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Major EMR Vendor Consolidation On The Verge

Posted on June 14, 2012 I Written By

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.

Note: This is a post by Katherine Rourke. Tomorrow watch for a post by John on EMR and EHR where he discusses some of his views on this discussion.

While it may not be immediately obvious, the EMR industry is at a major turning point in its history. Any day now, we’re going to see a bunch of mergers and acquisitions go off like a string of firecrackers, some of which may have a direct impact on your business.

Now, I don’t know how many EMR companies there are out there. In fact, I’m not sure anyone has a precise count. But can we agree that we’re looking at 1,000 or more, no?  And, heck, there’s probably thousands of companies pitching practice management + EMR,  medication management systems, clinical decision support, apps, mobile health plug-ins to EMRs and so on. Just visualize it all — you’ll get a headache but you’ll doubtless agree that we’re dealing with a raging flood of technology.

And most of it won’t stand alone forever. Every vendor likes to say that their product line has all the solutions, but even the most green sales rep doesn’t really believe that. Smart EMR tech firms and their natural allies are already beginning the mating dance, and quietly but inexorably, hooking up.

Since this isn’t the Wall Street Journal, I’m sure we don’t need to dig into deep financial discussion over this. And anyone who’s a regular reader of this site knows why software companies often buy rather than build the technologies they need to fill out their portfolio.

But I thought it was still worth noting that within, say, 18 months, the EMR world could look fairly different in the following ways:

* EMRs aimed at doctors are overabundant, to put it mildly. I predict that there will be a dozen or so well-publicized failures or buyouts in this space within the next year.

* Big vendors that pitch to both enterprises and medical practices will largely have to pick one,and it’s the enterprise side that will win. If you’re a doctor running a giant company’s EMR, stay in regular touch with your vendor and get their support promises in writing!

* There will be a flurry of mHealth activity, with EMRs that play nicely on tablets in center stage.  It’s possible the market will even support another IPO or two this year by EMR vendors if they’re offering a nifty mobile health aspect integrated with their core product.

* Doctors, in particular, risk finding that their product becomes abandonware this year as the market consolidates.  Have a Plan B available, and I mean a written plan developed by a consultant or tech-savvy senior member of your team.

So, what else do you think will happen as the market absorbs excess players and recombines relationships?

Few Doctors Ready To Qualify for Meaningful Use

Posted on May 3, 2012 I Written By

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.

A new study published in Health Affairs has confirmed what I, at least, have suspected for some time about physicians and their EMRs.  The study, which surveyed 3,996 physicians, found that while 91 percent were eligible for Medicare or Medicaid Meaningful Use programs, only 11 percent of those intending to apply had their act together.

Researchers, who analyzed data from the 2011 mail survey supplement to the annual National Ambulatory Medicare Care Survey, found that 51 percent of respondents were planning to apply for MU Stage 1 incentive programs. However, it seems that only 11 percent of doctors planning to apply have a capable enough EMR set-up to support up to two-thirds of Medicare Stage 1 core objectives.

Now, this was not completely unexpected. In the final Stage 1 MU rule, CMS had estimated that 10 to 36 percent of Medicare eligible pros, and 15 to 47 percent of Medicaid eligibles, would end up meeting the agency’s criteria.

And it should be noted, the HealthAffaits authors remind us, that about 124,000 eligibles had registered in 2011, and that CMS had paid out $275 million to 15,000 participants. Also, Medicaid programs paid out about $220 million to about 10,500 physicians.

Still, you can’t bury poor performance like this in a pile of data. Clearly, a program is lacking something important just over 1 in 10 physicians manage to set themselves up for Meaningful Use cash — especially if  they were trying hard to do so.

The problem with news items like these is that they don’t get into what’s holding physicians back. It’s actually a bit disappointing that the HealthAffairs study didn’t offer any red meat on the “Why Can’t Doctors Qualify?” issue, as we all know that talking about problems doesn’t make them go away.  (I do admit that in the world of public policy at least, simply underscoring a problem gives rulemakers ammunition to dig deeper into an issue.)

Still, I’d love to know what you’re seeing out there in terms of unprepared physicians. Are we talking practices that got fast-talked into buying inappropriate or junky technology?  Lack of understanding what they bought?  Slow-moving practices that are on the right track?

EHR Salesman Joke

Posted on October 14, 2011 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.

Since it’s Friday and I know that many of you stop reading the site cause you’ve already headed off for the weekend, I decided I’d keep it short and sweet this Friday. Plus, hopefully this joke will give you a great laugh to start the weekend.

Whats the difference between a EHR salesman and a used car salesman? The used car salesman KNOWS when he is lying!

Now you know why I have a category on this blog called EMR sales miscommunications.

Thanks to Mark Wright from Aquarius Imaging for giving me the joke.

