Electronic Medical Record

Healthcare IT Marketing

I’m often surprised by people’s reaction when I say that I’m a blogger. Most then believe that it must be a part time thing that I do for fun at nights. While it started that way, blogging is my full time job. If it weren’t for a large number of companies who’ve supported my work over the years, I’d probably have one blog that I’d post to a couple times a month. I can’t say how much these companies support means to me.

As my blogs have grown and the industry has changed (when I started people didn’t even know what a blog was), I’ve been working to evolve with the industry. While display advertising still does quite well for me and my advertisers, there are a number of shifts happening in healthcare marketing. That’s why I launched Influential Networks, an EHR Job board, EMR and EHR whitepapers, email blasts, and a number of other projects I’m still working to officially launch like my EHR and Health IT video series.

There’s a lot happening when it comes to healthcare marketing, and next week as part of my EHR and Health IT interview series, I’m going to be doing an interview with Don Seamons from Lumeno Marketing and Shahid Shah from Influential Networks. More details on that to come, but it should be a really interesting conversation on the changing healthcare marketing landscape.

With everything I do, my goal is to provide value to everyone involved. For example, those reading the site get value from the free content that’s available to them and also get introduced to companies they may not have known about otherwise. Those companies that advertise benefit from exposure to people reading the content we create. I don’t always nail this perfectly, but I’m sincere in my efforts to provide value all around. Plus, whenever there’s a financial interest involved in something I’m doing, I try to make that clear to the reader. That way everyone knows any bias I may have and can make their own judgement on the content I provide.

With all of this in mind, I want to take a second recognize the new and renewing EMR & HIPAA advertisers.

ZH Healthcare – As most of you know, my blog run on the backs of many open source software products. So, I’m really glad to have an open source EMR company supporting EMR and HIPAA. ZH Healthcare is built on the back of the most successful ambulatory EHR software to date, OpenEMR. If you want the flexibility of an open source EHR, check them out.

Caristix – I love the tagline from their ad, “HL7 interfacing 50% faster.” I think that pretty much describes what Caristix offers to those in healthcare IT. HL7 is going to be with us for a long time to come, so every institution and company should know a great HL7 company. Check out Caristix if you’re looking to do some HL7 integrations.

Chetu – Rather than me trying to describe Chetu, check out this interview I did with Craig Schmidt from Chetu. You can see the breadth of experience they have developing software for healthcare. If you’re looking to outsource some IT development work, check out Chetu.

Renewing Advertisers
The heart and soul of our support is in our renewing advertisers. So, a big thanks to all of the companies listed below for renewing their ads with us. It’s great to look over so many of these companies who have been supporting us for so many years. Here’s to many more years working together. If you enjoy what we do here at EMR and HIPAA, check out the advertisers below and see if they offer something you’re looking for.
Ambir – Advertising since 1/2010
Amazing Charts – Advertising since 5/2011
simplifyMD – Advertising since 9/2012
Canon – Advertising since 10/2012

A number of other exciting things coming in the future. Thanks to all the readers and supporters of EMR and HIPAA.

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May 22, 2013 I Written By John Lynn

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

Smart EMR & CDS

Written by: John Lynn

For those who don’t know, I’ve started a series of EMR, EHR and Healthcare IT video interviews with some of the leaders of our industry. You can attend the video interviews live and can ask questions on Twitter. If you want to receive email notifications of upcoming interviews, just subscribe on this page. Tomorrow I’ll be doing another video hangout on Hospital EHR and Healthcare Analytics with Dana Sellers and James Kouba.

The following video embed is from an interview I did with Sean Benson and Andre L’Heureux from Wolters Kluwer Health. We had a great discussion about the gap or white space between EMR software and what clinicians want them to do. We also talked about the challenge of integrating EMR with CDS systems. Plus, I asked them what EMR vendors could do to make the Smart EMR of the future possible. Their answer was quite interesting. We also discussed the challenge hospitals face of clinical knowledge management in their organization. Then, we wrapped up the conversation with a look at the WKH Innovation Lab’s sepsis project.

I think there’s a lot to be excited for when it comes to creating smart EHR and getting the most from clinical decision support systems. Enjoy the Smart EMR and CDS video interview embedded below.

