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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.

$5k Per EHR Lab Interface

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A provider organization recently reached out to me to discuss the issues they were having trying to get their EHR vendor to do a lab interface with their lab. It was a pretty standard large EHR vendor document where they nickle and dime you for little things like a lab interface. Looking at it always reminds me of when I’ve seen the $5 aspirin charge in the hospital.

The problem with the lab interface charge is that it’s usually $5000 instead of $5. When an organization is choosing to implement an EHR, they often forget about many of the future hidden costs associated with an EHR vendor like the EHR lab interface. Plus, they also forget that the EHR vendor will often charge them $5k for the interface and then the lab will charge them another $5k for that interface. This is often true even when an EHR vendor has created many interfaces with a particular lab vendor before.

In fact, the organization that I mentioned above brought a new light to the cost of lab interface. It turns out that this organization was on its third lab and thus its third lab interface with their EHR. I don’t expect clinics change labs this often, but it is very common for a medical organization to switch from one lab to another. Plus, let’s not even get started on the challenge of getting a hospital lab to integrate with your EHR.

Not all EHR vendors are like those I mention above. In fact, a number of EHR vendors have seen this as a great way to differentiate their EHR from other competing EHR vendors. I know of at least one EHR vendor that’s done a few hundred lab interfaces (all at no cost to the doctor). The large number of labs partially illustrates the challenge associated with lab interfaces. There are just so many of them that need to be done. It’s not like there’s 1 or 2 labs that dominate the market. However, many EHR vendors are offering a free lab interface as part of the EHR purchase. Be sure to ask before you buy.

The sad part of the lab interface story is that because of the items mentioned above, many doctors just end up scrapping a lab interface. They can’t justify a $10k expense to integrate their EHR with the lab. This is unfortunate, because it’s amazing how much benefit can come from a well integrated EHR Lab interface.

February 1, 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.

Healthcare Faces Massive Cybersecurity Risks

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When a consumer publication like The Washington Post – hardly an insider journal of computing — picks out your industry and slams it for having poor cybersecurity, you know something’s amiss.

The newspaper has just published a report, following a year-long cybersecurity investigation, arguing that healthcare is one of the most vulnerable industries in the U.S., making it a tasty target for terrorists, black-hat hackers and criminals.

It’s rather embarrassing, but it’s hard to argue with the Post’s conclusion that healthcare data security isn’t what it could be. A few data points:

* Researchers are finding that healthcare institutions routinely fail to fix known bugs in aging software, something other industries have largely overcome.

* Providers are making careless use of such public cybertools;  the paper cites the example of the University of Chicago medical center, which at one point operated an unsecured Dropbox site for new residents managing care through their iPads (with a single user name and password published online, yet!)

* According to Post research, open source system OpenEMR “has scores of security flaws that make it easy prey for hackers”

* In perhaps the scariest example, the paper notes that clinicians routinely work around cybersecurity measures to get their job done.

Another factor contributing to cybersecurity holes is confusion about the FDA’s position on security. While the agency actually wants vendors to update FDA-approved device interfaces and systems, vendors often believe that the FDA bars them from updating device software, the Post found.

That leaves devices, especially defibrillators and insulin pumps, open to attacks. Researchers have been able to find these devices, linked to the web in the clear, simply by using a specialized search engine.

As wireless medical devices and smartphones, iPads and Android devices creep into the mix, cybersecurity vulnerabilities are likely to get worse, not better.  I wonder whether we’ll need to see a cybersecurity disaster take place before the industry catches up to, say, financial services?

December 27, 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.

Verizon Hopes To Be Secure Healthcare Network For All

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If you’re like me, you might be wondering how carriers are  looking at their role in the healthcare business — and whether some of their talk about mHealth is just noise.  (I’ve always seen mHealth as a space ripe to be be dominated by applications developers and device manufacturers, not carriers.)

To get my head straight, I recently had a conversation with Dr. Peter Tippett, chief medical officer and vice president of Verizon Connected Health Care. In it, he changed my view of what Verizon is doing in mHealth, and moreover,  what ground Verizon specifically hopes to own in healthcare over the next several years.

When I think Verizon I think switches and routers and cables, not consumer-facing applications and medical devices. And before I talked to Dr. Tippett, I assumed that Verizon’s main healthcare efforts likely involved going head to head with other wireless/wireline connectivity players for connectivity business in some form.

Well, think again.  Verizon’s Connected Health Division, says Tippett, is aiming to set the bar much higher.

“The question is, ‘what happens after wireless data?’,” Dr. Tippett said. “This isn’t a two month plan, this is a strategic extension of Verizon to transform the healthcare industry using our huge capability around the world.”

