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Harnessing Open Source Technology to Drive Outcomes in Healthcare

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I’ve long been a fan of open source technologies. My blogs are run and created almost entirely on open source software. In fact, I first wrote about open source EMR on this blog back in January of 2006. We’ve come a long way since then with Vista being the top open source EHR in the hospital world and OpenEMR leading the pack in the ambulatory world.

We’re starting to see more and more application of open source technology in other areas of healthcare IT beyond EMR as well. There are some really amazing advantages to a thriving open source community. I think the key there is to have a thriving open source community behind the project. It’s not enough to just say that your software is open source. If you don’t have a great community behind the project, then the open source piece doesn’t do too much for you.

With that said, I was really intrigued by this whitepaper from Achieve Health that talks about why they are applying the popular open source Drupal framework to healthcare. While I’ve mostly used WordPress for the things I’ve done, I’ve had a chance to use Drupal for a few projects and I’m really intrigued by the idea of applying the Drupal framework to healthcare.

This section of the whitepaper describes their vision really well:

Drupal is not a replacement for legacy IT systems from EMRs, Billing, Practice Management etc., but rather an extension to these systems. Through sophisticated integrations Drupal can enhance the functionality of each system concurrently. While there is no one panacea for the trials ahead, Drupal is highly capable of rising to meet many of the existing and future challenges the industry has to offer.

In the whitepaper they mention open source success stories like Pfizer, Florida Hospitals, Amerigroup Health Services, and Alliance Imaging. I think we’ll continue to hear of more and more open source success stories in healthcare for the reasons outlined in the whitepaper Harnessing Open Source Technology to Drive Outcomes in Healthcare. It takes a bit of a different mentality to go the open source route, but those who do are usually very satisfied. I think healthcare IT could really benefit from this shift in mentality.

July 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

EHR Vendors Need to Expand Their Definition of Customer Service

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Living in Las Vegas I likely have a skewed idea of what customer service means. In the tech world, we have Zappos headquarters in downtown Las Vegas. Most of you are likely familiar with Zappos unique approach to customer service. They really have taken customer service to the next level and created an entire company culture around the customer service they provide. The same could be said for the experience that the various casinos on the strip offer their customers. They do a really amazing job at most casinos providing an amazing customer service experience.

With this background, I find it really smart of Kareo to open an office in Las Vegas. Although, that’s not really the point of this post. Instead, I want to focus on the idea that most EHR vendors need expand their idea of customer service.

As I look at the world of EHR customer service I see so many organization lacking. Certainly we see examples of terrible EHR customer service that include calling into a call center in another country where the person doesn’t speak English and has no power to actually solve a user’s problems (Disclaimer: I don’t have a problem with call centers in other countries if they are well trained and can actually solve problems). Of course, the same thing can apply to a call center in the US who can’t solve the users’ actual problems. Both are terrible customer service and a problem in the industry. However, there’s a far more painful problem that I don’t think most EHR vendors consider a part of their customer service plan and 99% of EHR vendors have done terrible at this.

Adding new features and accommodating an EHR user’s feature request is just as much a part of the EHR customer service experience as the person who answers the phone. I can assure you that every EHR vendor out there would get rated an F the past few years when it comes to this form of EHR customer service. Why do I know this? I know this because every EHR vendor has been focused on meaningful use that they haven’t had the time to add any meaningful EHR user feature requests and features outside of meaningful use.

This isn’t EHR vendors’ fault. The end users have required it and EHR vendors have had to spend the time doing it. However, EHR customer service has suffered as a consequence. Don’t believe me. Look through all the EHR press releases that have been released over the past couple years. Find me the plethora of press releases that talk about the innovations that EHR vendors have created for their end users that aren’t related to meaningful use. I get the press releases and they’re MIA.

That’s not to say that EHR vendors have done nothing for end users. They’ve made some incremental progress on a few things, but meaningful use has zapped their development time. Stage 2 was even worse. I look forward to the new day where EHR vendors can focus on great customer service and EHR features and not just MU.

July 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

What If Your EHR Only Had 25 Doctors?

