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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.

New MEDITECH EHR API – An Interview with Niraj Chaudhry

Posted on October 2, 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.

The EHR API has been a hot topic lately. Many healthcare organizations and startup companies are looking to EHR vendors in order to connect applications that exist outside the EHR with the EHR. Years ago (2012 to be exact), I wrote that the EHR is the database of healthcare and with all of these APIs coming out, we’re seeing that come to fruition.

The good news is that EHR vendors are finally starting to embrace this viewpoint as well. Many of you have probably read Colin Hung’s article that looks at 2 EHR vendors and their APIs. Many of you probably saw the announcement of MEDITECH’s new app development environment called MEDITECH Greenfield. It’s great to see MEDITECH launching an API for developers who want to engage with their Expanse platform. To learn more about this new platform, we sat down with Niraj Chaudhry, Director of Development Advanced Technology Division from MEDITECH.

What’s the motivation for MEDITECH to launch Greenfield?

Interoperable, open architecture EHR platforms that promote sharing resources for collective growth are critical for driving innovation and progress in today’s healthcare paradigm. By offering a space for mobile app development, MEDITECH is adding more capabilities and value to our customers’ EHRs and driving efficiencies for better community outcomes. Our customers will be able to enhance the EHR experiences of their providers, patients, and consumers with innovative apps available on any mobile device.

Greenfield is a natural extension of what we’ve done with MEDITECH Expanse and reinforces our commitment to a mobile, web-based EHR. We are excited about working with third-party developers and increasing our visibility with the creation of apps to augment Expanse.

What data will developers be able to access through Greenfield?  Is it a read-only environment or will developers be able to write back to MEDITECH using the Greenfield API as well?

Currently, our testing environment includes a list of available Common Clinical Data Set APIs and associated documentation. These APIs support GET methods and so give read-only access to the data. Developers can register now to get started. More APIs will be added to the Greenfield in future which will support other methods such as PUT and POST, and so will allow the ability to write data back to the Greenfield environment.

Will Greenfield only work with Expanse or will it work with other MEDITECH products?

Currently, MEDITECH Greenfield is available to MEDITECH Expanse customers.

Are there costs associated with companies participating in Greenfield (ie. signup and/or usage)?

There are no costs to sign up, access or use Greenfield.

What type of promotion will you do for companies who choose to leverage MEDITECH Greenfield in their application? What are you planning to do so MEDITECH users learn about new partners?

In the future, we plan on highlighting select (or “preferred”) mobile apps that we feel add significant value to the MEDITECH platform. This is still in the very early stages and business models for how we will list or promote apps are being discussed.

Will any company be able to sign up for Greenfield or will you restrict it to a certain number of companies or certain types of companies?

Any interested developers can sign up for access through a secure login process here.

Report Champions API Use To Improve Interoperability

Posted on September 26, 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.

A new research report has taken the not-so-radical position that greater use of APIs to extract and share health data could dramatically improve interoperability. It doesn’t account for the massive business obstacles that still prevent this from happening, though.

The report, which was released by The Pew Charitable Trusts, notes that both the federal government and the private sector are both favoring the development of APIs for health data sharing.

It notes that while the federal government is working to expand the use of open APIs for health data exchange, the private sector has focused on refining existing standards in developing new applications that enhance EHR capabilities.

EHR vendors, for their part, have begun to allow third-party application developers to access to systems using APIs, with some also offering supports such as testing tools and documentation.

While these efforts are worthwhile, it will take more to wrest the most benefit from API-based data sharing, the report suggests. Its recommendations for doing so include:

  • Making all relevant data available via these APIs, not just CCDs
  • Seeing to it that information already coded in health data system stays in that form during data exchange (rather than being transformed into less digestible formats such as PDFs)
  • Standardizing data elements in the health record by using existing terminologies and developing new ones where codes don’t exist
  • Offering access to a patient’s full health record across their lifetime, and holding it in all relevant systems so patients with chronic illnesses and care providers have complete histories of their condition(s)

Of course, some of these steps would be easier to implement than others. For example, while providing a longitudinal patient record would be a great thing, there are major barriers to doing so, including but not limited to inter-provider politics and competition for market share.

Another issue is the need to pick appropriate standards and convince all parties involved to use them. Even a forerunner like FHIR is not yet universally accepted, nor is it completely mature.

