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Thoughts On Hospital Telecommunications Infrastructure

Posted on August 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.

Given the prevalence of broadband telecom networks in place today, hospital IT leaders may feel secure – that their networks can handle whatever demands are thrown at them. But given the progress of new health IT initiatives and data use, they still might face bandwidth problems. And as healthcare technical architect Lanny Hart notes in a piece for SearchHealthIT, the networks need to accommodate new security demands as well.

These days, he notes healthcare networks must carry not only more-established data and voice data, but also growing volumes of EMR traffic. Not only that, hospital IT execs need to plan for connected device traffic and patient/visitor access to Wi-Fi, along with protecting the network from increasingly sophisticated data thieves hungry for health data.

So what’s a healthcare CIO to do when thinking about building out hospital telecommunications infrastructure?  Here’s some of Hart’s suggestions:

  • When building your network, keep cybersecurity at the top of your priorities, whether you handle it at the network layer or on applications layered over the network.
  • Use an efficient network topology. At most, create a hub-and-spoke design rather than a daisy chain of linked sub-networks and switches.
  • Avoid establishing a single point of failure for networks. Use two separate runs of fiber or cable from the network’s edge switches to ensure redundancy and increase uptime.
  • Use virtual local area networks for PACS and for separate hospital departments.
  • Segment access to your virtual networks – including your guest Wi-Fi service – allowing only authorized users to access individual networks.
  • Build as much wireless network connectivity into new hospital construction, and blend wireless and wired networks when you upgrade networks in older buildings.
  • When planning network infrastructure, bear in mind that hospital networks can’t be completely wireless yet, because big hardware devices like CT scans and MRIs can’t run off of wireless connections.
  • Bigger hospitals that use real-time location services should factor that traffic in when planning network capacity.

In addition to all of these considerations, I’d argue that hospital network planners need to keep a close eye on changes in network usage that affect where demand is going. For example, consider the ongoing shift from desktop computers to mobile devices use of cellular networks have on network bandwidth requirements.

If physicians and other clinical staffers are using cell connections to roam, they’re probably transferring large files and perhaps using video as well. (Of course, their video use is likely to increase as telemedicine rollouts move ahead.)

If you’re paying for those connections, why not evaluate whether there’s ways you could save by extending Internet connectivity? After all, closing gaps in your wireless network could both improve your clinicians’ mobile experience and help you understand how they work. It never hurts to know where the data is headed!

More Ideas On Tightening Hospital IT Security

Posted on August 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.

Security deserves all of the attention you can spare, and it never hurts to revisit the fundamentals, in part because the cost of lagging security measures is so high. After all, it’s more than likely that your organization will face a breach, as almost 90% of healthcare organizations experienced at least one breach within the past two years, according to a Poneman Institute study done earlier this year.

Here’s some options to consider when tightening up your security operations, courtesy of Healthcare IT Leaders, whose suggestions include the following:

Hire white hat hackers: Mayo Clinic reportedly tried this a few years ago, and learned a great deal. While its security measures seem to have gotten something of a beatdown, the Clinic also found a bunch of security holes and got recommendations on how to close those holes.

Lock down employee mobile devices: As mobile technology increasingly becomes a key part of your infrastructure, it’s important to keep it secured – but that can be tough when employees own the phone. One question to ask is whether your IT could lock or wipe data from employee phones and tablets if need be. What are your legal options for securing critical data on employee-owned devices?

Review medical device security:  Networked medical devices – from respirators and infusion pumps to MRI scanners – increasingly pose security threats, as any device that receives and transmits data can be a target for attackers.  It’s critical to audit these devices, while setting careful security standards for device makers.

Train staff on security issues:  Often, breaches are due to human error, so it’s critical to educate non-IT employees on the basics of security hygiene. Offering basic security training should cover not only cover ways to avoid security breakdowns – such as avoiding generic or default passwords and phishing e-mails — but also explanations of how such breaches affect patients.

