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Hospital Accused Of Firing Nurse For EMR Safety Complaints

Posted on June 29, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The former chief nursing officer of a California hospital is suing her former employer, alleging she was “forced out” of her position after questioning the safety of a little-known EMR donated by a major financial backer of the facility.

The suit filed by nurse Autumn AndRa also names Dan Smith, whose company donated the Harmoni software now used by Sebastopol, CA-based Sonoma West Medical Center. AndRa is claiming that Smith, who has contributed millions in donations and loans to the hospital, has used the hospital as a test bed for his company’s defective system. Smith is president of the medical center’s board of directors.

In an interview with a local newspaper, AndRa said that the Harmoni system has had major problems since the day it went live. Among other issues, the EMR was doing a poor job tracking and updating medications and was “intermingling” medical information between patients, her suit contends. According to AndRa, she went to hospital CEO Ray Hino a week before her dismissal and told him that the system was not safe. (Hino told the newspaper that Harmoni was fine and that no patients had been harmed by the system.)

E-Health Records International Inc., which makes the cloud-based system, primarily serves hospitals outside the U.S., including facilities in the Congo, Jamaica, India and the Philippines. Smith, whose first software development success came when he sold a construction management system to Intuit, serves as the company’s CEO, as well as chairman of telemedicine firm Offsite Care Resources.

Other than that, he seems to have little documented experience as an HIT developer. His other major business venture seems to have been operating a French restaurant with his wife, which he closed after being unable to get back $5.8 million he loaned the hospital.

Regardless of whether AndRa prevails in her suit, I think it’s safe to say that she came out on the wrong end of some questionable political maneuvering by hospital leaders, perhaps including Smith himself. When a hospital is forgiven a large loan, and then fires an executive who raises safety questions about the EMR developed by the lender, eyebrows should be raised.

Population Health Tech Will Lag Until Standards Emerge

Posted on June 22, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

There’s little doubt that healthcare organizations will continue to partner up with peers and acquire physician practices. The forces that drive healthcare network development are only intensifying as time goes by, particularly as the drive toward value-based payment moves ahead. But there’s a lot more to making such deals work than a handshake and a check. To make these deals work, it’s critical that networks become experts at population health management — and unfortunately, that’s going to be tough.

While merging health systems into ACOs or acquiring referring physicians has merit, this strategy won’t grow the steadily dropping pace of hospital admissions, notes William Faber, M.D., senior vice president of the GE Healthcare Camden Group. “Though clinically integrated networks do enlarge the patient base, one of their aims is also to reduce the percentage of admissions from that base,” making it unlikely that the networks will grow admissions, he points out.

To make a clinically integrated network successful, it certainly helps to take the initiative – to get to market more quickly than competitors – and to do a better job of controlling costs of care and demonstrating higher quality and service. Where things get stickier, however, is in managing that care across a large group. “The creation of a clinically integrated network must not be just a marketing or physician alignment strategy – it must truly enable effective population health management,” he writes.

And this, I’d argue, is where things get very tricky. Well, judge for yourself, but I’d argue that the HIT industry is ill-equipped to support these goals. Despite many years of paper-chart experimentation with population health, and several with population health technology, my sense is that the tech is far behind what it needs to be. Health IT vendors won’t get far until providers do a better job of defining what they need.

A different mindset

The truth is, this generation of EMRs is designed to track individual patients across an experience of care. While CIOs can add a layer of analytics technology to the mix, that is a far cry from creating tools that natively track population health trends. Looking at populations is simply a different mindset.

Admittedly, vendors will tell you that they’ve got the problem licked, but if they were completely candid many would have to admit that their products aren’t mature yet. Until someone creates an EMR or other basic tool which is designed, at its core, to track group health trends, I foresee more half-baked hacks than results.

What’s more, I doubt the health IT business will be able to help until it has at least an informal standard to which such products must adhere. Should such tools measure costs of care by diagnosis code? Compare such costs to national standards? Highlight patients in outpatient settings whose tests or exams suggest a crisis is about to happen? If so, which settings, and what cutoffs should be tracked for test scores? Does such a system need natural language processing to scour physician notes for trigger words, and if so which ones?

Without a doubt, medical and business executives leading integrated networks will come together and develop more answers to these questions. But until they do, health IT vendors won’t be able to help much with the population health challenge.

Methods of Data Exchange in Healthcare

Posted on June 20, 2016 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.

