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650 Posts, 500,000 Pageviews and Interesting Search Terms

It’s an exciting time for Hospital EMR and EHR. We just passed 650 blog posts since we started this hospital IT focused blog back on May 19, 2011. Hard to believe that this blog is already 3 years old. 215 posts a year is a pretty amazing body of work. Plus, we’re approaching nearly half a million pageviews in that time and have 1,198 email subscribers for just this blog (not including the general Healthcare Scene email subscribers). A big thank you to everyone who reads us regularly.

I thought it would also be fun to take a look at the funny, interesting and insightful things that people are searching on Google (and other search engines) that lead them to the site:

epic certification – With 1,625 searches (and thousands of more searches for variations of this term), there is a lot of interesting in becoming Epic certified. Unfortunately, I think that means there are a lot of really unsatisfied people when they find out that there’s no easy way to get Epic certified. I hope this changes.

epic emr – Obviously we’ve written a lot of content about Epic. Although, overall interest in Epic is always high. So, it’s not surprising that many of our readers are interested in reading about Epic.

soarian & soarian emr – At least for this site, Soarian takes the second spot on searches. I think that’s attributed to some great articles that we’ve written on Soarian over the years.

meditech emr – I’m a little surprised that we still don’t have Cener on the list, but Epic, Soarian, and MEDITECH are attracting more searches to this site than Cerner. I guess that means we need to write more content about Cerner.

meditech vs epic – Looks like many people have been searching to see if they should move from MEDITECH to Epic. At least I assume this is the direction they’re considering. Has anyone heard of someone going from Epic to MEDITECH?

epic certification salary – You can understand the interest in these numbers. Although, I’m surprised that Google didn’t send them to this post on Healthcare IT Today about Epic Salaries and Bonuses. Although, that’s for people working at Epic. Maybe I should do a post on Epic certified consultants salaries.

hospital ehr vendors – This search is not surprising since our Hospital EHR vendor page is one of our most popular pages.

ipad security issues – A great topic of discussion that every hospital is dealing with. Apple has come a long way on this issue, but they could still do better. Although, I’m not convinced they’ll ever fully embrace enterprise IT.

closed loop medication administration – We haven’t dug into this topic as much, but we should. I’ll add it to my list of future topics.

An interesting look at what people are searching on Google (albeit biased by the content of this site). Thanks everyone for reading. I look forward to our next 650 blog posts.

August 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Has Epic Fostered Any Real Healthcare Innovation?

I saw the following tweet and was really struck by the question.

I think we could broaden the question even more and ask if any EHR vendor has really fostered healthcare innovation. I’m sorry to say that I can’t think of any real major innovation from any of the top hospital EHR companies. They all seem very incremental in their process and focused on replicating previous processes in the digital world.

Considering the balance sheets of these companies, that seems to have been a really smart business decision. However, I think it’s missing out on the real opportunity of what technology can do to help healthcare.

I’ve said before that I think that the current EHR crop was possibly the baseline that would be needed to really innovate healthcare. I hope that’s right. Although, I’m scared that these closed EHR systems are going to try and lock in the status quo as opposed to enabling the future healthcare innovation.

Of course, I’ll also round out this conversation with a mention of meaningful use. The past 3-5 years meaningful use has defined the development roadmap for EHR companies. Show me the last press release from an EHR company about some innovation they achieved. Unfortunately, I haven’t found any and that’s because all of the press releases have been about EHR certification and meaningful use. Meaningful use has sucked the innovation opportunity out of EHR software. We’ll see if that changes in a post-meaningful use era.

August 13, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Pay at Epic – Did You Know There’s an Epic Reddit?

HIStalk recently pointed to a reddit post about the Salary, Raise and bonus structure at Epic. It’s a fascinating look at what you get paid to work at Epic. I’ll be covering that topic in detail on our Healthcare IT Today career blog. However, did you know that there’s a subreddit on Epic?

In some ways, I think this says a lot about how far reddit has come, but it also says something about the size of Epic and the type of employee they attract. The younger reddit generation is their hiring strategy.

The subreddit is quite interesting. They talk about things like lunch at Epic (cheap and good), what it’s like to be a mom at Epic, and even topics like whether you can have a tattoo at Epic. Although, this one talking about the creepy customer announcements made me laugh:

The customer announcements over the loud speaker are so bizarre. It makes me feel like I’m in a1984-esque reality with an unsilenceable propaganda machine.
I doubt they intend it to be this way, but it is all I ever feel when it occurs.
Does anyone not find them creepy?

Looks like they even preach the Epic culture over the loud speaker. I do like that their celebrating each customer win since an Epic customer win is a really big deal. Although, the description makes me wish I could hear one of these announcements.

The Epic subreditt isn’t super active, but I’ll have to keep an eye on it to see any other interesting topics that are started. Maybe start a few of my own.

August 11, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Cerner’s Siemens Acquisition and the Impact on the DoD Bid

One topic I didn’t address in my post covering the $1.3 billion Siemen’s acquisition by Cerner is how this will impact the $11+ billion DoD bid. There’s a lot of discussion about what this acquisition will do. Let me pull out my crystal ball and give you my thoughts.