Encourage risk reporting:  According to Poneman, almost half of healthcare organizations discovered a breach through an employee within the past two years. What’s more, nearly one-third of data breaches came to light due to patient complaints. It’s smart to encourage these reports, as IT staff can’t have eyes everywhere.

Disable laptop cameras and microphones:  Laptops generally come with a webcam and microphone, but at least in an enterprise setting, it may be better to disable these functions. Why? For one thing, attackers may be able to listen to private conversations through the microphone.

As I see it, the bottom line on all of these activities is to infuse security thinking into as many IT interactions as possible.  It may be trite to talk about a culture of security (it’s easier said than done, and too many organizations make empty promises) but such a culture can actually make a big impact on your security status.

To have the biggest impact, though, that culture has to extend all the way to the C-suite, and unfortunately, that rarely seems to happen. When I read research on how often healthcare organizations underspend on security, it seems pretty clear that many senior execs don’t take this issue as seriously as that should. And if the staggering level of health data breaches happening lately isn’t enough to scare them straight, I don’t know what will.

Decommissioning Legacy EHR systems with Data Archival – Tackling EHR & EMR Transition Series

Posted on August 25, 2016 I Written By

EMR Data Archival

In their latest infographic (Check out the full infographic), Galen Healthcare Solutions provides critical information and statistics surrounding EMR data archival including:

  • Healthcare Data Growth
  • Healthcare Data Archival Drivers
    • Mergers & Acquisitions
    • Legacy System Retention Requirements
  • Healthcare Data Archival Benefits
  • Average Patient Digital Footprint
  • Industry Leading Archival Solution

Healthcare Information Technology leaders face challenges in keeping pace with new initiatives and consequently, managing a growing collection of legacy systems. With drivers including mergers & acquisitions, vendor consolidation, application dissatisfaction and product sunsets, it’s estimated that 50% of health systems are projected to be on second-generation technology by 2020, according to the IDC. As these new systems are implemented, multiple legacy systems are left behind, requiring healthcare IT staff to provide support and maintain access.

The strategy of keeping a patchwork of legacy systems running in order to maintain access to data is risky, resource intensive and can be quite costly given licensing, support, and maintenance needs. Decommissioning legacy systems with a proven archival system reduces cost and labor, minimizes risk, ensures compliance, simplifies access and consolidates data.

  • Reduce Costs: Streamlining the long-term storage of historical PHI now will save money in the long-run. Not only will it reduce costs paid for the support and technical maintenance of the legacy system, but it will also save on training new staff on the new system over the next 7-25 years. In addition, incorporating data archival efforts with a discrete data migration provides significant economies of scale.
  • Minimize Risk: Preserving historical patient data is the responsibility of every provider. As servers and operating systems age, they become more prone to data corruption or loss. The archiving of patient data to a simplified and more stable storage solution ensures long-term access to the right information when it’s needed for an audit or legal inquiry. Incorporating a data archive avoids the costly and cumbersome task of a full data conversion.
  • Ensure Compliance: Providers are required to retain data for nearly a decade or more past the date of service. In addition, the costs of producing record for e-Discovery range from $5K to $30K/ GB (Source: Minnesota Journal of Law, Science & Technology). Check with your legal counsel, HIM Director, medical society or AHIMA on medical record retention requirements that affect the facility type or practice specialty in your state.
  • Simplify Access: We all want data at the touch of a button. Gone are the days of storing historical patient printouts in a binder or inactive medical charts in a basement or storage unit. By scanning and archiving medical documents, data, and images, the information becomes immediately accessible to those who need it.
  • Consolidate Data: Decades worth of data from disparate legacy software applications is archived for immediate access via any browser-based workstation or device. Also, medical document scanning and archiving provides access to patient paper charts.

Because the decision to decommission can impact many people and departments, organizations require a well-documented plan and associated technology to ensure data integrity.

Download the full archival whitepaper to understand the drivers that impact archival scope specific to both the industry and your organization.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

HHS OIG Says Unplanned Hospital EMR Outages Are Fairly Common

Posted on August 24, 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.

