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Top 10 EMR Software per Medical Software Advice

Posted on January 24, 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.

I always find it interesting to see various list of EMR and EHR software. Most of the lists don’t have much thought put into their creation. However, it’s fun to look through all the lists and see which EMR companies end up making it on the list. Plus, it’s good to know the next time you see them talking about being a top EMR software where that list might have come from.

This list of Top EMR Software companies comes from the people at Medical Software Advice. I’m not sure how they get this list, but it’s an interesting one. No doubt the list is a bit biased by the EHR vendors that actually work with Medical Software Device. Maybe this is the top 10 EMR software companies that can market. There are some of the major EHR companies on this list though, so take a look. Always good to triangulate multiple top EMR lists to narrow down your selection process.

For those in the industry, you’ll enjoy reading through the descriptions of each company.

101 Tips to Make Your EMR and EHR More Useful – EHR Tips 1-5

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.

Time for the next entry covering Shawn Riley’s list of 101 Tips to Make your EMR and EHR More Useful. I can’t believe that this is the last post in the series. I think it’s been a good series chalk full of good tips for those looking at implementing an EHR in their office. I’d love to hear what people thought and if they’d like me to do more series like this one. Now for the final 5 EMR tips.

5. Automatic trending helps all over the place – A picture is worth a thousand words and this is never more true than when we’re talking about trending. Make sure your EHR software can quickly take a set of results and/or data points and graph them over time.

4. Keep training over and over – Are you ever done learning software? The answer for those using an EMR is no. Part of this has to do with the vast volume of options that are available in EMR software. However, the training doesn’t necessarily have to come from formal training sessions. Much of the training can also come by facilitating interaction and discussion about how your users use the software. By talking to each other, they can often learn from their peers better ways to use the software.

3. Infrastructure is key to performance – I love when people say “My EMR is Slow” cause it’s such a general statement that could have so many possible meanings. Regardless of the cause of slowness, the EMR is going to get the blame. For those wanting to dig in to the EMR slowness issue, you can read my pretty comprehensive post about causes of EMR slowness. I think you’ll also enjoy some of the responses to that EMR slowness post.

Infrastructure really matters when someone is using an EMR all day every day. There’s no better way to kill someone’s desire to use an EMR than to have it be slow (regardless of who’s responsible).

2. Quit pulling charts as soon as possible – I think this tip should be done with some caution. In certain specialties the past chart history matters much more than in others. Although, it’s worth carefully considering how often you really look through the past paper chart in a visit. You might be surprised how rare it is that you really need the past paper chart. If that’s the case, consider only pulling the chart when it’s needed. If you only find yourself looking through the past paper chart for 2 or 3 key items, then just have someone get those 2 or 3 items put into the EMR ahead of time. Then, it will save you having to switch back and forth. Plus, then it’s there for the next time the patient visits.

1. Crap process + Technology = Fast Crap – Perfect way to end 101 EMR and EHR Tips! I like to describe technology as the great magnifier. The challenge is that it will magnify both the good and bad elements of your processes. Fix the process before you apply the technology.

If you want to see my analysis of the other 101 EMR and EHR tips, you can find them all at the following link: 101 EMR and EHR tips analysis.

Healthcare IT Data Entry Takeaways

Posted on January 23, 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.

I was looking over Rock Health’s writeup of the Health Innovation Summit. A lot of the post is more about what happened as opposed to what was said, but there were some really interesting takeaways that stuck out to me from the Form Reform: Data Entry for Humans session by Jackson Wilkinson. Here’s the section on it:

Jackson Wilkinson, Co-founder of WeSprout, gave attendees practical advice for data entry. Data is an important part of the healthcare equation, but input design is blocking progress. Quick take-aways: Don’t ask for anything you don’t need; whatever you request, return the favor in spades; make it fast, accurate, and simple. And don’t forget: The best form is the one you never have to fill out.

The money phrases:

Input design is blocking progress
and
Whatever you request, return the favor in spades
and
The best form is the one you never have to fill out.

While I’m quite sure this presentation had to do more with consumer health IT than EMR and EHR software, I think there’s a lot that could be learned from these comments by EMR companies. Far too many EHR companies believe that they have their users captive and so they can ask whatever they want of their users. Sure, they’d never admit this out loud, but when you look at their EHR software and the design, you realize that they weren’t focusing on the above points very well.

