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A Medical Software Billing Company Story

Posted on May 31, 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 did a post on EMR and EHR called Medical Billing Software Lost in the EHR Mix and then cross posted it to a group on LinkedIn. In that group, I got the following story from Daniel McDonald who works at a practice management software vendor. The response was so interesting I had to share it with more people:

We have been a PM vendor for more than 20 years and we made the decision to not pursue our own EMR as we are a small company with very close ties to our customers. My partner even supported them prior to our 20 years. Some have been with her for 27 years.

We built both an API process and a HL7 process to do the necessary information exchange and pull back the charge and diagnosis data to our PM software. Originally we were under the assumptio this process was supposed to be all about the ability to share data with physcians as well as others involved in patient care.

Unfortunately we have customers who were never told by the EMR vendor they had the ability to share the needed data because it would limit the salespersons commision even though this would limit the disruption in the office and limit larger than needed expenditures on software, training and conversions. The large companies only cared about their stock prices and not about making the process of the implementation quicker, easier by keeping one big part the offices were comfortable with and knew so well. The PM software ultimately affected the entire office and is making the transitions a nightmare. We even have groups paying us to host their data in the event they pull the plug.

We have an office with an attorney fighting the fact the office asked about an interface and the vendor said it was all or nothing. A week later at a luncheon the office manager found out all of the other doctors that bought that package were continuing to use their original PM and were not changing.

So far all this has done is made the fat pockets fatter, disrupted the office, and is pushing the smaller PM vendors customers they have had for 27 years. For the last two years we have not been able to focus solrly on our PM. We found several economical solutions we interface with to meet MU but several customers have been scarred by verbage used by the fat cats in their sales presentations and tactics.

Everyone of our customers were happy and got their calls returned promptly and on the same day. We also have a medical billing company so our software customers would call us with their questions about billing, credentialing and what affects getting a CT or MRI might require or how to bill a code they had never billed before. Now they call an 800 number and they get someone who is hard to understand only to be told they will be placed in the queue and that initial call is not always even on the same day. We know our product like the back of our hands as we developed our own in 1994 so not only do they get a prompt call, they get an answer.

As best I can tell, the comment is about the ProvidrSoft practice management software. I’ve seen some of the practices that Daniel mentions in his above comment. I’m not sure it’s just the big EHR vendors that are telling them that they need an integrated EHR and PM. That message has gotten out far and wide.

As I read the comment above, in the back of my mind I could see a hundred other practice management software companies in my head who could probably share a similar story. I’m not sure how this is all going to play out, but I know that many doctors love their practice management software. They’ve been through many battles together and they won’t leave it behind on the battlefield.

Swimming in Too Much EMR Data

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.

I don’t know about you, but the long holiday weekend was far too short for me. The majority of my family’s time was spent kicking off summer at various pools (with the appropriate sunblock, of course). Pools and swimming are somewhat second nature to me. The smell of chlorine takes me back to my high school and early college days of year round swim team, coaching summer swim league and sitting in a lifeguard chair in the brutal heat, whistle dangling around my neck.

As we gear up for my oldest daughter’s first summer swim meet this week (picking the appropriate swim cap, finding those goggles that fit just right and painting our toes the appropriate team color), I’m hoping that she’ll come to love the sights, sounds and smells of the pool as well. She certainly seemed to enjoy herself at one of the Memorial Day weekend pool parties we attended.

One family affair in particular found me wading into a conversation about Salesforce.com. Turns out a soon-to-be new member of the family works for the company, and I told him that, as part of my day job, I had been dabbling in using it. He quickly asked me about my likes and dislikes, at which point his fiancé chimed in with the lament that yes, Salesforce is an awesome tool, but more often than not, sales team do not have the time (and in some cases the inclination or training) to fully make use of all its bells and whistles.

I pondered her statement a bit further as I watched my daughter practice swimming with her new flippers, and realized that those of us that use SaaS (software as a service) technologies – like electronic medical records – tend to have the same complaint. Bells and whistles are great, but if I never have the time to learn to use them effectively to accomplish goals specific to my tasks, then I’m not going to use them at all. And I’m never going to pay much attention to the constant updates and add-ons these sorts of technologies usually come with.

I wonder if some EMR end-users feel the same way. They love the idea behind the technology, and certainly the government incentives that typically come along with using it, but after implementation find themselves with only enough time to utilize the EMR’s basic functions. I’d assume this might be a bigger problem for private practice physicians than for those working within a hospital.

