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One-Fifth Of Physician Practices Might Switch EMRs

Posted on February 26, 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.

Here’s yet more evidence that this is the year of the “big switch” in EMRs, at least among physicians. A new survey by Black Book Market Research has concluded that about 23 percent of practices with currently implemented EMRs are unhappy enough with their current system to consider switching to a different vendor.

According to a piece in Medical Economics, doctors’ concerns include a lack of interoperability, excessively complicated connectivity and networking and problems with mobile device integration.

The survey, which reached out to 17,000 doctors, found that internal medicine docs had the highest rates of satisfaction (89 percent), followed  by family practice (85 percent), general practice (82 percent) and pediatrics.

The unhappiest specialists were nephrologists (88 percent), followed closely by urologists (85 percent) and ophthalmologists (80 percent).

So if a practice is going to switch vendors, what are they looking for? The Medical Economics piece listed five “must-have” features doctors voted for in the Black Book survey:

* vendor viability

* data integration and network sharing

* adoption of mobile devices

* health information exchange support and connectivity

* perfected interfaces with lab, pharmacy, radiology, medical billing partners, and others

Unfortunately, they won’t find it easy to find all of these features in a single EMR.  Of course, you faithful editor isn’t the be-all and end-all when it comes to EMR products (who could be?) but it seems to me that if even pricier enterprise products seldom offer all of these options, it’s decidedly unlikely that ambulatory products will. (OK, vendor viability is a judgment call, but in a world where so many practices don’t like their EMR, it’s hard to imagine that vendors are at their strongest.)

Folks, the truth is that it looks like we’re coming to a market crash of some kind. Physicians aren’t getting what they need from EMRs, but vendors aren’t keeping up, especially in the realm of specialty EMRs.

As if that wasn’t enough, the threat of fines looms for practices that don’t get their Meaningful Use act together, something they may have trouble doing if they’re in the midst of EMR shopping, installation and adoption.

Time is getting tight, and customers aren’t happy. Ambulatory vendors, what’s your next move?

Patients and EMRs, EMR Value, and Healthy Food Guide: Around Healthcare Scene

Posted on November 18, 2012 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.

Hospital EMR and EHR

What do Patients Need From EMRs?

Meaningful Use Stage 3 requires that EMRs be accessible by both patients and providers for comments. This post contains several suggestions for what patient data must include. Some points discussed include links to medical information (to help identify unfamiliar terms), the ability to view information in different views, and mobile access to health information.

Adolescent Data Needs Stronger EMR Protections, Group Says

The AAP recently came out with a statement concerning the protection of adolescents in EMR. They believe that adolescents don’t enjoy the same protection as adults do, and this needs to change. To help with this, the AAP has presented a list of principals that should “govern” EMRs, PHRs, and HIEs. Some of the ideas include creating criteria for EMRs that meed standards for adolescent privacy, and flexibility within standards for protection of privacy for diagnoses, lab tests, etc. These new suggestions will place an added burden on EMR vendors.

EMR and EHR

EMR Value Diminished If Patients Can’t Access Care

A recent study was released that analyzed primary care practices in 10 countries around the world. While it indicated that more US physicians are using EMRs than in the past, a large percentage patients in the US are still struggling to pay for health treatments. This is well-below the numbers from other countries surveyed. This may suggest that even if EMR is in use, it doesn’t really matter if patients can’t afford getting help.

New Healthcare Facility Experiences IT Growing Pains

Jennifer Dennard recently has to visit a new facility in the area in order to treat an illness. She was pleasantly surprised with the facility, and recounts her experience here. However, she discusses some of the IT “growing pains” the facility is experiencing, such as still using paper prescriptions.

Smart Phone Health Care

Healthy Food Guide Uses MyPlate.Gov Standards to Track Calories

There are many mobile food diaries available, and a new one just hit the market. Healthy Food Guide puts a twist on the typical calorie counting idea, and helps its users make sure they are getting enough of each food group. There’s a few glitches here and there that need to be worked out, but it’s a neat little alternative to some of the other diaries out there, because of how simple and to the point it is.