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I recently had lunch with an EHR vendor that had an extremely small number of providers. I’ve known this EHR vendor for about 5 years, so this isn’t a new EHR vendor that’s trying to establish themselves in the industry. Instead they’ve focused on having a small, nimble team that’s focused on making the EHR work the right way for the doctors. It’s a novel approach I know, but pretty interesting that his business can survive with so few providers. Also worth noting is that the EHR is certified for meaningful use stage 2 as well.

Now think for a minute how the development process of an EHR vendor would be better if your EHR only had 25 doctors (For the record, the EHR vendor above has a few more than 25 doctors). Would it be much easier to satisfy just 25 physician users? Imagine the personalized service you could provide your users.

One of the real challenges I’ve seen with EHR vendors is that when they’re small, they are extremely responsive to their end users and the end users are very happy. As the EHR vendor grows, they lose that personal touch with the end users and many of those originally happy end users become dissatisfied with their EHR experience.

The problem with scaling an EHR user base is that you can’t make everyone happy. You have to make compromises that will be great in some people’s eyes and terrible in another person’s mind. What large EHR vendors do to try and solve this problem is they create configurable options that allow the end user to customize their system to meet their personal needs. Problem solved, right?

The problem with these configurations is two fold. First, you can’t make everything configurable. Once you go down the path of making everything configurable, it never ends. There’s always something else that could be made more configurable. So, the culture of configurability leads to unsatisfied users who can’t customize everything (even if what they want to customize shouldn’t matter).

Second, if everything is configurable, then it makes the implementation that much more complex. I’ve written before about the need for EHR vendors to have great “out of the box” user experience, but balancing that with allowing the user to configure everything that’s needed. This is a real challenge and most fail. Just look at the number of high priced EHR consulting companies out there. Many of them could better be defined as EHR configuration companies since the configuration needs are so large and complex.

Returning to where we started, when you’re an EHR vendor with 25 doctors you don’t have to build in all the flexibility and configurability. You’re small enough that as an EHR vendor you can do any needed customizations and configurations for the end user. Plus, with this kind of personalized service you can charge a little extra as well.

When you look at EHR development, there’s a spectrum of approaches starting with a fully in house, custom designed EHR through a fully outsourced EHR that can apply to any organization or specialty. In many ways a 25 doctor EHR has a lot of the same benefits of a fully custom EHR software, but spreads the costs of development across more doctors.

As a business, maybe a 25 doctor EHR company won’t dominate the world. Maybe they won’t have a huge exit to some other company or an IPO. However, that doesn’t mean it’s not a great small business if it’s doing something you love. Once you get World Domination out of your sites, it changes a lot of things about how you do business.

July 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

The House Call of the Future – Breakaway Thinking

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The following is a guest blog post by Jennifer Bergeron, Learning and Development Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Jennifer_web
The closest I’ve come to experiencing a house call was watching Dr. Baker on “Little House on the Prairie” visit the good folks of Walnut Grove. Today, most people have no choice but to trek to their doctors’ offices and hospitals for health maintenance, diagnoses and check-ups. But new technologies are returning the personalized attention of the house call and will need to be adopted to retain the convenience and accessibility they offer.

I haven’t met anyone with a practice like Dr. Baker’s, though I recently read a news article that highlights the comeback of the house call. Some practitioners are banding together to provide round-the-clock care to patients who benefit from the fast response and lower cost: If a deductible or copay is higher than the price of the doctor’s visit, the patient may opt for the home visit.(1) The updated versions of the house call, however, are born of the technology used for telehealth, mobile health and health stations.

Telehealth allows a person to connect with a provider via the Internet. Patient and doctor can video conference, share informational media, and experience a face-to-face interaction without either party traveling from his or her home or office.(2) This allows patients better access to specialists who may have been too far away to visit and more frequent care at the right time to reduce the chances of serious complications or hospitalization. For patients who require frequent care over time, telehealth enables them to receive the medical attention they need while staying near their support network.(4) For providers, access to networks of specialists who can provide remote consultation helps them retain and ensure the highest level of care for patients rather than refer patients to another location.(3)

Both patients and providers also save time and money when there is no commute to an office or to a patient’s home. This is especially true of patients who live in rural areas and have to travel long distances for care. The quicker a patient can connect with the right specialist to treat or prevent serious illness, the lower the overall cost of care. (3)

