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Cloud-Based EHRs With Analytics Options Popular With Larger Physician Groups

Posted on April 20, 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.

Ever wonder what large medical practices want from the EHRs these days? According to one study, the answer is “cloud-based systems with all the bells and whistles.”

Black Book Research just completed a six-month client satisfaction poll questioning members of large practices about their EHR preferences. The survey collected data from roughly 19,000 EHR users.

According to the survey, 30% of practices with more than 11 clinicians expect to replace their current EHR by 2021, primarily because they want a more customizable system. It’s not clear whether they are sure yet which vendors offer the best customization options, though it’s likely we’ll hear more about this soon enough.

Among groups planning an EHR replacement, what appealed to them most (with 93% ranking it as their preferred option) was cloud-based mobile solutions offering an array of analytical options. They’re looking for on-demand data and actionable insights into financial performance, compliance tracking and tools to manage contractual quality goals. Other popular features included telehealth/virtual support (87%) and speech recognition solutions for hands-free data entry (82%).

Among those practices that weren’t prepared for an EHR replacement, it seems that some are waiting to see how internal changes within Practice Fusion and eClinicalWorks play out. That’s not surprising given that both vendors boasted an over 93% customer loyalty level for Q1 2018.

The picture for practices with less than six or fewer physicians is considerably different, which shouldn’t surprise anybody given their lack of capital and staff time.  In many cases, these smaller practices haven’t optimized the EHRs they have in place, with many failing to use secure messaging, decision support and electronic data sharing or leverage tools that increase patient engagement.

Large practices and smaller ones do have a few things in common. Ninety-three percent of all sized medical and surgical practices using an installed, functional EHR system are using three basic EHR tools either frequently or always, specifically data repositories, order entry and results review.

On the other hand, few small to midsize groups use advanced features such as electronic messaging, clinical decision support, data sharing, patient engagement tools or interoperability support. Again, this is a world apart from the higher-end IT options the larger practices crave.

For the time being, the smaller practices may be able to hold their own. That being said, other surveys by Black Book suggest that the less-digitalized practices won’t be able to stay that way for long, at least if they want to keep the practice thriving.

A related 2018 Black Book survey of healthcare consumers concluded that 91% of patients under 50 prefer to work with digitally-based practices, especially practices that offer conductivity with other providers and modern portals giving them easy access to the health data via both phones and other devices.

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!”

Patients Expect Retail-Style Digital Health Experiences

Posted on March 30, 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 retail industry has been pretty successful in integrating digital tools into their business. All major retailers have customized apps of their own, many if not all retail sites offer chatbots to answer questions and virtually all have spent countless millions on their e-commerce websites.

Healthcare organizations, on the other hand, are far behind when judged by these standards. That’s particularly true in the case of medical practices, few of which offer much in the way of digital sophistication. In fact, in most cases the most patients can hope for is a basic portal offering data, scheduling and bill payment options. (Ok, at times, bigger offices may toss in a kiosk or two, but that’s not a huge service upgrade.)

According to one study, however, consumers are losing patience with this gap. New research by NTT DATA Services has concluded that 59% of US consumers expect their healthcare digital experience to be comparable to their retail digital experience. This is part of a larger trend in which patients are looking for seamless care bringing together diagnosis, treatment, rehab and health promotion, according to Alan Hughes of NTT in a prepared statement.

Some of consumers’ frustrations around mobile options include not being able to accomplish what they wanted to do (62%), feeling that the options offered are not relevant to them (42%) and that entering data into forms took too long to complete (40%). This is not exactly a good report card.

Meanwhile, patients have a long list of services they feel could be improved, including searching for a doctor or specialist (81%), accessing their family health records (80%), making or changing an appointment (79%), accessing test results (76%), paying their bills (75%) and filling a prescription (74%). In other words, consumers see most of the digital services provided by medical practices as subpar. Again, this is not encouraging news.

What’s more, within the general population of consumers, there is one subsection of patients who are particularly demanding, a group NTT has dubbed “explorers.” ITT research found that 78% of explorers say that the digital healthcare experience must improve. Perhaps even more importantly, 50% of these explorers would leave their current doctor if another offered a better digital experience.

If healthcare providers can barely meet the needs of the general population, they’re likely to lose these explorers pretty quickly if they don’t get their act together. Medical practices, in particular, need to step up their digital health game.