The Immortal Life of Healthcare IT, Secure Texting Scam, and iPhone Heart Rate — Around Health Care Scene

Posted on September 9, 2012 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.

EMR and EHR

The Immortal Life of Healthcare IT

Patient engagement has evolved in many ways in the past century. While patients used to rely on doctors for any information regarding health care, it’s now common for patients to “diagnose” themselves, before even stepping foot into a doctor’s office. “The Immortal Life” by Henrietta Lacks, and the authors thoughts, are compared and contrasted to life nowadays.

Interview with Verizon Wireless’ Arthur Lane

A leader for mobile health solution development for Verizon’s Connected Health, Arthur Lane, was interviewed over at EMR and EHR this past week. He focuses his work on developing solutions that help with Verizon’s wireless, cloud, and security. The interview focuses on Health IT and mHealth, and what is in the works at Verizon. He discussed the benefits of mHealth, and what is to come in the future.

Hospital EMR and EHR
What Won’t Happen in #HIT By September 2013

There’s a lot going on with Health Care IT, and it seems as if we’re always hearing about the latest and greatest innovation. However, despite the leaps and bounds that are being made, we can’t expect everything in the EMR industry to be perfect by next year. Anne Zeigler talks about things that won’t be happening in #HIT over the next year, including lack of major growth in remote monitoring and no high penetration HIE.

Meaningful Healthcare It News With Neil Versel

Sampling of opinions on meaningful use Stage 2

The meaningful use Stage 2 final rules have caused quite a bit of discussion across the web since they were announced. Some good, some bad. Neil Versel compiled some of the opinions and thoughts he has discovered over the past few weeks, and created this post with some of them.

Wired EMR and EHR Doctor

The Secure Texting Scam

Medical practices may be getting offers from companies that offer “secure texting,” that won’t violated HIPAA standards. However, how secure can texting be? Dr. Michael Koriwchak talks about the “secure texting scam,” and talks about the reasons why secure texting can fail. Don’t get caught in this trap, and end up paying a large amount for a product that might not deliver what you think.

Smart Phone Health Care

Detect Heart Rate With iPhone Camera – #HITsm Chat Discovery

Finding out your heart rate is now easier than ever — simply by using the camera on your iPhone. This new way to detect heart rate requires no special equipment, beyond an iPhone 4. The app tracks the information and allows the user to view changes over time, among other features.

VA Hospitals Had Big EMR, BCMA Implementation Problems, Study Says

Posted on April 12, 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 done at a group of seven VA hospitals has concluded the hospitals rolled out their EMRs with far too little planning, leading to problems that tied staff members and clinicians in knots.

The study, which was published in the American Journal of Managed Care, drew on interviews with doctors, IT staffers, nurses, pharmacists and managers.  The interviews were done several years after the VA had implemented its computerized patient record system (CPRS) and its bar code medication administration system (BCMA).

The respondents told interviewees that for most of them, the new technology created big difficulties. Many of the interviewees didn’t start out familiar with computer use, making the inevitable workflow disruption even worse than in other hospitals.

BCMA was a particualrly sore spot for the VA clinicians and staff, as it was phased in more rapidly and with little training for users.  Staff members at the hospitals essentially had to implement and use the system on their own, according to a story appearing in Information Week.

As if this wasn’t challenging enough, the hospitals ran into major issues in selecting and rolling out hardware to support these new technologies.

For one thing, some of the hospitals had little idea how to  build a wireless network capable of supporting the myriad of computer cards in use at their facility. In some cases, they faced major connectivity problems after failing to test the wireless systems prior to rollout of CPRS and BCMA.  Other hospitals in the seven had great difficulty figuring out how many computer terminal to order.

As I read the situation, the hospitals’ BCMA rollout led to the biggest problems and greatest possibility for harm.  All seven of the hospitals reported having major BCMA issues, including miscoded medications, empty unit-dose packages being delivered items not scanning.

