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KLAS Summit: Interoperability Doing the Work to Move HealthIT Forward

Posted on October 9, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed

I had the privilege of attending the KLAS research event with leaders in patient data interoperability. From the ONC to EHR vendors- executives from EHR vendors and hospital systems made their way to a summit about standards for measurement and improvement. These meetings are convened with the mutual goal of contributing to advancement in Health IT and improvement of patient outcomes. I’m a big fan of collaborative efforts that produce measurable results. KLAS research is successfully convening meetings everyone in the HealthIT industry has said are necessary for progress.

The theme of Interoperability lately is: Things are not moving fast enough.

The long history of data in health records and variety in standards across records have created a system that is reluctant to change. Some EMR vendors seem to think the next step is a single patient record- their record.

Watching interactions between EHR vendors and the ONC was interesting. Vendors are frustrated that progress and years of financial investment might be overturned by an unstable political atmosphere and lack of funding. Additionally, device innovation and creation is changing the medical device landscape at a rapid rate. We aren’t on the same page with new data and we are creating more and more data from disparate sources.

Informatics experts in healthcare require a huge knowledge base to organize data sharing and create a needs based strategy for data sharing. They have such a unique perspective across the organization. Few of the other executives have the optics into the business sense of the organization. They have to understand clinical workflows and strategy., as well as financial reimbursement. Informatics management is a major burden and responsibility- they are in charge of improving care and making workflows easier for clinicians and patients. EMR use has frequently been cited as a contributor to physician burnout and early retirement. Data moving from one system can have a huge impact on care delivery costs and patient outcomes. Duplicated tests and records can mean delayed diagnosis for surgeons and specialists. Participants of the summit discussed that patients can be part of improving data sharing.

We have made great progress in terms of interoperability but there is still much to be done. Some of the discussion was interesting, such as the monumental task the VA has in patient data with troop deployment and care. There was also frank discussion about business interests and data blocking ranging from government reluctance to create a single patient identifier to a lack of resources to clean duplicated records.

Stakeholders want to know what the next steps are- how do we innovate and how do we improve from this point forward? Do we create it internally or partner with outside vendors for scale? They are tired of the confusion and lack of progress. Participants want more. I asked a few participants what they think will help things move forward more quickly. Not everyone really knows how to make things move forward faster.

Keith Fraidenburg of CHIME praised systems for coming together and sharing patient data- to improve patient outcomes. I spoke with him about the Summit itself and his work with informatics in healthcare. He discussed how the people involved in this effort are some of the hardest working people in healthcare. Their expertise in terms of clinical knowledge and data science is highly specialized and has huge implications in patient outcomes.

“To get agreement on standards would be an important big step forward. It wouldn’t solve everything but to get industry wide standards to move things forward the industry needs a single set of standards or a playbook.”

We might have different interests, but the people involved in interoperability care about interoperability advancement. Klas research formed a collaborative of over 31 organizations that are dedicated to giving great feedback and data about end users. The formation of THE EMR Improvement Collaborative can help measure the success of data interoperability. Current satisfaction measures are helpful, but might not give health IT experts and CMIOs and CIOs the data they need to formulate an interoperability strategy.

The gaps in transitions of care is a significant oversight in the existing interoperability marketplace. Post acute organizations have a huge need for better data sharing and interorganizational trust is a factor. Government mandates about data blocking and regulating sharing has a huge impact on data coordination. Don Rucker, MD, John Fleming, MD, Genevieve Morris and Steve Posnack participated in a listening session about interoperability.  Some EMR vendors mentioned this listening session and ability to have a face to face meeting were the most valuable part of the Summit.

Conversations and meetings about interoperability help bridge the gaps in progress. Convening the key conversations between stakeholders helps healthcare interoperability move faster. There is still work to be done and many opportunities for innovation and improvement. Slow progress is still progress. Sharing data from these efforts by the KLAS research team shows a dedication to driving interoperability advancement. We will need better business communication between stakeholders and better data sharing to meet the needs of an increasingly complex and data rich world.

What do you think the next steps are in interoperability?

KLAS Keystone Summit and Enterprise Imaging

Posted on July 21, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed


Recently, KLAS Research hosted their annual invite only Keystone Summit surrounding Enterprise Medical Imaging solutions.. The goal? To improve the success with which enterprise imaging solutions are deployed and adopted. A group of 24 executives from healthcare provider organizations and 10 enterprise imaging vendors met for the exclusive work day at Snowbird, Utah. In the sea of noise about healthcare technology Utah has been quietly innovating and improving outcomes. I was honored to be able to attend and see the results of their hard work.

