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!

90% of Doctors Expect to Have EHR Within 3 Years per USA Today

Posted on November 30, 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.

@ElinoreBoeke – Elinore Boeke
90% of surveyed doctors expect to have EHRs within three years usat.ly/tSgBNG #HealthIT #EHR via @USATODAY

The survey also sets EHR adoption at 46% and quotes someone saying there are 1000 EHR software vendors out there. Well, I think all of those numbers are way off.

First, expect that doctors won’t meet their expectations cause 90% of doctors won’t have EHR within 3 years.

Second, I think we’re closer to 25-30% adoption. 46% probably includes a lot of people who have a PMS, but no real EMR. Maybe they do 1 or 2 small EHR like function.

Third, 1000 EHR software vendors, really? Even if you expand to things like ePrescribing I’d put the number closer to 600. If you take out the partial EHR software companies, I think it’s closer to 300. Granted, there are more and more EHR software coming out each day.

Guest Post: The Case for Modular EHR Over Complete EHR

Posted on 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.

Dr. Sullivan is a practicing cardiologist who joined DrFirst in 2004, just after completing his term as President of the Massachusetts Medical Society. He is known throughout the healthcare industry as the father of the Continuity of Care Record (“CCR”) and a leader on the future of healthcare technology. He is assisting DrFirst in ensuring that Rcopia continues to add the functionality necessary to maintain its leadership position both in electronic prescribing and in the channel of communication between various sectors of the healthcare community and the physician. Dr. Sullivan is active in organized medical groups at the state and national level, and is both a delegate to the AMA and the Chairperson of their Council on Medical Service as well as past Co-Chair of the Physicians EHR Consortium.

The buzz surrounding Electronic Health Records (EHR) is nothing short of constant.  The daunting task of selection, purchase and implementation is quite confusing, technical, and expensive, with many physicians, clinics and health systems uncertain of their needs and questioning how the technology is going to impact the way they practice medicine and their bottom line. It’s all about workflow and productivity.

More recently, Providers are faced with the intimidating task of deciding which kind of system to install. There are all inclusive systems, often referred to as fully paperless or standard EHRs and there are so called a la carte systems known as modular EHRs.

The Case for Modular

Modular EHR systems allow providers to take a stepping stone approach to health IT clinical documentation and order writing, by choosing the tools and functions which make the most sense in their practices and clinics; improving specialized workflow and efficiency.  Going the modular route can gradually ease the provider and the office staff into a more paperless environment without having to make a full and often-times difficult transition to a fully paperless workspace.

There is need for caution however. The sheer volume of modules available can make selecting appropriate ones an overwhelming task.  Not only do clinicians need to be wary of which modules they are choosing, but also what functions have been certified by an authorized organization.

By combining specific modular systems, it can become “qualified,” making the user eligible for the monetary reimbursements set forth by Title IV of the American Recovery and Reinvestment Act of 2009 (ARRA).

At DrFirst, our Rcopia-MUTM has taken all of the guess work out of this process and is a completely certified Modular EHR that physicians can implement and start earning incentive money directly out-of-the-box.

The implementation of a complete EHR system can be confusing and time consuming.  Herein lays some distinct advantages of implementing a modular EHR.  Practices that have already implemented e-prescribing or registry modules may not need to relearn a different system, or move their data from one to another (as long as the current module is certified).

Providers who are considering going the modular route can check the certification status of their options at Certified Health IT Products List. The cost for a modular approach is often much less expensive and providers can select the modules from various vendors to meet their financial and practice-based needs.  Upon implementation, providers must show they’re using certified EHR technology in measureable ways to receive their incentive monies from the Federal Government.  With this very high ROI, many providers see the advantage of using the modular approach to postpone the decision process in selecting a complete EHR and yet at the same time earn Meaningful Use incentive money to put towards the cost of  the much more expensive system.

According to the Centers for Medicare and Medicaid Services, doctors who have not adopted an EHR (either modular or complete) by 2015 will be penalized by Medicare — a 1% penalty to begin, then up to 3% within three years. Many providers are banking on the reimbursement that has been made available by the ARRA to help offset the initial costs.

