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Insights from Ted James, MD at the MEDITECH MD & CIO Forum

Posted on October 17, 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.

Over the next couple days, I’m attending the MEDITECH MD and CIO Forum. This is essentially the user conference for the MD and CIO users of MEDITECH software. This morning, they kicked off the event with Ted James, MD, Medical Director at BIDMC/Harvard Medical School. He provided a number of great insights into what’s happening in healthcare and what leaders can do to be more successful.

Below you’ll find a Twitter summary of Ted James, MD’s keynote. You can also watch the live video interviews I’m doing from the event on the Healthcare Scene Facebook page and follow along on Twitter using the hashtag #MDCIO2018.


Healthcare change seems to be an ever ongoing theme. The question really is around the pace of change.


Anyone that’s been through meaningful use understands this experience.


Routine is a powerful idea. So powerful that it prevents change.


Leadership is the key to any change and was a definite theme from Ted James, MD’s keynote.


I love the concept of nudges, but it only works for a subset of use cases in healthcare. Why? Because so many things in healthcare are really complex.


These 3 ideas were really interesting, but I definitely need more time to fully process what they mean. What do you think of these 3 ideas?


This was a really fascinating idea. It illustrates the need to constantly communicate changes so that people get use to the change before the change even occurs. Familiarity with something changes the experience.


Moving an iceberg feels like an apt descrition of healthcare.


This reminds me of when I recently heard that more yoga won’t fix the physician burnout problem.


This is an important lesson for leaders.


This was a refreshing experience to see so many women at a MD and CIO event.

Check back later for more coverage from the MEDITECH MD and CIO Forum.

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.

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.

Hospitals Puts Off Patient Billing For Several Months During EMR Rollout

Posted on January 6, 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.

Here’s something you don’t see every day. A New Hampshire hospital apparently delayed mailing out roughly 10,000 patient bills going back as far as 11 months ago while it rolled out its new EMR.

According to a report in the Foster’s Daily Democrat,  members of Frisbie Memorial Hospital’s medical staff recently went public with concerns about the hospital’s financial state. Then a flood of delayed patient bills followed, some requesting thousands of dollars, the paper reported.

Hospital officials, for their part, said the delay was planned. Hospital president John Marzinzik said Frisbie needed time to implement its new Meditech EMR and didn’t want to send out incorrect bills during the rollout.

In fact, Marzinzik told Foster’s, under the previous system, records generated during doctor visits weren’t compatible with forms for hospital billing.

Rather than relying further on this patchwork of incompatible systems, Marzinzik and his staff decided to wait until the process was “absolutely clean” for patients. The hospital decided to have a staff member validate every balance shown on a statement before sending them out, he says.

Previously, in December of last year, anonymous Frisbie medical staff members sent Foster’s a letter to share concerns about the hospital and its administrators. The criticisms included skepticism about the over-budget implementation of the $13.5 million Meditech system, which they named as one of the reasons they lack confidence in the hospital administration. The staff members said that this cost overrun, as well as other problems, have undermined the hospital’s financial position.

As is always the case in such situations, hospital leaders took the stage to deny these allegations. Frisbie Senior VP Joe Shields told the paper that the hospital is in sound financial condition, and also said that the only reason why the Meditech project went over budget by $1.5 million was that the administrators delayed the implementation by seven weeks to give the staff holiday time off.

Hmmm. I don’t know about you, but to me, some parts of this story look a little bit bogus. For example:

* I appreciate accurate hospital bills as much as anybody, but the staff was going to check them manually anyway, why did it take 10 or 11 months for them to do so?

* The holidays take place at the same time every year.  Did administrators actually forget they were coming to an event that necessitated an almost 10% cost overrun?

Of course, only a small number of people know the answers to these questions, and I’m certainly not one of them. But the whole picture is a little bit odd.

When It Comes To Meaningful Use, Some Vendors May Have An Edge

Posted on December 1, 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.

A new article appearing in the Journal of the American Medical Informatics Association has concluded that while EHRs certified under the meaningful use program should perform more or less equally, they don’t.