I’m certainly not the first to ponder the relationship between Salesforce and EMRs. Our fearless leader John Lynn wrote about Practice Fusion building a personal health record on top of Salesforce way back in 2009, seemingly not long after Salesforce invested in the HIT company.

What I’m talking about, however, is the amount of time and energy required to truly take advantage of the vast oceans of meaningful data that can be culled from an EMR. Big data is great. Lord knows we’ve all been convinced of the value of that and the business intelligence tools that help us decipher it. I’d be interested to hear from doctors that have pondered the same thing. Are providers swimming in too much EMR information? Are they faced with more than they could ever possibly utilize? Does it come down to user experience and user-centric design?

Let me know what you think in the comments below. In the meantime, I’ll be helping my daughter perfect her backstroke.

ONCHIT Health IT Software Contests – Some Thoughts

Posted on May 30, 2012 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.

Ken Terry at InformationWeek has an interesting editorial on Office of National Coordinator on Health IT’s (ONCHIT) latest contest for developers. This time the ONCHIT wants developers to come up with an IT product that can help ophthalmologists see better (yes, it’s a lame pun 🙂

Among the laundry list of requirements that this mythical software must possess: (I’m quoting from Terry’s article)

it must warehouse data from many different devices;
convert the data from proprietary formats to a single, vendor-neutral format;
enable clinicians to manipulate data and images;
and interface with existing EHR systems (presumably, just the top dozen or so)

Here’s the link to the slightly more detailed ONCHIT list. The first prize is $100,000 which is nothing to sneeze at.

Terry lists some problems uniquely faced by specialists such as oncologists and ophthalmologists: off the shelf EHRs don’t really grasp the nuances and details of information needed by specialists. Terry lists for example weight and height details that EHRs typically capture. Opthalmologists don’t really need this information. Typical EHRs on the other hand don’t allow for visual acuity information to be stored, at least not without (paid-for, and hence costly) customizations.

Looking at this issue as a some-time developer with some skin in the game, here’s how I see this process: ONCHIT wants to kick start IT development by getting developers interested via contests. This time it’s shining its light on opthalmologists. It has provided a list of not-so-impossible to design features, which might not capture all the nuances of features needed by ophthalmologists.

The major flaws I see in this process: the prize money is smallish, which means that the people that would be most interested in developing something would be the smaller IT shops. However, most IT developers don’t know enough about ophthalmology to truly understand what’s needed of their IT product. Till I saw Terry’s accompanying editorial, I was under the impression that this was a perfectly fine list of features to request. Also, I’m very underwhelmed by the “details” provided in the ONCHIT page. It is full of 20 dollar words, which will probably make little sense to the developers who are the intended targets of these words.

To be sure, you will see some health IT developers develop something and send them out, just because. Hell, it’s a contest, and there’s decent prize money.

Here’s what I’d rather have seen: maybe a short video that shows an ophthalmologist at work, a couple of minutes where s/he describes the main challenges s/he faces and provides the top 5-6 things that is on hizzer wishlist in an EMR. Or ONCHIT could facilitate talks between developers and specialists so each side understands what is required of them. Till then we’re doomed to square pegs in round holes software products that frustrate everyone soundly.

Fundings and Acquisitions Around the Medical Technology World in May

Posted on May 29, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

ACQUISITIONS:

Alliance Health Networks, who currently serves 1.5 million registered users, announced on May 15th plans to acquire Medify. Alliance is one of the country’s leading social network companies involved in the healthcare industry, and by combing with Medify, who specializes in data-driven treatment information, patients and caregivers will have access to “the industry’s most comprehensive social engagement platform.”

Stead Bruwell, CEO of Alliance Health discussed the benefits that are expected to come with this acquisition:

As social networks continue to transform industries and change the way people live, Alliance Health remains focused on empowering people to successfully navigate their personal health journey, free and independent of the healthcare system. The acquisition of Medify brings us two critical elements — powerful data analytics technologies and an extremely accomplished team — which reinforce our status as the industry’s most robust social engagement platform. Combined, we will be in the best position to help consumers make smart health care decisions by providing a unique combination of relevant knowledge and tools for every drug, treatment, and condition.

Quality Systems, Inc., announced on May 16th, that the company acquired the Poseidon Group. The acquisition closed on May 1st. Quality Systems went forward with this acquisition to help with the growth of its offering, NextGen Inpatient Solutions. NextGen offers to small hospitals a variety of healthcare IT services. With this acquisition, NextGen will able to “extend its suite of solutions and footprint across hospitals by leveraging the Poseidon Group’s Emergency Department Information System and integrating the solution into NextGen Healthcare’s current product offerings.”

