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Avoiding The EMR Alienation Effect

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Recently, I stumbled across a very interesting article talking about I call the “patient alienation effect” generated by EMRs.  The author, Charles Smith, who practices at the University of Arkansas, is an EMR old hand who has been using the Centricity ambulatory EMR for more than a decade.

The article, which appears in the Journal of Participatory Medicine, talks about the well-known offputting effect EMRs have on patients, and the frustration that they impose on doctors. And as readers know, we’re not talking about a minor impact here.

In the new EMR world, he notes, physicians have a list as long as your arm of EMR related tasks they must perform during the patient visit, including medication reconciliation, managing the problem list, e-prescribing, updating the patient’s history, review of systems, physical exam, entering the follow-up plan into the record, and printing “after the visit” summaries for the patient. And as he points out, this all has to happen for the patient is still sitting in the exam room.

The way he handles this problem is to treat the challenge is one for the patient and physician to solve things together:

*  At the outset, he and the patient have an open discussion of the EMR issue with new patients, discussing the advantages and challenges of the computer in the room.

*  Then, he asks the patient’s to allow him to move their chair beside him in the computer, noting that they will “all three” work together during the visit.

* He also tries to create a hybrid experience of completing some EMR tasks during the visit and others after (for example telling the patient, “hold on while I enter this order for you) before returning to face-to-face conversation.

* He finds that it works best to take notes here and there during the patient visit, then complete the past medical, surgical, family and social history and the review of systems together with the patient directly in the EMR.

Obviously, there’s no one right way to integrate patients into the process of documenting their visit in an EMR. But these ideas seem like good ones.

February 10, 2014 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.

One Platform to Connect to All EHR Software

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I’ve talked for years with people who want to solve the problem of connecting their non-EHR software to all the EHR vendors out there. Entrepreneur after entrepeneur has asked me how they can connect their product to ALL the EHR vendors. It usually ends up being a question like, “Isn’t there just one company we could connect to that will connect us to all the EHR vendors out there?”

I’ve dreamed about this as well. In fact, I recently wrote a post on Hospital EMR and EHR titled “Meaningful Use Drove the Data Gathering” where I suggest things like “EHR data is a treasure trove of opportunity.” and “In the future, EHR vendors will be differentiated more on the marketplace of third party applications they support than on their own in house developed apps.”

The problem is that even if every EHR vendor were to open up their application to third party applications, a startup company doesn’t want to have to integrate with all 300+ EHR vendors out there. Instead, they’d much rather integrate with one company who can connect them to all the other EHR vendors.

While a simple solution to connect to every EHR isn’t available yet, In a recent chat with Thanh Tran, Founder of Zoeticx, he showed me the closest thing to this vision that I’ve seen.

This slide shows what Zoeticx has built so far and a little bit of their vision for the future. When I saw this slide, it looked very much like what I described above.
Zoeticx Data Platform

As the slide shows, it only connects to 4 EHR vendors (5 EHR software) right now. So, they still have a lot of work to do to make this model work across all 300+ EHR vendors. However, it displays a vision of what’s possible if a company like Zoeticx builds the right middleware to connect EHR software to third party software.

After talking with Thanh Tran, you could tell that he lived, breathed, and loved the middleware space. He understood what it took to build a great middleware. For example, Zoeticx has a number of applications that leverage the middleware that they’re building. Some might argue that this makes Zoeticx a product company and not a middleware company. However, those that say this don’t understand what it takes to make great middleware.

By Zoeticx having some applications which leverage their middleware, they accomplish a couple very important things. First, they are essentially “eating their own dog food” and get to see first hand the challenges of building an application that uses their middleware. This will improve the middleware product better than any other technique. Second, Zoeticx applications will serve as essentially a set of demo applications which can be used to demonstrate what’s possible. Without these essentially demo applications, it’s often hard for people to understand how an API like Zoeticx can be used.

