Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

The Role of Practice Automation in Healthcare Communication

Posted on February 16, 2018 I Written By

The following is a guest blog post by Naveen Sarabu, Vice President of Product Management, AdvancedMD.

Practice automation was born out of the demand for quicker, more efficient manual processes. One of these manual processes is getting back to basics by using plain, old-fashioned communication – whether among members of a healthcare team, or between a physician and patient. Through automation we seek to deliver the right data to the right people exactly when they need it for the optimal provision of care. Likewise, we also seek to cut down on the manual processes that bog us down and add complexity. Many ambulatory practices struggle to find a solution that meets the complex demands of treating patients. Many admit that communication remains one of their greatest struggles – and miscommunication is one of the biggest frustrations for patients.

Doctors’ offices and hospital counterparts in the U.S. have shouldered $1.7 billion in malpractice costs due to poor communication—that’s 30 percent of all malpractice cases.

Automating manual processes of a physician practice enables the distribution of vital patient information in a fast, efficient, and accurate way. By leveraging an integrated physician-patient workflow system, physicians gain benefits of both accuracy and time in the sharing of clinical and billing information. This defines the next generation of the EHR: managing patient data among systems with authentic, automated data transfer and overall ease of use.

Task-based challenges

In a sense, many elements of communication, or information transfer points, are categorized as “tasks” by physicians. Obviously, every doctor in every office has his or her own way of organizing to-do’s. Rigid or cookie-cutter solutions can be more trouble than they’re worth for the busy ambulatory practice. The sheer volume of tasks and relentlessness of practice-specific workflow elements remain a huge burden to physicians and staff members. Without a straightforward means to categorize and execute frequently performed tasks such as prescriptions, refills, charge slips, notes, and orders, action items can fall through the cracks and leave room for errors.

Practices can address this by selecting flexible and customizable solutions that spell out all the moving parts of a practice and put them at the physician’s fingertips, much like an automated workflow analyst would. Visual tools like dashboards are helpful in presenting all tasks in a single snapshot, allowing physicians to manage to-do’s quickly and with ease to execute and communicate what must come next. Patient cards organized by specialty and workflow give physicians a snapshot of what’s really most important in a given moment. An integrated EHR dashboard not only helps physicians negotiate high-priority tasks of significant volume, it orients them to the vital patient information required for sound decision-making.

Impact of physician mobility on communication

A key asset of running a fully-automated ambulatory practice is the feasibility of team members accessing the same systems in real time, from any location. This has multiple benefits, including improved communication accuracy and workflow efficiencies.

“Many different user types [in my practice] from the nurse, to the office manager, to the biller, are all working with the same data on the same platform with real-time access. The seamless continuity is what I like about it,” said Larry J. Winikur, MD, pain management physician in Danville, Va.

Physician mobility is achieved through cloud-based technology and allows providers and staff members to communicate seamlessly from several practice locations: a home office, a patient’s home, the hospital or while traveling. It helps physicians respond to patient and staff messages quickly and stay on top of pressing work issues no matter where they are, preventing a backlog of tasks once they return onsite.

Surgical Specialists of Jackson (Miss.), treats more than 500 active patients, including those in rural areas. According to office manager Kristen Humphrey, having mobile capabilities as a result of complete practice automation has improved the quality of care the practice provides to patients. “When we have a physician seeing patients an hour away in a rural county, he takes the iPad and is able to log into the patients’ medical record and get any information he needs,” leveraging a seamless connectivity to the practice from our office in Jackson. “It makes life really easy,” Humphrey says.

Remote access also offers the feasibility of treating patients with video-based telemedicine, during hospital rounding, or home or hospice care. EHR mobile access is, without a doubt, a top priority for busy practices as they build out the future of their business.

The building blocks of patient engagement

As practices compete with other practices and larger health systems to secure and retain patients, these patients have developed a consumer-like healthcare mentality. Most patients want as much information about their condition as possible, so they can take a proactive role in their care. Patients want to engage with their physicians, by communicating openly and regularly about options and treatment decisions.

A fully-automated ambulatory practice utilizes patient engagement tools to secure satisfaction, retention, and referrals. Consider the ease with which patients can make appointments – online self-scheduling is a critical piece of functionality. Automated check-in tools such as an iPad kiosk are especially favorable to patients who can complete intake and consent forms electronically, eliminating the possibility of transcription errors that occur when data is transferred from paper to digital. A robust patient portal enables physicians to communicate with patients privately and efficiently; to share educational materials or share lab results.

