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Why We Store Data in an EHR

Posted on April 27, 2016 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.

Shereese Maynard offered this interesting stat about the data inside an EHR and how that data is used.


I then made up this statistic which isn’t validated, but I believe is directionally accurate:


Colin Hung then validated my tweet with his comment:

It’s a tricky world we live in, but the above discussion is not surprising. EHRs were created to make an office more efficient (many have largely failed at that goal) and to help a practice bill at the highest level. In the US, you get paid based on how you document. It’s safe to say that EHR software has made it easier to document at a higher level and get paid more.

Notice that the goals of EHR software weren’t to improve health outcomes or patient care. Those goals might have been desired by many, but it wasn’t the bill of goods sold to the practice. Now we’re trying to back all this EHR data into health outcomes and improved patient care. Is it any wonder it’s a challenge for us to accomplish these goals?

When was the last time a doctor chose an EHR based on how it could improve patient care? I think most were fine purchasing an EHR that they believed wouldn’t hurt patient care. Sadly, I can’t remember ever seeing a section of a RFP that talks about an EHRs ability to improve patient care and clinical outcomes.

No, we store data in an EHR so we can improve our billing. We store data in the EHR to avoid liability. We store data in the EHR because we need appropriate documentation of the visit. Can and should that data be used to improve health outcomes and improve the quality of care provided? Yes, and most are heading that way. Although, it’s trailing since customers never demanded it. Plus, customers don’t really see an improvement in their business by focusing on it (we’ll see if that changes in a value based and high deductible plan world).

In my previous post about medical practice innovation, Dr. Nieder commented on the need for doctors to have “margin in their lives” which allows them to explore innovation. Medical billing documentation is one of the things that sucks the margins out of a doctor’s life. We need to simplify the billing requirements. That would provide doctors more margins to innovate and explore ways EHR and other technology can improve patient care and clinical outcomes.

In response to yesterday’s post about Virtual ACO’s, Randall Oates, MD and Founder of SOAPware (and a few other companies), commented “Additional complexity will not solve healthcare crises in spite of intents.” He, like I, fear that all of this value based reimbursement and ACO movement is just adding more billing complexity as opposed to simplifying things so that doctors have more margin in their lives to improve healthcare. More complexity is not the answer. More room to innovate is the answer.

EMR and EHR Rating Websites

Posted on October 20, 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.

There are a number of EMR and EHR rating websites out there. The problem that I have is that none of them are really very good at all. They all have MAJOR weaknesses and some are just completely and utterly flawed. Some require the EMR and EHR vendors to pay them to be rated. Doesn’t that just wreak of conflict of interest?

There’s just so many ways to have the ratings of EMR and EHR vendors be skewed. Dr. Oates, Founder of SOAPware, recently wrote a blog post about the problems with many of the EMR and EHR rating websites and reports. Certainly he has a vested interest in his EMR software to be ranked highly, but this part aside he raises some very important questions about the accuracy and value of these various ranking systems.

Here’s one sample of the challenge of ranking and rating EMR and EHR vendors:

In addition to accepting user evaluations, many of the ranking systems require that vendors also fill in yes/no to a large list of features. Historically, many vendors have demonstrated tendencies to answer “yes” to functionalities to which a “no” would have been more accurate. Because we tend to answer honestly, we have sometimes ended up inaccurately appearing to be less functional than some others.
There are inherent problems with each of these surveys in that the survey results can, and often are, manipulated by the vendors who are paying a the most of attention to them. Because these surveys are the result of users offering information, some vendors will expend great effort to be certain that many, mostly happy users of their product are in some fashion encouraged to participate in the surveys. SOAPware has typically avoided such activities, because it ends up being a game to see who can motivate the most satisfied users to engage the ranking system.

This is just a small sample of the challenges of trying to honestly and effectively get quality ratings and reviews of EMR and EHR vendors. Yet, providers and practice managers have an insatiable appetite to try and get information on the various EMR and EHR vendors.

Trust me, this is not an easy issue. If I knew the solution, I’d have already done it myself. I write about this since I think it’s a valuable and important message for doctors to be very very careful trusting any of the data coming out of these EMR and EHR ratings websites. Instead, go download the Free copy of my EMR Selection e-Book and do the work necessary to rate them based on your specific practice needs.