Certainly it’s possible that the Zoeticx application business is so good that they don’t go after the middleware opportunity. However, knowing Thanh’s background makes me think that this is an unlikely possibility. He wants Zoeticx to be a middleware company.

Thanh Tran also said something really intriguing about the latest EHR that they connected to their universal patient clinical data model (Zoeticx Patient Clarity). He said that when they added the new EHR, they didn’t have to change the Zoeticx Patient Clarity side of the equation at all. I’ll be interested to see how this plays out as they connect to more and more EHR vendors.

In fact, I believe that’s the next key step for Zoeticx. They need to connect with the other EHR vendors. Although, my guess is that once they get enough momentum behind what they’re doing, then they can provide an API for EHR vendors and other software vendors to create a gateway to Zoeticx. Then, they’ll have something really powerful.

It’s still early for Zoeticx. We’ll see how they do at attracting third party applications to their platform. We’ll see how their gateways to EHR vendors go and how they’re able to scale up the number of EHR vendors they work with. However, their vision gave me some hope that we could have a simple model for entrepreneurs that want to connect their health IT software with multiple EHR software with one integration.

February 6, 2014 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

4 Reasons U.S. EMR Firms Won’t Try China

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If you have something to sell, chances are you’ve thought about selling it in China.

With a population of 1.35 billion, it’s become an attractive market for U.S. companies pushing everything from athletic shoes to light trucks to Tide. Given the natural limits of their home market, you’d assume that American EMR firms would eventually size up China’s nascent health IT scene.

And it’s likely they have. In a report a few years ago, 100 percent of vendors surveyed told the consulting firm Accenture that they saw global markets as an opportunity in the long term.

But health IT doesn’t export quite as easily as Pringles and KFC. I’ve seen China’s healthcare system up close several times, and if you ask me, making headway in the world’s most populous nation will be beyond difficult.

China, which is in the midst of its own health care reform, could certainly be tempting for companies such as Epic, McKesson and Cerner. As Benjamin Shobert wrote for Forbes, the country in 2009 extended basic health coverage to 97 percent of its citizens. It also promised to build 31,000 hospitals, upgrade 5,000 existing ones and train 150,000 new primary-care doctors.

McKinsey & Co. last year said health care spending in China would grow to $1 trillion in 2020 from $375 million in 2011.

Meanwhile, U.S. EMR companies are going to need new markets to conquer. Estimates of how much growth potential is left are many and varied. But no matter how you look at it, at some point every American healthcare organization of any size will have an EMR. Millennium Research Group last month predicted declining EMR-industry revenue from this year on because of “market saturation.”

Of course, plenty of IT firms, including Oracle and IBM, have a major presence in China. But the China market won’t happen in a significant way for U.S. health IT companies any time soon, and here’s why:

  • China’s healthcare is different. The private physician’s office that Americans are used to is more or less nonexistent. You go to a hospital-based clinic and see the doctor who’s available. Patient privacy hasn’t taken hold, so there could be other clinic-goers and family members milling about near — or in — your exam room. Chinese traditional medicine is practiced alongside the “Western” variety. Even with insurance, you typically pay up front and get reimbursed later. A U.S.-centric EMR would not map neatly onto China’s workflows. There’s an overview of China’s system here. I’ve written about a Chinese dental clinic here.
  • No one understands China’s health IT. OK, I’m sure some people do, and I hope they comment. But it’s a challenge. The health information firm KLAS Enterprises isn’t even attempting to cover China. A KLAS executive vice president, Jared Peterson, told Modern Healthcare, “The Chinese market, that’s a big mystery.” Meanwhile, Accenture omitted China from its 2010 report “Overview of International EMR/EHR Markets” because of “conflicting opinions of overall EMR maturity.”
  • The language barrier will be formidable. Epic CEO Judith Faulkner told Modern Healthcare how her company had adapted its system for another language. “We’ve only done it once, for Dutch,” she said in January 2012. “It’s a lot of mapping. It’s a task, but it hasn’t been that bad of a task.” But Dutch is not Chinese, and Chinese doesn’t use the Roman alphabet. I’m betting that when you throw Chinese characters into the mix, the conversion will be “that bad of a task” and then some.
  • Cloud-based systems could raise security issues. Some experts expect cloud-based services to play a significant role as health IT spreads to developing countries. But according to a U.S.-China Economic and Security Review Commission report, “Regulations requiring foreign firms to enter into joint cooperative arrangements with Chinese companies in order to offer cloud computing services may jeopardize the foreign firms’ information security arrangements.”