The truth is that no matter how you slice it, interoperability efforts have hit the wall. While hospitals, payers, and clinicians pretty much know what needs to happen, their interests don’t converge enough to make interoperability practical as of yet.

While I’m all for organizations like the Pew folks taking a shot at figuring interoperability out, I don’t think we’re likely to get anywhere until we find a way to synchronize everyone’s interests. And good luck with that.

Do We Need Another Interoperability Group?

Posted on September 20, 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.

Over the last few years, industry groups dedicated to interoperability have been popping up like mushrooms after a hard rain. All seem to be dedicated to solving the same set of intractable data sharing problems.

The latest interoperability initiative on my radar, known as the Da Vinci Project, is focused on supporting value-based care.

The Da Vinci Project, which brings together more than 20 healthcare companies, is using HL7 FHIR to foster VBC (Value Based Care). Members include technology vendors, providers, and payers, including Allscripts, Anthem Blue Cross and Blue Shield, Cerner, Epic, Rush University Medical Center, Surescripts, UnitedHealthcare, Humana and Optum. The initiative is hosted by HL7 International.

Da Vinci project members plan to develop a common set of standards for data exchange that can be used nationally. The idea is to help partner organizations avoid spending money on one-off data sharing development projects.

The members are already at work on two test cases, one addressing 30-day medication reconciliation and the other coverage requirements discovery. Next, members will begin work on test cases for document templates and coverage rules, along with eHealth record exchange in support of HEDIS/STARS and clinician exchange.

Of course, these goals sound good in theory. Making it simpler for health plans, vendors and providers to create data sharing standards in common is probably smart.

The question is, is this effort really different from others fronted by Epic, Cerner and the like? Or perhaps more importantly, does its approach suffer from limitations that seem to have crippled other attempts at fostering interoperability?

As my colleague John Lynn notes, it’s probably not wise to be too ambitious when it comes to solving interoperability problems. “One of the major failures of most interoperability efforts is that they’re too ambitious,” he wrote earlier this year. “They try to do everything and since that’s not achievable, they end up doing nothing.”

John’s belief – which I share — is that it makes more sense to address “slices of interoperability” rather than attempt to share everything with everyone.

It’s possible that the Da Vinci Project may actually be taking such a practical approach. Enabling partners to create point-to-point data sharing solutions easily sounds very worthwhile, and could conceivably save money and improve care quality. That’s what we’re all after, right?

Still, the fact that they’re packaging this as a VBC initiative gives me pause. Hey, I know that fee-for-service reimbursement is on its way out and that it will take new technology to support new payment models, but is this really what happening here? I have to wonder.

Bottom line, if the giants involved are still slapping buzzwords on the project, I’m not sure they know what they’re doing yet. I guess we’ll just have to wait and see where they go with it.

Underwhelming Epic Patient Engagement Features from #UGM2018

Posted on August 30, 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.

John Moore has been live-tweeting the Epic User Group meeting happening this week in Wisconsin. John has shared a lot of interesting perspectives, but I was quite intrigued by this picture he shared of the “Really Cool Software In the Works.” Presumably, these are the big new patient experiences features that will be coming to an Epic EHR software near you.

*Yes, that is Judy at the bottom of the big screen presenting these changes and yes she is dressed up like a park ranger. This year’s Epic User Group theme was The Great Outdoors.

It’s nice to see Epic focusing efforts on the patient experience, but am I the only one that was totally underwhelmed by this graphic?

Let’s start with MyChart Bedside on smartphones. You can see a preview of this here. It’s interesting that Epic chose to create a product like this rather than partnering with companies like Oneview or TVR Communications who already have similar products that would work even better with a nice Epic integration. This is why Epic should embrace an open ecosystem for partners.

The announcements around “Get Rid of Clipboards” and “Skip the Waiting Room” are underwhelming as well. I’ve known companies that have had this solution for a decade or so. Epic is just getting them now?

I have a hard time judging the “Catch a Ride” and “Patient-Entered Social Determinants” features. I’m still not convinced how an Epic connection to Lyft and Uber is going to help patients. How many hospitals will really adopt this and will hospitals really start paying for patients rides with this? If they will, why didn’t hospitals just buy cab rides for patients in the past? Will an integration with Epic change that?