More than half of U.S. hospitals responding to a new survey reported having unplanned EMR outages, according to a new report issued by the HHS Office of the Inspector General, due to a variety of common but difficult-to-predict technical problems. Some of these outages have merely been inconveniences, but some resulted in patient care problems, the OIG report said.

The agency said that it conducted this study as a follow up to its prior research, which found that both natural disasters and cyberattacks were having a major impact on EMR availability. For example, it noted, hospitals faced substantial health IT availability challenges in the wake of Superstorm Sandy, include damage to HIT systems and problems with access to patient records.

According to the survey, 59% of the hospitals reported having unplanned EMR outages. One-quarter said that the outages created delays in patient care and 15% said that the outage lead to rerouted patient care. Only 1 percent of outages were caused by hacking or breaches.

The most common causes, in order, were topped by hardware malfunctions, followed by Internet connectivity problems, power failures and natural disasters. (For more detail on the root causes of outages, see this great post by my colleague John Lynn.)

It’s worth noting that these hospitals were selected for having their act together to some degree. To conduct the study, researchers spoke with 400 hospitals which were getting Meaningful Use incentive payments for using a certified EMR system in place as of September 2014.

Nearly all of these hospitals reported having a HIPAA-required EMR contingency plan in place. Also, two thirds of the hospitals addressed the four HIPAA requirements reviewed by OIG researchers. Eighty-three percent of surveyed hospitals reported having a data backup plan, 95% had an emergency mode operations mode plan, 95% said they had a disaster recovery plan and 73% said they had testing and revision procedures in place.

Not only that, most of the hospitals contacted by the study were implementing many ONC and NIST-recommended practices for creating EMR contingency plans. Nearly all had implemented practices such as using paper records for backup and putting alternative power sources like generators in place.

Also, most hospitals said that they reviewed their EMR contingency plans regularly to stay current with system or organizational changes, and 88% said they’d reviewed such plans within the previous two years. Most responding hospitals said they regularly trained their staff on EMR outage contingency plans, though just 45% reported training staff through recommended drills on how to address EMR system downtime. And 40% of hospitals that activated contingency plans in the wake of an outage reported that they saw no disruption to patient care or adverse events.

Still, the OIG’s take on this data is that it’s time to better monitor hospitals’ ability to address EMR outages. Now more than ever, the agency would like to see the HHS Office for Civil Rights fully implement a permanent HIPAA compliance program, particularly given the mounting level of cyberattacks endured by the industry. The OIG admitted that HIPAA standards aren’t crafted specifically to address these types of outages, so it’s not clear such monitoring can solve the problem, but the agency would prefer to forge ahead with existing standards given the risks that are emerging.

Software Selection Done Right Part 2: Presenting a Vision through an RFI

Posted on August 22, 2016 I Written By

For the past twenty years, I been working with healthcare organizations to implement technologies and improve business processes for nearly twenty years. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Be sure to check out part 1 in the series.

The primary driving document of a software selection is often the RFI or RFP, the invitation to vendors to participate in the process.. In future articles in this series, we will discuss the process of software selection and obtaining buy-in from stakeholders after the RFI has been received. For this week, we will focus on that centerpiece document, the RFI. This document sets the stage for the process, creating the tone and establishing the way that the hospital will work with the vendor during the selection.

However, far too often creating this document becomes the focus of the process rather then the actual selection. Creating an RFI should not be a large effort and done properly, can be one of the easier steps, allowing the journey to begin much faster.

The purpose of an RFI should not be to provide a laundry list of needs and wants to the software vendors. An RFI that includes pages of checklists of features can take a considerable effort to create and an even more considerable effort for the vendor, and actually adds little value. When it comes to mature software solutions, such as ERP and EHR solutions, it is very likely that the vendor understands your needs better than you do. They demonstrate software to hospitals every day, and have numerous customers who have been through the same changes and challenges that you have.

