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Another Example Of EMR “Golden Age” Applications

Posted on July 30, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, John posted a piece about the “Golden Age of EMRs Being Over” and how that’s playing out from an EMR vendor perspective. Since writing that piece he’s found that while the Golden Age of EMR buyer frenzy has passed, we’re entering a new EMR Golden Age which will feature amazing applications for clinicians and public health administrators. John calls these applications Smart EMR.

Today, I came across some news which I think is a perfect example of the kind of innovative applications John is predicting will emerge as EMRs mature. At the University of Notre Dame, researchers have developed a system which uses collaborative filtering of EMR records to better guide treatment, manage disease and predict disease risks across a population.

Notre Dame computer science associate professor Nitesh Chawla and doctoral student Darcy Davis call the new system the Collaborative Assessment and Recommendation Engine (CARE). CARE uses collaborative filtering to detect similarities between patients and produce personalized disease risk profiles for individuals. It does so by looking at diseases in similar patients.

“In its most conservative use, the CARE rankings can provide reminders for conditions that busy doctors may have overlooked,” Chawla said in a prepared statement. “Utilized to its full potential, CARE can be used to explore broader disease histories, suggest previously unconsidered concerns and facilitate discussion about early testing and prevention, as well as wellness strategies that may ring a more familiar bell with an individual and are essentially doable.”

Ultimately, Chawla says, such a system can produce a host of benefits. For example, he suggests, it can reduce readmission rates, improve quality of care ratings, help demonstrate Meaningful Use and improve personal and population health. On a more micro level, it can allow patients to walk out of their doctor’s office with a list of recommendations based on predicted health risks, he notes.

This is just one example of the kind of new applications that are emerging as EMRs mature and the use of big data becomes a tool for wellness. I expect to see lots of announcements of this kind over the next year or two. It’s an exciting time.

March Madness and the EHR Vendor Shakeout

Posted on March 29, 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.

I’m not sure how many of my readers love March Madness as much as I do. I just love the emotion and the all day experience of March Madness. Unfortunately there haven’t been quite as many last minute buzzer beaters for the win as there have been in years past, but I still love the emotions of the games. These young kids have worked almost their entire life for this moment. I love to see the raw emotions from both teams.

As I think about March Madness, I couldn’t help but think about the EHR Madness we’re experiencing right now. We don’t have 68 teams in the EHR tournament. Instead, there are more like 300+ EHR vendors. In fact, in just the last week or two I’ve had two EHR vendors I’d never heard of contact me. Yes, we’ve seen some EHR software put out to pasture, but we still have a long ways to go before the EHR market really shakes itself out.

The nice thing for EHR vendors is that unlike the NCAA tournament which only has one winner, the EHR world is likely going to have many many successful companies. First, because many EHR vendors will likely get acquired by larger EHR vendors. Second, because it’s fair to say that the EHR world is going to be a heterogeneous environment. There won’t be one EHR to rule them all (although some EHR vendors still think they might get there).

Which type of vendors am I putting my money on in the EHR battle?

While many EHR vendors might win some short term battles, I think the big EHR winners are going to be those who end up battling through the mess of regulation while still having a laser focus on the impact to doctors. The most expensive employee in every healthcare institution is the doctors. EHR software that takes these high paid doctors away from seeing patients is going to have a real challenge long term.

I’ve written about the EHR Backlash a number of times before. I think productivity is going to be at the core of the EHR backlash. I’m hopeful that EHR vendors are taking this idea to heart, but I also still see a very long road in front of us to reach EHR nirvana.

I’ve been digging into the idea of a Smart EMR lately. At the core of the idea is how to make a doctor more efficient at what they do while increasing the quality of care provided. That certainly stands in stark contrast to many of the other EHR initiatives we see out there today.

Big Data Analytics vs Focused Patient Analytics

Posted on December 18, 2012 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.

One of the most common buzzwords in healthcare right now is “big data.” Everyone is talking about how to leverage big data in healthcare. There is little doubt that there are a whole list of opportunities that are available to healthcare using big data analytics.

When it comes to big data analytics, most people see it as healthcare business intelligence. In other words, how do we take all the data from within the organization and leverage it to benefit the business. Or in the case of a health insurance company, how can we use all the healthcare data that’s available out there to benefit our business. This is really powerful stuff that can’t be ignored. A lot of money can be made/saved by a business that properly leverages the data it holds.

However, I think there’s another side of healthcare big data that doesn’t get nearly enough attention. Instead of calling it big data analytics, I like to call it focused patient analytics.

What is focused patient analytics? It’s where you take relatively small elements from big data that are focused on a specific patient. In aggregate the data that you get is relatively small, but when you consider all of the data is focused around one patient it can be a significant amount of valuable data. Plus, it requires all the healthcare big data silos be available to make this happen. Unfortunately, we’re not there yet, but we will get there.

Imagine how much smarter you could make the EHR if the EHR could tap into the various silos of healthcare data in order to create focused patient analytics. Unfortunately, we can’t even design these type of smart EHR software, because too much of the data is unavailable to EHR software. I love to think about the innovation that would be possible if there was a free flow of data to those that needed it in healthcare.

Certainly there are plenty of security risks and privacy concerns to consider. However, we can’t let that challenge be an excuse for us not to create focused patient analytics that will benefit patients.