It’s worth mentioning that three years ago, China was mentioned as Cerner announced plans to develop global markets. It wanted to get into emerging regions before its U.S.-based competitors did.

There’s not much sign of life now in any China-related plans the company might have had, though. According to a message from Chad Haynes, managing director for Cerner Asia, on the firm’s website: “We look forward to improving the health of communities in ASEAN, China, and beyond.”

In the case of China, that could be a while.

October 23, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Intermountain Chooses Cerner, International EMR, and Patient Focused EMR

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This was really big news this week. I’m not sure it’s quite a turning point for EMR. I think we’re still early in the war, but this was a big battle for Cerner to win. We’ll see what GE decides to do after losing this deal. Will GE leave this business behind or buy another vendor?


I think we don’t look nearly enough at the international EMR experience. We could learn a lot in the US from what’s happening nationally. Plus, for many EHR vendors the international opportunity is a big one that most don’t even consider.


I’ve been preaching this for so long I can’t remember. I know there are EHR vendors that focus as much as they can on the patient, but compliance and reimbursement still means you have to make compromises. That’s not an indictment of those companies, but a reality of the situation.

September 29, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

EMR Market Share

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Editor’s Note: This is the first post on EMR and HIPAA by James Ritchie. James is a longtime journalist including the past eight years as a staff writer with the Cincinnati Business Courier.

Practice Fusion announced in June that it led the EMR industry in market-share gains.

Citing SK&A reports, the San Francisco-based firm boasted that it controlled 5.8 percent of the market as of May, up from 3.8 percent in July 2012. Beyond Practice Fusion, only Epic, AthenaHealth and Cerner showed gains.

In this data, which represents physician offices only, Allscripts was the market leader, with a 10.6 percent share. Not far behind were eClinicalWorks, with a 10.5 percent share, and Epic, with 10.3 percent. (The report that Practice Fusion links to is actually dated January 2013.)

But there’s more than one way to look at the EMR share picture.

Epic was the clear winner in a report by the Austin, Texas-based consultancy Software Advice on meaningful use attestations. Epic, based in Verona, Wis., accounted for 20.3 percent of attestations for a complete EHR in an ambulatory setting.

The firm’s competitors were nowhere close as of the March 2013 report. Allscripts was the system of choice for 11.6 percent of attestations by eligible professionals, and eClinicalWorks accounted for 8 percent. Next on the list were NextGen Healthcare, GE Healthcare and, with 2.7 percent share, Practice Fusion.

Software Advice claimed that the figures, based on Centers for Medicare and Medicaid Services data, might be the best around. They at least provide a standard in a market where vendors “use varied criteria to calculate their customer base,” according to the company.

Companies “might count number of users (which could include everyone from physicians to administrative staff), number of medical providers (which could include everyone from physicians to midwives) or number of practices,” Software Advice noted on its website.

Practice Fusion, founded in 2005, claimed in its press release to have doubled both its monthly active user base of medical professionals and its patient population between 2012 and 2013. The company claims to reach “a community of 150,000 medical professionals serving 65 million patients.”