Appointment reminders can also serve as simple communication tools that enhance not only the patient experience, but also the practice bottom line.

Dr. Winikur utilized a patient reminder system to help decrease costly no-show appointments in his busy schedule. The solution helped engage patients and reduced no-shows at his practice from about 12 percent to approximately two percent of appointments, which positively impacts his revenue.

The mobility benefits previously mentioned also allow physicians to demonstrate superior attention to patient needs. “I can pull up patient information no matter where I am in the world with internet access,” Winikur says. When patients receive a quick and effective response to inquiry, they perceive their doctor is in the office (even if he’s not!), which helps increase patient satisfaction.

Other important automated tools include post-visit surveys that enable patients to provide honest, timely feedback about the care they’ve received. These surveys can also trigger patients to post positive experiences to Google and social media outlets. In the event of a negative experience, patients can first communicate privately with the practice to resolve any potential problem or miscommunication.

The bottom line

In today’s competitive healthcare climate, patients have many options for their care. Practices that transition to cloud-based technology platforms with fully automated and customizable workflow elements show greater respect to the needs and time of their patients, increase revenues, and place greater value on their own needs and time. They also prove to be on the cutting edge of technology by streamlining processes and enhancing communication to deliver safer and more accurate care.

About Naveen Sarabu
Naveen Sarabu is Vice President of Product Management at AdvancedMD. Naveen has more than 15 years of experience developing innovative healthcare software solutions for the ambulatory, acute and accountable care organization (ACO) markets, including for Allscripts, Hill-Rom, and NTT DATA. Naveen received an MBA from University of North Carolina-Chapel Hill and an undergraduate degree from National Institute of Technology, Warangal, India.

Are EMR Clicks the Problem? – Deep Thought Thursday

Posted on February 15, 2018 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 agree with David Chou here when it comes to needing to make EMRs easier. However, I don’t believe reducing the number of clicks is the real issue. Clicks are just a symptom of the real problem. The real problem is regulations and reimbursement requirements that need revision and simplification.

If we simplified regulations and reimbursement requirements, EHRs would be significantly more usable and would require fewer clicks.

The next question you should ask yourself is whether this administrative simplification will happen first or whether the technology will evolve to the point where it can automatically document the patient visit to any level of complexity while not disrupting the physician workflow.

Where’s your bet? On government and payer changes? Or on technology?

My bets on technology even if Seema Verma, CMS Administrator, is calling for administrative simplification. However, we’re certainly not there yet on either front.

The Increasing Role of Surveys in Reimbursement, Profitability, and Quality Care

Posted on February 14, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Delivery of high-quality, patient-centered care has become the hallmark of the medical industry. The most commonly used indicators for measuring the quality of care are patient satisfaction and the patient experience. How patients feel about their experience is critical to overall practice success because it has been proven to impact health outcomes, patient retention, and medical malpractice claims.

The emerging standard for measuring patient satisfaction is the use of patient surveys. Patient satisfaction surveys are not only important when required for reimbursement, but also for practices focused on improving their patient-centered care (that should be everyone). A well written survey can be a very powerful and reliable tool. It can provide more information about what is going on in your practice. It demonstrates that your practice is working to improve. It shows patients that quality is your focus.

What are the key reasons that every practice should start implementing patient surveys?

Patient Surveys Increasingly Drive Reimbursement

Because both practice and hospital reimbursement are increasingly tied to health outcomes and patient satisfaction, patient surveys have become the go-to guide for improving the patient experience.

Currently, CMS (the Centers for Medicare and Medicaid Services) uses the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients feel about their hospital experience. They then take those results and compare them to hospitals locally, regionally and nationally and assign them a score. Those scores have been a big part of the Hospital Value-Based Purchasing program for nearly six years.

This past year, we have seen the implementation of MACRA. Under MACRA, physician and hospitals patient satisfaction scores are calculated. By 2019, these scores will impact Medicare reimbursements.

It is highly likely that this trend towards survey-based reimbursement will continue to grow. Even if your practice is not currently required to use patient satisfaction surveys for reimbursement, it is probable that you will at some point in the future. By sending out surveys now, you can get a better handle on changes that need to be made to secure high scores for future reimbursement.

