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What Does Health Informatics Mean to You?

Posted on March 23, 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.

A couple of weeks ago, I was involved in a great discussion about health informatics and what it actually entails. This wasn’t the first time I have been involved in this type of discussion as informatics has been a buzzword in healthcare for several years now. Since no two organizations are structured exactly the same, Informatics can mean different things to different people.

For me, I have seen informatics in practice as those roles involved in building and optimizing the electronic medical record (EMR) and clinical workflows. Informatics professionals ensure data is being collected appropriately so that it can be used for further healthcare decision making and operations. This was a daunting new task several years ago when Meaningful Use first came into play. I remember many articles and statistical reports stating there was a major shortage of IT professionals who were going to be needed to help organizations meet Meaningful Use criteria and perform the role of health informatics.

I do not see informaticists as being confined to any particular department of a healthcare organization but rather they are professionals that are skilled in applying technological and data science techniques to healthcare practices. I have seen many roles such as IT, HIM, and licensed clinical professionals take on informatics responsibilities to address the needs of the changing healthcare environment. Informatics needs the collaboration of these different skillsets to bridge the gap between the technology and healthcare consumer outcomes using data and research.

When we start to look at informatics as it relates to healthcare research methodologies, I believe this is where informatics starts to split off into a more refined usage of data. This goes beyond the EMR workflow optimization and into the realm of using the data to build registries, look at cause and effect relationships, and review patterns and trends in healthcare treatment and outcomes. Since most of us healthcare professionals are at different stages of EMR implementation and optimization, there are some early adopters testing the waters and beginning to understand the value of all of the healthcare data that has become readily available. I am excited to see what the future holds for health informatics and how these tasks will be aligned with the HIM professional’s skillset.

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

Healthcare Interoperability

Posted on February 18, 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.

UPDATE: In case you missed our discussion, you can watch the video recording below:

Healthcare Interoperability-blog

One of the hottest topics in all of healthcare is the concept of healthcare interoperability. I remember when Farzad Mostashari said that he would use every lever he had at his disposal to make healthcare interoperability happen. Karen DeSalvo and Andy Slavitt have carried on that tradition and really wants to make interoperability of health data a reality in healthcare. However, it’s certainly not without it’s challenges.

With this challenge in mind, on Monday, February 22, 2016 at Noon ET (9 AM PT), I’ll be sitting down with two of the biggest healthcare intoperability nerds I know (I say that with a ton of affection since I love nerds) to talk about the topic. Here’s a little more info on the healthcare interoperability panel we’ll be having:

You can join our live conversation with Mario and Richard and even add your own comments to the discussion or ask them questions. All you need to do to watch live is visit this blog post on Monday, February 22, 2016 at Noon ET (9 AM PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’ll be doing a more formal interview for the first 30 minutes and then open up the Blab to others who want to add to the conversation or ask us questions. The conversation will be recorded as well and available on this post after the interview.

In this discussion we’ll dive into the always popular FHIR standard and its potential to achieve “scalable interoperability” in health care. We’ll talk about FHIR’s weaknesses and challenges. Then, we’ll dive into health care interoperability testing and the recently announced AEGIS Touchstone Test platform and how it differs from other interoperability testing that’s being done today. We’ll talk about who’s paying for interoperability testing and where this is all headed in the future.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

EHR, What’s Next?

Posted on February 1, 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.

UPDATE: Here’s the YouTube video recording of my chat with Dana Sellers:

EHR Whats Next with Dana Sellers

With the announcement that meaningful use is going to be replaced (Not to be confused with meaningful use is dead like many claimed.) along with a maturing of the EHR market, I thought it might be time to ask the question, EHR, what’s next? This discussion should include how to better leverage your current EHR investment, but also look at what other investments organizations should be making to get the most out of everything that’s happening in healthcare IT. On Thursday, February 4, 2016 at 11:30 AM ET (8:30 AM PT), I’ll be sitting down with Dana Sellers, CEO of Encore, A Quintiles Company to talk over what’s next for EHR and healthcare IT.

