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My MEDITECH MD and CIO Forum Experience

Posted on October 29, 2018 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 recently had the pleasure of attending the annual MEDITECH MD and CIO Forum. Not only was the venue and MEDITECH hospitality great, but they also ordered up beautiful fall weather for the event in Boston. Although, I have to admit that it must be intimidating to speak at an event hosted in the round. Luckily all of the keynotes really delivered (See my post about Ted James, MD’s keynote).

As long-time readers know, there’s almost nothing better to me than attending a user conference. At user conferences, you hear the “from the trenches” perspectives on what’s life really like on the front lines of healthcare and technology. In many cases, you listen to sessions and discussions at lunch that sounds like they’re speaking another language. For the most part, that’s basically what they’re doing. The language of an EMR user is really unique and different and it’s what makes an EHR user conference like this so special. Those attending speak the same language and are able to uniquely help each other.

Given users’ propensity to share the good, the bad, and the ugly, it was really great that MEDITECH invited me to attend their MD and CIO Forum. The good news for them is that I’ve been to enough EHR user forums that I’ve heard it all. Nothing really shocks me anymore and every EHR vendor has their challenges. In one session, someone commented on the 500 open tickets they had with support. I think it kind of scared MEDITECH that I was hearing this. However, I’d recently heard from someone using their competitor’s EHR who had 4000 open tickets. Only 500 tickets sounded quite good comparatively. Perspective and nuance really matter when you talk about problems. That’s something that’s often missed by many media these days.

While at the Forum, MEDITECH made a number of interesting announcements. Read on for details below and check out the 4 video interviews we live streamed from the conference on Facebook. The biggest announcement from my viewpoint was around voice enabling the MEDITECH EHR software. Together in partnership with Nuance, MEDITECH created a simple way for users to request information from the EHR using their voice and even to create orders. On the mobile side, they’re creating similar functionality in partnership with Google’s voice recognition. No doubt this is just the start of voice enabling the EHR.

It’s easy to see how voice will become really valuable if providers are able to get information and create orders while their hands are tied up examining the patient. MEDITECH was also smart about the voice created orders. It doesn’t just order things automatically but queues up those orders for the doctors to approve later. This is a common step we’ve seen smart vendors take when adding voice and other AI to the documentation process. We’ll see over time whether the accuracy and trust reach the point that this human verification process is no longer needed.

MEDITECH also announced a number of things around interoperability. First, outbound FHIR integrations are included in every MEDITECH EHR. Plus, they’re working on inbound FHIR integrations. They didn’t set a timeline on inbound integrations but they did say they’d be “coming soon.” MEDITECH also talked about their new API called MEDITECH Greenfield. If you want more information on Greenfield, be sure to read our interview with Niraj Chaudhry where we cover it in detail.

Another interesting announcement was MEDITECH’s new population health oriented integration with Arcadia.io. It’s great to see MEDITECH embracing outside third party data that can help their users provide better care to patients. Plus, the integration looked really seamless from a physician user perspective.

Another big takeaway for me came from a session on governance and end user buy-in. The takeaway was simple. Enduser buy-in and governance are a challenge regardless of what EHR system you choose. To get more specific insights into how to improve buy-in and governance in your organization, check out the live tweets I shared on the #MDCIO2018 hashtag on Twitter.

A few other observations from the event are that I don’t think most people appreciate what a huge step forward Expanse (their latest EHR platform) is for MEDITECH and their users. I’ve often written that there’s no one feature about EHR software that’s hard to implement. However, it’s the 1000 features you need to create a complete EHR that makes it such a challenge. It was a pretty brave thing for a 50-year-old company, MEDITECH, to go back and start nearly from scratch using the latest technology to create Expanse. That means that Expanse is still a work in progress where they’re adding features as fast as they can. However, it also is true that it might be the only EHR software that was built in the post-meaningful use era.

I was also surprised by a number of users I talked to who commented on how the price of MEDITECH really mattered to their organization. I’m not sure if these organizations had read the many stories of expensive EHR implementations damaging healthcare organizations financially or if they were just more fiscally conservative organizations. Either way, you could tell these users appreciated that MEDITECH charged a much lower price for their software than other EHR competitors out there.

