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HIMSS Puts Optimistic Spin On EMR Value Data

Posted on February 5, 2016 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.

After several years of EMR deployment, one would think that the EMR value proposition had been pretty well established. But the truth is, the financial and clinical return on EMRs still seems to be in question, at least where some aspects of their functioning are concerned.

That, at least, is what I took from the recent HIMSS “Value of Health IT Survey”  released earlier this month. After all, you don’t see Ford releasing a “Value of Cars Survey,” because the value of a car has been pretty much understood since the first ones rolled off of the assembly line more than a century ago.

Industry-wide, the evidence for the value of EMRs is still mixed. At minimum, the value proposition for EMRs is a remarkably tough case to make considering how many billions have been spent on buying, implementing and maintaining them. It’s little surprise that in a recent survey of CHIME members, 71% of respondents said that their top priority for the next 12 months was to realize more value from their EMR investment. That certainly implies that they’re not happy with their EMR’s value prop as it exists.

So, on to the HIMSS survey. To do the research, HIMSS reached out to 52 executives, drawn exclusively from either HIMSS Analytics EMRAM Stage 6 or 7, or Davies Award winning hospitals. In other words, these respondents represent the creme de la creme of EMR implementors, at least as HIMSS measures such things.

HIMSS researchers measured HIT value perceptions among this elite group by sorting responses into one of five areas: Satisfaction, Treatment/Clinical, Electronic Information/Data, Patient Engagement and Population Management and Savings.

HIMSS’ topline conclusion — its success metric, if you will — is that 88 percent of execs reported at least one positive outcome from their EMR. The biggest area of success was in the Treatment/Clinical area, with quality performance of the clinical staff being cited by 83% of respondents. Another area that scored high was savings, with 81% reporting that they’d seen some benefits, primarily in coding accuracy, days in accounts receivable and transcription costs.

On the other end of the scale, execs had to admit that few of their clinical staffers are satisfied with their EMRs. Only 29% of execs said that their EMR had increased physician satisfaction, and less than half (44%) said their nurses were more satisfied. If that isn’t a red flag I don’t know what is.

Admittedly, there are positive results here, but you have to consider the broader context for this study. We’re talking about a piece of software that cost organizations tens or even hundreds of millions of dollars, upon which many of their current and future plans rest. If I told you that my new car’s engine worked and the wheels turned, but that the brakes were dodgy, fuel economy abysmal and the suspension bumpy, wouldn’t you wonder whether I should have bought it in the first place?

Great Healthcare IT Leaders

Posted on January 25, 2016 I Written By

David is a global digital healthcare leader that is focusing on the next era of healthcare IT.  Most recently David served as the CIO at an academic medical center where he was responsible for all technology related to the three missions of education, research and patient care. David has worked for various healthcare providers ranging from academic medical centers, non-profit, and the for-profit sectors. Subscribe to David's latest CXO Scene posts here.

As we prepare for the upcoming HIMSS conference on Feb 29 – Mar 4, 2016, I encourage the community to connect with these top thought leaders who will go above and beyond in engaging with the community. Looking forward to catching up in Vegas.
himss16 cio

Aaron Miri CIO at Walnut Hill Medical Center @AaronMiri 
Anna Turman CIO at Chadron Community Hospital and Health Services @iamTurman
Chad Eckes Board Member at NC HIMSS
Chris Belmont CIO at MD Anderson Cancer Center @CBelmont88 
Cletis Earle CIO at St. Luke’s Cornwall Hospital
Cris Ross CIO at Mayo Clinic
Darren Dworkin CIO at Cedar Sinai Medical Center @DworkinDarren
Dave Miller CIO at Optimum Healthcare IT @dlmilleroptimum
Dick Escue CIO at Valley View Hospital
Drex DeFord CIO Advisor @drexdeford 
Edward Marx CIO at The Advisory Board @marxists
Gareth Sherlock CIO at Cleveland Clinic Abu Dhabi
Gene Thomas CIO at Memorial Hospital of Gulfport
James Brady CIO, Kaiser Permanente Orange County
Jay Ferro CIO at American Cancer Center @jayferro 
John Delano CIO at Integris health
John Halamka CIO at Beth Israel Deaconess Medical Center @jhalamka
John Jay Kenagy CIO at Legacy Health
Jon Manis CIO at Sutter Health
Joseph Hobbs Regional CIO at NetApp @JOEtheCIO 
Kristin Darby CIO at Cancer Treatment Centers of America @khdarby
Marc Chasin CIO & CMIO at St. Luke’s Health System @M_Chasin
Marc Probst CIO at Intermountain Health @probst_marc
Michael Archuleta CIO at MT San Rafael Hospital @Michael81082
Mike Reagin CIO at Sentara Healthcare
Patrick Anderson CIO at Hoag Memorial
Pravene Nath CIO at Stanford Health @pravenenath
Robin Sarkar CIO at Lakeland Regional Health System
Sarah Richardson CIO at NCH Healthcare System @conciergeleader 
Scott Maclean Deputy CIO at Partners Health @stmaclean
Shafiq Rab CIO at Hackensack University Medical Center @CIOSHAFIQ
Steve Huffman CIO at Beacon Health System @SteveHuffman_IN
Steve Stanic CIO at Baptist Health (Jackson, MS)
Sue Schade CIO Advisor @sgschade 
Todd Richardson CIO at Aspirus
Will Weider CIO at Ministry Health @CandidCIO 