The prospects for the free model that Practice Fusion uses are still up in the air. Doctors might question whether they want ads, unobtrusive as they are at the bottom of the screen, to compete for their attention when they’re entering patient data. Data, by the way, might prove to be the real revenue generator for Practice Fusion. In June the firm launched Insight, an analytics product offering a population-level view of diagnoses, prescribing patterns and other information. It’s a model worth watching. If Facebook and google can build businesses on data, maybe Practice Fusion can, too.

The SK&A figures show just how fragmented the outpatient EMR/EHR market is. The top 10 vendors accounted for only 64.8 percent of attestations, leaving about 35 percent of the market to the “other” category. By Software Advice’s count, 560 firms logged at least one meaningful use attestation.

Eager to steal share are firms like Irvine, Calif.-based Kareo Inc. It launched its own free, cloud-based EHR in February based on technology acquired from San Mateo, Calif.-based Epocrates Inc. The firm reported in June that 4,000 providers had signed on, with a third of them moving from another EHR.

Of course, ambulatory adoption is only part of the EMR story.

Epic is No. 1 among the nearly 3,000 hospitals that have received federal incentives for using complete electronic records systems, according to Modern Healthcare. The company holds a 19.6 percent share, followed by Computer Programs and Systems Inc. with 15.5 percent, Meditech with 14.1 percent and Cerner with 11 percent. The late-May report was based on numbers from CMS and the Office of the National Coordinator for Health Information Technology.

The inpatient market is far less fragmented than the outpatient space. The top 10 companies control 92 percent of share, according to the report.

No matter how you count share, the EMR space will continue to be hypercompetitive because of the dollars at stake. The market amounted to $20.7 billion in 2012, up 15 percent from 2011, according to the research firm Kalorama Information.

July 18, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Cerner Supports Blue Button +

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Cerner has announced plans to support and participate in the Blue Button + initiative, marking a small step towards freer sharing of patient health information by its clients.

Blue Button +, launched as the Automate Blue Button Plus Initiative, is the next generation version of the Blue Button technology for consumer download of health information. This next gen Blue Button is intended to provide a blueprint for better-structured and secure transmission of personal health data.

What this announcement means in practical terms, according to an entry in Cerner’s blog, is that the EMR giant will make it possible for its Cerner Direct clients to securely zap information to any personal health record participating in Blue Button +.  Cerner Direct users will also be able to send automated reminders to people managing specific health conditions or who need age/gender-specific check-ups, plus send out summaries of care and instructions following a health visit.

Cerner Direct, as readers probably guessed, uses standards drawn from the Direct Project, a set of standards and documentation allowing providers to push data from one point to another. Cerner has obtained accreditation from the Direct Trusted Agent Accreditation Program offered by DirectTrust and the Electronic Healthcare Network Accreditation Commission.

And why is Cerner taking this step? “The primary goal we have for our clients is to help create a trusted, reliable group of participants with which to securely exchange health care information using Direct protocols over the open internet, helping them reduce their liabilities by creating an efficient, secure method of communication based on best practices,” writes Andy Heeren of Cerner.

This sounds like a reasonable move toward greater data interoperability, if not an earthshaking one. It will be interesting to see where Cerner takes this.

July 5, 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.

CommonWell Health Alliance – The Healthcare Interoperability Enabler?

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The biggest news that will likely come out of HIMSS was the big announcement that was made about the newly formed CommonWell Health Alliance. They’ve also rolled out a website for the new organization.

This was originally billed as a Cerner and McKesson announcement and would be a unique announcement from both the CEO of Cerner and McKesson. Of course, the news of what would be announced was leaked well before the press briefing, so we basically already knew that these two EHR companies were working on interoperability.

In what seemed like some final, last minute deals for some of the companies, 5 different software products were represented on stage at the press event announcement for CommonWell Health Alliance. The press event was quite entertaining as each of the various CEOs took some friendly jabs at each other.

Of course, Jonathan Bush stole the show (which is guaranteed to happen if he’s on stage). I think it was Neal Patterson who called Jonathan Bush the most articulate CEO in healthcare and possibly in any industry. Jonathan does definitely have a way with words.