Jane Sarasohn-Kahn has a great chart on her Health Populi blog which shows how healthcare shares health data:
Healthcare Data Sharing Methods and Options

The chart is great even if the results are pretty awful. Plus, the data is a little dated. I wonder how those numbers have changed since early 2015.

Amazing that the top 3 forms of data exchange in healthcare were old analogue technologies: paper, information (phone), and fax.

This will come as no surprise to anyone in healthcare. I do find it interesting that the 4th most popular method is scanning the documents directly to the provider. That illustrates that most clinics would love to have an electronic option for sharing data, but there’s not an easier way. The options that are currently available are too hard. If they were easier, then I believe almost every practice would adopt them.

With all the benefits of direct exchanges, HIE, portals, Direct, FHIR, etc, it’s amazing that a simple document scan sent directly to a clinic is more popular. It makes me take a step back and wonder if we’ve over complicated the process of health data exchange.

Would the best option be to step back and make exchange much easier? Could we strip out all the extra features that are nice but impede participation from so many?

I can’t wait for the day that my health data is available wherever it’s needed. The first step to that reality might be taking a step back and simplifying the exchange of data.

The Cost of Encouraging Patient Engagement

Posted on June 15, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

We all know that healthcare providers want to encourage patient engagement to ensure patients have the information they need to manage conditions and share information with other providers. There has been a longstanding push for the adoption and maintenance of personal health records for many years to give patients the power to share and disseminate information wherever it is needed. We have seen a remarkable new interest in this with Meaningful Use and population health initiatives. Since HIM professionals are charged with maintaining and producing legal copies of records, we are aware that the tasks surrounding these processes can be very expensive. This is especially true if any of the tasks are not handled properly and breaches of protected information occur.

My concern is that lately I have heard many discussions that are pushing for more access yet with fewer costs to patients to encourage patient engagement. Some are even pushing for patients to have “free” access to records- paper or electronic. Don’t get me wrong, I am a huge proponent for patients having copies of their records and I personally keep copies of my own records. The Office of Civil Rights (OCR) recently published further guidance on charging for records. In a nutshell, the OCR says: “copying fees should be reasonable. They may include the cost of labor for creating and delivering electronic or paper copies; the cost of supplies, including paper and portable media such as CDs or USB drives; and the cost of postage when copies of records are mailed to patients at their request.” The OCR actually has the authority to audit the costs of producing records if they feel your organization is violating this patient right and overcharging for release of information.

Living in a state such as Florida where the state law has allowed facilities to charge up to $1 per page means most facilities have charged $1 per page without blinking an eye. The latest OCR guidance has led to questioning if that amount is actually “reasonable” or true to cost. Afterall, HIM professionals must use expensive systems, supplies, and labor costs to produce these records. Many organizations have outsourced release of information functions (another cost) but it is still the responsibility of the custodian of records to oversee the processes for compliance.

That being said, it is beneficial for HIM departments to evaluate the expenses and methods used to produce records as technologies and laws change. Dr. Karen Desalvo of the Office of the National Coordinator (ONC) strives to lead the EMR interoperability movement. At the top of the ONC’s list of commitments is consumer access to records. HIM professionals should continue to assist in the quest for interoperability and electronic data sharing at the notion of patient engagement. We must lead patients to use EMR patient portals and facilitate the efficient electronic data sharing among healthcare providers. We must be creative in lowering overhead costs to produce and maintain the records in order to ensure costs are affordable for healthcare consumers. There will always be costs associated with this important task, whether on the provider’s end or the patient’s end, just as costs are incurred with most services or products in every industry.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Creating Alliances with Large Health IT Vendors – Benefits and Challenges

Posted on June 13, 2016 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.

Healthcare Scene recently sat down with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) to talk about their alliance with Philips Healthcare and the impact it’s had on their healthcare organization.

Along with talking about the benefits and challenges of creating a long term contract with a healthcare IT vendor, we also dive into the details of how medical device standardization has impacted their organization. Not to be left out, we also talk about how this relationship has impacted patients and doctors. If your organization is looking at how to standardize your medical equipment, this interview will give you some insight into creating a long term alliance with your vendor.

In the second part of my interview with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) we discuss how they’re taking the lessons learned from the Philips alliance and applying them to their agreement with Cerner. We also talk about how cybersecurity is better having a vendor representative on site like they have with Philips.