After conducting an analysis, researchers found that there were significant associations between specific vendors and level of hospital performance for all six meaningful use criteria they were using as a yardstick. Epic came out on top by this measure, demonstrating significantly higher performance on five of the six criteria.

However, it’s also worth noting that EHR vendor choice by hospitals accounted for anywhere between 7% and 34% of performance variation across the six meaningful use criteria. In other words, researchers found that at least in some cases, EHR performance was influenced as much by the fit between platform and hospital as the platform itself.

To conduct the study, researchers used recent national data on certified EHR vendors hospitals and implemented, along with hospital performance on six meaningful use criteria. They sought to find out:

  • Whether certain vendors were found more frequently among the highest performing hospitals, as measured by performance on Stage 2 meaningful use criteria;
  • Whether the relationship between vendor and hospital performance was consistent across the meaningful use criteria, or whether vendors specialized in certain areas; and
  • What proportion of variation in performance across hospitals could be explained by the vendor characteristics

To measure the performance of various vendors, the researchers chose six core stage two meaningful use criteria, including 60% of medication orders entered using CPOE;  providing 50% of patients with the ability to view/download/transmit their health information; for 50% of patients received from another setting or care provider, medication reconciliation is performed; for 50% of patient transitions to another setting or care provider, a summary of care record is provided; and for 10% of patient transitions to another setting or care provider, a summary of care record is electronically transmitted.

After completing their analysis, researchers found that three hospitals were in the top performance quartile for all meaningful use criteria, and all used Epic. Of the 17 hospitals in the top performance quartile for five criteria, 15 used Epic, one used MEDITECH and one another smaller vendor. Among the 68 hospitals in the top quartile for four criteria, 64.7% used Epic, 11.8% used Cerner and 8.8% used MEDITECH.

When it came to hospitals that were not in the top quartile for any of the criteria, there was no overwhelming connection between vendor and results. For the 355 hospitals in this category, 28.7% used MEDITECH, 25.1% used McKesson, 20.3% used Cerner, 14.4% used MEDHOST and 6.8% used Epic.

All of this being said, the researchers noted that news the hospital characteristics nor the vendor choice explained were then a small amount of the performance variation they saw. This won’t surprise anybody who’s seen firsthand how much other issues, notably human factors, can change the outcome of processes like these.

It’s also worth noting that there might be other causes for these differences. For example, if you can afford the notably expensive Epic systems, then your hospital and health system could likely afford to invest in meaningful use compliance as well. This added investment could explain hospitals meaningful use performance as much as EHR choice.

Is Allscripts An Also-Ran In The Hospital EMR Business?

Posted on August 18, 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.

It all began with a question, as many classic tales do. Someone writing for the HIStalk.com website  – I think it was ever-anonymous, eponymous  leader Mr. HISTalk – asked readers to answer the question “Who will benefit most from the proposed acquisition of McKesson EIS by Allscripts?”

The survey results were themselves worth a read:

* Approximately 29% voted for “McKesson customers”
* About 27% voted for “Allscripts customers”
* 8.4% voted for “McKesson shareholders”
* Roughly 23% voted for “Allscripts shareholders”
* About 13% voted for “Allscripts competitors”

Two things about these responses interested me. One is that almost a third of respondents seem to think McKesson will make the bigger score after being acquired by Allscripts. The other is that a not-inconsiderable 13% of the site’s well-informed readers think the deal will help Allscripts’ competitors. If these readers are right, perhaps Allscripts should rethink the deal.

I was even more engaged by the analysis that followed, which the writer took a close look at the dynamics of the hospital EMR market and commented on how Allscripts fit in. The results weren’t surprising, but again, if I were running Allscripts I’d take the following discussion seriously.

After working with data supplied by Blain Newton, EVP of HIMSS Analytics, the writer drew some firm conclusions. Here are some of the observations he shared:

  • While McKesson has twice as many hospitals as Allscripts, most of these hospitals have less than 150 beds, which means that the acquisition may offer less benefit, he suggests.
  • In addition to having only 3% of hospitals overall, Allscripts controls only 6% of the 250+ bed hospital market, which probably doesn’t position it for success. In contrast, he notes, Epic controls 20% of this market and Meditech 19%.
  • His sense is that while hospitals typically want a full suite of products when they work with Epic, Cerner or Meditech, Allscripts customers may be more prone to buying just a few key systems.
  • Ultimately, he argues, Cerner, Epic and Meditech have a commanding lead in this market, for reasons which include that the three are well ahead when it comes to the overall number of hospital served.
  • Given his premise, he believes that Epic is at the top of the pyramid, as it has almost double the number of hospitals with 500+ beds that Cerner does.