Several years ago I was working alongside an ERP software sales team and joined a meeting in which a potential customer had allowed them to present their solutions following completion of an extensive, laundry list style RFI. During the discussion the potential customer’s CIO was present and was looking through the response to the RFI carefully, with a frown on his face.

Then he looked up and asked a question. “I am reviewing your response to our RFI”, he said, “and I see that you answered no to many of the items in our requirements. Why should we choose you over another vendor who met more of those needs.” The salesperson from the ERP team was not only a seasoned salesperson, but also well versed in the business processes of ERP and was well prepared with an answer that I often reference to this day.

“Do you know what a Japanese auction is?”, he asked the CIO. “Actually”, he continued, “does anyone here know what a Japanese auction is?.” Everyone looked confused, but no one spoke.

“I don’t, but why would you ask that?” inquired the CIO.

“Because it is a requirement of the software in your RFP”, the salesperson responded, “and one of the examples where we said no”. He then went on to explain what a Japanese auction was to the hospital team, and asked if they would ever use that functionality. They all agreed that they would never have a use for it. In closing the salesperson asked what consulting firm wrote the RFI for them and if they were advised that they needed to include it, or if the consultant simply forgot to remove it from the template they were using.

This story highlights that the software vendor is well aware of the features and functionality that a hospital would typically use, and does not need a list of those features. It also demonstrates that paying a third party to develop an RFP does not always lead to a more effective document – and in some cases leads to a less effective document.

Rather than a laundry list of features, an RFP should tell a story. The story of who you are, where you are now, and where you want to go. It should explain the vision and objectives of your project, the organization’s current challenges, and your future vision for the hospital with the new software. The RFP should invite the vendor to participate and present how they will help you to achieve those goals. Each vendor can then present why their solution is the best to get you to your desired destination.

Specific features and functions are much less of a key difference between software solutions today. Feature lists have actually led many vendors to write and acquire software for the purpose of being able to check boxes in an RFP rather than reacting to actual customer needs or with the intent of producing a quality product. It is increasingly unlikely that a “smoking gun” will be found with a specific absolutely necessary feature existing in one vendor option but not the other. Rather, it is the design and the quality of the solution that is important, as well as confidence in the vendor and their ability to partner with you effectively and capability to deliver on their promises.

Indeed there is more to an RFP – and in a future article we will discuss how to define the rules of the road of the selection process and to make sure those rules are reflected in the RFP and that the vendors and staff follow those rules. However, the core content of an RFP is expressing that vision to your potential software partners.

Therefore rather than spending months of creating lists of checkboxes of features that you may or may not need, just tell your story. Explain the vision of where you want to go and invite the potential solution providers to explain to you how they will help you to achieve that vision. The result will not only be a significantly faster selection process, but also a better relationship with your vendor partners during the selection and beyond.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Olympic Polyclinics – the Future of Healthcare?

Posted on August 19, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

The first Olympic Village was built in Los Angeles In 1932. To help ensure the health and safety of athletes, a small hospital was built in the Village and provided care free of charge to the athletes.

Since 1932, every Olympic Village has featured a dedicated 24-hour healthcare facility – now called the Olympic Polyclinic – that provides free healthcare to anyone involved with the Olympics. The Polyclinic at this year’s Games in Rio de Janeiro is once again a marvel of modern medicine, much like the one at 2012’s London Games represented the pinnacle of medicine four years ago.

At 3,500 sq ft, the Rio Polyclinic is the largest ever constructed. It features a state-of-the-art equipment including: MRI scanners, x-ray machines and even cryotherapy pools (for low temperature treatments). All the equipment and the EHR that holds it all together is donated by Olympic sponsors. The staff are all volunteers.

I find the Polyclinics fascinating and the more I read about them, the more I am convinced they are a providing us a glimpse into the future of healthcare.

