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Will Carts Delay Adoption of Hospital Mobile Devices? Could Be…

Posted on June 24, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I just caught an interesting piece in on the use of plain old, unsexy carts in hospitals — one whose conclusions which may surprise you a bit.  The piece argues that since hospitals are comfortable using carts to haul around full-sized equipment, they may be slower than expected to adopt hot portable devices in care delivery.

The article notes that while mobile devices remain on hospital IT execs’ radar, carts laden with standard technologies like barcode scanners and laptops continue to be popular.

IT administrators interviewed by Health Data Management magazine said that hauling IT equipment with carts may be a better option than mobile deployment.  And research suggests that they’re not alone. According to a HIMSS study quoted in the article, carts are being used by 45 percent of hospitals in 2011, up from 26 percent in a related 2008 study. That’s a pretty dramatic leap.

It certainly makes sense. The fact is, carts make it possible to haul around a full-size keyboard (along with barcode scanners and medication), which allows nurses to work comfortably with EMRs at the bedside.

On the other hand, the small screens and awkward typing mechanisms used by mobile gear can actually slow down the care process.  Not only that, the small text used by mobile devices can be hard for an aging nursing workforce to read, according to Joan Harvey, RN, clinical nurse specialist at Ocean Medical Center, who was interviewed by HDM.

That being said, hospital IT leaders aren’t ignoring the mobile device explosion. At least one hospital interviewed by the reporter, Good Samaritan of Vincennes, Ind., is testing mobile devices for future use. But execs there are frustrated by problems with compatibility between the different operating systems used by the devices, and differences between devices using the same operating environment. When you consider how much easier it may be to just have nurses drag along a standard PC and keyboard, why would they consider buying an Android tablet or iPhone?

Unless this author’s got his facts completely wrong, he’s made a really important point — that mobile device makers had better get their act together if they want to really step into the healthcare market. No matter how fascinating their potential use cases may be, the reality is that mobile vendors won’t make major headway in hospitals unless they get smart about barriers like the ones mention here.  The cool factor just won’t cut it.

Should Hospitals Still Give Physicians An EMR?

Posted on March 11, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A while ago — I want to say maybe three years or so — we heard a great deal about hospitals and health systems beginning to push out EMR capabilities to affiliated medical practices.  Some were giving out software outright,  others were subsidizing physician systems, but in either case the idea was to force through EMR adoption.

It was a difficult process. This was back in the good old days before ARRA, HITECH or Meaningful Use,  of course, so hospitals were pretty much on their own in figuring out what kind of technical and financial relationships worked out best.  And they had to wait a while on HHS and the IRS, both of which had to reassure them that these deals were legally kosher.

Still, many soldiered on and invested big bucks to get their key doctors wired. (For an example, see this deal, in which a New York-area health system announced that it would spend $400 million to connect 7,000 physicians to a single EMR.)

Today, of course, with federal incentives in place, and the threat of financial punishment to come, the EMR landscape is different for both doctors and hospitals.

Like it or not, doctors are facing up to the reality that EMRs will soon become a standard part of running a medical practice.   Hospitals, meanwhile, are just beginning to realize just how ginormous their EMR expenses are going to be (usually, many times what they’d originally calculated).  Bottom line:  doctors have more reasons to move and hospitals less resources to hand out.

That being said, what’s a health system to do these days if despite all, local physicians are reeaallly reluctant to adopt EMRs within their practice?

Does it still make sense for hospitals and health systems to give out EMR software/access or help pay for physician EMR investments?  If so, when, and why? What do you think?

Physician Adoption of EMRs Growing, But Don’t Expect A Landslide

Posted on February 26, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

About 30 years ago, when cable television hit its stride,  pundits watching the industry assumed that home adoption would quickly climb to near 100 percent. Instead, for a variety of reasons, consumer adoption more or less froze at the 50 percent mark for many years.

Maybe the industry didn’t their pricing strategy right; maybe consumers were perfectly happy with broadcast television; or  maybe the existing broadcast networks greased a few palms and helped regulators slow down its growth in subtle ways.

In any event, the cable industry has improved its performance enormously; in fact, it hit 70% in the late 90s, though that number has fallen significantly as satellite providers have horned in.

So, why bring up cable TV in a forum aimed at dissecting the EMR business?  Because I think the cable industry’s experience is instructive in how we think about EMR adoption.

First, some data points.  According to study released in January by the CDC’s National Center for Health Statistics, 50.7 percent of physicians were using EMRs in their offices in 2010.  That’s a dramatic upswing from previous years, the agency noted.

