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Does adding all these EHR and other tech add or subtract to healthcare?

Posted on May 7, 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.

Such a compelling and tough question to consider. Let me repeat it again so you can let it roll around in your mind for a minute:

Does adding all these EHR and other tech add or subtract to healthcare?

This was one of the off hand comments I heard someone make in their presentation at TEDMED and I think it’s a serious question that every EHR company and healthcare IT vendor should consider.

The simple answer to the question is that some companies add to healthcare and some take away from healthcare. That’s just the nature of markets. However, there’s a deeper part of the question which fundamentally asks if the shift to electronic is helping healthcare or hurting it.

As I’ve mentioned previously, at my core I believe that technology has an overall positive impact on any industry. In my heart I believe that technology has the potential to improve most things.

My fear with the above question is whether we’re implementing the right technology that will help us have a positive impact on healthcare or whether we’re currently implementing dated technology which will set us back for years to come.

I got in a heated discussion today on LinkedIn about the MUMPS database. A HUGE portion of healthcare is built on the back of MUMPS. Nothing against MUMPS (although it does sound like an STD), but is it going to be powerful enough to “add” to healthcare or will we reach a point that its limitations start subtracting from what could be possible?

I don’t necessarily want this post to become a MUMPS pros and cons post, but I think it’s a great illustration of why I’m reticent to say that the technology foundation that healthcare is building today is providing a platform for an amazing healthcare IT future.

On the other side of the spectrum is the plethora of smart phone apps and devices in healthcare. You can’t tell me that the Alivecor device or AirStrip’s work in the mobile field isn’t incredibly exciting. They’re leveraging the latest technology in a beautiful way.

One challenge we do face is the HUGE number of EMR companies and mobile health apps. With so many companies, we’re bound to have a healthcare software graveyard soon. Hopefully the companies we find in the graveyard are those who were subtracting from healthcare instead of adding to it. Unfortunately, that’s still just a hope and may not be the reality.

Many of our newer readers might not be familiar with my reference to Jabba the Hutt EHRs. The concept would seem to apply well to this post. For those not familiar with the concept, Jabba the Hutt was a really powerful individual, but it’s safe to say that he wasn’t very nimble. Does this sound a bit like some of the healthcare IT and EHR companies that dominate the market today?

Maybe I’m wrong, but the nimble innovative companies are the ones that usually add the most to healthcare versus subtracting. Luckily history is on my side. I’m just not sure we have enough Princess Leia companies that are in a position to wrap their chain around the neck of Jabba the Hutt companies.

I’ll let you decide which companies you believe add to healthcare and which ones subtract from healthcare. Although, I think we’d all benefit if every company focused on adding to healthcare.

Succeed at EMR – A Vendor Perspective

Posted on April 19, 2011 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.

Rob Tholemeier from Crosstree Capital Partners had an interesting article a while back on the Health Data Management blogs about ways that EMR vendors succeed. He provides 5 approaches that these EMR companies take to the EMR and EHR market. Here’s the 5 methods he identifies with a few of my thoughts after each:
Leveraging Size – I call these the Jabba the Hutt EHR vendors. They’re really big and powerful and no doubt will continue to sell a bunch of software since they have “leading vendor” name recognition. Rob correctly notes that they’ll continue to grow through mergers and acquisitions.

Specialization – I find this segment of the market really interesting. I’ve been seeing more and more of these specialty specific EHR vendors carving out their niche in the market. I still think the best play for a “leading EHR vendor” is likely to acquire a number of specialty specific EHR.

Regional Focus – Many people to want to “buy local.” There’s something really powerful about knowing your EHR vendor’s office is down the street and you can go and wring their neck personally if something goes wrong. < sarcasm >Not that anything would ever go wrong with an EMR. < end sarcasm font>

Suite Selling – I found this one interesting. Although, I think that it’s more of a factor for hospital EMR selection. I guess you could make the case that practices purchasing their EHR based on the hospital system purchase might fall into this category as well. Basically, the practice adopts a certain EHR because their hospital is subsidizing it or has a nicely built connection to that specific EHR company.