As I think about these points, I’m taken back to a visit to San Francisco where I met with the founders of Elation EMR, Conan and Kyna. I absolutely loved their laser focus on stripping out the unneeded extras in their EMR software. They talked about becoming a certified EHR and handling ePrescribing and how they literally had to work tirelessly to make meaningful use of a certified EHR a seamless experience that didn’t place an undue burden on the provider. I saw this same focus through every part of their approach to EHR software development. I haven’t seen their software in a while so I don’t know how well they’ve followed through on this focus, but I’m interested to see it again to find out.

Is EMR a Four-Letter Word? You decide

Posted on 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.

For quite some time now, I’ve nursed my own doubts about:
– how effective EMRs are (disastrous in the short term, long term they’re supposed to make life easier, but we haven’t seen any evidence of that yet)
– why physicians are being paid to implement something that makes logical sense (you need something to nudge people out of status quo. And probably in the government’s thinking, what better use for taxpayer dollars, right?)

I came upon this blogpost, provocatively titled Why EMR is a four-letter word to most physicians. Adam Sharp, Par8o (“pareto”, not “par 80”) founder references this post from the Healthcare Blog. The discrepancy in the rates between adoption of any EMR is mind-boggling. It was projected to be close to 56.9% in 2010, vs. adoption of a fully functional EMR (projected to be close to 10.1% in 2010). (I’m not using the 2011 rates because the rates for fully functional EMR adoption in 2011 are not listed).

A reason Sharp gives for incentives and threats of decreased payment are “the industry and physicians have known for years that EMRs do not improve productivity and that it is highly questionable that EMRs lead to better patient outcomes”. While I would agree that in the short term, there is decreased productivity, I’m not so sure you can dismiss there is no productivity increase over the long term. This report about a UC Davis study for example, shows that the loss of productivity was just one month for internal medicine, and that productivity increased to pre-EMR implementation levels in the next six months. The not-so-good news is that productivity levels declined for pediatricians and family practices.

I interpret these findings like this: for specialties where there is loss of productivity, sure, the whole exercise needs a rethink. But in cases where your productivity is at par with your pre-EHR levels, I think there is a hidden benefit that detractors are more than willing to gloss over – the availability of patient data. Data is the holy grail – it’s up to us to figure out whether and how we use it.

Sharp also imagines some doomsday scenarios – of EMR vendors with uncanny abilities to do as they please.

“The goal of EMRs is to wrestle control of healthcare away from the doctor-patient relationship into the hands of third parties who can then implement their policies….by simply removing a button or an option in the EMR.”

Maybe I’m turning turncoat here and letting you guys in on the best kept secret of the IT industry, but every vendor I’ve worked for, past and present, figuratively quakes in his IT boots when it comes to contract renewal. Even for COTS products, vendors actually customize things here and there for customers, till you have 25 versions of the same code, all just to keep their customers happy and paying. While I’m pretty sure there are rogue vendors who can give you the best EMR nightmares money can buy, I also do think customers can, and do, help rein in errant ideas. In other words, vendors can’t simply remove buttons and options or randomly start charging you for stuff, not unless you let it happen. And you, the customer, hold the purse strings, ergo YOU, not the vendor, call the shots.

I don’t quite find myself agreeing with the cynical conclusion of the post which is that the point of EMRs is to wrest control away from doctors and patients into the hands of third parties who wish to regulate choice and eligibility. But there’s plenty there that’s food for thought. Go check it out.

One Doctor’s View of ePrescribing and Meaningful Use Incentives and Penalties

Posted on January 20, 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.

I came upon this comment from Kay Kirchler, MD in regards to the ePrescribing penalties and other government incentive money for health IT. You’ll have to overlook the poor grammar and abbreviations, but I wonder how many other doctors feel the way Dr. Kirchler does.

who made all these rules and why are we just lying down and taking it? the arbitrary requirement for “10 escribes ” by june 30th or “penelty” when our emr ( we have had emr for >>10 yrs) will not escribe due to delay in “retro-fitting ” our emr instead of spending yet another fortune for a new “government approved ” version. the requirement to print out visit note to be available w/i 3 days rule .. rediculous. pts dont want it , not going to pick it up, costly and opens door for pts info to be floating out in parking lots, garbage cans etc .. i could go on for days. i spend more time loading info in emr ( much more w “meaningless use” than i do taking care of the patient .why are we not organizing to stand up and fight this power grab !!!!