To cap off his analysis, Mr. HISTalk concludes that market forces make it unlikely that a dark horse will squeeze out one of the top hospital EMR vendors: “Everybody else is eating their dust and likely to lose business due to hospital consolidation and a shift toward the most successful vendors as much as all of us who – for our own reasons – wish that weren’t the case.”

It would take a separate analysis to predict whether the top three hospital EMR vendors are likely to win out over each other, but Epic seems to hold the most cards. Last year, I wrote a piece suggesting that Cerner was edging up on Epic, but I’m not sure whether or not my logic still holds. Epic may indeed be King of the (HIT) Universe for the foreseeable future.

Achieve MU3: Measure 3 with these 5 MEDITECH Clinical Decision Support Interventions (CDSi)

Posted on August 11, 2017 I Written By

The following is a guest blog post by Kelly Del Gaudio, Principal Consultant at Galen Healthcare Solutions.

Over the past several years, there has been significant investment and effort to attest to the various stages of meaningful use, with the goal of achieving better clinical outcomes. One area of MU3 that directly contributes to improved clinical outcomes is implementation of Clinical Decision Support Interventions (CDSi). Medicaid hospitals must implement 5 CDSi and enable drug-drug and/or drug-allergy checking.

From looking at this measure it seems like a walk in the park, but how does your organization fair when it comes to CDS?

Thanks to First Databank, users of EMR’s have been accomplishing drug to drug and drug to allergy checking for over a decade, but what about the edge cases you think will be covered but aren’t? Take a patient that is allergic to contrast for example. Since imaging studies requiring contrast are not drugs, what happens when they are ordered? Are they checking for allergies? In most cases, additional configuration is required to get that flag to pop. This is usually where we come in.

Let’s take a look at a simple CDSi definition provided by CMS.gov

“CDS intervention interaction. Interventions provided to a user must occur when a user is interacting with technology. These interventions should be based on the following data:  Problem list; Medication list; Medication allergy list; Laboratory tests; and Vital signs. “

Without a decent rule writer on staff, there are limitations within MEDITECH for accomplishing full CDSi. The primary reason we started recording these discrete data elements in the first place is the glimmer of hope that they would someday prove themselves useful. That day is here, friends. (If you don’t believe me, check out IBM’s Watson diagnosing cancer on YouTube. . .you might want to block off your schedule.)

In collaboration with 9 hospitals as part of a MEDITECH Rules focus group – Project Claire[IT] – we researched and designed intuitive tools to address Clinical Quality Measures (eCQM’s) and incorporated them into a content package. If your organization is struggling to meet these measures or you are interested in improving the patient and provider experience, but don’t have the resources to dedicate to months of research and development, Project Claire[IT]’s accelerated deployment schedule (less than 1 month) can help you meet that mark. Below are just some examples of the eCQM’s and CDS delivered by Project Claire[IT].

CMS131v5     Diabetes Eye Exam
CMS123v5     Diabetes: Foot Exam
CMS22v5       Screening for High Blood Pressure and Follow-Up Documented

Synopsis: The chronic disease management template will only display questions relevant to the Problem List (or other documented confirmed problems since we know not everyone uses the problem list). Popup suggestions trigger orders reminding the provider to complete these chronic condition follow-up items before letting the patient out of their sights. Our goal was to save providers time by ordering all orders in 1 click.