On the more immediate front, Verizon has mHealth technology under development which, to my mind, would solve a difficult problem.  For five years, he says, Verizon has been developing a new mHealtlh platform which will tie together data from testing devices like blood pressure cuffs, weight scales and EKGs into an analytics engine that makes sense of it all.

“No doctor wants four glucoses a day from 1,000 patients,” Dr. Tippett says. “Just mobilizing the data isn’t enough. You’ve got to create a cloud service that can do big data analytics on it and normalize the data, then trigger the alerts to the right people — including patients.”

I’m going to keep my eye on the mHealth platform, which definitely intrigues me.

But the really big play for Verizon in this space seems to be in HIPAA-secure data hosting and exchange.  Verizon already has a massive presence around hosting, app management, security, identity management and the cloud, having added Cybertrust and Terramark (enterprise hosting) to build up its lineup.

Verizon now offers secure data sharing on multiple levels:

*  A “medical data exchange” — not unlike the exchange banks use to pass transactions back and forth — allowing any member to share information using Verizon’s security services.

* An exchange “identity layer” which is secure enough to allow Schedule 2 drugs to be prescribed. According to Dr. Tippett, 40 percent of doctors in the U.S. are already using it.

* A global network of highly-secured data centers.

Members of the medical ecosystem who use secure Verizon services can consider their HIPAA compliance and security matters handled, then focus on their core business, Dr. Tippett says. And that can scale to hundreds of millions of users on the network, he notes.

Clearly, this doesn’t sound like the broadband carrier talking — these folks are out to take business from players as diverse as Verisign, IBM and the database giants.  It makes sense to me, on the surface, but in any grand vision there are holes to be picked.

You tell me:  Does Verizon sound like it’s positioned right to become the default secure healthcare backbone?

September 11, 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.

How Integrating Medical Device Data Improves EMR Data’s Value

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As we’ve noted here before, connecting medical device data to EMRs is no walk in the park.  Hospitals have to invest in next-gen devices with new capabilities — such as wireless connectivity — and across their entire campus too, if they want consistent results. Then there’s the labor involved in initiating, completing and managing an array of newly-capable devices.  This will create hiccups, or possibly worse, even under the best of circumstances.

But I’d guess most of us would agree that there’s plenty of good reasons to go ahead and install more-connected devices.  Here’s five reasons to consider, laid out in a recent article by Sue Niemeier of connectivity tech vendor Capsule:

1.  EMR data becomes more accurate. Since it’s being collected automatically, the data won’t suffer from transcription errors or omissions.

2. With connected devices, measurement data is collected in virtually real-time. Otherwise, Niemeier says, it can be anywhere from two to twelve hours in her experience before the data gets into a paper chart, which might not even go with the patient if moved.

3. EMR data comes in as a steady stream rather than “batch” fashion, making it easier to check and submit as it arrives — rather than at the end of the shift.

4.  Data delivered directly by devices is concise, making it easier to track patient progress, while nursing notes may bury the data in paragraph form.

While all of this is great, we’re not likely to see a grand switchover in the near term. Right now, integration stats are very low; for example, according to a recent KLAS hospital study, less than 10 percent of respondents had adopted connected smart infusion pumps.

Still, it’s good to be reminded of where we’re (probably) heading, rather than just carping about what bogs down today. I believe Niemeier makes a lot of sense, and vendor rep or not, her points are worth considering.

July 17, 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.

EMRs Can Spark Creativity

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Today I’ve been letting a few curious little theories germinate in my head. So I thought I might try out an idea on you good folks.  For those who have read my previous rants about breaking a doctor’s workflow, this may seem rather contrary, but hey, we can always duke it out later.

Yesterday, I went to see a specialist who’s a member of a decent sized practice (about a dozen docs, give or take).  The office is completely paper-based, efficiently and elegantly if my patient’s eye view is any indication.  The practice is something of a zoo — super-high volume — but I seldom if ever feel rushed or impatient.  In other words, we’re talking what looks like a pretty well-run shop from the pre-EMR era.

When I saw my doctor, we puzzled together a bit over a medical issue I’m facing, one which could be drug-induced or could be organic.  We spent some time talking about standard solutions and how to manage them and then, boom, my specialist had an inspiration.  We agreed that I should taper off one medication and begin the other shortly.

Luckily for me, my doctor was engaged and seemed interested in digging into the problem.  But in other cases, realistically, I might have gotten a physician that stuck blindly to the obvious and didn’t dig up what might be a slightly unconventional solution.

Here’s where I contradict myself to some degree.  In past essays, I’ve written on how inelegant and undesirable it can be to break physicians’ workflow for the sake of squeezing an EMR into place. I’ve argued that EMRs should be designed for physicians and not for administrators. And so on.