All in all, I had a great experience at the MEDITECH MD and CIO Forum. Their users really reflect the culture of MEDITECH. They’re largely unassuming and just want to do what’s best for their patients. It was actually fascinating to see how the same cultures seemed to attract. No doubt, their users were still suffering from burnout like so many others. That’s common across all of healthcare. They also still had their long list of features and functions they wanted to be implemented. However, I have yet to attend an EHR user conference where that wasn’t the case.

Note: MEDITECH is a sponsor of Healthcare Scene.

AI Project Set To Offer Hospital $20 Million In Savings Over Three Years

Posted on October 4, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While they have great potential, healthcare AI technologies are still at the exploration stage in most healthcare organizations. However, here and there AI is already making a concrete difference for hospitals, and the following is one example.

According to an article in Internet Health Management, one community hospital located in St. Augustine, Florida expects to save $20 million dollars over the next the three years thanks to its AI investments.

Not long ago, 335-bed Flagler Hospital kicked off a $75,000 pilot project dedicated to improving the treatment of pneumonia, sepsis and other high mortality conditions, building on AI tools from vendor Ayasdi Inc.

Michael Sanders, a physician who serves as chief medical informatics officer for the hospital, told the publication that the idea was to “let the data guide us.” “Our ability to rapidly construct clinical pathways based on our own data and measure adherence by our staff to those standards provides us with the opportunity to deliver better care at a lower cost to our patients,” Sanders told IHM.

The pilot, which took place over just nine weeks, reviewed records dating back five years. Flagler’s IT team used Ayasdi’s tools to analyze data held in the hospital’s Allscripts EHR, including patient records, billing, and administrative data. Analysts looked at data on patterns of care, lengths of stay and patient outcomes, including the types of medications docs and for prescribing and when doctors were ordering CT scans.

After analyzing the data, Sanders and his colleagues used the AI tools to build guidelines into the Allscripts EHR, which Sanders hoped would make it easy for physicians to use them.

The project generated some impressive results. For example, the publication reported, pathways for pneumonia treatment resulted in $1,336 in administrative savings for a typical hospital stay and cut down lengths of stay by two days. All told, the new approach cut administrative costs for pneumonia treatment by $800,000.

Now, Flagler plans to create pathways to improve care for sepsis, substance abuse, heart attacks, and other heart conditions, gastrointestinal disorders and chronic conditions such as diabetes.

Given the success of the project, the hospital expects to expand the scope of its future efforts. At the outset of the project, Sanders had expected to use AI tools to take on 12 conditions, but given the initial success with rolling out AI-based pathways, Sanders now plans to take on one condition each month, with an eye on meeting a goal of generating $20 million in savings over the new few years, he told IHM.

Flagler is not the first, nor will it be the last, hospital to streamline care using AI. For another example, check out the efforts underway at Montefiore Health, which seems to be transforming its entire data infrastructure to support AI-based analytics efforts.

Yale New Haven Hospital Partners With Epic On Centralized Operations Center

Posted on February 5, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Info, info, all around, and not a place to manage it all. That’s the dilemma faced by most hospitals as they work to leverage the massive data stores they’re accumulating in their health IT systems.

Yale New Haven Hospital’s solution to the problem is to create a centralized operations center which connects the right people to real-time data analytics. Its Capacity Command Center (nifty alliteration, folks!) was created by YNHH, Epic and the YNHH Clinical Redesign Initiative.

The Command Center project comes five years into YNHH’s long-term High Reliability project, which is designed to prepare the institution for future challenges. These efforts are focused not only on care quality and patient safety but also managing what YNHH says are the highest patient volumes in Connecticut. Its statement also notes that with transfers from other hospitals increasing, the hospital is seeing a growth in patient acuity, which is obviously another challenge it must address.

The Capacity Command Center’s functions are fairly straightforward, though they have to have been a beast to develop.

On the one hand, the Center offers technology which sorts through the flood of operational data generated by and stored in its Epic system, generating dashboards which change in real time and drive process changes. These dashboards present real-time metrics such as bed capacity, delays for procedures and tests and ambulatory utilization, which are made available on Center screens as well as within Epic.

In addition, YNHH has brought representatives from all of the relevant operational areas into a single physical location, including bed management, the Emergency Department, nursing staffing, environmental services and patient transport. Not only is this a good approach overall, it’s particularly helpful when patient admissions levels climb precipitously, the hospital notes.