Patient Surveys Increase Profitability

High patient satisfaction levels impact a practice’s profitability for reasons beyond just reimbursement. Studies have found a significant correlation between high patient satisfaction and the overall profitability of a practice. Consider this:

  • A good patient experience significantly lowers your risk of a malpractice suit. In fact, for each drop in satisfaction score, a provider is nearly 22 percent more likely to be hit by a lawsuit.
  • One surprising effect of an improved patient experience is reduced staff turnover. Because a better patient experience often involves implementing more efficient and effective processes, staff are able to work in a more pleasant environment. One provider saw their turnover rate drop 5 percent after efforts to improve the patient experience.
  • A good patient experience leads to lower patient turnover. This one is more obvious. Today’s consumer-minded patients are looking for a great experience. One study found that practices with poor patient-physician relationships are three times more likely to move to a new practice than those with good patient-physician relationships.

It’s easy to see why the use of a patient survey to track and improve the patient experience is quickly becoming best practice. As Joe Greskoviak, president and COO of Press Ganey explained, “We are seeing a shift in the way organizations look at the engagement of their patient populations. The ability to use patient experience as a competitive and strategic differentiator to gain market share is a valuable tool,” Mr. Greskoviak said.

Patient Surveys Lead to Quality Improvement

As dozens of studies have found, there is quantifiable evidence that tracking the patient experience leads to quality improvement in multiple ways. These studies have found that:

  • A good patient experience improves both prevention and disease management. In one study, diabetic patients increased their ability to self-manage their disease and, subsequently, improved their quality of life simply due to a good experience with their provider.
  • Positive patient experiences lead to a higher likelihood of care adherence for the patient. This is especially true for those with chronic conditions who meet regularly with their provider.
  • Patients who have a good patient experience and a positive view of their provider have better health outcomes compared to patients that have poor patient experiences. Heart attack patients who were highly satisfied with their practice saw significant improvements over their less satisfied peers one year post-attack.

Understanding how your patients feel through patient satisfaction surveys is an invaluable tool. These surveys can be as important to the success as your healthcare credentials. If implemented and used properly, a patient survey can help you increase profitability, healthcare outcomes, and reimbursement.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

There’s a Disturbance in the Force We Know as MACRA

Posted on February 13, 2018 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.

Yesterday Anne Zieger wrote about AAFP’s proposals to reduce the EHR Administrative Burdens and then we got this tweet from CMS Administrator Seema Verma:

That’s some really strong language from the CMS Director.

If you care about this topic, you should go and read all of Seema Verma’s tweets, but here are two more for those who don’t want to read them all:

Change is in the air it seems. Many providers are rejoicing if you look through the replies to Seema Verma’s tweets.

Dr. Ronald Hirsch asked the question that I’m sure many doctors were asking:

The short answer is no MACRA and MIPS aren’t going away. If my understanding of policy is right, Seema Verma doesn’t have the authority to make MACRA go away. That would take actions from Congress and I don’t know anyone holding their breath on that one. However, Seema can streamline the way MACRA and MIPS are implemented to make it much easier for doctors. That seems to be what’s happening now.

What will this mean for the future of MACRA? I don’t think anyone knows the answers to that question. However, what does seem clear from these tweets is that change is in the air. We’ll have to wait and see what those changes are and who influences the changes they make.

What do you think this means for MACRA and MIPS? I’d love to hear your thoughts in the comments.

AAFP Proposes Tactics For Reducing EHR Administrative Burdens

Posted on February 12, 2018 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.

The American Academy of Family Physicians has proposed a series of approaches it says will reduce the administrative burdens EHRs impose on primary care doctors.

The recommendations, which come in the form of a letter to CMS, address health IT simplification, prior authorization and standardization of quality measurement. However, the letter leads off with EHR concerns and much of the content is focused on making physician IT use easier.

Few would argue that the average physician spends too much time struggling with EHR-related administrative work. The AAFP backs this assertion up with a couple of studies, including one finding that primary care physicians spend almost 6 hours per day interacting with EHRs. It also cites research concluding that four types of specialist spent almost 2 hours using the EHR for every hour of direct patient care.

