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Healthcare Analytics is a Big Privacy Issue

Coming out of HIMSS, everyone said that healthcare analytics was a major discussion. I talked to someone from Allscripts today and they quoted me that something like 42% of their business is coming from population health (analytics, patient portal, and HIE) functionality. Today someone else told me that the future of healthcare IT is going to really be around analytics and how we use the data. When you think about future revenue streams, the data is likely going to be the center of most business models.

Analytics is going to play a major role in the future of health IT and I believe will lead to really important improves in the care patients receive. My guess is that one day we’ll look back on the EHR of today and wonder how we saw patients with such limited data and intelligence built into the EHR.

However, Sheri Stoltenberg from Stoltenberg Consulting made a great comment to me at HIMSS which is the title of this blog post: Healthcare Analytics is a Big Privacy Issue.

While we love to talk about the benefits of big healthcare data and the value of healthcare analytics, it’s also got a lot of big privacy issues that I think we’re going to need to address. Many will argue that we already have HIPAA and that should be enough. Certainly it will provide the framework for privacy and security of healthcare data and analytics. However, that’s likely going to need to evolve as the healthcare analytics involves. I’m not sure we even know the issues that healthcare analytics will pose to privacy in 5 years. Unfortunately, I don’t see HIPAA being able to keep up with it.

If the healthcare IT industry were smart, it would start working together and appropriate privacy and security within healthcare analytics. If they don’t, be ready for the government to step in and impose it on them. We know how that usually works out.

Hopefully this blog post will be inspiration for every organization to consider the privacy and security issues associated with their healthcare analytics.

March 18, 2014 I Written By

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

KLAS: Epic Losing Ground To Cerner

At this point in the EMR buying cycle, one would figure that the market for new hospital EMR purchases is pretty saturated, especially among larger hospitals with the capital to invest in big health IT projects. But according to a recent blog entry from KLAS, that’s not exactly the case.

In his blog item, KLAS researcher Colin Buckley notes that his firm has been watching clinical IT vendor wins and losses at 200+ bed hospitals for 10 years.  During that period — and especially post- Meaningful Use — KLAS has seen a growing number of new hospital EMR contracts.

By this point, after lots of EMR buying, and some switching out technology for second and third-choice EMRs, one might think that over-200-bed hospitals had settled on a platform that they could live with through Meaningful  Use Stage 3. Actually, not quite, Buckley says.

In fact, KLAS data shows that there are more hospitals running legacy EMRs, homegrown EMRs or no EMR at all than those who have bought a currently-marketed solution sometime in the past four years. And it’s likely these hospitals will be choosing a new EMR from the current vendor marketplace within the new few years, KLAS projects.

As sales increase in the 200+ bed hospital segment, market forces are shifting to favor new vendors. What’s particularly noteworthy about this is that the research firm has seen the ratio of Epic-to-Cerner wins shrink from 5-to-1 in 2010 to 2-to-1 in 2012.

According to KLAS, the hospitals that are likely to be out buying new EMRs look different than those which have already bought and implemented the EMR they’ll use for the next several years. “They are smaller and more cost conscious than the large hospital IDNs that have given Epic a lion’s share of wins year after year,” Buckley writes.

With Cerner and Epic busy eating each other’s lunch, Allscripts, MEDITECH, McKesson and Siemens are moving ahead as quickly as possible to roll out integrated ancillary and ambulatory solutions, Buckley notes. In other words, the competition for both ambulatory and hospital EMRs is far from played out.

Despite all of this activity, we are clearly in a late stage of the EMR market as a whole, or as my colleague John Lynn puts it, “the Golden Age of EHR adoption is over.” But if KLAS is right, there’s still some very healthy bucks to be made selling to laggard mid-sized hospitals. Let’s see if vendors used to serving hospital giants can adapt in time.

September 6, 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.

KLAS Reports Cerner and Epic Combined to Capture More Than 3/4 of New Large Hospital EMR Contracts

This tweet and associated messages are circling all around social media. Here’s the short description of the KLAS report:

HITECH has drastically changed the acute care EMR market. Previous industry mainstays like GE Healthcare and QuadraMed have effectively dropped out. McKesson has promoted their community hospital solution, Paragon, over their former flagship, Horizon. Allscripts, MEDITECH, and Siemens are all racing to recover from past stumbles and regain market share. Since meaningful use became a reality, Cerner and Epic have captured a large majority of new hospital contracts. However, there are still many decisions to be made in coming years and the remaining market is potentially more competitive than in years past.

For those of us following the industry, this isn’t really big news. Cerner and Epic have been battling for the big hospitals for quite a while. In fact, coming out of this year’s HIMSS I was more interested in the battle for small hospitals than large hospitals. Of course, we’ll see how hospital consolidation affects this as well.

What does seem clear and this report confirms is that Epic and Cerner all well positioned in the large hospital EMR market. I predict they’ll dominate until at least the end of meaningful use.

