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Can Cloud Computing Help Solve Healthcare’s Looming IT Crisis?

Posted on November 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The title of this post comes from a whitepaper called “How Cloud Computing Can Help Solve Healthcare’s Looming IT Crisis” that was done by Intel together with CareCloud and terremark (A Verizon Company). My initial reaction when reading this whitepaper was “what looming healthcare IT crisis are they talking about?”

The whitepaper makes the general case about the challenges of so much regulation, security, and privacy issues related to healthcare IT. I guess that’s the crisis that they talk about. Certainly I agree that many a healthcare CIO is overwhelmed by the rate of change that’s happened in healthcare IT to date. Is it a crisis? Maybe in some organizations.

However, more core to what they discuss in the paper is whether cloud computing can provide some benefits to healthcare that many organizations aren’t experiencing today. The whitepaper cites a CDW study that just 30 percent of medical practices have transitioned to cloud computing services. No doubt I’ve seen the reluctance of many organizations to go with cloud computing. Although, as one hospital CIO told me, we have to do it.

The whitepaper makes the case that cloud computing can help with:
-Security, compliance and privacy
-Cost efficiency and improved focus
-Flexibility and scalability

I’d love to hear your thoughts on the whitepaper and its comments on the value of cloud computing. Should healthcare be shifting everything to cloud computing? Is there a case to be made for in house over cloud computing? Will some sort of hybrid approach win out?

Healthcare Cloud Spending To Ramp Up Over Next Few Years

Posted on October 4, 2013 I Written By

Anne Zieger 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.

For years, healthcare IT executives have wrestled with the idea of deploying cloud services, concerned that the cloud would not offer enough security for their data. However, a new study suggests that this trend is shifting direction.

A new study by market research firm MarketsandMarkets has concluded that the healthcare industry will invest $5.4 billion in cloud computing by 2017.  This year should see a particularly big change, with total healthcare cloud investment moving from 4 percent to 20.5 percent of the industry, according to an article in the Cloud Times.

The current US cloud market for healthcare is dominated by SaaS vendors such as CareCloud, Carestream Health and Merge Healthcare, according to MarketsandMarkets. These vendors are tapping into an overall cloud computing market which should grow at a combined annual growth rate of 20.5 percent between 2012 and 2017, the researchers say.

As the report notes, there are good reasons why healthcare IT leaders are taking a closer look at cloud computing. For example, the cloud offers easy access to high-performance computing and high-volume storage, access which would be very costly to duplicate with on-premise computing.

On the other hand, the MarketsandMarkets researchers admit, healthcare still has particularly stringent data security requirements, and a need for strict confidentiality, access control and long-term data storage. Cloud vendors will need to offer services and products which meet these unique needs, and just as importantly, change and adapt as regulatory requirements shift. And they’ll have to have an impeccable reputation.

That last item — the cloud vendor’s reputation — will play a major role in the coming shift to cloud-based deployments. If giants like AT&T, IBM and Verizon stay in the healthcare cloud business, which seems likely to me, then healthcare institutions will be able to admit that they’re engaged in cloud deployments without suffering a public black eye over potential security problems.

On the other hand, if the giants were to get cold feet, cloud adoption would probably slow substantially, and remain at the trickle it has been for several years. While vendors like Merge and Carestream may be doing well, I’d argue that the presence of the 2,000-pound gorilla vendors ultimately dictates whether a market thrives.

Real-Time Analytics and Dashboards for Streamlining Revenue Cycle Automation

Posted on January 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Last month CareCloud announced a new real-time analytics dashboard to help doctor streamline revenue cycle automation. The core of their product is what they call CareCloud Analytics. As I think about the announcement, I wondered if it was really a big deal or not and why we hadn’t seen more of this in the various practice management systems and EHR software on the market today.

Is Data Analytics important in Healthcare?
I think this type of information is a big deal. Information is power and this is never more true than in healthcare. The press release does a great job of describing how real-time analytics and dashboards provide information which provides transparency and accountability to a practice. One quote from the article says, “The practice can now manage the productivity of the office staff, monitor in real time the productivity of billers, and gain transparency into the business side of operations to help form better decisions through data, instead of intuition.”