Let us know if you think there’s someone else you think we should add to the list. We always love to learn about new people that are worth following.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

GE Phasing Out Centricity Enterprise, To Some Surprise

Posted on April 22, 2015 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.

Conceding that its competitors have the upper hand, GE is phasing out its Centricity Enterprise product, informing the world in a #HIMSS15 announcement which has gotten little play from our tech media colleagues.  As we’ve argued before, HIMSS is not only a great time to announce big plays, it’s also a great time to bury unpleasant news, and GE seems to have succeeded.

Not surprisingly, employees saw things coming long ago. More than a year ago, for example, a 10-year-plus employee of GE Healthcare called the vendor out on what they saw as low-wattage efforts on company rating site Glassdoor.com. The ex-employee cited a “lack of resources to deliver a good EHR product, [causing] a strong customer base to choose other EHR vendors.”

It’s little wonder that GE is backing out of Centricity Enterprise, which according to a report in MedCity News generated only 5 percent of its EMR revenue, according to Jon Zimmerman, general manager of clinical business solutions. “Is it in the best interest of our customers, shareholders and employees to (be) in a market where competitors are clearly ahead, or should we recognize the situation and go to where the market is going?” Zimmerman told MedCity.

But the fact is, Zimmerman’s comments are somewhat disingenuous. At HIMSS, the company admitted that it had begun the process of dumping Centricity Enterprise three years ago, though it’s not clear how long ago it began to let customers know about its plans. For example, I doubt that Continuum Health Partners CIO Mark Moroses, who as of summer 2013 was moving his organization to the Centricity enterprise EMR, expected to have it phased out less than two years later.

It’s worth wondering why a player with GE’s resources seemingly couldn’t hack the enterprise market. But the problem isn’t new. As far back  as 2011, GE was forced to admit that some of its ambulatory and enterprise customers wouldn’t be able to achieve Meaningful Use with their products. That was probably the beginning of the end for the Enterprise product, which ranked either fifth or sixth in the market recently depending on who you asked. But with Epic alone controlling 15% to 20% of the enterprise EMR market of late, and Cerner hot on its heels, giving up probably was a reasonable response.

The real question is what comes next. If Glassdoor.com posters are any indication, GE Healthcare is prone to frequent strategic changes as management shifts, so who knows what the future holds for its ambulatory Centricity EMR?

At the moment,  it seems that GE is firmly behind its ambulatory product. And that makes sense. After all, physicians are decommissioning their existing EMRs at a frantic rate, and are eager to find substitutes, and that gives GE plenty of sales opportunities. With 70% of physicians unhappy with their EMR, according to a study announced in February of last year, it should be easy pickins.

But given the way GE may have fumbled the ball on the enterprise side, I’d want some proof that leaders there had a long-term commitment to ambulatory care. Practices have a hard enough time finding EMRs that work for them; having to switch for reasons that have nothing to do with them makes no sense.

Where Are All the Doctors at HIMSS15?

Posted on April 16, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I think about the past week in Chicago at HIMSS 2015, I’m wondering where all of the doctors are at HIMSS. Yes, I know there are actually quite a few doctors at HIMSS, but the vast majority of them are now administrators or are working for vendors. There are very few practicing doctors at HIMSS. It’s really quite unfortunate, because their voice is so important to everything that we’re doing.

I know why many doctors don’t go to HIMSS. I’ve seen multiple times where a practicing doctor comes to HIMSS and they’re overwhelmed by the disconnect between what’s being spouted by vendors and what they’re experiencing in their daily work. Most of them say, “I’m never coming back.” It’s really sad for me when this happens, but it also provides us with an opportunity to keep what’s said at HIMSS in perspective.

I wish that HIMSS would work to resolve this problem since having many practicing doctors at HIMSS would really elevate the quality of the conference. I realize that it’s hard to get a busy doctor to leave for a few days where they’re not making any money. However, with some effort and creativity they could make it a reality.

For example, they could create some sort of physician scholarship program that would help encourage more doctors to come. They could reach out to the doctors in the local area to get them to come and participate in the event. They could offer a number of quality CME options since we know that doctors need CMEs.