Advanced Technology – I’ve seen a few companies that have made this pitch. I still find this a challenge for an EMR company to make this pitch and be heard above all the EMR noise. However, I think if anyone is going to do it, I think it will likely come in the user interface.

An interesting way to stratify the various EMR companies. Are there any other categories of approaches that he missed?

New APN’s View of EMR

Posted on January 14, 2011 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.

Today I got the following message (actually on Facebook) from a previous colleague of mine. When I worked with her she was an RN, but she just finished her education to become an APN and found a job at a local well known medical provider. Here’e her message to me after starting the job (specific names removed):

Help! I need to learn [Jabba the Hutt EMR’s] charting system;-( No bueno… Mucho hard!! I like [previous job’s] EMR so much better!!

Excuse the spanglish and almost text message style feel to the message. In fact, I wouldn’t be surprised if she sent me that Facebook message from her phone. Yes, our methods of communicating are changing.

I was pretty taken a back by her message actually. Not because I haven’t heard complaints about this Jabba the Hutt EMR system (Definition of Jabba the Hutt EMR Vendors: Good in their day, but have gotten so big and bulky that they’re barely functional) before. I actually had heard similar stories, but I just didn’t expect it from her. She was always very good at computers and doing what she needed to do with the EMR when I worked with her. Plus, she’d already used a couple different EMR in her career.

I will discount part of her reaction as the knee jerk response to a new job, a new company, APN instead of RN and a new EMR software. That’s a pretty steep learning curve for anyone.

The challenge this comment provides however is how do clinics train new doctors on their EMR. In my opinion, the real problem for my friend isn’t like the EMR software, but is instead the training that she received on the EMR software. Properly trained, I’m sure she’d like using the EMR software a lot more than she just expressed.

Training new staff on the EMR is a challenge and vitally important. I was in charge of training the new staff at my previous work. I trained everyone from medical records staff to Lab Tech’s to MA’s to RN’s to APN’s to PA’s to MD’s and DO’s. I trained general medicine providers, dietitians, GYN’s, dermatologists, and a few other specialists. That’s a wide variety of people to train, but overall we did a pretty good job with most. Outside of our initial implementation where the whole staff was trained, I probably trained 50 different people. Let’s just say that people definitely learn at different paces.

About 2 minutes into the training I could tell you how good (or bad) the training was going to go. I could train a provider on our EMR system in about 45 minutes to an hour to the point that they’d feel comfortable doing their job. Certainly there were some intricacies to looking up various codes and charges, but generally they knew what they were doing after an hour. The worst case scenarios usually ended up needing about 2 hours of training where I had a little more time to let them flounder through the charting process themselves on our test install so that they could really learn in a low pressure environment.

In our case, we had a contract with an outside company where they were always swapping out providers. Luckily our nursing staff was very consistent and could assist the new providers as various questions popped up.

To be honest, I think this system of training worked pretty well. One of the keys to our success was that we had a well defined process for using the EMR. So, a technical person like myself could easily train a clinical provider. Plus, I was deliberate in only showing them the easiest route to chart (at first) even though there was almost always 3-4 ways to do something. I learned this lesson the hard way. Far too many people get confused when you train them on 3 ways to do the same thing.

My favorite story about training a doctor though was when a doctor was ill and so a replacement doctor was provided from the company we partnered with. Turns out the new doctor they sent was pretty tech savvy and confident (not to be confused with arrogant). We looked at the clock and realized him and I would only have 5-10 minutes to train him on the EMR system. This was far from ideal, but you make the most of whatever situations come. So, I cranked through the most important features and processes. Then, I wished him good luck! He had a great day with no issues. Of course, as I said above, we had a nursing staff that could assist him as needed as well.

Moral to the Story: As a clinic it’s important to have a way to train new staff on your EMR.