Health-Aware Patients

The doctors and nurses at the Polyclinics see some of the most health-aware patients on the planet. Olympic athletes track everything from their diet to their sleep patterns to resting heart rates. When they show up at the Polyclinic they often have a very good idea of what is wrong and come armed with lots of baseline health data. The Polyclinic staff expect this and collaborate with their patients when they walk in the door.

As more and more people track their fitness through apps and trackers, we too are becoming more and more health-aware as patients. In the future we will have a lot of digital information about our own health – information that can and should be shared with our care team. Physician practices will have to learn to collaborate as the Polyclinic staff have learned – or they risk alienating potential health-aware patients.

Health-Abstaining Patients

The Olympic Polyclinics also see patients that are at the complete opposite end of the spectrum. For many athletes (and support staff) from developing countries, the Polyclinics are the only opportunity they have to receive quality healthcare.

According to a piece in USA Today the MRI suite, x-ray machines and ultrasound machines at the Rio Polyclinic has been running non-stop. In addition, the Polyclinic has provided:

  • 1,000 dental checks
  • 450 dental x-rays
  • 300 specialized mouth guards
  • 1,730 eye exams
  • 1,410 sets of prescription glasses

…and it’s only the mid-point of the Games.

Due to lack of access and high cost, many Olympians are forced to forgo medical care. This is the same phenomenon that is happening in the United States as high deductible plans and increasing healthcare costs are forcing many to abstain from seeking care. Because of this, staff will see more and more patients with higher and higher acuities – something that the Polyclinic staff see often at the Games.

Completely Autonomous

The Polyclinics are self-contained healthcare facilities. They have an onsite lab, a full imaging suite and a full staff of specialists. It takes less than an hour to get blood test results and image readings. Short of major surgeries, the Polyclinics can handle most patient needs without need to refer them to another facility.

This one-stop approach is what patients want. They want to go to a single nearby facility and have access to all the specialists and equipment they need. It would be impractical to build Polyclinics in every rural town, but through the magic of telemedicine, it may one day be possible to access needed specialists without having to drive hundreds of miles.

With the advances in remote testing and telemedicine coupled with patient preference for one-stop shopping I expect to see more multi-specialty, completely autonomous clinics open in the next few years.

Culturally Aware

Being in the middle of Olympic Village, the staff at the Polyclinics have to be very culturally aware. Instead of insisting on a “Western Approach”, doctors and nurses are encouraged to listen to the patient and take into consideration their religion as well as cultural norms.

It will not be long until smart healthcare organizations realize that catering to cultural differences in their communities is a differentiator. The same has happened in the grocery industry with the rise of halal meats and ethnic food aisles. Being culturally aware will attract more patients.

Admittedly, the Polyclinics, like the Olympic Games themselves, exist within their own reality bubble. There is little concern over finances, there is no shortage of clinicians, they have a completely captive audience and they don’t have to care for their patients for more than two weeks.

Despite this, I see the Polyclinics as a barometer of things to come – especially in terms of the types of patients they see. It’s going to be fun to read more stories from the Polyclinic after the Rio Games end. Now back to watching synchronized swimming.

For an insider look at life inside the Polyclinic, I would highly recommend this post from Trisha Greenhalgh who documented her experience at the London Games Polyclinic in 2012.

Managing Health Information to Ensure Patient Safety

Posted on August 17, 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Electronic Medical Records (EMRs) have been a great addition to healthcare organizations and I know many would agree that some tasks have been significantly improved from paper to electronic. Others may still be cautious with EMRs due to the potential patient safety concerns that EMRs bring to light.

The Joint Commission expects healthcare organizations to engage in the latest health information technologies but we must do so safely and appropriately. In 2008, The Joint Commission released Sentinel Event Alert Issue 42 which advised organizations to be mindful of the patient safety risks that can result from “converging technologies”.

The electronic technologies we use to gather patient data could pose potential threats and adverse events. Some of these threats include the use of computerized physician order entry (CPOE), information security, incorrect documentation, and clinical decision support (CDS).  Sentinel Event Alert Issue 54 in 2015 again addressed the safety risks of EMRs and the expectation that healthcare organizations will safely implement health information technology.

