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eClinicalWorks Faces Additional Fine For Violating Terms Of Fraud Settlement

Posted on August 10, 2018 I Written By

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

In mid-2017, the news broke that EHR vendor eClinicalWorks had agreed to pay $155 million to settle a whistleblower lawsuit brought by a former employee. The government had accused the company of doctoring its code to cover the fact that its platform couldn’t pass certification testing,

Following the agreement with the government, eCW was hit with two class-action lawsuits related to the certification fraud, one filed by a group of clinicians over funds lost due to the certification and another by patients who say that data display errors may have affected their care.

Unfortunately for eCW, its legal troubles aren’t over. The vendor is now on the hook for a fine it incurred for failing to comply with the Corporate Integrity Agreement it signed as part of its settlement deal. The $132,500 fine probably won’t have a massive impact on the company, but it’s a reminder of how much trouble the certification problem continues to cause.

In signing the CIA, which will be in place for five years, eCW agreed to a number of things, including that it would adhere to software standards and practices, identify and address patient safety and certification issues and meet obligations to existing and future customers. eCW also promised to report patient safety issues in a timely manner.

Apparently, it didn’t do so, and that triggered the penalty stipulated in the CIA. Among the terms buried in the hefty CIA document is that the vendor would be fined $2,500 for each day eCW failed to establish and implement patient safety issues as reportable events. Somehow, the vendor let this go for almost two months. Bummer.

Of course, eCW leaders must be reeling. This has to have been the most painful year in the company’s history, without a doubt. Customers are understandably quite angry with eCW, and some of them are suing. Patients are suing. Its reputation has taken a major hit.

The financial implications of the settlement are staggering too. Very few companies could cover a $155 million payout without a struggle, and even if a business liability insurer is covering the loss, the settlement can’t be good for its relationships with financial institutions. It’s a mess I’d wish on no one.

On the other hand, am I being too harsh when I suggest that under the circumstances, letting a reporting problem go for 53 days doesn’t speak well of eCW’s recovery? Yes, I’m sure that keeping up with CIA requirements has been pretty burdensome, but we’re talking about survival here.

I’m not going to hazard a guess as to whether eCW is on the skids or just struggling to recover from a massive blow to its fundament. But geez, folks. Let’s hope you get on top of these issues soon. Violating the terms of the CIA within year two of the five-year agreement doesn’t exactly inspire confidence.

Nurse Satisfaction With EHRs Rises Dramatically, But Problems Remain

Posted on May 18, 2018 I Written By

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

In the past, nurses despised EHRs as much as doctors did – perhaps even more. In fact, in mid-2014, 92% of nurses surveyed weren’t satisfied with the EHR they used, according to a study by Black Book Research. But things have changed a lot since then, Black Book says. The following data is focused largely on hospital-based nursing, but I think many of these data points are relevant to medical practices too.

Despite their previous antipathy to EHR’s, as of Q2 2018, 96% of nurses told Black Book that they wouldn’t want to go back to using paper records. That score is up 24% since 2016, the research firm reports.

Part of the reason the nurses are happier is that they feel they’re getting the technical support they need. Eighty-eight percent of responding nurses said that their IT departments and administrators were responding quickly when they asked for EHR changes, as compared with 30% in 2016.

On the other hand, the study also noted that when hospitals outsource the EHR helpdesk, nurses don’t always like the experience. Twenty-one percent said their experience with the EHR’s call center didn’t meet their expectations for communication skills and product knowledge. On the other hand, that’s a huge improvement from 88% in 2016.

Not only that, RNs are eager to improve their EHR skillsets. Most nurses are now glad that they are skilled at using at least one EHR, and 65% believe that persons who are skilled at working with multiple systems are seen as highly-desirable job candidates by health systems.

