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What If Your EHR Only Had 25 Doctors?

Posted on July 18, 2014 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.

I recently had lunch with an EHR vendor that had an extremely small number of providers. I’ve known this EHR vendor for about 5 years, so this isn’t a new EHR vendor that’s trying to establish themselves in the industry. Instead they’ve focused on having a small, nimble team that’s focused on making the EHR work the right way for the doctors. It’s a novel approach I know, but pretty interesting that his business can survive with so few providers. Also worth noting is that the EHR is certified for meaningful use stage 2 as well.

Now think for a minute how the development process of an EHR vendor would be better if your EHR only had 25 doctors (For the record, the EHR vendor above has a few more than 25 doctors). Would it be much easier to satisfy just 25 physician users? Imagine the personalized service you could provide your users.

One of the real challenges I’ve seen with EHR vendors is that when they’re small, they are extremely responsive to their end users and the end users are very happy. As the EHR vendor grows, they lose that personal touch with the end users and many of those originally happy end users become dissatisfied with their EHR experience.

The problem with scaling an EHR user base is that you can’t make everyone happy. You have to make compromises that will be great in some people’s eyes and terrible in another person’s mind. What large EHR vendors do to try and solve this problem is they create configurable options that allow the end user to customize their system to meet their personal needs. Problem solved, right?

The problem with these configurations is two fold. First, you can’t make everything configurable. Once you go down the path of making everything configurable, it never ends. There’s always something else that could be made more configurable. So, the culture of configurability leads to unsatisfied users who can’t customize everything (even if what they want to customize shouldn’t matter).

Second, if everything is configurable, then it makes the implementation that much more complex. I’ve written before about the need for EHR vendors to have great “out of the box” user experience, but balancing that with allowing the user to configure everything that’s needed. This is a real challenge and most fail. Just look at the number of high priced EHR consulting companies out there. Many of them could better be defined as EHR configuration companies since the configuration needs are so large and complex.

Returning to where we started, when you’re an EHR vendor with 25 doctors you don’t have to build in all the flexibility and configurability. You’re small enough that as an EHR vendor you can do any needed customizations and configurations for the end user. Plus, with this kind of personalized service you can charge a little extra as well.

When you look at EHR development, there’s a spectrum of approaches starting with a fully in house, custom designed EHR through a fully outsourced EHR that can apply to any organization or specialty. In many ways a 25 doctor EHR has a lot of the same benefits of a fully custom EHR software, but spreads the costs of development across more doctors.

As a business, maybe a 25 doctor EHR company won’t dominate the world. Maybe they won’t have a huge exit to some other company or an IPO. However, that doesn’t mean it’s not a great small business if it’s doing something you love. Once you get World Domination out of your sites, it changes a lot of things about how you do business.

How Do You Improve the Quality of EHR Data for Healthcare Analytics?

Posted on May 8, 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.

A month or so ago I wrote a post comparing healthcare big data with skinny data. I was introduced to the concept of skinny data by Encore Health Resources at HIMSS. I absolutely love the idea of skinny data that provides meaningful results. I wish we could see more of it in healthcare.

However, I was also intrigued by something else that James Kouba, HIT Strategist at Encore Health Resources, told me during our discussion at HIMSS. James has a long background in doing big data in healthcare. He told me about a number of projects he’d worked on including full enterprise data warehouses for hospitals. Then, he described the challenge he’d faced on his previous healthcare data warehouse projects: quality data.

Anyone that’s participated in a healthcare data project won’t find the concept of quality data that intriguing. However, James then proceeded to tell me that he loved doing healthcare data projects with Encore Health Resources (largely a consulting company) because they could help improve the quality of the data.

When you think about the consulting services that Encore Health Resources and other consulting companies provide, they are well positioned to improve data quality. First, they know the data because they usually helped implement the EHR or other system that’s collecting the data. Second, they know how to change the systems that are collecting the data so that they’re collecting the right data. Third, these consultants are often much better at working with the end users to ensure they’re entering the data accurately. Most of the consultants have been end users before and so they know and often have a relationship with the end users. An EHR consultant’s discussion with an end user about data is very different than a big data analyst trying to convince the end user why data matters.

I found this to be a really unique opportunity for companies like Encore Health Resources. They can bridge the gap between medical workflows and data. Plus, if you’re focused on skinny data versus big data, then you know that all of the data you’re collecting is for a meaningful purpose.

I’d love to hear other methods you use to improve the quality of the EHR data. What have you seen work? Is the garbage in leads to garbage out the key to quality data? Many of the future healthcare IT innovations are going to come from the use of healthcare data. What can we do to make sure the healthcare data is worth using?

Short and Sweet Health IT and EHR Thoughts

Posted on November 9, 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.

I thought for a fun Friday post, I would post a bunch of short and sweet quotes and thoughts from people I talked to this last month at various Health IT & EMR conferences I went to around the country. Hopefully some of these will drive some interesting conversations in the comments.

“ACOs facilitate HIE.”

“They [A hospital] had a hard EHR go-live…well, they all have a hard EHR go-live.”

“Not All ICD-10 engines are created equal.”

“EHR consulting firms have a bad name [image].”

“All the money in hospital IT is in clinical apps.”

I’m a Plumber Despite Just Wanting to be an EMR Blogger

Posted on April 22, 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.