You can join my live conversation with Dana Sellers and even add your own comments to the discussion or ask Dana questions. All you need to do to watch live is visit this blog post on Thursday, February 4, 2016 at 11:30 AM ET (8:30 AM PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’ll be doing a more formal interview for the first 30 minutes and then open up the Blab to others who want to add to the conversation or ask us questions. The conversation will be recorded as well and available on this post after the interview.

With an amazing depth of experience, Dana’s been through a wide variety of healthcare IT cycles. I can’t wait to hear Dana’s thoughts on what’s going to happen with meaningful use, how can healthcare organizations better leverage their EHR investment, where are we really seeing analytics and other buzzword worthy terms breaking through, and what other technologies are on the horizon that will improve healthcare? Please join us Thursday and share your experience as well.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.

HCA Builds Capacity For Resilience Into EMR Rollout Training

Posted on January 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.

A few weeks ago, Hospital Corporation of America had a rather substantial EMR outage. The outage, which was caused by a problem with storage hardware, lasted about 24 hours. It largely affected a portion of the 50 hospitals it operates in Florida, but some of the 115 HCA hospitals located outside Florida were impacted too.

Though large EMR outages are worth noting, my purpose in writing this blog is not to slam HCA. Actually, HCA staffers seem to have been prepared for the worst. In fact, according to an article from the Healthcare Financial Management Association, HCA built resiliency into its EMR rollout and operations process. And that is interesting indeed.

Hiring for talent and attitude

To roll out an EMR across its large network of hospitals, HCA leaders settled on an unusual strategy.  Rather than sign up a cadre of pure HIT specialists, HCA decided to hire professionals across a wide variety of disciplines.

As it turned out, all of the 120 EMR implementation specialists it hired were under age 30, with strong organizing, communication and collaborative skills. Their degrees included English, marketing and biomedical science.

Training for rollout

To train the newly-blessed specialists, HCA created hCare University. The new team members got four to six weeks of training, including both hands-on and classroom education, in vital skills such as working with clinicians and managing projects.

hCare University also taught the implementation specialists HCA’s EMR methodology, refining the approach — and how it taught that approach — over time. HCA trialed its methods at one pilot hospital, then two more, and eventually rolled it out to 20 to 40 hospitals at a time, HFMA reports.

Stressing inclusiveness and communication

As the rollout progressed, hCare teachers and system leaders continued to hammer home the importance of effective communication — and just as importantly, making sure that clinicians felt included.

“We probably spent as much, if not more, time on the people aspects as on the technology,” said consultant Mary Mirabelli, who oversaw the rollout, as well as HCA’s Stage 1 Meaningful Use efforts. “Because you’re expecting clinicians to exhibit new behaviors and embrace a system that is sometimes not well designed for their needs, you have to figure out ways to give them control and involve them in decision making.”

Now, I admit to being a bit biased, as I’m the kind of liberal arts jack-of-all-trades HCA relied on to supervise its rollout. And I want to emphasize that I’m not suggesting that traditional HIT hires are per-se inflexible!

That being said (having declared my prejudices), I would tend to believe that HCA is telling the truth when it asserts that staff confidently worked around the outage, despite its length and breadth.  I would assert that mixing in people whose primary skills are “soft” with HIT pros is an excellent way to support a resilient attitude when EMR problelms emerge.

Investing in people who can coordinate with all sides is actually good for HIT staffers. After all, doesn’t it benefit the HIT department when other folks are out there building good will, fostering cooperation and (in hopefully rare cases) minimizing damage to morale when snags or outages occur?

Maybe It’s Time To Phase Out The Meaningful Use Program

Posted on December 29, 2015 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.

Since Stage 1 of the Meaningful Use incentive program kicked off in 2011, the level of health IT adoption has risen dramatically across the United States. As publicly-funded programs go, it’s had quite a ride.

A few years in, nearly 97% of U.S. hospitals had achieved Stage 1 or higher of the HIMSS EMR Adoption model (as of Q1 2015). And a plurality (roughly 57%) were at Stage 5 or higher.