Mobile health, or mHealth, takes technology one step further by allowing providers to track and monitor patient health on mobile devices such as tablets or phones. This includes monitoring devices that measure heart rate, blood pressure, oxygen levels, blood glucose and body weight. mHealth can be used in the office or taken on the road the way mobile clinics do. When healthcare is mobile, the ability to bring a doctor’s office to a neighborhood gives access to communities that otherwise wouldn’t seek or know how to find care. Currently, all 50 U.S. states have mobile clinics.(4)

Another trend in the making is the health kiosk. These look like private pods, about the size of four phone booths side by side. Think of it as telehealth combined with a mobile clinic. HealthSpot, a provider of health kiosks, describes them as “the access point to better healthcare.”(5) In addition to providing interaction with healthcare professionals via video conferencing, each station has an attendant and an automatic cleaning system. HealthSpot aims to give patients a private, personal, efficient experience.

Healthcare is on the move to better accommodate our lives, schedules, family structures and communities, which have vastly evolved from the “Little House on the Prairie” days and even from a decade ago. At the same time, our industry faces challenges in making the new technologies simple to use in order for them to be effective. With telehealth, for example, people typically need help setting up a home system and technical assistance. Meanwhile, providers face communicating and documenting in a new environment.

As we enter this new, modern, faster era of healthcare, both patients and providers will need to learn how to implement and adopt new systems, technologies and ways of interacting. Easing adoption is what we are prepared to do at The Breakaway Group. Once the learning-and-comfort curve is overcome, patients can experience the convenience of Dr. Baker’s updated home visit.

References:
(1) Godoy, Maria, (December 19, 2005). A Doctor at the Door: House Calls Make Comeback.
(2) Health Resources and Services Administration Rural Health, (2012). Telehealth.
(3) Hands on telehealth, (2013). 15 Benefits of telehealth.
(4) Hill, C., Powers, B., Jain, S., Bennet, J., Vavasis, A., and Oriol, N. (March 20, 2014). Mobile Health Clinics in the Era of Reform.
(5) The HealthSpot Station.

Xerox is a sponsor of the Breakaway Thinking series of blog posts.

July 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

My EHR User Conference Keynote – Where is EHR and Healthcare IT Headed?

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Last month I was invited to give the keynote address at the gMed EHR User Conference. For those not familiar with gMed, it’s a Gastro focused EHR company out of Florida. Along with giving the keynote address, I loved the chance to mix and mingle with doctors, practice managers, and gMed’s staff to learn from them. No doubt, their experiences and insights will inform my future posts.

gMed was nice enough to have their videographer record my presentation so I could share it with all of you. I had many people come up to me after the presentation and say very nice things including invitations to come and speak other places. I’ve embedded the video recording below. Hopefully many of you will enjoy my talk as well.

Also, here are the slides I used for my presentation (Note: I don’t just read my slides so some of them might not make sense without the audio):

Full Disclosure: gMed is an advertiser on Healthcare Scene.

July 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Is Healthcare IT Hiring Part of the Problem with Healthcare?

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I’ve been thinking quite a bit lately about hiring in healthcare IT since Healthcare IT Central joined the Healthcare Scene family. Recently I started thinking about the way we hire people in healthcare IT. Here are two facets of what we hire in healthcare:

  • We hire those who know healthcare.
  • We hire those who know old technologies.

When you think about the health IT software world it includes things like MUMPS, Fax Machines, and lots of client server. Where else in technology do you find that combination of old technology. Or as I read on Twitter today, “Why do we think that client server is going to survive in healthcare? Didn’t Microsoft show us how that was a failed long term strategy.” Ok, that wasn’t an exact quote, but you get the gist. Plus, I don’t want to dwell on client server vs cloud systems here either (I’ve got a great post coming where we can do that). I just want to illustrate that healthcare is home to a lot of old technology (see the pager if you need added evidence).

Now think about the people we have to hire to work on these old technologies. Do the innovators and creators of the world want to work on old technologies? Of course, they don’t. Sure, there are some exceptions, but they are exceptions. As a rule, the really innovative, creative thinkers are going to want to work on the latest and greatest technology.