The line that gets me is the one where he says that he spends more time loading data into the EMR than he spends with the patient. As a patient, the idea of this just makes me cringe. However, it’s a reality for many.

The other part that is quite interesting is that there really haven’t been many physician voices in all of this. There’s definitely not been any #OccupyMeaningfulUse protests happening by doctors. The closest thing I’ve seen to doctors rising up against Meaningful Use and other government programs for health IT has been at medical association conferences where doctors have gotten quite worked up. However, the message rarely leaves the medical conference. Plus, the majority of doctors in the room just shake their head, but don’t do anything after that.

I imagine many doctors look at it and see EHR software as the inevitable.

Preparing for HIMSS 2012 – #HIMSS12

Posted on January 19, 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.

It seems like everyone I talk to or interact with in the Health IT world is in full on HIMSS 12 preparation mode. I only attended my first HIMSS 2 years ago in Atlanta. So, I’m mostly a newbie at HIMSS. I sometimes long for the days when I just went to HIMSS with little real planning. I just went and enjoyed myself.

As you can imagine, HIMSS is a perfect place for me and my business. I’ve often told people that the core of my business is great content and advertisers. Turns out that every booth and every person at HIMSS is possibly both. For me, it’s like being a kid in a candy store. So, many exciting things to try (and you might even say you get sick after “eating” too many as the flavors all run together). To be quite honest, I love the entire experience. I was meant for the system overload that happens at HIMSS. I love large crowds of people and being overstimulated. I guess that’s why I love living in Las Vegas (which is also convenient for this year’s HIMSS).

HIMSS Attendee and Exhibitor Count
Enough about me. What can we expect at this fantastic affair called HIMSS 2012? Last year there were 30,000 attendees and I wouldn’t be surprised if this year it’s somewhere in the neighborhood of 35,000 people attending HIMSS. During an #HITsm twitter chat about HIMSS, I said that there would be at least 1000 vendors exhibiting at HIMSS. If I remember right (I can’t find the tweet), one of the HIMSS staff corrected me and said there would be 1100 companies exhibiting at HIMSS this year.

What does all this mean? Well, as my mother always told me: You can’t do everything. I’d always look at her shaking my head saying, “You’re right….but I’m sure going to try.” I think this describes my approach to HIMSS as well. Although, each year I am getting more selective on what I spend my time doing.

Press at HIMSS
I’m sure that many reading this are wondering how they can get some coverage on the Healthcare Scene blog network at HIMSS. Considering the 40 or so emails from PR people that I have filed away already, I’m going to have to apply a pretty strict filter.

What then are my filters?

First, if you’re an EHR company, then I’m probably interested in connecting with you in some form. Although, if you’re an EHR company that’s just seen me and has nothing new to say, then I’ll probably pass at this HIMSS. To be honest, I could probably fill my entire schedule with just EHR companies considering how many EHR companies there are out there. Plus, I think I’m going to bring around my flip video and do an EHR series called “5 Questions with EHR Companies.” I’ll see how many EHR companies I can get to answer the same 5 questions.

However, an entire week of just EHR talk would be a little rough. Plus, I asked on Twitter if I should look at things outside of EHR and they all said I should. I’m a man for the people, so I must listen. How then could another healthcare IT company get me interested in meeting with them at HIMSS?

The best way to get me interested in talking with your company is to provide something that will be interesting, unique and insightful to my readers. Remember that my main goals are great content and advertising. If you provide me with great content that my readers will love, then I’ll love you and likely write about that content.

I didn’t realize this when I started blogging, but I’m not like a lot of journalists. I don’t go to any conference with stories in mind. I’m not digging around HIMSS to try and find an ACO story for example. Instead, every person that I talk to I’m trying to discover what stories are being told at HIMSS that are worth telling. I’m always happy when people help me find interesting stories.