What is your practice considering, complete EHR or modular? Do you see benefits of one over the other?

“Prius Effect” of Non-Judgmental Reporting

Posted on November 29, 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.

@forbodyandmind – Scott Henady, MSTCM
“Prius effect” changing behavior via non-judgmental reporting – quoting Dr. Ravi Iyer #pfconnect

The above was a tweet from Scott Henady who attended the panel that had Dr. Ravi Iyer at the Practice Fusion Connect user meeting. Dr. Iyer made some really interesting comments about Non-Judgmental reporting of data that helps to improve behavior. He called it the “Prius Effect.”

A search on Google seems to indicated there are a number of Prius Effects out there. However, the one that Dr. Iyer mentions is the display in the Prius that tells you how much gas mileage you’re getting and when you’re using the battery versus the gas in the car. It becomes quite clear as you accelerate, your miles per gallon goes down and so most people’s automatic response is to not push the gas pedal as much. I know I’ve had this exact experience. Just by being informed of the consequence of what I was doing, it changes behavior.

I believe it was Dr. Iyer also that talked about the signs on the side of the road that display how fast you’re driving down a street. It’s amazing how this little piece of non-judgmental information gets people to do something they wouldn’t have done otherwise (in this case push on the brake and slow down).

I think we could see a lot of benefit from these non-judgmental reporting of data in healthcare and EHR software as well. In fact, this is true for both a doctor who can provide better patient care with the right information warnings at the right time and also to patients who aren’t taking good care of their bodies. Just by providing good information to people, we can see behaviors improve. That’s a powerful concept that I think we need to see more of in EMR and EHR software and in healthcare.

Guest Blog: HR Changes Coming to Digital Doctors’ Offices

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

Happy EMR Doctor’s Note:  Ken Harrington, PhD, is my practice manager and he accompanied me recently to the Practice Fusion Connect 2011 users conference on 11.11.11. Here are his thoughts on doctors’ offices that have made the switch to a digital work environment and the HR differences it will inherently bring.

I recently attended the Practice Fusion users conference Connect 2011 where I viewed a lecture on the evolution of the doctor’s office with the arrival of electronic medical record software systems. Many blogs and articles have already been written on (1) how EMRs are saving space in the doctor’s office with the elimination of the paper charts and (2) the saving of dollars with the elimination of staff to file and manage the paper charts.  However, I am finding in the office where I work that EMRs are also changing the HR aspect of the doctor’s office.

I am the Practice Manager responsible for coordinating hiring all new employees at The Washington Endocrine Clinic in Washington, DC.  When the office opened a little less than two years ago, there was no shortage of area doctors who wanted to offer their advice to Dr. West on how best to run the office and meet staffing needs. One of these suggestions was to keep costs down by not paying more than a minimal hourly wage for front desk staff.  Being a novice at running a doctor’s office, I followed this suggestion and employed people in this low price range.  What I found was that this salary range usually resulted in staff that had not completed a college-level education, had little experience in using the technology involved with an EMR, and seemed to have little motivation to push the envelope in terms of learning new skills.

Now I should mention that when this doctor’s office was set up, it was designed to be as paperless as possible. This meant that there would be no paper charts in the office, and every document related to a patient was stored in the EMR. A website was developed where new patients were directed for registering and reviewing the policies of the clinic. A high-speed scanner was installed to convert to a PDF form all documents that patients brought into the clinic, and an electronic fax was set up to convert all incoming documents to PDF files. All of this required staff who were familiar with working with such technology.  We thought it would be simple enough to teach anyone how to use all of this equipment and software, but this was not exactly the case.  We discovered that, while intellectual curiosity was a key human element required for excelling in this new world, such a characteristic was not present in our earlier workers.  Indeed, I remember it taking all day for these employees to complete tasks that are now completed in around 30-60 minutes by our newer staff.

We went through several employees before we finally decided that we would hire future employees with the minimum of a college bachelor’s degree and pay them a higher wage. What we found in doing this was a different type of employee. The employees we have in the office now are skilled enough with technology and time management skills from their college and corporate work experience to perform efficiently. The employees who are paid a higher salary bring to the office better customer service abilities, more intellectual curiosity, better problem solving skills, and team playership skills. As much as we liked saving money on previous employees, the skill set bought with such money was simply insufficient for a technology-centered doctor’s office.