E-Patient Update: Clinicians Who Email Patients Have Stronger Patient Relationships

Posted on January 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.

I don’t know about you, but before I signed up with Kaiser Permanente – which relies heavily on doctor-to-patient messaging via a portal – it was almost unthinkable for a primary care clinician to share their email address with me. Maybe I was dealing with old-fashioned folks, but in every other respect, most of my PCPs have seemed modern enough.

Few physicians have been willing to talk with me on the phone, either, though nurses and clinical assistants typically passed along messages. Yes, I know that it’s almost impossible for doctors to chat with patients these days, but it doesn’t change that this set-up impedes communication somewhat. (I know – no solution is perfect.)

Given these experiences, I was quite interested to read about a new study looking at modes of communication between doctors and patients in the good old days before EHR implementation. The study, which appeared in the European Journal for Person Centered Healthcare, compared how PCPs used cellphones, email messages and texts, as well as how these communication styles affected patient satisfaction.

To conduct the study, researchers conducted a 16-question survey of 149 Mid-Atlantic primary care providers. The survey took place in the year before the practices rolled out EHRs offering the ability to send secure messages to patients.

In short, researchers found that PCPs who gave patients their email addresses were more likely to engage in ongoing email conversations. When providers did this, patients reported higher overall satisfaction than with providers who didn’t share their address. Cellphone use and text messaging didn’t have this effect.

According to the authors, the study suggests that when providers share their email addresses, it may point to a stronger relationship with the patient in question. OK, I get that. But I’d go further and say that when doctors give patients their email address it can create a stronger patient relationship than they had before.

Look, I’m aware that historically, physicians have been understandably reluctant to share contact information with patients. Many doctors are already being pushed to the edge by existing demands on their time. They had good reason to fear that they would be deluged with messages, spending time for which they wouldn’t be reimbursed and incurring potential medical malpractice liability in the process.

Over time, though, it’s become clear that PCPs haven’t gotten as many messages as they expected. Also, researchers have found that physician-patient email exchanges improve the quality of care they deliver. Not only that, in some cases email messaging between doctors and patients has helped chronically-ill patients manage their conditions more effectively.

Of course, no communication style is right for everyone, and obviously, that includes doctors. But it seems that in many cases, ongoing messaging between physicians and patients may well be worth the trouble.

Should Doctors Offer Concierge IT Security Services?

Posted on December 20, 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.

Today, just for fun, I’m gonna start with a thesis and work my way back to see if you agree with its foundations. My conclusion: With the cost of IT security services climbing, the cost of care coordination rising and practice income in many cases remaining relatively level, group practices will have to change their business model substantially.

Specifically, though this may sound insane, I’m suggesting that they may have to begin charging patients for beyond-the-call-of-duty security efforts.

Of course, as we all know, practices are required to offer at least a minimal level of security protection as specified in rules like those in HIPAA. Necessary though it is, it’s a pricey exercise for many groups.

Even so, cold economics may push them to cut data protection further. Given that care coordination will be necessary to meet population health goals, and that quality monitoring and management are indispensable, they may see security as the most dispensable of these spending options.

As the need for care coordination staff, quality management and other necessities of value-based care rise, paying for IT security services will become almost impossible to pay for without borrowing from another source.

That source can come from an internal budgetary resource, such as money allocated for routine general expenses, or other overhead, such as salaries for existing staff members, neither of which is desirable. Of course, there’s also the possibility of obtaining a line of credit, but that’s arguably even worse for the future of the company.

But since no medical organization can go entirely without IT security protection, it will have to find the funds to pay for it somehow. Given that any of the possibilities discussed above will drain the practice and possibly cut its finances to the bone, but something will have to give.

At this point, many practices decide to sell their group to a hospital or health system. That’s certainly a legitimate way of taking on unmanageable levels of overhead and getting access to far more infrastructure options and financial resources.

But if that’s not the direction you want to take, here’s off-ball idea for recapturing some IT security revenue: concierge security services.

While every patient’s data needs to be protected, obviously, you could offer concierge security patients access to extra layers of security attentiveness, such as a private IT staff or to answer any data privacy and security questions they might have about the practice, hospital where they are seen or other entity.