Of course, practices are eager to collect Meaningful Use incentives if they can.  Also, as older physicians retire, younger, more-wired MDs are taking up the EMR banner. (In fact, CDC data concludes that the younger a physician is, the more likely they were to adopt EMR technology.)

Not only that, hospitals are helping to grease the skids, with one-third offering to subsidize EMR buys and 60 percent offering doctors access to the facility’s EMR, the CDC found.

All of that sounds great, particularly if you’re an EMR vendor.  But I think it’s a bit early, as it was for cable pundits, to predict that EMR adoption is at some kind of tipping point.  Whiz-bang technology always looks great from the peanut gallery — especially to analysts and editors — but it often looks different on the ground.

Not only do I think exponential growth is unlikely, I’d argue that adoption by physicians will be painfully slow for at least a few years more, gaining say, 5 to 7 percentage points a year at best.

Why do I feel that way?  Here’s a few reasons:

*  Few (if any) vendors can honestly say that introducing their product won’t bog down a practice and trash its productivity for months at least.  Doctors know this.

*  Smaller practices don’t, and aren’t likely to, have full-time IT staffers.  Even practices that want to adopt don’t have the reassurance of a dedicated IT brain that knows their needs. Under these circumstances, buying an EMR is a scary investment.

* Other trends that might spark EMR adoption — such as the emergence of RHIOs/HIEs — are moving at a snail’s pace.  If a doctor doesn’t have the added incentive of sharing patient data to spark adoption, that’s one more reason to delay.

Look, maybe I’m being pessimistic, or short-sighted. But I simply don’t think the EMR vendor market nor the physician buyer side have gelled enough to spark a revolution. I guess we’ll just have to wait and see.

Many Hospitals May Not Meet MU Goals By 2015

Posted on January 25, 2011 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.

John’s Note: I’d like to welcome accomplished healthcare journalist, Anne Zieger, to EMR and EHR. Anne has a long history in the healthcare IT space and I’m really looking forward to her contributions to EMR and EHR. I’ll still be posting on EMR and EHR as well and of course on EMR and HIPAA. However, I’m excited to bring another voice to EMR and EHR. Welcome Anne!

Nobody said that meeting Meaningful Use standards for EMRs would be easy, but if a new Accenture study is any indication, things are even worse than they seem out there.

Accenture argues that hospitals have a a staggering amount of work to do, and that few are ready. If they hope to get to MU compliance by 2015, hospitals going to have to think differently about change management, plan for a long, tough project, spend heavily and find qualified new personnel.

According to the study, less than 1 percent of health systems were mature EMR users in 2009.  What’s more troubling is that if Accenture is right, only half of U.S. hospitals will meet MU criteria by  2015. That could mean penalties of $3 million to $4 million per year for a 500-bed hospital, the consulting firm estimates.

Why are hospitals and health systems lagging behind?  They’re underestimating how hard the MU compliance job is — and getting blindsided what can be an 80% jump in costs during the transition.

My question:  are these massive transformation headaches and eye-popping costs are inevitable if you want to prove Meaningful Use of an EMR?  Or will hospitals that run lean IT and plan well enjoy a smoother ride?

iPad Won’t Transform Hospital IT, But Has Potential With EMR

Posted on September 17, 2010 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.

i Medical Apps recently posted an article about Apple’s iPad falling short of transforming hospital Medical Care, but says it may have potential with EMR. We’ve discussed the iPad and EMR quite a few times on this blog with interesting responses.

The above article offers 3 reasons why their skeptical that the iPad will transform the way EMR software is done:
1) For a healthcare provider’s day-to-day use, the iPad doesn’t do anything better than an iPhone or a laptop/desktop.
2) Big hurdles face development of peripherals for more advanced healthcare functions
3) Safety

I guess for me the most important thing I’ve seen was a conversation I recently had with a doctor. This doctor is a HUGE Apple fan boy and always has the latest Apple gadget (like the iPad). I asked him now that he’s had the iPad for a while, what he thought about it.

He responded, “It’s a great toy.”

I think that basically summed it up for me. It is a great tool for doing a lot of things, but EMR is not likely one of them. I’ll still go back to my initial projection that the methods of input that the iPad are providing might be the basis for the future of data input. However, the iPad device itself isn’t what’s going to see the widespread adoption in healthcare IT and EMR.

It does make a great giveaway at conferences though.