Providers’ choice of EHR can be an advantage for some in attracting top dressing talented. Apparently, RNs are beginning to choose job openings for the EHR product and vendor the provider uses as an indication of how the working environment may be than the provider itself. Eighty percent of job-seeking RNs reported that the reputation of the hospital’s EHR system is one of the top three considerations impacting where they choose to work.

That being said, there are still some IT issues that concern nurses. Eighty-two percent of nurses in inpatient facilities said they don’t have computers in each room or handheld/mobile devices they can use to access the EHR. That number is down from 93% in 2016, but still high.

These statistics should be of great interest to both hospitals and physicians. Obviously, hospitals have an institutional interest in knowing how nurses feel about their EHR platform and how they supported. Meanwhile, while most average size practices don’t address the same IT issues faced by hospitals, it benefits them to know what their nurses are looking for in a system. There’s much to think about here.

Almost 20 Percent of CDS Alert Dismissals May Be Inappropriate

Posted on April 13, 2018 I Written By

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

The number of alerts generated by clinical decision support systems can be overwhelming for clinicians. It’s little wonder that the Joint Commission has long identified alert fatigue as a critical safety issue for providers, particularly given how many turn out to be unimportant or even irrelevant.

Unfortunately, however, there’s a flipside to this issue. Sometimes, CDS alerts can actually prevent care problems, clearly suggesting that clinicians shouldn’t dismiss them out of hand either. In fact, recently-published research found that at least in an ICU setting, overriding alerts might be associated with patient harm.

The study, which appeared in BMJ Quality & Safety, focused on the nature and impact of medication-related CDS overrides in the ICU. To conduct the analysis, the authors gathered data on adults admitted to any of six ICUs between July 2016 and April 2017.

The research team looked at a total of 2,448 overridden alerts from 712 unique patient encounters. The studies looked at patients with provider-overridden CDS alerts for dose, drug allergies, drug-drug interaction, geriatric and renal alerts. They also looked at how frequently patients suffered adverse drug events following alert overrides and the risk of adverse drug events given the appropriateness of the overrides.

A team of two independent reviewers concluded that while 81.6% of the overrides were appropriate, the roughly 19% remaining were inappropriate.

Researchers found that inappropriate overrides were associated with a greater risk of adverse drug events. In addition, they concluded that they could find more potential and definite adverse drug events following inappropriate overrides than appropriate overrides. They also found that inappropriate overrides were associated with an increased risk of adverse drug events.

Overall, inappropriate overrides were six times as likely to be associated with potential and definite adverse drug events.  That’s too big a correlation to ignore.

One thing the study doesn’t comment on is how the alerts were presented. Given that they may have been presented through multiple interfaces, the question arises of how big a difference those interfaces make in how clinicians respond to alerts. It could be that these interfaces have more impact than the clinical content of the alerts.

Bottom line, this problem may very well fall under the larger umbrella of usability problems. Just one more reason why the industry needs to keep a laser focus on improving usability in HIT across the board.

AAFP Opposes Direction Of Federal Patient Data Access Efforts

Posted on April 4, 2018 I Written By

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

Not long ago, a group of federal agencies announced the kickoff of the MyHealthEData initiative, an effort designed to give patients control of their data and the ability to take it with them from provider to provider. Participants in the initiative include virtually every agency with skin in the game, including HHS, ONC, NIH and the VA. CMS has also announced that it will be launching Medicare’s Blue Button 2.0, which will allow Medicare beneficiaries to access and share their health information.

Generally speaking, these programs sound okay, but the devil is always in the details. And according to the American Academy of Family Physicians, some of the assumptions behind these initiatives put too much responsibility on medical practices, according to a letter the group sent recently to CMS administrator Seema Verma.

The AAFP’s primary objection to these efforts is that they place responsibility for the adoption of interoperable health IT systems on physicians. The letter argues that instead, CMS should pressure EHR vendors to meet interoperability standards.

Not only that, it’s critical to prevent the vendors from charging high prices for relevant software upgrades and maintenance, the AAFP argues. “To realize meaningful patient access to their data, we strongly urge CMS to require EHR vendors to provide any new government-required updates such systems without additional cost to the medical practice,” the group writes.