To address these concerns, the AAFP recommends taking the following steps:

  • Eliminating HIT utilization measures in MIPS: The group argues that such measures are not needed anymore now that MIPS includes quality, cost and practice improvement measures.
  • Updating documentation requirements: With the agency’s Evaluation and Management recommendation guidelines having been developed 20 years ago, prior to the widespread use of EHRs, it’s time to rethink their use, the letter asserts. Today, the group says, they have a negative impact on EHR usability and hinder interoperability. The group recommends eliminating documentation requirements for codes 99211-99215 and 99201-99205 entirely and allowing any care team member to enter medical information.
  • Rethinking data exchange policies: The AAFP is asking CMS and ONC to focus on how and when data is exchanged rather than demanding that specific data types be included. The group also urges CMS and ONC to penalize healthcare organizations not appropriately sharing information, using its authority granted by the 21st Century Cures Act.
  • Creating standardized clinical data models: To share data effectively across the healthcare ecosystem, the AAFP argues, it’s necessary to develop nationally-recognized, consistent data models that can be used to share data efficiently. It recommends that such principles be developed by physicians and other clinicians rather than policymakers, vendors or engineers.

I don’t know about you, but I find much of this to be a no-brainer. Of course, the decades-old E/M guidelines need to be reformed, consistent data models must emerge if we hope to improve interoperability and physicians need to lead the charge.

Unfortunately, it’s hard to tell whether CMS and ONC are willing and prepared to listen to these recommendations. In theory, leaders at ONC should be only too glad to help providers achieve these goals and CMS should support their efforts. But given how obvious some of this is, it should have happened already. The fact that it hasn’t points up how hard all of this could be to pull off.

E-Patient Update: Alexa Nowhere Near Ready For Healthcare Prime Time

Posted on February 9, 2018 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.

Folks, I just purchased an Amazon Echo (Alexa) and I’ll tell you up front that I love it. I’m enjoying the heck out of summoning my favorite music with a simple voice command, ordering up a hypnotherapy session when my back hurts and tracking Amazon packages with a four-word request. I’m not sure all of these options are important but they sure are fun to use.

Being who I am, I’ve also checked out what, if anything, Alexa can do to address health issues. I tested it out with some simple but important comments related to my health. I had high hopes, but its performance turned out to be spotty. My statements included:

“Alexa, I’m hungry.”
“Alexa, I have a migraine.”
”Alexa, I’m lonely.”
”Alexa, I’m anxious.”
”Alexa, my chest hurts.”
“Alexa, I can’t breathe.”
“Alexa, I need help.”
“Alexa, I’m suicidal.”
“Alexa, my face is drooping.”

In running these informal tests, it became pretty clear what the Echo was and was not set up to do. In short, it offered brief but appropriate response to communications that involved conditions (such as experiencing suicidality) but drew a blank when confronted with some serious symptoms.

For example, when I told the Echo that I had a migraine, she (yes, it has a female voice and I’ve given it a gender) offered vague but helpful suggestions on how to deal with headaches, while warning me to call 911 if it got much worse suddenly. She also responded appropriately when I said I was lonely or that I needed help.

On the other hand, some of the symptoms I asked about drew the response “I don’t know about that.” I realize that Alexa isn’t a substitute for a clinician and it can’t triage me, but even a blanket suggestion that I call 911 would’ve been nice.

It’s clear that part of the problem is Echo’s reliance on “skills,” apps which seem to interact with its core systems. It can’t offer very much in the way of information or referral unless you invoke one of these skills with an “open” command. (The Echo can tell you a joke, though. A lame joke, but a joke nonetheless.)

Not only that, while I’m sure I missed some things, the selection of skills seems to be relatively minimal for such a prominent platform, particularly one backed by a giant like Amazon. That’s particularly true in the case of health-related skills. Visualize where chatbots and consumer-oriented AI were a couple of years ago and you’ll get the picture.

Ultimately, my guess is that physicians will prescribe Alexa alongside connected glucose meters, smart scales and the like, but not very soon. As my colleague John Lynn points out, information shared via the Echo isn’t confidential, as the Alexa isn’t HIPAA-compliant, and that’s just one of many difficulties that the healthcare industry will need to overcome before deploying this otherwise nifty device.

Still, like John, I have little doubt that the Echo and his siblings will eventually support medical practice in one form or another. It’s just a matter of how quickly it moves from an embryonic stage to a fully-fledged technology ecosystem linked with the excellent tools and apps that already exist.

Blockchain in Healthcare

Posted on February 8, 2018 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 predicting that one of the hot topics at the HIMSS 2018 Annual conference in 3 weeks is going to be blockchain. I must admit that I’m a little torn on blockchain and what its impact will be on healthcare. I see the potential, but we still have a way to go with the technology. For example, it needs to find a way that it can scale.