This model is already having a positive impact on the care process, according to YNHH’s statement. For example, it notes, infection prevention staffers can now identify all patients with Foley catheters and review their charts. With this knowledge in hand, these staffers can discuss whether the patient is ready to have the catheter removed and avoid related urinary tract infections associated with prolonged use.

I don’t know about you, but I was excited to read about this initiative. It sounds like YNHH is doing exactly what it should do to get more out of patient data. For example, I was glad to read that the dashboard offered real-time analytics options rather than one-off projections from old data. Bringing key operational players together in one place makes great sense as well.

Of course, not all hospitals will have the resources to pull something off something like this. YNHH is a 1,541-bed giant which had the cash to take on a command center project. Few community hospitals would have the staff or money to make such a thing happen. Still, it’s good to see somebody at the cutting edge.

An EHR Vendor’s Efforts to Address Physician Burnout with Corinne Proctor Boudreau from MEDITECH

Posted on January 24, 2018 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.

Physician burnout is a major problem in healthcare. While there are a lot of things that are contributing to physician burnout, many like to point to the EHR as a major reason why so many physicians are getting burnt out. So, while the EHR can’t completely solve physician burnout, a well designed EHR can help to alleviate some of the stress a physician experiences.

With this idea in mind, we jumped at the chance to sit down with Corinne Proctor Boudreau, Senior Manager, Physician Experience at MEDITECH, to learn about what MEDITECH is hearing from their customers about physician burnout and what they’ve been doing and plan to do to alleviate this challenging problem.

Check out our full physician burnout interview with Corinne Proctor Boudreau embedded below or on YouTube.

You can find all of Healthcare Scene’s interviews on the Healthcare Scene YouTube channel. Also, at the start of the video, I mentioned our new conference, Health IT Expo happening at the end of May in New Orleans. We hope you’ll all be able to join us in New Orleans to learn about practical innovations that can benefit your organization.

Did EMRs Help Hospitals Hit By Hurricane Harvey?

Posted on September 5, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

On August 25, 2005, Hurricane Katrina made landfall. Over the next few days, it devastated communities from Florida to Texas, generating massive storm surges and triggering levee failures that drowned cities like New Orleans. It was the costliest natural disaster in the history of the United States.

At the time, virtually all healthcare providers used paper medical records, many of which were destroyed by flooding. According to an AHIMA article, the flood waters destroyed roughly 400,000 paper records, a catastrophic loss by any standard.

The situation wasn’t nearly as dire at facilities like Tulane University Hospital and Clinic, though. The New Orleans-based organization had implemented an EMR before the storm hit. In the trying weeks afterward, physicians at these hospitals had access to medical records, while many other hospitals were struggling to gather patient information for months or even years after Katrina.

Now, we’re facing the aftermath of Hurricane Harvey, which has all but submerged the city of Houston. Days after the storm’s peak, which dumped a record 51.88 inches of rain on Texas, roughly a third of the Houston area was covered in water, and Texas officials estimated that close to 49,000 homes had suffered flood damage.

During the worst of the storm, some 20 Houston hospitals transferred some or all of their patients to facilities outside of the area as water rose in their basements or levees seemed ready to burst. In its immediate aftermath, many of the area’s 110 facilities shut down outpatient services and canceled elective surgeries.

But despite the challenges they faced, the majority of Houston-area hospitals remained open for business.  One reason for their ability to function: unlike the hospitals battered by Katrina, they have EMRs in place. The area didn’t see any major power outages and the systems seem to stayed online.

It’s hard to say whether New Orleans would’ve fared better if the city’s hospitals had already implemented EMRs. Houston hospitals were apparently better prepared for hurricane flooding, having put a host of storm fortifications in place after Tropical Storm Allison wreaked massive damage sixteen years ago.

That being said, it seems likely that the EMRs have helped hospitals keep the doors open and keep caring for patients. If nothing else, they gave facilities a giant head start over New Orleans hospitals post-disaster, which in some cases had virtually nothing to go on when delivering care.

Of course, digital data offers some significant advantages over paper records of any kind, including but not limited to the ability to backup records to off-site facilities well out of a given disaster zone.  But organizing patient data in an EMR, arguably, offers additional benefits, not the least of which is the ability to access existing workflows and protocols. Few tools are better suited to capturing, sharing and preserving care records in the midst of a catastrophic event like Harvey.