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May 21, 2013 I Written By John Lynn

Filed Under: EHR Electronic Health Record Electronic Medical Record EMR HealthCare IT

Tags:Andre L'Heureux CDS EHR Video Chats Sean Benson Smart EMR WKH Wolters Kluwer Health

Mitochon Shuts Down Free EHR Service

Written by: John Lynn

The news just came out the Mitochon is shutting down their Free EHR service. They aren’t closing as a company (more details below), but they will no longer be offering EHR software. Here’s the full shutdown message:

Effective mid June 2013, Mitochon intends to exit the EHR market and cease our physician service.

We are sensitive that our providers’ medical practices will be affected by this. However this difficult decision has been driven by the need to focus on other lines of business, and the increasing liabilities we are incurring while supporting our free EHR service.

We will keep our active subscribers updated in the coming days as to how we will address the important issue of clinical data retrieval as well as possible alternate systems and solutions we are in discussion with.

It is with a heavy heart that we are existing the EHR market. The Mitochon team appreciates the support all of our clients have shown to us over the past few years and will work diligently to ensure this transition will be as smooth as possible for their practices.

Best Regards,
Dr. Andre Vovan & Mr. Chris Riley

Mitochon has been a great supporter of EMR and HIPAA over the years, and so I’m sorry that Dr. Vovan won’t be able to see his vision come to fruition with the Mitochon EHR. He was one of the first people I met who was talking about a community based approach to caring for patients. It’s interesting to see many of the topics he told me years ago are being talked about so much now in the world of ACOs.

As for the Mitochon EHR software, I won’t be surprised if some other players in the EHR space decide to take over the code and EHR business from Mitochon. There are actually a number of companies that have been white labeling the Mitochon EHR and it won’t surprise me if one of those companies takes over the codebase and users.

What’s likely more interesting is where Mitochon plans to take the company. Ever since I first met Mitochon years ago, their goal had been to build their own ad network and supply other third party networks. Now their focus will be exclusively on their content delivery and advertising network business. As Chris Riley, CEO, mentioned to me in an email, being in the EMR business and trying to partner with EMR vendors can often be a big issue.

Mitochon has some patents around CPT and ICD level targeting of ads. So, it will be interesting to see if Mitochon can become the pharma ad network for EMR companies. Although, there are a lot of non EMR opportunities for Pharma advertising as well. It will be interesting to see where Mitochon takes the company going forward.

EMR Selection Time, Mobile EMR, and Difficult EMR Selection

Written by: John Lynn

More Time Spent Selecting the Right EMR Vendor is a Prudent Investment ow.ly/kRPvC

— Billy Cline (@RecruiterBillyC) May 20, 2013

A prudent investment is an understatement. The very best use of your time in an EMR implementation is in the selection process. Although, I’ve also seen some clinics go too far and run into the issue called “paradox of choice.”

EMR – Electronic Medical Records Going Mobile getreferralmd.com/2012/04/emr-el… #mhealth #digitalhealth #HIMSS

— Jonathan Govette (@ReferralMD) May 19, 2013

Mobile EMR has always been a wonderful idea, but how many are really using their EMR on a mobile device. Let’s also not confuse mobile EMR with remote EMR. Certainly many doctors are using the same EMR from multiple clinics. That’s common and beautiful. However, far fewer are using their EMR on a mobile device. The most common response I get from doctors about a mobile EMR is “I can access my EMR on a mobile device, but the experience is terrible.” I expect this will dramatically change over the next 3-5 years, but won’t likely be the full EMR. Instead, I think it will be a really focused set of EMR functions on the mobile device. I’m not sure anyone has nailed that experience yet. Although, a lot of EMR vendors are working on it.

Choosing an an EHR is about as much fun a root canal and as straightforward as buying a vehicle. #EHR #EMR #Electronic

— Dr. Vicki Roberts (@fmsemo) May 19, 2013

Everyone that’s read this site for a while knows how much I love analogies. Both of these are pretty spot on. The root canal is necessary and can relieve a lot of long term pain, but it’s no fun going through the process. Buying a car is hard because there are so many choices and so many details that it’s hard to know what really differentiates the complex item you want to buy.