HIMSS has a ton of value for a large number of groups. In fact, many people have argued that HIMSS has grown so large that it needs to be divided into a number of different conferences. I don’t share that view since I like the mixing of various parts of healthcare, but HIMSS has become pretty unwieldy. As I said to someone today, I just had to let go and ride the wave. It made for a great ride. I just wonder if the ride would have been even better with more physician participants.

Mostashari’s Call for “Day of Action” Is a Double Edged Sword

Posted on April 13, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Neil Versel has a great article on MedCity News that covers some comments from Farzad Mostashari at HIMSS 2015. Here’s a section of his article:

Patient advocates are planning a “day of action” to generate mass demand for consumer access to medical records in the wake of a plan to roll back the Meaningful Use requirement for engaging patients in their own care.

“I think we need to show the policymakers that they’re not just pushing rope here. We need to show that there’s demand,” former national health IT coordinator Dr. Farzad Mostashari said Sunday afternoon during a preconference symposium on patient engagement before the start of HIMSS15 in Chicago.

While I think that Farzad’s suggestion is noble in idea, my gut tells me that it could backfire in a very significant way. You have to remember that a call for a “day of action” is a double edge sword. If that day goes off successfully, then it could make a great case for why we should be requiring the 5% patient engagement in meaningful use as opposed to the single patient record download that’s just been proposed.

However, the opposite can also happen too. If you call for a day of action and then patients don’t request access to their records, then it will lead many to say “We were right. Patients don’t care about accessing their patient records.” This conclusion would be incredibly damaging to the movement towards patients’ getting access to their medical records.

This would be true even if there were other reasons that the day of action wasn’t successful. For example, if you do some poor PR and marketing of the day of action, then It could very likely fail. I’m talking big boy PR and marketing to really get the word out to patients. Healthcare social media and even all of the attendees at HIMSS won’t have the power to get the word out about this idea in order to really see it take off.

While I think the goal is noble and Farzad is right that patients need to really start demanding their data, I think this idea of a “Day of Action” could end really poorly if we’re not careful about it.

Meaningful Use Reporting Period Changed to 90 Days and Other Proposed Changes

Posted on April 10, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed the news, CMS posted the proposed rule that modifies meaningful use in 2015-2017 (Here’s the rule on the Federal Register). The 210 page document dropped late on Friday right before HIMSS. If you think we’ve seen CMS do this before, we’ve seen it happen a lot. They love to issue the rules on Friday and often right before HIMSS. At least that’s better than when they released the rule during HIMSS, but not much.

The summary of the changes is pretty straightforward:

  • Streamlining reporting by removing redundant, duplicative, and topped-out measures
  • Modifying patient action measures in Stage 2 objectives related to patient engagement
  • Aligning the EHR reporting period for eligible hospitals and CAHs with the full calendar year
  • Changing the EHR reporting period in 2015 to a 90-day period to accommodate modifications

The patient engagement was changed from 5% to a single download, view, and transmit as it’s been called. I think many will look on this as a very favorable change since you can’t force a patient to do something and so your incentive and penalties shouldn’t depend on their action.

It also makes sense that they change the hospital reporting period to the calendar year like it’s been for EPs. The change probably has some logistical questions for many hospitals, but it will make the process cleaner.

The big one of course is the 90 day attestation period. We knew it was coming and I think everyone’s glad that it’s here. Now it will be interesting to see how many wait until October to start their attestation period. That’s pretty risky if you ask me, but that didn’t stop organizations from waiting just the same.

I don’t think there will be many issues with what’s in this proposed rule. Although, we’ll see over the next week what other things people find as they dig into the rule. I know many were waiting for this to drop and are now breathing a sigh of relief over the 90 day reporting period.

Let us know in the comments if there are other details you find that we didn’t talk about or nuances we might have missed. Enjoy the light reading on the flight to HIMSS.

Working to Understand FHIR

Posted on April 9, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ever since I’d heard so many good things about FHIR, I’ve been slowly trying to learn more about it, how it will be implemented, what challenges it faces, and what’s the pathway for FHIR to have widespread adoption.

So, it was no surprise that the Corepoint Health sessions on FHIR caught my eye and will be part of my HIMSS 2015. As part of that education they sent me their FHIR whitepaper which they’ll be handing out at their booth along with their sessions on FHIR. As with most things, the more I learn about FHIR, the more I realize I need to learn.

One example of this comes from the FHIR whitepaper linked above. It talks about defining resources for FHIR:

Resources are small, logically discrete units of exchange. Resources define behavior and meaning, have a known identity and location, are the smallest possible unit of transaction, and provide meaningful data that is of interest to healthcare. The plan is to limit resources to 100 to 150 in total. They are sometimes compared to an HL7 V2 segment.