Over the next few decades, some observers predict that care will become massively decentralized, with remote nurses, telemedicine and connected health doing much of the heavy lifting day-to-day. If that comes to pass, and health IT intelligence is distributed across mobile devices instead, the EMR of today may be far less important to healthcare organizations hoping to rebound after a disaster. But until then, it’s safe to say that it’s a good thing Houston’s hospitals don’t rely on paper records anymore.

E-Patient Update: Before You Call Me A “Frequent Flier,” Check Your EMR

Posted on April 28, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While there’s some debate about what constitutes an emergency, there’s no doubt I’ve had a bunch of ambiguous, potentially symptoms lately that needed to be addressed promptly. Unfortunately, that’s exposed me to providers brainwashed to believe that anyone who comes to the emergency department regularly is a problem.

Not only is that irritating, and sometimes intimidating, it’s easy to fix. If medical providers were to just dig a bit further into my existing records – or ideally, do a sophisticated analysis of my health history – they’d understand my behavior, and perhaps even provide more effective care.

If they looked at the context their big ‘ol EMR could provide, they wouldn’t waste time wondering whether I’m overreacting or wasting their time.

As I see it, slapping the “frequent flier” label on patients is particularly inappropriate when they have enough data on hand to know better. (Actually, the American College of Emergency Physicians notes that a very small number of frequent ED visitors are actually homeless, drug seekers or mentally ill, all of which is in play when you show up a bit often. But that’s a topic for another time.)

Taking no chances

The truth is, I’ve only been hitting the ED of late because I’ve been responding to issues that are truly concerning, or doing what my primary doctor or HMO nurse line suggests.

For example, my primary care doctor routed me straight to the local emergency department for a Doppler when my calves swelled abruptly, as I had a DVT episode and subsequent pulmonary embolism just six months ago.

More recently, when I had a sudden right-sided facial droop, I wasn’t going to wait around and see if it was caused by a stroke. It turns out that I probably had an atypical onset of Bell’s Palsy, but there was no way I was going to try and sort that out on my own.

And given that I have a very strong history of family members dropping dead of MI, I wasn’t going to fool around when I felt breathless, my heart was racing and I my chest ached. Panic attack, you’re thinking? No, as it turned out that like my mother, I had aFib. Once again, I don’t have a lab or imaging equipment in my apartment – and my PCP doesn’t either – so I think I did the right thing.

The truth is, in each case I’d probably have been OK, but I erred on the side of caution. You know what? I don’t want to die needlessly or sustain major injuries to prove I’m no wimp.

The whole picture

Nonetheless, having been to the ED pretty regularly of late, I still encounter clinicians that wonder if I’m a malingerer, an attention seeker or a hypochondriac. I pick up just a hint of condescension, a sense of being delicately patronized from both clinicians and staffer who think I’m nuts. It’s subtle, but I know it’s there.

Now, if these folks kept up with their industry, they might have read the following, from Health Affairs. The article in question notes that “the overwhelming majority of frequent [ED} users have only episodic periods of high ED use, instead of consistent use over multiple years.” Yup, that’s me.

If they weren’t so prone to judging me and my choices – OK, not everyone but certainly some – it might occur to them to leverage my data. Hey, if I’m being screened but in no deep distress, why not ask what my wearable or health app data has told me of late? More importantly, why haven’t the IT folks at this otherwise excellent hospital equipped providers with even basic filters the ED treatment team can use to spot larger patterns? (Yeah, bringing big data analytics into today’s mix might be a stretch, but still, where are they?)

Don’t get me wrong. I understand that it’s hard to break long-established patterns, change attitudes and integrate any form of analytics into the extremely complex ED workflow. But as I see it, there’s no excuse to just ignore these problems. Soon, the day will come when on-the-spot analytics is the minimum professional requirement for treating ED patients, so confront the problem now.

Oh, and by the way, treat me with more respect, OK?

Do Health IT Certificate Of Need Requirements Make Sense?

Posted on January 23, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The other day, I read an interesting piece about the University of Vermont Medical Center’s plans to create an integrated EMR connecting its four network hospitals. The article noted that unlike its peers in some other states, UVMC was required to file a Certificate of Need (CON) application with the state before it proceeds with the work.  And that struck me as deserving some analysis.