Now some critics will say that, in the end, I did not end up saving money with the adoption of an EMR because I paid higher salaries. I do not agree with this thought.  The higher motivation among our current employees, we estimate, has actually been able to cut our staffing needs by an additional full-time person.

Other critics might say that the adoption of an EMR has created such a highly technical office that it will become too technical to manage.  Again, I do not agree. Our employees are so comfortable around the technology that they can usually figure out the answers to challenges that arise. They know how to clear a print spool when the printer hangs up. They know how to use a PDF converter program to sign a document or fill out a form without having to actually print it.  They know how to walk a patient through filling out and e-mailing the online registration form when patients encounter difficulty.

EMRs are changing not just the physical appearance of doctors’ offices, but also are changing the culture of the office through raising the bar for qualifications of people hired to run and manage the office.  It is not that employees paid lower salaries cannot learn these new techniques.  My point is that hiring employees who are more educated and skilled with using technology allows for a smoother transition into a paperless and technology-centered office. This fundamental change in HR will reshape the ethos of future physician offices.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.  He blogs at HappyEMRDoctor.com and EHROutlook.com.

A Report on ePrescribing Challenges

Posted on November 28, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

From the Center for Studying Health System Change (hschange.com) comes a study on e-prescriptions, and how providers and pharmacies work together to electronically transmit and fulfill prescriptions. Now, I don’t know how reliable this organization or its research is (the .com in its name, for example, is something that bothers me. Also the report focuses almost exclusively on SureScripts). But the study is interesting to me for what it reveals statistically.

HSChange.com conducted 114 phone interviews with 24 physician practices, 48 community pharmacies, divided between local and national companies. The national respondents included 3 mail-order pharmacies, and 3 chain pharmacy headquarters. Those of you who are interested in the numbers, the methodology and other sundries, go ahead and read the report in its entirety. Here’s a quick summary from the report’s results the rest of us. My comments are bolded.

According to the report:
Two-thirds of the practices sent at least 70% of their prescriptions electronically. Which means about 46.2% of the prescriptions are e-prescribed. Plenty of room for growth, methinks.

Pharmacists at more than 50% of Community said their pharmacies received less than 15% of their prescriptions electronically. The reasons: providers didn’t transmit electronically, or sent out computer-generated prescriptions by fax or mail. Interesting – could be indicative of either lack of knowhow, or infrastructure that allows for e-transmission.
New prescriptions are more likely to be e-prescribed than prescription refills (renewals). The report states that many pharmacies don’t use this feature in order to avoid SureScripts fees for renewals.

There are plenty of inefficiencies. E.g. a) multiple requests for the same prescription were sent (say by phone, fax and through SureScripts) by pharmacies b) providers mistakenly deny prescriptions and then re-send the same prescription as a new one.

E-prescribing to mail order pharmacies is a different process – (apparently providers need to be Surescripts certified to e-prescribe with community pharmacies, and also need to be certified to e-prescribe to mail order pharmacies. So, even when a provider selects a mail order pharmacy to fulfill an e-prescription, the prescription is delivered by fax to the the mail order pharmacy by Surescripts.)
Prescription specificity falls on the provider – tablets, capsules, and liquid formulations might have different costs. Pharmacists can’t change the prescription from a capsule to a tablet on their own, without consulting with the prescribing provider. This might result in unexpected costs.
Providers’ patient instructions are still incomprehensible! Pharmacists often have to play translator (maybe because as the report alludes to, the instructions are intended for pharmacist eyes, not the patient.)

an independent pharmacist explained, ‘A lot of times we can’t copy the directions word for word because the patient doesn’t understand them, just like with paper prescriptions. We have to go in and erase ‘t.i.d.’ and put in, ‘One tablet three times a day’.’