Social Media at HIMSS 12
Speaking of finding stories. One of the most interesting ways I use to find stories and connect with people is through social media and in particular Twitter (see this post I did on EMR and HIPAA about Twitter). I guarantee you that Twitter usage at HIMSS 12 is going to be off the charts. There is going to literally be no way to keep up. I love the idea that Cari McLean had of the HIMSS Social Media Center summarizing the most important tweets during HIMSS. Granted, that’s an almost impossible task to ask anyone to do.

Of course, the HIMSS related hashtags will be another great way to filter through the various HIMSS related tweets that are happening. Here are some of the ones I’m sure I’ll be using:
#HIMSS12 — official hashtag for the event
#HSMC — HIMSS Social Media Center
#HITX0 — HIT X.0: Beyond the Edge specialty program
#LFTF12 — Leading from the Future specialty program
#eCollab12 — eCollaborative Forum
Here’s a bunch more HIMSS related social media hashtags you might want to consider:

HIMSS Social Media Center
If you love social media like I do, then you’re also going to love the HIMSS Social Media Center. They’re doing a number of Meet the Bloggers sessions again and I’ve been invited to participate in the Health IT Edition of Meet the Bloggers at HIMSS. I’m on the panel along with: Brian Ahier (Moderator) Health IT Evangelist, Mid-Columbia Medical Center, Jennifer Dennard, Social Marketing Director at Billian’s HealthDATA/Porter Research/HITR.com, Neil Versel, Freelance Journalist and Blogger, Carissa Caramanis O’Brien, Social Media Community and Content Director, Aetna. Should make for a pretty interesting conversation. Plus, you know I always like to mix it up a bit.

New Media Meetup at HIMSS
More details coming soon. We’ll have to work on Neil Versel’s idea of starting a Twitter storm to get Biz Stone to come to the HIMSS meetup.

Dates of HIMSS
Be sure to check the dates of HIMSS. As Neil Versel noted, it’s a little different days than it’s been in the past. I personally like these dates better than the other ones.

There you have it. I thought I’d do a short post on HIMSS and I guess I had a lot more to say. I’d love to hear if you’re going to HIMSS. If you know of any events, sessions, parties, announcements, technologies etc. that I should know about at HIMSS, let me know.

And the most exciting part of HIMSS…seeing old friends and making new friends. I can’t wait.

Merck Investment in Physicians Interactive Holdings (Skyscape.com)

Posted on January 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.

The news came out that Merck was investing up to $17 million in Physicians Interactive Holdings (better known as Skyscape.com). Here’s a section from the press release.

Physicians Interactive Holdings, Inc. the leading provider of mobile and web-based clinical resources and solutions for healthcare professionals, today announced it entered into an agreement with Merck Global Health Innovation Fund, LLC (“GHIF”) to invest up to $17 million in the Company. The financing includes an initial investment of $8.5 million and potential future investments of up to $8.5 million contingent upon achieving certain pre-specified milestones. The proceeds will be used to fund the growth initiatives of four key products and other initiatives as identified by the Board. Physicians Interactive Holdings was identified by GHIF as being on the forefront of healthcare innovation, and the investment is part of the fund’s strategy to help nurture leading global healthcare solutions.

Uh huh, nurture leading global healthcare solutions. I think this line describes what’s really in the works after they describe PIH’s clinical medical reference tools, electronic drug sampling and interactive education they say, “The solutions are blended into the clinician’s daily workflow via web, mobile and electronic health records channels…” Exactly. Is there any wonder why Merck would be interested in this type of company?

There are a lot of companies that would love to be blended into the clinician’s daily workflow. Why do you think drug companies want to find some way to access the clinician through their EHR software? It’s because the EHR software is blended into the clinician’s daily workflow. There’s no better place to advertise, market and inform someone.

Collaboration is Key When it Comes to HIT Workforce Development

Posted on 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.

One thing that I love about this industry is its willingness to collaborate, and I’m not just talking about collaborative care. I’m talking about healthcare IT’s propensity to brainstorm new ideas as the drop of a hat. Put two HIT folks – be they physician, vendor or blogger – in a room, and 20 minutes later you’re going to have a new idea related to care delivery, product development or possible partnership on your hands. It gets even more prolific when editorially minded marketing folks like me are added to the mix.