One of Jonathan’s best quote was in response to a question of whether the CommonWell Health Alliance would just be open to any health IT software system, or whether it was just creating another closed garden. Jonathan replied that “even a vendor of epic proportions” would be welcome in the organization. Don Fluckinger from Search Health IT News, decided to ask directly if Judy from Epic had been asked about the alliance and what she said. They adeptly avoided answering the question specifically and instead said that they’d talked to a lot of EHR vendors and were happy to talk to any and all.

Although, this is still the core question that has yet to be answered by the CommonWell Health Alliance. Will it just be another closed garden (albeit with a few more vendors inside the closed garden)? From what I could gather from the press conference, their intent is to make it available to anyone and everyone. This would even include vendors that don’t do EHR. I think their intent is good.

What I’m not so sure about is whether they’ll put up artificial barriers to entry that stop an innovative startup company from participating. This is what was done with EHR certification when it was started. The price was so high that it made no sense for a small EHR vendor to participate. They could have certified as well, but the cost to become certified was so high that it created an artificial barrier to participation for many EHR vendors. Will similar barriers be put up in the CommonWell Health Alliance? Time will tell.

With this said, I think it is a step forward. The direction of working to share data is the right one. I hope the details don’t ruin the intent and direction they’re heading. Plus, the website even says they’re going to do a pretty lengthy pilot period to implement the interoperability. Let’s hope that pilot period doesn’t keep getting extended and extended.

Finally, I loved when Jonathan Bush explained that there were plenty of other points of competition that he was glad that creating a closed garden won’t be one of them. I hope that vision is really achieved. If so, then it will be a real healthcare interoperability enabler. Although, artificially shutting out innovative healthcare IT companies would make it a healthcare interoperability killer.

March 4, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

EMR and EHR Ads

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It seems fitting on Super Bowl week to take a second and look at the advertisers that make what we do here at EMR and HIPAA possible. None of their ads cost $1-2 million like the Super Bowl ads, but if you’re looking for some great Healthcare IT and EHR products then you’ve come to the right place. If you like what we do here at EMR and HIPAA, then take a minute and see the advertisers who like what we do as well.

Also, I have a special ad promotion for new advertisers from now through the middle of February. If you’re interested in knowing the details, drop me a note on our Contact Us page.

New EMR and HIPAA Advertisers
Canon – I can’t imagine anyone reading this needs an introduction to Canon. In the Healthcare IT space they offer a suite of scanners, printers and copiers that are found in healthcare organizations across the country. I even have the Canon imageFORMULA DR-C125 in my house and use it regularly. The need for heavy duty scanners in healthcare isn’t going to go away for a long time. I’m glad to have Canon on board as an advertiser.

iPatientCare – EHR vendors always do well as advertisers on EMR and HIPAA and so it’s great to have iPatientCare as a new advertiser. They provide the full suite of EHR, PMS, PHR, HIE, and Mobile that you could need along with all the important EHR and meaningful use certifications. I see that they’re going to be exhibiting at HIMSS at Booth #5519 if you want to check them out at HIMSS. Plus, I love that their website has an image that says they won 9 TEPR Awards. Many of you probably won’t even know what TEPR is since it’s no longer around. However, TEPR was a conference focused exclusively on EHR (although it was probably called EMR back then since it was before EHR became in Vogue). The fact that they won awards at TEPR shows how long iPatientCare’s been doing EHR.

simplifyMD – I first started working with simplifyMD when they graciously sponsored the New Media Meetup at HIMSS 2012 (The 2013 event will be announced shortly, but save Tuesday, March 5th from 6-8 on your calendar). It was a great event and they were a great sponsor. simplifyMD is a certifed EHR vendor that strives to tailor their EHR workflow to the doctor’s current workflow. Something that dotors love to hear and experience from their EHR. They’re a web based EHR. Plus, they recently came out with these great simplifyMD and EHR cartoons. I’m sure I’ll be featuring more of their cartoons in the future.