 

Fred Wilson on Healthcare IT Investment

Posted on 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 my favorite venture capitalist bloggers (yes, I’m a nerd like that) is Fred Wilson from Union Square Ventures. He’s been posting something like every day for the past 10 years or something close to that. I’m sure I take a lot of my blogging style from him which is funny since I mostly write about EMR and healthcare IT, but I’m only at 6 years of blogging. [Excuse the digression]

Anyway, yesterday Fred wrote a post about his view of Healthcare investment. Being in the healthcare IT world where he’d want to invest I read with keen interest to hear his thoughts. The first and last paragraph of his post sums up his position on healthcare investing:

A few weeks ago, I met with a VC who has been investing in healthcare for over 30 years. He asked if we invested in healthcare and I told him that we’d like to but we don’t really know how to fit it into our investment thesis which is focused on large networks of engaged users disrupting large markets. Clearly healthcare is a large market, possibly the largest measured as a percent of GDP. But we haven’t seen many large networks of engaged users emerging in healthcare.

It is likely that we’ll be doing more looking and studying and less investing in healthcare for a while (as we did in education). But I’m hopeful that entrepreneurs, industry observers, and of course all of you, will help us develop a thesis that allows us to start investing in healthcare. Like education, it feels like a market where you can make strong returns and also help facilitate important and needed changes.

Fred does clarify in his post that there are probably a lot of great healthcare IT investment opportunities out there, but that doesn’t mean that those opportunities meet the investment thesis for their VC investment portfolio.

I left my gut reaction to Fred’s post in the comments as follows:

One challenge with your investment thesis for healthcare is that healthcare is somewhat unique in that a HUGE amount of market power (see pharma, other medical procedures) is held by such a small number of people (see doctors). So, there’s a huge market, but there’s not a huge number of users to engage. Of course, there’s still the consumer (patient) side where you could have the large engaged users. Plus, patients are slowly becoming more engaged in their healthcare.

As a side note, I’ve started kicking around the idea of hosting a Healthcare “Disrupt” for healthcare IT companies to pitch their companies. Could be a great place to continue your research.

Fred then replied:

yes, that consolidation of market power is the primary reason we have avoided healthcare to date

As I’ve thought more about the consolidation of market power, healthcare is not completely unique in this but it does make for an interesting dynamic that doesn’t exist in a lot of consumer applications which Fred Wilson usually focuses on. Although, the patients getting involved could swing that pendulum the other way enough to get Fred Wilson and similar investors to start investing in healthcare.

Also, I’m dead serious about the idea of doing a Healthcare “Disrupt” like conference. We’ll see if we can get all the right people in place to make it happen.

A Little EHR Education Could Go a Long Way

Posted on November 23, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I’ve always got my eyes open for news of healthcare facilities marketing their healthcare IT systems to patients. To me, explaining the new high-tech gadgetry at check-in and the new computers/laptops/tablets in each exam room goes a long way towards making patients feel more comfortable before, during and after a visit to the doctor or even hospital.

I came across two recent examples of patient outreach that I think are great ideas, and would certainly get my attention, and perhaps even get me to consider switching providers.

The first is an ad from Martin Memorial Health Systems in Florida, promoting their transition from paper-based records to an electronic medical records system (Epic, if you must know.) News of the implementation in a recent HISTalk post mentions that the ad is part of a campaign announcing the system’s transition starting in December. I couldn’t find any mention of the campaign, or the transition, on the hospital’s website, so I’m not sure where exactly this ad will appear – hospital hallways, local newspapers, etc.

The second comes from Kay Gooding, Project Director of the Region D Health Information Technology Consortium at Pitt Community College. She alerted me to HealthIT.gov’s Campaign Toolkit – a variety of online resources that organizations can use to educate the general public about healthcare IT. The toolkit includes a short video (see below) on Ensuring the Security of Electronic Health Records. I could see this being played in hospital lobbies, doctor’s waiting rooms, or even embedded in some sort of physician-sponsored new patient welcome site, which could also house medical history/personal health records, consent and privacy forms, and the like.

I’d be interested to know from a marketing perspective, whether patient-facing educational campaigns result in an increase in new patients who are attracted to more technically advanced facilities, and if these same patients experience better clinical outcomes and satisfaction as a direct result of new HIT systems. If you hear of anything, let me know.