Healthcare innovation needs voices that move out of the echo chamber and collaborate. We need more makers and quality information across measurement. Consistent messaging between large healthcare organizations as well as between vendors and providers improves outcomes for enterprise imaging.  

Adam Gale of KLAS shared his personal experiences leading youth in a pioneer trek during his remarks to the group and likened it to leading this market. Prior to the conference, Adam went as a leader for youth to travel some of the trails that early settlers of Utah followed. These settlers are called “The Pioneers” and the experience of a short pilgrimage can help today’s over connected and digital youth understand to a small degree, what past generations experienced in walking through Wyoming.

Adam Gale told of his experience:  “I spent several unique days last week on the plains of Wyoming with about 400 young people. The goal was to instill in them an appreciation for the legacy that comes from these early pioneers. You can imagine the enthusiasm of these youth switching from video games to handcarts. We had a lot of fun, but there were also some reverent moments when we walked by the gravesites of those that died on the trail. It was a touching moment for these young individuals to see the sacrifices of those who had come before them, and for them to take inspiration from the dead to move forward in life”

This personalized vision of in the midst of sensationalized health stories about predicting death and shiny technology, we are charged with caring for people’s lives. There are solutions that save lives, and for many patients access to images across providers allows them to get critical medical care.

Adam Gale went on to mention Mark Twain’s quote:

“Do the right thing. It will gratify some and astonish the rest.”

Leaders from the KLAS summit met together to outline what that “right thing” looks like and create a way to measure if Enterprise imaging was on track, and how to get on track. Current and expected functionality was outlined for five areas, including: Capture, Storage, Viewing, Interoperability and Analytics. They also outlined common delivery and implementation failures and Executive Recommendations.

Enterprise Imaging is a vital part of healthcare delivery and care and often doesn’t translate well between hospital systems or between providers. Don Woodstock, VP and GM of enterprise imaging for GE Healthcare, spoke about this vision of patient centered care and the collaborative effort:

“Images are an absolutely vital component of patient-centered care.  Providing every physician and caregiver that full comprehensive view of the patient to feed into their diagnostic and treatment decisions is so important but to date has been challenged.  This collective effort with KLAS, leading providers, and the major imaging vendors is leading the way for us to realize this vision.”

One of the complexities surrounding enterprise imaging is that each healthcare system is personalized. Richard Wiggins MD, is the Director of Imaging Informatics for the University of Utah Health Science Center and directs the Society for Imaging Informatics in Medicine. I spoke with him about some of the important aspects of Imaging Informatics as a field and developing a structure for enterprise imaging. Diversity of workflow in each health care system makes a one sized fits all enterprise imaging strategy untenable. He spoke about his experience working with the University of Utah:

“The University of Utah started incorporating visible light images for Enterprise imaging (EI) into our PACS in 2012. We believe that the PACS should be the repository for all digital imaging, not the EMR. Initially there was the usual issue of changing the mindset from individual silos of data to an enterprise imaging strategy for UUHSC.  Usually institutional imaging strategies are focused on being an individual service line, the changes in governance take time and energy.

Radiology already has an established workflow for digital imaging, with the order, RIS interface (or EMR if integrated) which drives a modality worklist to allow the tech to identify the patient, then the image is created on the modality, and then the image is sent to PACS in an organized fashion with metadata that is searchable. An order is needed for this system because it provides a clear entry point and assignment of a unique ID with some contextual information, but there are other imaging workflows that require an encounter workflow running in parallel to the traditional radiology order workflow. We need this workflow to allow for mobile devices, since they are ubiquitous not only for the medical professional, but also for the patient, with authentication, security, and the ability to have an app iOS and Android that will allow for multiple high resolution images and video to be acquired in a fashion that they can easily be incorporated into PACS, possibly through the EMR, while the images or video is not stored permanently on the device.”

