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Emergency Department Information Systems Market Fueled By Growing Patient Flow

Posted on March 20, 2017 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.

A new research report has concluded that the size of the emergency department information systems market is expanding, driven by increasing patient flows. This dovetails with a report focused on 2016 data which also sees EDIS upgrades underway, though it points out that some hospital buyers don’t have the management support or a large enough budget to support the upgrade.

The more recent report, by Transparency Market Research, notes that ED traffic is being boosted by increases in the geriatric population, an increasing rate of accidents and overall population growth. In part to cope with this increase in patient flow, emergency departments are beginning to choose specialized, best-of-breed EDISs rather than less-differentiated electronic medical records systems, Transparency concludes.

Its analysis is supported by Black Book Research, whose 2016 report found that 69% of hospitals upgrading their existing EDIS are moving from enterprise EMR emergency models to freestanding platforms. Meanwhile, growing spending on healthcare and healthcare infrastructure is making the funds available to purchase EDIS platforms.

These factors are helping to fuel the emergence of robust EDIS market growth, according to Black Book. Its 2016 research, predicted that 35% of hospitals over 150 beds would replace their EDIS that year. Spurred by this spending, the US EDIS market should hit $420M, Black Book projects.

The most-popular EDIS features identified by Black Book include ease of use, reporting improvements, interoperability, physician productivity improvements, diagnosis enhancements and patient satisfaction, its research concluded.

All that being said, not all hospital leaders are well-informed about EDIS implementation and usability, which is holding growth back in some sectors. Also, high costs pose a barrier to adoption of these systems, according to Transparency.

Not only that, some hospital leaders don’t feel that it’s necessary to invest in an EDIS in addition to their enterprise EMR,. Black Book found. Thirty-nine percent of respondents to the 2016 study said that they were moderately or highly dissatisfied with their current EDIS, but 90% of the dissatisfied said they were being forced to rely on generic hospital-wide EMRs.

While all of this is interesting, it’s worth noting that EDIS investment is far from the biggest concern for hospital IT departments. According to a HIMSS survey on 2017 hospitals’ IT plans, top investment priorities include pharmacy technologies and EMR components.

Still, it appears that considering EDIS enhancements may be worth the trouble. For example, seventy-six percent of Black Book respondents implementing a replacement EDIS in Q2 2014 to Q1 2015 saw improved customer service outcomes attributed to the platform.

Also, 44% of hospitals over 200 beds implementing a replacement EDIS over the same period said that it reduced visit costs between 4% and 12%, the research firm found.

Payor Recalls ED EMR After Problem Is Discovered

Posted on October 15, 2013 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.

UnitedHealth Group has voluntarily recalled its emergency department EMR after a bug resulted in doctors’ notes not appearing in medical records, according to a story in Healthcare IT News.

Customers of the EMR, OptumInsight’s Picis ED PulseCheck, are spread across 35 facilities in more than 20 states. These users were notified of the issue — prescription notes not showing upon the prescription or patient chart — back in June, HIN reports.

Picis Inc., which was acquired by UHG in 2010, had already issued six software-related recalls since 2009, according to a Bloomberg report.  Incidents include one case where anesthesia-management software sold nationwide that in one case displayed one patient’s medical information in another patient’s file.

Another problem involved software sold worldwide in which on an unspecified number of occasions, the system failed to display discontinued status on medication orders.  Still others included issues causing failures to display appropriate allergy interaction warning and lock out of administrators, Bloomberg said.

While the recall is doubtless a black eye for Picis, the problems it has had are far from unusual. In fact, according to a study reported in the  Annals of Emergency Medicine, emergency department EMR designs vary widely, with some having problems which can compromise clinician workflow, communication and ultimately quality and safety of care.

ED Docs Spend More Time With EMRs Than Patients

Posted on October 2, 2013 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.

Emergency department doctors spend substantially more time entering data into EMRs than they do interacting with patients, according to an American Journal of Emergency Medicine study reported by FierceEMR.

According to FierceEMR, the study found that the average percentage of time ED docs spend on data entry was 43 percent. During a 10-hour shift, researchers concluded, total mouse clicks neared 4,000.

In contrast, the amount of time emergency department doctors spent interacting directly with patients during the AJEM study was 28 percent, the researchers found.  Meanwhile, reviewing tests and records accounted for an average of 12 percent of the doctors’ time, and talking to colleagues consumed 13 percent.

It’s hardly surprising that doctors would rack up nearly 4,000 clicks during a shift. Mouse clicks for common charting functions and patient encounters range from a low of six clicks for ordering an aspirin to a high of 227 for completing a record for patients with abdominal pain through the point of discharge, according to an article in Medscape Medical News cited by FierceEMR.

These results are consistent with those of a similar study published earlier this year in the Journal of General Internal MedicineiHealthBeat reports. According to iHealthBeat‘s story,  researchers who observed 29 medical interns at Johns Hopkins Hospital in the University of Maryland Medical College found that the interns spent 40 percent of their time on computer related tasks, and 12 percent of the time talking with and examining patients.

Such reliance on EMRs in the ED may have some benefits, but there are also risks involved,  according to a recent study appearing in the Annals of Emergency Medicine. According to the study, the design of EMRs for emergency departments varies widely, with some having problems which can compromise clinician workflow, communication and ultimately, quality and safety of care.

The Annals research suggests that hospitals ought to be auditing the performance of their EDISs regularly,  given how central these tools are to emergency medicine these days.  If doctors are going to click nearly 4,000 times during a single shift, it’s best if the EDIS in question doesn’t foster communication failures, alert fatigue or wrong order/wrong patient mistakes, all problems which emerge when the EDIS doesn’t function well, researchers concluded.

Emergency Department EMR Designs Can Compromise Safety

Posted on June 28, 2013 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.

Emergency department EMR designs vary widely, with some having problems which can compromise clinician workflow, communication and ultimately, quality and safety of care, according to a new study reported in the Annals of Emergency MedicineiHealthBeat reports.

The study, which was written by the American College of Emergency Physicians’ work groups on informatics and quality improvement and patient safety, outlines four situations in which EDISs can generate medical errors. According to iHealthBeat, these include:

* Communication failures
* Poor data displays
* Wrong order or wrong patient mistakes
* Alert fatigue

The degree to which these issues emerge in EDs is not consistent, given how widely system functionality varies among EDISs. Factors that lead to this variation include whether the systems were homegrown within the hospital, purchased from a commercial EMR provider or are “best of breed” systems, iHealthBeat reports.

Researchers with the work groups noted there are several factors which hinder efforts to address such issues, including a lack of research on the problems, the lack of a mechanism to collect feedback  from  users on safety concerns systematically, and provisions within vendor contracts which prevent ED professionals from sharing information on software safety.

To improve the performance of EDISs, the researchers recommend the following, according to iHealthBeat:

  • Appointing a “clinician champion” to oversee the EDIS performance improvement process
  • Creating an EDIS performance improvement group
  • Establishing a review process to monitor ongoing safety issues within EDISs
  • Promptly addressing issues that providers, administration and vendors have identified during the review process
  • Making public lessons learned concerning performance efforts
  • Learning and promptly distributing vendors’ patient safety improvements
  • Removing the “hold harmless” and “learned intermediary” clauses from vendor contracts

The work group was particularly emphatic about the need to do away with “hold harmless” and “learned intermediary” provisions in vendor contracts, as such clauses create a lack of accountability among vendors and unreasonably shift liability to clinicians, iHealthBeat notes.