KLAS | Hospital EMR and EHR

EMR Vendors Need To Get Their Act Together

For quite some time now, EMR vendors have gotten away with selling products that aren’t very usable and may even pose safety risks. But that’s the price enterprise EMR buyers have been willing to pay to jump in and automate. Very soon, though, vendors may be held to a higher standard, a new report from KLAS.

KLAS recently held a bake-off comparing Allscripts, Cerner, Epic, McKesson’s Paragon, Meditech 6 and Siemens’ Soarian EMRs head to head where it comes to usability and efficiency, SearchHealthIT reports. The study looked at how the products worked for individual users, and then looked at how they meet organizational quality of care demands.

Some of the EMRs – and I wish SearchHealthIT had told us which ones — took a full month for physicians to learn. In some cases, physicians who were willing to take that month ended up with a richer experience than those which were easy and quick to learn, while in other cases, the darned thing still wasn’t usable. Of course, those with long learning curves and unimpressive features suffered from low physician adoption, the publication notes.

This is all interesting enough, but what grabbed me about the story was a provider quote from an end user, supplied by KLAS:

“As suggested by the new 2014 certification standards, vendors should take more responsibility for both the usability and safety of their products. These responsibilities shouldn’t be the sole purview of healthcare organizations and providers like they have been until now.”

Could it be that providers have finally gotten to the point where they’re no longer going to put up with unusable products and bring the hammer down even on giants like the big-shouldered group listed above? After all, so far providers have swallowed hard and accepted a lot of ugly technology.

Maybe Meaningful Use demands are finally giving health organizations the backbone they need to stand up to Jabba the Hutt vendors?

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March 22, 2013 I Written By Anne Zieger

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.

Tags:Allscripts Cerner Epic KLAS McKesson MEDITECH Siemens Soarian

Oops! Community Hospitals Unhappy With EMR Purchase

A new report from KLAS seems to confirm what we all know already — that buying an EMR is a tricky business that can easily end in failure. The new KLAS report found that increasingly, community hospitals are questioning whether they bought the right EMR, and that a substantial number are already ripping out and replacing their system.

The authors of the report found that about 200 hospitals with less than 200 beds said they were planning to replace their EMR. And in an even more dramatic turn, KLAS found that one in three community hospitals who’d gone live with their EMR in the past 12 months felt they’d made the wrong decision.

Epic had the most overall community hospital wins for 2011, followed by Healthland, Cerner and CPSI. Looked at another, by market share, Meditech came in first with 20 percent, followed by Epic and Cerner, both with 12 percent.

This ferment comes against a backdrop of bigger institutional changes, in which smaller hospitals are joining integrated delivery networks, and as a result, are being shoehorned into using enterprise systems like Epic and Cerner already in place within the IDNs.

This level of disappointment in technical investments would be pretty remarkable in just about any industry. Given the pressure to get on the Meaningful Use train, it’s perhaps a bit less surprising, since pressure to invest can lead to fatal flaws in just about any decision-making process. Still, as an observer, it alarms me to see just how common EMR dissatisfaction is in smaller community hospitals.

As we’ve noted here before, giant institutions making giant investments seem a lot less prone to expressing dissatisfaction with their EMR. Maybe it’s because those hospitals really are getting more for their money — who knows? But my guess is that they’ve as prone as smaller hospitals to wish they’d gone another way, given how hard it is to make an enterprise software buy that pleases everybody.

In any event, let’s hope that community hospitals largely make their peace with the EMR they’ve got. Rip and replace can’t be good for morale, finances or patient care.

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December 18, 2012 I Written By Anne Zieger

Filed Under: Community Hospitals Hospital EHR Hospital EHR Vendor Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital EMR Company Hospital Healthcare IT Hospital IT Budget Hospital IT Systems IDN Meaningful Use

Tags:Cerner CPSI Epic Healthland KLAS MEDITECH

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.