Toss in a special “security report” (in all candor, probably info they could’ve read in any trade magazine), personalized to patient needs, and a free zip drive with secured copies of their data and you’ll have them hooked.

If this worked, and I’m not suggesting that it necessarily would, it could help carry the cost of mundane IT security services. What do you think? Would this model have a chance?

Study Says Physicians Have Major Cybersecurity Problems

Posted on December 18, 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.

New research sponsored by the AMA and consulting firm Accenture has concluded that cyberattacks on medical practices are common – in fact, far more common than one might think.

Not only do these numbers suggest patient data is far more vulnerable than expected, it suggests that clinicians are often poorly educated about security and the implications of handling it badly. It’s fair to say that unless this trend is turned around, it could undermine industry efforts to build trusting relationships with patients and encourage them to engage in two-way data exchange.

The study found that most physicians (85%) think that sharing electronic protected health information is a good idea and that two-thirds believe that giving patients more access to their health data would improve care. One-third of respondents said that they share ePHI if they trust the vendors involved.

Thirty-seven percent get training content on security from their health IT vendor, and 50% said they trust these training providers are sure the content is adequate. However, this may be a mistake. While 87% of respondents said that their practice is HIPAA-compliant, the study also found that two-thirds of doctors still have basic questions about HIPAA. It’s clear, in other words, that trusted relationships aren’t doing the job here.

In fact, an eye-popping 83% of medical practices have experienced some form of cyberattack such as malware, phishing or viruses. Not surprisingly, 55% of physicians surveyed are very worried about future cyberattacks. Unfortunately, worrying is what many people do instead of taking action, and that may be what’s going on here.

What makes these lax attitudes all the more problematic is that when attacks occur, the effect can be very substantial. For example, 74% of respondents said that a cyberattack was likely to interrupt their clinical practice, and 29% of doctors working in medium-sized practices said that it could take up to a full day to recover from an attack, a crippling length of time for any small business.

So what are practices willing to do to avoid these problems? Among these respondents, 60% said they would pay someone to create a security framework to protect ePHI. Also, 49% of practices surveyed have in-house security staffers on board. However, it should be noted that three times more medium and large practices have such an officer in place compared to smaller medical groups, probably because security expertise is very pricey.

However, probably the most valuable thing they can do is the least expensive of the list. Every practice should require that physicians stay current at least on HIPAA and cybersecurity basics. If medical groups do this, at least they’ve established a baseline from which they can work on other security issues.

In What Seems Like An Effort To Make Nice, eClinicalWorks Joins OpenNotes Initiative

Posted on October 12, 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.

eClinicalWorks has decided to try something new. The health IT vendor has announced that it will support the OpenNotes project, an initiative in which doctors share their notes with patients.

As most readers will know, it recently came to light that eClinicalWorks had gotten itself into some very hot water with the feds. eCW was forced to pay a $155 million settlement when the U.S. Department of Justice concluded that it had faked compliance with EMR certification standards.

Now, perhaps in an effort to make nice, eCW is making it possible for its customers to share visit notes using its patient portal. Actually, to be precise, the patient portal already had the ability to offer visit summaries to patients, but OpenNotes capabilities enhance these summaries with additional information.

OpenNotes, for its part, got its start in 2010, when Beth Israel Deaconess Medical Center, Geisinger Health System and Seattle’s Harborview Medical Center decided to study the effects of letting patients read their medical notes via a portal.

The study, the results of which were published in the Annals of Internal Medicine in 2012, concluded that patients approved of note-sharing wholeheartedly, felt more in control of their care and had an easier time with medication adherence. Also, while some doctors reported changing documentation during this process, the study also found that doctors saw no significant changes in workload.

Perhaps most telling, at the end of the process 99% of patients wanted OpenNotes to continue, and none of the participating doctors opted out. A movement had been launched.

Since then, a long list of organizations has come on board to drive implementation of open notes, including Kaiser Permanente Northwest, Providence Health System, Salem Health and Oregon Health and Science University. This year, OpenNotes announced that 16 million Americans now had access to their medical notes online.

Back in 2012, I asked readers whether OpenNotes would eventually influence EMR design. Today, I would suggest that the answer is both “yes” and “no.”