I’m a huge fan of analytics in my business. I call myself a stats addict. I have 2-3 stats programs running on my websites at all times. I get stats from my ad server, from Google’s ad server, and from every other stats engine I can find that has reliable data. Much of my success with my websites is because of my passion for knowing what’s happening with my websites. To me, Data is power! The same can be said for a practice. Data is the power to make important decisions that are needed for the success of your practice.

Why don’t more EHR and PMS vendors provide these analytics?
I’m sure there are a number of reasons why we don’t see real time analytics happening very often in the small practices. Hospitals are a bit different. There are whole companies devoted to just providing these types of services to hospitals that can pay for a full scale data warehouse environment to provide this type of data. A hospital that doesn’t do this type of data mining is missing out as well, but they have a number of options. Although, I don’t think many hospital HIS vendors offer this info by default.

The key reason I think real-time analytics and customizable dashboards are missing in the small practice environment has to do with doctors demand (or lack thereof) for such a feature. This will surprise some, but most will agree that the majority of doctors don’t care much for the business side of the practice. Sure, they care that the business side of the practice effects how much money they take home at the end of the day, but a large portion of doctors would love their lives a lot more if they didn’t have anything to do with the business of a practice. Yes, I know there are exceptions to this, but most doctors want to practice medicine not business.

With this as background, if you ask most doctors what they want from their EHR and Practice Management software, they’ll start to list off all of the clinical and workflow needs that they have. Very few of them will even venture into the business requests like real time analytics. Plus, even if they did venture into the business side of things, would they know how to request such a feature?

EHR and Practice Management Vendors have to show them why it matters to have these real time analytics. It reminds me of the famous quote attributed to Henry Ford. “If I had asked people what they wanted, they would have said faster horses.” This can often be taken too far, but I think it applies well when it comes to things like real-time analytics of a practice.

One other reason that a number of companies are missing the analytics and its relationship with revenue cycle management is that they’re too focused on EHR. Many just consider the PMS a standard thing that everyone has already and that there’s no room to innovate. Last I checked meaningful use didn’t have any practice management elements and that’s taken up at least one development cycle for most companies. Too many doctors later dismay, the EHR selection process often puts the practice management side of the puzzle on the backseat. This is a mistake that many practices are paying for today.

As one PR rep for a major EHR company said to me, “Revenue Cycle Management isn’t sexy.” Although, she said this directly after telling me how beneficial it was to their bottom line.

Free EHR Model Has Bent the EHR Cost Curve

Posted on September 7, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the most fascinating people I met on my recent trip to San Francisco was a doctor named Aaron Blackledge from @CarePractice. We spent a great evening together talking EMR, healthcare and entrepreneurship in general. You may also remember me posting about Aaron drinking the CareCloud EHR kool-aid (See also an opposing view of CareCloud and my thoughts after seeing CareCloud), but I digress.

Dr. Blackledge has posted a thoughtful look at how the EHR cost curve has changed over the past few years. It’s an interesting read for those looking for an interesting take from a physician in Silicon Valley and his idea of the value of a widely adopted platform.

I love the idea of a healthcare/EMR platform. Would you rather be a $100 million EMR company or a billion dollar platform company? Think those numbers are exaggerations? That’s the question that SalesForce.com basically answered. They could have easily become a $100 million CRM company, but instead they’re now a multi billion dollar platform company. I won’t be surprised if we see the same happen for some company in healthcare.

Whether you agree or not on the value of a widely adopted platform, one thing is certain: The Free EHR Model (with Practice Fusion as the first to make the big “free EHR” splash) has absolutely brought the cost of EHR down. I’m sure there were some other forces at play too, but I believe the Free EHR model held everyone else accountable for their pricing.

As Dr. Blackledge says in his post, little by little EHR vendors couldn’t get away with charging $20,000 per user up front for an EHR. I started blogging about EMR when this was the norm. Most clinics would take out a hefty loan to buy their $100,000+ EMR software. It was a scary idea and certainly burnt a lot of physician bridges along the way.

Along came a new pricing model where a doctor could pay a small fee per month. Sure, if you evaluated that amount over 5 years it was still a fair amount of money, but no longer were doctors on the hook for the entire amount even if the EMR software failed to deliver on their promises. Plus, the EMR vendor couldn’t come back later and charge them even more money for future upgrades (that’s right…$20k up front and then amazing upgrade fees).