More EHR Company Lines

Posted on June 4, 2009 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 previously wrote about the reasons EHR companies use to get you to buy an EHR Now. Today I came across a post that’s really similar to my idea. The post is by Evan Steele, CEO SRSsoft and it’s entitled “From EMR Vendors: Fact or Fiction?” I think that Evan does a really good job covering some of the misconceptions/lies that are being spread by overzealous EHR salespeople in regards to the HITECH act’s EHR stimulus money. My favorite one was this:

“You must act now—buy an EHR now because in order to get the money from the government, you must be using the EMR by 2011.” As with used-car salesmen, “buy now” is always popular, but you actually have until 2013 to implement and potentially qualify for the lion’s share of the incentives.

Even if you do not implement until 2014 (5 years from now), you would still be eligible for almost 80% of the money.

My Least Favorite EMR Vendor Sales Line

Posted on May 26, 2009 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 feature of every EMR vendor is a whole multitude of sales lines. If you’ve ever talked to a EMR sales person, you know what I’m talking about. This isn’t really unique to EMR sales. The same can be said of most software that’s trying to solve complex problems.

Well, there’s one EMR vendor sales line that gets on my nerves more than any other line. Let’s take a demo of an EMR vendor’s templates. Now here’s the line that I absolutely abhor:

“You can make it do whatever you want.”

Hearing this is like hearing fingernails on a chalkboard for me. Certainly, the intent of their comment is that the EMR template creation is really flexible (and it very well might be). However, the superlative “whatever” is just wrong. Every software system has limitations and I can guarantee you that if you really start using an EMR system you’re going to bump into those limitations.

I guess my problem is using superlatives like whatever, any, all, always, etc. is just misleading and leads to what I call EMR sales miscommunication. Anytime you hear one of those things during an EMR demo (or even during an EMR training) you better start asking lots of questions.

Of course, these superlatives do a lot better job selling EMR software. I guess that’s why I’ll never be an EMR salesperson. Maybe it’s also why people seem to like reading my EMR blog posts.

EMR Salesperson Myth – Specialty Templates

Posted on May 11, 2009 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.

Time to call out another myth that EMR salespeople love to use to sell their EMR system. Here’s the question and answer that will be familiar to many:

Doctor: Do you have templates for my specialty?
EMR Salesperson: Of course, we have tons of templates for your specialty.

Available templates is one of those myths that is perpetuated by many EMR companies. The problem with the question being asked is that “EMR salespeople” wouldn’t know the difference between a good and bad EMR template if they tried. Add in the idea of specialty specific templates and it’s no wonder they don’t know how to give a doctor a real answer to that question. They are also so far removed from the EMR template development that they can’t reasonably answer that question. So, stop asking the salesperson.

Instead, ask to see all of the specialty specific templates. At least then you’ll know up front the quality (or lack therof) of the EMR templates offered for your specialty.

I’d personally even take it one step further. Ask the EMR vendor to make a change to one of the templates you like. The harsh reality of templates is that almost every (and possibly EVERY) template you get from an EMR vendor is going to need at least some modification to make it look the way you want it to look. You might want to reorder the data, brand the note, add in missing options in drop down lists, or some other edit. Regardless of how big or small, you’re going to be editing the templates you’re given. Better to know up front the process for editing the template. If the person showing you the template baulks at your request to modify the template, that’s a really bad sign.

I’m not hammering on templates either. They can be very effective if created correctly. Just don’t expect a set of practice changing templates right out of the box.

Benefits of Using an EMR/EHR Consultant – Selection Process

Posted on January 11, 2008 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 while back I wrote something about why having an EMR or EHR consultant could be beneficial to a doctor looking to implement an EHR. Here’s the first part of a five part series on reasons why I think a well qualified, experienced EMR or EHR consultant is valuable. The first part is how an EMR or EHR consultant helps with the selection process.

EHR Selection Process

By first evaluating a doctor’s needs and preferences EHR consultants are able to eliminate a majority of the EHR companies and provide doctors with a short list of high quality EHR vendors to evaluate. By providing a smaller pool of EHR vendors, doctors are more comfortable with the selection process and don’t get discouraged seeing hundreds of EHR vendors that don’t meet their needs. EHR consultants also help doctors through the evaluation process. EHR consultants often provide a list of questions that can be used to evaluate EHR vendors. These questions have been designed to tease out information which will better enable doctors to select the right software. EHR consultants also assist doctors that need help negotiating with EHR vendors. These services include requesting enhancements to meet doctor specific needs or even ensuring that EHR vendor pricing is comparable to other EHR implementations.

When it comes down to it, a good EHR consultant can save a doctor large amounts of time and money that would have been wasted looking amongst the hundreds of EHR companies. It’s not hard to say that doctor’s most precious commodity is time.

See other parts of Benefits of using an EMR/EHR Consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in

Presenting on EMR at PCCHA Conference

Posted on October 18, 2007 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 day is fast approaching for me to present at the Pacific Coast College Health Association conference in Hawaii. In fact, I have less than a month to finish my preparations. I feel pretty good about my ability to present and also my knowledge of EMR, but presenting something always gets my nerves going. I think once I get started talking about EMR, then I won’t be able to stop. My real hope is that the people that attend my session will be interested in what I have to say, find it useful and ask good questions. Honestly, a part of me really wishes that I was a member of a panel where I just answered questions about EMR. I think that would be a lot of fun.