I’ve been pleasantly surprised at how even blogs can foster this sort of collaboration. Last month in “Finding an EMR Job Champion,” I chatted with Rich Wicker, HIMS Director at Shore Memorial Hospital in New Jersey, about how this industry can best align recent graduates of HIT certification programs with training and jobs. Some of you may have noticed several comments left on that post by Sean McPhillips, a man of many hats. He is currently an adjunct instructor at Cincinnati State – a community college in the HITECH College Consortia; project manager at the Kentucky Regional Extension Center; and creator of the HITECHWorkforce.com, a free resource to help students enter the HIT work environment.

In his comments, he advocates for a mentor-protégé program: “Students still need some more help finding jobs. What I think needs to happen is a “Mentor/Protégé” model. That is, pairing students with industry professionals who can mentor them into the industry. I’ve passively done that…to success. I think that will work.” He later followed up with the news that he hopes to work with HIMSS, which is developing a similar program, to get this model off the ground.

I recently had the opportunity to speak with McPhillips a bit more about his idea. I was eager to find out just how he plans to jumpstart it:

It seems as if you’ve been kicking this idea around for a while. How did it come about?
Being with the extension center, I’ve mentored a handful of people along the way, and I think there needs to be a more structured process so that students coming out of these [HITECH College Consortia] programs who want to be mentored have a place to go, they know how to get and stay engaged in the process. I think that there is with HIMSS, but I don’t think it’s really been tightly coupled with the workforce development program.

When I spoke with Helen Figge, Senior Director of Career Services at HIMSS, she was really excited to talk with me, and pointed me to HIMSS’ career development page to look around and see what they have out there. I’m thinking of how we can connect [what they’re already doing] into the workforce development program within the overall HITECH project structure, so that we can connect students who come out of these programs with their local HIMSS chapter, which could then pair them up with a mentor that’s in their region. That’s what’s really missing. That’s what’s really necessary to get people plugged into this profession – especially if they’re coming from outside of this profession.

HIMSS does not already have some sort of relationship with the college consortia?
They kind of do, but I don’t think it’s really tightly coupled. I think HIMSS recognizes this, so they’ve been developing their career development program. They’re near completion of a new, entry-level certification called the CSHIMS certification. That is something where you don’t need to have a whole lot of experience in health information technology, but you need to demonstrate some degree of knowledge in subject matter to obtain that certification. That might be a good way to help these students take the next step into the profession, when they’re looking to get a job. That could be part of the whole mentorship program concept.

Isn’t there a double-edged sword to it financially? Wouldn’t students have to become paying members of HIMSS, and then would they have to pay for certification? If they’re looking for jobs, finances might be tighter than usual.
That’s a great point. The question is, what are the costs associated with certification and becoming a member. There is a student membership discount. There’s a cost to certification, obviously, so these are things that are to be considered. That has not escaped me, so that’s going to be part of my brainstorming session. I’m going to meet up with them in Vegas when I go out to HIMSS.

One of the things I want to be able to do is make this attractive for people, particularly students, and if they have to lay out $500 or $1,000, and they’re already unemployed or they’re financially strapped, it becomes not just a double-edged sword, it becomes a disincentive.

I wonder if the vendors couldn’t get involved and offer scholarships.
It’s funny that you mention scholarships because that might be something the local HIMSS chapters can do. I know the Ohio HIMSS chapter used to do a $1,000 scholarship every year for students. So this might be something that the boards or the individual chapters could subsidize.

If you’re in the HITECH workforce development program, maybe HIMSS would be willing to waive membership for one year. That might be something they may be interested in doing.

This is part of the whole brainstorming session that I’m going to try to have over the next month or so. I’ll vet this through HIMSS over the next couple of weeks and hopefully we’ll come up with a good strategy by the end of February. And then we’ll start piloting it in the March timeframe.

I hope to run into McPhillips in Vegas to see how his chat with the HIMSS career development folks is coming along. It’s nice to know that one industry insider’s idea, and subsequent blog comments, might actually create job opportunity in the industry.

Omada Health Raises $800k for Diabetes Prevention Program

Posted on January 17, 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.

