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Percent of ePrescribing for Meaningful Use

Posted on April 30, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m still really disturbed by the fact that we have so few practical meaningful use details. Sure, we have a lot of guidelines and a lot of prognosticators guessing at what they mean and how they’ll be measured. We even have a certifying body trying to guess what the EHR certification will be. Sadly, they’re all still guesses.

Let’s just take a simple example for a second and see some of the complexities.

Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: At least 75 percent of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

This certainly seems pretty straight forward. Probably about as straightforward as it comes as far as objectives. Basically, 75% of the prescriptions have to be ePrescribed using a certified EHR technology to meet the meaningful use guidelines.

Of course, the real question’s going to be around the word “permissible.” What’s considered a permissible prescription? I imagine this was added because currently you aren’t allowed to ePrescribe controlled substances. If I remember right, controlled substances make up about 15-20 percent of prescriptions. Certainly it wouldn’t be fair to include something that you’re not legally allowed to prescribe electronically in the requirements. Are there other exceptions under the “permissible” rule?

What’s going to happen once ePrescribing of controlled substances is allowed? Will doctors then be required to flip a switch and start sending controlled substance prescriptions electronically as well? Once they’re allowed, they’ll be considered permissible, no?

Let’s also not be surprised if the technology is built to do eprescribing in 2 systems (controlled vs not controlled). Of course, this adds a bit more complexity to measuring the 75% of prescriptions done electronically.

Also, does it give anyone else a bit of angst that the EHR software is basically going to spit out a report saying, “Yes, I ePrescribed 75% of my prescriptions.” I’m not sure how you scale a more sophisticated solution, but just taking some report from an EHR seems plenty gameable to me.

Will ONC be going around and doing some audits of the submissions to ensure that the data was actually good and not messed with? Can you imagine the challenge of having to audit some 300+ EMR vendors. Good luck with that.

I also love how the ePrescribing has to be done with a certified EHR system. A part of me really feels for those specialists that only write a few prescriptions a week. They get to learn the fun thing we call ePrescribing and they forget what they learned by the next time they have to ePrescribe.

UPDATE: Thanks to Russ in the comments, he pointed out the issue of calculating a percentage when your EMR won’t know if you just handed them a paper prescription instead of ePrescribing. I guess the criteria assumes they’re going to order the script and then print it out instead of sending it electronically? So, maybe the criteria should say 75% of scripts ordered in the EMR sent electronically. Just makes me laugh to think about it.

Lest ye think paper scripts don’t happen with an EMR, we can at least argue for them happening during EMR downtime (or printer or workstation or internet or…downtime). Although, they happen other times as well. How will an EMR calculate that percentage of prescriptions? Are they going to translate the freetext note that was entered into the EMR about the paper script that was given? Ideally the doctors will just enter in the script after the fact, but that’s not always the case.

I’m sure I’m missing other intricacies. My point is that there’s still a lot of unanswered questions around meaningful use. It would be nice to get some answers. It would be nice if ONC had a way to get and provide practical answers. You’d think they’d want that type of interaction as well.

Guest Post: Will Your New Smartphone Ruin Your Practice?

Posted on April 29, 2010 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.

Guest Post: Hayden Hartland works at Spearstone, makers of Spearstone’s DiskAgent offering which provides a multi-platform approach to smartphone security by allowing lock, data-wipe, and GPS-tracking from any web-browser along with online backup for your business.

Breathtaking advances in smartphone capabilities are changing the ways we work and live. In their latest forms, phones such as the iPhone, Android, Blackberry, Windows Phone, Symbian, and Palm are beginning to rival, and in several areas (think GPS, camera and video) exceed the capabilities of laptops and desktops.

Increasingly, we email, keep contacts, track tasks and appointments, browse the internet, capture family moments, connect with friends, shop, and even run powerful business apps from our hand-held do-it-alls. No wonder then that surveys show some people giving up computers altogether for smartphones. Trends indicate smartphone sales and usage will exceed that of laptops in the next five years. Analysts describe a future where Smartphones that dock to keyboards and monitors obsolesce the laptop altogether.

The problem is that while smartphones are leapfrogging laptops and desktops in utility and connectivity, they have introduced security risks that too few take seriously. Unlike desktops and laptops where some of the biggest risks lie in viruses, and the eventual failure of spinning hard drives, the biggest risk with a smartphone is the loss and exposure of the information you store on it.