August 28, 2013 I Written By

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

CommonWell Alliance Goals Challenged By ONC

As virtually everyone in health IT knows, HIMSS saw the dawning of a new EMR vendor alliance which proposes to make health data exchange simpler.  The group, the CommonWell Alliance, includes McKesson, Cerner, Allscripts, Greenway and athenahealth, plus McKesson’s connectivity business RelayHealth.

Now that the PR fairy dust has settled and we’re talking serious business, it’s a good time to consider exactly what these vendors hope to accomplish, as we’re talking about enough vendor muscle to have a serious impact on the way health data is shared.

This week, ONC released a report doing just that, according to a piece in Government Health IT.  At a meeting of the Health IT Policy Committee on April 3, National Coordinator for Health Information Technology Farzad Mostashari, MD and other committee members discussed the report, which raised some hard questions about the Alliance.

According to Government Health IT, the report outlined the following as CommonWell’s chief goals:

  • Enabling providers to unambiguously identify patients – but not with a national patient identifier;
  • Providing a way to match patients with their healthcare records as they transition through care facilities;
  • Using existing unique identifiers (salted/hashed) such as cell phone number, email addresses or driver’s licenses for identity management;
  • Enabling patients to manage consent and authorization;
  • Creating a HIPAA-compliant and patient-centered means to simplify management of data-sharing consents and authorizations, focusing initially on the most common treatment situations;
  • Helping providers to find the location of patient records across care locations via a secure nationwide records locator service;
  • Enabling providers, with appropriate authorization, to issue targeted (directed) queries that provide for peer-to-peer (e.g., EHR to EHR) exchange.

Unlike most standards-setting efforts, members of the group are going to have to pay if they want to participate, a nice little detail that wasn’t made clear when CommonWell was announced.

Though it will be at least a year before CommonWell pilots its approach, members of the Committee are quite appropriately wondering now about the impact of such an effort.

Dr. Mostashari argued that the key question is whether the service will work as an optional overlay across a regional exchange, or whether it requires exclusive participation. Other committee members agreed.

The bottom line for committee members, Government Health IT reports, is that they’re willing to take a wait-and-see approach. As for us out here in the peanut gallery, I believe we should challenge the heck out of this thing.

Members of the Health IT Policy Committee are well advised to wonder whether this coming together of powerful HIT vendors could undermine broader efforts to foster interoperability. There’s a lot to look into here, even if the allmighty Epic never joins.

April 8, 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.

EMR Vendors Need To Get Their Act Together

For quite some time now, EMR vendors have gotten away with selling products that aren’t very usable and may even pose safety risks. But that’s the price enterprise EMR buyers have been willing to pay to jump in and automate. Very soon, though, vendors may be held to a higher standard, a new report from KLAS.

KLAS recently held a bake-off comparing Allscripts, Cerner, Epic, McKesson’s Paragon, Meditech 6 and Siemens’ Soarian EMRs head to head where it comes to usability and efficiency, SearchHealthIT reports. The study looked at how the products worked for individual users, and then looked at how they meet organizational quality of care demands.

Some of the EMRs  – and I wish SearchHealthIT had told us which ones — took a full month for physicians to learn. In some cases, physicians who were willing to take that month ended up with a richer experience than those which were easy and quick to learn, while in other cases, the darned thing still wasn’t usable.  Of course, those with long learning curves and unimpressive features suffered from low physician adoption, the  publication notes.

This is all interesting enough, but what grabbed me about the story was a provider quote from an end user, supplied by KLAS:

“As suggested by the new 2014 certification standards, vendors should take more responsibility for both the usability and safety of their products. These responsibilities shouldn’t be the sole purview of healthcare organizations and providers like they have been until now.”

Could it be that providers have finally gotten to the point where they’re no longer going to put up with unusable products and bring the hammer down even on giants like the big-shouldered group listed above?  After all, so far providers have swallowed hard and accepted a lot of ugly technology.

Maybe Meaningful Use demands are finally giving health organizations the backbone they need to stand up to Jabba the Hutt vendors?

March 22, 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.

Epic Not Invited To CommonWell Interoperability Alliance

Well, well, well. Far from refusing to participate, it looks like Epic may have been caught off-guard when a group of EMR players announced at HIMSS that they’d formed an interoperability alliance, according to a story appearing in Forbes.

For those who haven’t heard, Cerner, McKesson, Allscripts, Greenway Medical Technologies and athenahealth announced this week that they were forming the CommonWell Health Alliance, a non-profit dedicated to promoting interoperability between their products. Epic was conspicuously absent from the list of participants.

At the announcement’s outset, commentators like yours truly assumed that Epic, in its imperial way, had refused to join the party.  After all, McKesson CEO John Hammergren had told the press that “everyone in the industry” had been invited to take part in the club.

But no, apparently this isn’t the case. “No, we were not asked to join,” Carl Dvorak, COO of Epic told the business magazine’s Zina Moukheiber. “We found out about it when you guys did.”   Perhaps Epic wouldn’t have joined anyway — Dvorak is more of a fan of existing interoperability standards — but leaving a $1.5 billion EMR company off of the eVite list is pretty conspicuous too.