Those specific issues aside I had two recent experiences that have me thinking more and more about blockchain and healthcare.

The first came from Jim Tate who shared “Death of the Middleman: Healthcare & Blockchain.” Jim is one of the bright, intelligent, pragmatic people I look to for insights into the industry. He’s got deep experience and understanding of the healthcare machine. So, it always causes me to wake up a little when he’s espousing something like he is with blockchain.

Jim’s comments are really fascinating as far as blockchain having the potential to be revolutionary while other things like 3D Printing, AI, and Cloud being evolutionary or as he calls them “The Next Big Thing.” We could have a discussion about whether these things are, have been, or will be revolutionary, but I agree with Jim Tate the blockchain has much more potential to be revolutionary. That’s exciting. As I dig into it more, I can see some little aha moments for how Blockchain’s distributed nature can change a lot of things. That’s really exciting even though we’re still in the early days. It’s close to when people saw Netscape for the first time. You could see the potential, but there’s still a lot of things that need to be built out and problems to solve.

The other experience I had recently was having lunch with a friend who has dove head first into blockchain ICO (Initial Coin Offering) consulting. Without going into all the details and discussion of ICOs, it was crazy to hear him talk about all the companies that are willing to gain his consulting wisdom and influence (he has a few hundred thousand followers on Twitter) in return for what he called funny money and they’d call coins. On paper, those coins can be worth a lot, but it depends on a lot of things. They could also end up being worth nothing. That’s what makes it all so scary and crazy. I live in Vegas and this feels much crazier than any gamble on the strip. At least on the strip there are clear odds for how much you’re going to lose. With ICOs and other blockchain efforts, it’s anyone’s guess.

The message I got is that we’re entering a different world that’s going to be hard to understand and comprehend if you don’t really dig into it. Could it lead to a blockchain bubble pop similar to what happened with the internet and the dotcom bubble pop? Absolutely. Some are already saying it’s happening now as bitcoin and other cryptocurrencies have dropped dramatically in value. While it bears watching, I think the blockchain bubble (which I should note is different than bitcoin or even cryptocurrency) is just starting to grow. I don’t think we’re close to it blowing up.

While this wild speculation is scary for me to consider, this type of wild investment and speculation could be a great thing and some might argue is a necessary part of blockchain maturing. All the crazy investment will hopefully sift the wheat from the tares and better help us understand what’s good and what’s bad with blockchain. It’s a necessary part of its maturation.

What does this mean for healthcare? I’m not sure. I’m still watching and trying to learn as we go like everyone else. On the one hand, it’s exciting but there’s plenty to be feared. I’d love to hear your thoughts on blockchain and healthcare. Will it have an impact for good, bad, or other? Let us hear your thoughts in the comments.

Crypto Breach at Hospital, EHR Customization, and Some EHR Humor – Twitter Roundup

Posted on February 7, 2018 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.

It had been a while since we did a Twitter roundup. So many interesting, entertaining, and insightful things are shared. We decided to keep this one light but valuable. We hope you enjoy the Twitter roundup and some of our own added commentary.


Not sure this is the first, but certain it’s not the last. A lot of money to be made from cryptocurrency mining and hospitals have a lot of CPU that can be stolen to mine cryptocurrency. This is going to become a popular malware. It goes mostly hidden from site and so many organizations don’t even realize what’s happening.


If you’ve been part of an EHR implementation you know that Linda is right. However, there are some general lessons learned that are extremely valuable and help every implementation or now EHR optimization. The question I’d ask is, should EHR be standard?


I should have saved this for a Fun Frdiay post, but why not treat Wednesday like Friday. Some other replies to this tweet were just as hilarious (until you realize what they really mean):
If my patients went unresponsive as often as my EMR, I’d be a coroner. – @FredWuMD

Just spray a little epi into the USB port – @roto_tudor

Yes it would be like an episode of the resident. Multiple codes a day. @CaitlynMooneyMD

Three-Quarters Of Medical Practices Aren’t Getting Full Value From Their EHR

Posted on February 6, 2018 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 how many EHRs seem to feature position-hostile designs, it’s hardly surprising to learn that many medical practices aren’t getting the most from them. However, I was taken aback by how deep this underutilization seems to run.