Having incorrect data in the EMR poses serious patient safety risks that are preventable which is why The Joint Commission has put this emphasis on safely using the technology. We will not be able to blame patient safety errors on the EMR when questioned by surveyors, especially when they could have been prevented.

Ensuring medical record integrity has always been the objective of HIM departments. HIM professionals’ role in preventing errors and adverse events has been apparent from the start of EMR implementations. HIM professionals should monitor and develop methods to prevent issues in the following areas, to name a few:

Copy and paste

Ensure policies are in place to address copy and paste. Records can contain repeated documentation from day to day which could have been documented in error or is no longer current. Preventing and governing the use of copy and paste will prevent many adverse issues with conflicting or erroneous documentation.

Dictation/Transcription errors

Dictation software tools are becoming more intelligent and many organizations are utilizing front end speech recognition to complete EMR documentation. With traditional transcription, we have seen anomalies remaining in the record due to poor dictation quality and uncorrected errors. With front end speech recognition, providers are expected to review and correct their own dictations which presents similar issues if incorrect documentation is left in the record.

Information Security

The data that is captured in the EMR must be kept secure and available when needed. We must ensure the data remains functional and accessible to the correct users and not accessible by those without the need to know. Cybersecurity breaches are a serious threat to electronic data including those within the EMR and surrounding applications.

Downtime

Organizations must be ready to function if there is a planned or unexpected downtime of systems. Proper planning includes maintaining a master list of forms and order-sets that will be called upon in the case of a downtime to ensure documentation is captured appropriately. Historical information should be maintained in a format that will allow access during a downtime making sure users are able to provide uninterrupted care for patients.

Ongoing EMR maintenance

As we continue to enhance and optimize EMRs, we must take into consideration all of the potential downstream effects of each change and how these changes will affect the integrity of the record. HIM professionals need prior notification of upcoming changes and adequate time to test the new functionality. No changes should be made to an EMR without all of the key stakeholders reviewing and approving the changes downstream implications. The Joint Commission claims, “as health IT adoption becomes more widespread, the potential for health IT-related patient harm may increase.”

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

Is It a Hot or Cold Hospital EHR Buying Market? – Response

Posted on August 15, 2016 I Written By

For the past twenty years, I been working with healthcare organizations to implement technologies and improve business processes for nearly twenty years. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

This article is in response to John Lynn’s recent posting, Is It a Hot or Cold Hospital EHR Buying Market?

In his recent posting, John Lynn asked the question “Is it a Hot or Cold Hospital EHR Buying Market?”. In it he highlights a recent KLAS report that over 490 hospitals, a staggering 10% of the entire market, were involved in an EHR decision in 2015. After reading his posting, I wanted to take a moment to share my observations.

2015 was indeed an amazing year for EHR sales, partly driven by the pending sunset date of Mckesson Horizon forcing many customers to switch EHR solutions. Some of those customers are going to Paragon, but many more purchased or are evaluating other solutions. During a recent trip to Epic University, I was surprised to find that nearly half of the attendees of the classes were hospitals switching from Mckesson Horizon to Epic – and all had just recently completed their purchases (late 2015/early 2016) and were facing the same live dates of late 2017/early 2018.

Hospitals who have purchased and implemented Epic or Cerner are very unlikely to make a change. Regardless of which solution is preferred, the investment in these solutions and the level of effort required to switch from one to another is so high, that it would take a significant triggering event for a hospital to make that change. Therefore it is likely that customers on these solutions will not be making a change in the near future.

However, KLAS reports that nearly 40% of MEDITECH customers would change EMR’s if they could, and that Paragon customers also report unrest. Therefore in addition to the shrinking number of those that have not implemented a viable EHR solution, the possibility that there will be a wave of customers switching from one of these solutions to Epic or Cerner remains a consideration. There is also the question of how the recent spin-off of Mckesson’s software division will impact the future of Paragon. If Paragon were discontinued or sold, it could lead to another explosion of EHR decisions. If instead there was a significant investment in the solution, it could become a more viable alternative as customers look to switch from one EHR to another.