This tweet from Greg Meyer (@Greg_Meyer93 if you prefer) highlights the divide really well:

The reality of healthcare is that we have an industrial workforce and industrial products. Should we expect creative results? Maybe we need to switch up how we think about hiring and how we approach technology if we want to really disrupt healthcare. Or maybe healthcare will just get so bad and so far behind that it will create a gap that will allow someone from outside healthcare to enter and disrupt it all.

July 10, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Unofficial 2014 #HIT100 Rankings

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Editor’s Notes: My Twitter friend, Steve Sisko (@ShimCode if you prefer), sent me his list of unofficial #HIT100 rankings and asked if I wanted to publish them. Always someone interested in a sneak peak at the final results, I was of course happy to publish his findings. Plus, it will be fun to compare them against @TheEHRGuy’s final list.

I made my feelings on the #HIT100 list quite clear in past years. I don’t feel any different now. The list as a whole is quite interesting and a great way to discover new and interesting people in healthcare IT. However, specific rank on the list is meaningless to me since it can easily be gamed. For example, if you nominate a lot of other people, then you’re very likely to get reciprocal nominations and be at the top of the list. Not to mention, with just my own Health IT related Twitter accounts I could get someone to the top 50 if I’d wanted. Although, I didn’t. I think I nominated two people who bought me chocolate shakes and cheesecake in the past. I guess you now know how to win me over.

What I think would be interesting is to dive into this list a little deeper and see who’s new, who dropped from the list and also to dive deeper into the story of the people on this list. Sounds like a good future project for my blogs. I might start with those on the bottom of the list.

Without further ado, enjoy the unofficial #HIT100 list.

For those who simply must know, here are the unofficial 2014 #HIT100 rankings.

Note: These are not the “official results” that should be coming from @TheEHRGuy. They were derived as and have the limitations listed below the table.

Unofficial Nominee 2014 Votes 2014 Rank True 2014 Rank 2013 Rank Comments
@Brad_Justus 58 1 1 3
@MandiBPro 49 2 2 9
@ahier 33 3 3 4
@EMRAnswers 33 4 3 5
@bhparrish 29 5 5 25
@Colin_Hung 28 6 6 79
@DodgeComm 28 7 7 80
@nrip 28 8 8 12
@HealthcareWen 27 9 9 1
@HITAdvisor 27 10 9 2
@PremierHA 27 11 9 #N/A
@JohnNosta 26 12 12 6
@OchoTex 24 13 13 18
@ReginaHolliday 24 14 14 7
@VinceKuraitis 23 15 15 38
@JennDennard 21 16 16 #N/A @SmyrnaGirl – 15th
@TheEHRGuy 21 17 16 30
@2healthguru 20 18 18 13
@DonFluckinger 20 19 18 66
@Brian_Eastwood 19 20 20 53
@laurencstill 19 21 20 #N/A
@CDW_Healthcare 17 22 22 19
@drtom_kareo 17 23 22 #N/A
@ElinSilveous 17 24 22 23
@HITConsultant 17 25 22 28
@ShimCode 17 26 22 29
@techguy 17 27 22 20
@ColeFACHE 16 28 28 26
@GovHITeditor 16 29 28 35
@dz45tr 15 30 30 57
@GaryPalgon 15 31 30 17
@GoKareo 15 32 30 #N/A
@nxtstop1 15 33 30 #N/A
@DSSHealthIT 14 34 34 #N/A
@gerryweider 14 35 34 #N/A
@HealthcareMBA 14 36 34 #N/A
@drnic1 13 37 37 46
@Farzad_MD 13 38 37 #N/A @Farzad_ONC – 21st
@KenOnHIT 13 39 37 36
@leonardkish 13 40 37 24
@MelSmithJones 13 41 37 #N/A
@Cascadia 12 42 42 41
@dirkstanley 12 43 42 34
@motorcycle_guy 12 44 42 10
@Paul_Sonnier 12 45 42 11
@wareFLO 12 46 42 #N/A
@westr 12 47 42 77
@giasison 11 48 48 #N/A
@healthythinker 10 49 49 70
@janicemccallum 10 50 49 39
@jennylaurello 10 51 49 #N/A
@JonMertz 10 52 49 22
@MichaelGaspar 10 53 49 #N/A
@danmunro 9 54 54 #N/A
@gnayyar 9 55 54 51
@RasuShrestha 9 56 54 #N/A
@drttsang 8 57 57 #N/A
@HITLeaders 8 58 57 #N/A
@JohnSharp 8 59 57 #N/A
@MightyCasey 8 60 57 #N/A
@Docweighsin 7 61 61 #N/A
@ePatientDave 7 62 61 47
@EricTopol 7 63 61 48
@Greg_Meyer93 7 64 61 #N/A
@HealthFusionKMc 7 65 61 #N/A
@lsaldanamd 7 66 61 #N/A
@NaomiFried 7 67 61 83
@askjoyrios 6 68 68 #N/A
@boltyboy 6 69 68 52
@dineshrs 6 70 68 #N/A
@ehrandhit 6 71 68 #N/A
@fredtrotter 6 72 68 49
@hjluks 6 73 68 89
@JBBC 6 74 68 #N/A
@jhalamka 6 75 68 42
@SusannahFox 6 76 68 45
@CancerGeek 5 77 77 #N/A
@carimclean 5 78 77 #N/A
@CyndyNayer 5 79 77 #N/A
@intakeme 5 80 77 #N/A
@john_chilmark 5 81 77 62
@kathymccoy 5 82 77 55
@KBDeSalvo 5 83 77 #N/A
@Lygeia 5 84 77 40
@mloxton 5 85 77 #N/A
@nursefriendly 5 86 77 #N/A
@nversel 5 87 77 44
@PracticalWisdom 5 88 77 31
@ShahidNShah 5 89 77 98
@skram 5 90 77 #N/A
@ThePatientSide 5 91 77 #N/A
@annelizhannan 4 92 92 65
@chasedave 4 93 92 54
@Christianassad 4 94 92 16
@cmaer 4 95 92 #N/A
@CMichaelGibson 4 96 92 #N/A
@danamlewis 4 97 92 #N/A
@DCPatient 4 98 92 #N/A
@haroldsmith3rd 4 99 92 #N/A
@HITNewsTweet 4 100 92 #N/A

