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Communication With Providers, Patient Alert Fatigue, and #HealthIT — #HITsm Chat Highlights

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#HITsm T1: How do you WANT to communicate with your healthcare provider? How does it differ from what’s available?

 

#HITsm T2: How can we avoid patient alert fatigue as we move toward engaged care and #mHealth acceptance?

 

#HITsm T3: Will the shortage of qualified #healthIT professionals to fill openings force a delay in meeting Meaningful Use requirements?

 

#HITsm T4: Open Forum> What #healthIT topic has interested you most this week?

April 6, 2013 I Written By

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.

EHR Expert Jobs, Healthcare Social Media, MU Attestation Data

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I guess Cleveland Clinic doesn’t think the government trained EHR workforce. I know a lot of them that can’t get a job in any EHR position.


This story is a crazy one and spiral out of control is the right term. Although, this post by Amanda Blum is the best look at the issues from my point of view. Dr. Nick is right that you do have to be careful. In fact, the case above wasn’t even something that happened on social media. It was something that happened in person at a conference and then social media blew it up. So, I’d actually argue that it’s more important than ever for you to be involved in social media. That way if something does blow up, you see it and can deal with the situation before it spins out of control.

What I do hate most about the story is the lack of civility and not giving people the benefit of the doubt. I hate that part of the way society is heading. Communication can solve a lot of issues if people would just use it. Instead, we assume the worst in people. That’s unfortunate.


Evan’s opening line to the blog post says, “CMS just released the December 2012 attestation data, and one thing is abundantly clear—many EHR vendors will not be around to see Stage 2.” I don’t agree with his conclusion. I expect we’ll have nearly as many in meaningful use stage 2 as we did in stage 1. Meaningful Use stage 3 is likely where we’re going to see fallout. Although, it does beg the question of how many EHR vendors will stay in business without EHR incentive money?

I’ve often said that it’s surprising how good of a business you can run with just a few thousand doctors.

March 31, 2013 I Written By

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.

EHR Penalties after Meaningful Use Failure

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While at HIMSS I had a discussion with the consulting firm Stoltenberg Consulting. I was really intrigued by their approach to EHR consulting and will likely write more about it later. Plus, the started what in many ways became a theme of my HIMSS experience around rural healthcare EHR. You can be sure I’ll be writing about rural EHR here on this site and on Hospital EMR and EHR much more in the future.

In our casual introductory conversation we had a good discussion about how many of the smaller hospitals look at meaningful use and the EHR incentive money. Needless to say, many of these smaller institutions are faced with a huge challenge when it comes to adopting an EHR and showing meaningful use. Many of these rural hospitals barely have an IT staff and the CFO usually takes care of the IT environment. I heard one story at HIMSS where the IT person at a rural hospital started out as the janitor and his home IT skill made him the most qualified person to help.

Needless to say, rural and smaller hospitals have some real challenges facing them when it comes to EHR adoption and showing meaningful use of that EHR. Although, an even worse thought struck me in my discussions about these smaller hospitals.

Imagine many of these smaller hospitals making a good faith effort to adopt EHR and show meaningful use. It’s not that hard to see many of these hospitals falling short of the meaningful use standard. What will this mean to that organization? They’ve spent millions on an EHR. They won’t get the EHR incentive money they likely used as a justification for the EHR spending. To add insult to injury, now they’re going to get penalized for not being meaningful users of an EHR.

This scenario honestly makes me sick to even consider. Something similar could easily happen in small ambulatory practices as well. The scale of the damage will just be different. I expect in meaningful use stage 1 this won’t likely be a problem since it’s self attestation. However, this could become a much bigger issue in meaningful use stage 2.

Although, consider an organization who fails a meaningful use stage 1 audit. In most cases you can’t go back and fix whatever you failed in the audit. You’d be in a very similar situation where you have to return the EHR incentive money and would be open to the meaningful use penalties. At least that’s my understanding of how the EHR penalties will be implemented. If you know otherwise, I’d love to hear it.

While I think the above scenarios are brutal, hopefully this will also serve as a warning for those hospitals pursuing EHR and the EHR incentive money. Be sure you are able to show meaningful use or you’ll not only lose out on the incentive money, but you’ll also be open to the EHR penalties. Not to mention, are you ready for a meaningful use audit?

March 15, 2013 I Written By

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.