Other requests from the AAFP include that CMS:

  • Drop all HIT utilization measures now that MIPS has offered more effective measures of quality, cost and practice improvement
  • Implement the core measure sets developed by the Core Quality Measures Collaborative
  • Penalize healthcare organizations that don’t share health information appropriately
  • Focus on improving HIT usability first, and then shift its attention to interoperability
  • Work to make sure that admission, discharge and transfer data are interoperable

Though the letter calls CMS to task to some degree, my sense is that the AAFP shares many of the agency’s goals. The physician group and CMS certainly have reason to agree that if patients share data, everybody wins.  The AAFP also suggests measures which foster administrative simplification, such as reducing duplicative lab tests, which CMS must appreciate.

Still, if the group of federal organizations thinks that doctors can be forced to make interoperability work, they’ve got another thing coming. It’s hard to argue the matter how willing they are to do so, most practices have nowhere near the resources needed to take a leading role in fostering health data interoperability.

Yes, CMS, ONC and other agencies involved with HIT must be very frustrated with vendors. There don’t seem to be enough sanctions available to prevent them from slow-walking through every step of the interoperability process. But that doesn’t mean you can simply throw up your hands and say “Let’s have the doctors do it!”

Comprehensive Health Record Vs. Connected Health Record

Posted on March 26, 2018 I Written By

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

The “comprehensive health record” model is quite in vogue these days. Epic, in particular, is championing this model, which supplants existing EHR verbiage and integrates social determinants of health. “Most health systems know they have to go beyond their walls,” Epic CEO Judy Faulkner told Healthcare IT News. A number of other EMR vendors have followed Epic’s lead.

To date, however, most clinicians have yet to embrace this model, perhaps because they’re out of patience with the requirements imposed by EHRs. What’s more, the broader healthcare industry hasn’t reached a consensus on the subject. For example, a team of experts from UCSF argues that healthcare needs a “connected health record,” a much different animal than vendors like Epic are proposing.

The authors see today’s EHR as an “electronic file cabinet” which is poorly equipped to handle health activities and use cases such as shared care planning, genomics and personalized medicine, population health and public health, remote monitoring and sensors.

They contend that to create an interoperable healthcare ecosystem, we will need to move far beyond point-to-point, EHR-to-EHR connections. Instead, they suggest adding connections with patients and family caregivers, non-clinical providers such as school clinics for youth and community health centers. (They do agree with Faulkner that incorporating data on social determinants of health is important.)

Their connected health record ties more professionals together and adapts to new models of care. It would foster connections between primary care physicians, multiple specialists, hospitals, clinics, pharmacies, laboratories, public health registries and new models of care such as ACOs. It would be adaptive rather than reactive.

For example, if the patient at home with cancer gets a fever, her temperature data would be transmitted to her primary care physician, her oncologist, her home care nurse and family caregiver. The care plan would evolve based on the recommendations of team members, and the revised vision would be accessible automatically to the entire care team. “A static, allegedly comprehensive health record misses the dynamics of an interactive, learning health system,” the authors say.

All that being said, this model still appears to be at the vision stage. Perhaps given its backing, the comprehensive health record seems to be getting far more attention. And arguably, attempting to integrate a good deal more data on patients into an EHR could be beneficial.

However, both models are largely untested, and both beg the question of whether building more content on an EHR skeleton can lead to transformation. On the other hand, while the concept of a connected health record is attractive, my sense is that the components needed to this happen have not matured yet.

Ultimately, it will be clinicians who decide which model actually works for them, not vendors or abstract thinkers. Let’s see which model makes the most sense to them.

Ways To Minimize Physicians’ Administrative Burdens

Posted on January 24, 2018 I Written By

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

It’s hardly a secret that physicians are buckling under the weight of their administrative responsibilities. The question is, how do we lessen the load? A new article published on a site backed by technology vendor CDW offers some creative ways for doing so.