More than 5,000 smartphones are lost or stolen each day. Most smartphones hold thousands of confidential records – patient lists, emails, documents, medical records, patient payment records, and so on – yet there is little or no ability to prevent their compromise if your phone is lost or stolen. Many were carried by healthcare professionals (doctors, nurses, dentists, office managers, billing providers, support staff, and so on) whose information represents real risk to their practices and patients if compromised.

Next time you notice a staff member, equipment rep, supply rep  or any BAA using a smartphone, consider asking, “Are our emails accessible on that phone?” and “If you lose it, can anyone access them on the phone?” If you are a medical professional carrying a smartphone you need protection because odds are that eventually you will lose your phone. Furthermore, HIPAA, the FTC and state consumer organizations require notification of all patients of a data breach (not exactly good for any practice or healthcare business).

Current phones and typical user practices do a poor job of safeguarding your confidential information. While many smartphones can require a password or PIN number to use them, few of us can tolerate the hassle of actually using one. We simply use our phones too frequently to put up with it. Yet without one, we’re completely exposed. And while a phone password may protect your information in the case of loss, it can’t stop someone with phone hacking skills who wants to access your information.

Here are some practical tips you can employ to reduce your risks:

  1. Create a passcode for your phone. If you (like me) hate being pestered by it, set it to be required after 4 or 8 hours, so that you only need to enter it once or twice a day. If your phone is stolen and locked the thief will either need to hack your phone or reset the phone to factory settings thereby removing all the data in the process.
  2. Create a splash screen when your phone is locked displaying a contact phone number or email address and reward value. Consider etching your name and contact information somewhere on the phone.
  3. Remove sensitive information from your phone as soon as possible.
  4. Write down your IMEI (International Mobile Equipment Identity) number. If your phone is stolen, call your carrier immediately and ask them to deactivate the IMEI number and the phone will be rendered inoperable for calling on all networks. This ensures the phone is unusable although it doesn’t protect any unencrypted information on your phone.

Fortunately, a few larger clinics and hospitals are beginning to address these concerns. If yours is a larger practice with a Blackberry Enterprise server and or Exchange Mail Server and your users exclusively use the corresponding phones (Blackberries, and Windows Mobile devices), you can remotely remove emails and some other sensitive information in the event of a loss or theft. Other alternatives are to deploy encryption software or use the expensive MobileMe services provided by Apple. For other organizations, Spearstone’s DiskAgent offering provides a multi-platform approach to smartphone security by allowing lock, data-wipe, and GPS-tracking from any web-browser.

EMR and HIPAA Advertising

Posted on April 28, 2010 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.

Last time I took a second to recognize the advertisers on EMR and HIPAA I was just starting my planning for HIMSS 10. Now, HIMSS 10 isn’t much more than a spec in the rear view mirror. It’s amazing how time flies. Well, at this point I’m even more grateful for the companies that support this website as advertisers since I’m now a full time entrepreneur. Luckily, I think that the advertisers are happy with their investment in this site as well.

On that note, here’s a quick look at some new companies that have started supporting EMR and HIPAA since my previous post.

Practice Fusion – I must admit that I was really happy when i got the email from the people at Practice Fusion saying they wanted to advertise on EMR and HIPAA. I’ve said previously, that I think they’re the closest company to a pure internet startup company that I’ve seen in the EMR world. As a nerd, internet startups fascinate me. Mostly, I was glad to see that a company that understands Web 2.0 finds value on advertising on my site.

My personal musings aside, Practice Fusion was the first company I found that offered a free EMR. I’ve often written lengthy posts about their Free EMR model and SaaS EMR in general. You’ll find few companies more passionate about SaaS EHR. They also offer an interesting “Live in Five” program which commits to having you signed up and charting in Practice Fusion in 5 minutes. Once I have 5 minutes of free time, I’m planning to take that challenge and see what happens.

Digi Recs – Digi Recs (officially Digital Records, Inc.) is the first document imaging company to join as an advertiser. They’re a relatively new entrant to healthcare document imaging, but have a long history of document imaging with Fortune 500 corporations, small/ medium/ large size healthcare practices, hospitals and government agencies.

Digi Recs is happy to work with those that are pre-EMR with ongoing scanning or post EMR implementation scanning all your old paper records. I did this in our clinic and I can’t imagine anyone who tries to scan the old paper charts by themselves. A scanning service like this is so smooth and frees up all that paper chart space. Digi Recs is also interested in working with EMR companies who want to offer these scanning services.

EMR Jobs Promotion – I also am running a short promotion this week for EMR jobs. This week they’re offering 50% off a 1 year subscription job post plan with the promo code SAVE50.