As far as patient-entered SDoH (Social Determinants of Health for those following along at home), are patients really going to do this? Once they do, what will the doctor do with this information? Nothing? On the less pessimistic side, as a fact-finding approach, this could be interesting. Assuming patients are willing to share this information (which may be possible in this world of over sharing) this could be a way to discover what SDoH are most prevalent in an area so that hospitals can then find ways to alleviate these challenges.

Finally, the “Talk to MyChart” feature. We’ve long heard that voice was coming to EHR software. Yes, I’m talking beyond the voice recognition that every EHR software has had forever. First, let me share that I’m a huge proponent of voice. It’s amazing the way Alexa has changed my and my family’s lives. I could be wrong, but the feature mentioned above feels like they’ve just voice enabled MyChart. Is it really that much easier to use voice in MyChart? Even if I enjoy the “pleasant voice”? Color me skeptical that this will really change any behavior. If Epic wanted a big voice empowered announcement it should have been being able to access MyChart through Alexa or Google Home (I’m pretty sure Epic would blame HIPAA on this one). That would be a really cool software.

Of course, here I’m just analyzing one slide in Judy’s presentation. I think John Moore commented that the analytics looked promising, but then he hedged the comment by saying that it was better than their competitors.

What can I say? Epic has made billions. I guess I just expect more from them.

Who is the Real EHR Customer?

Posted on August 2, 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.

What a fascinating question from Clay Forsberg. In my experience writing about the EHR space, the EHR customer is the healthcare provider and not the patient. In fact, I think the impact on patients played a very small role in most EHR implementations. I don’t remember ever seeing an EHR RFP that had much of any focus on the patient. The closest you might come is that the EHR would need to have a patient portal or something along those lines. Have you seen patient focused sections of EHR RFPs? If so, I’d love to see them. If not, I’d love to see it too.

When EHR software was first being purchased (technically it was EMR at the time), the decision was largely around how they could better handle things like E/M coding and being able to use the automation in the EHR to be able to bill for higher levels of care (ie. more money). This is what’s led us to EHR note bloat.

Following this EHR era was what I call the golden age of EHR adoption fueled by $36 billion of meaningful use money. I was shocked at how irrational the market became as doctors chased EHR software that would get them access to the meaningful use dollars and avoid any penalties. There was no time for doctors that purchased EHR software in this era to really think about patients. They were too focused on the government handouts.

Long story short, the patient has generally been far from the thoughts of those purchasing EHR software. Don’t get me wrong. I don’t think most people purchasing EHR wanted to recklessly damage the patient. In fact, EHR benefits the patients in a lot of ways (access to the records is one example). However, it’s not any stretch to say that those selecting and implementing EHR software weren’t trying to improve the patient experience. If it was, they would have made different choices.

The question is will this change in the future. Or maybe even more importantly is will EHR vendors be able to evolve in a way that patients will benefit. I think we will see some evolution in this regard, but I don’t expect to see a sea change when it comes to EHR software’s focus on the patient. I think instead we’ll see 3rd party software that will change the patient experience. Some of them will integrate with EHR software which is why EHR APIs are so important, but I’m not looking for the EHR to make the patient their customer. Maybe they should, but I don’t see it happening.

“We’re Goin’ Live with Epic Now” – An EHR Go-live Parody Video

Posted on May 25, 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.

Many of you may remember the Hamilton parody video that Mary Washington Healthcare did back when they selected Epic as their new EHR. Well, Mary Washington Healthcare’ CEO, Mike McDermott, and his Epic team are back again with another Hamilton parody video as they go live on Epic. Check out the video below:

I’m sure many people wonder why a healthcare leader would engage their employees in a video like this. Many underestimate the value of bringing a team together to create a project like this. It’s an extremely valuable team building experience. Plus, it’s nice to have a little fun together when dealing with something as grueling as an Epic EHR implementation.

Furthermore, one of the keys to effectively implementing an EHR is creating a deep relationship with your EHR vendor. There are always problems that come up where you need your EHR vendors support to solve the problems. What better way to get noticed and appreciated by your EHR vendor than to create a video like the one above?

Nice work to the team at Mary Washington Healthcare for creating such a great video. I especially like the drone shots and the shout out to the Epic employees not dressed in the period clothes like everyone else.

In The Aftermath Of Sutter Health EMR Crash, Nurses Raise Safety Questions

Posted on May 24, 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.

In mid-May, Sutter Health’s Epic EMR crashed, accompanied by other technical problems. Officials said the system failures were caused by the activation of the fire suppression system in one of their IT buildings.

