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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.

Does HIMSS Serve Practicing Doctors Well?

Posted on March 5, 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.

Take a look around you at HIMSS18 and you will see a lot of different types. Of course, the biggest and flashiest presence will be the hordes of vendor marketing and salespeople. You’ll also run into C-suite and mid-level executives with health systems in hospitals or managing partners of large medical practices, along with a grab bag of consultants, researchers, attorneys and bloggers like myself.

What you seldom see, however — and this has been true for decades — are physicians active in day-to-day medical practice. I’m sure the reasons for this vary, including a reluctance to spend the time and money to attend and questions about the show’s immediate value, but regardless, practicing doctors are sorely underrepresented at the annual HIT blast.

In the past, I might’ve suggested that the reason they aren’t showing up was lack of interest. After all, in the past, most physicians had very little contact with their IT infrastructure. Sure, they interacted with billing and coding systems, and to a lesser extent practice management platforms, but that was about it.

That’s hardly the case today, though. For most doctors, it’s smartphones in the morning, tablets in the afternoon and EMRs all day. What’s more, some practices are integrating connected health monitoring and wearables data to the mix and some are rolling out telemedicine services.  While few doctors have to dig into the guts of these tools, they’re increasingly dependent upon them and in some cases, and hardly function without daily access.

Given the extent to which these tools are ultimately designed to serve clinicians at the point of care, it’s disconcerting how seldom HIMSS attendees seem to put clinicians’ IT challenges front and center.

Perhaps I’m being unfair, but my sense is that most of the show is designed to serve health systems CIOs, practice leaders with complex IT needs and to a lesser extent, the influencers that guide sales decisions (such as analyst firms). I’m not saying small-practice doctors get ignored, but from what I’ve seen they don’t get catered to either. In fact, many companies focused on small practices have stopped exhibiting at HIMSS because of this and instead focus on the various medical society conferences.

Sadly, this reflects the larger dynamic in which vendors work to strike deals with senior executives first, putting physician needs largely aside. Rather than seeing to it that the actual end users find the products to be workable, they accept the reality that most cases, non-physicians are calling the shots.

For the benefit of the entire health IT community, I hope that in successive years, HIMSS does far more to attract the 10-doctor and below practices that make up the backbone of the medical community. Letting the deepest pockets in health IT systems dictate everything is simply toxic.

Do You Need An EMR To Make ACOs Work?

Posted on February 28, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Right now, as things stand, only a small percentage of medical practices have fully implemented EMRs (about 15 percent), research suggests.  But the trend toward integrating physicians in Accountable Care Organizations is moving much faster.

I don’t have stats to hand, but everything I’ve read and heard suggests that the provider community is a lot more comfortable with the ACO concept than EMR adoption.

The thing is, can ACOs advance without higher EMR adoption rates?  I don’t think so.  To my mind, if you want to integrate medical practices and hospitals — with the goal of managing quality jointly — a shared EMR seems virtually indispensable.

During the first wave of ACO adoption, we’re seeing tie-ups between mid-sized to large practices and large health systems.  Those large practices are reasonably likely to have EMR systems in place, and just as importantly, an IT department to support them.

But if ACOs models are to work, they’ll eventually have to embrace smaller practices, which make up the vast majority of U.S. medical groups overall. And if those groups are either EMR-less or just getting started, it’s going to be pretty tough to share value-based payments, coordinate across episodes of care and track quality jointly.

Yes, hospitals can give doctors access to their own, industrial-grade EMRs — and some do — but ultimately, EMR use will have to be part of the smaller practices’ culture for ACOs to work.

And while medical practices will understand ACOs, particularly if they’ve been through lots of fashionable hospital-practice partnership models, EMRs will still be tough to swallow.

So, ACO backers, do you think you can move ahead if your physician partners aren’t EMR-connected and savvy?  Or are we looking at a big problem here?

The Impact of Healthcare Reform on Medicine

Posted on December 1, 2010 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 must admit that I don’t post that often about healthcare reform and the changing doctors practice. Not to mention things like the Accountable Care Organizations (ACO) and other trends in healthcare. Although, I do watch them peripherally and in many cases these changes are important in relation to EMR since they impact what the future of EMR might look like.

So, I was pretty interested in a post by Barbara Duck about the impact of Healthcare Reform on medicine as we know it today. Barbara has a quote which describes the change:

“Healthcare reform will usher in a new era of medicine in which physicians will largely cease to operate as full-time, independent, private practitioners accepting third party payments.”

Then, she quotes a study which describes how medicine will change and the four possible courses that physicians will take amidst all this change.
• Work as employees of increasingly larger medical groups or hospital systems
• Establish cash-only practices that eliminate third party payers
• Reduce their clinical roles by working part-time
• Opt out of medicine altogether by accepting non-clinical positions or by retiring.

This information isn’t all that new. I also have read many people who just see this as the same cycle that we’ve seen before. I think that’s probably true, but it’s still a cycle that should be considered going forward.

Assuming the above assumptions are correct, does that spell the end of the small practice EMR software? Essentially it would leave only EMR software that supports larger medical groups or hospital systems and EMR software that handles cash only practices (something every EMR vendor would probably love to do).

Personally I don’t see it as the end of small practice EMR software. Although, it definitely will see a shrinking of the market for that software. At least temporarily.