Meanwhile, 83% of office-based doctors are now using EMRs, according to a recent report from ONC.  The percentage drops to 74% when counting only physicians using certified EMRs, but that’s still a very substantial increase over the 57% of office-based docs using EMRs in 2011.

Whether this progress was worth the $28.1 billion paid out (as of December 2014) is anyone’s guess, but clearly, the program had a huge impact. In fact, it’s hard to argue that MU payments helped to trigger a major change in how medicine is practiced.

That being said, some critics are floating the idea that it’s time to retire Meaningful Use, or at minimum, pull back its implementation dramatically. For example, HIT superstar John Halamka contends that Meaningful Use programs “have served their purpose.”

In his blog, Halamka — who serves as CIO of both the Beth Israel Deaconess Medical Center — suggests that Stage 3 of MU is little more than a multi-train pile-up (the following quote is long but deserves to be read in full):

 Stage 3 makes many of the same mistakes as Stage 2, trying to do too much too soon. It requires patient accessible Application Programming Interfaces (APIs) without specifying any standards.   It requires sending discharge e-prescriptions although pharmacies cannot widely support the cancel transaction that is essential to discharge medication management workflow.   It requires public health transactions but CMS has no authority to require public health authorities to standardize the way they receive data.

Clinicians cannot get through a 12 minute visit, enter the necessary Stage 3 data elements, reconcile problems/allergies/medications from multiple institutions, meet the demands of the  Stage 3 clinical quality measures, make eye contact with patients, and deliver safe medical care.

Having read the above, you won’t be surprised to learn that elsewhere, Halamka argues that Stage 3 of Meaningful Use should be dropped completely. Instead, he’d like to see the government offer merit-based rewards for positive outcomes and innovative approaches.

While Halamka’s arguments make a lot of sense, another group of people want to address the fact that the Meaningful Use program incentives have never been available to most mental health providers. As readers may know, mental health facilities such as psychiatric hospitals and substance abuse treatment facilities currently aren’t eligible for Medicaid and Medicare MU incentives. Also, front-line mental health professionals such as psychologists and licensed social workers are not included in the current definition of “eligible professionals.”

A bill progressing through the U.S. House of Representatives, H.R. 2646 (“Helping Families in Mental Health Crisis Act of 2015”) proposes to add clinical psychologists to the list of eligible professionals, and psychiatric hospitals, community mental health centers, residential or outpatient mental health and substance abuse treatment facilities to the list of eligible providers. While I’m not suggesting that Meaningful Use as currently structured is the only way to address the mental health industry’s HIT needs, those needs shouldn’t be forgotten. In fact, John would argue that not being involved in meaningful use might be the best thing that happened to mental health EHR.

I’d agree that eliminating — or at minimum transforming — the existing Meaningful Use program may be a good idea. Better to try something new than drag providers through a wasteful, painful rout.

Rural Hospitals Catching Up In HIT Adoption

Posted on December 14, 2015 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.

Historically, rural hospitals have lagged when it comes to health IT adoption. But according to at least one yardstick, the HIMSS EMR Adoption Model (EMRAM), rural facilities seem to have closed much of the gap.

Just a few years ago, many rural hospitals were barely at stage one of the model, which ranks facilities from Stage 0 (All three ancillaries not installed) to Stage 7 (Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP). Only two years ago, research suggested that rural and critical access hospitals were lagging far behind in meeting Meaningful Use criteria, and risked incurring penalties this year.

By the end of 2014, however, rural hospitals averaged a Stage 4 rating (CPOE, Clinical Decision Support (clinical protocols). This compares favorably with the 4.7 rank achieved by urban hospitals, and though academic/teaching hospitals were well ahead at a 5.4 ranking, that’s a much smaller difference than you might have seen even five years ago. Meaningful Use incentives, plus overall industry pressure to automate, seem to have done their job.

I’m pondering this, in part, because the CPSI acquisition of Healthland piqued my interest. CPSI picked up Healthland, a provider of rural and critical access hospital software, for $250 million. Given rural hospitals’ history of slow HIT adoption, I wasn’t sure what CPSI saw in Healthland, though the deal does bring revenue cycle management and an EMR for post-acute care facilities to the table.