After that, the Free EHR model made a big splash. While certainly viewed with a fair amount of skepticism (myself included), many other industries are proving this model and doing quite well. We still have a ways to go to see which company is going to be able to execute the Free EHR model, but as I discussed in my recent Pharmacy Ads and Free EHR software post there are a lot of pharmaceutical marketing dollars on the table.

Reminds me of the favorite thing my Dell sales and marketing guy loved to say, “Whether you go with Dell or not, we’re keeping prices low so that everyone else has to offer you lower prices.” I believe Free EHR companies have had that same effect on the EHR industry.

Best Description of the CareCloud EHR Platform

Posted on August 31, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a post on EMR and EHR about Social Media and EMRs, Andre Vovan, MD MBA from Mitochon Systems offered an interesting insight into the comparison between EMR and social media.

Social media and EMR are a natural fit. Think about what social media really enables. The ablity to stay connected, following different strings of info/story weaved by connected people. Say for instance you and your friends went to the Grand Canyon, one person took pictures while the other did the cooking, planning, and was responsible for entertainment during the trip. When they try to retell the story to their friends, each will be able to add different aspect of the story and with social network platforms such as facebook, this is possible.

Now take the story above, and insert 2 doctors and change the trip taken to be a patient going from a diagnosis to a surgery and afterwards trying to tell other physician providers on went on. If we design the EHR with this capability, then medicine will be improved.
A social media version of electronic medical records would have EMHR, HIE and PHR as one product not as separate.

I know that this was actually Andre’s initial vision for Mitochon Systems EHR. He wanted to create an EHR that could bring a healthcare community together in this way. I’m sure he’ll keep grinding away until he can achieve that vision. I haven’t looked at the Mitochon Systems EHR recently, so I can’t say how close they are to achieving that dream, but when I read Andre’s description I couldn’t help but remember the demo of the CareCloud EHR platform.

Many of you might remember my previous (some might call scathing) post about the CareCloud EHR and an opposing view by David about the CareCloud EHR. That post and a recent trip to San Francisco made it possible for me to see the CareCloud EHR first hand.

I had a great time meeting with Albert Santalo and Mike Cuesta from CareCloud. That was good considering my previous devil’s advocate post about CareCloud. One thing is absolutely certain, Albert has a vision of what he wants CareCloud to be and he’s dead set on achieving that vision. I like that in a CEO and founder of a company.

When it comes to their EHR, I must admit that it kind of reminded me of a lot of other EHR out there. There were a few EMR subtleties that I noticed in the demo, but I can’t say I saw any real wow features that made it a must have EHR. Maybe a full demo and experience with the EHR would create a rainbow of EMR subtleties that would change my mind, but it was a relatively short demo.

Instead, the wow factor wasn’t in the EHR software, but was instead in the CareCloud platform that powers the EHR, PMS and CareCloud Community of users. The description above about an almost “social network of doctors” and the health stream of a patient seems like an apt description of what CareCloud has created. In fact, the social elements of the platform are integrated throughout all of the CareCloud software which makes for some really interesting possibilities.

The challenge that CareCloud has is that a social network or Care Platform if you prefer is only as good as the people and organizations that use that platform. If two doctors are seeing a patient, then both doctors need to be on the same platform to really see a lot of the benefits of a patient’s health stream.

I imagine this is part of the reason why CareCloud has to provide a solid PMS and EHR solution on top of the CareCloud platform. Doing so will seed the platform with users so that with each PMS/EHR sold the platform becomes that much more valuable.

It’s hard to predict the future. Maybe CareCloud won’t get outside of its Miami base and maybe they won’t reach their vision of a CareCloud platform (Maybe Andre and Mitochon Systems or some other HIT vendor will do it instead). However, I’m willing to predict that whether CareCloud wins the healthcare platform war or not, some company will create a healthcare platform like what CareCloud has started to create that will be too valuable not to participate.

Full Disclosure: Mitochon Systems is an advertiser on this site, but they didn’t know I was going to post Andre’s comment.

An Opposing View of Carecloud EHR

Posted on August 2, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Turns out David, who manages the Smart Phone Healthcare, EMR Videos, EMR Screenshots and EMR News websites, didn’t agree with some of the devil’s advocate positions I took in my Carecloud EHR post. He said that after reading Dr. Blackledge’s post, I missed a number of things. So, the following is his commentary on what I missed in my previous Carecloud post.