This collaborative patient centered event reviewed some of the challenges and successes which each stakeholder had with enterprise imaging. They also made official recommendations for leadership. These recommendations for provider leadership are a must read for healthcare executives responsible for understanding. The recommendations from the KLAS whitepaper are:

  • Providers often fail to prepare enough for the deep commitment of an enterprise imaging journey. This preparation includes the investment of resources, personnel, and understanding. Organizations need to understand, prepare and commit that these deployments often take years.
  • Providers often ask vendors for quotes without knowing what they want to accomplish as an organization. Providers need to do more work upfront and have alignment on the scope and goals. When the provider customers do not know what they want to accomplish, vendors are put into a box. How can a vendor provide a solution to customers who do not know what they want to solve?
  • The views of clinical users must be included in an enterprise imaging strategy. The number of image users/viewers dwarfs the number of image producers, and if the systems are built only by the producers, we will miss the mark.
  • The C-suite really needs to lead out with enterprise imaging, but today, enterprise imaging is regulated to a position of limited resources and alignment. That hurts the likelihood of success. The message of value to the c-suite is lacking today, and that is a challenge. Vendors and providers need to work together to educate c-suite leaders.
  • Governance is difficult to set up because it takes a group of people who are willing to govern as well as a group of people who are willing to be governed. Leaders from many departments need to be drawn into this conversation. If a provider organization does not have multiple departments and specialties involved in the governance, they don’t have a true governance model, and the governance will die on the vine.

 

Without a strong leadership structure and clearly delineated roles, providers and hospital systems will resist even helpful change. Change has to be provider driven, not IT driven. The dedication of top leaders must be paired with end user buy in from physicians. The KLAS Keystone Summit had four provider leaders that collaborated before and during the June Meeting to developme tools for measuring progress. One of the most important aspects of a hospital system improving enterprise imaging is clear standards for workflow.

Richard Wiggins, MD of the University of Utah spoke about the value of working together and creating as a group with diverse experiences:

“The ability to have input from the executives,  providers, and vendors, and thought leaders all combined allows for a powerful forum.  The integration of short talks with table discussions and then cross table pollination of ideas and the systematic placement of providers, vendors and thought leaders all intermixed at the tables led to some good discussions. Frequently there are systems, like PACS that have features that were likely very exciting and interesting to the CS and EE people who put it together, but have no actual use in the imaging clinical workflow. In addition, we have found that each site has its own idiosyncratic workflow and productivity issues, so one PACS may work great in one shop, but not in another, and this becomes more complicated with the integration PACS/SR/RIS.  A combination of the systems at one shop may work great, and the same combination may not work well at another site.”

The measurement vehicle for enterprise imaging adoption, progress and success was defined by a group of four provider leaders:

  • Rasu B. Shrestha, MD, MBA: Chief Innovation Officer, UPMC
  • Alexander J. Towbin, MD: Associate Chief, Clinical Operations and Radiology Informatics, Cincinnati Children’s Hospital Medical Center.
  • Paul G. Nagy, Ph.D: Associate Professor of Radiology, John Hopkins University.
  • Christopher J. Roth, MD: Assistant Professor of Radiology, Vice Chair Information Technology and Clinical Informatics, Director of Imaging Informatics Strategy, Duke Health.

These measures are to be administered to organizations who have in place a multi-speciality governance and one of the following:

  1. Capture including DICOM and at least one of the following: visible light images, audio, or waveforms.
  2. Storage of images in a single enterprise archive or in a federated by connected set of archives.
  3. Viewing of images through a universal viewer integrated into the EMR.

This measurement tool will be available through KLAS research and can be used for industry wide information and ongoing system management. Alexander Towbin MD shared his experiences in creating the measurement vehicle and meeting with colleagues at the Keystone Summit:

“I was impressed that so many thought leaders in imaging IT – both on the provider side and the vendor side- were able to come together to discuss enterprise imaging.  There was palpable excitement in the room that we were working on the next BIG thing in healthcare IT and that our work would allow providers of all types to better care for their patients.”

Better patient care is always the center of Keystone Summit meetings. Creating standards for deployment and adoption of imaging will benefit doctors in providing patient care and improve collaboration within and between healthcare organizations, enabling better care for each individual. Standards development by a group of experts in the field will help improve vendor and provider clarity.

Many of the participants worked for competitors or had worked together at different points in their careers. Don Woodlock shared some of his experiences with the collaboration between key stakeholders involved in Enterprise Imaging.

“I personally loved the discussion, love taking the lead from our luminary providers, and working together across vendors to come up with the ideal workflow, user experience, and image availability solutions.  From a vendor perspective this was much more of a community trying to make patient care better than a group of competitors doing their own things.  In my case this may have been helped by personally having 4 people that worked for me over the years now at 4 different vendors at the meeting with me – friendships, a common vision, and serving the patient and the physician always trump competition.  We’ll all get our chance to innovate and create our own unique variants to this common vision down the road.”