On the one hand, I have little doubt that the project helped to advance the notion that patients should have on-demand access to their healthcare information, and moreover, to use it in managing their care. While some doubted this approach would work, OpenNotes can now be said to have sold the idea that health data transparency is a good idea. While the initiative had its doubters at its outset, today patient record access is far better accepted.

On the other hand, eClinicalWorks is the first EMR vendor I’m aware of to explicitly announce its support for OpenNotes. While it’s hard to tell what this means, my guess is that its competitors don’t see a need to take a position on the matter. While vendors are certainly being forced to take patient-facing data access into account, we clearly have a long way to go.

A Look At Share Everywhere, Epic’s Patient Data Sharing Tool

Posted on September 28, 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.

Lately, it looks like Epic has begun to try and demonstrate that it’s not selling a walled garden. Honestly, I doubt it will manage to convince me, but I’m trying to keep an open mind on the matter. I do have to admit that it’s made some steps forward.

One example of this trend is the launch of App Orchard, a program allowing medical practices and hospitals to build customized apps on its platform. App Orchard also supports independent mobile app developers that target providers and patients.

Marking a break from Epic’s past practices, the new program lets developers use a FHIR-based API to access and Epic development sandbox. (Previously, Epic wouldn’t give mobile app developers permission to connect to its EMR unless a customer requested permission on its behalf.) We’ll have to keep an eye on the contracts they require developers to sign to see if they’re really opening up Epic or not.

But enough about App Orchard. The latest news from Epic is its launch of Share Everywhere, a new tool which will give patients the ability to grant access to their health data to any provider with Internet access. The provider in question doesn’t even have to have an EHR in place. Share Everywhere will be distributed to Epic customers at no cost in the November update of its MyChart portal.

Share Everywhere builds on its Care Everywhere tool, which gives providers the ability to share data with other healthcare organizations. Epic, which launched Care Everywhere ten years ago, says 100% of its health system customers can exchange health data using the C-CDA format.

To use Share Everywhere, patients must log into MyChart and generate a one-time access code. Patients then give the code to any provider with whom they wish to share information, according to a report in Medscape. Once they receive the code, the clinician visits the Share Everywhere website, then uses the code once they verify it against the patient’s date of birth.

As usual, the biggest flaw in all this is that Epic’s still at the center of everything. While patients whose providers use Epic gain options, patients whose health information resides in a non-Epic system gain nothing.

Also, while it’s good that Epic is empowering patients, Direct record sharing seems to offer more. After all, patients using Direct don’t have to use a portal, need not have any particular vendor in the mix, and can attach a wide range of file formats to Direct messages, including PDFs, Word documents and C-CDA files. (This may be why CHIME has partnered with DirectTrust to launch its broad-based HIE.)

Participating does require a modest amount of work — patients have to get a Direct Address from one of its partners — and their provider has to be connected to the DirectTrust network. But given the size of its network, Direct record sharing compares favorably with Share Everywhere, without involving a specific vendor.

Despite my skepticism, I did find Share Everywhere’s patient consent mechanism interesting. Without a doubt, seeing to it that patients have consented to a specific use or transmission of their health data is a valuable service. Someday, blockchain may make this approach obsolete, but for now, it’s something.

Nonetheless, overall I see Share Everywhere as evolutionary, not revolutionary. If this is the best Epic can do when it comes to patient data exchange, I’m not too impressed.

What’s Involved In Getting To EHR 2.0?

Posted on September 22, 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.

While the current crop of EHRs have (arguably) served a useful purpose, I think we’d all agree that there’s a ton of room for improvement. The question is, what will it take to move EHRs forward?

Certainly, we face some significant obstacles to progress.

There are environmental factors in play, such as reimbursement issues.

There’s the question of what providers will do with existing EHR infrastructure, which has cost them tens or even hundreds of millions of dollars if next-gen EHRs call for a new technical approach.

Then, of course, there’s the challenge of making the darn things usable by real, human clinicians. So far, we simply haven’t gotten anything that solves that issue yet.

That doesn’t mean people aren’t considering the issue, however. One health IT leader that’s stepped up to the plate is Dr. John Halamka, chief information officer of the Beth Israel Deaconess Medical Center and CIO and dean for technology at Harvard Medical School.