Planning for EHR Consultants in an EHR Go Live

At CHIME 2012 I asked David Tucker, MBA, MHA, FCHIME, VP of National Sales at ESD and Kelly Mulligan, RN, BA, Chief Operating Officer at ESD about how a hospital CIO should plan for an EHR consultant. While we’d love to think that a hospital could just ask for an EHR consultant and have one there the next day, the reality is much different. Sure, you could have an EHR consultant there the next day, but if you want the best EHR consultants it takes some forethought and planning to make sure you get on their schedule. David Tucker, former hospital CIO, talks more about planning for EHR consultants in the video below.

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December 13, 2012 I Written By John

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Filed Under: Healthcare CIO Hospital CIO Hospital EHR Hospital EHR Consulting Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital Healthcare IT

Tags:CHIME CHIME 2012 David Tucker EHR Consultants EHR Go Live EMR Consultants ESD Hospital EHR Videos Hospital EMR Consulting Kelly Mulligan KLAS

What differentiates EHR Consulting Companies?

While at CHIME 2012, I had the chance to sit down with David Tucker, MBA, MHA, FCHIME, VP of National Sales at ESD and Kelly Mulligan, RN, BA, Chief Operating Officer at ESD. I learned a lot from them about what’s happening with hospital CIOs. Plus, it was great to get some first hand perspective on the EHR industry from a former hospital CIO (David Tucker) and an RN (Kelly Mulligan).

I pulled out a video camera to capture some of the things we talked about. I’ll be posting a number of videos with them over the next few weeks, but I’ll start with their answer to the question: What differentiates EHR consulting companies? They mention the KLAS EHR consulting form ratings and even talk about hospital CIO’s being burned by EHR consulting companies in the past.

What Differentiates EHR Consulting Companies Video

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October 24, 2012 I Written By John

Filed Under: Healthcare CIO Hospital CIO Hospital EHR Hospital EHR Consulting Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital Healthcare IT

Tags:CHIME CHIME 2012 David Tucker Hospital EHR Videos Hospital EMR Consulting Kelly Mulligan KLAS

Connecting EMRs and Smart Pumps Proving Difficult

As they settle into their implementation, hospitals are hoping to connect key medical devices to their EMRs. But vanishingly few have pulled off connecting one important device, the smart infusion pump, according to recent research by KLAS.

KLAS’s new study surveyed 251 providers from 218 organizations. Researchers concluded that less than 10 providers in the country are tying smart pumps to their EMRs, despite the fact that most providers see such connections as an important safety measure. The smart pumps let clinicians know if the pumps aren’t set to match a facility’s guidelines, while standard pumps are programmed by hand.

More than half of providers told KLAS that EMR integration is a key factor in selecting future pumps, the firm says. And they handed out higher satisfaction ratings to vendors whose technology development is moving along. Smart pump vendors Baxter, Carefusion and Hospira, for example, led in wireless technology.

That hospitals are demanding wireless pumps that connect with EMRs is no big surprise. Far too many — 23 percent — of surveyed provider organizations reported serious medication incidents within the previous 24 months. Sixty percent of the serious errors were made while using drug libraries. Clearly, using the libraries is good, but connecting to an EMR with auto-programming could make a difference.

Given the difference EMR-connected pumps could make, why are so few providers already connected? Well, one obvious issue is that only 60 percent of providers are live on wireless pump technology, which is necessary to get the integration done.

It’s not just the pump that’s an issue, however. When hospitals roll out this approach, it requires a great deal of coordination between IT, EMR users, clinical analysts and more, notes Kristen O’Shea, clinical transformation officer for WellSpan Health, who spoke with InformationWeek magazine about her organization’s smart-pump rollout.

To make sure the team worked together smoothly with the new device connections, WellSpan created a new hybrid biomedical/IT position to manage medical device connectivity. (Smart move — maybe more would be getting done in the EMR/device connection realm if they did more hiring of this kind?)

Hospitals: Urgent Care Centers Are Ready To Buy (Incompatible) EMRs

Hospitals, if you’re going to have input into how urgent care firms choose their EMR, now is the time. According to a new study from your friend and mine, KLAS, urgent care players are growing and ready to add an EMR to their IT shopping list.