Collaborating across interest groups and with provider entities and vendors is one of the best ways to ensure that products meet provider needs and expectations. This work will allow providers to give better care and improve future enterprise imaging product creation. KLAS research facilitated the meeting of leaders to reflect on the current state of enterprise imaging and plan for the future. Moving the needle from hype and hyperbole to hope for better patient care. KLAS Research is quietly facilitating nationwide leadership from the mountains of Utah. The pioneers of healthcare will take inspiration from current experts and lead the next generation of people dedicated to do what is right.

EHR Data Migration – Tackling EHR & EMR Transition Series

Posted on August 10, 2016 I Written By

EHR Data Migration
(See Full EHR Data Migration Infographic)

In this infographic, Galen Healthcare Solutions provides critical information and statistics pertaining to EHR data migration including:

  • Healthcare Data Growth
  • EHR Data Migration Drivers
    • Mergers & Acquisitions
    • System Consolidation
  • EHR Data Migration Challenges
  • Industry Leading EHR Migration Solution

The demand for data migration within the U.S. healthcare market is growing exponentially. The increase in mergers and acquisitions is driving system consolidation as is the increasing number of HCOs seeking EHR replacements to address usability and productivity concerns. A recent survey by Black Book Rankings found that nearly one-fifth of large practices and clinics intend to undergo an EHR replacement by the end of 2016. In addition, a 2015 Kalaroma report shows that the EHR replacement market will grow at an annual rate of 7-8% over the next five years.

EHR Data Migration Process

The process of migrating from one EHR to another is among the most difficult technical and functional projects a healthcare organization will ever confront. The EHR transition requires vendor selection, assessment and scoping, legacy system optimization, data migration, legacy application support, data archival, and new system implementation. If organizations fail to address any of these components properly, their migration could leave healthcare providers without the information needed to make the best patient care decisions, and organizations without easy access to the historical data necessary for participating in quality reporting initiatives and other current and emerging value based care reimbursement methodologies.

Learn more about EHR transition, replacement and migration strategies, methodologies, tips & tricks, and best practices by downloading our EHR Migration Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement and data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell

About Galen Healthcare Solutions

Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and proud sponsor of the Tackling EHR & EMR Transition Series. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on Twitter, Facebook and LinkedIn.

Where’s Interoperability Happening in Healthcare?

Posted on October 19, 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.

My tweet this morning inspired this post. Interoperability this and interoperability that. We hear all about interoperability everywhere in healthcare. It’s so important that ONC has put together a 10 year plan for healthcare interoperability. We have more interoperability initiatives than we have actual interoperability. I asked one EHR vendor recently about their thoughts on interoperability and which interoperability initiatives they were involved in. They responded that they were taking part in all of them and then they started listing off them all: Common Well, Argonaut, etc etc etc.

With all of this talk about interoperability, you’d think we’d have a wave of success stories. It’s hard for me to believe that with the hundreds of millions of dollars that’s been spent on HIEs and who knows how much money being spent by private organizations, we don’t have a wave of success stories.

You’d think by this point we’d have so many stories of lives saves, costs reduced and care improved that every organization would have to hop on the healthcare interoperability bandwagon. Peer pressure is a real thing. It’s unfortunate that we don’t have so many good interoperability stories that the peer pressure for everyone to take part isn’t reaching a maximum level.

Sadly, I think the opposite is occurring. All of the stories say that healthcare interoperability isn’t happening. These stories provide peer pressure in the opposite direction. “No one is doing it, so why should I start?”

Although, I think the real problem with interoperability was highlighted in this recent press release about the KLAS Keystone Summit. KLAS brought together 12 EHR vendors (we’ll leave a discussion of which EHR vendors were left out for another post) to “independently and transparently measure/assess the status and trajectory of interoperability.”

While it’s great that these EHR vendors have started talking (5 years ago this would have been laughable), it’s disappointing that this meeting where they supposedly “agree” to an interoperability metric then says “The next step is to put a cohesive plan in place to launch and monitor the measurement.”

Excuse me if I’m skeptical, but I feel like I’ve been here before. A bunch of vendors get together and agree to interoperability. The next step is to put together a plan which never happens and never actually reaches reality. I feel like I’m in interoperability groundhog day.

This isn’t a knock on this specific meeting since it seems to be what’s happened at every meeting which has tried to work on interoperability. We have a nice kumbaya moment where all the EHR vendor executives get in a circle, hold hands and say we’re going to work together and then it never happens.