Returning EMR and HIPAA Advertisers
Sfax – I call Sfax a returning advertiser because they first started advertising on EMR and HIPAA back in December of 2009. So, they supported EMR and HIPAA back when we were just starting to get some traction. After a short hiatus, they’re back as an advertiser. What many don’t realize is that Sfax handles the faxing for a large number of the EHR vendors out there. While I generally avoid faxing as much as possible, sometimes it can’t be avoided and so I’m always grateful I can just send a fax similar to how I send an email using Sfax. Word on the street is that they have the next version of their software coming out soon. I’m excited to check it out.

Mitochon – Similar to Sfax, Mitochon first started advertising on EMR and HIPAA back in Decmber of 2010. After a short break they’re back again as advertisers. I’ve really enjoyed watching Mitochon mature as a Free EHR vendor (They do offer the full suite of free services: PM, EMR, HIE, etc). When Mitochon first started advertising with me, they were a brand new company with a big vision and lots of ideas, but still a lot of work to do. They’ve come a long way since then with their product and their company. One example of that was in their mobile EHR solution that I wrote about previously.

Renewing EMR and HIPAA Advertisers
A big thanks to all these renewing advertisers. It’s beautiful seeing so many of them supporting us for so long.
Practice Fusion – Advertising since April 2010
EMR Consultant – Advertising since July 2009
Amazing Charts – Advertising since May 2010
Cerner – Advertising since September 2011

I’m very appreciative of those advertisers who support the work we do. As I look at the stats for the advertisers, I’m really happy that we’re providing real value to their companies.

January 31, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

NBA Implements Cerner EHR – NFL Implements eCW

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Over the past couple weeks, a number of major athletic organizations have announced that they’re standardizing their healthcare documentation using EHR software. The NBA is using Cerner’s EHR and the NFL is using eCW’s EHR.

At first blush these announcements remind me of Walmart selling eCW at Sam’s Club and Costco selling Allscripts EHR. Everyone wondered why Costco and Sam’s Club were selling EHR. The obvious answer was that it was a great PR move by eCW and Allscripts. Although, I did hear about one doctor that hijacked an EHR selection process thanks to a Costco mailing. I think that’s the exception.

While big popular sports organizations like the NBA and eCW might be great PR for a company, it is really interesting to consider the unique healthcare needs of a sports league. The first thing that came to my mind was actually whether the teams would want to have their athletes’ health data on one platform. Often, the health of their players is part of their strategic advantage. Certainly there are a lot more rules about disclosure of injuries, but teams still play the injury card before games, in trades, and when signing new players. I imagine the staff doctors for the teams have to be careful how and what they document in the EHR if it’s going to be available to other teams. And we thought privacy was an issue in general EHR use. It’s much more complicated when you have millions of dollars riding on a player.

From a big data perspective, I’m interested to see if either of these leagues will be able to leverage the EHR data they collect in order to deal with the long term health issues of players. This is particularly true in the physically brutal NFL. I’m sure readers are familiar with the long term concussion questions and research that’s happening with the NFL. Not to mention the ongoing battle against the use of steroids and other performance enhancing drugs. Can a unified EHR help to provide a basis for research and understanding of the health consequences of playing in the NFL?

When I start to think about all the medical devices that are coming out, they’re really interesting in an NFL context as well. Imagine all the health data from various devices being sucked into the league’s EHR. When I talked with FitLinxx at the mHealth Summit, they said that the Boston Red Sox used their activity tracking device the year they won the World Series (Seems like Boston might want to consider using it again). From what they described, The Pebble (their activity tracking device) was a great way for the trainer to keep track of compliance with the fitness regiment they suggested. Should this data be in the league’s EHR? I can see health reasons to do so, but it does go back to the question of teams’ competitive advantages.