This encounter, however, convinced me that when EMRs break passive, standard workflows, it could be a spur to creativity in some cases.  In the right situation, if the doctor I saw was distracted or bored, the EMR could throw second line solutions at him or her just when they were ready to e-prescribe and sign off on the visit. (Yeah, a “do you want to leave this chart now?” prompt with a med recommendation might be annoying, but it could be productive!)

Of course, no system can force a physician to engage if they simply don’t want to do so, or don’t have time to think. But if the system is designed right, maybe the changes EMRs engender can lead to fresh ideas, better grasp of details or just a reminder on a bad day.  At least I hope so. What do you think?

June 15, 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.

EHR Vendors and ONC Need to Rebrand CCD

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A really interesting point came out of the discussion in the comments of my post titled “What Information an HIE Should Pass?” Here’s one of my responses:

I think what you describe is that the branding of the CCD isn’t right for doctors. Instead of saying that they can get a CCD document from a doctor which sounds technical and scary they need to hear that they’re going to get an “Electronic Note” transferred from a doctor. If in reality that’s a CCD document that gets converted into a beautifully displayed “note” for the doctor, they don’t really care. That’s semantics which don’t matter to them. Your “football” naming goes towards these same lines, but I think that actually naming it a “football” will confuse doctors more. It works great as a way to describe what’s happening, but they’d get lost wondering how football had to do with a note. I actually think this is an important point that’s worthy of its own blog post.

Of course this discussion is really about branding and communication. It’s not about the technical details of a CCD (Continuity of Care Document) document (That’s a topic for another discussion). I believe the problem probably lies in the fact that most of the technical people I know behind standards like CCD are more worried about the technical details and don’t realize the importance of how those technical details translate for those not entrenched in the standards creation.

Most of them know the ins and outs of CCD so well that many probably don’t realize that those outside of the standards creation really don’t have a clue of the realities of what CCD will do for them. Even just saying the name CCD starts the confusion for many. Certainly there are exceptions to this, but most doctors couldn’t care less about the standards details.

Here’s something a physician understands:
Your physician notes are being transferred to another doctor.
or
You’re receiving physician notes from another doctor.

What they have a hard time processing is:
You can send a CCD document to another doctor.
or
You’ve got a CCD document from another doctor.

Sure, there are subtle nuances between physician note and CCD, but those can be communicated as well. Maybe physician note isn’t the exact right word either, but I think it gets closer to communicating what’s really happening then saying a CCD document.

Regardless, we need to do a better job communicating what’s happening. I know a lot of doctors that would love to transfer a physician note. I don’t know many that care about CCD documents.

April 18, 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.

Quest EHR Lab Interfaces

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While at HIMSS I had the pleasure of spending some time talking with Rohit Nayak, VP of Physician Tech Solutions at Quest Diagnostics. Not only is Rohit a very nice gentleman, but he also provides a number of really interesting perspectives on the healthcare industry. Quest is obviously known in the lab world, but as I mentioned last year, Quest is shifting from being a lab company to a technology company. This is clearly seen by their Care360 EHR product.

At one point, Rohit and I started talking about Quest’s approach to interfacing with EHR software. When you consider that Quest has the lab results that many EHR companies want and now Quest is offering their own EHR it makes for an interesting situation. Rohit told me that Quest has 120 EHR interfaces. He told me Quest’s approach was to be open when it comes to sharing data.

Before I talk more about these interfaces, I think it’s worth commenting on the 120 EHR interface number. The number of EHR vendors is often debated and discussed. I personally like to use the 300 EHR companies number. I’ve seen some go as high as 600 EHR companies, but I think those people are counting any software regardless of if it offers a comprehensive EHR product. For example, they might include an ePrescribing app which is part of an EHR, but I wouldn’t count it in my number.

With that as background, I find the 120 EHR interfaces with Quest quite interesting. Outside of some very localized EHR companies, you’d think that most legitimate EHR companies would have been almost forced to build an interface with Quest. Although, someone did recently tell me that Quest and LabCorp only have 7% of the lab market so maybe I’m overstating EHR vendors need to interface with Quest. I’d be interested to hear from EHR vendors who don’t interface with Quest and why they haven’t yet done so.

Heading back to interfacing with Quest, I was interested in how Care360 EHR users that don’t use Quest for their labs would be handled. Say I was a doctor who used LabCorp for my labs, but wanted to use Quest’s Care360 EHR. Would Quest support a lab interface from Care360 to LabCorp? Rohit told me that Quest would have no problem integrating Care360 with Labcorp, but that LabCorp wouldn’t let them do it. Don’t you love competition?

Of course, I only had the chance to talk with Quest about this topic. I don’t remember ever even seeing LabCorp at HIMSS. Considering LabCorp hasn’t taken the EHR route directly that could be why. I’m not sure many LabCorp users would want to use the Care360 EHR, but it is interesting to consider.