HIMSS Analytics Clinical & BI Maturity Model

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While the theme of HIMSS 2013 may have been, “How Great Is Interoperability,” the effectiveness of the many facets of interoperability are only as good as the actionable value of the shared data. The clinical insights that should be enabled by Meaningful Use Stage 2+ are expected to drive market trends in myriad areas of the healthcare system: chronic disease management, targeted member interventions, quality measures. In order to assess organizational readiness to capitalize on the promise of Meaningful Use, HIMSS Analytics began measuring the implementation and adoption of EMR and clinical documentation using a maturity model called EMRAM.

EMRAM

But, in analytics terms, EMRAM’s results are simply targeted foundational reporting, answering the question, “WHAT happened with Meaningful Use EMR adoption criteria.” So, you’ve got your clinical data in an EMR. Now what are you able to DO with it?

In 2013, HIMSS Analytics is taking a broader approach with the introduction of a new Clinical Business Intelligence maturity model, creating a framework to benchmark participating providers’ analytics maturity level.

I’ve been fortunate to know James Gaston, Senior Director of HIMSS Analytics Clinical & Business Intelligence, for many years, going back to his days with Arkansas Blue Cross. His appreciation for BI initiatives is matched only by his enthusiasm for the first day of turkey hunting season. When I ran into him at TDWI’s BI World summit in Orlando in November, he acted like a kid on Christmas morning, telling me about the brave new world of clinical data management that he was about to tackle. The excitement continued to build in the months leading up to HIMSS. James was practically glowing when we spoke about the upcoming C&BI Maturity Model release.

“Our customers are interested in not just understanding how to deploy IT applications, but how effectively they’re using those applications to support clinical business intelligence, as well as analytical pursuits,” James said. “So, HIMSS Analytics partnered with IIA to create and present a Clinical & BI Maturity Model that helps healthcare organizations measure that level of effectiveness.”

Sarah Gates, the VP of Research for IIA (the International Institute of Analytics), elaborated. “The HIMSS Analytics C&BI Maturity Model leverages the Competing on Analytics DELTA model, developed by Tom Davenport, which measures not only how well you’re using data and technology, but how well you’re building an analytical organization.” There are 5 core competency measurements in the DELTA model that will inform the HIMSS Analytics C&BI analysis: Data, Enterprise, Leadership, Targets, and Analysts. The methodology is holistic, touching on the cultural aspects of the organization as well as the technical, allowing a longitudinal view of the organization’s analytics program. A yardstick value from 1-5 will be assigned to each respondent based on Davenport’s criteria for each core competency.

Although HIMSS Analytics will eventually offer Level 1-5 certification program for those organizations with observed results for analytics, James and Sarah agreed that it is not appropriate for every provider to reach for the Level 5 gold star. Per Sarah, “Healthcare is an industry just starting to discover analytics. We’re expecting to see lots of practitioners that are emerging in use of analytics, so we believe it (survey results) will be heavy on the lower end of the maturity scale. Data warehouse capabilities and staffing career paths for data analysts will be key differentiators for mature programs.” Not all providers have the resources – financial, human, and/or technical – to attain advanced analytics nirvana, and James wants to insure that these providers don’t feel as if they’ve “failed”; the goal is to baseline against the peer group, identify opportunities for improvement, and focus on what is possible for each individual organization, working within their constraints.

What can we expect to see at next year’s C&BI survey results presentation? James said, “We want to be able to talk about benchmarking the industry as a whole, helping healthcare find its way with clinical business intelligence and begin to understand how important it is, and where opportunities lie Everyone’s talking about clinical and BI – it is the opportunity to realize savings in healthcare, to use information to empower people to make better decisions.”

So, it’s up to you, providers and technology partners. You’ve implemented your EMR, achieved a high adoption rate across your organization’s core clinical processes, attested to Meaningful Use Stage 2, achieved Stage 7 on the HIMSS EMRAM scale, perhaps even participated in multi-HIE CCD medical records sharing with other provider networks. You’ve got the data in-house and availabe. It’s time to see how ready you are to rise to the analytics challenge and maximize your return on those EMR and HIE investments.

Attempt to beat your previous Doug Fridsma long jump.

Note: for the complete HIMSS 2013 Leadership Survey Results, please download PDF here.

March 14, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

The Marvelous Land of Oz: The HIMSS Interoperability Showcase

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As I walked the floor of the HIMSS Interoperability Showcase, listening to the tour guide’s carnie-esque pitch on the wonders awaiting me with each successive use case encounter, I ALMOST wished I hadn’t worked with so many of the organizations hawking their wares. It’s a bit sad to know the man behind the curtain, to realize that The Great and Powerful Oz is simply a man with a highly mechanized presentation. But that knowledge gives me insight that others attending the Showcase may not have had – and validation that, in the end, Oz IS Great and Powerful, even though he’s just a man.