Integrating Telemedicine And EMRs

Written by: Katherine Rourke

Have you considered what an EMR would look and feel like if it integrated telemedicine? Rashid Bashshur, director of telemedicine at the University of Michigan Health System, has given the idea a lot of thought.

In an interview with InformationWeek Healthcare, Bashshur tells IW’s Ken Terry that it’s critical to integrate HIEs, ACOs, Meaningful Use and electronic health records.

Makes sense in theory. How would it work?

To begin with, Bashshur said, healthcare providers who have virtual encounters with patients via a telehealth set-up should create an electronic health record for that patient. The record could then be ported over to the patient’s PHR. The physician can also share the health record via an HIE with other providers.

When providers attempt mobile and home monitoring, it steps the complexity up a notch, as such activities generate a large flow of data. The key, in this situation, is to use the EMR to sensitively filter incoming data.

Unfortunately, few EMRs today can easily pinpoint the information providers need to process, so most organizations have nurse care managers sift through incoming monitoring data. That’s the case at University of Michigan Health System, where care managers sift data manually to determine whether patients seem to be seeing changes in their conditions.

Unfortunately, even attentive care managers can’t catch everything a properly-designed system can, Bashshur notes. To integrate EMRs and telemedicine/remote monitoring, it will be important for EMRs to have sophisticated filters in place which can pinpoint trouble spots in a patient’s condition, using a standard protocol which is applied uniformly.

According to InformationWeek, vendor eClinicalWorks has promised a new feature which can pick out relevant data from a large data stream. But until eCW or another EMR vendor produces such a feature, it seems that remote monitoring will be labor-intensive and expensive.

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May 17, 2013 I Written By Katherine Rourke

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Filed Under: ACO Clinical Decision Support EHR Electronic Health Record Electronic Medical Record EMR Healthcare HealthCare IT HIE Hospital EHR Meaningful Use PHR

Tags:ACO eClinicalWorks HIE Information Week Healthcare Rashid Bashshur Telemedicine University of Michigan Health System

Counter Intuitive Findings from Patient Portal Use

Written by: John Lynn

The patient portal is becoming a really hot topic in healthcare. I think we can attribute much of the discussion to the EMR meaningful use requirements to engage with patients in a patient portal. I recently started a thread on LinkedIn based on a post by Jennifer Dennard called Opening up the Pandora’s Box of Patient Portals. The conversation in the thread was great, but David Voran, MD provided some incredibly valuable insight that I wanted to share with all of my readers. The following are Dr. Voran’s comments based on his experience using a patient portal.

Long have exploited the portal in our organization and we’ve now progressed to where the entire chart is available to patients. Can begin to list the results but here are my counter intuitive findings:
1) The more barriers a clinician erects between them and the patient the MORE work they wind up doing.
- Those of us physicians who have configured the portal to have most message types routed directly to the physician wind up answering less messages at the end of the day.
- Typically physicians will have all medication refill requests, questions about the last visit, requests for visits, etc. routed to a nurse or a pool to attempt to answer first. The majority of the time the person receiving this message can answer only part of the question and will then send a message to a physician for direction; the physician responds and then the nurse will interact with the patient; then the physician has to approve any orders or actions taken. This usually involves having the physician receive or respond in some way to 2 messages in their inbox. Those of us who receive the patient’s message directly answer one.
- Many other examples but typically those physicians who have barriers are answering or responding to 35-50% more messages than those who have no barriers.

2) The more the patient has access to the more engaged they will be and the more accurate the record will be. The patient is the best auditor of the record and will point out inconsistencies that can be corrected.

3) If the physician is the one to enroll or engage the patient. Those physicians who promote the portal will get 60-75% utilization of the portal. Those that are passive will see about 30% response rate.

4) Aggressive use of the portal will eliminate up to 8 hours of patient related phone conversations per nurse per week.

EMR Workforce Shortage

Written by: John Lynn

One of the longest running conversations we’ve had on this site is the shortage of qualified EMR workers. It’s a discussion that quite frankly is difficult on many levels. On the one hand you have the hospitals and clinics who are suffering because they can’t find the right people to work on their EMR. On the other hand, you have the unemployed but experienced IT worker that’s trying to crack into the healthcare IT and EMR world.

