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!

Hospitals Still Struggling With HIE Data Sharing

Posted on September 30, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Hospitals are trying hard to make HIEs work, but establishing robust data exchange remains a major challenge, particularly given the difficulty involved in processing paper records, a new study by HIMSS Analytics suggests.

The report, sponsored by ASG Software Solutions, draws on a survey of 157 senior hospital IT executives.

More than 70 percent of respondents to the survey reported that they participated in an HIE with other hospitals and health systems.

The thing is, the facilities reported that they’re having difficulty exchanging patient information in meaningful, powerful ways. Also, survey respondents noted that sharing information outside of HIEs is held back by budget concerns and staffing problems.

Juggling electronic and paper-based data is still a major issue, the study suggests:

* 64 percent of health information organizations reported that they shared data with nonparticipating hospitals via fax
* 63 percent of the same organizations converted faxed information into digital form via scanning
* 84 percent of respondents integrated their output/print environment directly into their EMR/HIS system
* 42 percent of survey respondents said their output/print environment was “high effort”

Unfortunately for HIE fans, coordination and management of paper records is far from the only issue standing in the way of making them work acceptably in a hospital environment.

According to a study by Chilmark Research, the focus of most HIEs is still on secure clinical messaging, which doesn’t do the job for cross-enterprise care coordination. The Chilmark research estimates that queries of databases for patient information needed at the point of care account for just 2 percent to 10 percent of HIE transactions overall.

As Chilmark CEO John Moore recently told Information Week, the problem is particularly acute in ambulatory care. Most ambulatory EMRs haven’t been able to generate CCDs that other EMRs can consume or execute queries using a record locator service. This is a pretty serious weakness in the HIE space, given that 80 percent of care takes place in ambulatory setting.

Given their importance, it’s troubling to see how many obstacles remain to robust HIE use by hospitals and physicians. Let’s hope the next 12 months see some breakthroughs.

Mulling Over EMR Market Consolidation

Posted on September 27, 2013 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 had the pleasure of attending a Technology Association of Georgia Health Society event last week on mobile health. It offered me a chance to chat with colleagues, and hear from a panel of payers, providers, startups and vendors on the current state of and predictions for mobile health. While networking beforehand, I found myself trying to succinctly answer a colleague’s question of, “Where do you see the EMR market heading in the next few years?”

My short answer was, “It is consolidating and will continue to consolidate.” I had more details and theories on the tip of my tongue, but didn’t get the chance to back up my statements before we were ushered in to the evening’s presentation. It was a big question – one that I think has only one correct answer, but also one that potentially has a variety of explanations behind that answer. Needless to say, I mulled it over that night and into the next day, when, coincidentally, I awoke to news of the Vitera/Greenway Medical deal.

If I had the chance to do it over again, I’d break my response down like this: Meaningful Use obviously provided incentive for businesses to get into the EMR game. Some were already in healthcare, while others were on the fringes. Combine those new industry entrants with companies that have provided EMRs since before HITECH, and you’re left with a crowded market.

Implementations and go lives coinciding with Stage 1 left many providers dissatisfied with the EMR experience thus far, but still willing to forge ahead. As they look to Stage 2, some realize their vendors – whom many are already disenchanted with – will not be up to the task of helping hospitals meet digital patient engagement quotas, among other Meaningful Use guidelines. And so began the rip and replace movement.

Vendors deemed not up to par looked at their options. Many took a step back and reassessed product development and strategy, deciding to either: get out of the healthcare game, close up shop altogether, merge with a competitor, or make themselves available for possible acquisition.

That’s one wave of consolidation. I’m fairly confident we’ll see another wave in the next 12 to 18 months, if it hasn’t already started. (I don’t think we’ll see too many Phoenix-type situations like Google.) As providers dive deeper into using technologies around Stage 2 engagement requirements, they’ll experience a second wave of acceptance or denial. At some point, the EMR replacement market will die down, providers will settle into the technology they’ve settled on, and purchases of new systems will stagnate. EMR sales will thus dry up a bit, forcing vendors to again look at their options. I would think that many will turn into consulting services once the demand for new software has died down.

Now that I’ve put pen to paper and laid out my thoughts, I wonder what readers predict. I encourage you to let me know whether I’m on the mark, totally off base, or somewhere in between.

Anatomy Eye Candy – Blausen

Posted on September 26, 2013 I Written By

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

I’ve been following the progression of a company called Blausen for over a year now. Some of you might remember my post about the Blausen Medical Content Google Chrome Extension.