Since it’s not a panel, then I’d love to hear any feedback from people on things I should include in my presentation about “Lessons Learned from EMR Implementation.” I have a ton of things already planned about EMR implementation, but I’m sure there are some important things that I’ve missed. Time has a way of doing that to you.

Either way, I’ll be happy if one person in my session on EMR goes away saying they were better prepared to implement an EMR system, then I’ll be happy.

Preliminary Questions for an EMR Vendor

Posted on February 21, 2007 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.

In my recent post about EMR site visits, I got a comment from prakash about what questions a doctor should ask an EMR vendor. He gave me the following list of preliminary questions:

What is the cost per physician license?
Do you have any existing clients in our specialty?
Does your system come pre-loaded with templates for my specialty?
Is your company the developers of the software or is it re-branded from another vendor?
Is your system client/server based or ASP based?
Does your system include practice management software?
How many clients does your company have?
Is your system HL7 compliant?
How long has your company been in business?
Is your development done overseas?
Is support done overseas?
Is your software CCHIT certified? If not, why?
How often is the software updated?

I don’t think this is nearly a comprehensive list of questions. In fact, I think it just is the tip of the iceberg. I also would consider changing some of the way the questions are phrased. However, I thought it was a good starting point that could be built out over time. In fact, I think I’m going to make a static page on this website for these type of questions.

Hopefully, my valuable readers will continue to point me to other good resources that might have a nice list of questions that I can continue to compile into a valuable resource for those searching for an EMR. Just post a comment if you have other questions you think should be asked or know of other resources and I’ll continue to compile questions for EMR vendors.

Thanks Prakash.

Paper Charts, No More – 5 Stories of EMR Success, Even Amidst Some Failure

Posted on June 1, 2006 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 was very nice to see a well written article that documented 5 cases of users implementing an EMR system. I think there are hundreds of more stories that need to be told. They laid out the stories into 5 phases as follows:
Phase 1: The Spark
Phase 2: The Vendor Search
Phase 3: The Installation
Phase 4: The Payoff
Phase 5: The Future

I love the idea of the 5 phases, but some of the stories didn’t seem to fit the phases described above. Looking at the phases above it does seem like they left out a nice gap between installation until payoff. Thankfully the stories didn’t leave the hard work of implementing an EMR out. Therefore I loved the article from Health Leaders Media. Here’s a little play by play of the 5 stories:

Phase 1: The Spark
This woman is courageous. Running a solo practice by herself with one part time medical assistant. Talk about thinking outside the box and managing costs. I was super impressed by this ladies thought process. I imagine this type of gyn practice allows her a lot of freedom. More importantly for this site was that she sunk $70,000 into an EMR system. I hope those reading this will know that you don’t need to spend that much money. EMR programs shouldn’t cost nearly that much money. Espescially for a solo practice. She does point out an important point to remember with an EMR program. Buy the upgrade package. You don’t want your EMR stagnant. Stay with the latest and greatest in EMR development. Don’t get left behind on an old EMR system where a few years down the road you’ll have to upgrade again.

Phase 2: The Vendor Search
Excellent story of EMR vendor selection failure but eventual EMR implementation success. It really makes me sad that an EMR vendor the size of NextGen couldn’t deliver in this story. I guess kudos go out to Companions EMR software (which I’ve never heard of) for helping them be a success. I still think the story needs more detail on what happened with the second EMR vendor. It’s only fair to compare the differences between the EMR failure and EMR success.

Phase 3: The Installation
This story seemed quite off target. Why would they use a home grown EMR system to Illustrate the installation phase of an EMR? Programming and implementing your own EMR system, besides being a crazy idea, is not a good example for those implementing an EMR package. I’ll push that aside and say that there were some good points in the story.
-Katrina proved that EMR’s are essential
-Continuing testing and reworking your EMR processes
-Have physician champions
I loved that they actually payed an IT salary to a few of the doctors who helped test their EMR system. That’s thinking outside the box.

Phase 4: The Payoff
Be careful comparing financial rewards of one clinic with another. They are too hard to compare. I think it is important to see the clinical outcomes he is able to show because of an EMR. If your EMR breaks you even and provides your patients better care then I call that a Win. This should be the hope and expectation when starting an EMR implementation. Isn’t healthier patients payoff enough?

Phase 5: The Future
The Quote of the article:
For six months, I lived EMR.
This pretty much describes most implementation and the reason I got the job I did. They needed me to live EMR. Now you see why I call it the EMR experience. I think a lot more could be said about what EMR will allow a doctor to do in the future. This fifth EMR story doesn’t even do the future justice. It does point out one great monetary key to EMR implementation. Transcription cost savings can be a key driver for purchasing an EMR program.