I suspect that 2016 will be another strong year from EHR sales in general and for Epic and Cerner in particular. Beyond that, much will depend on the strength of the other solutions and which ones break out into the top tier. Regardless, the recent explosion of EHR sales and the rush to replace Horizon will in many cases lead to minimized installs – where the bare minimum work was completed and there is significant opportunity to improve business processes, implement new modules, and roll out advanced functionality within those solutions. As a result I believe that within a few years, the market will be more stabilized with fewer customers switching solutions, and instead focusing on maximizing what they have.

Unless another player comes in and disrupts the marketplace or a significant shift in the industry creates a reason to make a change yet again…

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Is It a Hot or Cold Hospital EHR Buying Market?

Posted on August 12, 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.

In a recent blog post by Erik Bermudez, he asks the question about whether the Hospital EMR market is heating up or cooling down. He suggests that it’s heating up and offers this commentary as proof:

In 2015, KLAS validated that over 490 acute care hospitals were involved in an EMR contract decision of some kind, which represents an increase of almost 200% over 2014. That’s nearly 10% of the entire US hospital market making an EMR decision in 2015 alone.

We’ll see if this trend continues. No doubt there was a cooling off of the market as meaningful use matured in 2014. Given that cooling off period, it’s not really a surprise that it would start to heat up.

Eric also points out that buzzwords like population health and interoperability are dominating the conversation as opposed to EHR. I’d in the healthcare analytics buzzword to that list. These are indeed hot topics, but what’s interesting is that each of these topics really requires an EHR. You’re not likely to buy a healthcare analytics system if you don’t have an EHR. You need the data to be electronic (presumably in an EHR) to do the analytics (yes, I know there are edge cases where you don’t).

Given this dependency on EHR, we shouldn’t be surprised that many organizations are making an EMR decision. No doubt some healthcare organizations have an EMR that doesn’t support the advanced population health, interoperability and analytics initiatives they’d like to do. No doubt these advanced efforts are going to drive adoption of new EHR vendors that can support these efforts.

What do you think? Is the EHR buying market hot or cold? Let us know your thoughts in the comments.

EHR Data Migration – Tackling EHR & EMR Transition Series

Posted on August 10, 2016 I Written By

EHR Data Migration
(See Full EHR Data Migration Infographic)

In this infographic, Galen Healthcare Solutions provides critical information and statistics pertaining to EHR data migration including:

  • Healthcare Data Growth
  • EHR Data Migration Drivers
    • Mergers & Acquisitions
    • System Consolidation
  • EHR Data Migration Challenges
  • Industry Leading EHR Migration Solution

The demand for data migration within the U.S. healthcare market is growing exponentially. The increase in mergers and acquisitions is driving system consolidation as is the increasing number of HCOs seeking EHR replacements to address usability and productivity concerns. A recent survey by Black Book Rankings found that nearly one-fifth of large practices and clinics intend to undergo an EHR replacement by the end of 2016. In addition, a 2015 Kalaroma report shows that the EHR replacement market will grow at an annual rate of 7-8% over the next five years.

EHR Data Migration Process

The process of migrating from one EHR to another is among the most difficult technical and functional projects a healthcare organization will ever confront. The EHR transition requires vendor selection, assessment and scoping, legacy system optimization, data migration, legacy application support, data archival, and new system implementation. If organizations fail to address any of these components properly, their migration could leave healthcare providers without the information needed to make the best patient care decisions, and organizations without easy access to the historical data necessary for participating in quality reporting initiatives and other current and emerging value based care reimbursement methodologies.

Learn more about EHR transition, replacement and migration strategies, methodologies, tips & tricks, and best practices by downloading our EHR Migration Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions

Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.