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Patients Showing Positive Interest In NY-Based HIE

Posted on November 16, 2017 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.

A few months ago, I shared the story of HEALTHeLINK, an HIE serving Western New York. At the time, HEALTHeLINK was announcing that it had managed to obtain 1 million patient consents to share PHI. The HIE network includes 4,600 physicians, in addition to hospitals, health plans and other providers.

This month, HEALTHeLINK has followed up with another announcement suggesting that it’s making significant progress in getting patients and physicians connected and perhaps more importantly, interested in what it can do for them. In particular, the study suggested that consumers were far more aware of the HIE’s existence, function and benefits than one might’ve assumed.

The study found that 90% of respondents said they knew their doctors use EHRs, a percentage which differed but remained high across all demographic groups study. Respondents also knew that their doctor could send and receive medical information back and forth with other healthcare providers involved in their care using EHRs.

Not only that, 51% of respondents felt that the use of EHRs by doctors and hospitals made healthcare “more safe,” though 24% said EHRs made no impact on their care and 18% said EHRs made care “less safe.” Fifty-eight percent of respondents said that electronic access is good for healthcare, and 24% answered “strongly yes” when asked whether electronic access was beneficial.

When asked whether electronic access is good for healthcare, 24% of respondents said “strongly yes” and 58% said “yes.” Things looked even more positive for the future of the HIE when patients were specifically aware of HEALTHeLINK, with 57% of this group of patients rating care as “more safe.”

Those who rated care as “more safe” using HEALTHeLINK also included respondents with a two-year degree, those who visited Dr. more than 15 times a year and those who fell into 35 to 44-year-old age bracket.(However, it is worth noting that 41% to respondents said they weren’t aware of the name HEALTHeLINK.)

The only significant downside mentioned by HEALTHeLINK users was a lack of face time, with 37% reporting that their doctor or healthcare professional was spending too much time on a laptop or computer, and another 11% saying that this was a significant problem. (Another 60% had no issue with this aspect of the electronic medical records use process.)

Despite those reservations, when asked if they were willing to cut their doctor to use the HIE to give the other providers instant access to medical records, 57 percent said “yes” and 24% said their answer was “strongly yes.”

Lest this begin to sound like a press release for HEALTHeLINK, let me stop you right there. I am in no way suggesting that these folks are doing a better overall job of running its business than those in other parts of the country. However, I do think it’s worth noting that HEALTHeLINK’s management is building awareness of its benefits more effectively than many others.

As obvious as the benefits of health information sharing may seem to folks like us, it never hurts to remind end users that they’re getting something good out of it — and if they’re not, to find out quickly and address the problem.

New EHR Virtual Assistant: Samantha from NoteSwift

Posted on November 14, 2017 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.

Sometimes in a blog post, it’s much easier to show something than it is to write about something. That’s definitely the case with the recently announced EHR Virtual Assistant from NoteSwift called Samantha. That’s why I asked NoteSwift to create a demo video of Samantha at work so you could see what they’re doing. Check out the video demo of Samantha working with Allscripts Professional below.

Samantha currently works with Allscripts Professional EHR and athenaClinicals EHR and they’re looking at integrating with other EHRs in the future.

When NoteSwift first reached out to me with this tool I told them that it sounded a lot like the voice recognition and NLP solutions that I’d seen previously. I remember one EMR a long time ago that had really deeply integrated voice navigation that got pretty close to this type of interface. Plus, I’d seen demos of NLP that would pull out the granular data elements from a narrative text before.

The key question for me was how tightly integrated the voice recognition and NLP technology was with the EHR software. As you can see from the demo above it’s quite integrated. I do still have some questions on what the learning curve for some of the specific voice commands will be for the NLP to work properly and document the visit the right way. Plus, similar to voice recognition I’m interested to know if the mistakes you have to correct are as time intensive as just clicking the boxes yourself. I’m sure there will be the full spectrum of experiences.

One thing that really impressed me about NoteSwift’s implementation of Samantha was the verification process that the doctor goes through near the end of the video (about 2 min and 12 seconds in for those keeping track at home). I’ve always thought that, at least for now, this was an essential part of using NLP in the medical world. The doctor still needs to verify that everything is accurate before moving on. The way NoteSwift has implemented this is quite slick.

In talking with Wayne Crandall, the President and CEO of NoteSwift, he also told me that Samantha can work with any input mechanism including voice recognition from Nuance or MModal. He even told me that some doctors believe they can type faster than they can do speech recognition which isn’t a problem for Samantha either. The real magic of Samantha is in taking a narrative text, however it’s produced, parsing the structured data, assigning the coding and entering it into the correct areas of the EHR.

