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Is That EHR Poll Worth The PDF It’s Printed On?

Posted on September 3, 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.

The following is a guest post by Carl Bergman from EHR Selector.

One thing that’s certain in the EHR world, someone is either polling or blogging about the results. The problem is how do you know which poll to believe and which to trash? It’s not an easy question, if for no other reason than the remarkable volume of studies.

Five Questions

To figure this out, I ask myself five questions about EHR polls. The answers help me figure out which are the real deal and which to ignore. Here my five:

  1. What does it say? What is its take away? Not just the headline, but what do the findings reveal? A study may be rigorously done, but if the author makes an inductive leap over a cliff from results to meaning, the work is for naught.
  2. Who’d they ask? A valid poll’s sample should be a microcosm of the whole group. The idea is that if you contacted everyone in the group you’d get the same results you got from your poll.
    If the survey lets anyone answer, then it only represents those who answered. For example, let’s say in 2012 Fox News and MSNBC each ran an on line poll of Romney versus Obama. The polls let anyone vote. Would you be surprised that Romney won on Fox, but Obama won on MSNBC?
  3. What did they ask? If I can read the questions, I look to see if they are fairly worded. I’m leery if they’re a version of the classic leading question, “How long have you been beating your wife?”
  4. Is it free? I can understand paying for a study that’s cost a lot to produce. What I can’t understand is a study that touts its findings, but puts its methodology behind a pay wall.
  5. Who did it? If you have questions, you should be able to contact the chief investigator.

Two EHR Poll Examples

Here are two recent studies that make important statements about the EHR field. Let’s see how they fare:

1. Accenture Survey Reveals Most US Doctors Believe Patients Should Help Update Their Electronic Health Records, But Shouldn’t Have Access to Their Full Record. URL: http://goo.gl/2ymctw.
     a. The Claim. This poll makes a strong statement about how US doctors view patient’s role in their medical record. It says an overwhelming number of physicians, 82 percent, want their patients to update their EHRs, but only 31 percent believe that patients should be able to see their full record. If true, this has major policy implications.
     b. Who Was Asked? Accenture hired Harris Interactive to administer the poll. Harris asked 3,700 physicians in eight countries. This included 500 US doctors. The poll was done on line. Any physician could participate.
The poll’s biggest problem is that it is a self selecting sample. There is no attempt to show that it is representative of US doctors as a whole, much less ambulatory, in patient, etc.
     c. Questions? The questions asked aren’t listed.
     d. Free? There is no charge for the viewing the poll. The results are posted in two .pdf pages on Accenuture’s site.
     e. Investigator. No contact’s given for Harris Interactive. It lists three major Accenture officials.

2. Software Advice: Four Years Later: The Impact of the HITECH Act on EHR Implementations. URL: http://goo.gl/OcIeVO.
     a. The Claim. Software Advice is an online technology service for those shopping for vertical software products. Their survey has these major findings:
          i. Replacements. 31.2 percent of EHR shoppers were looking for a replacement. It was 21.0 percent in 2010.
          ii. New. 16.4 percent of shoppers in 2013 were opening a new practice versus 12.2 in 2010.
          iii. Paper. 50.9 percent were dropping paper systems compared to 64.9 percent in 2010.
     b. Who Was Asked? Software Advice (SA) polled 385 practices chosen at random from those who had contacted the firm. They were chosen from a group of likely buyers who had contacted the firm. SA is clear about who was in their full group and who they sampled. They say:
          i. Self-Selection Bias. Almost all of the individuals we qualified discovered our site through an Internet search and then consented to a 15-minute phone call discussing their EHR selection process. This may skew the results toward buyers who are more technologically savvy, as well as to those who are uncertain as to which product they are going to buy. Buyers who rely exclusively on referrals from colleagues to make their EHR purchase decisions, for example, were not likely to have been sampled. . . . [It also states:]Not included in this survey sample are the countless successful EHR implementations: buyers who purchased an EHR and absolutely love it; or practices for whom the savings in time and efficiency were well worth the costs of the software and the transition.
     c. Questions? The questions are not available.
     d. Free. Yes. The results are posted on its web site.
     e. Investigator? There are no contacts for the survey, however SA’S Larik Malish answered comments from readers.

Of these two examples, Accenture’s claims are based on a self selecting survey, which is unlikely to represent more than those who answered. I wouldn’t give its claims much weight.

SA’s study is representative within its defined limits. Within those limits, it’s worth taking into account.

Trying to make sense of EHR poll claims is not for the meek. There are polls and then there are polls. A few questions can help sort them out.

EHR Selection Services

Posted on June 12, 2012 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.

Those of you who’ve read my Free e-Book on EMR selection know that one of the things I suggest you do is to narrow down your list of EHR vendors to a small group of ~5 EHR vendors to start your EHR selection process. The book has the full rationale, but the challenge is that with 600 EHR companies out there you can’t review them all.