I also want to thank those advertisers that have recently renewed their advertisement on EMR and HIPAA: Sfax, Sequelmed, The Drug Company, and MxSecure.

As a side note, the ad in the 7th slot down in the sidebar will be available for new advertisers on 5/1/10. You can see all the details about advertising on EMR and HIPAA here.

I’m also interested in looking at other opportunities to present on the EMR stimulus, EMR Selection or EMR implementation similar to this presentation I did in Austin on the EMR stimulus. Drop me a note on my Contact Us page if you’re interested.

One Example of Rating Long Term Care EMR Software

Posted on April 27, 2010 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.

After my previous post on EMR company ratings, one of my readers pointed me to a resource (pdf) that kind of rates the various long term care EMR software vendors. There are 64 listed and not all are EMR vendors, but it’s an interesting way to approach listing the various long term care software providers. Basically, a list of each vendor and a mark in the column that matches the software.

Of course, the real problem with this type of resource is that it’s just a grid with no qualitative information. The grid works great when you’re talking about static details like database or supported operating systems. However, when you’re talking about various functions in an EMR software, you need some more qualitative information and not just a check box.

For example, it would be simple to put a check box next to ePrescribing for various vendors, but not all ePrescribing are created equal. This requires some qualitative information and no doubt can have multiple perspectives.

The question is, how do you rate the various EMR features in a meaningful way?

Weight Loss Compared to EMR Implementation

Posted on April 26, 2010 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.

If you’ve read this blog for a while you know that I love to compare EMR implementation to other parts of life. It’s always amazing to me how similar other parts of life are to EMR selection and implementation. In case, you’re a newer reader, go and read my posts comparing EMR to Marriage (also talks about divorcing your EMR), EMR implementation to Pregnancy, and Marrying an EMR for Money (VERY important with all this EMR stimulus money). A presentation on comparing EMR to life would be a fun presentation to give, but I digress.

The other day I came across a comparison that will be familiar to all types of people, but doctors will be acutely aware of this comparison (even more so than I). EMR implementation is very much like weight loss. Yes, that’s right. Weight Loss!

Think about it, there are a lot of similarities. Most patients that need to lose weight know that they need to lose weight. Deep down they really know they need to lose weight, but a part of them is still trying to argue that they don’t need to lose weight. A part of them still kind of wonders, “what’s so wrong with being overweight?” Sounds like many doctors looking at an EMR implementation. They know deep down that they need to implement an EMR. However, they just keep asking themselves “Why can’t I just keep using paper charts?”

No doubt many older people that are overweight have basically given up the fight to lose weight. They figure that they’re older and they have no need for weight loss anymore. Sound a bit like older doctors and how they approach EMR?

Of course, the most interesting comparison between weight loss and EMR implementation comes when applied to the actual implementation itself. Weight loss requires a huge change in someone’s life. Thus, it usually requires a lot of “hand holding” and reminders about the value of losing weight. They’ll often lose motivation and need someone to pick them up and help them continue to make the changes in their life so they can lose weight.

No doubt implementing an EMR requires change. Weight loss is about changing habits. EMR implementations are about changing habits too. Often they are habits which were instilled many years ago during medical school. I don’t have to describe why changing habits are hard (although, here’s a couple change pictures to illustrate what I mean). That’s why so many people have a challenge losing weight and why so many people have avoided implementing an EMR.

Yes, and most EMR implementations require a certain amount of hand holding along the way. That’s more a feature of change than anything else. The real question a clinic should be asking themselves is who will be doing the hand holding. The answer might surprise you when you find out that it will likely not be one person, but many.

Doctors and Patients and Paperwork

Posted on April 23, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was reading through a thread over on EMR Update which talks about this New York Times article. Here’s some really interesting quotes from both sources that are worth considering:

In “The Hostile Hospital,” from the Lemony Snicket “Series of Unfortunate Events” books, the three young orphans at the center of the story visit the fictitious Heimlich Hospital, where Babs, the head of human resources, asks them if they know what the most important work done in a hospital is.

“Healing sick people?” one of the children asks innocently.

“You’re wrong,” Babs growls, silencing the children. “The most important thing we do at the hospital,” she continues without flinching, “is paperwork.”

Humor is the most funny when it stabs so close to the truth.

Currently, most systems have been designed not with clinical needs in mind but to meet the demands of the fee-for-service payment system. The software rapidly codifies diagnoses and symptoms, thus facilitating billing.