We need to have more stories shared about EHR vendors and healthcare organizations actually sharing data. That’s going to be the only thing that will turn the tide. I don’t even care if it’s really small data sets. Let’s stop talking about interoperability and start doing it.

If you know of places where interoperability is actually occurring, I’d love to hear about it. Please leave a note in the comment or on our contact us page.

Athenahealth Going to Inpatient EHR School

Posted on February 4, 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 it, Athenahealth announced a collaboration with Beth Israel Deaconess Medical Center and the purchase of their webOMR platform. This comes on the heels of Athenahealth’s acquisition of RazorInsight’s inpatient EHR. Here’s a short video where Jonathan Bush and John Halamka talk about the acquisition:

When you dig into the details of the acquisition, you realize that Athenahealth isn’t going to sell the webOMR software. They’ve purchased the right to be able to copy what’s been built into that EHR software and no doubt bake it into the RazorInsights software. Plus, they’ll have the people at BIDMC providing feedback and guidance as Athenahealth builds out a full inpatient EHR platform that can compete with Epic and Cerner. Jonathan Bush makes it clear that it’s going to take a couple years to make this full vision come to pass, but he believes building it on the right technology will make all the difference as they go after the inpatient EHR market.

I have to admit that I think KLAS got it right when they said that this deal is really about Athenahealth going to inpatient EHR school:

No doubt this was also a way for Athenahealth to get into BIDMC in order to sell their ambulatory software. As part of the deal they’re starting the rollout of Athenahealth ambulatory EHR to a few of their clinics. It will be interesting to hear how that goes since it will say a lot about how the future BIDMC partnership will go for Athenahealth. No doubt, Athenahealth is going to throw all of its resources at the implementation to make sure they’re a success.

This move by Athenahealth is a big one and fraught with risk. It combines the complicated hospital environment with an existing software base and the acquisition of another software base as they integrate a third software base’s experience into a new platform for inpatient EHR. Yeah, nothing could go wrong with that mix. Of course, in a high stakes game of poker when there’s a lot of risk, there’s a lot of reward. Jonathan Bush and Athenahealth have pushed their chips all in. We’ll see the final card in about 2-3 years.

Health Organizations Investing In Best-of-Breed ACO Tools

Posted on December 23, 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.

With accountable care becoming the standard for providers, more and more are seeking out best-of-breed vendors that can fill in the gaps in their health IT lineup and meet expected ACO requirements. It seems that just having it EMR in place doesn’t do the trick by itself.

That, at least, is the conclusion one can draw from the latest KLAS report , which finds that 65 percent of providers surveyed are looking at niche vendors to address emerging population health, HIE and business intelligence needs, reports Healthcare IT News.

To draw this conclusion, KLAS spoke with 73 organizations, mostly medium to large sized ID ends in hospitals to see where they are in the ACO journey.

The survey’s results surprised researcher Mark Allphin, who wrote the report, Healthcare IT News notes.

As Allphin sees it, it’s much more common these days to see healthcare organizations move towards integrating their IT properties. The idea that some are more focused on finding best-of-breed tools to address ACO needs, rather than relying on their EMRs, “tells us that the ACO market very likely still up for grabs,” Allphin said.

We’ve known all along that the ACO game was going to be an expensive one. If KLAS is right, it’s going to be a whole new independent marketplace, in which providers shop for calls that fill in huge gaps in their existing ACO toolkit. If I were CIO, however, I’d be pretty annoyed that the huge investment made situation made in an EMR can’t get the job done all by itself.

Now the question is which health IT areas hospitals and medical practices will take on first; after all, there’s lots of ways to attack the question of how to prepare for the new, bold ACO world. My guess is that tools supporting population health measures will be particularly popular, as population health management is a key capability ACOs bring to the table that health systems alone may not.

Stages, Rankings, and Other Vanity Metrics

Posted on November 18, 2013 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.

It seems like we’re always getting bombarded with the latest and greatest list of hospitals and EHR vendors being ranked, classified or sorted into the various levels of IT adoption. The most famous are probably the HIMSS stages, KLAS rankings, and Most Wired Hospitals. While I’m like most of you and can’t resist glancing at them, every time I do I wonder what value those rankings and classifications really have when it comes to Health IT adoption.