EHR Related Stocks Up 82% Since EHR Stimulus Package

Posted on November 22, 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.

If you’re like me and work in the healthcare IT industry, you know that we’re in a really amazing environment right now. Turns out, healthcare IT related companies are enjoying the EHR stimulus money from the HITECH act as much or more than anyone else.

In an analysis by USA Today, they found that since 2009, the healthcare IT related companies stock value increased by an average of 82%. 11 of the 45 companies they analyzed they increased by a combined total of at least $20 billion since the HITECH act was passed.

They also break down how much each healthcare IT and EHR related stock increased since the HITECH act took effect:

  • 194% for Cerner;
  • 134% for Allscripts Healthcare Solutions;
  • 105% for Computer Programs and Systems;
  • 105% for McKesson;
  • 96% for Siemens;
  • 89% for UnitedHealth Group;
  • 83% for Accenture;
  • 55% for athenahealth;
  • 51% for Dell;
  • 34% for General Electric.
  • During that time, the stock value for Quality Systems dropped by 3%

Some pretty amazing numbers. Plus, it’s interesting to think that the stimulus money is just getting started. Greenway EHR users have gotten $5 million and Cerner EHR users have gotten well over $2.2 million in EHR incentive money.

I’m not stock analyst, but I’m sure these stocks will continue to grow in this frothy healthcare IT environment.

OccupyYourEMR! – An Idea Whose Time Has Come

Posted on 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.

Note:  The following is not to be taken at face value, exactly — I’m not literally convinced that it’s time for a revolution — but you might see a point or two here that are worth considering further.

Doctors, are you sick of having an EMR pushed down your throat by administrators and IT leaders that don’t care how disruptive or painful the change may be?  Do you feel like your complaints and concerns aren’t being heard?  Are you actually afraid a patient will be hurt someday because of the EMR’s limitations?

Well, I say it’s high time you get radical and OccupyYourEMR!  Get in there and resist until your (absolutely critical) voice is being heard.

If you don’t, you know you’re going to be steamrolled into using a platform that’s awkward, ugly, inflexible and slow — in short, a system only the IT admin and hospital board who funded it could love.   Maybe you’re not ready to stop working, but what if you refused to log in?

As things stand, you have little to gain and a lot to lose by blindly kowtowing to EMR adoption demands.

Hey, if Hospital X installs an EHR and it seems to work, the CIO and the CEO and the board of directors look like geniuses. Some of them will probably get big bonuses if everything falls into place just right.

You, on the other hand, will be lucky if the new system doesn’t cut your work pace in half, confuse you and make charting a painful chore. Oh, and if things really go badly, you’ll harm or kill a patient because you didn’t read the EMR right.  Of course, the hospital will be right there beside you offering the best legal defense money can buy, right? (Uh, not really…)

Yes, there are some stories out there about EMRs that actually improve patient care and make doctors’ lives easier, but let’s face it, there’s a reason we don’t publish a ton of those here (or on sister blog Hospital EMR and EHR).  I’m not suggesting that all EMR rollouts are a mess, but few are a walk in the garden either. And it’s more common than you might think for a provider organization to go through a second or even a third installation before everything works.

Hey, don’t misunderstand me, I still believe EMRs are going to be a positive force over the long term.  In the mean time, though, some clinicians will be casualties — either becoming burned out by new work expectations, hating the new process or even making dangerous mistakes. Don’t be one of them.

Demand an EHR that helps your workflow, helps you provide better patient care, makes your life better, and lives up to the expectations the EMR salesperson made. An EHR that does those things will be welcomed by almost all doctors and other staff.

Greenway Medical Users Get $5 Million in EHR Incentive Money

Posted on November 21, 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.

https://twitter.com/#!/HITAdvisor/status/137968890784399361

Back at the end of August I posted the Cerner EHR incentive money total at $2.2 Million. No doubt that’s a lot higher now. However, it’s interesting to compare the totals of Cerner’s EHR incentive money and Greenway’s EHR incentive money.

If you know of other EHR incentive money numbers that are published, please let me know.