blogs that have been announced with 6 more blogs that will be announced shortly (Have you found them already?). We’re growing rapidly and expanding the number of people that are sharing great content with the world of healthcare IT and in particular EMR and EHR. The goal of providing a platform for the independent Healthcare IT voice is becoming a reality.

It’s a really exciting thing to be a part of. The most exciting part of it all is the amazing people that I get to work with and the content they create. Here’s a quick glimpse at some of their content with my thoughts on their posts.

EMR and HIPAA
Neil Versel recently started posting a regular weekly column on EMR and HIPAA. Check out his latest post on clinical decision support and an update on Dr. Larry Weed. Reading articles like that from Neil help me to appreciate more fully the history of healthcare IT. I’ve admittedly showed up late to the party, but Neil provides some interesting perspectives based on his knowledge and experience in healthcare IT. Here’s my favorite quote from his article:

“Patients may surmise that a physician who uses a [decision support system] is not as capable as a physician who makes the diagnosis with no assistance from a DSS.” I then noted that Weed has been saying for more than 50 years that physicians shouldn’t have to rely on their memory to make clinical decisions when computers can help them process an increasingly voluminous knowledge base.

Meaningful HIT News
Neil’s blog Meaningful Healthcare IT News is also a member of the Healthcare Scene blog network. How can you not enjoy a post entitled Skype for “Redneck Telehealth”? Sometimes, you’ve got to do what you’ve got to do.

Happy EMR Doctor
What doctor isn’t interested in reading another doctor’s perspective on “Getting a Life with Electronic Medical Records,” “Gag Orders and Bad EMR Systems,” and a Doctor’s issues with PQRI Incentive Money? Those are the latest topics from Dr. West over on Happy EMR Doctor. Of course, now that Dr. West has gotten the blogging bug, his EMR gave him a life and his new blog has taken it back. I always appreciate a practicing doctor’s perspective.

Smart Phone Health Care
I’d been covering a number of mobile health care and mHealth related topics on this and my EMR and HIPAA blog, but the topic has become so popular that I knew it was time to start a mobile health care related site of its very own. I’m now doing it in partnership with David. He’s been churning out some interesting posts about Cell Phones Saving Lives in Africa and a Mobile App that Could Detect an Acute Stroke. I’ve always seen one of the major developments of mobile health happening in the developing world where the IT networks aren’t yet in place. Mobile phones can have such a tremendous impact for good. It’s beautiful to learn about. Although, mobile health is still in its infancy in the developed world as well. Personally, I’ve been trying to kick around some mobile gaming app that would encourage activity (ie. movement). Far too many of us sit in front of our computers all day. Healthcare would be so much better if more people just moved (written as I sit in front of my computer).

EMR, EHR and Healthcare IT News
This site is still very young, but just hit it’s 100,000 pageview mark. That’s a result that I would have never been able to predict. Although, news like the one posted today about the First Medicare EHR Stimulus Checks is something that many find interesting. If you know of other news we should be posting, let us know.

EMR and EHR Screenshots
The most recently announced member of the Healthcare Scene blog network is a website called EMR and EHR Screenshots. There’s still a lot I want to do to improve the interface for viewing the various EMR and EHR screenshots, but I think the concept is really interesting. My goal is to aggregate as many of the EMR and EHR screenshots as I can get. Hopefully that will mean even screenshots from the same EMR and EHR software as it releases new versions of the software. I’d love to have screenshots of CPOE, ePrescribing, scheduling, charting, diagnosing, etc. Basically if you’re interested in knowing what an EMR looks like or what it looked like previously, we’re hoping to provide you that view into an EMR’s development. A lofty vision. We’ll see how many EMR and EHR vendors, doctors, and other users will support it.

See what I mean when I talk about the amazing content that’s being generated. This doesn’t even include the great posts that Katherine Rourke is doing on this blog and my own posts (which could be classified as good or bad).

As I mentioned, I have 6 more blogs to be announced shortly. So, keep an eye on Healthcare Scene to see what will be announced next.

Calling for EMR, EHR and Healthcare IT News Items

Posted on January 2, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

I recently quietly launched a new blog designed to just post the various EMR, EHR and health care IT news announcements. It’s been seeing some good traffic, but I think I’m ready to start getting more EMR related news that I can post to the site.

Of course, the more interesting the EMR related news, the more likely I am to post it. However, we’ll be pretty flexible at first and see how it goes. If you have any EMR news, just drop us a note on our Contact Us page. Plus, then you can get my direct email for future EMR news that you might want shared.