There were 20 specific interoperability use cases represented at HIMSS this year, collectively, by 101 vendors. In order to qualify to participate, each of the organizations had to successfully demonstrate proficiency with their chosen use case at the Connectathon event in Chicago. In January. In a basement the size of a football field. Packed shoulder-to-shoulder with your closest competitors at high school-cafeteria tables. Talk about a frigid atmosphere!

Perhaps to stay warm, perhaps to pass the time, perhaps in the pursuit of the patient-centric design principles the healthcare industry espouses publicly yet so seldom seems to put into practice, cross-company collaboration occurs. Competitors converge on each others’ laptops, debugging code, refining business rules and algorithms. Functional use cases emerge, success stories are shared, everyone goes home happy with a list of enhancements to incorporate before the main event at HIMSS. The frantic rush to prep for Connectathon is amplified by the urgency and importance of HIMSS. The ONC is watching! Your competitors are watching! The 40K HIMSS attendees will be watching!

Invariably, the use cases are perfected in the weeks leading up to HIMSS, each click carefully orchestrated, each transition scripted, all parties putting forth their best effort to insure success for the spectators – many of whom are clients, prospects, regulatory officials, or journalists seeking The Next Big Healthcare Thing to go viral in the blogosphere. The yellow brick road is constructed, and as one walks its length, the carefully choreographed demonstrations come to life with compelling tales: “Keeping a Newborn Safe,” “Improving Pediatric Care,” “Optimizing Cancer Care,” “Beneficiary Enrollment.” The show goes on, and it’s a good one – albeit with the occasional glimpse of the man behind the curtain.

The perfectly nice gentleman manning the Federal Health Architecture booth seemed eager to demonstrate the capability to request and retrieve a patient’s medical record from multiple HIEs and disparate EMRs. He walked me through the provider portal view, showed me how he could see that there were multiple medical records available for this patient across providers, and talked me through each click up until the print button. Print?

“Aren’t you importing the records into the requesting EMR?” I asked.

“No. Right now, they have to print each set of records.”

“So, each time this scenario presents itself, the provider has to click on each available external record, print multiple pages, compare notes across screen and paper, and later choose whether to manually update his own EMR with the other information?”

The perfectly nice gentleman suddenly seemed uncomfortable. The Great and Powerful Oz, exposed as mere mortal, Oscar Zoroaster Diggs. You’d think I’d know when to quit.

“The standards and technology exist to do CCD discrete data import, and a couple of the large EMR vendors are implementing that capability for high Medicare population IDNs. How does it make the provider more efficient, and give the patient more face-time with his doctor, if we’re still printing and no data consolidation or reconciliation is happening prior to point-of-care? Why didn’t you extend the use case to show end state?”

He assured me that they’re working on it, and we made a deal that NEXT year, I’ll come back and he’ll walk me through their progress towards discrete data import. No printing, he promised. I’m going to hold him to it.

Aside from this specific use case, across the Marvelous Land of Oz, what I’d REALLY love to see next year: the basement Connectathon advancements made to support the use cases for HIMSS actually incorporated into the products. As part of the qualifying criteria for repeat showcase exhibitors, have them demonstrate the capabilities developed in prior years actually functioning in the marketplace under general release. That would be a substantial improvement on this year’s long jump attempt for the Interoperability Showcase.

I want to fall in love with the hard-working man behind the curtain, not the showy pyrotechnics.

March 11, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

What Would ONC’s Dr. Doug Fridsma Do? (THIS Geek Girl’s Guide to HIMSS)

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I know you’ve all been wondering how I’m planning to spend my mad crazy week at HIMSS in New Orleans. Well, maybe not ALL of you, but perhaps at least one – who is most likely my blog boss, the master John Lynn. Given the array of exciting developments in healthcare IT across the spectrum, from mobile and telehealth to wearable vital sign monitoring devices, EMR consolidation to cloud-based analytics platforms, it’s been extraordinarily difficult to keep myself from acting like Dori in “Finding Nemo”: “Oooooh! Shiny!” I’ve had to remind myself daily that I will have an opportunity to play with everything that catches my eye, but that I am only qualified to write and speak intelligently on my particular areas of expertise. And so, I’m proud to say I’ve finally solidified my agenda for the entire week, and I cannot WAIT to go ubergeek fan girl on so many industry luminaries and fascinating up-and-comers making great strides towards interoperability, deriving the “meaning” in “Meaningful Use” from clinical data, and leveraging the power of big data analytics to improve quality of patient experience and outcomes.