MU Stats, “Cadillac” EMR, EHR Patent, and Big Data

Posted on November 4, 2012 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.


Some really interesting stats for meaningful use. I think I’d seen most of them in one place or another, but it was great to see them all in once place. Nice work Fred.


Cadillac of EHR. Very interesting.


This is really annoying for me. I haven’t written much on these blogs about why I don’t like software patents, but I’ll have to in the future. You can also read this piece by Anne Zieger about mHealth patents. Software patents are such terrible innovation inhibitors which is ironic since it’s the opposite of what they were designed to accomplish.


I can’t wait until this convergence is normal. It will usher in the start of Smart EMR.

Creating The Intelligence-Based EMR

Posted on August 21, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Given today’s trends, I’m betting most of us would agree that EMRs need to evolve from transaction-based to intelligence based systems. They need to do better leveraging “big data,” make context-based care recommendations and support smart processes.  John likes to call them “Smart EMR,” but what would such an EMR look like?

In a recent issue of Hospitals & Health Networks, Dr. John Glaser, Ph.D.,  lays out a long– but useful– explanation as to why EMRs are stiffly focused on transactions such as documenting a visit or writing a prescription. (Very short summary: That’s just where they are coming from historically.)  Then he offers a take on the “intelligence-based EMR” and what it will take to get there.

Glaser, CEO of the Health Services Business for Siemens Healthcare, was formerly VP and CIO for Partners HealthCare, so he’s got both the vendor and the care provider view, which I think proves very useful for this discussion.

In his article, he argues that the next-gen EMR needs to offer the following:

  • foundational sets of templates, guidelines and order sets that reflect the best evidence or established best practice;
  • a process-management infrastructure that supports basic transaction checking such as drug-drug interactions, as well as asynchronous alerting like panic lab reporting and process monitoring and guidance;
  • team-based care support such as shared work lists, as well as tools for patient engagement and health information exchange;
  • novel decision aids like predictive models that can tell us if a particular patient is likely to be readmitted because he or she is fragile or has a substandard social situation at home that may negatively impact healing;
  • context-aware order sets and documentation templates that guide the physician and help infer what types of orders should be placed and what types of documentation should be done
  • intelligent displays of data, intelligent correction and identification of data, and extraction of structure by going through free text and pulling out quality measures or problems that were not previously in a patient’s problem list, for example.

The question is, are these functions science fiction (i.e. many years away from being standard) or just an evolutionary leap from today’s systems?  What are you seeing out there?

EHR Company Funding Risks – Large EHR Companies

Posted on May 29, 2012 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.

This is the fourth post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Large EHR companies.

Large EHR Companies
Most of the EHR companies that fit into this category are publicly traded EHR companies (with a few notable exceptions). Each of these EHR companies has their own story, but the majority include some mix of EHR acquisition or EHR merger to get into or expand their EHR market reach. Often this means that the EHR company has more than one EHR software under their purview.

Many of the larger EHR group practices and particularly the multi specialty clinics look to the larger EHR companies because these large EHR companies have usually worked to try and cover every EHR specialty in their EHR. In most cases the EHR software has been around for a very long time. This is good because then the software is often mature, but it’s also bad because it’s often built on old technology.

The large complaint against these large EHR companies is that they’re large and impersonal. That they are out of touch with the customer. Of course, this is kind of the nature of being a large company and having a large user base. Plus, you can imagine the challenge listening across a half dozen different EHR software products.

The risks associated with these large EHR companies software usually has much less to do with cash flow and much more to do with the decisions of the EHR company executives. With multiple EHR software under their umbrella, will they choose to close the one you use down and focus on their other EHR products? Will your EHR product get lost in the corporate shuffle of priorities? Sure, they’ll still support your EHR product if there’s an issue, but have they dedicated the company resources to your EHR or to another product in the company’s portfolio?

One argument that larger EHR vendors have made is that they’re the only companies that have the resources available to create the EHR software of the future. Some argue that many of the smaller EHR companies won’t be able to meet meaningful use stage 3, because they don’t have the resources available to do that. Not to mention when we eventually have to do Watson like Smart EHR software integrations across large data sets. I think the first part about doing MU is overstated. I think the jury is still out on how smart EHR software will become over time and how smart physicians require their EHR to be.

Next up, we’ll look at Large Company Backed EHR. Read all the posts in the EHR Company Funding Risks series.

Genomics Based EHR

Posted on January 10, 2012 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.

This is a pretty old tweet that I’d stored away, but I’m completely interested in the idea of a Genomics based EHR. I meant to reach out to Don Fluckinger to see what he was talking about. I don’t think that there is any EHR that is based on Genomics. Although, if there is I’d love to know about it. Instead, I’m pretty sure that Don is just talking about integrating Genomics into EHR software.

I’ve made this prediction for a number of years now: Genomics will be part of the EHR software of the future. Genomics is one of the core elements that I think a “Smart EMR” will be required to have in the future. I really feel that the future of patient care will require some sort of interaction with genomic data and that will only be able to be done with a computer and likely an EHR. I love some of the quotes by Shahid Shah in this eWeek article about Digital Biology and Digital Chemistry.

As I think about genomics interacting with EHR data and the benefits that could provide healthcare going forward, I realize that at some point doctors won’t have any choice but to adopt an EHR software. It will eventually be like a doctor saying they don’t want to use a blood pressure cuff since they don’t like technology.