Steve Pucket, executive vice president of NextGen Healthcare Inpatient Solutions,  said concerning the acquisition:

This acquisition provides our clients additional value by extending our hospital suite portfolio advanced solutions to the Emergency Department. This product, along with our surgical services suite, will help support our rapid growth upward into the community hospital market. It will also provide existing Poseidon clients with access to our complete portfolio of hospital products and services. We believe this acquisition will further strengthen our capabilities, expand our client base and position NextGen Healthcare Inpatient Solutions for continued growth, as we work to meet the needs of hospitals and their patients.

High-ranking officials from the Poseidon Group, Carr Scott and W. Kyle Taylor, will both have senior roles at NextGen Healthcare, while Jeff Oyler, Poseidon Group’s President and founder, will assume a position with healthcare technology transformation.

FUNDINGS:

$1.6 million has been raised for Enforcer eCoaching, a health coaching start-up founded by Dr. Michael Roizen and Dr. Mehmet Oz, also known together as “You Docs”. This amount came from 15 different investors, which made a big dent in the $3 million goal that Enforcer is aiming for.

There isn’t much known about Enforcer eCoaching, as it has no website and Marty Butler, President and chief operating officer, made no comments on funding. However, the premise of the company is “a series of email-based, daily interactive wellness coaching programs designed to help people prevent and/or reverse diseases attributed to excessive weight and use of tobacco products,” according to an article on MedCity News. Enforcer also offers four programs; tobacco cessation, weight loss, weight loss to manage diabetes and weight loss to manage hypertension. It is mainly being aimed toward employers in order to “help companies improve the health, vitality and satisfaction of employees and reduce employers’ healthcare costs.”

Proteus Biomedical is hoping to raise $50 million for “Raisin”, an “intelligent medicine suite of technology” created by the company, according to Mobi Health News. They have raised around $17.5 million in a recent round of funding. Proteus hasn’t been seen raising money in a few years, since Novartis, a company which piloted Raisin, invested $24 million in 2010.

The technology suite, “Raisin” includes “an ingestible biomedical sensor, a wearable, peel-and-stick patch, and a companion smartphone app.” According to another article on Mobi Health News, the “Raisin technology runs on an electric charge generated by the patient’s stomach acid,” and “the charge is detected through the patient’s body by a sensing patch on the patient’s skin.” Then, the time and date that the pill was taken is recorded by the patch, as well as other vitals such as heart rate and activity. This information is in turn sent to the app on the patient’s smart phone as well as the internet where others can review and analyze it.

The Raisin system has debuted in the UK and there are plans for it go live commercially in countries across Europe in the near future.

Fans of Simplee, a website similar to Mint.com for tracking medical expenses, will be pleased to hear that the company has finished Series A round of funding, bringing in $6 million. The Social+Capital Partnership led the round and investors in the company, Greylock Partners Israel, were involved.

While Simplee currently offers bill tracking and payments, this round of funding will allow the company to add plan recommendations, care recommendations, and eventually launch a mobile app. CEO Tom Shoval announced that a feature that detects and flags billing areas will be added soon as well. Other features that are already available in Simplee are tracking a person’s insurance company’s database and updating the customer’s profile when a new bill becomes available, lists how much both the customer and insurance company has to pay, and allows payments to be made directly through the site. It was launched a year ago and claims that the average Simplee bill pay user spends about $1,000 on bills by using the website, iwth more than 65% of users using the website regularly.

EHR Company Funding Risks – Large EHR Companies

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.

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

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

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

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

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

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

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

Guest Post: Do EMRs Cause a Mirage of Health?

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.

This is a guest post by Ken Harrington, Practice Manager at the Washington Endocrine Clinic.

The smart phone (blackberry, android, iphone) is an icon of the postmodern age.  In my fingertips, I hold the power of the internet.  I can look up my e-mail messages in real time, search anything in the world on the web, and be socially connected to a world-wide community of people – all in the palm of my hand.  This concept is slowly being applied to medical records.

Many of the new EMR systems that are beginning to infiltrate into the physician’s office now allow patients access (even if partial for now) to their own medical record.  With a few clicks of the computer mouse, a patient can now access his or her labs, radiology, and pathology reports.  Even better, the EMR that we use at the doctor’s office in which I work will soon be available on the iPhone and iPad.  This will enable any of the patients in our office to login anywhere and have instant access to their medical chart.  No longer does a patient have to guess at what she thought the doctor said or didn’t say about her results – the patient can now have access to the official record herself.