On Sunday, I’m setting the stage for the rest of the week with a sit-down with ONC’s Director of Standards and Interoperability and Acting Chief Scientist, Dr. Doug Fridsma. His groundbreaking work in interoperability spans multiple initiatives, including: the Nationwide Health Information Network (NwHIN) and the CONNECT project, as well as the Federal Health Architecture. For insight into his passion for transforming the healthcare system through health IT, check out his blog: From The Desk of the Chief Science Officer.

Through the rest of the week, I aspire to see the world through Dr. Fridsma’s eyes, focusing on how each of the organizations and individuals contribute to the standards-based processes and policies that form the foundation for actionable analytics – and improved health. I’ve selected interviews with key visionaries from companies large and small, who I feel are representative of positive forward movement:

Health Care DataWorks piques my interest as an up-and-comer to watch, empowering healthcare systems to improve outcomes and reduce medical costs by providing accelerated EDW design and implementation, whether on-premise or via SaaS solution. Embedded industry analytics models supporting alternative network models, population-based payment models, and value-based purchasing allow for rapid realization of positive ROI.

Emdeon, is the single largest clinical, financial, and administrative network, connecting over 400,000 providers and executing more than seven billion health exchanges annually. And if that’s not enough to attract keen attention, they recently announced a partnership with Atigeo to provide intelligent analytics solutions with Emdeon’s PETABYTES of data.

Serving an area near and dear to my heart, Clinovations provides healthcare management consulting services to stakeholders at each link in the chain, from providers to payers and supporting trading partners – in areas from EMR implementation (and requisite clinical data standards) to market and vendor assessments, and data management activities throughout. With the dearth in qualified SME resources in the clinical data field, I look forward to learning about how Clinovations plans to manage their growth and retain key talent.

Who doesn’t love a great legacy decommissioning story? Mediquant proports adopting their DataArk product can result in an 80% reduction in legacy system costs through increased interoperability across disparate source systems and consolidated access. The “active archiving” solution allows for a centralized repository and consolidated accounting functions out of legacy data without continuing to operate (and support) the legacy system. Longitudinal clinical records? Yes, please!

Those are just a few on my must-see list, and I think Dr. Doug Fridsma would be proud of their vision, and find alignment to his ONC program goals. But will he be proud of their execution?

Can’t wait to find out, on the exhibit hall floor – and in the hallway conversations, and the client case study sessions, and the general scuttlebutt – at HIMSS!

March 2, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Meaningful Use Stage 3 Retires Measures that Doctors Don’t Do

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The other day I was spending some time going through the proposed meaningful use stage 3 measures. It’s quite an experience if you haven’t done this already.

As I was going through each of the measures I realized something that could be a little troubling. In a number of cases, they are proposing that certain measures should be retired from the meaningful use attestation process because essentially those measures have reached a percentage in meaningful use stage 2 that they’re fully adopted. I think this is generally a good idea. We don’t need clinics and hospitals reporting information just to report information.

Although, I did find a surprising trend when it came to the measures that were being retired in meaningful use stage 3. Almost all of the measures (possibly all, but I didn’t dig that deep) were measures that were done by someone other than the doctor. A few examples were vitals, smoking status, and demographics. I guess in some cases the doctor might enter these, but you can see how the vitals were likely entered by a nurse or MA and not the doctor.

On the one hand this is a really great thing. That means that in the previous meaningful use stages, the biggest burden was placed on someone other than the doctor while the doctor was only required to have a much smaller percentage. Unfortunately this means that the higher percentages required in meaningful use stage 3 put the burden largely on the backs of physicians.

February 19, 2013 I Written By

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.

The Next Generation of Doctors – #HITsm Chat Highlights

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The theme for today’s chat was “The Next Generation of Doctors.” When I read this, I wasn’t sure what to expect. It definitely sounded like an interesting topic, and it proved to be one. Here are the questions that were asked, and some of my favorite responses:

Topic One: Who are the emerging leaders you admire for their ideas in shaping the future of medicine? Why? Share resources!

 

 

 

Topic Two: Do you think new ways of learning will attract different types of personalities to the field of medicine?