E-Patient Update: If Hospitals Were Like Airports

Posted on June 6, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Almost everyone reading this blog has spent some time in an airport. And though not much of it is visible on the surface, airlines do an amazing job of managing people and things seamlessly while you sit reading the New York Times and drinking your latte. People are ushered on and off of flights, baggage is dispatched around the world and airplanes maintained and fueled at a miraculous pace. Although, you probably forget about that when it’s your flight that has delays or issues.

The hospitals many of us work for also do an amazing job of managing people and things, typically in a way that patients never need notice. While the carefully orchestrated dance of care plays out, patients simply eat their meals, sleep, visit with their friends and family and provide whatever bodily fluids are necessary to diagnose them. Meanwhile, multi-million dollar IT systems help see to it that the process works.

In some ways, however, the two industries are quite different in how they work with the people they serve. And in my opinion, the healthcare system would work better if it borrowed from the airlines when it comes to using IT to simplify the customer experience.

Status updates

One thing airlines do well is keep passengers informed about the status of their flight, or the flights of those for whom they might be waiting. Airlines began posting real-time schedules and allowing passengers to preregister for flights from early in the emergence of the commercial Internet.

In more recent times, the airlines have added a mobile dimension to their customer experience, offering small but valuable services like reminder texts and mobile-only information. While being able to check on your flight from your home desktop is great, it’s even better to know what’s up as you head for the airport, and mobile apps make this possible.

Traffic information

Unlike hospitals, airlines post scrolling information on key progress indicators — i.e. arrivals and departures. While you, as a consumer, typically only need to know the status of your own flight, having a comprehensive information source sometimes allows you to better understand delays, orient yourself to time and place and even make a mental note as to which destinations your chosen airline travels.

Such displays don’t disclose any personal information about passengers, but they still offer some value to individuals, if for no other reason than that having this information available helps to put airline staff and consumers on the same page.

Kiosks

These days, many airlines allow passengers to check in for their flights and print tickets without ever speaking to a human clerk. The process not only saves time, but also personal aggravation, as waiting in long airline ticketing queues can be quite tiring.

Checking in at a kiosk also offers passengers additional reassurance that they are indeed booked on the fight of their choice, allows them to confirm their seating choice and in some cases, even add additional flight options.

Transparency is key

I could go on, but I’m sure you get the idea. By exposing what might otherwise have been internal systems to consumers, airlines have substantially improved aspects of their customers’ experience. And they’ve done so without exposing individualized data or subjecting themselves to increased risk of hacking episodes. On the other hand, while health systems and hospitals have dabbled in these areas — for example, by posting ED waiting times on the web — it’s still something of a rarity for them to share live patient information.

Admittedly, hospitals may be leery of giving the patient too much visibility into the process they undergo. After all, their interaction with consumers is a good deal more complex than that of the airline industry, and they don’t have time to explain what they’re doing and why beyond a certain degree.

Still, as a patient who wants to know what the heck is going on with my care, a little transparency would go a long way. If you want patients to be prepared to care for themselves, treat them like adults and include them in what you’re doing.

Will Your EMR Go-Live Education Miss The Mark?

Posted on June 3, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

LinkedIn conversations can be quite the font of wisdom, and today was no exception. In comments on a post discussing how training can lead to buy-in, David Kelley, D.O. made it clear that such training often leaves participants cold:

[Have] been the recipient in a couple of Go Lives and been on a few Go Live support teams. The younger/tech-savvy people verbalize the pre-Go Live to have been not worth their time as it was targeted for below their knowledge base. In stark contrast, the more senior/less tech-savvy verbalize near-hatred of those pre-Go Live educational courses as they were so far above their heads as to equate to tech-gibberish.

By reposting these remarks, I’m by no means suggesting that go-live training is a waste of time. Nor am I suggesting that every time hospitals attempt to prepare staffers for EMR implementation, they bore the heck out of staffers while accomplishing nothing. But if Kelley’s experience is any guide, many such trainings are doing a lousy job of connecting with their audience.

His complaints also raise several questions for me, including the following:

  • Who was teaching the courses? Was it vendor reps? If so, it’s little wonder that they produced content only a developer could love.
  • What was the focus of the courses? From Kelley’s comments, it sounds like clinicians and staff typically got a general overview which didn’t do much to foster success.
  • Did the training offer hands-on instruction? And I don’t mean a quick look at basic functions, but rather specific guidance on how to perform key job functions.
  • Did instructors explain the advantages of the new systems? To get buy-in from clinicians and staff, instructors need to hammer home how the new technologies save time, improve efficiency and better patient care.