Previously, the home page of Blausen did little to illustrate the really amazing work they’d done creating various medical related animated videos. However, they’ve gone through a redesign that really captures the beauty of what they’ve created. If you enjoy amazing animations of anatomy and physiology, then you’ll really enjoy the Blausen videos.
Blausen Medical   Medical Animations
I’ll be interested to see what Blausen does with all of these videos. I’m still skeptical that this will work as a standalone website. I feel like it needs to be integrated with another product to be really valuable. With that said, I’m told that they’ve already had 2 million hits and 50,000 videos watched in last 30 days. So, maybe there is a business that can be built around high quality anatomy videos.

I’d be interested to hear what doctors think of these videos. Would you use them with your patients? Could these be useful in medical education?

Almost 3 Million EMR and EHR Pageviews

Posted on September 25, 2013 I Written By

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

I just checked the stats for EMR and EHR and realized that we’re about to top 3 million pageviews since we first started the blog back in April 2009. That’s pretty exciting since the first year of the blog I really didn’t do much with it. Over the life of EMR and EHR we’ve posted 1057 posts and had 2927 comments (not counting the 95,665 spam comments we’ve filtered).

A big thanks to Anne Zieger (244 posts) and Jennifer Dennard (114 posts) for all their contributions over the years as well. They’ve both made amazing contributions to the site and likely don’t get the credit they deserve. I’m lucky because not only are they great writers who know the industry well, but they’re wonderful people. I’m proud to associate with them.

If you’ve made it this far through the blog post, then hopefully you’ll take a few minutes to take a look at the new and renewing EMR and EHR advertisers below. Without them, none of this would be possible. I’m really blessed to have their support.

New EMR and EHR Advertisers
Clinithink – I’ve often heard doctors proclaim NLP as the perfect balance between clinical narrative and structured data. Clinithink is focused squarely on this challenge. How do you take your healthcare data and extract the value out of it? Clinithink’s answer is preserving the context and meaning intended by the narrative while structuring and encoding it with rich, granular data.

DrChrono – An EHR created with the iPad tablet interface in mind. You can see the difference between a native iPad EHR application and some sort of remote desktop EHR application on the iPad. DrChrono offers a free basic version so you can try it out before you buy.

gMed – A specialty specific EHR focused on Gastroenterologists. I was excited to work with gMed on a mix of advertising across the Healthcare Scene blog network together with some whitepaper distribution that should work well for their specialty specific EHR. Any gastro doctor should consider gMed and compare it with the non-specialty specific EHR out there. There’s usually a vast difference in focus.

The Breakaway Group – A Xerox company, The Breakaway Group is doing some really interesting things in the area of EHR training. I worked together with them to provide some coverage of their Healthcare Forum event. Plus, I’m excited that we just closed a deal for them to create a series of blog posts on the Healthcare Scene network.

Renewing EMR and EHR Advertisers
I can’t thank the following advertisers enough for their support. As you can see, many of them have been supporting EMR and EHR for 2 or 3 years. I’m glad they still see value in supporting the work we do.
Ambir – Advertiser since 1/2010
Amazing Charts – Advertiser since 5/2011
Cerner – Advertiser since 9/2011
Quest Quality Solutions – Advertiser since 9/2011
SimplifyMD – Advertiser since 9/2012
Canon – Advertiser since 10/2012

Check out our EMR and EHR advertising page for more information on supporting EMR and EHR.

Will We See More Free EMRs?

Posted on September 24, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Wondering what’s up in the free EMR world? In a recent article in the redoubtable KevinMD.com, an author described three current EMRs which are free to physician users:

* Hello Health, which collects fees from patients ranging from $36-$120 per year but charges no fees to physicians. (Patients who pay for Hello Health get various privileges, including online appointment scheduling with blocked out periods of time reserved for Hello Health patients, the article reports.)

* Kareo, which gives away its EMR in hopes that medical offices will buy its other products, including practice management and billing services.

* Practice Fusion, whose business model allows physicians to use its EMR for free in exchange for tolerating ads on screen.

To me, what’s interesting about these models is that there are so few of them. When Practice Fusion first emerged years ago I assumed that there would be tons of other free EMR plays emerging to compete with it. That has not been the case.

To me, this fits in with John’s observation that the Golden Age of EMR Adoption is over, or as he puts it, that “we’re now getting ready to enter the nasty, ugly, dirty, swamp – filled waters of EMR adoption.”

Five years ago or so, free EMRs were just one of the neat new EMR business models emerging as vendors went after Meaningful Use money. Fast forward, to today, and you find that things have gotten a lot simpler and clearer. While early players like Practice Fusion may have seen good adoption of their free EMR, I don’t think they’re going to have much competition for that business model in the future. The market just isn’t as open to new ideas as it was.