In the article, by the way, Dvorak repeats Epic’s often-made claim that their product isn’t a closed platform, stating that one-third of Epic EMR transactions are with non-Epic systems.  In fact, he says that Epic can already connect with Greenway, Cerner and Allscripts, as well as NextGen. I’m not sure everybody reading this will take that statement face value.

Invited or not, Dvorak doesn’t miss the chance to get off a shot at the CommonWell guys nonetheless. He argues, as I have, that CommonWell may be more of a PR play than a real forward movement for interoperabiility. “It’s a marketing opportunity [for vendors],” he told Forbes. “They create the perception of leaders in the space, where they’re followers.”

March 7, 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.

Top Inpatient EHR Vendors – 2013 Black Book Rankings

I think that most of you know how I feel about the various EHR ranking systems. They all have their issues, but they are another interesting data point in the search for the right EHR. Plus, the EHR ranking trends over time can be interesting. Not to mention, it’s hard not to look at a post that has rankings. It’s almost un-American not to look.

So, I figured I’d post some of the Black Book Rankings over the next week. The following are the Top Ranked EHR Vendors for Inpatient Hospital Systems, Chains and IDN (in alphabetical order).

4MEDICA
ALLSCRIPTS
CPSI
EPIC
GE HEALTHCARE
HCS EMR
HEALTH MANAGEMENT SYSTEMS
HEALTHLAND
INFOMEDIKA
KEANE
MCKESSON
MEDITECH
NEXTGEN
PROGNOSIS HIT
QUADRAMED
SEQUEL
SIEMENS
UNI/CARE
VERSASUITE

Not too many surprises on the list. Was their any Hospital EHR vendor that you think should have made it on this list? I think this list would be more interesting if it just ranked the top 5 Hospital EHR vendors.

February 22, 2013 I Written By

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

Other EHR Options When Epic Denies You

I got the following email from the CIO of a hospital.

They’ve [Quadramed] got the whole ONC-ATCB certified EHR for Phase 1 MU (although the point in your post is valid about that certification being fairly general anymore). They are working on obtaining and integrating/interfacing ambulatory functionality for physician practices, but for hospitals they have some pretty good sized hospitals running their QCPR product. KLAS includes them in their evaluation of EHR vendors (along with the likes of Allscripts, Cerner, Epic, GE, McKesson, Meditech, and Siemens) although they clearly don’t have as many installed hospitals that most of that list has. They also need to develop some real patient portal type of functionality to stay certified for future MU Phases. Not a market leader, but they are a market player. In spirit of full disclosure, we are almost live with Quadramed product, and we will be using it as a full EHR for both inpatient and outpatient care settings. We could not afford the bigger vendor solutions, and Epic wouldn’t even talk with us because we are below their minimum size to qualify for their sales efforts….only vendor I’ve seen that has that luxury of flat out ignoring possible business. We didn’t like the inflexibility of the lower end EHR vendors, and Quadramed provided a lot of the flexibility of bigger vendors for the price of the smaller vendors.

I’d love to learn where other hospital CIOs turn when Epic won’t give them the time of day. Considering Epic’s hospital size requirements and who they will work with, this is more hospitals than not. I started a list of hospital EMR and EHR vendors that might help. Where do hospital CIOs go when Epic isn’t an option? Is there a Denied by Epic support group somewhere online where hospital CIOs can commiserate?

January 18, 2013 I Written By

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

Video: Florida Hospital Throws Dance Party To Celebrate EMR

It’s always nice when people are excited by your EMR launch. Seldom will you see more excitement over an EMR, though, than the dance party they threw at St. Augustine, FL-based Flagler Hospital.

In the extremely cute video below, nurses, pharmacy techs, transporters, supply chain staff, educators, IT specialists, phlebotomists, lab techs, housekeepers and the engineering crew show off their dance skills to Stereo MC’s “Connected,” all to celebrate the launch of Flagler’s Allscripts EMR. (I particularly liked the section where dancing medical records folks held up charts, each with one letter on them, spelling out “Good-Bye Paper” — then dropped them.) So get down with Stereo MC and get connected with Flagler — you’ll get more than one giggle out of it. :-)

January 3, 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.

Top 10 Hospital EHR Vendors By Installed Systems

I came across this list of Top 10 Hospital EHR vendors by installed systems on Dark Daily (a great resource, particularly if you’re into Labs). The data is a little dated, but I thought it would be interesting to consider the numbers in 2011 and how they might look different today. Here’s the list:

Vendor Name Total Installations Percent of Installations
• Meditech 1212 25.50%
• Cerner 606 12.80%
• McKesson 573 12.10%
• Epic Systems 413 8.70%
• Siemens Healthcare 397 8.40%
• CPSI 392 8.30%
• Healthcare Management Systems 347 7.30%
• Self-developed 273 5.80%
• Healthland 223 4.70%
• Eclipsys (Bought by Allscripts) 185 3.90%

This list was taken from the HIMSS Analytics database. I wish I had access so I could compare these numbers for 2012. The interesting thing is that I’m not sure the Hospital EHR vendor numbers would be all that much different. Epic is the media darling, but its focus is squarely on the large hospital systems so they often lag behind when it comes to total installations.

December 21, 2012 I Written By

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