According to a story appearing in Healthcare Informatics,  UVMC plans to invest an initial $112.4 million in the project, which includes an upgrade to informatics, billing and scheduling systems used by UVMC and network facilities Central Vermont Medical Center, Champlain Valley Physicians Hospital and Elizabethtown Community Hospital. The total costs of implementing and operating the integrated system should hit $151.6 million over the first six years. (For all of you vendor-watchers, UVMC is an Epic shop.)

In its CON application, UVMC noted that some of the systems maintained by network hospitals are 20 years old and in dire need of replacement. It also asserted that if the four hospitals made upgrades independently rather than in concert, it would cost $200 million and still leave the facilities without a connection to each other.

Given the broad outline provided in the article, these numbers seem reasonable, perhaps even modest given what execs are trying to accomplish. And that would be all most hospital executives would need to win the approval of their board and steam ahead with the project, particularly if they were gunning for value-based contracts.

But clearly, this doesn’t necessarily mean that such investments aren’t risky, or don’t stand a chance of triggering a financial meltdown. For example, there’s countless examples of health systems which have faced major financial problems (like this and this),  operational problems (particularly in this case) or have been forced to make difficult tradeoffs (such as this). And their health IT decisions can have a major impact on the rest of the marketplace, which sometimes bears the indirect costs of any mistakes they make.

Given these concerns, I think there’s an argument to be made for requiring hospitals to get CONs for major health IT investments. If there’s any case to be made for CON programs make any sense, I can’t see why it doesn’t apply here. After all, the idea behind them is to look at the big picture rather than incremental successes of one organization. If investment in, say, MRIs can increase costs needlessly, the big bucks dropped on health IT systems certainly could.

Part of the reason I sympathize with these requirements is I believe that healthcare IS fundamentally different than any other industry, and that as a public good, should face oversight that other industries do not. Simply put, healthcare costs are everybody’s costs, and that’s unique.

What’s more, I’m all too familiar with the bubble in which hospital execs and board members often live. Because they are compelled to generate the maximum profit (or excess) they can, there’s little room for analyzing how such investments impact their communities over the long term. Yes, the trend toward ACOs and population health may mitigate this effect to some degree, but probably not enough.

Of course, there’s lots of arguments against CONs, and ultimately against government intervention in the marketplace generally. If nothing else, it’s obvious that CON board members aren’t necessarily impartial arbiters of truth. (I once knew a consultant who pushed CONs through for a healthcare chain, who said that whichever competitor presented the last – not the best — statistics to the room almost always won.)

Regardless, I’d be interested in studying the results of health IT CON requirements in five or ten years and see if they had any measurable impact on healthcare competition and costs.  We’d learn a lot about health IT market dynamics, don’t you think?

Study: Hospital EMR Rollouts Didn’t Cause Patient Harm

Posted on September 14, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Rolling out a hospital EMR can be very disruptive. The predictable problems that can arise – from the need to cut back on ambulatory patient visits to the staff learning curve to unplanned outages – are bad enough. And of course, when the implementation hits a major snag, things can get much worse.

Just to pull one name out of a hat, consider the experience of the Vancouver Island Health Authority in British Columbia, Canada. One of the hospitals managed by the Authority, which is embroiled in a $174 million Cerner implementation, had to move physicians in its emergency department back to pen and paper in July. Physicians had complained that the system was changing medication orders and physician instructions.

But fortunately, this experience is definitely the exception rather than the rule, according to a study appearing in The BMJ. In fact, such rollouts typically don’t cause adverse events or needless deaths, nor do they seem to boost hospital readmissions, according to the journal.

The study, which was led by a research team from Harvard, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center and Massachusetts General Hospital, looked at the association between EHR implementation and short-term inpatient mortality, adverse safety events or readmissions among Medicare enrollees getting care at 17 U.S. hospitals. The hospitals selected for the study had rolled out or replaced their EHRs in a “big bang”-style, single-day go-live in 2011 and 2012.

To get a sense of how selected hospitals performed, the team studied patients admitted to the studied facilities 90 days before and 90 days after EHR implementation. The researchers also gathered similar data from a control group of all admissions during the same period by hospitals in the same referral region. For selected hospitals, they analyzed data on 28,235 patients admitted 90 days before the implementation, and 26,453 admitted 90 days after the EHR cutover. (The control size was 284,632 admissions before and 276,513 after.)