At present, leaders of the estimated 9,000 urgent care centers in the U.S. are beginning to choose between ambulatory EMRs, ED solutions, and best-of-breed urgent care EMRs. Hospital IT leaders, maybe this is the time to find out technology works for them; once the urgent care centers make their actual investment, it’ll be a lot harder to convince them that you might have something better or easier to use for data sharing.

In its research, KLAS focused directly on three vendors that it deemed “best of breed,” CodoniX, DocuTap and Practice Velocity, as well as taking an early look at Integritas. KLAS interviewed 76 urgent care organizations about their EMR’s performance, especially how they rated in patient safety/efficiency, reporting and charge capture, and vendor support/communication.

For once, even KLAS admits that this research led to a photo finish, with Practice Velocity seeming edging out its competitors but still grouped very closely with the others score wise. In other words, KLAS doesn’t think any of these have established a clear lead just yet. I have little doubt that we’ll have some leaders in 12, hey, maybe six months but for now it’s a toss-up.

So whose vendor will win? It’s not clear yet. Report author Eric Bermudez notes that (as we might have predicted), urgent care centers which are part of chain tend to use a best of breed vendor. Meanwhile, hospital-affiliated locations apparently often the hospital’s in-house ED or ambulatory EMR, he told HealthcareITNews. But even these are just hunches at this point, it seems.

Bermudez’ comments make sense, but let’s dig a little deeper than that. Do we want to let urgent care centers largely go their own way and hope that their affiliated doctors want to grow closer with well-integrated solutions? I wouldn’t if I were you.

I guess what I’m saying is that if we know urgent care players are on the move, readying themselves to spend on possibly incompatible solutions, now’s the time to be holding meetings, holding hands and pitching the heck out of the advantages of integrating with hospital software. Let the dog and pony show begin!

Differences Between ROI, Ease of Meaningful Use Vary Between Vendors

New research by KLAS seems to have uncovered important differences between the way EMR vendors perform when organizations are mounting them for Meaningful Use compliance.

According to the research firm, which interviewed 104 MU-compliant providers, both large and small hospitals successfully passed through Meaningful Use attestation. However, the choice of vendor did seem to make a difference — one which, if KLAS is right, hospitals would be ill-advised to ignore.

KLAS concluded that hospitals using Allscripts, Healthland, HMS, McKesson had a harder time moving ahead on MU than organizations that went with MEDITECH, Cerner, CPSI and Epic. (It should be noted that while MEDITECH had the highest number of successful attesters, most of those came from a single large IDN, which makes it a bit hard to tell whether the IDN’s execution strategy or the product deserves the credit.)

One surprising bit of data, for me at least, that community hospitals were having an easier time covering their costs than larger IDNs. KLAS notes that this varied from vendor to vendor, but didn’t name which were the higher performers.

Why the difference? My guess is that the bigger IDNs bought “Extormity” software (such as Epic and Cerner) and are having a hard time paying for it; that they have higher integration costs; and that they’re dealing with larger piles of smoking heaps of machinery (oh, excuse me, I meant very outdated mainframes and what have you).

As for problems, providers obviously had plenty to share. Reporting and problem list functions were the most commonly reported challenges, KLAS said. In these areas, it seems, all vendors performed poorly, including the ever-popular Epic Systems.

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March 21, 2012 I Written By Anne Zieger

Filed Under: Community Hospitals EMR ROI Healthcare CIO Hospital CIO Hospital EHR Hospital EHR Vendor Hospital Electronic Health Record Hospital Electronic Medical Record Hospital EMR Hospital EMR Company Hospital EMR Vendor Hospital Healthcare IT IDN Meaningful Use

Tags:Cerner CPSI EHR ROI EMR ROI Epic Systems Healthland HMS Hospital EHR Software IDN KLAS McKesson Meaningful Use MEDITECH Siemens

A Split Verdict On MEDITECH V.6 EMR: It Stinks, But We’ll Take It

So, here’s a neat little report from KLAS which, as far as we can tell, hasn’t gotten a lot of attention. I think you’ll find it to be quite interesting, though sort of depressing as well.