Pretty slick solution and one that I think many doctors would like to try so they can stop their slow death by a million clicks.

MIPS Penalties Include Medicare Part B Drugs – MACRA Monday

Posted on November 13, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

I’m sure most regular readers can tell that we’re pretty worn out and tired of MACRA, MIPS, and related government regulation. No doubt you’ll see us posting fewer MACRA Mondays going forward, but we’ll still try to cover major MACRA events as they occur. We just won’t be publishing MACRA Monday every Monday like we’ve been doing.

Jim Tate recently posted about the Real MIPS Timeline which included:

  • Phase 1 – Denial
  • Phase 2 – Shock/Anger
  • Phase 3 – Acceptance

You should read his full writeup, but he’s right. There’s a lot of denial that’s going to lead to shock and anger until the majority of healthcare have to finally accept that MIPS and MACA aren’t going anywhere.

Jim Tate also wrote another important piece related to the MIPS penalties and Medicare Part B drugs. You can read the full details of the change, but for those too lazy to click over, here’s the summary:

  • Many organizations argued that Medicare Part B Drug Costs Shouldn’t be Included in the MIPS Penalties (I mean…payment adjustments)
  • The MACRA Final rule still includes Medicare Part B drug costs (for the majority of people) in the MIPS reimbursement and eligibility calculations

If you’re a practice with a high volume of part B drugs, you better start figuring out your MIPS strategy now! Otherwise, that payment adjustment is going to hit pretty hard.

Thanks Jim for the great insights into MACRA and MIPS. If you need help with MIPS, be sure to check out Jim’s company MIPS Consulting.

Elderly Doctor May Lose Medical License Due In Part To Lack Of Computer Skills

Posted on November 10, 2017 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.

Do physicians need to be computer-literate to run a safe and effective medical practice? The question has come into high relief recently as an 84-year-old New Hampshire physician fights to get her medical license reinstated.

Dr. Anna Konopka, who recently lost her license due in part to a lack of computer skills, is suing the New Hampshire Board of Medicine in an effort to get it reinstated.

Back in September, Konopka had signed an agreement to surrender her license with the medical board. The agreement settled pending allegations regarding her “record-keeping, prescribing practices, and medical decision-making,” according to an article in Ars Technica. The agreement reportedly permits her to apply to regain her license, but to succeed in doing so she’d have to prove that she did no wrong.

In her interview with the publication, the elderly physician denied any misconduct and said she was under duress when she voluntarily surrendered her license previously. She has said that she wants to continue practicing medicine, but does not want to participate in what she calls “electronic medicine.”

“I am getting the patients from the system [her term for the medical bureaucracy surrounding the use of EMRs today], and I see how badly they are mistreated and misdiagnosed or not diagnosed at all,” she told Ars Technica. “Therefore, I am not going to compromise patients’ lives or health for the system.”

For what it’s worth, Konopka’s troubles with the state medical board didn’t arise from computer use or lack thereof. They were triggered when a formal complaint was filed with the board alleging that she treated a young patient with asthma incorrectly.

The dispute resulted in a formal reprimand from the medical board in April 2017. The board also required her to undergo 14 hours of medical training as a condition of continuing to practice. After that, other investigations followed, including disputes over the scope of her original agreement with the medical board.

Ordinarily, Konopka’s struggles for reinstatement might never have come to public view. What differentiates them from others is the role her unwillingness to use computers has played in the process. Specifically, unless she learns to use the Internet, she won’t be able to comply with the state’s new law requiring her to access an online opiate monitoring program. (As part of her attempts to regain her license, she’s agreed to do so.)

It’s hard to tell who is right in this particular case, but the situation does raise interesting questions about the role of computer use in medical practice generally.

Should physicians be required to use computers as part of their practice in this day and age, and if so, what level of competency should they be required to attain? Are there specific pieces of software, such as EMRs, they have become as important to medicine as a stethoscope was in a prior era? Should use of health IT software be a required part of all medical training at this point?

I don’t have any answers to these questions, and you may not either. But if a doctor’s license can be threatened, even in part, by failing to use computer technology, we’d better work on finding some.

Wearables Makers Pitching Health Trackers For Babies

Posted on November 9, 2017 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 my older son was born, we relied on a low-tech “sense of hearing” solution to track crying alerts from his crib at the other end of the hallway.

But were he born today, my son would never have settled for such pedestrian technology. Today’s discriminating newborn expects his parents to collect a wide array of data points and conduct advanced analytics on them to optimize his health.