As you might expect, employees at locations affected by the downtime weren’t able to access patient medical records. On top of that, they didn’t have access to email or even use their phones. In addition, the system had to contact some patients to reschedule appointments.

On the whole, this sounds like the kind of routine issue which, though embarrassing, can be brought to heel if an organization does the disaster planning and employee training on how to react to the situations.

According to some nurses, however, Sutter Medical Center may not have handled things so well. The nurses, who spoke on condition of anonymity with The Sacrament Bee, told the newspaper that the hospital moved ahead with some forms of care before the outage was completely resolved.

The nurses told that when some patients were admitted after the systems failure, clinicians still didn’t have access to critical patient information. For example, a surgical nurse noted that the surgical team relies upon EMR access to review patient histories and physicals performed within the previous 30 days. According to Sutter protocols, these results need to be certified by the physician as still being valid on the date of surgery.

Instead, patients were arriving with their histories and physical exam records on paper, and those documents didn’t include the doctor’s certification that the patient’s condition hadn’t changed. If something went wrong during elective surgery, the team would’ve had to rely on paper documents to determine the cause, the nurses said.

They argue that Sutter Medical Center shouldn’t have taken those cases until the EMR was fully online. “Other Sutter hospitals canceled elective surgeries,” one nurse told a reporter. “Why did Sutter Medical Center feel like they needed to do elective surgeries?”

Also, they say that at least one surgical procedure was affected by the outage, when a surgeon needed a particular instrument to proceed. Normally, they said, operating room telephones display a directory of numbers to supply rooms or nurse stations, but these weren’t available and it forced the surgical team to break its process. Under standard conditions, the team tries not to leave the operating room because a patient’s condition can deteriorate in seconds. In this case, however, a nurse had to hurry out of the room to get instruments the surgeon needed.

While it’s hard to tell from the outside, this sounds a bit, well, unseemly at best. Let’s hope Sutter’s decision-making in this case was based on thoughtful decisions rather than a need to maintain cash flow.

Let this also be an important reminder to every healthcare organization to make sure you have well thought out disaster plans that have been communicated to everyone in your organization. You don’t want to be caught liable when disaster strikes and your staff start free wheeling without having thought through all of the potential consequences.

5 Ways Allscripts Will Help Fight Opioid Abuse In 2018

Posted on May 22, 2018 I Written By

The following is a guest blog post by Paul Black, CEO of Allscripts, a proud sponsor of Health IT Expo.

Prescription opioid misuse and overdoses are on the rise. The Centers for Disease Control and Prevention (CDC) reports that more than 40 Americans die every day from prescription opioid overdose. It also estimates that the economic impact in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment and criminal justice involvement.

The opioid crisis has taken a devastating toll on our communities, families and loved ones. It is a complex problem that will require a lot of hard work from stakeholders across the healthcare continuum.

We all have a part to play. At Allscripts, we feel it is our responsibility to continuously improve our solutions to help providers address public health concerns. Our mission is to design technology that enables smarter care, delivered with greater precision, for better outcomes.

Here are five ways Allscripts plans to help clinicians combat the opioid crisis in 2018:

1) Establish a baseline. Does your patient population have a problem with opioids?

Before healthcare organizations can start addressing opioid abuse, they need to understand how the crisis is affecting their patient population. We are all familiar with the national statistics, but how does the crisis manifest in each community? What are the specific prescribing practices or overdose patterns that need the most attention?

Now that healthcare is on a fully digital platform, we can gain insights from the data. Organizations can more precisely manage the needs of each patient population. We are working with clients to uncover some of these patterns. For example, one client is using Sunrise™ Clinical Performance Manager (CPM) reports to more closely examine opioid prescribing patterns in emergency rooms.

2) Secure the prescribing process. Is your prescribing process safe and secure?

Electronic prescribing of controlled substances (EPCS) can help reduce fraud. Unfortunately, even though the technology is widely available, it is not widely adopted. Areas where clinicians regularly use EPCS have seen significantly less prescription fraud and abuse.

EPCS functionality is already in place across our EHRs. While more than 90% of all pharmacies are EPCS-enabled, only 14% of controlled substances are prescribed electronically. We’re making EPCS adoption one of our top priorities at Allscripts, and we continue to discuss the benefits with policymakers.

3) Provide clinical decision support. Are you current with evidence-based best practices?