This later group breaks my heart about once a week. There stories and efforts trying to find a job in healthcare IT are hard for me to take. Sadly, I haven’t figured out a way to help them beyond pointing them to our EMR and EHR Job board which appears in the sidebar of each of our sites. Otherwise, I’m not sure how to bridge the gap between the EHR workforce shortage that many people describe and those looking for jobs in the EHR world.

Although, I was reading something recently that opened my eyes a little bit to why I hear two sides of the same story. This is what I read:

There’s always a shortage of the perfect worker.

This is a challenging idea to consider, but an important one. There are only a handful of perfect workers out there for each situation, so of course there’s a shortage of that talent. Plus, it’s amazing how the perfect workers always seem to have work. Yes, there are a few exceptions and much of job hunting is about timing and location. However, I wonder if the EHR shortage that many describe is the lack of the perfect worker and not an actual EHR worker shortage.

I thought it would be interesting to have a poll to see what people think about the EMR workforce shortage. Is there one or isn’t there? Select your answer below.

Feel free to elaborate on your poll response in the comments.

5 Tips for Improving Provider Productivity with an EMR

Written by: John Lynn

The most recent EMR adoption numbers I’ve seen are putting EMR adoption at about 60% of doctors. When I think about the other 40% of doctors that have yet to adopt an EMR, my guess is that the biggest reason they haven’t adopted an EMR is based on their fear that an EMR will negatively impact their practice and their productivity. They fear that a change to EMR is going to be negative rather than a positive that it could be.

A whitepaper called Getting Lean with Your Practice: Five Tips for Improving Provider Productivity with an EHR does a good job looking at the issues of productivity in a practice and how to improve that productivity. One thing it points out is that if you can’t measure it, then you don’t really know how you’re doing. Turns out, an EMR is a great way to measure productivity.

Think about all the data an EMR can produce that would have never been possible in an EMR. Patient wait times and documentation times are the most obvious when we’re talking about productivity. In the paper world, you really didn’t have a good idea if a doctor had 20 charts outstanding or none other than looking at the stack of charts on the desk and checking them. In the EMR world, you can easily report on who’s staying up with their charting and who is not.

In the productivity whitepaper mentioned above, after studying 25 providers at 12 diverse practices they found that same-day encounter close rates (ie. finishing the charting the day of the visit) was the single most revealing metric about the success of patient workflow processes. They suggest that this doesn’t mean you document every patient as you seem them. Instead, they suggest documenting as much as you can with the patient when you’re with them and then you wrap up any complex patients as the end of the day. This is usually the right balance for most doctors I’ve worked with as well.

Here are the full 5 tips from the whitepaper:

Start on time.
Work with cross-trained staff that can handle intake and documentation.
Document encounters as much as possible during and immediately after visits, but don’t document more than necessary or spend too much clinical time on complex documentation.
Close all patient encounters by the end of the day – This should involve just wrapping up documentation for complex encounters.
Route documents appropriately and delegate responsibility for document handling effectively.

One of the other great takeaways from the whitepaper is the idea that doctors can and should be delegating more of the documentation to their staff. A Dr. Lizabeth Riley pointed out that “the data the system provided immediately opened my eyes to the fact that I was only giving my staff 1% of charting duties! Once I saw that, I knew thing had to change. My staff now does 40%-60% of my charting for me.”

There was a lot more interesting data in the whitepaper including the 5 different physician work styles from Truly Lean to Falling Behind and Frustrated. This last group is behind the EMR backlash. Hopefully some of the tips above can help a doctor become more productive with their EMR.

The Rise Of mHealth And EHR Use, And The World Of Telehealth – Around Healthcare Scene

Written by: Katie

mHealth is on the rise, and it looks like usage of smart phones among physicians is following that same trend. A recent study shows that usage rose about nine percent in 2012, which shows that it is becoming more accepted in the medical world. It will be interesting to see if it increases even more this year (I have a feeling it might.)

Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

Even though 90 percent of doctors are using an EMR at one point or another, only about 55 percent have actually adopted an EHR into their practice. It can be nerve-racking trying to find the perfect EHR. If you are finding yourself at that crossroad, be sure to read these five tips from ADP AdvancedMD on how to have a successful EHR implementation.

Still, some of you may be hesitant to implement an EHR. You may ask, is it worth it? Does it takeaway from healthcare? There is debate from both sides, each with compelling arguments. John believes that technology is overall positive in any industry, and discusses his thoughts, and some of the challenges that faces the industry.

Telehealth and medicine is so huge, it can be hard to digest. Neil Versel recently attended the American Telemedicine Association’s annual conference in Austin, Texas, and saw just how huge this market was. Be sure to check out this video he created from his experience, and to perhaps get a better idea about the many types of telehealth. Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

With summer quickly approaching, it’s more important than ever to stay hydrated. But if you need a little reminder, be sure to look into the Jomi Band. It gives you warnings when you might be on the brink of dehydration, and makes it easy to keep track of how much water you’ve consumed in a day’s time.

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May 12, 2013 I Written By Katie

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Filed Under: EHR EHR Benefits Electronic Health Record Electronic Medical Record EMR EMR Selection EMR Technology Healthcare Healthcare Communication Healthcare Devices HealthCare IT Hospitals Medical Privacy Patients Personal Musings

Tags:EHR EMR mHealth Telehealth

Healthcare IT From the Mouth of Babes

Written by: John Lynn

A little Fun Friday post to get you started for the weekend. This past week was Take Your Child to Work Day. This is always an interesting thing for me since I work from home. However, I usually try and head out to one of the local Las Vegas tech startup hangouts so my kids can see some other people I work with.

This time I decided to put my son to work a little bit. I had him on the iPad following some people on Twitter. It was fun to see him working.

As we started to work my son asked me, “What DO you do for work dad?” I knew that sooner or later this question would be coming since I mostly work from home. I responded, “I’m a blogger.” My son replied, “Oh, I told my class you were a typist.” I guess my son’s teacher had asked those planning to go to work with their parents what their parents did. He was right about me typing. It’s a pretty fundamental part of my job and really the only visible part of my work from his perspective.

I then went on to explain to my son a little bit more about what I did for my job. I told him that I wrote about how doctors can keep track of their patients on the computer. My son then responded, “That’s kind of weird that a doctor would write on paper…and then give it to a bird to deliver it, but you’d have to train the birds. That’s how they use to do it.” Sadly, he’s not that far from the truth.

From the mouth of babes indeed. Looks like I need to spend a little more time teaching them what I do for work. Although, I was grateful for the good laugh. I hope you enjoyed it as well.

Now I’m going back to work as a “typist” so I can write about doctors switching from pigeon chart delivery to electronic exchange of charts.

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May 10, 2013 I Written By John Lynn

Filed Under: EHR Electronic Health Record Electronic Medical Record EMR HealthCare IT

Tags:EMR Blogger EMR Blogging

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- EMR Selection Time, Mobile EMR, and Difficult EMR Selection (3)
  - John Lynn: David, It looks like PatientKeeper is just CPOE and not the full EHR. Is that right? I think if it is,...
  - DananD: There are some EHRs that have been designed from the ground up to run on mobile devices. For example, Health...
  - David Domeshek: There’s no need to wait 3-5 years for effective mobile EMR access that provides a good...
- Mitochon Shuts Down Free EHR Service (7)
  - John Lynn: Chandresh, It’s also about execution of those and other revenue models. Executing them is not an...
  - Chandresh Shah: John, potential is always there and I for one would love to see ‘game changers’. Not...
  - John Lynn: Chandresh, The ironic thing is that Practice Fusion could embrace Mitochon’s ad service and become...
- Counter Intuitive Findings from Patient Portal Use (7)
  - R Troy: I do get a feeling that doctors – and workers in their practices, are scared of portals. I remember how...
  - John Lynn: John, You describe the concerns of many doctors, but I’m talking with more and more people actually...
  - R Troy: John, We all know that each practice is different. This practice makes little to no use of nurses, just a few...
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