Pretty much every company out there has some good and bad about it.  There are a few that are completely useless, and a few that think they are perfect, but for the most part every company has some worthwhile traits and some things they need to work on.

Last week, John wrote about a new EHR, Carecloud that has been talked about for months, but finally was released last week.  He referenced a post that was written by Aaron Blackledge M.D. back in April about Carecloud.

John played somewhat of a devil’s advocate in analyzing the post and his views of CareCloud.  While I generally agree with his assessment that the post was, “…one where you can tell that the EMR employee has drunk the Kool-aid they’ve been fed by the company.”  I do think there were some very positive things that were addressed in the post. [Items in italics below are quotes from the original post or John’s post]

“What I like most about CareCloud is that when asked about a timeline for release they will only say that they won’t release it until they get it right…That is rare maturity for a company with huge numbers of customers and investors clamoring for a release date.”  While there is something to be said for the “release early and often” approach, I like to see a company that is willing to be patient in order to release a quality product rather than just make some money.

“Another thing I like is they are worried about not just becoming a very successful billing company,…I like a team to be actively looking at and worried about how their successes can derail the larger vision of what they want to accomplish.”  This goes hand in hand with the previous comment.  Companies that are willing to sacrifice long term goals for short term success are bound to fail in the long run.  For a company to truly succeed they must have clear, established goals and be willing to do the work necessary to achieve them.

“I would guess CareCloud’s calm steady course is because they just don’t feel that anyone else is on the same path they are on so why hurry when you have time to get your vision done right.”                         This is possible. Although, it’s also possible that they spent so much time waiting to release that it’s too late for them to capture the EHR market.  I for one believe it is never too late if you have the right product. There are plenty of great examples out there.  Consider how Facebook came in and stole the market away from MySpace, and how Google+ is trying to do the same thing now.  No matter how much people love a product they will always change if there is something better.

“Even the office space at CareCloud is beautiful and reflects this attention to aesthetic and experience of the individual, in this case the employee experience.”  While John is right that a company who spends too much on aesthetics ends up having to pass that cost onto the consumer, there is something to be said for taking care of your employees.  In the military they often offer bonuses for staying in longer than your original commitment.  It has been shown that most of the people who accept those bonuses would have stayed in the military anyway.  On the other hand, many companies have shown that improving the quality of life for their employees encourages them to stay.  The reality is that a crappy job, even with a bonus is still a crappy job.  On the other hand a great job, in a great environment, attracts the best employees and keeps them there the longest.

I will end where John started: “My recommendation is if you are about to give up and lay down some hard earned cash on an EMR that is just good enough I would urge you to wait a few more months and compare CareCloud’s first iteration with other emerging platforms now gaining a foothold in the marketplace.”  This sums up Dr. Blackledge’s post quite well.  Luckily, for those that may be interested you don’t have to wait a few months anymore.  Carecloud has been released and can be viewed at their website whenever you want.

There is no doubt that there are already companies firmly planted in the EHR market, and that there are plenty of others trying to do the same.  Some of them will fail, and others will succeed, that is the reality of business.  One thing is for sure though, EHRs will continue to be implemented across the country, and for those that are willing to put forth the effort to develop a quality product, there is plenty of success to be had.

New EHR Company Ready to Launch – Carecloud

Posted on July 26, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Aaron Blackledge M.D., founder of Care Practice clinic in San Francisco, sent me a link to a post he did back in April about a new EMR company called Carecloud. The irony of this is that Carecloud had just reached out to me for information about advertising their EMR on my sites since they are getting ready to launch their product. Their impending launch was why Aaron decided to share his post with me.

I think Dr. Blackledge’s post about Carecloud is summarized in his final paragraph:

My recommendation is if you are about to give up and lay down some hard earned cash on an EMR that is just good enough I would urge you to wait a few more months and compare CareCloud’s first iteration with other emerging platforms now gaining a foothold in the marketplace.

Since Carecloud is about to launch, you won’t have to wait a few months to check it out, but if you read the rest of the post, you see that Dr. Blackledge is high on Carecloud and its potential.