CMS71v7     Anticoagulation Therapy for Atrial Fibrillation/Flutter
CMS102v6   Assessed for Rehabilitation

“The Framingham Heart Study noted a dramatic increase in stroke risk associated with atrial fibrillation with advancing age, from 1.5% for those 50 to 59 years of age to 23.5% for those 80 to 89 years of age. Furthermore, a prior stroke or transient ischemic attack (TIA) are among a limited number of predictors of high stroke risk within the population of patients with atrial fibrillation. Therefore, much emphasis has been placed on identifying methods for preventing recurrent ischemic stroke as well as preventing first stroke. Prevention strategies focus on the modifiable risk factors such as hypertension, smoking, and atrial fibrillation.” – CMS71v7

The above quote is taken directly from this measure indicating the use of the Framingham Heart Study we used to identify and risk stratify stroke. Claire[IT] content comes complete with three Framingham Scoring tools:

                Framingham Risk for Stroke
                Framingham Risk for Cardiovascular Disease
                Framingham Risk for Heart Attack

These calculators use all the aforementioned data elements to drive the score, interpretation and recommendations and the best part is they only require one click.

*User adds BP. BP mean auto calculates. Diabetes and Smoking Status update from the Problem List. Total Cholesterol and HDL update from last lab values.
Ten year and comparative risk by age auto calculates.

*User adds BP. BP mean auto calculates. Diabetes, Smoking Status, CVD, Afib and LVH update from the Problem List. On Hypertension meds looks to Ambulatory Orders.
Ten year risk auto calculates.

*User adds BP. BP mean auto calculates. Diabetes and Smoking Status update from the Problem List. Hypertension meds looks to Ambulatory Orders. Total Cholesterol and HDL update from lab values.
Ten year risk auto calculates.

CMS149v5      Dementia: Cognitive Assessment

Synopsis: Not only is this tool built specifically as a conversational assessment, it screens for 4 tiers of mental status within one tool (Mental Status, Education, Cognitive Function and Dementia). The utilization of popup messages allows us to overcome the barrier of character limits and makes for a really smooth display on a tablet or hybrid. Our popups are driven by the primary language field in registration and our content currently consists of English and Spanish translations.

CMS108v6     VTE Prophylaxis
CMS190v6     VTE Prophylaxis is the ICU

Synopsis: Patients that have an acute or suspected VTE problem with no orders placed for coumadin (acute/ambulatory or both) receive clinical decision support flags. Clicking the acknowledge tracks the user mnemonic and date/time stamp in an audit trail. Hard stops are also in place if NONE is chosen as a contraindication. The discharge order cannot be filed unless coumadin is ordered or a contraindication is defined. These rules evaluate the problem list and compare it to the medication list to present the provider with the right message.

Learn more about the work of our focus group and Project Claire[IT] by viewing our MEDITECH Clinical Optimization Toolkit.

VIEW THE TOOLKIT TO ACCESS:

  • Deliverable Package of Complex Rules, Assessments, CDS’s and Workflows
    • Problem List Evaluation
    • Total Parenteral Nutrition
    • Manage Transfer Guidance
  • Surveillance Dashboard Setup Guide
    • Dictionary Setup & Validation
  • 6.x Rules Setup Guide
    • Basic Rules for Assessments, Documents & Orders
  • IV Charge Capture Setup Guide

About Kelly Del Gaudio
Kelly is Principal Consultant at Galen Healthcare Solutions, and has been optimizing MEDITECH systems for over 10 years. She worked for MEDITECH on an elite 4-person team (the MEDITECH SWAT Team), whose sole concentration was clinical optimization, ROI analysis, MU certification, and achievement of HIMSS EMRAM Stage 6/7. Kelly currently leads Galen’s MEDITECH practice, and championed a focus group, which led to the delivery of Project Claire[IT], a MEDITECH content package of complex rules, assessments, CDS’s, and workflows that evaluate, suggest, and support documentation of chronic and acute problems. Learn more about Kelly in the #IAmGalen series.

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 EMR Clinical Optimization 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.

Top Hospital EMR and EHR Blog Posts for 2016

Posted on December 30, 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.

It’s that time of year when you look back at the past year and think about what you’ve accomplished. At Hospital EMR and EHR, we like to look back at the stats for the top blog posts we’ve published. It’s always interesting to see what’s resonated with people. Plus, it’s interesting to see how things have changed since we’ve posted on a topic. So, without further ado, here’s a look at the top blog posts in 2016 for Hospital EMR and EHR along with some commentary on each.