Of course the next question I’m asked is how you narrow down the companies to start your EHR selection review process. One thing that’s really developed over the 6 years I’ve been blogging is the EHR selection services. They’re still all far from perfect, but I suggest you take a look at a couple of them to start getting a list of EMR companies that you might want to consider. Then, take those lists and ask around to your colleagues. I call this approach triangulating the EHR data points to get you down to a smaller group of EHR companies.

One challenge is that there are a lot of EHR selection website out there. Here are just a few for you to consider. If you’re just looking for a really simple way to get access to price quotes and demos of EHR software, then go check out Software Advice or EHR Scope.

If you want a deeper, more custom EMR / EHR matching system then you’ll want to take a look at EMR Consultant, EHR Selector, and Hielix Apps. All 3 of these websites have made significant investments to try and help doctors match their needs with the EHR software.

I’ll admit that I’m probably a little bias towards EMR consultant since they’ve been around ever since I first started blogging about EMR. Plus, I love that it’s free. Although, a little birdie told me that EHR selector is considering a Free EHR selection option as well. There’s something I really love about the free EHR selection model. Basically, physicians that use it to help with their EHR selection have very little to lose.

Hielix on the other hand costs a few hundred dollars to use. They did send me a promo code for those that want $25 off their service. Just enter: “EMRANDEHR” Hielix is definitely taking a much more hands on approach to the EHR selection process so it makes some sense that they’d charge for the service. In one email exchange with them they talked about their CEO meeting with one of their customers to discuss their report. I’m sure many doctors will like this type of high touch service.

Always trying to get some good info for my readers, I got permission to publish a PDF file of a sample report that Hielix produces. I think the really good stuff in this report starts about page 7.

As I said previously, none of the EHR selection services are perfect. Although, I think using a couple of them isn’t a bad idea to start narrowing down the long list of EHR companies. I see it as an extra data point that can be used to narrow your list. Unfortunately, none of these services make it so you don’t have to do a thorough evaluation of multiple EHR vendor before you buy. I’d love it if someone figured out how to solve that problem. Until then, an EHR selection service isn’t a bad place to start.

Top 10 EMR Software per Medical Software Advice

Posted on January 24, 2012 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 always find it interesting to see various list of EMR and EHR software. Most of the lists don’t have much thought put into their creation. However, it’s fun to look through all the lists and see which EMR companies end up making it on the list. Plus, it’s good to know the next time you see them talking about being a top EMR software where that list might have come from.

This list of Top EMR Software companies comes from the people at Medical Software Advice. I’m not sure how they get this list, but it’s an interesting one. No doubt the list is a bit biased by the EHR vendors that actually work with Medical Software Device. Maybe this is the top 10 EMR software companies that can market. There are some of the major EHR companies on this list though, so take a look. Always good to triangulate multiple top EMR lists to narrow down your selection process.

For those in the industry, you’ll enjoy reading through the descriptions of each company.

HIPAA Violations Aren’t Happening in SaaS EHR

Posted on June 20, 2011 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.

Micheal Koploy over at Medical Software Advice put together an interesting post that looked at all the HHS breach data. He does a pretty in depth look at the various incidents of breach that occurred and even does a deep dive into the specific EMR related HIPAA breaches that are listed. He then forms an interesting conclusion:

HIPAA Violations Aren’t in the Cloud
Some have said that increasing the number of EMRs make our records more vulnerable. I’d cite the above data to argue otherwise. Paper records and portable devices are the weakest link in HIPAA security. The systems themselves – and certainly cloud-based systems – have a pretty good track record. HIPPA violations aren’t happening in the cloud. Rather, they’re happening in the doctor’s office, hospital IT closets, cars, subways, and homes.

And the statement that cloud-based EMR systems are more vulnerable to security breaches simply isn’t supported by facts. Of course, it remains to be seen if this holds true as more cloud-based systems are deployed. As more physicians move their records to the cloud, the opportunity for breaches will increase.

If my doctor asked me how to ensure patients’ data is secure, I would offer the following: go to the cloud. Web-based EMRs eliminate the most common security risks because there aren’t physical files to be compromised. And no matter your system, it’s essential to train your staff on the necessary security measures to ensure patient privacy is a systematic imperative

I think he makes a good point about it possibly being too early to really know how many cloud based SaaS EHR companies are going to have breaches. I also think it’s fair to consider that when those do happen, they’re going to be big breaches. They won’t just be a few records that are breached, but a whole bunch. Although, this is true for any electronic medical record HIPAA breach as compared with a paper chart HIPAA breach.

The other thing I can’t help but wonder is if there are more breaches with cloud EHR software, but we just don’t know that their happening. Although, that goes against the common thinking that EHR software does a much better job of tracking breaches than a paper chart. Your digital fingerprints are all over a digital chart and can be reported on quite easily. It’s a little harder to track the inappropriate fingerprints on a paper chart.

All in all, I’d have to agree with Michael and his assertion that we’re likely to see many fewer EHR breaches from a SaaS or cloud based EHR company than we will see from all the in house EHR software. In an in house system, the EHR company can just blame the clinic for the breach (in most cases). In a SaaS based EHR system, a HIPAA breach would have a much more damaging effect on the future sales of that EHR company. So, they’re more likely to put in the effort needed to avoid such breaches.