I personally think that this acquisition will have very little impact on which cluster of companies will win the DoD EHR contract. Some might say that Cerner gains some advantage by having some of the Siemens capabilities on board. Others could argue that Cerner will be distracted with the Siemens acquisition and so they wouldn’t be able to focus on such a large EHR contract. While both of things have some truth, I really don’t think they’ll factor into the DoD decision making.

It seems the consensus out there is people expect Epic to win the DoD contract. If that happens, the Siemens acquisition could become even more interesting for Cerner. It’s a very likely reality that whoever gets the DoD contract will lose some potential clients due to concerns about capacity. If Epic or Cerner get the DoD contract, then it’s possible that these capacity concerns will move them down a notch in people’s EHR selection process. This is a situation where Cerner will benefit from having connections to all of these Soarian customers. As I posted previously, it might be best for Epic not to win the DoD contract.

Are there other ways that Cerner’s acquisition of Siemens impacts the DoD EHR bid?

August 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

EHR Consolidation Continues as Cerner Acquires Siemens Soarian

The big news that had been rumored for a while was that Cerner was going to acquire the Siemens Health Services product line including Soarian. The rumor became reality as the acquisition was announced today. You can see the investor slide deck they published here. Most notably, Cerner has committed to supporting the Siemens Soarian product line for a decade:

Following the acquisition, support for Siemens Health Services core platforms will remain in place. Current implementations will continue, and Cerner plans to support and advance the Soarian platform for at least the next decade.

Of course, it’s one thing to suggest this in a press release. It’s another thing to actually do it in practice. However, it was smart of them to announce this approach to allay the fears of Soarian customers. If enough Soarian customers move over to Cerner, then you can be sure the announcement to sunset Soarian will happen. That’s a feature of EHR acquisition and consolidation. It’s just too expensive, especially in this regulatory environment, to maintain two code bases which perform the same functions.

These stats about the combined organizations are quite interesting:

  • 20,000 associates in more than 30 countries
  • 18,000 client facilities, including some of the largest health care organizations in their respective countries
  • $4.5 billion of annual revenue
  • $650 million of annual R&D investment

The last one is interesting given yesterday’s post on R&D companies. However, I think one of the key numbers there is the associates in 30 countries. Siemens Health Services has approximately 5,000 client facilities in over 40 countries including a strong presence in Germany, Sweden, Austria, Spain, Norway, and the Netherlands. You can be sure that a large part of this acquisition by Cerner is being able to go after the global market. There’s a huge opportunity in many countries that haven’t had billions of dollars falsely stimulating the market.

What I found particularly interesting on the investor call about the deal was Siemens efforts to take care of their existing customers. I’d describe it as finding a soft landing for their customers. You can understand why this is important. Many of those Soarian customers are still Siemens customers in other parts of the business like radiology. Siemens no doubt didn’t want to kill their other business by selling Siemens Health Services.

We’ll see what comes of the Siemens and Cerner $100 million innovation budget. If you look at the wording it says stuff like up to $100 million budget. Plus, these two companies are going to have to work together on some projects regardless. Cerner needs the data Siemens has and Siemens will need to get the data into Cerner. Will anything beyond that really occur, I’m not as optimistic.

I did find Neil Patterson’s comments on the post-Meaningful Use era interesting. I’d love to explore more of what he sees in that future. One person described it as a move from documenting the care given to a patient to technology that drives the care given a patient.

I’m not sure hospital execs should be that excited about this acquisition. It takes out another competitor from keeping EHR vendors honest. This really is getting down to a two horse race between Cerner and Epic and I think this acquisition will put Cerner just ahead of Epic in market share.

I liked this tweet from Hospital CIO Will Weider about the acquisition:

August 5, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

R&D Budget or Your Company Is R&D

Today I realized a good way to describe the difference between a large company and a startup company. I was reading an interview with a very large healthcare IT company and whenever he was asked about the innovations they’re working on in healthcare IT he referred to their R&D budget or their R&D efforts. As more of a startup person myself, I found the mentality interesting to compare against a startup company. At a startup company, your entire company is focused on innovating.

I find the approach so uniquely different and explains why many hospital organizations don’t want to work with startup companies. These hospital organizations are afraid that the startup company won’t deliver the results they expect. I get it. It’s much easier to “choose IBM” versus go with a newer startup company when working on a project. I think we regularly underestimate the value of a great brand.

I’ve seen the same. While my blog network has deep reach into the healthcare IT community, I’ve seen companies fawn all over Forbes bloggers (not to be confused with Forbes journalists) mostly because they saw the Forbes brand. The power of a great brand is tremendous. In fact, the power of a known brand (even if it’s not a great brand) is extremely powerful.

What I find most ironic though is that most hospitals love being part of the “innovation” programs these large companies put together. You’ve all seen the press releases that are put out between large company A and hospital B. Why are hospitals so interested in being part of large health IT companies R&D efforts and yet they’re scared of health IT startups?