You think this is ridiculous? Wipe that smile off of your face, you slackers. Ever sensitive to the expanding needs of today’s modern baby, wearables manufacturers have begun testing health trackers designed to monitor their tiny bodies, according to an article appearing on the CNN.com site.

In fact, there are already dozens of wearables for babies on the market, CNN found, including devices that monitor their heart rate, smart socks that track oxygen levels and a baby monitor button that snaps onto the child’s clothes. Any of these could cost a few hundred dollars. But there’s also smart thermometers and pacifiers, such as Vick’s or Blue Maestro’s Pacif-i, which start around $20 and go up from there, the site reports.

The CNN article also shares the tale of Crystal King, an Atlanta mom who’s monitoring her six-month son Avery using one of these emerging trackers.

The piece describes how using her cell phone, King can check her baby’s temperature on her cell phone and get app-driven alerts when it’s time for Avery’s next bottle feeding.

Meanwhile, if King picks up her tablet, she can also monitor her son’s breathing, body position, skin temperature and sleeping schedule. (Back in the Stone Age, I had to settle for keeping his body in position with pillow wedges and tracking his sleeping schedule using a little trick known as “staying awake.”)

As part of his work with CNN, Avery has been testing a number of different wearable devices. He seems to be a tough critic. On the one hand, he seemed pretty comfy wearing a biometric-tracking onesie while playing on his mat, but kept spitting out the smart pacifier, which was apparently a nonstarter.

Of course, we don’t actually know what Avery thinks about these devices, but his mom has developed some ideas. For example, King told CNN she thinks it would be good to help parents control the number of notifications they get from baby-monitoring apps and technologies.

If nothing else, equipping their baby with a health tracker may offer parents a little extra reassurance that their child is safe. He might still erupt in deafening screams at 3AM now and again, but if he’s wearing a health tracker, you might at least know why.

Digital Health Venture Snags $10M Investment After Buzzword Upgrade

Posted on November 7, 2017 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.

Melon Springs, FL – In a deal observers are calling “disruptive,” “groundbreaking” and “lemon-scented,” high-profile wellness startup ICanHazHealth has closed a $10 million investment round on the heels of its recent buzzword upgrade.

Investors participating in ICanHazHealth’s Series B round include Bracelet Capital, Two Right Thumbs LLC and Window Dressing Digital. Few details of the agreements were disclosed, though Bracelet’s Jared Spoon-Monicker told Wired that its investment contract included an agreement to provide buzzword platform to its other portfolio companies. “We’re calling it ‘BaaS’ — buzzwords-as-a service,” said Spoon-Monicker, an early backer of exaggeration engine JIVETalk. “It will be the Uber of monetizing incremental marketing hyperbole.”

Launched in 2010 to tap the emerging market for digital health investment catchwords, the vendor’s BLOviATE platform offers both employer-and consumer-compatible content libraries. “Today, it’s not enough for consumers to use digital health buzzwords,” said ICHH founder P. Foster Bellbottom. “If we want to improve outcomes, we need to increase their level of buzzword engagement.”

The latest iteration of ICHH’s enterprise jargon platform, BLOviATE nACTION, now offers modules supporting several functional areas, including bragging, wishful thinking, puffery, exaggeration, self-deception, embellishment, and hyperbole.

Hospitals and health systems can also opt for a 10-year buzzword maintenance contract which supports BLOviATE deployment over existing SLANG and LinGO databases. However, ICHH won’t be offering distortion upgrades for BLOviATE past 2020, so after that point facilities will need to do their own grandiloquence support.

When asked what they thought of the emerging doubletalk startup’s prospects, analysts noted that ICHH faces several competitors with well-established client bases. Many pointed to iNtercAP, iNc., a niche buzzword developer specializing in novel tech company names, whose customers include Hangzhou No Trouble Looking for Trouble Internet Technologies (usually referred to as HNTLFTIT for short) and connected health giant Slippers and Sonograms.

“The issue is not whether there’s enough demand to support a bunch of balderdash startups,” said Warren Wallaby, head of the braggadocio research consulting firm the Seesaw Group. “At the moment there’s definitely a market for a range of bravado solutions.” The thing is, there’s no guarantee that the buzzword market won’t go soft at some point. “Health IT buyers have to be ruthless,” Wallaby says. “The day CIOs can get the same results from a few white lies and a little dissembling, these startups will be out of business.”

Note: This is a parody for those so inundated by buzzwords that it’s hard to tell.

Alert Fatigue: It May Be Worse Than You Thought

Posted on November 3, 2017 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.