In the startup world there’s a term that’s very popular called vanity metrics. I believe it was first made popular by Eric Ries in this post. The idea is simple. Organizations (and the press that cover them) love to publish big numbers for an organization, but do those metrics really have any meaning?

When I look at the various stages and ranking systems out there in healthcare IT, I wonder if they’re all just vanity metrics. The press loves to put a number on something or to classify an organization versus another one. However, does the stage or ranking really say anything about what really matters to a healthcare organization?

I haven’t done any specific research on things like the quality of care or the financial qualities of organizations across these stages and rankings. Maybe organizations that rank higher or have achieved a higher stage actually do provide better care and have better financials. Although, no doubt that research would have to also inspect the causal relationship between rankings and these results. However, I wonder if these rankings and classifications are really just vanity metrics.

I wonder if there are other metrics we could use to evaluate a healthcare organization. I think the results of such metrics would find every institution wanting in some areas and excelling in others. Stages and rankings don’t take this into account. However, I believe it’s the reality at every institution.

This actually reminds me of Farzad Mostashari’s comments about Healthcare’s Inability to “Step on a Scale” Today. As Farzad asserts, healthcare can’t “step on a scale” today and know how they’re doing. This is partially because the “scales” we’re using today aren’t measuring the right metrics. It’s like the scale is telling us that we’re 5’9″ and so we’re concluding we’re overweight. Although I expect that many might argue that the scale is blank and we’re concluding whatever we want to conclude.

I’d love to hear what metrics you think a healthcare organization should be measuring. Let’s hear your thoughts in the comments.

Cerner, Intermountain Form Major Development Partnership

Posted on October 1, 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.

Normally, when I read the news of a vendor partnership, it’s a major snoozefest. After all, marketing deals and customer wins may be important to the vendor, but they don’t change our life much.

This time, though, I’m willing to go out a limb and say that the following is an important deal. Cerner, one of the leading players on the enterprise EMR front, has struck an agreement with healthcare chain Intermountain Healthcare under which the two will partner long-term on activity-based costing.

Intermountain, the largest health provider in the Intermountain West region of the US, is making a huge Cerner buy, Information Week reports. As part of its agreement with Cerner, Intermountain is tearing out its existing systems, including two EMRs, two billing systems and desktop integration system, and replacing them with Cerner technology.

In this deal, you can certainly chalk up one more win for Cerner, which has been gaining ground in the 200+ bed hospital segment of late. According to KLAS, the ratio of Epic-to-Cerner wins has fallen from 5-to-1 in 2010 to 2-to-1 in 2012 in this segment, according to the research firm.

But the agreement goes well beyond being a mere sale. Once the new, integrated Cerner system is in place, it will serve as the foundation for the long-term project partners have in mind.

Intermountain chose to partner with Cerner because of its system’s open architecture, which will allow for the addition of new content Intermountain plans to provide, CIO Marc Probst told Information Week.

The partners plan a closely-integrated relationship which involves the movement of several Cerner executives and staffers to Intermountain’s headquarters in Salt Lake City. Their work will include development of care process models, connectivity-based costing, advanced decision support and clinical workflows, IW reports.

Getting this work done requires little short of a wedding. ” “We’re looking at 20 plus years of collaboration. We have shared interests in making this be a great success,” Probst told the magazine.

KLAS Reports Cerner and Epic Combined to Capture More Than 3/4 of New Large Hospital EMR Contracts

Posted on August 28, 2013 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.

This tweet and associated messages are circling all around social media. Here’s the short description of the KLAS report:

HITECH has drastically changed the acute care EMR market. Previous industry mainstays like GE Healthcare and QuadraMed have effectively dropped out. McKesson has promoted their community hospital solution, Paragon, over their former flagship, Horizon. Allscripts, MEDITECH, and Siemens are all racing to recover from past stumbles and regain market share. Since meaningful use became a reality, Cerner and Epic have captured a large majority of new hospital contracts. However, there are still many decisions to be made in coming years and the remaining market is potentially more competitive than in years past.

For those of us following the industry, this isn’t really big news. Cerner and Epic have been battling for the big hospitals for quite a while. In fact, coming out of this year’s HIMSS I was more interested in the battle for small hospitals than large hospitals. Of course, we’ll see how hospital consolidation affects this as well.

What does seem clear and this report confirms is that Epic and Cerner all well positioned in the large hospital EMR market. I predict they’ll dominate until at least the end of meaningful use.

EMR Vendors Need To Get Their Act Together

Posted on March 22, 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.

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?