Perhaps even worse, nurses sometimes had to cut the ID bands off of patient wrists just to scan them, or scan from extra wristbands in patient charts. “At some VA hospitals, staff were implicitly or explicitly permitted to use various workarounds with BCMA, such as…doing all scanning after medication administration,” the magazine reports, quoting the research report.

Not only that, many workarounds remained in place years after the BCMA rollout — a testimony, if there ever was one, to getting things right the first time.

Apparently, according to IW, BCMA is at stage 5 in the maturity scale HIMSS Analytics has established for measuring the maturity of a hospital EMR rollout. HIMSS says that 8.4 percent of hospitals are at this stage.

The thing is, a maturity scale shows its own weakness when you can laud a hospital for getting there even if their implementation has disrupted workflow greatly and even put patients at risk.  And I’m not aware of any ratings scale from HIMSS (or a similar entity) that grades quality of execution.

Do you know of other ratings systems for hospital EMR rollouts that do more to adjust for poor planning or implementation problems?  If you do, I’d love to hear about them.  This story is pretty scary.

Electronic Prescribing “News” in Las Vegas – EMR Money in Rochester, NY

Posted on June 9, 2006 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

Electronic Prescribing(e-Prescribing) in Las Vegas
I’m not afraid to say that I live and work in Las Vegas. I don’t think I would call it completely home, but possibly home for now. Well, my third favorite Healthcare IT blog Just recently posted an interesting link to the local Las Vegas newspaper. I will admit that it is really the only newspaper that people read in Las Vegas. There are a few other that try to challenge, but really it is all about the Las Vegas Review Journal or “RJ” as it is affectionately known. I digress. Neil points out that an article on what the RJ called news is in his opinion stale news since he personally wrote about the same story in October in a Health IT World article. It’s interesting what can be considered “stale” news to one might be great news for another.

More importantly I was grateful that Neil pointed this article out to me since I’m very interested in getting Allscripts for free. I’ll have to see how it integrates with my EMR package and how Allscripts works, but I’ve wanted to use it for a while. One other problem I may have with Allscripts is that we have our own pharmacy. I wonder what is involved in getting Allscripts to work at our pharmacy. Does the e-Pescribing in Allscripts integrate with our pharmacy software ProPharm from Kalos Inc? These are all questions that I’ll have to be looking at soon. I’m also interested in how the alternative works when a pharmacy is not Allscripts compliant. I’ve heard it just sends through the fax which is something I’ve been looking into myself as an interim solution. Now if I could just find the time to work on all these fun projects. Thanks Neil for pointing it out to me. I guess I should have become part of the healthcare IT blogosphere sooner.

EMR Money in Rochester, NY
I recently ran into some other EMR news in my wife’s home town of Rochester, NY. I’m always interested in what’s happening there since I’m sure we’d consider moving there one day if the opportunity is right(despite Kodak pretty much leaving Rochester). The EMR article’s first line went as followed:

Two local coalitions will use $4.6 million in state grants to expand the use of electronic medical records. They hope the result will improve the quality of care for patients.

However, as I delved into the article I found that almost no amount of the money is going towards actual doctor’s implementations of EMR. In fact, almost all the money is going towards the development of an RHIO in Rochester. I think this is a great thing I can’t wait to see what a full working RHIO looks like. This type of money should give them a good start. Maybe some of you could disagree and say that RHIO’s are EMR. However, I would disagree with you. I will agree that RHIO’s are linked to an EMR and that an RHIO is very beneficial when you have an EMR. I’ll even say that an EMR becomes infinitely more important when there is an RHIO available. However, an RHIO is not an EMR. So, I was disappointed to read what I thought was a bunch of cash to support a nice EMR project in the Rochester area turn out to be a bunch of money for an RHIO. Maybe I should start working with an RHIO in the Las Vegas area. Is there one? I best find out.

Bi-directional interfaces vs. Uni-directional interfaces

Posted on January 23, 2006 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

If you are implementing an EMR you need to understand the difference in types of interfaces. Unfortunately I bet this is a significant misunderstanding that occurs when discussing interfaces in an EMR purchase. Maybe this opinion is biased because that is what happened to my clinic. After a few long discussions we finally understood the questions we should have asked rather than assuming we knew how an interface works.