While there may be other viable free EMRs not mentioned in the blog item, I think the industry has concluded that at best, pay-for-play EMRs are more viable over the long run than most free EMR models floating around the vendorsphere. Although, Practice Fusion’s new $70 million round of funding will keep them in the game for a while to come. What do you think?

Simpler EMRs Lower Physician Stress

Posted on September 23, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

When it comes to EMRs, simpler may be better, according to a new study. 

Researchers have concluded that doctors who use EMRs with a moderate number of functions are more stressed out and have a lower level of job satisfaction than those who use EMRs with fewer functions.

The study also suggested that doctors who used highly functioning EMRs are especially challenged providing care if they feel the time allowed to do so isn’t adequate.

The study, which was reported in Healthcare Informatics magazine, originally appeared in the Journal of the American Medical Informatics Association. In the study, researchers examined variables including doctor-reported stress, burnout, satisfaction and intent to leave the practice, then used these variables to compare decisions before and after EMR systems were implemented.

To gauge how physicians react to EMR features, the study authors looked at 379 primary care physicians, along with 92 managers at 92 clinics from New York City and the upper Midwest.

The physicians and managers were participating in the Minimizing Error, Maximizing Outcome study, a 2001 – 2005 study assessing relationships between the structure and culture of the primary care workplace, physician stress and burnout, and the quality of care experienced by their patients, Healthcare Informatics reported.

The researchers actually found the job stress went down slightly for physicians using sophisticated EMR system compared to physicians with moderately complex EMRs. However, time pressure during examinations was more highly associated with adverse physician outcomes in the high EMR function group, the study authors wrote.

It’s worth remembering, however, that EMR complexity isn’t the only factor which determines how comfortable physicians are with their system.

Ultimately, seeing to it that doctors are comfortable with EMR features and functions before they’re installed and set in stone is the best way to see to their satisfaction, according to health IT expert Mark Olschesky.

8 Elements of Total Patient Engagement

Posted on September 20, 2013 I Written By

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

A major trend in healthcare today is the shift to patient engagement. As part of this trend, I did a video interview with Dr. Nick recently where we discussed some of the shifts towards patient engagement in healthcare. If you enjoy healthcare IT, you’ll enjoy the full video discussion.

After doing that I interview I came across this whitepaper called 8 Elements of Total Patient Engagement. It takes a really in depth look at 8 areas of patient engagement:
1. Understand how to synthesize and deliver actionable information to patients
2. Facilitate engagement in all settings across the continuum of care
3. Activate patients at their convenience
4. Integrate seamlessly into IT systems and workflows
5. Deliver results down to the individual patient
6. Measure and provide clinical and financial outcomes
7. Backed by an organization with expert knowledge and experience
8. Support the near-term and long-term objectives of the organization including supporting IHI’s Triple Aim

Check out the full whitepaper where it digs into all 9 areas of patient engagement. Certainly meaningful use stage 2 has legislated the start of patient engagement as one of the measures. However, we’re only at the start of this shift. I with many others believe that increased patient engagement will lead to better care and can even been a financial benefit to doctors. Plus, we’re close to the point where the financial benefits of patient engagement will be legislated as well through quality reimbursement.

Much like we went through a shift in EHR from asking “whether we should do EMR” to “how we should do EMR.” I think we’re also going from wondering “if we should do more patient engagement” to “how we should do more patient engagement.”

The Internet of Everything Puts New Face Value on HIT

Posted on September 19, 2013 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.

As I mull over the value of health IT, as so many of my colleagues are doing during National Health IT week, I can’t help but wonder if we are missing the bigger picture. Health IT is a relatively niche term in the grand scheme of things; one that is passionately advocated, espoused, naysayed and even booed from time to time by a select few in the industry. (I say “few” because, in comparison with industries such as finance and telecom, health IT doesn’t yet have the same global brand recognition, and so is evolving in a smaller ecosystem.)

As technology becomes more ubiquitous, and the “Internet of Everything” slowly takes over our lives by integrating everything we say, do, purchase, plan for and act upon, I can’t help but also wonder if health IT will soon lose its value as a buzzword – at least in the eyes of consumers – in favor of more apropos phrases like “connected health” or “digital health.”

Healthcare, after all, is all around us. It’s in the apps we use to track our exercise regimens, the text we respond to in order to confirm a doctor’s appointment, the glasses next year’s graduating class of MDs will wear to surgery on a regular basis … it’s everywhere. Healthcare isn’t just in a hospital, or physician’s office or pharmacy or urgent care clinic. It’s coming to your car, your watch, your smart-er mobile phone, your wearable tech … the list could (and will) go on and on.

