Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

EMR Issues To Address In 2013

Posted on December 10, 2012 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.

So, we’re coming up on 2013, dragging many of the issues that dogged 2012 right along with us.  My theory is that many of the following are likely to linger through next  year as well, though maybe I’m being too cynical.

Here’s my list of ongoing EMR issues that don’t seem to be going away:

* Usability problems:  While there are scattered efforts to improve the entire EMR usability model, none rules the industry. So as things stand, clinicians generally dislike (or, let’s admit it, in many cases loathe ) enterprise EMRs hospitals have mortgaged their future to buy.

* Interoperability:  With proprietary Epic software ruling a growing percentage of U.S. hospitals, getting true interoperability that fuels HIE growth seems a mere dream at the moment. And even if Epic and it’s “ours is best” philosophy didn’t rule the waves of late, connecting other hospital EMR vendors is at a primitive stage at best.

* Poor compatibility with popular mobile devices:  Far too few vendors offer a mobile-native client for their EMR, instead forcing clinicians to cope with the limitations of Citrix compatibility. This state of affairs is terrible for the growth of mHealth, which I think we can agree is a Bad Thing.

* Extremely high cost for enterprise EMR systems: When you’re talking about enterprise software, you’re generally talking about a large price tag. But am  I the only one who thinks that vendors are padding the heck out of their prices because Meaningful Use has hospitals under the gun?

* Lack of documented ROI and clinical improvement generated by EMRs:  Other than collecting an incentive check, most hospitals don’t seem to know how their EMR will generate money, much less savings or return on investment.  And as for a body of well-documented research demonstrating that EMRs can generate better clinical results, we just aren’t there yet.

What other problems do we face this year that are going to remain tough to fix next year? Are any of these problems on the verge of being solved?

Can iPads Make Docs More Efficient? There Are Many Views

Posted on March 14, 2012 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.

As some may recall, I wrote a piece a couple of months ago about a disastrous iPad implementation at a Seattle hospital. The doctors all gave back their tablet, saying that they couldn’t work with it, and the hospital ended up implementing a thin client solution.

Here’s an interesting follow-up, in which the iPad came out looking great.

A new study published this week in the Archives of Internal Medicine found that a group of internal medicine students actually did become more efficient by slinging iPads. Researchers with the journal surveyed 115 internal medicine residents affiliated with the University of Chicago before and after giving them iPads to access EMRs, the hospital paging system and medical publications,  Reuters reports. Ninety-five percent of  students said the set-up improved their efficiency.

How did the hospital make the iPad set up work?  According to a piece in imedicalapps.com, U of C took great care to help make the iPad integrate well, including the following:

User support

— Used Citrix to grant access the hospital’s Epic system

— Documented carefully how Epic works with Citrix, including materials showing residents how to find local printers

— Spelled out some advantages of an iPad/Epic marriage, including addressing patient issues while in conference the capacity to discharge patients on rounds

Security

— Explained how to address the problem if the resident’s iPad is stolen, including a policy that residents couldn’t store patient data on the iPad

Obviously, one prominent success and one prominent failure aren’t going to settle the issue of whether iPads are the future of medicine.   And while Android isn’t getting a lot of talk  in medical circles, I wouldn’t count out Android apps by a long shot. Plus, I’m sure John would passionately argue for a native iPad EHR app versus a Citrix connection.

Still, it’s interesting to see a case study in which doctors are neither frustrated nor burnt out by iPad use. I’m not sure if conditions can be replicated — after all, interns are young, eager and more prone to be tech-friendly — but it’s worth considering all the same.

iPads Out, “Zero Clients” In As EMR Front Ends At Seattle Children’s

Posted on December 14, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

It’s a good thing the IT execs at Seattle Children’s Hospital did a thorough test before they rolled out an iPad front end to their Cerner EMR.  As it turns, out going with the iPad might have been a disaster. In fact, the whole incident begs the question as to whether the iPad works as a browser-based EMR client at all.

As readers know, iPads are very popular with doctors, and many hospitals are considering using iPads as a front door to their EMR system. But in many cases, doctors are finding that the iPad isn’t a great host for desktop-sized applications.

That’s certainly what happened at Seattle Children’s, which trialed iPads with its doctors earlier this fall.  In theory, the hospital was a great fit, as it was in the process of a Citrix virtual desktop infrastructure rollout, an approach which made apps available to any Web-connected device running a browser.

But doctors didn’t like using the iPad to access their EMR. Every doctor who was asked to test out the iPad returned it, saying that it was far too awkward to use, according to CIO magazine. “The EMR apps are unwieldy on the iPad,” CTO Wes Wright told the publication.

And when you think about it, the doctors’ reaction is no surprise. After all, they were using Safari on a small tablet to access apps designed for a 21 inch monitor, an awkward experience at best, notes CIO’s Neil Versel.

So, rather than use iPads as endpoints, the hospital has rolled out 2,600 “zero client” devices from Wyze, mounting the devices on COWs sitting by the patient bedside. (It’s also beta-testing Cisco’s Cius tablets, according to Computerworld.) Seattle Children’s should save $400,000 a year by replacing 70 watt desktops with 7 watt zero clients, Wright projects.

The hospital is consolidating access to the apps on Cisco’s Unified Computing System, and virtualizing access to Cerner using Citrix XenDesktop.

Given the problems doctors face in using the iPad-plus-browser to access EMRs, I do have to wonder so few vendors seem to have developed native iPad applications yet — even giants like Cerner with huge development budgets.

Though I have no proof of this, I get the distinct feeling many vendors would prefer to wait out the current iPad development cycle and see what Meaningful Use brings next before they jump in.  If so, are they stifling the iPad market or just being smart?  What do you think?