The assumption that was made by my clinic(thankfull not me since I hadn’t been hired) was that the interface would be bi-directional. What does that mean? That means that when a Pharmacy is ordered by a Doctor the script would automatically be available in the Pharmacy program(one direction). Then, when the script was filled it would post the charge back to your EMR(second direction). The assumption was made that this would just happen without considering a few questions. First, what happens when someone doesn’t want to fill their script at our pharmacy? Then, the Pharmacy database is filled with a ton of scripts that they never needed to fill. Also, what happens when a drug is filled in your EMR that isn’t available in your Pharmacy program? How does your HL7 interface match a prescribed drug with the drug in the pharmacy database which has enough inventory? How does the interface pass the charge back when someone brings in a pharmacy from another doctor?

For those of you familiar with HL7 interfaces you know that many of these things can be solved. In fact, I hope that somebody will post some ideas on the best ways to accomplish this. However, these are important things to consider and discuss when purchasing an interface. In many cases the “mythical” concept of it all just working may leave you with a uni directional interface.

Not that a uni-directional interface is bad. The fact is that my clinic currently have two uni-directional interfaces. One direction patient information and insurance eligibility is passed. The other direction charges get passed back. This has worked out quite well even though we expected a bi-directional interface.

The moral of the story is to Ask Questions and then Ask MORE Questions! You aren’t an expert on HL7 and you have the right to know what your vendor means by an HL7 interface.

I imagine there are other options than HL7, but so far I haven’t seen any. So, I’ll assume for now that there aren’t any until someone corrects me.

Pharmacy Kiosk

Posted on January 14, 2006 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 recent article described a fascinating way of allowing people to pick up pharmacy refills using a kiosk machine. What a great idea!! I can really see how this could save you some money and really takes service to the next level. Their is definitely some risk involved with the process, because of what is required to authenticate that you are giving the drug to the correct person. I hope they have some sort of video surveillance or other security methods in order to satisfy all the HIPAA regulations(or whatever regulations pharmacies are required to follow). Either way there could be some serious consequences if those drugs were picked up by the wrong person. Also, what happens to the counseling that the pharmacist gives? I guess that is gone.

I really enjoyed a quote from the Asteres Company Website who is the creator of these kiosk machines.

The best customer service begins with choice.
There are times when we need personal attention
and there are times when every minute counts.

I for one am very grateful for companies like these. I’m not sure if it’s the same company, but I love renting DVD’s from a machine for a much cheaper price.

College Health Survey for Sun Belt Region

Posted on January 10, 2006 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 saw a really good survey about the technical systems that University Health Centers in the Sun Belt region are using. It covered Medical Clinic Systems, Electronic Medical Records, Appointments made by email and online, Pharmacy systems, Mental Health Systems, Wellness Education Systems(not many of these), Laboratory, Digital X-ray and Computer portals. I twas interesting to see the variety. In fact, there was a lot more variety than I would have expected. Pyramed seems to have a good Medical Clinic System(I assume this is appointments and billing probably) because so many University’s had it. This could also because it is only the Sunbelt region. Medicat seemed to have the most listed for EMR with a variety of other choices. QS/1 seems to be the pharmacy of choice.

I was a little disappointed that this was just a subset of the US. I would love to see a similar survey for the entire US. I also wish it was in excel rather than PDF, but that was even more important for the jobs part of the survey. Here’s a link to the tech report.

EMR and HIPAA Blog

Posted on December 11, 2005 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

My desire is to post things I find of importance related to HIPAA and EMR. My personal experience is in College Health so I will focus on posting items related more specifically to College Health. However, I will try to incorporate any aspects of EMR and HIPAA because I think best practices across the industry are important to know. Please feel free to post all you want if you find some good information that I haven’t seen and correct me if I’m wrong. This is my best knowledge from my research and is not guaranteed in anyway.

EMR BLOG