I’m sure some would make the case that the large health IT companies will be around for a while and the health IT startup companies might not be. This is true, but what’s to keep a large health IT company from cutting their R&D budget and killing your innovation program? Nothing. Isn’t that the same thing as a health IT startup company closing up shop? In fact, I’d argue that the later might be better for you. If the health IT startup company was on to something and just ran out of funding, you could buy the whole startup company and continue your efforts. Try doing that with a shutdown innovation program at a large company.

I think healthcare would really benefit from being more open to startup innovations. I realize that the politics of a hospital system make it tough. However, with some smart planning and thought, we could find ways to make working with health IT startups easier. Our hospitals and healthcare in general would really benefit from doing so.

August 4, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Study Says Overcharging by the Hospital Might Be Overstated

Despite concerns first raised a few years ago, hospitals do not seem to be abusing their electronic data systems to generate bigger bills and boost their income — at least according to authors of a large study released Tuesday. Other leaders in the field say the jury’s still out.

The concern over possible misuse of records grabbed headlines in 2012 after an investigation by the Center for Public Integrity and the New York Times found that some hospitals using electronic records were billing Medicare for significantly more than hospitals that still used paper records.

After the stories appeared, the Departments of Justice and Health and Human Services sent hospitals a strongly worded letter warning them against misusing the ease of electronic forms to pad their bills.

Source

What an interesting study. I especially like the part of the article where they suggest that hospitals aren’t charging more for their services because of EHR because the hospitals had already been maximizing their revenue for a long time before EHR. It’s a fine point that’s worthy of consideration. I don’t think it’s as true in some ambulatory practices, but in the hospital world they’d made a lot of efforts to maximize their revenue even without EHR.

One angle the article above doesn’t cover is that many people were suggesting that this EHR over billing of services was fraud on the part of these organizations. I’ve always thought that was ridiculous. Sure, fraud exists and is facilitated by technology in many cases. However, what the majority of hospitals are doing to maximize revenue isn’t anywhere close to fraud. The problem is that Medicare and other payers have been able to avoid paying for services that were rendered, but never billed. If EHR has increased claims (and this study suggests it hasn’t), then I’d submit it was because hospitals are finally charging for all of the services their rendering.

What do you think? Does EHR increase the cost of healthcare by charging for all of the services provided? Does EHR facilitate fraudulent claims?

August 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Security Issues of Paper Medical Records and Faxes

I loved this tweet. It’s a great reminder that far too often when we look at EHR Implementations we compare it against a world that is 100% and 100% efficient. This is an unfair comparison. Instead of comparing EHR against the perfect world, we need to compare EHR to the alternative. In most cases, we should be comparing the EHR world to the paper chart world. Doing so makes all the difference.

I’ve written previously about this concept when I wrote, It’s Not Like Paper Charts Were Fast. In that instance I was comparing the speed of EHR documentation with paper chart documentation. They’re much closer than we like to remember. In fact, in many cases EHR documentation is much faster than paper charts. Although, critics of EHR prefer to compare the speed of EHR to an automatic documentation world. Unfortunately, the automatic documentation world is still a fantasy. Hopefully that dream eventually comes true.

As the tweet above mentions, the same could be applied to security. No doubt there are security challenges in an EHR world. However, there were and are security challenges with paper charts and faxes as well. For example, there was no good way to audit who accessed a paper chart. That’s not an issue in an EHR world. I could go on and on, but you get the idea.

When evaluating EHR, let’s always remember to compare it to the alternative and not the perfect world that really doesn’t exist.

July 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Reporting EHR Medical Errors

Tom Hubbard brings up some interesting points about EHR medical errors. He suggests that nobody routinely reports EHR medical errors. I would ask if anyone reports EHR medical errors. Where would they report the EHR medical errors? There’s no real governing body for EHR medical errors. Sure, we could make up some places.

A number of years ago I remember some organization stood itself up to be a place where doctors could report errors they found in an EHR software. Of course, this brings up an interesting question. When is the error a user error and when is the error an EHR system error? That gets pretty complex and I’m sure some expert witnesses are going to make a killing testifying for and against the EHR companies. Unfortunately (or fortunately depending on how you look at it), I’m not interested in that kind of work. I prefer building and supporting cool things as opposed to tearing things down.

What do you think of EHR medical errors? Who should have oversight of these problems? Where and how should something be reported? Is this much ado about nothing? Or should we be making a bigger deal out of this since it’s currently just being swept under the rug and ignored?

July 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Point of Care Systems vs EMR

Bob Brown sent out this interesting tweet about point of care systems that create EMRs.

Obviously, there are a lot of different ways to put together an EMR system. One is to create the system and then push it out to the point of care. Another is to create the systems at the point of care that then push back to the EMR system.

I agree with Bob that EMR systems were created first and we’re now trying to push them to the point of care. Sadly, most of them have done a pretty poor job of pushing the documentation to the point of care. Although, we have made some significant progress on this and will make more in the future.

With that said, I personally don’t think the real problem with useful and usable EMR is how they were created. The real problem with them is that we created big billing engines and now we’ve created big government meaningful use reporting engines. If we’d created an EMR focused on improving efficiencies and providing better quality care, we’d have a very different result. We might even have something that doctors would call useful and usable.

July 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.