1. Why Is It So Hard to Become a Certified Epic consultant? – This is by far the top post generating 4-10 times as much traffic as the posts below.  It’s also why I’ve wanted to make the time to do a whole series of blog posts on Epic Certification and along with it Cerner Certification, MEDITECH Certification, etc.  When you make something like Epic Certification hard to get, people want it even more.  It’s just too bad they’re so closed since it drives up the prices for Epic consultants and thus the cost to implement Epic.  Certainly, we’ll be writing about this more in the future.

2. NYC Hospitals Face Massive Problems With Epic Install – This was a big story back in 2013 and still is today.  We should probably look at doing a follow up story to see what’s happening at NYC hospitals a few years after this story hit.

3. Epic Install Triggers Loss At MD Anderson – No surprise, people love to read about challenges in EHR implementations.  We saw quite a few of these from Epic in 2016 and people were interested in what went wrong.  The problem from the outside is it’s really hard to know who is to blame for the failure.  What has become clear over this year is that many healthcare organizations are blaming Epic for their revenue issues.

4. Hospital EMR and EHR Vendors – This page needs some work, but no doubt many people want to know who the big players in the hospital EMR and EHR market are.  This is true if they’re selecting a new EHR, switching EHR or looking to partner with EHR companies.

5. Why Do People Dislike Epic So Much? Let Me Count The Ways – This post is 5.5 years old and still going strong.  I imagine many people are still counting the ways they hate Epic.  I think I read that Epic finally hired a PR person.  Maybe that new hire can work on this.

6. A Study on the Impact of ICD-10 on Coding and Revenue Cycle – This was a good study that illustrated the impact of ICD-10.  It also gave some good words of caution about the impact of ICD-10 going forward.

7. Epic EMR Costs Drag Down Finances At Brigham and Women’s – Another example of the cost to implement Epic.  I knew this was a hot topic this year and the stats show that people were interested in the details.

8. The Argument for Meditech – I can’t believe this post is 5 years old already, but it still rings true today.  MEDITECH is not without its challenges, but it also doesn’t get the credit it deserves either.  I had a chance to visit their offices near Boston this year.  I’ll be really interested to see where MEDITECH takes their product next.  Many people have counted them out, but I certainly haven’t.

9. Can HIM Professionals Become Clinical Documentation Improvement Specialists? – We’ve published a lot about the changing world of HIM thanks to our new series of HIM Scene blog posts.  This post was a great example of how there are a lot of new opportunities for HIM professionals that are willing to embrace change and adapt as needed.

10. Great Healthcare IT Leaders – This is a great list of healthcare IT leaders as shared by David Chou.  David made the case for meeting up with them at HIMSS 2016, but the nice part is thanks to social media you can follow most of them year round.

An honorable mention to the 11th post on the list which talks about Dr. Rasu Shrestha helping an injured passenger on his way to HIMSS 2016.  Love stories like this.  Did you have a favorite post on Hospital EMR and EHR?  Was there an idea or concept you read on Hospital EMR and EHR?  We’d love to hear about it in the comments.

Cerner Tops List Of Hospital Vendors For Medicare EHR Incentive Program

Posted on September 28, 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.

Research from the ONC concludes that Cerner systems are in use by the most hospitals using certified technology to participate in the Medicare EHR Incentive Program. It’s interesting to note that this list includes players that rarely appear on overall lists of top hospital EHR vendors, though admittedly, there’s no one way to measure market dominance that produces consistent results every time.

According to ONC statistics, there were 175 vendors supplying certified health IT to 4,474 nonfederal acute-care hospitals participating in the Medicare EHR Incentive Program. Ninety-five percent of these vendors have 2014 certified technology.

The report notes that six of these vendors (Cerner, Meditech, Epic, Evident, Medhost and McKesson) provide 2014 certified technology 92% of hospitals using the technology. When you throw in athenahealth, Prognosis and QuadraMed, bringing the list to 10 vendors, you’ve got a group that supplies 2014 technology to 98% of eligible hospitals.