This gives a patient a lot of new power over his own healthcare that he did not previously hold.  For example, now the patient can research online about cholesterol if his test results show he had an elevated level. Granted he still cannot write his own prescription for a medication, but he can educate himself and use that knowledge when he speaks to his doctor about the test results.  This is a game changer of sorts which will add the physician’s office to the growing list of other institutions that have become transparent in the postmodern age.

This is all good for the consumer/patient – right?  On many levels, it is.  Patient empowerment in the realm of healthcare is what doctors have been complaining about for years.  Theoretically, this should lead to the patient having greater control over the choices she can make regarding her healthcare.

To boost this empowerment, certain companies are taking all of this patient data and showing what the future could look like.  The particular EMR that we use is partnering with a start-up company called 100Plus.  100Plus is taking the data and filtering it through a computer algorithm to project what someone’s future health would look like if he did not make the recommended choices to improve his health.  A future projection might mean death 10 years earlier if he had not made the choice to start exercising and eating right when the test results began to show a problem.  The entrepreneurs behind 100Plus know they have a market-winning idea because, in the postmodern world, people want to take control of their reality, including their health, as much as possible. This is just one more way to gain a little bit more control.

But what really do you gain by having all of this control and power?  A recent news article described a doctor in California who offered himself up as a test case for a new personal human genome sequencing test.  This test would look at whether a person’s DNA sequence could foretell that the person would be more predisposed to certain diseases over others.  This particular doctor’s test result showed he had a strong predisposition in his genes for developing diabetes, despite that fact that he was in good shape and ate health-consciously. However, six months after the test results were reviewed, the doctor was diagnosed with diabetes.

This makes me wonder whether it’s possible to have ultimate control over one’s health. Will access to a patient’s medical chart cause them to make better choices – or any choice – to improve their health? One would think it would at least give them a leg-up on the limited choices their recent ancestors had and make life-changing decisions possible sooner rather than later. But sometimes empowerment leads people to think that they have ultimate control and can make all the right choices. I’m not convinced that this is the case. If it is built into my genes that I am gong to die of a disease that I cannot do much about, doesn’t this level of transparency simply cause me to worry about something I have no control over? I guess you could say, “Well, we will all die of something, and if we know what that something might be, then we might try to limit its damage with better choices now.” But, unless someone can actually change the direction of my genes, I might actually be quite limited still in what I know.

The same may hold true for open EMRs. If the patient is focused enough to make choices with the knowledge they now have on a 24/7 basis, will it cause their health to be any better? Maybe. But could patients’ thoughts that they have a growing control over their own healthcare (via knowledge of their medical records) also potentially lead to developing a culture of false security? In other words, will such thinking only lead to a mirage of health? For me, I think it might.

* Dr. West’s note: This reminds me of a book titled “Mirage of Health” by Rene Dubos, the famous microbiologist who wrote that mankind develops a false sense of security with the acquisition of technological advances over his environment.

A Memorial Day Message from EMR Thoughts

Posted on May 28, 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.

A big thanks to all our military! We’re lucky to have so many brave people who fight for our freedoms. I found a series of Memorial Day Cartoons which each share a message of the real importance of Memorial Day. I’ll post them across the Healthcare Scene network as a way to honor and remember those people who sacrifice so much.

Have a great Memorial Day and enjoy time with your family as I will do also!

A Memorial Day Message from EMR and 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.

A big thanks to all our military! We’re lucky to have so many brave people who fight for our freedoms. I found a series of Memorial Day Cartoons which each share a message of the real importance of Memorial Day. I’ll post them across the Healthcare Scene network as a way to honor and remember those people who sacrifice so much.

Have a great Memorial Day and enjoy time with your family as I will do also!

Protecting Children from Identity Theft, the Holy Grail of mHealth, and Using PHR to Improve Safety: This Week at HealthCareScene.com

Posted on May 27, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR and HIPAA
The Real Money is in the ACO, Not Meaningful Use
As part of a series of posts that John’s doing about Accountable Care Organizations (ACO’s) John started an interesting discussion about where the money is in healthcare. We see so many EHR companies and doctors chasing after meaningful use dollars, when the reality could very well be that they’re spending a lot of time and money on something that has a limited and short lived pay out. Instead, many of them should consider focusing on the rapidly changing ACO environment since it will likely have long range and a dramatic impact on their financial future.