The resources can be extended and adapted to provide a more manageable solution to the healthcare demand for optionality and customization.
Source: Corepoint Health

This section reminded me of a comment Greg Meyer tweeted during an #HITsm chat about FHIR’s biggest challenge being to define profiles. When he said, that I made a note to myself to learn more about what made up profiles. What Greg called profiles, it seems Corepoint Health is calling resources. They seem to be the same thing. This chart from the whitepaper does a great job summarizing why creating these resources (or profiles if you prefer) is so challenging:

FHIR Resource Examples
Source: Corepoint Health

I still have a lot more to learn about FHIR, but it seems like it does have really good founding principles. We’ll see if the powers that be can keep it pure or try and corrupt and modify its core principles. Not to mention take it and make it so complex that it’s not usable. I’ll be learning more about FHIR at HIMSS and I’ll be sure to report back. Until then, this FHIR whitepaper provides a pretty good historical overview of FHIR versus the other healthcare IT standards.

The Future of…Healthcare IT

Posted on March 23, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As part of HIMSS 2015, they’re holding a blog carnival where people throughout the healthcare IT community can contribute blog posts covering 5 different topics. Each topic looks at “The Future of…” and then “Connected System, Big Data, Security, Innovation, and Patient Engagement.” I thought the topics were quite interesting, so I created a post for each of the 5 topics. Here’s links to each of them:

I’d love to have you chime in on each of the topics that interest you. Let me know if you agree or disagree with my commentary and prognostication. Even better, feel free to write your own blog post on any or all of these topics. They are important topics that will make up much of what happens in healthcare IT.

Are there any other “Future of…” topics you wish would have been discussed?

Two Hidden Gems at the HIMSS15 Annual Conference

Posted on March 20, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m deep in my preparations for the HIMSS Annual Conference in Chicago. It’s amazing how quickly the schedule fills up. It has me really excited to meet with so many amazing people. To all the PR people who have sent me pitches, I’ll be getting back to you shortly. Yes, I do respond to each and every one of you. No, sending another request won’t get a response faster. In fact, it will make the response slower.

My own schedule aside, I was thinking today that there are two gems at HIMSS that many people don’t know about. So, I thought I’d share them with you.

The CIO Forum
This event is put together by CHIME and is a shorter version of the CHIME Fall CIO Forum. You can check out the schedule of events here. CHIME always does a great job bringing together some great speakers from the industry and also some to address topics like leadership.

While the content is great, the best part of the event is being surrounded by CIOs. Everywhere you turn is another hospital CIO. It makes for a tremendous opportunity to connect and learn from hospital CIOs. The event does cost extra, so make sure you get the right pass if you want to attend. If you’re there, come say hi.

New Media Meetup
I’m a little bias on this event since it’s the one I host, but it’s always my favorite part of HIMSS. There’s a special energy at the event that comes from all of the amazing people in New Media that are at HIMSS. Everywhere you turn at the event you run into someone else that you’ve likely interacted with on Twitter or some other social media.

The event has evolved over time. Originally it brought together bloggers, but quickly expanded to anyone involved in social media. You can find all the details for the event here. I hope that some readers can make it. If you do, be sure to come take a selfie with me or something.

Those are a few of my favorite events at HIMSS that many people don’t know about. What are your favorite parts of HIMSS?

Exploring Non-EHR Technologies – What’s Next?

Posted on March 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While this site is named Hospital EMR and EHR, you may have noticed that we’ve been covering more and more non-EHR related technologies. I’m certain that this trend will continue as EHR software becomes mature and most hospitals have implemented an EHR. Although, I’m sure we’ll still cover some EHR switching and related topics as well.

While it’s safe to say that many of these non-EHR technologies still have some tie to the EHR, there are some that can really benefit a hospital and may have nothing to do with the EHR. Think about your HR system for example. Almost nothing to do with your EHR (unless you want to talk about EHR user provisioning). However, a well implemented HR system can dramatically improve a hospital’s human resource function.

This idea is actually a theme for my coverage of the upcoming HIMSS 2015 annual conference in Chicago. In the past I’ve always done a bunch of meetings with EHR vendors and sprinkled in a few other non-EHR meetings. This year I’m pretty sure I’ll be doing a bunch of non-EHR meetings with a few EHR meetings sprinkled in. I’m looking for the answer to: What’s Next?

I think this is on trend with what most hospital IT leadership are thinking. EHR’s are mostly installed and they have a handle on meaningful use along with a group of resources that understand the challenge deeply. Now I think they’re starting to look at what’s next.

When I think about what’s next after an EHR is implemented, I think about it in two ways:

  • How Can I Get the Most Out of My EHR?
  • What Other Non-EHR Technologies Could Benefit My Organization?

I’d love to get your thoughts on both of these questions. Hopefully my posts in 2015 we’ll help to answer these questions. It’s certainly what I’ll be looking for at HIMSS 2015 and of course I’ll share what I find.