 

Methodology and Disclaimers

  1. This is an unofficial list.
  2. Selected all tweets tagged with #HIT100 from 7/1/14 (12:00 EST) thru 7/8/14 (13:00 EST) that complied with the essence of the requested format and general rules.
  3. Eliminated all duplicate votes made by the same person for the same nominee
  4. Didn’t combine people with multiple Twitter accounts. Like @KathyMcCoy/@HealthFusionKMc and @techguy/@ehrandhit and
  5. Didn’t exclude anyone who had less than 6 months on Twitter. That would take a little scripting or manual effort I don’t have right now.
  6. Didn’t exclude anyone who isn’t “an active participant of both the #HealthIT and #HITsm channels” as I’m not sure how to determine that without being subjective.
  7. Also, note that comparison to 2013 rankings has a few holes in it due to people changing their handles since 2013. Like @Farzad_MD /@Farzad_ONC and a couple others.
  8. Accounts with same vote count were sorted alphabetically.

Previous #HIT100 Rankings:

2011 – #HIT100 List – http://nateosit.wordpress.com/2011/07/17/hit100-the-list/

2012 – #HIT100 List – http://www.healthcareitnews.com/news/hit100-2012-list-revealed

2013 – #HIT100 List – http://www.healthitoutcomes.com/doc/hit-100-list-unveiled-0001

July 9, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

EHR Incentive Market Share Charts Worth A Thousand Words

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One thing I really love about the government lately is their goal to be as transparent as possible. Certainly they still have a ways to go, but I think healthcare has done some significant things when it comes to transparency into the government health programs. A great example of this is the Health IT Dashboard which has all of the data for the various health IT programs.

I don’t want to steal Carl Bergman’s thunder, because he’s already posted some really interesting Hospital EHR market share data and his previous EHR market share data. Plus, he’s planning to dive into the meaningful use market share data next. I love the approach of multiple sources when it comes to evaluating EHR market share and so I look forward to his analysis of EHR incentive market share against the EHR adoption market share from Definitive Healthcare and SK&A.

Until then, I thought I’d give you a taste of the EHR vendor participation in the EHR incentive program. This data comes from the ONC dashboards listed above and are put into some really nice snapshots of the data by ONC.