Rohit and I also started an interesting discussion about how well EHR software is consuming the Lab data that’s being sent across these lab interfaces. I’ve asked him to do a guest post on the subject, so I hope to bring you that in the future. You can also check out this 5 EHR Questions with Rohit Nayak video I did while at HIMSS as well.

March 7, 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.

Wacom STU-500 Signature Tablet Review

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One thing I love about blogging is that on occasion you get access to all sorts of cool toys to try out and write about. Ok, my inner geek is coming out that I call these toys. Others probably call them useful devices for work. However, you look at it, I was excited when Wacom asked if I was interested in trying out the Wacom Sign&Save signature pad.

I’ve long been a fan of the signature pad since I implemented one at check-in kiosks about 5 years ago. I was amazed at how a signature pad could remove so much paper from the office. Turns out the same is true for my HealthcareScene.com business. The only time I really have to print something out is when I have to sign the paper. This always annoys me since I basically sign the paper and then scan the signed paper back into my computer so I can send the signed document to someone.

With this in mind I was ready to test out the Wacom STU-500 signature pad with Wacom’s sign | pro PDF software. Here’s the corporate description of the product with a nice picture:


Wacom’s sign&save is a plug-and-play signature capture solution for small to medium size businesses that are seeking to improve customer-facing digital transaction processes. The sign&save solution combines a Wacom signature tablet with the company’s newly designed software, called sign | pro PDF, to deliver an affordable and efficient way to integrate electronic handwritten signatures into a business’s daily workflow. Both versions are easy to connect to Windows®-based personal computers. Additionally, each signature tablet is able to capture the static and biometric aspects of individual signatures, providing an effective defense against fraud. The STU-500, has a larger and higher resolution screen than the baseline version, and is ideal for uses that require more real estate for a premium signing experience.

Setup
The setup and install of the device was really easy. I installed the software and plugged the device into my USB port and I was ready to go. I do wish that the instructions would have said whether I should have waited to insert the device into the USB port before installing the software or not. My guess is that in this case it doesn’t matter, but since in some cases it does matter I would have liked them to say which was preferred or that it didn’t matter if that was the case. Either way, I got it installed and started using it really quickly.

Pen
I also loved that the pen that you use doesn’t require a battery or any sort of cord attachment to be able to communicate with the signature pad. Although, it did have a small camera cord like strap that would be nice to be sure someone doesn’t accidentally run away with the pen. I would have preferred more of a snap in “dock” for the pen, but the spot for the pen wasn’t terrible.

Usability
I’ve had quite a few experiences with signature pads and I’m happy to say that the Wacom STU-500 worked really well. From my experience the real key to a successful signature pad is the LCD screen where you can see what’s being written. I’ve tried some other cheaper models and the experience is terrible. I’d try and sign my name on these cheap models and it would turn out on screen like my two year old son had scribbled on it. I had no such problems with the STU-500. It captured my signature just the way I wrote it and displayed it very nicely on the document.

PDF Software
For my purposes, I tested the signature pad out on the newly designed software: sign | pro PDF. I really liked the simple interface for being able to add a signature to a PDF. I did run into a couple problems using the software. First, one of the documents that I wanted to sign was in some sort of secure format and so I could only view the document. I could probably have asked the person who sent me the document to send it to me another way, but it was just easier to print and scan. Although, in the future I’ll ask him to send the document unsecured.

The second problem I ran into is that sometimes I wanted to put my signature in a small space. When I tried to do this the software kind of freaked out and put a big old fat signature across the page. Not too big of a deal. I just reopened the PDF and made the area I wanted to sign bigger and I was good to go. I do wish that they had an undo button for when I don’t like the way the signature I added looks. I couldn’t find one at least and the regular ctrl-x keyboard shortcut didn’t work either.

Here’s a video which shows this software and the signature pad in action:

Interfaces/SDK Packages
I obviously didn’t dig into the Wacom SDK packages that you’d want to use to integrate this with your EHR software. Although, I asked what SDK packages they have available for those EHR vendors or other healthcare IT software vendors that want to be able to integrate a signature pad into their software. In fact, they said they have two SDK packages available. One of them is a basic package and the other an advanced package which also includes a licensing fee. I imagine with the advanced package you could integrate some much more advanced workflows that go beyond just signing something as well.

Conclusion
I found the Wacom STU-500 to be a really fine quality product. It could see this signature pad implemented in a number of clinics and saving a lot of paper. Be sure to consult a lawyer to make sure of the laws in your state regarding signatures captured electronically, but I imagine in most states this won’t be an issue.

I’m looking forward to printing less and less as I will continue to sign all the documents I get with the Wacom signature pad. As I use it over time, I’ll be happy to provide an update if I learn anything new. If an EHR or other software vendor checks out the SDK’s and wants to do a full writeup, I’d love to include that in the future as well.

February 15, 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.