No worries though. The EMR billing machines that we have now will soon be replaced with EMR meaningful use machines. {a little satire of my own}

While EMR can capture certain information like medication lists and test results with mind-boggling accuracy and efficiency, it often fails to relay the nuances of a patient’s illness course. “Physicians think in stories,” said Dr. C. T. Lin, a practicing internist and chief medical information officer for the University of Colorado Hospital in Denver, which has used electronic records since 1994. “How can you possibly point and click your way through a patient’s 10-year history?”

This reminds me of the rather compelling video I did with Mmodal where they talk about the need to have both the narrative and granular data in the EMR. I’m always amazed at a physicians ability to look at a narrative section and get the story of what’s happened. Something that lists and results just can’t do justice. As valuable as those lists and results can be in other ways.

Possible REC Business Model

Posted on April 22, 2010 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.

As I said before, I’m finding the EHR RECs very intriguing right now. Thus a few extra posts about the RECs. First, thanks for those who have been helping update the EHR REC wiki page. There’s still a ways to go, but little by little we’ll get all of the RECs listed in one space.

From what I can tell, and as evidenced by this CalHIPSO REC blog, these REC organizations have A LOT on their plate. First, they have to meet the mandates of the government (which I’ll talk about more another time). Second, they have to create an organization that didn’t really exist previously (for the most part). Third, they have to look at a long term business model for when the government funding for EHR RECs runs out. Not a simple task.

I find the third item pretty interesting since it might be the hardest of them all. In the post I did yesterday about rating top EMR companies, Brad made an interesting comment about the RECs providing this type of EHR implementation feedback loop.

Makes sense that these RECs are going to work with 1000 of doctors to meaningfully implement an EMR. Why not have these doctors whom they’ve helped (for free I might add) provide some feedback on the EMR software they implemented. This feedback on its own has little value, but in aggregate could be very valuable and could provide part of the business model for the REC going forward.

Let’s also make clear that even after these EHR RECs do great work and help thousands of doctors we’re still likely to only to be at 50% adoption range. Even if we reach the 70% EHR adoption as some EMR analysts predict, there will still be thousands of doctors that need to implement an EMR. Plus, there are going to be thousands of other doctors who didn’t like the first EMR they implemented and will want information on what other EMR software might be better.

Unfortunately, I see three potential problems with this idea. First, as part of the RECs requirements they have to help so many people. Yes, that means that we’re going to see many RECs obsessing over the number of people they can count on their numbers for the government. It’s just kind of a feature of government grant work. So, RECs will have to tread lightly in what they require from doctors. Remember the RECs are suppose to help the doctors and not the doctors help the RECs. Certainly in a perfect world it should go both ways. Definitely a challenge that RECs can overcome if they are careful in their approach.

The second problem is if RECs only end up recommending a small handful of EMR vendors (which sadly it seems many are going to do), then the RECs will only get back feedback for that small handful of EMR vendors. That makes the EMR implementation data much less valuable than if it were spread across a larger number of EMR vendors.

The third problem was something mentioned by Brad who inspired this post. In his comment he talked about many of the current ratings organizations rating based on “under the table offerings rather than credible data.” Sadly, this same thing could happen with RECs. It will depend on if the REC decides that it’s business model is built on the backs of the EMR vendors or on the backs of the credible data they get from the doctors they’ve helped. I could see it going either way.

Of course, this is just one possible business model. I’d love to hear people’s ideas on other sustainable revenue models for these EHR RECs.

Rating Top EMR Companies

Posted on April 21, 2010 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.

Lately I’ve been really intrigued by the concept of trying to rate the long list of EMR vendors in order to identify the “Top EMR Companies.” I guess I’ve been intrigued by this idea for a number of reasons.

First, tons of people are searching the internet and finding this website in their search for the top EMR vendors. Makes a lot of sense that doctors would want to narrow down their search for an EMR since it’s just unreasonable for them to try and review 300+ EMR vendors. Although, I do think it’s a little bit funny that they think they can just enter “top EMR vendors” into Google to find the answer.

Second, I’ve seen a number of groups touting an EMR vendor showcase with the “top EMR vendors.” The problem I have with this is that how can they say that they’re the top EMR vendors. More than likely these organization took the EMR vendors they had connections with and allowed them to present. In fact, in this case, I know one EMR vendor gets to present because they’ve made those connections. This is all well and good, but that’s not really “top EMR vendors” in my book.

Finally, a number of EMR vendors are interested in having some sort of “top EMR vendor” rating. Kind of a stamp of approval that they have a high quality EMR system. EHR certification has attempted to give this assurance. The problem there is that EHR certification doesn’t actually rate the top EMR vendor. It just tests a list of criteria which can easily be gamed and does little to measure the usability or actual clinical acceptance of that software product.