In his Life As Healthcare CIO, Halamka lays out the changes he sees as driving the shift to EHR 2.0. Here are some of his main points:

  • Regulators are shifting their focus from prescribing certain types of EHR functionality to looking at results technology achieves. This supports the healthcare industry’s movement from a data recording focus to an outcomes focus.
  • With doctors being pulled in too many directions, it will take teams to maintain patient health, this calls for a new generation of communication and groupware tools. These tools should include workflow integration, rules-based escalation messages, and routing based on time of day, location, schedules, urgency, and licensure.
  • With value-based purchasing gradually becoming the norm, EHRs need new capabilities. These should include the ability to document care plans and variation from those plans, along with outcomes reported from patient-generated healthcare data. Eventually, this will mean the dawn of the Care Management Medical Record, which enrolls patients and protocols based on their condition then ensures that patients get recommended services.
  • EHRs must be more usable. To accomplish this, it’s helpful to think of EHRs as platforms upon which entrepreneurs can create add-on functionality, along the lines of apps that rest on top of mobile operating systems.
  • Next-gen EHRs need to become more consumer-driven, making patients an equal member of the care team. Although existing EHR models do have patient portals, they aren’t robust enough to connect patients fully with their care, and they don’t include tools helping patients navigate their care system.

As far as I can tell, Dr. Halamka has covered the majority of issues we need to address in transitioning to new EHR models. I was also interested to learn that regulatory bodies have begun to “get it” about the limitations of demanding certain functions be included in an EHR system.

I’m still left with one question, however. How does interoperability fit into this picture? Can we even get to the next generation of EHRs without answering the question of how they share data between one another? To me, it’s clear that the answer is no, we can’t leave this issue aside.

Other than that, though, I found Dr. Halamka’s analysis to be fairly comforting. Nothing he’s described is out of reach, unless, of course, vendors won’t cooperate. I think that as providers reach the conclusions he has, they’ll demand the kind of functionality he’s outlined, and vendors will have no choice but to pony up. In other words, there might actually be light at the end of the EHR tunnel.

Should EMR Vendors Care If Patients Get Their Records?

Posted on August 11, 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.

Not long ago, Epic CEO Judy Faulkner and former Vice President Joe Biden reportedly butted heads over whether patients need and can understand their full medical records. The alleged conversation took place at a private meeting for Cancer Moonshot, a program with which Biden has been associated since his son died of cancer.

According to a piece in Becker’s Health IT & CIO Review, Faulkner asked Biden why patients actually needed their full medical records. “Why do you want your medical records? They’re a thousand pages of which you understand 10,” she is said to have told Biden.

Epic responded to the widely-reported conversation with a statement arguing that Faulkner had been quoted out of context, and that the vendor supported patients’ rights to having their entire record. Given that Becker’s had the story third-hand (it drew on a Politico column which itself was based on the remarks of someone who had been present at the meeting) I have little difficulty believing that something was lost in translation.

Still, I am left wondering whether this piece had touched on something important nonetheless. It raises the question of whether EMR vendor CEOs have the attitude towards patient medical record access Faulkner is portrayed as having.

Yes, I suspect virtually every EMR vendor CEO agrees in principle that patients are entitled to access their complete records. Of course, the law recognizes this right as well. However, do they, personally, feel strongly about providing such access? Is making patient access to records easy a priority for them? My guess is “no” and “no.”

The truth is, EMR vendors — like every other business — deliver what their customers want. Their customers, providers, may talk a good game when it comes to patient record access, but only a few seem to have made improving access a central part of their culture. In my experience, at least, most do what medical records laws require and little else. It’s hard to imagine that vendors spend any energy trying to change customers’ records practices for the better.

Besides, both vendors and providers are used to thinking about medical record data as a proprietary asset. Even if they see the necessity of sharing this information, it probably rubs at least some the wrong way to ladle it out at minimal cost to patients.

Given all this background, it’s easy to understand why health IT editors jumped on the story. While she may have been misrepresented this time, it’s not hard to imagine the famously blunt Faulkner confronting Biden, especially if she thought he didn’t have a leg to stand on.

Even if she never spoke the words in question, or her comments were taken out of context, I have the feeling that at least some of her peers would’ve spoken them unashamedly, and if so, people need to call them out. If we’re going to achieve the ambitious goals we’ve set for value-based care, every player needs to be on board with empowering patients.