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!!

The Surprise of Broad EMR Adoption

Posted on July 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.

Pat Rioux on LinkedIn made the following comment about a possible surprise that could come from the move to broad EMR adoption:

I hope the biggest surprise that we get from this huge undertaking is that we finally have providers wondering how they did their job without an EMR in the past. Improvement that is measurable speaks for itself. Patients who finally have access to their medical data and become participants in their own healthcare will be the best reward.

Well said. I’d also add that there are going to be a whole group of doctors in 5 years who never knew how to practice medicine without an EMR. There’s challenges with this too, but it’s an interesting view. Not to mention doctors who’ve been on an EMR for 10-15 years and can barely remember what it was like using a paper chart.

Yes, a few doctors will start using their EMR and miss the great chart hunt they use to embark on to find a missing chart. Or…

What Are EMR Vendors Planning for ICD-10?

Posted on July 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.

I remember when I first started my job at a healthcare facility 5+ years ago, I ran into these codes they called ICD-9. Yes, this was all very foreign to me, but I learned quickly the meaning of ICD-9. I also learned quickly that the EMR vendor which had been selected (before I was there) didn’t provide a list of ICD-9 as part of their EMR software (they do now). They did provide an upload feature and so we exported a list out of our old PMS, cleaned them up a little and then uploaded them into the new EMR. Not a fun or effective process even that way.

Obviously, we’ve come a long way in five years. There are plenty of free lists of ICD-9 codes around the net that people can use, manipulate and add to their EMR software pretty easily.

However, I couldn’t help but wonder what solutions were being offered for EMR vendors planning for ICD-10. Yes, EMR vendors do have until October 1st, 2013 (which has been moved back a bunch of times so let me know if it’s been changed again) and so maybe EMR vendors aren’t concerned about it yet. Although, I’m guessing that many have already put a lot of thought into preparing for ICD-10.

My question for EMR vendors is, how are you planning to handle the ICD-10 codes? We’re talking about going from 14,315 diagnosis codes to 69,101 diagnosis codes. The National Center for Health Statistics (NCHS), the Centers for Medicare and Medicaid Services (CMS), AHIMA, the American Hospital Association, and 3M Health Information Systems have put together some General Equivalence Mappings (GEMs) that I believe try to do some mapping between ICD-9 and ICD-10. However, like translating a language there’s rarely a one to one match. With 4+ times as many codes there couldn’t be. So, certainly there’s the question of how you’re going to make the transition from ICD-9 to ICD-10 coding?

Although, at a simpler level, how are you planning to get the almost 70k ICD-10 codes in your system? Does anyone know of a database of these codes that’s available for EMR vendors? Is each EMR vendor going to try and create their own? What’s happening in this regard?

And maybe the answer is….ask us once we’re done dealing with stage 1 meaningful use. ICD-10 isn’t until stage 2 or stage 3 meaningful use.

Easy EMR Stimulus Money for Current EMR User

Posted on July 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.

A common contributor to this blog lately has been BobbyG (check out his REC blog for more). He tells an interesting story that runs counter to my post about even existing EMR users not currently showing meaningful use.

Meaningful use is in fact quite doable — at least in the outpatient setting

One clinic I visited yesterday in northern Nevada — Silver Sage — will be an exemplar for me (I’m an REC adoption support workflow specialist). They look to be a shoo-in for Meaningful Use compliance. They use eMDs, and they are really using it. eRx? Check. CPOE? Check. 2-way lab interface feeding back structured data? Check. Reminders? Check. Patient cohort lists by various problem areas? Check. Active meds list (incl drug-drug, drug-allergies, formularies)? Check. Patient portal? Check… etc, etc, etc.

With the Final Rule relaxation of the MU criteria and what I saw in operation yesterday, I’m now of the “stop-whining-and-just-DO-it” mindset. Use your Regional Extension Center services, too. We’re not in it for the money, we’re in it to improve healthcare, period.

Yes, you will need a viable, highly “usable” system, and will need to use it in a way that goes beyond just an electronic filing cabinet (e.g., scanning everything in sight into TIFF files, etc). Yes, you will need to re-do workflow in order to eliminate process waste and align information flow. Of course. Just do it. You’ll improve both patient outcomes and your bottom line, attacked adroitly…

While I have many concerns with the way this whole HITECH Act thing has been rolled out (and with U.S. health care policy more broadly), it’s time for everyone to pull together and make this work.

Away From Blogging Sick

Posted on July 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.

The latest flu bug that’s been going around has hit me pretty hard. I’ll be back tomorrow (assuming all goes well) with more posts.

Until then, some interesting news items for you to consider:
SOAPware Announces Release of PMS – They’ve been working on this for a while. Plus, it’s interesting to see the pure EMR companies getting a PMS. Check out this interview I did previously with the SOAPware president.