Now that I’ve learned what progress the rural health IT market has seen, I’m no longer so skeptical. In fact, when you consider that the Healthland acquisition brings 3,300 post-acute customers that it didn’t have before, it seems like CPSI got a pretty nice deal.

Given the growing strength of the rural HIT market, I don’t think the Healthland buyout will be the last domino to fall here. I can easily imagine the giants — Cerner in particular — seeing their way clear to acquiring the combined CPSI/Healthland entity. Why Cerner? Well, if for no other reasons than having a ton of cash — and a more flexible attitude than Epic — I can imagine Cerner getting excited about rural access.

But even putting aside M&A dynamics, the news from rural markets is still intriguing. While having sophisticated health IT infrastructure is a plus anywhere, my guess is that it will be particularly powerful for rural and critical access hospitals. I hope that the growth of HIT capabilities brings a breath of fresh air — and the benefits of cutting-edge care management — to facilities that have traditionally gotten the short end of the stick.

HIM Professional Sing-Along – Let’s Help Doctors Be Doctors Again

Posted on October 28, 2015 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.

Last week, someone shared with me this amazing video and I have been singing along all weekend. There is quite a bit of skepticism in the lyrics to “EHR State of Mind” but it’s a clever expression of a physician’s view of the shortcomings of using EMRs. I enjoyed the creativity of this song and the video and I hope that these EMR issues are addressed soon as the frustrations he shared are definitely unintentional.

I have highlighted some of my favorite lines from the song below and wanted to share my interpretation from an HIM viewpoint.

“Notes used to be our story…narrative…but replaced with copy-paste…now a bloated ransom note”

This statement really resonated with me and my experiences over the past several years. I have definitely seen the decline in the quality of documentation since the install of the EMR. It doesn’t matter what vendor product is used, the reality is that the documentation has severely suffered because we’ve shifted the physicians’ attention to other workflow processes and EMR checkboxes. Copy and paste has reared its ugly head in far too many charts and we must stop the madness! HIM professionals have stepped in to assist with this by providing real-time auditing and feedback. Plus, HIM has provided assistance by enhancing documentation tools.

“Just a glorified billing platform with some patient stuff tacked on.”

I have heard similar statements on many different occasions. Some EMRs were structured around automating billing processes but that doesn’t mean they have to lack in clinical functionality. From the HIM perspective, we are accustomed to reimbursement and clinical documentation going hand in hand. Coding and billing processes were in need of an overhaul to make for more timely reimbursement and EMRs promised to do just that. Having the clinical documentation and data built into the same system was revolutionary and very exciting for us but it’s still a work in progress to optimize the clinical documentation.

“Uncle Sam promoted it but gone is the interop.” 

Wow- this is sad but true. I remember when I first heard about EMRs, HITECH, and Meaningful Use. I had dreams of sharing data with anyone involved in a patient’s care regardless of geographic location through an EMR health information exchange. Unfortunately, this hasn’t even been possible within the same zip code and sometimes not even among providers in the same organization. True interoperability is definitely missing from our EMR systems.

And lastly, “Crappy software some vendor made us.”

Out-of-the-box EMRs are not a one size fits all by any means. EMRs must be customized, trained on, and implemented in a fashion that works for each provider and healthcare system. The implementation process is not complete at “go-live”. The optimization (and most likely, re-build) period must continue indefinitely until the EMR workflows and data capture are ideal for all patient care, quality reporting, and billing purposes.

Do we really need a “new chart” or is enough optimization possible to get us where we need to be? We are constantly having discussions, starting committees, releasing updates, running reports, and everything in between with hopes that our enhancements will make the EMR more functional and meaningful. I value the feedback from physicians and other clinicians who are using the system daily because their intentions are to deliver the best patient care. EMR obstacles are unacceptable and must be fixed with the help of skilled EMR specialists, HIM and IT professionals, and workflow experts.

Enjoy the video by Dr. Z.