The hard thing for me is that I’ve seen this same EMR high from people over and over. You know the EMR employee (particularly the EMR sales people) “high.” (Although, Dr. Blackledge is not a Carecloud sales person and calls himself a “wayward disgruntled platform evangelist waiting for the future to arrive.”) The one where you can tell that the EMR employee has drunk the Kool-aid they’ve been fed by the company. They’ve likely not looked at many other competing systems and only know the stuff they’ve read in their email from the company highlighting how they’re better than everyone else in the industry.

This “high” is especially potent before a product is actually released. Why? Because it’s easy to get excited about an ideal and see the potential of the ideal. What’s much harder is when the customers start using your product and telling you what’s wrong and trust me that customers will find something wrong. No product is ever perfect.

This pre-product launch “high” is not unique to the EMR industry. It’s found throughout the tech industry (and likely many others). Funny thing is that Dr. Blackledge probably knows this pre-launch hype better than most doctors since he practices medicine in in the internet startup mecca: silicon valley. Ironically he traveled to an EMR company in Miami to find his EMR “high.”

Funny thing is that as I read Dr. Blackledge’s post on Carecloud, a number of comments he made popped out to me as potential red flags. Here are a few:

“First off, they have a really impressive group of people with ambitious plans for building something robust and elegant.”
How many big ambitious plans by companies have fallen apart? Many! I’m not saying that companies shouldn’t think big. I am saying that a group of impressive people with ambitious plans often leads to a momentous flop. At least the startup company numbers seem to spell this out.

“What I like most about CareCloud is that when asked about a timeline for release they will only say that they won’t release it until they get it right. They simply don’t know when it will be ready.”
Some might say that this sounds like a company that’s too afraid to release a product. That the company won’t ever find out what’s right until they launch the product and get customer feedback on what needs to be improved. I guess they don’t follow the release early and often approach to software development.

“Another thing I like is they are worried about not just becoming a very successful billing company, but they want to achieve much more by building something that really resonates with users and transforms the space.”
I applaud this ambition since I’ve been preaching that current EMR software are often just expensive billing machines for a long time. If they solve that problem I’ll be quite happy. Let’s just hope they didn’t forget the billing part though. Sadly, it’s still very important.

“I would guess CareCloud’s calm steady course is because they just don’t feel that anyone else is on the same path they are on so why hurry when you have time to get your vision done right.”
This is possible. Although, it’s also possible that they spent so much time waiting to release that it’s too late for them to capture the EHR market.

“If you hear an EMR company offer you 20 hours of free training with your purchase you can stop right there because any software that needs 20 hours of free onsite training forgot about the user long ago during the building and won’t be doing much in 5 years.”
Of course, in this comment it’s assumed that Carecloud’s focus on a great UI will limit the number of hours needed for EMR training. I love the irony of this being said right after he describes it as a “very complex and difficult to develop product.” I guess you could say it’s making a complex process simple is what’s so difficult. No doubt I agree that many EHR vendors over charge for their EHR training services. Problem with Carecloud is that we don’t know if they’ll charge, how much they’ll charge, and how many hours of training is needed since they haven’t launched.

“Even the office space at CareCloud is beautiful and reflects this attention to aesthetic and experience of the individual, in this case the employee experience.”
That’s one way to look at it. Another is that they overspent on office space and you’re going to pay for that overspending when you buy the software.

Ok, I won’t go through and nit pick the whole post. I think you get the basic idea. Dr. Blackledge describes Carecloud as the best thing since sliced bread. In this post, I’ve played devil’s advocate and described how maybe it’s an over funded, slow to release software company that’s trying to bite off more than it can chew. The reality is that Carecloud is probably somewhere in the middle of those two extremes.

The fact of the matter is that I really don’t have any clue if Carecloud is a good EMR system or not. They haven’t even launched their product, so I’m not sure that anyone knows. However, after creating this post, I have to admit that I’m excited to see it in action in a real doctor’s office. Plus, I think the founder, Albert Santalo, and Dr. Blackledge are going to be at a healthcare IT conference I’m hoping to go to in SF in a couple weeks. I’m looking forward to learning more and talking with them in person.

If nothing else, I love the audacity that it takes for someone to launch an EHR company now. I’ll be interested to see if their product is compelling enough to be “heard above all the EMR noise.”