Regardless, what I gather from Kelley’s story is that too often, hospitals often talk at future EMR users rather than helping them get productive and oriented. It would appear that those responsible for go-lives often fail to consider how the implementation impacts specific functions, and talk around the issues rather than blending training with problem-solving.

I’ve actually seen the effects of what seems to have been a questionable go-live training strategy here in metro DC. Now, the hospital talked a good change management game — even loading screen savers onto all computers stating that “[vendor] is coming!” and posting signs letting patients know about the upcoming shift — for months prior to the system kickoff.

But what do you suppose happened when I spent a few days as an inpatient later that year? I saw nurses and doctors desperately trying to make the system behave by sharing workarounds with each other. Now, you tell me: Would clinical staffers be going to these lengths if they’d had thorough, pitch-perfect, hands-on training?

EHRs Can Help Find Patients At High Risk Of Dying

Posted on June 1, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Much of the discussion around EMRs and EHRs these days focuses on achieving broad, long-term goals such as improved population health. But here’s some data suggesting that these systems can serve a far more immediate purpose – finding inpatients at imminent risk of death.

A study appearing in The American Journal of Medicine details how researchers from Arizona-based Banner Health created an algorithm looking for key indicators suggesting that patients were in immediate danger of death. It was set up to send an alert when patients met at least two of four systemic inflammatory response syndrome criteria, plus at least one over 14 acute organ dysfunction parameters. The algorithm was applied in real time to 312,214 patients across 24 hospitals in the Banner system.

Researchers found that the alert was able to identify the majority of high-risk patients within 48 hours of their admission to a hospital, allowing clinical staff to deliver early and targeted medical interventions.

This is not the first study to suggest that clinical data analysis can have a significant impact on patients’ health status. Research from last year on clinical decision support tools appearing in Generating Evidence & Methods to Improve Patient Outcomes found that such tools can be beefed up to help providers prevent stroke in vulnerable patients.

In that study, researchers from Ohio State University created the Stroke Prevention in Healthcare Delivery Environments tool to pull together and display data relevant to cardiovascular health. The idea behind the tool was to help clinicians have more effective discussions with patients and help address risk factors such as smoking and weight.

They found that the tool, which was tested at two outpatient settings at Ohio State University’s Wexner Medical Center, garnered a “high” level of satisfaction from providers. Also, patient outcomes improved in some areas, such as diabetes status and body mass index.

Despite their potential, few tools are in place today to achieve such immediate benefits as identifying inpatients at high risk of death. Certainly, clinicians are deluged with alerts, such as the ever-present med interaction warnings, but alerts analyzing specific patients’ clinical picture aren’t common. However, they should be. While drug warnings might irritate physicians, I can’t see them ignoring an alert warning them that the patient might die.

And I can hardly imagine a better use of EMR data than leveraging it to predict adverse events among sick inpatients. After all, few hospitals would spend dozens or hundreds of millions of dollars to implement the system which creates a repository that simply mimics paper records.

In addition to preventing adverse events, real-time EMR data analytics will also support the movement to value-based care. If the system can predict which patients are likely to develop expensive complications, physicians can do a better job of preventing them. While clinicians, understandably, aren’t thrilled will being told how to deliver care, they are trained to respond to problems and solve them.

I’m hoping to read more about technologies that leverage EMR data to solve day-to-day care problems. This is a huge opportunity.

Epic Install Triggers Loss At MD Anderson

Posted on May 31, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Surprising pretty much no one, another healthcare organization has attributed adverse financial outcomes largely to its Epic installation. In this case, the complaining party is the University of Texas MD Anderson Cancer Center, which attributes its recent shortfall to both EMR costs and lower revenues. The news follows a long series of cost overruns, losses and budget crises by other healthcare providers implementing Epic of late.

According to Becker’s Hospital CFO, MD Anderson reported adjusted income of $122.9 million during that period a 56.6% drop over the seven-month period ending March 31. During that period, the cancer center’s wages and salaries climbed, and Epic-related consulting costs were climbed as well. This follows a $9.9 million operating loss for the first quarter of the 2016 fiscal year, which the University of Texas attributed to higher-than-expected EMR expenses.