A couple of weeks ago, the research firm surveyed 38 clients to see what they thought of the latest version of MEDITECH’s hospital EMR platform (v.6). Would you be surprised to learn that customers don’t like the release much, but in essence, are grateful it isn’t worse?

According to KLAS, the release is something of a dog. Customers think v.6 is fairly buggy, and have found that its modules aren’t completely integrated, researchers report. (For a more positive view on MEDITECH – from a former KLAS exec — read “The Argument for Meditech.”)

Some hospital IT folks are steamed that bringing V.6 on board is a “complex, time intensive build that requires a lot of resources,” writes KLAS report author Colin Buckley.

Still, in a twist that speaks volumes about the state of EMR technology, other buyers weren’t surprised in the least, “and they seem to ride the waves quite well,” Buckley notes.

The kicker — which actually made me laugh out loud when I read it — is as follows. Though providers see V.6 as “half baked” and are paying more for it than other MEDITECH options, going with it is still cheaper than using competing vendor products, so in most cases it’s “worth the pain to make it work for them,” Buckley reports.

Stop. Please. (wiping my eyes) You’re killing me, guys. You’re saying V.6 stinks, but if you wanted to buy something that worked you have to pay retail and that won’t fly? This isn’t some practical joke?

You know, when I first checked out the fictional Extormity EMR (“at the confluence of extortion and conformity”) I thought the creators might have gone a bit overboard. But sometimes, the truth is more painful than fiction.

P.S. If you prefer more entertaining EMR news, you may enjoy Extormity’s latest standards update, in which it announces that it supports CCD, CCR and “other acronyms beginning with CC.”

KLAS: Number of HIEs Growing, But Vendor List Still Short

These days, the number of active health information exchanges is actually mounting, and it seems they’re in much better financial shape than the previous generation of projects. And in what may be another sign of maturity, the HIEs are defaulting to a rather short list of tried vendors, though no single vendor dominates the market.

For several years, HIEs have been mostly talk, and many have risen only to fall again, largely because their business models didn’t work. But these days, the number of HIEs in operation is climbing again — this time sustainably, in my view — and hospitals are putting HIE connectivity at the forefront of their strategic plans.

According to Jason Hess, research executive vice president for KLAS, the HIE market is accelerating, though most of the growth is on the private side.

Hess, who spoke at the CHIME11 Fall CIO Forum last week, noted that the number of private HIEs have increased from 62 to 161 since 2009, one of the bigger jumps this editor has seen in several years. Meanwhile, the number of public HIEs has grown from 37 to 67 since 2009, he said.

Perhaps more interestingly, a short list of vendors seem to have figured out how to deliver the package of services hospitals and doctors want. I say this because according to one industry expert, 70 percent of HIEs use one of ten vendor technologies, while 25 vendors serve the remaining 30 percent.

According to unrelated research from the eHealth Initiative, Axolotl (now OptumInsight) is top HIE vendor to date, serving 22 of the 255 HIEs currently operating in the U.S. A close second is Medicity, which is used for 14 HIEs, followed by Cerner and Mirth, both of which serve nine HIEs.

You won’t be surprised to hear that big guns like GE, Microsoft and IBM are lingering around the fringes, and have by no means given up on the market. If I were an IT exec with a large hospital, and wanted to create my own HIE, I might go to one of them rather than the established players. Why? Because they still need to make their mark and may actually be more accommodating than the more established HIE vendors. (I admit that’s just a hunch though.)

Anyway, much worth looking at going on in the HIE world, and I suspect it will get more interesting over time. I’ll keep you posted.

EMR Vendors Need To Get Their Act Together

Oops! Community Hospitals Unhappy With EMR Purchase

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

Planning for EHR Consultants in an EHR Go Live

What differentiates EHR Consulting Companies?

Connecting EMRs and Smart Pumps Proving Difficult

Hospitals: Urgent Care Centers Are Ready To Buy (Incompatible) EMRs

Differences Between ROI, Ease of Meaningful Use Vary Between Vendors

A Split Verdict On MEDITECH V.6 EMR: It Stinks, But We’ll Take It

KLAS: Number of HIEs Growing, But Vendor List Still Short

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