EHR Technical Breaches, Great Human and Computer Collaborations, and EMR in India
The number of people tweeting about EMR and health care IT is on the upswing. John posts about some of his most interesting finds in the health care twittersphere this past week. He adds his own commentary on the topics as well, such as disagreeing that the use of Cloud will increase security breaches and agreeing that EMRs should be on the “Six Great Human and Computer Collaborations” list.

EMR AND EHR
Veriphyr HIT Gives Littlest Victims of Patient Identity Theft a Fighting Chance
Adults aren’t the only ones that are susceptible to identity theft; children are some of the biggest targets these days. A recent study revealed that 10% of 40,000 children become victims. Veriphyr HIT recently donated a patient privacy breach detection system to a Minnesota hospital, and Jennifer Dennard decided to follow up on the motives behind this. Alan Norquist, CEO of Veriphyr, discussed with her his feelings on why there have been many hospital breaches recently, the time frame for the donation, and more.

Smart Phone Health Care 
Behavior Change May Be the Holy Grail of mHealth, but Should it Be?
Recently, an article was written by Sara Jackson titled mHealth’s Holy Grail: Behavior change. Over at Smart Phone HC this week, David discusses his thoughts on the article. According to David, he believes that the “human element” that is integrated into many apps today really needs to be human and that the best apps encourage behavior change after the use of the app is discontinued. Can the lack of human interaction with certain apps just make some issues worse? Express your thoughts on the matter over at Smart Phone HC.

EMR and EHR Videos
Nuesoft Podcast Series; Medical Practice Design: Meeting Practical Needs While Improving Patient Comfort
Jeffrey K. Griffin is a LEED certified architect that specializes in health care facilities. In this video he talks about different qualities that should be considered when designing (or in some cases, re-designing) a patient care facility. Topics such as sustainability, current trends in products and features, and what to avoid during this process are discussed.

EMR Thoughts
New York eHealth Collaborative Opens Application for Accelerator Program
The NYeC applications are now available for its accelerator program, New York Digital Health Accelerator. Companies that are selected for this program will receive up to $300,000 and have access to technology experts, NYeC-led EHR/HIE Interoperability Workgroup, and more. Check out this post on EMR thoughts for more information; the deadline to apply is coming up on June 1st.

Hospital EMR and EHR
Using PHR To Correct Provider Drug Lists Can Improve Safety
Medication list discrepancies is a problem to occurs more often than it should. A recent study published in the Journal of the American Medical Informatics Association found that when a patient reviewed their medication list through a linked PHR, the likelihood of unexplained errors dropped significantly. This raises the question of if patients should be shown their information located in their provider’s EMR. Also, would enough patients be willing to review PHR information? The discussion on this topic is over at Hospital EMR and EHR this week.

EHR Company Funding Risks – Positive Cash Flow EHR Companies

Posted on May 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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

Positive Cash Flow EHR Companies
This type of EHR company is usually a conservatively funded EHR company (often through non traditional funding mechanisms, or through a private buy out) that have grown large enough that their current user base provides enough cash flow to cover the EHR company’s ongoing expenses. The majority of these EHR companies have been around for a long time. In most cases they started out as EHR only companies (since everyone already had a PM system) and over time were able to grow a large EHR user base.

Instead of going after a large funding round, these EHR companies stayed small and chose to grow slow and steady over time. At this point, most of these companies have a large enough user base and enough cash flow that they’re in it for the long haul. While a sale could happen, most are content to continue growing the way they’ve done for a long time.

The users of these systems are usually happy with the software. Plus, they’ve often been using it so long that the idea of switching is something they wouldn’t even entertain. Even if the EHR software has some issues, the practices know the problems and have found ways to work around them. Plus, I’ve heard from many about the kinship they have with the EHR software that they’ve had for so long.

The real question for these EHR companies is how well they’ll be able to retain their existing EHR user base and/or how well can they acquire new EHR users. At some point if they aren’t maintaining or growing their EHR user base, they won’t have the cash flow needed to continually improve the EHR system with changing technology and clinical requirements. Plus, considering the fast pace of technology, time and their legacy software creation starts to catch up with them.

Many of the best specialty specific EHR companies have been able to reach this category. Some are still in the seed funded or well funded categories, but most of the specialty specific EHR companies I’ve seen have reached the cash flow positive category or are really close to getting there. Most of them realized that they had a very specific EHR market and so they had to grow it slow, steady and focus on revenues early.

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