SRS and Ingenix Collaborate to Deliver PMS and EHR – Another case of an EMR partnering with a PMS system. Plus, now SRSsoft can get to meaningful use. As expected, EVERY EMR vendor is likely going to need to be able to say, “Our EMR can show meaningful use.”

EMR Stimulus Q&A: Do You Have to Use a CCHIT Certified EHR Vendor?

Posted on July 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.

AK sent me the following EHR Certification question:

Is it necessary to get CCHIT certified vendor just because you want to qualify for incentives or regardless you MUST go for a certified solution?

Because I make the case that one should go with the one that provides the most amount of value.

You only need to use a certified EHR (doesn’t have to be CCHIT certified either, but HHS Certified) if you want to get the EMR stimulus money. The only caveat is that if you don’t show “meaningful use” of a “certified EHR,” then in a few years there are 1-5% Medicare penalties for not using one and showing meaningful use. However, many people strongly believe that those penalties will actually never be implemented. Of course, that part is just conjecture and may or may not happen.

So, there’s nothing forcing physicians to use a certified EMR solution. More and more people are doing as you describe, ” go with the one that provides the most amount of value.” They make the valid argument that if you get $44k in EMR stimulus money and lose $50k in productivity then you would have been better to go with an EMR that can’t get you stimulus money, but still maintains or even improves your productivity (among other EMR benefits).

At one of my EMR stimulus speaking engagements, a physician came up to me after the presentation and asked, “If I don’t accept Medicare or Medicaid, then do I care about meaningful use or certified EHR?” The easy answer was, nope. He can just decide on the right EMR without having to worry about government requirements.

Some have suggested that insurance companies might impose the certified EMR or meaningful use requirements, but I personally think that’s pretty unlikely.

Nuance and MModal – Natural Language Processing Expertise

Posted on July 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.

Many of you might remember that one of the most interesting things I saw at HIMSS this year was the natural language processing that was being done by MModal. In case you don’t know what I’m talking about, check out this video interview of MModal that I did at HIMSS. I still think there really could be something to the idea of retaining the narrative that dictation provides while also pulling out the granular data elements in that narrative.

With that background, I found it really interesting when I was on LinkedIn the other day and saw Dr. Nick van Terheyden,the same guy I interviewed in the video linked above had switched companies. Nick’s profile on LinkedIn had him listed as working for Nuance instead of MModal. I guess this shouldn’t have been a surprise. Nuance has a lot of skin in the natural language processing game and it seemed to me that MModal had the technology that would make it a reality. So, now Dr. Nick van Terheyden is the Chief of Medical Information Officer for Nuance.

I’d say this is a really good move by Nuance and I’m sure Nick is being richly rewarded as well. Nick was one of the most interesting people that I met at HIMSS this year. I’ll be certain to search him out at next year’s event to hear the whole story. Luckily, I also found out that Nick is blogging about voice recognition in healthcare on his blog Voice of the Doctor. I always love it when smart people like Nick start blogging.

Challenge of Meaningful Use Even for Existing EHR Users

Posted on July 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.

Paul decided to stop by the post I did that referred to his comments on the skepticism around meaningful use. He shared a really interesting experience he had with a client that has an existing CPOE and EHR and their evaluation of the meaningful use requirements.

My point in my post on EHR and Meaningful Use is that providers ought to look at their organization and determine what they need EHR to do for them, not what they need to do to EHR to get a check—those are two very different business and HIT strategies.

One of my clients had already implemented CPOE and EHR. We assessed what they had to do just to meet Stage One MU requirements. Incentive dollars minus cost, to have the chance to meet Meaningful Use, left them upside down by five million dollars, and it would use eighty percent of their IT resources for the next three years.

If the organization is so quick to divest itself from the IT projects that would have been completed were there no Meaningful Use, what does that say for the planning that went into defining those projects? How much further down the ROI chasm should an organization be willing to fall to grab a check? To whom do these organizations ultimately have to answer—CMS?

Obviously, I agree wholeheartedly with his point of using EMR for the benefits of EMR and not for the stimulus checks (since I’ve repeated it dozens of times on this site). Use the stimulus money as a nice bonus if all goes well.

His comments also remind me a bit of my post, “Would Any Current EMR Users Be Able to Show Meaningful Use?

Don’t be confused. I’m completely PRO EMR. I can’t imagine clinics run without an EMR. I’m just still on the fence about whether showing meaningful use to get the EMR stimulus money is worth it.

Physicians Don’t Want to Be Told What to Do

Posted on July 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.