A new study appearing in the American Journal of Managed Care has concluded that a whopping 73% of practices weren’t using their EHRs to the fullest extent and that another 40% make little or no use of health IT functions. Even given the obstacles to using EHRs, this seems like a big waste of money, time and potential, doesn’t it?

To conduct the study, researchers used data from a relevant HIMSS Analytics survey. The data included responses from 30,123 ambulatory practices with an operational EHR in place, most with fewer than seven affiliated doctors in place.  Researchers sifted the data to determine the extent to which these practices were using EHR-based health IT functionalities.

Of course, some medical groups were on top of their game. Researchers found that 26.6% of practices could be classified as health IT super-users that squeezed every benefit from their systems. As you might guess, the likelihood that a practice was a super-user grew as the number of affiliate doctors increased, as well as when the practice was located in a metropolitan area. But far more groups seem to have fallen well behind the leaders.

According to the data, among practices using CPOE tools, only 36% used them for more than 75% of orders. Also, while groups commonly used basic functions such as data storage, with 100% of practices storing transcribed reports electronically and 61% using the EHR for nursing documentation, most lagged in other areas. For example, only 29% used tools allowing them to find and modified orders for all patients on a specific medication.

To address this gap, researchers say, policymakers should consider how to address the barriers PCP and specialist practices face in using the health IT tools more fully. Understanding how this disparity has emerged and how to address it is critical, they suggest, as less sophisticated use of EHRs may have an impact on care quality and also on groups’ ability to participate in community efforts such as HIEs.

The truth is, if the under-utilizer practices don’t get some kind of help or support, it’s unlikely they’ll step up their use of EHR functions. Particularly if they’ve had the system in place for a while, the workflow is baked into the system and physician habits established. Maybe the pressure to provide value-based care will do the trick, but it remains to be seen. This is a problem that won’t go away quickly.

Medical Groups Adopting Telehealth, But Cautiously

Posted on February 5, 2018 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.

Telehealth has gone from a neat idea to an accepted part of the spectrum of care. However, it’s largely been hospitals, not doctors, which have dived into telemedicine wholeheartedly

Recent data suggests that while doctors are gradually adopting telecare, they have many reservations about doing so. A study published last year by Reaction Data found that while 68% of physicians said they were in favor of telemedicine, most were using it only in special situations such as reaching patients in rural areas, visit follow-ups and managing specific patient populations.

A new survey by the Medical Group Management Association has reached a similar conclusion. In a poll conducted last month by the trade group, the MGMA found medical practices’ approaches to telemedicine have changed only marginally since January of last year.

In this year’s Stat poll, which had 1,292 respondents, 26% of respondents said their organization offered telehealth services, and another 15% said they planned to offer them in the future. That’s up only 3% from January 2017 research, which found that 23% of respondents provided such services and 18% planned to add them.

Meanwhile, two key statistics have stayed in place from last year. Thirty-nine percent of respondents to this year’s survey said they didn’t offer telehealth services and 20% weren’t sure if they would, the same percentages found in last year’s research.

When it announced the results, MGMA shared some specific suggestions for planning and implementing a telehealth program. They include:

  • Researching and understanding patient needs
  • Setting clear goals for telehealth and tying them to an existing strategic plan, which demands fewer organizational changes and speeds adoption
  • Understanding how telehealth supports value-based care
  • Researching telehealth vendors and platforms
  • Researching reimbursement and licensure requirements (if any) in the practice environment
  • Engaging and educating practice staff members on telehealth issues and strategies
  • Having doctors reach out to colleagues in their specialty to learn how their telehealth implementation experience has gone
  • Bearing in mind that telehealth implementations typically take an average of one year from plan to rollout

All that being said, it seems likely that some of the practices which are hanging back from telehealth have taken most or even all of the steps outlined above. The thing is, even if a practice has researched the telemedicine market, understands its patients’ needs and knows what issues it will face during a service rollout, these steps still can’t address some of the fundamental realities holding telehealth back today.

The truth is, from what I’ve seen medical practices still face two difficult issues when they consider telehealth seriously: how to make money at it and how to fit it into their workflow. These are major problems and won’t be resolved by advice alone (not that this is MGMA’s fault of course).

Despite medical groups’ concerns, there will doubtless be a tipping point where practices begin to see telehealth services as a routine part of what they provide. However, it seems clear that we’re far from getting there.