Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

More Comments from Marc Probst’s Talk on EMR

Written by:

If you’ve had enough of my posts from a talk Marc Probst gave, then you’ll be glad to know this is the last one. There’s no hiding my respect for Marc and hearing him in person did nothing but elevate that respect for him. Some of the comments below will feel a bit random, but I thought they were interesting enough to share with you all.

Meaningful Use and Certified EHR Overlap
I asked Marc about the challenge of reconciling the overlap between the certified EHR criteria modeled after the meaningful use matrix and meaningful use itself. It seemed that they were measuring basically the same thing. Marc’s response was, “That’s a battle I lost.” Then, Marc muttered under his breathe something about certifying the software versus the users. Basically, he was in agreement and under the same confusion I’ve had in regards to the value of certifying the software related to MU versus you actually meaningful using your EMR.

Challenge for Hospital Systems
At one point Marc talked about the challenge of a hospital to adopt an EHR if they haven’t started this already. He started listing off things like a data center and encryption. The data center for a hospital is a significant challenge that takes time. I’ve been a part of the design, creation and building of a couple of data centers and infrastructure like this takes time to implement. I still believe it’s premature to purchase an EHR, but I don’t think it’s premature to plan for things like network infrastructure, data centers, etc.

Certification and Procurring the Right EMR
I had to smile when Marc, co-chair of the EHR certification workgroup, said point blank, “EHR certification is not about procuring the right EHR system.” If you’ve read this blog for any length of time you know how I feel about this subject. Glad to hear Marc say it too.

Funding and EHR Adoption
Marc was really honest when he described that IHC had 0 doctors doing CPOE. I was surprised by this since my childhood doctor was from IHC and had an EHR back then. That said, Marc made an interesting point after saying that IHC had 0 doctors doing CPOE. He proceeded to say he didn’t think the reason they hadn’t adopted CPOE yet was because of a lack of funding. It was all the other things that took time to figure out which has delayed adoption.

September 30, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

More Meaningful EHR Use To Be Simplified

Written by:

On my twitter stream I was getting a number of skeptics around my previous post about meaningful use and EHR certification being simplified by CMS (Medicare & Medicaid Services). They seemed a bit surprised that CMS would simplify meaningful EHR use.

Let me add a little more content and context to why Marc Probst thinks the way he does about this subject and why I wholeheartedly agree with him that MU and certified EHR’s final rules will be simpler than they are in their current form.

One of the most compelling reasons Marc gave was when he talked about a meeting he had with David Brailer. In their meeting David Brailler told Marc Probst that “Meaningful use will be a small bump in the road.” Marc then described David Brailler’s reasoning. Basically, the EHR stimulus package is only $20 billion (yes, I rounded to make the math nicer) of spending by the government after you take into account the penalties and other savings they should achieve. If you look at that spending over the number of years it will be given out we’re looking at somewhere in the neighborhood of $3 billion per year (another round number) of spending by the government. Then, the all important question:

Is CMS going to put a bunch of major roadblocks in the way of the government spending $3 billion per year on EHR?

Of course the answer could be discussed, but the point is that $3 billion in the government’s budget is nothing. Yes, I’m cringing while typing that, but it’s true. That’s why David Brailer is dead on when he says that meaningful EHR use will be a small bump in the road.

Personally, I think this is a great thing. I’ve been arguing that the barriers to this money are too high that it would be a mistake for doctors and clinics to focus too much of their energy on getting the EHR stimulus money. Now if those barriers were to lower, we’d not only see the increase in interest in EHR software, but we’d also see a significant and meaningful increase in adoption and purchase of EHR software. Then, the fun really begins.

September 29, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Meaningful Use and Therefore HHS EHR Certification Criteria Will Dillute

Written by:

In my ongoing series of posts from Marc Probst’s visit to Las Vegas (you can see my first post here), these next comments by Marc were really interesting.

Marc said, “The guesses are good that CMS will dilute meaningful use.”

I also asked Marc a question about whether he thought that the HHS certification criteria would be less than what CCHIT submitted as their “meaningful use” EHR certification criteria. He responded that the HHS certification criteria will be designed around the meaningful use requirements (which we already knew) and so it is likely that if the meaningful use criteria are diluted then the HHS certification criteria would be diluted as well.

What do you think of the suggestion that MU will be diluted? Which parts of MU do you think will be diluted or do you wish would be diluted?

September 28, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

EMR Stimulus Money Makes Rich Richer

Written by:

I had the privilege to hear Marc Probst speak on Friday and he was everything I hoped he’d be. I’ll be writing a number of posts from things I heard from Marc Probst over the next couple days, but I wanted to start with one thing Marc Probst said that was very interesting.

Marc said that he was afraid that the EMR stimulus money is going to make the rich richer.

Reminded me a little of my Big Winners from the ARRA EHR Stimulus Money post. I’m afraid like Marc that this is very accurate. The EMR stimulus money is going to end up in the rich clinics pockets.

