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The Often Missed Benefit of SaaS EHR

I came across a great article by Geoffrey Moore on LinkedIn talking about “SaaS’s Real Triumph.” He suggests that the “greatest contribution of SaaS is to free the enterprise from the tyranny of the product release model.”

This is a really interesting concept. Far too often when we talk about SaaS EHR software we talk about the payments being spread out over time as opposed to a big lump sum payment up front. Plus, we love to talk about how that means you can leave that EHR software if you don’t like it. The former is an important consideration for every CFO. The later usually doesn’t play itself out as nicely since you often have to sign a contract for a certain number of years. However, at least if there are major issues you still hold most of the money.

I think Geoffrey is right about this rarely discussed benefit of SaaS. As he acknowledges, SaaS EHR software does have some level of ongoing disruption that must be dealt with, but it’s nothing like the disruption that occurs with a major product release form an enterprise software like an EHR. In fact, I think these major release updates are likely going to be the eventual downfall of the major EHR systems we know today. It won’t happen until after meaningful use, but it will present an opportunity for a scrappy startup. We’ll see if the current EHR companies will be able to adapt.

I’m sure many of you reading this have stories and experiences you can share on the topic of enterprise EHR upgrades. I look forward to reading them in the comments. Of course, I bet there’s just as many stories about hospital IT leadership being afraid of SaaS as well. The clash has begun.

December 12, 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.

Deploying WiFi For Clinicians, Hospital Guests A Complex Problem

These days, offering WiFi for both hospital visitors and clinicians is pretty much de rigeur. The problem is, clinicians need different things from their Wi-Fi connection than consumers do. And as a recent story in Healthcare IT News notes, that can make it difficult to keep up with everyone’s demands.

According to Ali Youssef, senior clinical mobile solutions architect at Detroit-based Henry Ford Health System, maintaining a wireless network that suits everyone’s needs is “moving target.”

Youssef was responsible for planning and implementing the HFHS wireless network, which included expanding coverage from 4 million to 8 million square feet. What’s more, the network rollout had to take into account the needs of the HFHS enterprise EMR system, according to the HIN piece.

For Youssef, one of the most difficult problems health IT managers face in this situation is provisioning bandwidth appropriately to all the different types of devices that will share the bandwidth.

Not surprisingly, Youssef believes that one of the most important ways to see that everyone has enough bandwidth is regular contact with the system’s clinicians.

In some situations, clinicians may need far more bandwidth then the IT department had anticipated, for example, where clinician is launching a new project fueled by grant money, notes the Healthcare IT News piece. (We’re also increasingly see a growing list of wireless medical devices, such as wireless glucometers, edge into mainstream clinical care.)

To cope with these rapidly changing demands, Youssef recommends planning for a high level of wireless system redundancy and conducting site surveys.

And in what may be a more difficult challenge, he recommends that network architects keep continuous tabs on what types of devices are going to be used, and testing them see how they behave on their health system’s network.

Youssef didn’t offer any detailed advice on how to accommodate hospital visitors in this story, but clearly, they will pose a significant challenge to any hospital network architect as well.

Particularly as apps become part of patients’ health system experience, network architects will need to bear consumer experience of the network in mind as well. It will be interesting to see, over the next few years, whether consumer wireless health use demands a fresh approach to network architecture generally.

December 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.

Hospitals, Health Systems And Clinics Adding Portals, But Consumers Not Synched Up

With Meaningful Use Stage 2 requiring that 5 percent of patients use them, a growing number of health systems, hospitals and clinics have rolled out patient portals, according to a recent study by KLAS. In fact, 57 percent of providers now offer a portal, typically connected to their enterprise EMR, KLAS found.

The thing is, somehow these efforts aren’t reaching consumers. In a new Wolters Kluwer Health survey of 1,000 consumers, only 19 percent said that they have access to a personal health record.

It’s not that patients don’t want to be engaged in their health — 80 percent of respondents said greater control of healthcare is positive — but it seems that they either don’t like or don’t know how to find the portals available to them.

Ultimately, the broad mass of consumers simply don’t seem to see a crying need to use portals as of yet. Seventy-six percent of respondents to the Wolters Kluwer survey said that they have the information and tools they need to manage basic healthcare functions such as choosing providers and researching treatment options, clearly dwarfing the number who care to look at their own patient data.

That being said, there’s a small (but I’d argue, growing) minority of patients who do take connections with providers seriously. Nineteen percent of respondents told researchers that the ability to communicate via e-mail with doctors and nurses and schedule appointments online was an important factor in choosing a medical practice. In other words, there’s clearly a wired contingent out there which would probably respond well to a truly useful portal.

How can hospitals and clinics get patients engaged in PHR use?  My gut instinct is that consumers won’t give a hoot about PHRs until they become a tool that’s part of their medical or hospital visit. If doctors work with a PHR, turning the visit into a collaboration, patients will be motivated to follow up and review what they’ve learned.

I guess what I’m saying is that we should start by getting doctors engaged with PHRs as a means of getting patients involved. If they do that, PHRs will go from being some Web site to a valuable tool for sharing care information.  If not, don’t expect the number of PHR-interested consumers to climb anytime soon.

December 17, 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.

Are Best Of Breed EMRs Going Out Of Fashion?

This week, I visited a hospital which belonged to a health system going with Epic. This hospital, one of the smaller facilities in the chain, was running Picis in the ED and (I think) Cerner throughout, but the decision had been made to convert everything to Epic sometime soon, a tech told me.

I can’t say the news was surprising, but it was disappointing nonetheless. The community hospital in question has given me excellent service, and my guess is that when Epic barrels in, it will lose its way — at least for a while — frazzling the staff and decreasing the quality of their interaction with me.

However, I ‘d better get used to this trend. As Healthcare Technology Online editor in chief Ken Congdon notes in an excellent editorial, the pendulum is definitely swinging toward enterprise-wide EMR implementations, a direction encouraged by the standardized demands imposed nationwide by Meaningful Use.

If interoperability was easier to pull off, things might be different. But with HL7 and other integration standards and languages still not quite up to the job, one can see the sense of going with an enterprise option.

Here’s the story one CIO told Congdon as to why he’s deploying Siemens Soarian solution:

Michael Mistretta, CIO of MedCentral Health System  [said:]  “Vendor management was a key consideration in our decision to use a single vendor approach to EMR implementation,” says Mistretta. “With a single vendor, I only have one finger to point at. It simplifies my environment because I don’t have Siemens telling me it’s McKesson’s problem and vice versa. Also, the built-in interoperability is key. There is a trade-off in the fact that the system does not provide prime functionality to certain departments or specialties within our health system, but at this point in time, it’s much more beneficial for our organization to have the ability to share data across the continuum of care quickly and easily.” 

CIOs of large hospitals also told Congdon that enterprise system replacements were much cheaper than going through a long-term, highly-complex integration effort.

In an interesting twist, however, hospital IT leaders from mid-sized to smaller hospitals have reached the opposite conclusion, Congdon reports. They’ve been telling him that buying an enterprise system would be much more expensive than sticking with what they had and making it interoperate.

I see a market opening here. If enterprise EMR vendors can get their pricing in line for smaller hospitals, they may have a lot more wins coming their way than they expected.  Interesting stuff.

September 4, 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.