First up is the data for EHR vendor attestations by eligible professionals (ie. ambulatory doctors):
EHR Incentive Market Share - Eligible Professionals

And the EHR vendor attestations by hospitals:
EHR Incentive Market Share - Hospitals

It’s worth noting that the above data is just the EHR incentive money data. No doubt the actual EHR adoption data would have a few differences and include some companies in specialties that don’t qualify for EHR incentive money. Not to mention specialty specific EHR vendors who likely don’t make the chart even if they dominate their specialty. These charts do serve as an interesting proxy for EHR market share that’s worthy of discussion even if it doesn’t paint the full picture. Plus, even more important will be to watch the change in these numbers over time.

With that disclaimer, we could analyze this data a lot of ways. I’ll just offer a few interesting insights I noticed. First, 711 vendors have been used in the ambulatory EHR incentive program. That’s a lot of vendors. Only 78 of those 711 supply secondary EHRs as opposed to the primary EHR. 452 EHR vendors supply a primary EHR to less than 100 eligible professionals. 200 EHR vendors supply a primary EHR to fewer than 10 eligible professionals. These observations and a comparison of the ambulatory versus hospital EHR incentive charts’ “Other Vendors” shows how fragmented the ambulatory EHR market share is right now.

I was also intrigued that Mitochon Systems, Inc. was on the list even though they shut down their Free EHR software in May 2013. They had white labeled their EHR software to a number of other companies and so it will be interesting to see how that number evolves. I assume they sold the software to those companies, but I hadn’t heard an update.

On the hospital side of things, MEDITECH certainly doesn’t get the credit they deserve for the size of their install base. The same goes for CPSI, MEDHOST and Healthland. I think their problem is that people only want to read about the Mayo, Cleveland Clinic, and Kaiser’s of the world and so the articles about Billings Montana Hospital (I made that hospital up) rarely happen. I should find more ways to solve that since the small hospital market is huge.

I do wish that there was a way to divide the ambulatory chart into hospital owned ambulatory practices and independent ambulatory practices. That would paint an even clearer picture of that market.

What do you think of these charts? What can we learn from them?

July 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Is Healthcare So Complex That It Can’t Be Fixed with the Existing Parts?

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In one of my recent discussions I had someone suggest the following idea:

You can’t model a solution to fix healthcare with the existing parts.

I found this to be a really intriguing idea that is worthy of some deep consideration by those of us involved in healthcare. I’ve often talked with people about the many perverse incentives that exist in our current healthcare system. There are so many incentives that point us the wrong way that the idea that we can’t model a solution to our healthcare cost problem makes a lot of sense to me.

Of course, I don’t think that this means we shouldn’t have hope that healthcare can’t be fixed. It just means that the fix will be much harder and that it will likely come from outside of the current healthcare system. You need to change the healthcare model to really dramatically improve our healthcare system.

I’m certainly bias, but I think that technology will serve as the basis for any new model. Unfortunately, most of the technology that’s been applied to healthcare is more about trying to make the current model more efficient as opposed to disrupting the current model. A great example of this is the EHR. As I posted previously, the EHR is not disruptive and never will be.

That’s not to say that the EHR doesn’t have value or benefits. There are a lot of benefits to EHR, but it won’t be the disruptive change that healthcare needs. I’ll be interested to see what mix of technologies, policies, and pressures lead to a really disruptive change in how we deliver healthcare.

While I’m optimistic that something will come that will really change the quality and efficiency of our healthcare, it’s not going to be an easy path.

July 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

FDA EMR Regulation, EMR Jobs, and EMR Supports Fraud?

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I’ve written up my thoughts on the FDA regulating EMR. I hope the FDA stays far away from EMR.


There are lots of EMR jobs out there. If you’re looking for a better job or a first time health IT job, check out Healthcare IT Central.


This makes for a good headline, but let’s be honest about the fraud that’s happening. It was happening without EMR. Plus, I think that much of the increased reimbursement is more about doctors finally billing appropriately and not fraud. That’s something that many people don’t want to face. Certainly there is plenty of fraud in healthcare, but I think overall EMR software is going to better help track it down versus causing more fraud. What do you think?

July 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.