About a month ago, the market finally fell enough for my wife and I to buy our first house. It’s pretty exciting to finally be able to do it since we pretty much tried to buy a house every year since we moved to Las Vegas 6 years ago. Thankfully, we never did until now (although that’s another story).

After purchasing the home, I found myself spending a fair amount of time having to repair a number of things around the house. One day I pretty much spent all day being a plumber as I (and a nice friend) replaced the garbage disposal, fixed a leaking sink, replaced the mechanism (whatever it’s called) in the toilet. Turns out that none of these things are really all that difficult. Although, it definitely had the initial learning curve for me to realize that it’s pretty straightforward once I got into it.

After spending the day as a plumber on my new house, I couldn’t help but think, “I’m doing the job of a plumber and all I want to really do is blog.”

Many of you are probably wondering what any of this has to do with EMR and healthcare IT. Well, I am the EMR blogger who loves analogies (see marriage and divorce, pregnancy, marriage for money, weight loss, and Katherine posted a Lady or the Tiger one that I enjoyed).

The comparison seems obvious to me. There’s a whole lot of doctors out there that really don’t want to be IT project managers. They don’t want to be EMR implementation specialists. They don’t want to be EMR Contract negotiators. They don’t want to be software evaluation specialists. They want to practice medicine by providing care to patients.

Of course, many of you might easily suggest that I could have paid someone else to do the plumbing and I could stick to the EMR blogging like I want. This is absolutely true. I’m sure there were plenty of plumbers that would have been happy to take my money. Unfortunately, they charge an arm and a leg and I like my limbs. Plus, there’s something valuable about having the knowledge of how something that I’m going to use every day is done.

Extend that to doctors. They could certainly hire an EMR consultant to come and help them do their EMR implementation. In fact, my first job doing EMR was partially to solve this issue. They needed someone who could take care of the EMR implementation from top to bottom. If you find the right person, there’s no doubt that it can work very well. However, similar to the plumber, there’s a cost associated with doing that. Plus, if you use a consultant, you’re outsourcing some of the knowledge and expertise that you would gain if you and your staff put your nose to the grindstone and did it yourself.

Plus, while I can’t say that I particularly enjoy plumbing, I have to admit that there really was an amazing feeling of satisfaction knowing that I was able to accomplish a task which I’d never done before. I think many doctors and clinics have had that same sense of satisfaction after implementing an EMR in their office.

HIMSS Attire Day 2 – Top 10 Real Reasons I’m at HIMSS11

Posted on February 21, 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.

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Today I have a special shirt made just for HIMSS, thanks to the great people at Enterprise Software Deployment.

If you see me at HIMSS, check out my shirt. It has the top 10 real reasons I’m at HIMSS listed on the back of the shirt. My favorite is #4 Booth babes. I’ll post the full top 10 later tonight.

Also, be sure to check out Enterprise Software Deployment at HIMSS if you need a great EMR consultant or if you’re looking for a position doing EMR consulting. You can find them at Booth #2777.

Here’s their HIMSS exhibitor description:
At ESD, our goal is to ensure successful implementation of a new EHR system or upgrade from start to finish in healthcare organizations around the globe. Our services include Clinical Transformation, Legacy System Support, Training, Supplemental Staff Augmentations, Clinical and System Transformation, as well as education and training in all aspects of Cerner®, Siemens®, Epic®, Eclipsys®, MEDITECH, and McKesson systems.

Thanks for ESD for sponsoring such a cool shirt for me.

EMR Consulting Business Model

Posted on September 3, 2010 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.

I’ve been thinking about the EMR consulting business model for a long time (check out my first post on EMR consulting back on October 27, 2006). My personal career path has taken me a different direction. I do some occasional consulting for people, but it’s not really my core business. Unfortunately, I don’t scale very well.

With that said, I think there’s definitely a business model for a company that does EMR consulting. In fact, today I learned that one of my advertisers and also an EMR consulting company, Enterprise Software Deployment, was ranked #561 out of the 5000 fastest growing companies in America (see press release).

That’s right. I guess EMR consulting is a good enough business that they can use an EMR consulting business to become one of the fast growing American companies. Plus, I agree with the press release that this next year we’re likely to see EMR consulting grow even more.

While I ABHOR EMR sales people who like to call themselves EMR consultants, I think there’s definitely a place in the EMR industry for qualified EMR consultants. In fact, check out this series of EMR consultant posts where I talk about the possible advantages of using an EMR consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in
NOTE: I wrote all these in early 2008. I don’t think too much has changed since then. Although, there are likely more EMR consultant opportunities.

My Article on Understanding the Types of EHR Consultants

Posted on February 24, 2009 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.

I mentioned previously that I was working on an article about EHR consultants. I wanted to sincerely thank all those people who commented on EHR consultants and sent me feedback on things I should include in my article.

As you’ll see, I used a lot of the feedback that you gave me to form the article. That’s really the power of the internet to bring a bunch of bright people together to create something of far greater value than I could have created on my own. Thank you for your feedback.

I’m told the Magazine has been sent to the presses and those of you who get MDNG magazine will see my article soon (hopefully someone will get one to me). The cool thing is that my article is the cover story for the February issue of MDNG.

For those that don’t want to wait for the magazine or don’t get the magazine, my article on EHR consultants has already been posted online. It’s called: Does Your EHR Consultant Have Your Best Interests in Mind?

Let me know what you think about it.