One suggestion the article makes is to have patients write and add notes to their personal medical charts.According to the piece, doctors at UCLA Health and Beth Israel Deaconess Medical Center will pilot “OurNotes,” a tool allowing patients to input medical data, in 2018. Patients will use the new tool to add information such as symptoms, emerging health issues and even goals for future visits. OurNotes is an outgrowth of the OpenNotes project, an initiative that encourages clinicians to share their notes with patients.

Will the OurNotes effort actually make things easier for physicians? Dr. John Mafi, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, believes it can.

“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” Dr. Mafi said in a statement about a research project on the OpenNotes approach. (Mafi was the lead author of a paper on the project’s results.)

Another option is using “remote scribe” services via Google Glass. Yes, you heard me right, Google Glass. Google is relaunching its smart glasses and it’s retooled its approach to serving the healthcare industry. The number of applications for Glass has crept up gradually as well, including an EMR accessible using the smart glasses from vendor DrChrono. DrChrono calls it the “wearable health record,” which is pretty nifty.

San Francisco-based clinical practice Dignity Health has been working with Google Glass startup Augmedix to access offsite scribes. Dignity Health vice president and CMIO Davin Lundquist told MobiHealthNews that after three years of using Glass this way, he’s cut down on time spent administrative tasks from 30% per day to 10% per day. Pretty impressive.

Yet another way for healthcare organizations to reduce adminsitrative overhead is, as always, making sure their EMR is properly configured and supports physician workflow. Of course, duh, but worth mentioning anyway for good measure.

As the CDW piece notes, one way to reduce the administrative time for physicians is to make sure EMRs are integrated with other systems effectively. Again, duh. But it never hurts to bear in mind that making it easy for physicians to search for information is critical. There’s no excuse for making physicians hunt for test results or patient histories, particularly in a crisis.

Of course, these approaches are just a beginning. As interesting as, say, the use of Google Glass is, it doesn’t seem like a mature technology at this point. OurNotes is at the pilot stage. And as we all know, optimizing EMRs for physician use is an endless task with no clear stopping point. I guess it’s still on us to come up with more options.

Clinicians File Class Action Suit Against eClinicalWorks

Posted on January 9, 2018 I Written By

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

EMR provider eClinicalWorks has been hit by another class action lawsuit, this time a suit led by clinicians, raising questions as to how much legal trouble the vendor can survive.

The new suit is the latest of a series of dominos falling on eCW. Its legal problems began in May of last year, when it was forced to settle a suit filed by the U.S. Department of Justice for $155 million. The suit contended that eCW got its Meaningful Use certification by misrepresenting its capabilities.

Then, in November of last year, eCW was slammed with a class action lawsuit, this one demanding $1 billion. The suit alleged that by lying about the capabilities of its software, eCW “failed millions of patients by failing to maintain the integrity of patient records.”

Now, eCW faces another class action suit, this time led by primary care doctors. The suit alleges that because eCW’s software didn’t meet MU standards as promised, they lost government reimbursement. The suit asserts the eCW gave the PCPs “no reason to suspect that [it] had made false statements to obtain its certification.”

All of this is interesting in and of itself, but it doesn’t address the bigger question: Can eCW survive the legal firestorm that has engulfed the company?

eClinicalWorks is a private company, so I can’t offer detailed information on its finances, but it reported revenue of $130 million for the third quarter of 2017. If that’s a representative number, the company generates roughly half a billion dollars a year.

That’s a lot of money, but it’s not an infinite supply. The $155 million settlement has to have hurt (though I suppose it might have been covered in part or entirely by business liability insurance).

The other two lawsuits could prove more deadly. While it’s hard to predict whether a suit will go anywhere, there’s at least some chance that eCW will face a $1 billion judgment. Of course, even if it does lose the case, it will take effect only after several years of legal wrangling. Nonetheless, it seems likely that such a conclusion could bankrupt the company.