We are actively pursuing partnerships with health plans, pharmaceutical companies and third-party content providers to collaborate on evidence-based prescribing guidelines. These guidelines may suggest quantity limits, recommendations for fast-acting versus extended-release medications, protocols for additional and alternative therapies, and expanded educational material and content.

We’ll use the clinical decision support technologies we already have in place to present these assessment tools and guidelines at the time needed within clinical workflows. Our goal is to provide the information to providers at the right time, so that they can engage in productive conversations with patients, make informed decisions and create optimal treatment plans.

4) Simplify access to Prescription Drug Monitoring Programs (PDMPs). Are you avoiding prescribing because it’s too hard to check PDMPs?

PDMPs are state-level databases that collect, monitor and analyze e-prescribing data from pharmacies and prescribers. The CDC Guidelines recommend clinicians should review the patient’s history of controlled substance prescriptions by checking PDMPs.

PDMPs, however, are not a unified source of information, which can make it challenging for providers to check them at the point of care. The College of Healthcare Information Management Executives (CHIME) has called for better EHR-PDMP integration, combined with data-driven reports to identify physician prescribing patterns.

In 2018, we’re working on integrating the PDMP into the clinician’s workflow for every patient. The EHR will take PDMP data and provide real-time alert scores that can make it easier to discern problems at the point of care.

5) Predict risk. Can big data help you predict risk for addiction?

Allscripts has a team of data scientists dedicated to transforming data into information and actionable insights. These analysts combine vast amounts of information from within the EHR, our Clinical Data Warehouse – data that represents millions of patients – and public health mechanisms (such as PDMPs).

We use this “data lake” to develop algorithms to identify at-risk patients and reveal prescription patterns that most often lead to abuse, overdose and death. Our research on this is nascent, and early insights are compelling.

The opioid epidemic cannot be solved overnight, nor is it something any of us can address alone. But we are enthusiastic about the teamwork and efforts of our entire industry to address this complex, multi-faceted epidemic.

Hear Paul Black discuss the future of health IT beyond the EHR at this year’s HIT Expo.

Health Leaders Go Beyond EHRs To Tackle Value-Based Care

Posted on March 30, 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.

In the broadest sense, EHRs were built to manage patient populations — but largely one patient at a time. As a result, it’s little wonder that they aren’t offering much support for value-based care as is, as a recent report from Sage Growth Partners suggests.

Sage spoke with 100 healthcare executives to find out what they saw as their value-based care capabilities and obstacles. Participants included leaders from a wide range of entities, including an ACO, several large physician practices and a midsize integrated delivery network.

The overall sense Sage seems to have gotten from its research was that while value-based care contracts are beginning to pay off, health execs are finding it difficult support these contacts using the EHRs they have in place. While their EHRs can produce quality reports, most don’t offer data aggregation and analytics, risk stratification, care coordination or tools to foster patient and clinician engagement, the report notes.

To get the capabilities they need for value-based contracting, health organizations are layering population health management solutions on top of their EHRs. Though these additional PHM tools may not be fully mature, health executives told Sage that there already seeing a return on such investments.

This is not necessarily because these organizations aren’t comfortable with their existing EHR. The Sage study found that 65% of respondents were somewhat or highly unlikely to replace their EHR in the next three years.

However, roughly half of the 70% of providers who had EHRs for at least three years also have third-party PHM tools in place as well. Also, 64% of providers said that EHRs haven’t delivered many important value-based contracting tools.

Meanwhile, 60% to 75% of respondents are seeking value-based care solutions outside their EHR platform. And they are liking the results. Forty-six percent of the roughly three-quarters of respondents who were seeing ROI with value-based care felt that their third-party population PHM solution was essential to their success.

Despite their concerns, healthcare organizations may not feel impelled to invest in value-based care tools immediately. Right now, just 5% of respondents said that value-based care accounted for over 50% of their revenues, while 62% said that such contracts represented just 0 to 10% of their revenues. Arguably, while the growth in value-based contracting is continuing apace, it may not be at a tipping point just yet.

Still, traditional EHR vendors may need to do a better job of supporting value-based contracting (not that they’re not trying). The situation may change, but in the near term, health executives are going elsewhere when they look at building their value-based contracting capabilities. It’s hard to predict how this will turn out, but if I were an enterprise EHR vendor, I’d take competition with population health management specialist vendors very seriously.