Apparently, researchers were expecting to see patient care problems arise. Their assumption was that in the wake of the go-live, the hospitals would see a short increase in mortality, readmissions and adverse safety events. One of the reasons they expected to see this bump in problems is that some negative problems related to time and season, such as the “weekend effect” and the “July effect,” are well documented in existing research. Surely the big changes engendered by an EHR cutover would have an impact as well, they reasoned.

But that’s not what they found. In fact, the researchers wrote, “there was no evidence of a significant or consistent negative association between EHR implementation and short-term mortality, readmissions, or adverse events.”

I was as surprised as the researchers to learn that EHR rollouts studied didn’t cause patient harm or health instability. Considering the immense impact an EHR can have on clinical workflow, it seems strange to read that no new problems arose. That being said, hospitals in this group may have been doing upgrades – which have to be less challenging than going digital for the first time – and were adopting at a time when some best practices had emerged.

Regardless, given the immense challenges posed by hospital EHR rollouts, it’s good to read about a few that went well.  We all need some good news!

Value Based Care Hurting Most Vulnerable Hospitals

Posted on March 25, 2016 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 an article by the Washington Examiner, they highlight an interesting impact of the shift to value based reimbursement on hospitals:

Safety-net hospitals are getting hit by Obamacare’s push to penalize poor quality, the latest evidence of problems with the law’s effort to improve quality of care.

A new study from Harvard Medical School found that safety-net hospitals that treat many low-income or uninsured individuals are being penalized more for hospital readmission rates than other hospitals.

If a hospital readmits too many patients 30 days after they are discharged after being treated for a certain condition, that hospital gets penalized. A hospital could receive up to a 3 percent reduction in its Medicare annual patient payments.

The policy, which started in 2011, a year after Obamacare was passed, is intended to address a quality issue at hospitals. It is part of a larger shift in Obamacare to transition Medicare payments away from traditional fees for service toward a new model that rewards quality care.

We saw something similar to this happen during meaningful use as well. The most vulnerable hospitals couldn’t get the EHR incentive money because the incentive money wasn’t enough to cover the entire costs of the EHR. So, they just went without. In fact, an argument could be made that a large portion of the meaningful use EHR incentive money was paid to hospitals that were already on the path to EHR, but that’s a topic for another day.

When it comes to value based reimbursement it takes the right investment in technology and processes to be successful. I know a lot of hospitals that are just trying to keep their doors open. Where does that leave them time to think about these new complex government regulations? No doubt this shift to value based reimbursement is going to cause a lot of them to close their doors or be merged into the larger hospital systems. In fact, the later has been happening for a while and will continue to accelerate.

The article above does suggest a possible solution:

One alternative would have a hospital be measured by how its readmission rate improves rather than whether it meets a national average.

“Hospitals could be rewarded based on improvements off what their prior performance has been,” Barnett said.

Another alternative is for a hospital to become an accountable care organization. The concept gives a hospital a spending growth target that it has to meet for its Medicare patients.

I like the idea of benchmarking, but that can get really messy really quickly. The more I learn about value based reimbursement the more I worry that we’re just making things more complex without actually solving healthcare’s core problems.

A Look at MEDITECH’s Place in the EHR Marketplace and Where They’re Headed

Posted on February 12, 2016 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.

Healthcare Scene was lucky to sit down with Helen Waters, VP at MEDITECH, to talk about the EHR market and MEDITECH’s place in that market. Plus, we dive into the culture and history of MEDITECH and how it’s changed. We also explore MEDITECH’s plans around innovation, integration, and value along with MEDITECH’s efforts to deploy cloud and mobile solutions. Finally, we had to talk about healthcare interoperability. We hope you’ll enjoy this wide ranging interview with Helen Waters:

After the formal interview we did above, we allow people watching live to be able to ask questions and even hop on camera to offer their insights or ask questions of Helen in what we call the “after party.” In this “after party” discussion we talk to Helen about her thoughts on the changing healthcare reimbursement landscape and what MEDITECH is doing to prepare for it. We also talk about integrating telemedicine into MEDITECH. I also ask Helen about MEDITECH’s views on EHR APIs. Check out the second half of our interview below:

We hope you’ll enjoy this look into EHR vendor, MEDITECH.