Omada Health comes out of the first batch of Rock Health startups. Back in December it raised $800k from Esther Dyson, NEA, Aberdare, Kapor Capital, and TriplePoint Ventures. I’m quite interested in Omada Health since a Diabetes Prevention Program was on my Health IT 2012 Wish List.

The unfortunate part about Omada Health is that their website has no real information about what they’re doing. It has their vision for doing disease prevention and it tells about their team, but their product isn’t out yet. I do like their idea of “Using the power of human relationships to drive behavior change.”

I think they call this peer pressure, but it sounds like they’re trying to leverage it for good in this case. It’s definitely a powerful idea if they can execute on it. I’ve often thought that the most valuable mHealth startup companies are going to be those that are able to create something that will get people to change. Change is hard and if you create something that facilitates change, then that’s powerful!

Since Diabetes Prevention is on my Wish list, I hope that Omada Health is wildly successful.

Sad Illustration of Government’s Understanding of 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.

I recently saw a tweet to the National Conference of State Legislatures (NCLS) list of “Top 12 Legislative Issues of 2012.” It’s an interesting look into issues that state legislatures will be dealing with in 2012. Plus, it makes an interesting observation at the outset that state budgets have been cut so much in past years that lawmakers won’t have to focus all of their initial energy on budget shortfalls.

Most of the list is not surprising with managing the state budget and jobs are at the top of the list. However, there are a couple healthcare and health IT related sections in their list of top government issues as well.

One of the issues is Medicaid: Efficiencies and quality. It talks about how the tough economy is making the Medicaid budgets in states a real challenge and many are looking for cost containing actions. Plus, it points to ACO type reimbursement based on patients’ health outcomes, medical homes and streamlining services. The ACO part was quite interesting to me. I wonder how much of an effect lack of Medicaid budget will push forward a new model of healthcare.

The disturbing part of the report comes in the “Health: Reform in the states, health care exchanges, technology and benefits. Here’s the section on health IT, the EHR incentive money and HIEs.

HEALTH INFORMATION EXCHANGE: One focus for state legislatures in 2012 will be how to move health care providers, especially those participating in the Medicaid program, toward the adoption of certified electronic health records (EHRs). Essentially, instead of having a different health record at each doctor or provider you visit, an EHR will serve as one file that all of your doctors can see. EHRs, once fully implemented, are expected to provide doctors and health professionals with easier access to patient histories and data, resulting in cost-savings and better health outcomes by removing costly errors and duplications in services.

I love how this basically assumes that by having widespread adoption of EHR software, that we’ll then have one patient record that each doctor you visit can see instead of having a different health record at every doctor. Of course, those of us in the EHR world know that this is a far cry from the reality of EHR software today. In most cases you can’t even share a patient record with someone using the same EHR software as you let alone sharing a patient record with a doctor who is using a different EHR.

The sad part is that whoever wrote these legislative issues must have realized that there was some issue with EHR software exchanging information, because then they wrote the following about the state HIE initiatives.

In addition, states are responsible for building and implementing health information exchanges (HIEs) where those EHRs can be accessed by health care providers. HIEs function like an online file cabinet where your medical record is securely stored, and can be accessed by any doctor or health care professional you visit. By mid-year 2012, every state should have Medicaid EHR Incentive programs in place and will be working toward building an HIE by late 2014 or early 2015 as required by deadlines attached to federal cooperative agreements.

So, wait. If EHR software has created one file where any doctor can access our patient record, then why do we need “an online file cabinet” for our medical records? We know the answer is that we need the online filing cabinet because EHR software isn’t connected and there isn’t one patient record. Each doctor maintains their own patient record and that’s not going to change any time soon.

The above quote also implies that every state is working towards an HIE program per the federal program. I must admit that I haven’t gone through every state, but is every state working on an HIE? I certainly know there are a lot of states working on some sort of HIE project, but I didn’t think that every state had funding for HIE. I guess maybe the question is whether there is any state that doesn’t have some sort of HIE program in the works.

Reading issues described like this, you can understand how government passes legislation with limited understanding. Based on this resource, EHR software creates one patient record. Wouldn’t that be nice if it were the case?