It seems like a theme is cropping up around meaningful use. It has little to do with the regulations themselves. Instead it has to do with the fundamental concept of meaningful use essentially “Telling Physicians How They Should Practice.”

A comment on a previous post described it well when they said, “I am willing to bet that no matter what the final rule was, the majority of those involved in this industry would be upset with them.” It’s an enlightening point since I think it’s right on point.

It also illustrates that it’s not the meaningful use regulations that really bother people. Most physicians want to provide great care to their patients and many of the meaningful use requirements are no brainers. Physicians just don’t want to be told what someone else defines as great care. Physicians aren’t alone in this either. Just take a look at children’s reactions to their parents and you’ll see that for the most part humans don’t want to be told what to do and they kick against anything or anyone that tries to tell them what to do.

Anthony Guerra, founder and editor of Health System CIO, in an Information Week article highlights some similar points. He aptly points out that optimal performance is achieved not by issuing “prescriptive directives,” but by creating high level goals and let ownership of those goals take effect.

Anthony even suggests that the HITECH act money should have been spent to create a “set of best practices around EMR readiness assessment (think gap analysis), vendor selection, workflow redesign and system maintenance (think ASP/SaaS) for the providers that do care” While a certainly noble and worthy goal, I think there’s little evidence that this would have much impact. Why would doctors look to a government process to provide a best practice any better than they now look on meaningful use guidelines?

Meaningful use and the pile of EHR stimulus money reminds me a lot of a parent child relationship. The parents think they know what’s best and so they tell the child what they should do. The child kicks against those things regardless of whether it’s a good or a bad thing that the parent’s asking them to do. The parent then dangles the money in front of the child and says that if they want the money, then the child better do what the parent told them to do.

This is where we’re at with meaningful use. The parents (the government) have required something (meaningful use) of the children (the physicians) if they want the benefit (Stimulus Money). Now we’re waiting to see if the children will rebel or listen to their parents. I’m predicting physicians to be a little more rebellious than the average child. It’s not like the parents in this situation have a great history of past responsibility.

EMR Marketing

Posted on July 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.

It seems to me like EMR marketing is really kicking into gear now that we have the meaningful use final rule. Makes sense with the intense competition that’s happening between the 300+ EMR vendors.

One EMR vendor recently emailed me about advertising on EMR and HIPAA. He summed it up really well when he said, “We are looking at actually doing some advertisement other than big publications that charge us 20K.” Honestly, it still amazes me how much money companies pour into the various trade magazines when they could advertise for an entire year on this site for a fraction of the cost.

On that note, I’d like to welcome 2 new advertisers to EMR and HIPAA:
Enterprise Software Deployment – I actually met the people behind Enterprise Software Deployment at a virtual conference for healthcare IT and loved my interaction with the company. They offer a full suite of services to support your EHR implementation. These types of services are going to be in high demand. Check out their list of EHR software they support.

MDCare EMR – A Preliminary ARRA IFR Stage 1 Certified EHR. They offer a full integrated EMR and PMS. Check out their list of EMR features here.

I also want to thank Intersystems, Practice Fusion and Ambir Scanners for recently renewing their advertisements on EMR and HIPAA. It’s always gratifying when advertisers continue to renew.

Thanks for reading EMR and HIPAA and for supporting the advertisers of this site as well. I’ve got a few more in the hopper, but they’re not quite final so I’ll talk about them later.

Official ONC and CMS Conference Call on EHR Stimulus Programs

Posted on July 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.

The “Official” ONC/CMS Audio conference call on the EHR stimulus programs. Don’t want to miss this one!

ONC Certification and Medicare and Medicaid EHR Incentive Programs:
Final Rules
How will they impact you?

The Centers for Medicare & Medicaid Services (CMS) together with The Office of the National Coordinator for Health Information Technology (ONC) invite you to join us for an Audio Training on the Final Rules for ONC Certification and Medicare and Medicaid EHR Incentive Programs.

Learn about:

• The Benefit of HIT
• Summary of the final rules
o ONC temporary certification process
o ONC initial set of standards and implementation specifications
o Medicare and Medicaid EHR Incentives Programs including the initial definition of meaningful Use
• Where to find additional resources

Hear first hand from ONC and CMS Experts!

Date: Thursday, July 22, 2010
Time: 2:00-3:30 pm EST

Call in information
Dial:
1-877-251-0301

Conference ID pass code:
87841621

Materials will be made available prior to the training at the following web address: http://www.cms.gov/EHRIncentivePrograms/05_Spotlight_and_Upcoming_Events.asp
Be sure to visit CMS’ web section on the Medicare & Medicaid EHR Incentive Programs at: http://www.cms.gov/EHRIncentivePrograms/

Thanks to Charles Phelps from MedXSolutions for the tip.