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

HIM Professionals and the Patient Portal

Posted on October 21, 2015 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.

One of the hot topics in healthcare that has been consistently developing and growing over the past few years is the patient portal. Since many different EMRs and portal platforms are used across hospitals and physician offices, each facility is left to develop policies and procedures for what will be released through the portals and how they will be used. There are no specific standards for patient portals, aside from those needed to meet Meaningful Use requirements, which results in different experiences and functionality for end users.

HIM involvement with patient portal implementations has been a little spotty over the years from what I gather from my peers. I heard someone say we “missed the boat” on patient portals. I don’t necessarily agree but I do see inconsistencies in the level of HIM involvement. When it comes to developing policies governing the content that will be released through the portal, HIM professionals are the experts on this initiative. HIM professionals have always been the stewards of the medical record and keeping release of information processes secure and appropriate. There has been a focus on encouraging patients to keep a personal health record long before EMRs and patient portals came to exist. So how could some HIM professionals get left out of the patient portal process?

My first assumption is that patient portals came to exist mostly, although not solely, as a result of Meaningful Use initiatives. If you have had similar experiences to mine, you have witnessed Meaningful Use initiatives typically being handled by IT professionals. As a result, patient portals have fallen under that umbrella from a technology standpoint but I see great opportunities for HIM professionals to be involved to optimize the content shared for the end users. Since the main intent of patient portals is to encourage patients to be engaged in their own care, these portal initiatives have much more benefit beyond attesting to Meaningful Use and should be incorporated into organizational strategic plans for patient engagement.

There has been a lot of discussion around the struggle of increasing patient portal participation. A common factor in patient portal adoption is the lack of patient competencies in using the technology involved. Some patient populations do not frequently use computers, email, or mobile applications which are all a part of the patient portal functionality. To address this at my facility, we created a position within the HIM department to coordinate all patient portal functions including enhancing the user experience by creating frequently asked questions and answers, troubleshooting issues that patients may have when attempting to login, and resetting portal passwords as needed among many other initiatives. Policies were developed to address who can have access to the portal information, how the patients confirm their identity to log in, what is released, and the duration of the availability of the information. We have an interdisciplinary team that contributes to the patient portal process but having the point person reside in the HIM department makes the most sense for governing the entire concept.

One thing to remember is that patient portals do not eliminate the need for traditional release of information processes because we release information to many different requestors for different purposes. The portal does not include every patient document due to the sensitive nature of some results therefore requests for entire charts and abstracts are still necessary in some cases. Patients should participate in the portal for the personal benefit of being proactive in their own healthcare but they should not expect it to replace release of information. I encourage HIM professionals to be involved in the patient portal process in an administrative capacity. The strides made with patient portal optimization are key in optimizing the transition to health information exchange (HIE) concepts which also require heavy HIM involvement.

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

Thoughts on Leveraging EMRs Effectively

Posted on September 28, 2015 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.

Whenever I scan Twitter for #HIT ideas, I find something neat. For example, consider this intriguing tweet:

I say intriguing not because the formula outlined will surprise anyone, but rather, because it captures some very difficult problems in a concise and impactful manner.

Here’s some thoughts on the issues Portnoy raises:

* Optimization:  Of course, every healthcare IT organization works to optimize every technology it deploys. But doing so with EMRs is one of the most difficult problems it is likely to encounter. Not only do IT leaders need to optimize the EMR platform technically, they may also face external demands placed by ACOs, HIE partners and affiliated providers. And it’s also important to optimize for Meaningful Use functions.

* Workflows:  Building workflows that address the needs of various stakeholders is critical, as pre-designed vendor workflow options may be far from adequate. While implementing an EMR may be an opportunity for a hospital to redesign workflows, or to enshrine existing workflows in the EMR interface and logic, hospital leaders need to take charge of the workflow implementation process. Inefficiencies at this level can be costly and will erode the confidence of clinical teams.

* Revenue capture:  When properly implemented, EMRs can help providers generate more complete documentation for claims reimbursement, which leads to higher collections volume. As time has shown, difficult-to-use EMRs can lead to physician frustration, and in turn, cut-and-paste re-use of existing documentation — which is why carefully-designed workflow is so important. But if they are used appropriately, EMRs can boost revenue painlessly.