The other key question is whether eCW can hold onto its customers as lawsuit after lawsuit is filed. It might seem to some that eCW has been punished enough for its indiscretions, and that the additional lawsuits are largely part of a feeding frenzy. On the other hand, one might suggest that if eCW lied to all of its customers, it deserves to be forced out of business. It’s a flip of the coin at  this point.

Regardless, the suits do suggest that EMR vendors had better keep their noses clean. If they try to fool customers – or the feds – the results could be catastrophic.

Thoughts on Practice Fusion Raising $70 Million

Posted on September 24, 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.

Today, Practice Fusion announced that they have just closed a $70 million round of funding. This series D round of funding brings Practice Fusion’s total funding to $134 million and a valuation estimated at $700 million. The round was led by Kleiner Perkins Caufield & Byers, OrbiMed Advisors, and Deerfield Management Company.

We’d heard that this round was close almost 2 months ago. I’m not sure what took them so long to finally close the round. I also found it interesting in this Forbes article about the funding round that “Practice Fusion leads vendors this year in acquiring Allscripts’ former customers.” I have a feeling Aprima might have something to say about that.

In that same article, Practice Fusion declined to disclose revenues, but Ryan Howard suggested that he expects Practice Fusion revenues to triple next year. Then, it was suggested in the article that payments from labs connected to Practice Fusion customers would make up a significant source of revenue. You might remember that Practice Fusion lost one revenue stream when Kareo decided to launch their own free EHR. Practice Fusion has since rolled out 3 new billing companies and so they could have made up that revenue.

The article also suggests that revenue is available from Pharma for mining the Practice Fusion data for insights. Then, they’ve always talked about the potential for pharma advertising in the Free EHR. I also had someone suggest to me recently that Practice Fusion could be making money off of selling leads to the various healthcare education companies out there. Considering the number of emails I get from these healthcare education companies, they definitely have money to spend on targeted leads.

The question I’ve asked for many years isn’t whether Practice Fusion has created value. No doubt their current user base and data set has value. The question that remains is whether they’ve created a company that merits a $700 million valuation and whether the $134 million investment will yield a quality return. Plus, can Practice Fusion build the company’s revenue while still maintaining physicians’ trust in Practice Fusion. They now have $70 million in funding to find out.

Aprima EHR’s Offline Functionality

Posted on August 29, 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 writing for a number of years on the challenge that EMR downtime causes a clinic. In case you missed them, check out some of the following posts:
My EMR is DOWN!!!
Working Offline When Your EHR Isn’t Available
Cost of EHR Down Time
Reasons Your EHR Will Go Down
SaaS EHR Down Time vs. In House EHR Down Time

Not to mention Katherine Rourke’s recent post titled, “When The EMR Goes Down, Doctors Freak Out.” Obviously, downtime is a big problem as doctors become more reliant on their EHR software. Plus, as I state in some of the article, downtime is inevitable.

One of the most common comments I got on those posts was doctors asking why they couldn’t work in the EHR software even when it was down. My answer was usually that the EHR vendor could do that, but that it would require them to architect the EHR to be able to support offline use of the EHR and that wasn’t a simple task.

Turns out that Aprima has built this functionality into their EHR called Aprima Replication. Here’s their description of the replication feature:

Every installation of Aprima EHR includes the Replication functionality. This allows physicians to continue working within patient charts when they are not able to be connected to their server (whether it is hosted locally in their office or in the cloud). They have identical functionality as if they were fully connected with the ability to look up or enter data, perform everyday tasks such as messaging and tasking, create orders, review results, etc. Everything is stored locally on their hard drive in a secure and encrypted environment and automatically syncs information the next time they are online whether that be over a mobile wireless connection, wifi + VPN over a public network, back in their office over a wired or wifi network, at home, or wherever and however they are able to connect. Additionally, all of the synchronization is done behind the scenes allowing the provider to continue working live without having to wait for the replication to complete.