Until recently, I didn’t take the problem of clinical decision alert fatigue that seriously, or at least not as seriously as I should have. After all, it’s just an alert, right? You can just shut it off if you don’t like hearing it. Or so it seemed to me, admittedly a naïve pundit from the peanut gallery who’s never treated a patient in her life.

But despite my ignorance, researchers have continued to unearth evidence that alert fatigue may be one of the worst safety hazards afflicting medicine today. After all, this fatigue comes from a deadly one-two punch: the excess noises camouflage the alerts clinicians really need to hear while distracting them from what they’re doing with useless sounds. (If you put me in a situation like that I’d get booted out the door for throwing particularly noisy devices out the window.)

Sadly, alert fatigue is far more than a nuisance. The latest evidence to this effect comes from the Journal of the American Medical Informatics Association, where an article published last month underscored how often alerts cause clinicians to ignore important information.

To conduct their study, a group of researchers conducted a cross-sectional study of medication-related clinical decision support alerts. They collected data at a 793-bed tertiary-care teaching institution, measuring the rate of alert overrides, the reasons cited for overrides and the appropriateness of those reasons.

The results of their analysis were disquieting. On the one hand, they found that roughly 60% of overrides were appropriate overall. In particular, 98% of duplicate drug overrides, 96.5% of patient allergy overrides and 82.5% of formulary substitution overrides were appropriate. That’s the good news. On the other hand, they concluded that 40% of physician alert overrides were inappropriate.

All told, overrides of alerts in certain categories were inappropriate greater than 75% of the time. Let’s take a moment to think about that. Seventy. Five. Percent. Now, I know that “inappropriate” doesn’t mean that the patient would’ve died if the error was corrected, or even that they incur serious harm, but this still isn’t great to hear.

Not surprisingly, researchers said that future studies should optimize alert types and frequencies to improve their clinical relevance so clinicians don’t slap them down over and over like a snooze alarm.

The truth is, studies have been drawing this conclusion for quite some time now, and from what I can see little has changed here.

My assumption is that vendors keep doing what they do because nobody has pressured them enough to make them rethink their CDS logic and drop needless alarms. I’m also guessing that some misinformed health leaders might be reassured by the sound of alerts going on and equating it with higher safety ratings. If so, let’s hope they get disabused of this notion soon.

MACRA Twitter Roundup – MACRA Monday

Posted on October 30, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

We took last week off from our MACRA Monday series of blog posts. It seems like we’re in a kind of lull period for the program. Either you’ve started collecting the data you’ve needed or you haven’t. Plus, we’re kind of waiting for the next MACRA Final rule to drop for more details.

With that in mind, I did want to see what some of the latest things that were being shared on Twitter when it comes to MACRA. I found a lot of strong opinions about the program, some good resources, and some forward-looking thoughts on what could be coming in the next MACRA final rule.


It’s hard to argue with John. Not just because he’s a smart guy, but because he’s right that it’s hard to imagine a path forward that’s fee for service and doesn’t include a shift to value based care in some form or fashion. At least given the current market dynamics.


This caution from Workflow Chuck should have us all nervous about the shift. I see a lot of healthcare organizations going after the target as opposed to the goal of value based care.


MACRA is going to impact your biz. I liked the way Kelly broke it out into 4 areas. No doubt some of these things could be argued both ways.


This is still how most doctors I know feel about MACRA and even meaningful use before it. They feel like they’ve been thrown under the bus.

Here are two forward looking resources that look at what we might get from the MACRA Final Rule:

What else are you hearing about MACRA? Would love to hear your thoughts, insights, questions, perspectives, rants, etc in the comments.

Independent Clinical Archive Brings Complete Patient Record Together in One Place

Posted on October 27, 2017 I Written By

The following is a guest blog post by Tim Kaschinske, Senior Product Manager, North America, BridgeHead Software.

How many photos and documents do you have stored on your home computer or in the cloud? How easily would it be to find those photos of, say, the family beach vacation you took in 2010? What about the trip in 2001? Most of us would have to search blindly through scores of electronic file folders and myriad devices before finding what we need.

Now think about your physicians who need to access historical patient information, such as baseline mammograms, medication history, lab results or the course of a patient’s cancer treatment. Nearly every hospital is on its second or third EMR, and any new EMR vendor wants as little previous data to come over from legacy systems as possible to help ensure a “clean” install. So that leaves physicians and assistants poring through older EMRs, or other applications and media to find needed data. This takes time away from direct patient care, an increasingly critical consideration in value-based care arrangements.

