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Physicians Like EMR-Connected Apps

A new survey by vendor eClinicalWorks has concluded that the vast majority of physicians like EMR-connected apps, and many cases, believe that apps can improve patient care.

Of course, the research is a bit self-serving. The study announcement comes alongside news that the company plans to invest $25 million on patient engagement tools over the next 12 months, starting with a free mobile app for patients available on iOS and Android. Still, it’s worth a look anyway.

The study, conducted online, collected responses from 2,291 healthcare professionals in mid-January, reports SearchHealthIT.com.  Of that total, 649 respondents were physicians.

Researchers found that nearly all doctors responding (93 percent) think it’s valuable to have a mobile health app connected to an EMR, the site reports.  The same number of doctors said that mobile health apps can improve a patient’s health outcome, and 80 percent said they were likely to recommend a mobile health app to a patient.

So what do physicians hope to gain from such apps, specifically?  According to SearchHealthIT.com:

* 58 percent of physicians were particularly interested in the ability to provider automatic appointment alerts and reminders. (Six out of ten physicians said that at least half their patients would like getting appointment reminders from an app, too.)
* Almost half of doctors felt giving patients access to their medical records was a key benefit
* Many suggested that using apps to make appointment scheduling easier would be very helpful

The study also concluded that apps could help with patient wellness. Sixty-five percent said they could improve medication adherence, 54 percent diabetes care and 52 percent preventative care, the site reported.

February 18, 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.

Survey: Virtually All Docs Want Mobile EMRs

Here’s news that shouldn’t come as a surprise:  a new study has concluded that nine out of ten doctors would like to be able to use an EMR on their mobile device. The survey was conducted by a vendor, which arguably suggests that the study reflects its agenda, but if you’re like me you’ve been hearing the same thing from doctors almost daily.

By the way, to be clear, plenty of physicians are already accessing EMRs via mobile devices. The thing is, most access the EMR through some kludgy solution like a Citrix client,  which leaves much to be desired in the way of flexibility and usability.  So getting a “real” client onto the key devices is a hot item.

The survey, which was conduced by Sage Software successor Vitera Healthcare, reached out to 240 Vitera customers, most of whom were office-based physicians.  In the study, which was reported by Information Week, 72 percent of respondents said they used mobile devices in healthcare.  However, they mostly used their tablets and smartphones to do medical research or communicate with other staff members  – in fact, only six percent were using the devices to connect to EMRs or do e-prescribing.

What stood out most of all in this research was that 91 percent of physician respondents said they’d be interested in a mobile EMR solution. Features they like the best include ability to review and update patient charts and order prescriptions, along with documenting patient encounters.  In other words, they want to be able to do virtually everything they can do from a desktop.

Not surprisingly, Vitera is working on its own mobile EMR solution, designed for use on iPads (though usable on iPhones).  eClinicalworks is expected to launch an iPad-native EMR shortly.

It’s a lock that over the next few months, other vendors will take the same steps. The question is how usable these iPad and Android clients will be.  We’ll soon find out though!

August 21, 2012 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.

Stalking the “Perfect” EMR

Everyone’s heard about it, but nobody’s seen it — the perfect EMR. You know, the one that satisfies every doctor, integrates easily with every related hospital system, plays well with HIEs and even makes coffee for the CIO.

In all seriousness, virtually every EMR installation seems to involve systems integration problems, workflow requirements, user interface design or a  baker’s dozen of additional problems that hang like a cloud of smoke over even the more successful rollouts.

In theory, you might be able to resolve these disputes by letting the staff choose which EMR they’d like to see in place. But in reality, that doesn’t work either, argues John Halamka, MD, MS, whose many titles include CIO of Beth Israel Deaconess Medical Center and CIO at Harvard Medical School.  “I’ve heard from GE users who want Allscripts, eClinicalWorks users who want Epic, Allscripts users who want AthenaHealth, and NextGen users who want eClinicalWorks,” he notes.

Worse, if you let every department and clinical constituency pick what they want to include in their EMR, you end up with “an unintegrated melange of different products that make care standardization impossible,”  Dr. Halamka suggests.

As nice as it would be to satisfy everyone, there’s really only one approach that works, Dr. Halamka says. IT leaders need to pick an EMR for their enterprise that meets the enterprises overall strategic goals, one “providing the greatest good for the greatest number.”  Then, follow up with substantial training, education, collaboration, user engagement support and healthcare information exchange, he says.

No matter what your EMR turns out to be, it’s going to fix some workflow and process issues while creating others, he suggests. The best thing healthcare CIOs can do is simply go with smart enterprise-wide technology and help providers user it effectively.

This argument makes a lot of sense to me, at least at this stage in the emergence of EMRs. In, say, five years when key features are more standardized, it might be easier to buy “off the shelf” EMRs that please almost everyone. Or will it?  What do you think?

February 13, 2012 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.