No doubt there’s a desire to try and have a “top rated EMR comany” list. The real question is how do you go about making a list like this?

I don’t know all the details around JD Power and Associates, but I think that many EMR vendors and physicians alike would love to give that type of stamp of approval that an EMR vendor’s software meets some standard level. However, I think just a general stamp with no other data just feels empty to me. It’s almost like you need to rate and provide qualitative feedback on various rating areas. Otherwise, the stamp of approval has little value to doctors and clinics trying to select an EMR.

Beyond that, it almost seems like there needs to be an evaluation or verification with existing users of the EMR. They’re the ones who really know how well an EMR functions, how responsive the support people are, and how usable the EMR system really is. Of course, this would require talking to multiple users of an EMR system and not just the company shills (excuse the term). Definitely a challenge.

Beyond that, it seems wrong to just provide a general rating for an EMR. For example, one EMR vendor might be great for general medicine, but might be horrible for an OB/GYN. It’s almost like you need to rate the EMR vendor based on various specialties to provide real value. Not to mention, adding in things like size of the organization, location of the organization, etc. There’s a lot of factors that would drastically change the rating of an EMR vendor.

Of course, the other problem with the concept of “top EMR companies” is that any EMR company could be the top. What are they the top of? Are they the top implemented EMR vendor? Are they the top customer support EMR vendor? Are they the top specialist EMR vendor? Are they the top SaaS based EMR vendor? etc etc etc

Obviously, I don’t yet have all the answers to this problem. Although, I’m very interested in the idea. More importantly, I’m interested in finding ways to provide valuable information like “top rated EMR vendors” that could help doctors select the right EMR. Seems like RECs could benefit from this information as well.

EHR Regional Extension Centers (RECs)

Posted on April 20, 2010 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.

Every day I’m seeing little pieces of information come out about the EHR Regional Extension Centers (RECs). Sadly, there’s not one central location that is covering the activity of these RECs so that doctors and clinics could quickly see what’s going on and enjoy the benefits of the millions of dollars that was given to these RECs as part of the ARRA EHR stimulus money.

Rather than just complain, I’ve started to create a wiki page that lists each of the EHR RECs, how much funding they’ve received and hopefully links to all of the REC websites. I have a long way to go, so I’d love to get your help in updating this list. So, leave a comment or feel free to update the wiki with the information you have about these RECs.

Unfortunately, I’d guess that 90% of doctors have never even heard that hundreds of millions of dollars has been given to these RECs to help them select and implement an EMR (73% of all stats are made up like this one too). Maybe that percentage is off, but the point is worth highlighting. Most doctors don’t know that there are possibly some resources that will be available to them in their EMR selection and implementation efforts.

The problem is that most of us don’t really know what type of resources these RECs are going to provide doctors. Will the RECs be providing unbiased information and resources? Will the RECs be EMR vendor salespeople dressed in non profit REC clothing? Will we see RECs who are truly doctor advocates? What type of on the ground, in your face and practical resources will these RECs provide doctors who’ve kicked against EMR (many, not all) for so many years?

This is going to be a really interesting period in the EMR world. If RECs get things right, they can have a tremendous impact for good on EMR adoption. I’m optimistically hopeful that they won’t let the money go to waste.

EMR Technology Exacerbates Problems

Posted on April 19, 2010 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.

One thing that I’ve mentioned many times in the 4+ years of blogging about EMR is the impact of technology on a clinic. I’ve regularly mentioned that you shouldn’t implement an EMR to try and fix process problems in your clinic. Instead, you should first address the process problems in your clinic and then implement the EMR with the proper processes already in place.

The reason for this is quite clear. Technology, in this case EMR, has a tendency to just exacerbate any problems that exist in a clinic. In fact, it will often bring to light problems that you didn’t know existed before EMR.

A simple example is doctors who are behind on their charts. In the paper world, you might not know how far behind they are on their charting. In the electronic world many EMR software make it abundantly clear how many charts still need to be completed.

In a call I had recently with the people behind the Mitochon EMR, they made a really interesting point about communication between doctors. It’s basically the same concept as I’ve described above. If communication between doctors is bad in the current world, then layering some sort of HIE or other technology on top of it will just make communication worse. Technology is going to accentuate and enhance (for good and bad) whatever might be going on currently.

Interestingly, this concept might add further light as to why so many EMR implementations fail. Sometimes it’s hard to look in the mirror for the first time and take a good hard look at what’s really happening in your clinic.