 

 

Topic Three: How can the next generation of doctors learn from patients who are active through social media?

 

 

 

Topic Four: What does the next generation of doctors think of Quantified Self? How will the role of hte docotr change because of #OS?

 

Topic Five: What is your big idea or dream for the future of medicine.

 

January 27, 2013 I Written By

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.

Healthcare Groups Want Meaningful Use Evaluated Before Stage 3

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Though the final rules for Meaningful Use Stage 3 aren’t due to take effect until 2016, ONC has already made the draft rules available for public comment.  And comments, to be sure, the agency is getting.

While various groups have chosen their own details to critique, the general consensus seems to be that ONC is getting ahead of itself and ought to give Meaningful Use Stage 1 and 2 a good hard look first.

Accordng to a nice summary from iHealthBeat, here’s where some of the major healthcare groups stand:

* The American Hospital Association is recommending that ONC fund a comprehensive evaluation of MU generally, and while it does, hold off on finalizing Stage 3 recommendations.

*  CHIME, too, is asking ONC to evaluate the existing Meaningful Use program to decide whether achieving stage 3 is realistically possible by 2016.

* The Federation of American Hospitals is also arguing that ONC needs to evaluate current Meaningful Use requirements.  Also, in its letter to ONC, the group argues that the existing structure of two years per stage doesn’t cut it.

* The AMA weighed in with its own recommendation that ONC evaluate Meaningful Use as is before moving ahead. It also suggested changing some thresholds to  make them more reachable; greater flexibility in program requirements; change the certification process to address usability; and improve HIT’s capability to share patient data.

Personally, I think the idea of doing an extensive Meaningful Use evalulation sounds like a good one, and I hope ONC actually does so.  When you’re setting new standards that affect so many providers, why not gather some data on how existing standards work?

January 16, 2013 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.

The Fiscal Cliff of Primary Care

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The Hello Health blog has a really interesting article up discussing what they called the Primary Care Fiscal Cliff. The thing I like most about the post is the data they provide on what’s happening with primary care doctors. Take for example this list of statistics:

  • Primary care practice income rose just $500 from 2008-2011
  • Operating expenses of a practice continues to rise each year
  • Primary care physicians can spend an average of 13 hours a week of uncompensated care worth over $30,000 in lost revenue a year
  • The cost of a traditional electronic health record can easily exceed $20,000 in the first year with a 5-year projected cost approaching $50,000 per physician

I’m not sure that the US government’s fiscal cliff has much relationship to the primary care doctor fiscal cliff (except for the possible Medicare cuts), but it’s very safe to say that primary care doctors are in a real financial predicament.

In the Hello Health post they suggested from their own research that practice finances and EHR are the two issues keeping primary care physicians up at night. I’m sure these findings won’t be a surprise to any primary care doctors. Plus, it’s worth noting that the finances of a primary care practice are tied to an EHR in many ways.

I have often questioned how much influence the government EHR incentive money has had on getting doctors to adopt EHR. Whenever I do, I usually get a response from a primary care doctor saying that they wouldn’t be implementing an EHR if it weren’t for the EHR incentive money and that they were depending on the EHR incentive money to help cover the new EHR expense.

In my recently started EHR benefit series I’m hoping to expand the thinking when it comes to EHR revenue implications. There are still tens of thousands of primary care doctors that need to implement an EHR or replace their existing EMR. Understanding the financial ties to EHR will help a practice ensure a more successful EHR implementation.

At the core of the question is whether EHR software is a financial benefit or a financial loss. The cop out answer to that question is that it depends on how you implement the EHR and which EHR you implement. I wish someone would take the time to study the top 20 EHR companies and evaluate how practices have done pre-EHR implementation and post EHR implementation. Plus, they’d need to take into account the cost of an EHR. That type of study would produce a lot of interesting EHR data.

My gut feeling having participated in numerous EHR implementations and heard from thousands of other EHR implementations is that the result is usually a wash. In most EHR implementations I don’t think there’s a net financial gain or loss. There are outliers on both sides of that spectrum, but I think for most it has some pros and some cons.

With that said, I think there are long term benefits to a practice that has an EHR. While the immediate financial returns may not come, I think that the EHR in a practice is going to be essential for many of the financial gains a practice wants to achieve in the future. The most obvious example is becoming part of an ACO. Can you really get the financial benefits of being in an ACO without an EHR? I think the answer will likely be no. You need the EHR data to obtain and report on the ACO improvements your practice achieves.

December 20, 2012 I Written By

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.