September 26, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

EMR Data Archiving

Written by:

In my previous post I talked about a few of the options related to shredding or archiving your paper charts after you’ve implemented an EMR and the paper charts aren’t being accessed.

Now let’s take a look at what’s just begun to come up in our clinic: EMR Data Archiving

Archiving Old EMR Records
Once you’ve been on an EMR for a number of years, you start to think about all of the data that’s stored in your EMR. Do you really want to store ALL of the information you’ve entered into an EMR in perpetuity? The answer as usual is maybe.

Quick Disclaimer: Before you do any EMR data archiving, you better talk to a good lawyer to make sure what you’re doing is legal in your state. I am not a lawyer and don’t even play one on TV. Just don’t be surprised if your lawyer say there’s no case law on this and so they’ll only be able to give you a best guess.

Now back to the point. The concepts in this are very similar to retention of paper charts. In fact, I’m guessing the laws for this will be similar to the laws on retention of paper charts.

On the one hand, it’s a great thing to be able to have years and years of a patient’s history available to you at the click of the button. In fact, in certain cases where you’re dealing with chronic conditions having all of the EMR data forever could be VERY valuable.

However, I see two possible problems with retaining all of your EMR data forever. First, there is a potential liability issue if you retain all of those records which are very old. If you’ve disposed of the data properly and according to state and federal laws, then you are no longer liable for the removed information that’s stored in the EMR. The second issue is that your EMR database grows larger and larger each year you use your EMR. Between all of the data that’s entered in the EMR and all the various scanned documents that are added to the EMR, the size of the database can be a huge issue after a number of years.

I’ll leave the first problem of liability to the lawyers. The second problem is really interesting. As your database grows, now database backups go from 5 minutes to sometimes hours (in some cases). Restoring all of that data will take a long time as well. At some point your server can run out of disk space for your database and will you even notice that it’s out of space before it’s too late and your server is in trouble? These are just a few of the issues related to storing all of your EMR data forever.

I don’t know of any EMR company that has implemented a solution for this problem. Although, it’s theoretically possible that you could extract the data from your EMR that was previous to a certain date. There could be multiple options with that data. For those concerned about liability, they could delete the extracted data and it would be gone forever. For those just concerned with the database size, you could move the extracted data onto another device or even just saved in a safe location (probably more than one location). In fact, you could even add it as its own database and your EMR company could give you a way to switch to the “archived EMR database” to see all of the archived data. Doing this will make your EMR database much smaller and much more manageable.

I have a feeling this post might have gotten a little too technical. Oh well, I guess sometimes the tech guy in me just comes out.

Also, lest someone starts typing a comment that the database will never get that big to matter. Be careful in saying never. Between scanned image files which are getting bigger and bigger as the quality improves and just the sheer length of time that people have owned an EMR this can happen. In fact, it has happened.

September 25, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Paper Chart Disposal After Implementing an EMR

Written by:

I’d be planning on posting about this for a while and someone brought it up in the comments of one of my other posts. So I figure it must be time to talk about what to do with all those old paper charts. I’m not going to go into the specific regulations. First, I’m not a lawyer and don’t want to give any legal advice. Second, these regulations often vary from state to state and 50 is a lot of different regulations.

With that disclaimer, let’s take a look first at what to do with all the old paper charts that are no longer being accessed.

Archiving or Shredding Old Paper Charts
One of the big questions people ask is what do we do with the old paper charts. In this post I’m not going to talk about the various ways that you can incorporate your old paper charts into your EMR workflow. I’ve covered that a number of times before including my post about thinning your paper chart.

Instead let’s talk about what you do after you’ve had an EMR for a reasonable amount of time and you find that you’re no longer pulling paper charts on a regular basis. You might still pull the paper chart on some rare occasion, but for the most part the information you need is now in your EMR.

In my office, we chose to hire an outside company to take our paper charts and scan them into a little program for us. This did cost a bit, but it’s nice to have all of those old paper charts in a nice indexed format that we can quickly search and print out if someone requests their old records. You can even put it on a web server and do some partial integration with the program we store all these old scanned paper charts with our EMR. However, we haven’t needed to do that since medical records is the only one who ends up really accessing the charts.

Of course, the other option that I think many people do is just store them somewhere. This isn’t a horrible option since it can be in a part of your office that isn’t being utilized. It can even be off site if it’s cheaper to store it somewhere else. However, you just have to be careful of course that the location is still secured properly.

Are there other options available to those dealing with the old paper charts after implementing an EMR?

Tomorrow, I’ll follow up with a post on archiving your EMR records.

September 24, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

To Wait or Not to Wait on Selecting and Implementing an EMR…

Written by:

John Halamka recently posted the following about whether doctors and practices should wait to purchase an EMR. Here’s his response:

I’m often asked by clinicians and hospitals if they should wait to purchase an EHR because of the uncertainty regarding meaningful use and certification.

I tell them to move forward now.