HCA Gets HITECH Bonuses — And Goody For Them! — But Will EHR Really Help?

When it comes to raking in the Meaningful Use bucks, HCA had a pretty good year. According to its recent conference call, HCA hospitals took in $120 million in incentive income during its fourth quarter, balanced against about $19 million in expenses. For 2011, it spent $77 million to take in EHR incentive income of $210 million. Sounds pretty sweet.

HCA’s nice margin on EMR adoption may be in part because it has gone with relatively small (and arguably, less costly) vendor eClinicalWorks rather one of the big iron giants like Cerner or Epic.  Regardless, something is working.

Still, HCA clearly can’t live on incentives alone. For this past quarter, cash flows shot up from $534 million during the previous quarter in 2010 to $1.387 billion during the 4th quarter of 2011. And it expects to see equivalent admission growth to range from 7 percent to 8 percent for the year, a nice bump if I do say so myself; what’s more, net revenue per equivalent admission growth should climb 3 percent to 3.5 percent.

In case all of this is making you yawn, let me bottom line it: HCA seems to be set up for a good year, and EMR adoption incentives aren’t likely to make a giant impact given the cost of putting the systems in place.

Given its size and scope, HCA offers a nice model for looking at how effective an EMR can be in doing more than fulfilling a government mandate and collecting prize money.  HCA CEO and chairman Richard Bracken calls the company’s EMR “an important foundational step in our ability to create a clinical data set to assist in the provision of more cost efficient and effective healthcare services.”

But this, obviously, is a seriously slippery collection of buzzwords. Mr. Bracken, could you be more specific?  Wall Street may not care but we do.

For the record, I saw an eClinicalWorks demo at a recent trade show and man, I was truly unimpressed. Not only was the user interface ugly and hard to use, the sales beings at the booth seemed determined to blow off a single doctor brave enough to ask a question about how to use his product on her job. Not an appealing picture.

So, what can eClinicalWorks actually do to improve clinical care or even move HCA hospitals beyond Meaningful Use stage 1?  You’ve got me, buddy.

February 9, 2012 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.

Ready Or Not, Cloud-Based EMRs Getting More Popular

Several days ago, I wrote a piece griping about the vague use of the term “cloud” in describing networking strategy — and particularly, the notion of the cloud as platform upon which to deploy an EMR. My gripes didn’t even take on the idea of whether virtualized EMRs were a smart approach; I was just troubled by the way vendors were throwing the term around, and perhaps selling vastly different products under the same moniker.

Well, I give, at least for the moment. The more I read about cloud deployments of EMRs,  the more it appears that something useful is going on.  (Cloud security is still a question mark, but that’s a subject for a whole ‘nother article.)

If nothing else, cloud-based models of EMR deployment seem to be easier and more flexible to use than some SaaS models, as client users almost certainly won’t need to download additional apps or even browser scripts to use them.

Some recent examples of cloud deployments in the hospital setting:

* This month, a pair of London hospitals began storing patient data in the cloud. The two hospitals, Chelsea and Westminster Hospital, are part of a National Health Service pilot known as E-Health Cloud. Since writing this item up in July, I’ve learned that the private cloud effort will be supported by a Scottish cloud vendor named Flexiant.  To fend off worries over security, users will have to pass multiple ID checkpoints to get to patient data.

*  Hudson, NY-based Columbia Memorial Hospital has maintained a private cloud-based platform to support its eClinicalWorks system since early 2010, one which serves 26 clinical locations and 300 providers.  Hospital CIO Cathleen Crowley told SearchHealthIT that the cloud approach has allowed the facility to use less physical servers and minimized the hospital’s need for IT support for the EHR. (Interestingly, the hospital is also participating in a pilot HIE project, bolstered by a $1.03 million grant from the state’s Department of Health.)

* Harvard Medical School and Beth Israel Deaconess Medical Center have taken what leaders see as the best of the public and private cloud models to provision their EHR.  As defined by then-CIO John Halamkha, the public cloud involves rapid provisioning of CPU cycles, software licenses and storage, but no guaranteed service level or strong security. To address these limitations, the two institutions built Orchestra, a 6,000-core blade-based supercomputer, designed to be highly secure and available, as well as adding grid technologies to share CPU cycles among high performing computing facilities nationwide. This superplatform offers a virtualized environment for 150 clinical offices, hosting 20 instances of logically isolated EHR apps per physical CPU. (By the way, I believe these institutions use a home-grown EHR of their own.)

What can we take from these stories? Well, we don’t have enough information to draw scientific conclusions, but it seems that a) building out private cloud virtualization of EHRs can be (very) expensive, but ultimately works well and that b) Securing data in the cloud still takes a long ton of effort.

The next challenge for the vendor community, it seems clear, is to offer a cheaper private cloud infrastructure that hospitals trust. Not sure how long that will take, though. Heaven knows this will prove to be a big challenge.

August 26, 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.

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 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.