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An Example of EHR as Database of Healthcare

Posted on December 13, 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.

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.

The Real Money is in the ACO, Not Meaningful Use

Posted on May 24, 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.

John Moore from Chilmark Research offers this great insight for those of us in the healthcare IT and EHR industry:

The MU requirements have become little more than a “spec-sheet” for vendors, consultants and IT shops and departments. These requirements have nothing to do with innovation and have little to do with the dramatic changes that will occur in this industry in the next decade. Quoting that oft-used phrase, “follow the money” one can quickly see that the billions in funding for incentivizing providers to adopt EHRs under the HITECH Act is relative chump change to the dramatic fortunes that may be won or lost under the new value-based payment models that are proliferating throughout the industry – payment models that commonly fall under the rubric of ACO or PCMH. In each of these models, EHRs are important to a degree, they are part of the basic infrastructure. But it is what one does with the data that matters (collect, communicate, collaborate, synthesize, analyze, measure and improve). Therefore, if you want to see innovation look beyond today and the tactical push to effectively adopt and meaningfully use EHRs and towards the future of how that data will be used to drive quality improvements, better outcomes and lowering risk exposure.

As the title says, I translate this to mean: The Real Money is in the ACO (Accountable Care Organizations), Not Meaningful Use

Of course, his description of the current healthcare IT landscape also reminds me of two posts I did previously: EHR is the Database of Healthcare and Is Revenue Cycle Management Sexy?

Both of those posts highlight many of the the observations that John Moore makes. First, if the EHR is nothing more than a repository of data, then it has value (Oracle did pretty well as a database) but it’s limited. Those who can take the data stored in EHR and other healthcare data sources and do something amazing with it are going to be the big winners in healthcare IT. Could an EHR vendor be the one to do this? Possibly, but looking at other industries, I think this is unlikely. That’s why I describe EHR’s similar to databases.

The answer to the question posed in the second post linked above is “Yes, if you like money.” Sure, healthcare isn’t all about money, but money can be a tremendous driving force for doing good as well. It turns out that dealing with revenue cycle problems provides tremendous value to a clinic. However, many people for some reason look past it since they think it’s not “sexy.”

The ACO model that is fast approaching is also going to make this even more important. It’s still too early to describe exactly how it’s all going to play out, but many who don’t have a handle on the business side of their practice are going to miss out.

I’ve heard some describe meaningful use as a high bar to achieve. I disagree. Meaningful use is prescriptive and simple for EHR software to achieve. Sure, it takes some time and effort, but any one with time and effort can achieve it. I don’t think we’ll be able to say the same for ACOs. That’s why the value of the ACO is going to be much higher than meaningful use. It’s the traditional higher risk leads to higher reward.