But that older information still has value, for both patient care as well as for regulatory reasons. The problem, then, is how to store, protect and share that information in a way it remains readily accessible, available and readable even as technology changes.

Disparate data, common archive

The answer is an independent clinical archive (ICA) that can accept disparate data from multiple systems such as an EMR or a PACS and store it using open data standards commonly found in healthcare. An ICA does not replace an EMR or a PACS – it works in concert with them, allowing a hospital to formally retire previous EMRs, PACS and other IT systems while ensuring the electronic patient data contained within lives on as part of the 360-degree patient view. This saves money on licensing fees, storage costs and IT personnel costs to maintain and update rarely used technology.

An ICA is a centralized, standards-based data repository that ingests disparate data types such as DICOM images, HL7 reports, physician notes and other unstructured data. Information is managed based on unique patient information and further subdivided by specialty or date, for example. The ICA works best when integrated with a hospital’s EMR (via an application programming interface (API)), allowing providers to seamlessly compile a complete, longitudinal patient record without having to remember additional log-ins.

APIs are also used to connect to multiple legacy systems. However, security protocols on legacy systems are not as stringent as they are with newer technology, leaving hospitals potentially vulnerable to accidental or intentional data breaches. A hospital using an ICA as a central data repository only requires APIs among the ICA, the EMR and the PACS. Plus, the ICA has built-in security and protection features to ensure the safeguarding of critical patient data.

A true, 360-degree patient view

When an ICA is properly implemented, providers access the information being populated from the EMR and the information coming from the ICA through one system and in the appropriate context for the patient. And that’s the holy grail of patient information: one environment aggregating all of the information outlining chronic conditions, physician notes, medications, diagnoses, surgeries and much more.

And if a physician needs to drill down into radiology reports, for instance, he can pull up just that data. Finding information about a specific hospitalization is as easy as inputting the correct date range to locate just those records.

While Software-as-a-Service revolutionized the delivery of IT services, an ICA can revolutionize the way physicians find all of the data they need, quickly and within their normal workflows. At the same time, hospitals can save money and increase data security by retiring older electronic systems.

EHR Data Allows Hospital To Find C. Diff Source

Posted on October 26, 2017 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.

Here’s a kind of story that makes you feel better about your EHR investment. A new journal article is reporting that researchers were able to find a source of Clostridium difficile within a hospital, not with elaborate big data analytics but simply by using basic EHR data.

According to the item, which appeared in JAMA Internal Medicine, a group of researchers examined EHR data on time and location to map roughly 435,000 patient location changes at the University of California San Francisco Medical Center. The effort was led by Russ Cucina, chief health information officer at UCSF.

After analyzing overall data, the researchers found a total of 1,152 cases of laboratory-documented CDI. The data indicated that CDI-positive patients moved through an average of four locations during their hospitalization, but that the CDI events came from a single location.

Researchers concluded that when patients were exposed to C. diff infections in the emergency department’s CT scanner, it was associated with a 4% incidence of CDI. They also noted that the association between CT exposure and CDI was still significant even after adjusting other influences such as antibiotic use and patients’ length of hospital stay. The association also remained significant when their sensitivity analysis extended the incubation period from 24 to 72 hours.

Having identified the CT as a potential vector of infection, the hospital next looked at how the that happened. It found that cleaning practices for the device didn’t meet the standards set for other radiology suites, and took steps to address the problem.

While healthcare leaders will ultimately use EHR data to make broad process changes, addressing day-to-day problems that impact care is also valuable. After all, finding the source of CDI is no trivial manner.

For example, a study recently concluded that ambulatory care organizations can do a pretty good job of analyzing their workflow by using EHR timestamp data.

Researchers had developed the study, a write up of which appeared in the Journal of the American Medical Informatics Association, to look at how such data be could be used in outpatient settings. Aware that many outpatient organizations don’t have the resources to conduct workflow studies, the researchers looked for alternatives.

During the research process, the team began by studying the workflow at four outpatient ophthalmology clinics associated with the Oregon Health and Science University, timing each workflow step. They then mapped the EHR timestamps to the workflow timings to see how they compared.

As it turned out, the workflow times generated by analyzing EHR timestamps were within three minutes of observed times for more than 80% of the clinics’ appointments. The study offers evidence that outpatient organizations can examine their workflow without spending a fortune, using data they already collect automatically.

Of course, hospitals will continue to do more in-depth workflow analyses using higher-end tools like big data analytics software. These efforts will provide a multidimensional picture that wouldn’t be available using only timestamp analysis.  But for hospitals and clinics with fewer resources, timestamp analysis may be a starting point for some useful research.