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Patient EMR Access May Be The Biggest Cultural Shift

As most readers probably know, U.S. doctors are skittish about giving patients full access to their medical records. That fact was underscored by a recent Accenture study, which concluded that 65 percent of doctors think patients should only have limited access, and 4 percent feel patients should have no access.

While I have no proof of this, my gut feeling is that these results aren’t just a snapshot in time, but rather a sign of a stubborn problem that’s not likely to melt away quickly. Though much of the high-level thinking about EMRs counts on building collaborative patient relationships over shared records, that thinking may be flawed.

Why are doctors hanging back from full and free disclosure of electronic health data?

Self-consciousness:  Doctors may say things in records that they’d be a bit embarrassed to reveal. To some extent, this is a problem whether the doc is  using paper or an EMR, but EMRs are trickier for doctors to use, adding to the awkwardness factor if a patient questions their work or feels offended by the commentary.

Poor collaboration skills:  If patients get to see their records, they’re likely to become all e-patient-ish and want to have more control of their care.  Old-school doctors aren’t trained to think this way, nor are they likely to want such a relationship temperamentally.

Low digital comfort generally:  Even among younger physicians, there are those that are naturally wired and those that only use computing devices when they must. I’d argue that when you toss in the generation of doctors who trained 100 percent on paper, you’re looking at a large population of physicians who may never quite be on board with touchy-feely data sharing.

Bottom line, data sharing with patients requires a cultural shift which a surprising number of healthcare pros seem ill-equipped to embrace.  I believe it is this cultural shift — from patient as object of notes to patient as co-creator — which will ultimately pose the biggest obstacles to getting value from EMR investments.

Yes, it’d be nice to think that as doctors get more used to living with EMRs, a large number will loosen up, but I doubt that’s the case. Let’s hope the cynic in me is wrong this time.

April 15, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Accenture: Five Questions Hospital Boards Should Ask Before EMR Buys

As we’ve noted in the past, hospitals are on not only an EMR buying binge, they’re doing a lot of switching from one EMR to another. Check out these stats from Accenture:

Accenture research shows that 4 to 4.5 percent of hospitals plan to make an EMR buying decision each year. This
could exceed 110+ EMR contracts or 200 to 250 hospitals per year. This trend is expected to continue well into the
future. In fact, in 2012, 50 percent of EMR deals [were] replacements, up from 30 percent in 2011, according to KLAS Research.

Whether your hospital is a switcher, a late adopter or  planning some kind of EMR upgrade, it’s making a decision of grave importance. So what are some of the key considerations boards should bear in mind? Here’s Accenture’s list of five key questions boards should keep front and center as they consider (more)  big EMR investments and plan for the future:

*  Does your current system offer enough functionality to meet up and coming Meaningful Use requirements, such as the ability to make patient family health histories and imaging results available? Does your current or contemplated EMR vendor have plans in place to keep up with future requirements/changes?

*  Is the EMR vendor’s development strategy in line with your strategy? “Boards should ask of the EMR vendor: do they have adequate resources…to help complete the business roadmap on time and successfully?” Accenture asks. And just as importantly: “Can the vendor help ensure that future product functions are strategically aligned to the healthcare [system's] key initatives?”

* Is your hospital currently on track to meet ICD-10 adoption and Meaningful Use Stage 2 requirements?  Is your vendor going to be able to help support you in these efforts as your hospital works to meet these multiple goals, or does it lack the resources to do so?

* If we decide to switch EMRs, do we have the internal resources needed to support such a bandwidth-sucking effort? Given competition for healthcare IT labor today, will you have the ability to hire on additional resources if needed? And while you’re at it, is your C-level and IT leadership solid enough to make such a treacherous journey?

* Can your hospital afford to switch EMRs, bearing in mind not only direct costs such as licensing, implementation and new technical support, but also ongoing support costs in the neighborhood of 20 percent per year?

To answer these questions, Accenture recommends you conduct an independent analysis of EMR vendors (presumably, rather than relying on analyst firms or peer feedback exclusively).  This sounds like a very good idea to me.

January 24, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Hospital EHR

To kick things off on the Hospital EHR and EMR blog, I decided I’d do a Google search for the term “hospital EHR.” I thought it would be fun to see what Google lists as the top resources online for hospital EHR software. I must admit that I’m mostly disappointed with the result.

There was a “Hospital EHR Adoption Database” for $3550. Sounds like a great deal, but I think HIStalk was putting out the info they had for free. At least that resource was from 2011 along with a couple KevinMD blog posts about hospital EHR. One of which was very recent. I guess Google’s rewarding it for being so recent.

I won’t go over all of the links. Some required a registration which I didn’t want to do. Others were from 2007 or talking about the hospital EHR certification being open for public comment. I did like this post by Fred Trotter about “What does it mean to have a hospital EHR?” That article is a little dated too, but I always love Fred’s in your face style of writing. He calls it the way he sees it and I love that about him.

I also have to admit that I was happy (and a bit surprised) that EMRandHIPAA.com had the category for Hospital EHR posts listed 10th on the Hospital EHR search as well. That’s particularly interesting, because I just created that category on EMRandHIPAA.com about 10 minutes before I did the search.

What’s probably more interesting is the EHR vendors and other EHR related companies that are advertising for the keyword Hospital EHR. Here’s a list of the EHR vendors that came up with my search:
Clear Practice
Athena Health
eClinicalWorks
Care 360 (Quest Diagnostics)
Allscripts
Practice Fusion

Pretty interesting list of “Hospital EHR.” Ok, I am being facetious. How many of those even have a hospital EHR software? Allscripts does. I think Athena Health and eClinicalWorks have some services for hospitals, but they don’t really get in the hospital EHR space. I think they are interested in the ACO stuff which is what the Athena Health ad was really about. I do find it interesting that none of the major hospital EHR software vendors are doing advertising on Google. Plus, it seems that some of the ambulatory EHR companies might want to work on their Google Ads targeting.

There were also 3 “EMR List” websites that had paid ads on there as well:
EMR Consultant
Business Software EMR List
Capterra

Then, it made sense why Accenture would want to sell their hospital EHR consulting services. I’m not sure what Bio Visual Tech is, but it was on there as well.

There you go. Now we’ve got this blog kicked off. It’s taken a while to get this blog started, but now we’re ready to go. In fact, I have 3 other writers that are planning to write on this blog. So, check back often to see the latest and greatest info on hospital EHR software.

If you have any must read resources and/or perspectives on the hospital EHR world, please do share them in the comments.

June 20, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.