MD Anderson announced its choice of Epic in spring 2013, and went live on the system in March of this year as anticipated. The cancer center’s rollout was guided by Epic veteran Chris Belmont, the center’s CIO, who implemented Epic across 10 hospitals and more than three dozen clinics for New Orleans-based Ochsner Health System.

The organization didn’t announce what it was spending on the Epic install, but we all know it doesn’t come cheap. However, one would think the University of Texas health system could afford the investment. According to EHR Intelligence, the Texas health system ranks in the 99th percentile for net patient revenue in the US, with total revenue topping $5.58 billion.

And UT leaders seem to have been prepared for the bump, reporting that they’d planned for a material impact to revenues and expenses as a result of the Epic implementation. The system didn’t announce any staff cuts, hiring freezes or other budget-trimming moves resulting from these financial issues.

Having said all this, however, no organization wants to see its income drop. So what actually happened?

For example, when the UT system reports that a drop in patient revenues contributed to the drop in income, what does that mean? Does this refer to scheduled drops in patient volume, planned for ahead of time, or problems billing for services? I’d be interested to know if the center managed to keep on top of revenue cycle management during the transition.

Another question I have is what caused the unanticipated expenses. Did they come from contract disputes with Epic? Unexpected technical problems? Markups on consulting services? Or did the organization have to pour money into the project to meet its go-live deadline? There’s a lot of ways to generate costs, and I’d love to get some granular information on what happened.

Also, I wonder what steps UT leaders will take to avoid unexpected expenses in the future. While it may have learned some lessons from the problems it’s had so far, there’s no guarantee that it won’t face of the costly problems going forward.

If, perchance, and the system has figured out how to stay in the black with its Epic investment, it could sell that secret to cover its IT expenses for years. I’m betting other systems would pay good money for that information!

Appointment Scheduling Site Zocdoc Connects With Epic

Posted on May 25, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In a bid to capture hospital and health system business, appointment scheduling site Zocdoc announced that its customers can now connect the site to their Epic EMRs via an API. The updated Zocdoc platform targets the partners’ joint customers, which include Yale New Haven Health, NYU Langone Medical Center, Inova Health System and Hartford HealthCare. And I’ll admit it – I’m intrigued.

Typically, I don’t write stories about vendors other than the top EMR players. And on the surface, the deal may not appear very interesting. But the truth is, this partnership may turn out to offer a new model for digital health relationships. If nothing else, it’s a shrewd move.

Historically, Zocdoc has focused on connecting medical practices to patients. Physicians list their appointment schedule and biographical data on the site, as well as their specialty. Patients, who join for free, can search the site for doctors, see when their chosen physician’s next available appointment is and reserve a time of their choosing. If patients provide insurance information, they are only shown doctors who take their insurance.

As a patient, I find this to be pretty nifty. Particularly if you manage chronic conditions, it’s great be able to set timely medical appointments without making a bunch of phone calls. There are some glitches (for example, it appears that doctors often don’t get the drug list I entered), but when I report problems, the site’s customer service team does an excellent job of patching things up. So all told, it’s a very useful and consumer-friendly site.

That being said, there are probably limits to how much money Zocdoc can make this way. My guess is that onboarding doctors is somewhat costly, and that the site can’t charge enough to generate a high profit margin. After all, medical practices are not known for their lavish marketing spending.

On the other hand, working with health systems and hospitals solves both the onboarding problem and the margin problem. If a health system or hospital goes with Zocdoc, they’re likely to bring a high volume of physicians to the table, and what’s more, they are likely to train those doctors on the platform. Also, hospitals and health systems have larger marketing budgets than medical practices, and if they see Zocdoc as offering a real competitive advantage, they’ll probably pay more than physicians.

Now, it appears that Zocdoc had already attracted some health systems and hospitals to the table prior to the Epic linkage. But if it wants to be a major player in the enterprise space, connecting the service to Epic matters. Health systems and hospitals are desperate to connect disparate systems, and they’re more likely to do deals with partners that work with their mission-critical EMR.

To be fair, this approach may not stick. While connecting an EMR to Zocdoc’s systems may help health systems and hospitals build patient loyalty, appointment records don’t add anything to the patient’s clinical picture. So we’re not talking about the invention of the light bulb here.

Still, I could see other ancillary service vendors, particularly web-based vendors, following in Zocdoc’s footsteps if they can. As health systems and hospitals work to provide value-based healthcare, they’ll be less and less tolerant of complexity, and an Epic connection may simplify things. All told, Zocdoc’s deal is driven by an idea whose time has come.