According to the data, the vendors at the top fall in as follows. Cerner tops the list of total hospitals using its certified health IT, with 1,029 hospitals;  Meditech was next with 953 hospitals; Epic came in third with 869 hospitals; CPSI’s Evident (formerly Healthland) was fourth with 637 hospitals; McKesson fifth with 462 hospitals; and Medhost sixth with 359 hospitals.

As is usually the case with any attempt to look at market share, the data comes with its own quirks. For example, when looking at ONC’s data as of July 2016 on ambulatory healthcare providers choice of certified technology, Epic was way ahead of the pack with 83,674 users. Allscripts came in at a distant second with 33,123 users. Cerner came in sixth with 15,100 ambulatory users. In other words, vendors one might class as “enterprise” focused are doing well among clinicians. (See more data along these lines in a Medscape survey I summarized previously.)

Then consider data from HIMSS Analytics, which concludes that Epic has 40% of the hospital health IT market, followed by Cerner at a distant second with 13%, Allscripts at 10%, Meditech at 7% and eClinicalWorks at 5% and NextGen with 4%. Why the big difference in numbers? It seems that HIMSS Analytics includes the size of the hospital in its calculations versus the ONC data above which talks about the number of hospitals.

No doubt the buying patterns vary when you look at the number of beds a hospital has. For example, according to research done last year by peer60, CPSI and eClinicalWorks held the biggest share of the market among facilities with less than 100 beds, MEDITECH, McKesson and Siemens dominated the mid-sized hospital categories, and as the number of beds rises from 250 to 1000+ plus, Cerner and Epic emerge as the top players.

The truth is, market share numbers are interesting, and not just to the vendors who hope to emerge on top. Everyone loves a good horse race, after all. But it’s good to take these numbers with a large dose of context, or they mean very little.

Is It a Hot or Cold Hospital EHR Buying Market? – Response

Posted on August 15, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

This article is in response to John Lynn’s recent posting, Is It a Hot or Cold Hospital EHR Buying Market?

In his recent posting, John Lynn asked the question “Is it a Hot or Cold Hospital EHR Buying Market?”. In it he highlights a recent KLAS report that over 490 hospitals, a staggering 10% of the entire market, were involved in an EHR decision in 2015. After reading his posting, I wanted to take a moment to share my observations.

2015 was indeed an amazing year for EHR sales, partly driven by the pending sunset date of Mckesson Horizon forcing many customers to switch EHR solutions. Some of those customers are going to Paragon, but many more purchased or are evaluating other solutions. During a recent trip to Epic University, I was surprised to find that nearly half of the attendees of the classes were hospitals switching from Mckesson Horizon to Epic – and all had just recently completed their purchases (late 2015/early 2016) and were facing the same live dates of late 2017/early 2018.

Hospitals who have purchased and implemented Epic or Cerner are very unlikely to make a change. Regardless of which solution is preferred, the investment in these solutions and the level of effort required to switch from one to another is so high, that it would take a significant triggering event for a hospital to make that change. Therefore it is likely that customers on these solutions will not be making a change in the near future.

However, KLAS reports that nearly 40% of MEDITECH customers would change EMR’s if they could, and that Paragon customers also report unrest. Therefore in addition to the shrinking number of those that have not implemented a viable EHR solution, the possibility that there will be a wave of customers switching from one of these solutions to Epic or Cerner remains a consideration. There is also the question of how the recent spin-off of Mckesson’s software division will impact the future of Paragon. If Paragon were discontinued or sold, it could lead to another explosion of EHR decisions. If instead there was a significant investment in the solution, it could become a more viable alternative as customers look to switch from one EHR to another.

I suspect that 2016 will be another strong year from EHR sales in general and for Epic and Cerner in particular. Beyond that, much will depend on the strength of the other solutions and which ones break out into the top tier. Regardless, the recent explosion of EHR sales and the rush to replace Horizon will in many cases lead to minimized installs – where the bare minimum work was completed and there is significant opportunity to improve business processes, implement new modules, and roll out advanced functionality within those solutions. As a result I believe that within a few years, the market will be more stabilized with fewer customers switching solutions, and instead focusing on maximizing what they have.

Unless another player comes in and disrupts the marketplace or a significant shift in the industry creates a reason to make a change yet again…

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