I think we’re shortchanging the concept if we think only in terms of EMR installations, ICD-10 codes or revenue cycle management systems. The value of health IT has increased exponentially in terms of the impact it is having and will have on just about every other industry out there. As such, its definition is becoming broader. Thanks to the Internet of Everything (aka the Internet of Things), it may one day flatten out entirely. I don’t think it’s too off the mark to consider that 50 years from now, “healthcare” will assume the integration of IT. There will be no separation of church and state, as it were.

I’m off on this tangent thanks to a policy memo I recently read by Michael Mandel and the Progressive Policy Institute. He writes: “[T]he Internet of Everything potentially has the capability of transforming ‘physical’ activities such as manufacturing, energy, transportation, healthcare and public sector services. [M]any of these industries have not shown much productivity acceleration in the Internet era.”

The memo also notes that “Cisco projects that there is $14.4 trillion in ‘value at stake’ over the next ten years in economic benefits for companies and countries that can successfully implement the Internet of Everything. Cisco’s calculations include better asset utilization, higher worker productivity, improved supply chain logistics, a better customer experience, and faster innovation.”

Sounds a lot like the goals of this healthcare transformation we all find ourselves struggling to move forward with.

Healthcare IT certainly has a high price tag, but I think we’ll begin to see, as connected health technologies spread out, that this price will diminish as adoption becomes pervasive. Will we question the value of health IT five years from now? Hopefully we’ll have moved beyond dollars and cents to lives saved, life expectancies increased and, finally, greater access to better care at negligible cost.

Does EHR Have a “Big 5”?

Posted on September 18, 2013 I Written By

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

I was recently reading something that referenced the Big 5 EHR vendors. I thought the reference was really interesting. It obviously comes from what was commonly referred to as the Big 5 accounting firms. For those following along at home, the big 5 are currently the big 4 after Arthur Andersen’s demise following its involvement in the Enron scandal. The question I have is whether there’s a Big 5 when it comes to EHR vendors.

Much like everyone has to have an accounting firm, it’s becoming very clear that every healthcare organization will have an EHR vendor. The problem is that I don’t think we’ve really gotten to where we can say there are 5 (or some other number) EHR vendors that get all of the top business.

In the large hospital space, I’ve heard some argue that there’s a Big 2 (Epic and Cerner). Beyond that, I think there’s a bloody battle going on between EHR vendors. I think this is true in the small hospital space and in the ambulatory space. Plus, we’re somewhere between 40-60% EHR adoption and so that still leaves a large amount of ground for a smaller EHR vendor to still capture market share.

Everyone has been preaching that EHR consolidation is going to happen. I’ve suggested that we won’t see widespread consolidation until at least after MU stage 2. I don’t know many EHR vendors that don’t have enough cash to see it through MU stage 2. We could see some fall off from those vendors post-MU stage 2.

The real challenge is that it’s not easy to bring together two EHR companies. If you don’t believe me, ask Allscripts about it. It’s not a sure bet that the users of an acquired EHR will just move to the acquiring companies EHR. Often it means that users will leave and find a new EHR.

Certainly our current plethora of EHR vendors is unsustainable, but I don’t believe we’ll ever get to a Big 5 EHR list either. You can still have a great EHR business model with 1000 or so doctors.

Many US Consumers Would Switch Doctors To Gain EMR Data Access

Posted on September 17, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Evidence continues to mount that consumers not only accept EMRs, but want to have access to the data they contain. The latest on this subject comes in the form of a new Accenture survey, which concluded that 41 percent of US consumers would be willing to switch doctors to obtain online access to their EMR data.

To get a sense of how consumers are responding to the EMR revolution, Accenture surveyed more than 9,000 people in nine countries.  The survey sought to assess consumer perceptions of their doctors’ electronic capabilities across nine countries: Australia Brazil, Canada, England, France, Germany, Singapore, Spain, and the United States. (The survey included 1,000 US consumers.)

Researchers with Harris interactive, which fielded the study, found that at present, roughly one third of US consumers (36 percent) have full access to their EMR. However,  57 percent of consumers surveyed are self-tracking their personal health information, keeping data on items such as their health history (37 percent), physical activity (34 percent) and other health indicators such as blood pressure and weight.

Other survey results suggest that consumers on something of a collision course with doctors when it comes to access to medical data. While roughly four out of five consumers (84 percent) believe they should have full access to the EMR data, only one third of doctors (36 percent) agree.  The same study found that the majority of US doctors (65 percent) believe patient should have only limited access to their records.

These results strongly suggest that sharing full EMR data with patients is likely to become common practice in the future. After all, it seems that engaged patients are most of the way there already, and will continue to put pressure on doctors to open up the kimono for the foreseeable future.

P.S.  This data dovetails nicely with another recent report by independent research firms Aeffect and 88 Brand Partners which concludes that almost 50 percent of patients take EMR access into account when they consider choosing a  healthcare provider.