The following is my response I made to him in the comments of his blog:

Thanks for sharing the timeline[also included in the blog post listed above and similar to my previous post on the EMR stimulus meaningful use and certified EHR timeline]. However, I do disagree with you that people should be selecting and implementing an EHR now. There’s no rush to do this. I can agree that users should start reviewing the various EHR vendors and technologies that are available so that they are familiar with the choices that exist. However, it’s premature for those users to actually select and implement an EHR.

Your suggestion of choosing a CCHIT certified EHR is also off base. The fact is that not even the onerous CCHIT certification criteria meets the meaningful use matrix that you reference. So, the certification criteria will change and it’s likely that not all CCHIT certified EHR will achieve HHS EHR certification (which is what really matters for the $$).

Instead, the wisest counsel that can be given to providers is to select an EHR based on which EHR software will best meet their business needs. If they do that, then whether they’re able to get the EHR stimulus money or not they’ll be happy with the decision they make. The EHR stimulus money will just be a nice bonus if it all works out well.

What do you guys think? Is the time now to purchase an EMR?

September 23, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Long Term Care Missing Out on EMR Stimulus Money

Written by:

A short while back I posted about my interest in the long term care EMR market. From that post I’ve started a number of really interesting discussions. It’s been quite enlightening and fun for me to learn about the long term care market since I was previously unfamiliar with the details.

One thing that kind of strikes me about the long term care EMR market is that it doesn’t seem to me that their going to be getting any help from the EMR stimulus money that everyone’s talking about. At least if my assumptions are correct. Since the EMR stimulus money is going to be paid out per provider, it seems like most long term care facilities are going to not be eligible since they’re nurse run and not provider (doctor) run. Someone please correct me if I’m wrong in this assumption.

Certainly, there is the possibility that ONC and HHS might make some of the other ARRA money they received available as grants to the long term care market for purchase of an EMR. However, that is still yet to be seen.

This is rather unfortunate for long term care facilities. I think we can safely say that healthcare’s use of technology is behind almost every other industry. Low EMR adoption rates are evidence of this fact. With that said, from what I’ve read and seen long term care facilities are even farther behind on their adoption of technology. Sadly, if long term care facilities aren’t getting any EMR stimulus money, then it’s possible they will lag behind even farther in adoption of healthcare IT.

Are there any other specialty areas or healthcare segments that are going to miss out on the EMR stimulus money as well?

UPDATE: One reader of my site sent the following additional information and questions: “Nursing Homes overall are considered as a provider. The Nursing Home is issued a Provider Number (not the administrator) and is used for billing purposes and reimbursement purposes. When the Feds say that providers are going to get stimulus money through grants does this mean that LTC facilities are excluded? Who knows at this time. What is the difference between an individual Provider and a Facility as a Provider? I can’t answer this. Only the Feds know at this time.”

I’ve talked to some other Long Term Care EMR companies and they have the same questions. Looks like the problem is that we just don’t know. Although, I’d argue that it’s likely that the Feds don’t know yet either.

September 22, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

EMR Vendor Advisor

Written by:

This weekend I had a nice meeting with an EMR vendor. We had a nice discussion of the possibilities that are available right now in the EMR world. It was also interesting to consider the value that I could add to an EMR company as an advisor to that EMR company. Seems like between my expertise, my network and this website I could provide quite a bit of value to an EMR company as an advisor.

Here’s some of the things (off the top of my head) that I think I can offer an EMR company:

  • Promotion/Advertising on this Site
  • Feedback on Product Development (from me and from my network)
  • Advice on EHR Stimulus money
  • Counsel on EHR Certification Options
  • Suggestions on IT Options for Your Company (I am an IT person after all)
  • Help on Use of Social Media and Online Marketing for your EHR
  • Connections to investors/VCs

The key for me is to find the right EMR company for which I can be a HUGE advocate for their product and that my skills and expertise will make that EMR company better. In fact, I think there’s some possibilities for me to become an advisor to a few different EMR companies that don’t have overlapping markets (ie. pediatric EMR, ER EMR, specialty specific EMR, etc). I think that there’s also some potential to expand to other related EMR technologies like those doing transcription for example.

The other challenge is ensuring the right compensation model. I think the only reasonable arrangement is some sort of equity. Why? Because if I’m going to be an advisor, then you want me to have some skin in the game. You want me to be working hard to promote your product, provide you the best counsel possible and to help out your company in every way possible. Equity in a company does just that for me.

So, consider this post my request to talk with those EMR Companies that might be interested in this sort of arrangement. If you’re interested in talking, drop me a line on my contact us page.

September 21, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

How Many Will Actually Collect ARRA EMR Stimulus Money?

Written by:

In my last post Michael Milne made the following comment that I think was worth discussing:

I firmly believe that less than 5% of all doctors who do buy a “certified” EMR are going to collect.

For example, how many here, or even heard of someone, have actually collected the e-prescribing incentive?

I think that 5% is a low estimate of who will collect on the EMR stimulus money. Although not that much lower. What do you think?

September 19, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.