Aprima Replication goes beyond other mobile technologies because this does not require connectivity, and even more importantly it is not simply a copy of the server that is “read only,” or a partial export of charts that leaves the server side locked until the provider “checks the chart back in.” This is fully functional on the provider side while disconnected AND allows others to also continue to make updates and changes to the chart, patient scheduling, handle all the needs surrounding coordination of care, billing and collections, etc. This can also be used as a great “downtime” alternative to paper in the event of an internet outage for those using the cloud or a server failure when running it locally.

I asked a couple follow up questions to clarify exactly how the offline EMR functionality worked. Here are my questions and their answers (originally an email exchange):
The challenge I have is understanding how the patient records are available without an internet connection. You can’t be downloading every single patient record locally are you?

In our unique, patent pending Replication process, every provider has a profile unique to their needs and preferences. This includes a subset of patients based on their previous schedule, future schedule, open orders and tasks, a specific facility they may be servicing such as a nursing home, their messages, attachments, (they can set size limits to address minimal bandwidth environments such as wireless air cards) etc. Based on these parameters the appropriate patient charts are “replicated” to their tablet/laptop computer. This is an ongoing, real-time process while they are connected to the network that keeps the data current. Any time they disconnect, or even lose connectivity if there is an outage, they continue to have full chart access for reviewing, adding, and editing as if they were still connected. As soon as connectivity is restored the synchronization starts up again and continues until all of their work, plus all of the work done simultaneously on the server side, is merged back together.

Does it just download some “active patient” list or the records for the patients on your schedule for some certain time period? It’s a really beautiful thing that you’re program can work without the internet. I assume all of the drug databases, etc are downloaded and available locally as well?

Yes, they are, including all drug interaction checking which remains fully functional while off line. Any orders for scripts, labs, diagnostics, or anything else, can be created offline and then processed when the computer is back in network range. So the script or order will be ‘staged’ and ready to go. It’s just like when you write an email when your offline, then when you get in range, the emails in your outbox just go.

The other question I have is how the records deal with multiple people modifying the record in a disconnected mode. What if the nurse accesses the record and documents something and then the doctor gets in and document something. Does the record get reconciled once it’s reconnected?

Yes indeed it does.

Are there every any issues that have to be reconciled manually?

There is a “collision” report. These “collisions” are rare but we do accommodate them very well. If a Replication “save” conflict occurs, a message will be sent to the user group that is defined to be notified. Replication conflict messages contain details of the conflict and the name of the associated patient if applicable.

The next time I see Aprima at a conference, I plan to check out this feature first hand. Reconciling a patient record that two people are editing can get pretty complex. I’d like to see how it handles it. Plus, I’d love to see how well it does at resyncing the data after being offline for a while. Not to mention how well it does at identifying the patient info it should have stored locally.

This is a really challenging feature to implement. I think it says something about Aprima that they took it on. If it works well, I know there are a lot of doctors that would love this feature in their EHR.

Modernizing Medicine EHR Vendor Raises $14 Million

Posted on August 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.

Modernizing Medicine®, the creator of the Electronic Medical Assistant® (EMA™), a cloud-based specialty-specific electronic medical record (EMR) system, announced today that it has received $14 million from Summit Partners, a global growth equity investor. –Source

I’ve been a big fan of Modernizing Medicine since I first came across them. Their approach to EHR is very smart and very different than many of the EHR software out there. They’re extremely focused on the specialties that work well with their visual method of documentation and that documentation method is something unique.

I’ll be interested to see if Modernizing Medicine plans to use this $14 million to expand beyond their current specialties or whether they plan to stay as a specialty specific EHR. I’m a big fan of specialty specific EHR software and so I hope that it’s the later. You have to compromise so many things when you expand an EHR to support so many different specialties. The number of doctors still not using Modernizing Medicine’s EMA EMR is still large enough for them to do very well.