* Patient and provider engagement: True, IT needs to take the lead on getting the EMR in place, and must make some important deployment decisions on its own. Still, hospitals will have trouble meeting their goals if patients and providers aren’t invested in its success, and without patient interest in their data I’d argue that meeting long-term population health goals is unlikely. On the flip side, if clinicians and patients are engaged, the feedback they offer can help hospitals shape not only the future of their EMR, but also the rest of their clinical data infrastructure.

If there’s any common theme to all of this, I’d submit, it’s participation. Unlike most efforts corporate IT departments undertake, EMR rollouts are unlikely to work until everyone they touch gets on board. Hospitals can invest in any EMR technology they like, but if providers can’t use the system comfortably to document care, patients don’t log on to access their data, or revenue cycle managers don’t see how it can improve revenue capture, the project is unlikely to offer much ROI.

Another Giant In Play: 3M Looking At “Strategic Alternatives” For HIS Unit

Posted on September 14, 2015 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.

Given the staggering number of EMR launches that took place in the wake of the Meaningful Use kickoff, mergers, sell-offs and business failures were quite predictable. Despite the feds’ doling out $30B in incentive dollars, even that wasn’t enough to keep hundreds of EMR entrants afloat.

It hasn’t been as clear what would happen to large vendors with HIT interests, given that they had enough capital to ride more than one wave of provider adoption. The field has just begun to shake out, with only a small handful of major transactions taking place. Recent plays by large tech players include Cerner’s $1.3B acquisition of Siemens Health Services, which included the Soarian EMR. There’s also ADP’s sale of EMR solution AdvancedMD to Marlin Equity Partners after previously acquiring e-MDs. Not to mention Greenway and Vitera Healthcare Solutions joining forces and Pri-Med acquiring Amazing Charts.

Another major move was announced this April at HIMSS 15, when GE Healthcare announced that it was phasing out its Centricity Enterprise product. According to news reports, the Enterprise product only generated 5% of the Healthcare division’s EMR revenue. I could keep going, but you get the point.

Now, 3M has joined the fray, announcing this week that it was “exploring strategic alternatives” for its HIS business, including spinning off or selling the unit.  (It’s also considering keeping its HIS business on board and investing in its future.)  The company, which has signed Goldman, Sachs & Co. as strategic advisor and investment banker, says that it will probably announce what direction it will head in by the end of the first quarter of next year.

On the surface, 3M Health Information Systems looks like a very solid business. The HIS unit, which is focused on computer-assisted coding, clinical documentation improvement, performance monitoring, quality outcomes reporting and terminology management, reportedly works with more than 5,000 hospitals, plus government and commercial payers. According to 3M, the HIS business generated trailing 12-month revenues of about $730M, and has sustained 10%+ compounded annual growth for 10 years.

That being said, it’s hard to say what the fallout from the ICD-10 switchover will be, and it’s not unreasonable for 3M to consider whether it wants to compete in the post-switchover world. After all, while the HIS unit seems to be quite healthy, it’s certainly faces stiff competition from several directions, including EMRs with integrated billing and coding technology. Also, the company may be saddled with outdated legacy infrastructure, which makes it hard to keep up in this new era of revenue cycle management.

By the end of the first quarter of 2016, 3M will have had a chance to see how its customers are faring post-ICD-10, and how its customers needs are shifting. 3M will also find out whether other HIS players with (presumably) newer technology in place are interested in doing a rollup with its business.

Truthfully, if 3M doesn’t think it can benefit from investing in the HIS unit, I’m not sure who else would benefit from doing so. In fact, I’d argue that 3M is undermining its chances at a deal by waffling over whether it plans to invest or divest; as I see it, this implies that the HIS unit will be on life support without a major cash infusion, which is not something I’d find attractive as an investor.  If nothing else I’d want to buy the unit at a firesale price! But I guess we’ll have to wait until March 2016 to see what happens.