I bet device makers would love to compare professional athlete’s use of their devices against all of the other data that’s being collected by regular users. Would make for some pretty compelling charts if I could compare my health indicators against Lebron James or Peyton Manning.

What’s also interesting to consider about a major sports league using an EHR is a connected PHR. In these situations you want your players to be well connected to the doctor and you have a real financial interest in their compliance with doctors orders. PHR in this case could make a lot of sense. Although, I wonder if many prima donna athletes would balk at the idea. Well, at least they can have their agent or assistan log in for them.

I do wonder what special features Cerner and eCW were asked to do for the NFL and NBA. Of course, not much of it would likely be useful for the rest of us.

December 17, 2012 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

An Example of EHR as Database of Healthcare

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One of my favorite interviews at mHealth Summit was with Alan Portela, CEO of AirStrip Technologies. I’d definitely heard good things about AirStrip, but I must admit that before our meeting I didn’t have a very good understanding of what AirStrip was really all about. I was pleased to learn that they are well deserving of the hype. I believe AirStrip will do wonderful things to help make healthcare data mobile and AirStrip is lucky to have Alan Portela leading the company. Alan is unique when it comes to healthcare IT leaders in that he understands the healthcare culture, but also has a unique vision for how healthcare can embrace the future.

The core of what AirStrip has done to date has been in OB and Cardiology. In fact, each of those areas is worthy of their own post and look into how they’ve changed the game in both of those areas. The OB side speaks to me since we recently had our fourth child. I can imagine how much better the workflow would have been had my wife’s OB had access to the fetal waveforms (CTGs) on her mobile device. Instead, it was left to the nurse to interpret the recordings and communicate them to the OB. There’s real power for an OB to have the data in the palm of their hand.

Similar concepts can be applied to cardiology. Timing is so huge when it comes to the heart and there’s little doubt that mobile access to healthcare data for a cardiologists can save a lot of time from when the data is collected to when the cardiologist interprets the results.

The real question is why did it take so long for someone like AirStrip to make this data mobile. The answer has many complexities, but it turns out that ensuring that the data displays to clinical grade quality is not as easy as one might think. An ECG waveform needs to be much more precise than a graph of steps taken.

While both of these areas are quite interesting, since I’m so embedded in the EHR world I was particularly interested in AirStrip’s move into making EHR data mobile. They’ve started with Meaningful Use Tracker, but based on my conversation with Alan Portela this is just the beginning. AirStrip wants to make your important clinical information mobile.

I pushed Alan on how he’ll be able to do this since so many EHR companies have created big barriers to being able to access their data. Turns out that Alan seems to share my view that EHR is the Database of Healthcare. This idea means that instead of the EHR doing everything for everyone, a whole ecosystem of companies are going to build amazingly advanced functionality on the back of the EHR data and functions.

In AirStrip’s case, they want to take EHR data and make it mobile. They don’t want to store the data. They don’t want to do the advanced clinical decision support. Instead, they want to leverage the EHR data and EHR functionality on a mobile device.

One key to this approach is that AirStrip wants to be able to do this for an organization regardless of which EHR you use on the backend. In fact, Alan argues that most hospital organizations are going to have multiple EHR systems under their purview. As hospitals continue to consolidate you can easily see how one organization is going to have a couple hospitals on Epic, a couple on Cerner, a couple on Meditech, etc. If AirStrip can be the consistent mobile front end for all of the major EHR companies, that’s a powerful value proposition for any hospital organization.

Of course, we’ll see if AirStrip gets that far. Right now they’re taking a smart approach to mobilizing specific clinical data elements. Although, don’t be surprised when they work to mobilize all of an organization’s healthcare data.

AirStrip is just one example of a company that’s using EHR as their database of healthcare data. I’m sure we’re going to see hundreds and thousands of companies who build powerful applications on the back of EHR data.

December 13, 2012 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.