Many of you have likely noticed that I like to use the terms EMR and EHR almost synonymously. In fact, it’s kind of a game for me now. I generally try to stick with one term for a certain blog post, but I even break that rule on occasion. I guess the thing is that it really doesn’t matter to me at all.

I don’t like to debate the meanings and definitions of words since it doesn’t matter how you define a term. Instead, I just try and communicate the substance of the issues. Words matter as part of that communication, but whether I call it an EMR or an EHR doesn’t change the value of what I’m trying to communicate (at least 99% of the time).

There are a few rare cases when I do differentiate. For example, I would likely never say that you need a “certifed EMR” to get the available HITECH Act stimulus money. I wouldn’t do so because the legislation specifically says “certified EHR” and so I’d respect the verbiage. Although, these cases are few and far between.

Plus, I try to be the voice of the physician. I’d bet if you asked most physicians the difference between an EMR and EHR they’d likely laugh, walk away or know what an EMR was but ask you to define the term EHR. I, like most physicians, don’t care what you call it. They (and I) care more about the substance of selecting, implementing, using, maximizing, enjoying and even sometimes enduring an EMR or EHR.

As you can imagine my inbox has been kind of blown up with all the people talking about the final meaningful use rule. It’s going to take a bit to really digest what the final rule will mean for healthcare and EMR in general. I’m still trying to digest everything that’s been said and the 864 pages of the meaningful use rule (seriously, that’s longer than most books I read). Later today I’ll be posting a list of links to the various meaningful use articles and summaries I find on EMR and EHR. I think that will become a really valuable resource since a lot of people have done a lot of digging into the rule already.

While I still have some concerns about how doctors will or will not take to the meaningful use rule and the EMR stimulus money, I have to admit that HHS did scale back some of the requirements rather significantly. I’ve always found David Blumenthal and the other people at ONC to be sincere people that were trying to make a sincere effort to make this work. I think the changes to the meaningful use rule reflect this sincerity also.

Of course, the million dollar question is what will doctors think? There going to be inundated with information. I’m pretty sure a lot of doctors aren’t going to know which way is up and will be sitting out at list the first round of fun to see how their colleagues who take the meaningful use plunge fair first.

Also, here’s the 864 pages of the meaningful use final rule for those who want to go to the source:

If you want to see the HHS dog and pony show that you missed yesterday, I’ve embedded the video of the press conference for meaningful use below:

A lot of people have been asking me lately how long I’ve been blogging about EMR. It’s kind of hard for me to believe that I’ve been blogging about EMR for about 4.5 years. What’s even more crazy is that this is my 902 blog post on my EMR and HIPAA & EMR and EHR blogs. Not too bad for what started out as a Christmas break project.

What’s disappointing about all of these blog posts is that most people that visit the site only see the most current blog posts. Certainly some of the older blog posts aren’t worth reading (ie. some of my initial stimulus money posts). However, many others are just as relevant today as they were 4 years ago (don’t ask me if this is a good or a bad thing).

So, I think every week or so I’m going to do a blog post linking back to some of my old posts that people probably haven’t read before. Plus, I’ll look at some of the previous posts and do updates to those posts to highlight any new information we have on those subjects.

However, since this is my first look back post, I thought I’d highlight some unique ways to read content on my site.

EMR Tags:
Tags are a really cool way to read and find content about a specific topic. I try my best to be good about tagging posts appropriately. For example, here’s a list of links that include posts I’ve done and tagged with a certain keyword:
Meaningful Use
Certified EHR
EMR Stimulus
EMR Selection
EMR Implementation
You’ll find more links like this at the bottom of every post I do.

EMR and HIPAA Search:
There are 3 ways to search through all my posts on the site.
EMR and HIPAA Search – This is the built in search function that comes with the site.
EMR and HIPAA Google Search – This is the embedded Google search feature that will actually search across both EMR and HIPAA & EMR and EHR.
EMR and HIPAA Archive – This is a list of all the EMR posts I’ve done along with links to the posts By Subject and By Month.

Today I have a lot of mixed emotions going on. Although, the one that overwhelms all of the other emotions is excitement. Yesterday was the last day of my day job and so today is my first official day as a full time entrepreneur.

It’s a big step for myself and my family, but I can’t wait to see what I’m going to be able to do online working on it full time. I’ll be continuing my work on this site and EMR and EHR. I also have a number of TV related blogs and so I’ll continue my work on those. Then, I’ll be doing a few little side consulting gigs and speaking events (like this one) to kind of bridge the gap in income.

Then, I’ll also be working to create a new website to help amateur sports teams and other organizations to fund raise (currently called Sportsriffic). I’ll be leveraging the low cost web to give as much back to the organizations as possible. Almost a “Facebook for fundraising.”

In some respects fundraising by these organizations is similar to healthcare. Fundraising hasn’t benefited from technology the way it could, similar to healthcare. I’ve also wondered how this idea might apply to non-profit hospitals, so if you’re part of that I’d love to chat with you. It’s been amazing to see how many people are affected by fundraising and how many different types of organizations could use what I’m building.

This is going to be quite the adventure. I don’t think it will change too much about what I do here. So far, people seem pretty happy with the content I’m creating. However, I’m certainly open to hear feedback on what I could do better, topics I could focus on more, etc. This is going to be an exciting year!

As I mentioned in my post discussing the last year on EMR and HIPAA, I thought it worth talking about some of our plans for the coming year. 2010 is going to be an absolute banner year for EMR. We’re going to see the beginning of major shifts in the EMR world. Everything from merging EMR companies to clinics fretting over the EMR stimulus money. It’s going to be a very exciting and interesting time for those interested in EMR.

EMR and HIPAA Blogging – We’ll continue blogging, although maybe not as much as we did last year. However, it’s just part of my routine so I’ll be surprised if too much changes in that regard. I’ve NEVER had an issue with things to blog about. In 2010 I think sifting through all the content and news will be the real challenge. At the end of the day, my goal with blogging is to provide value to readers. Hopefully I can achieve that goal in 2010.

EMR and EHR Blog – Many of you know that I’ve been doing quite a bit of blogging on EMR and EHR. I expect the blogging on that site will increase in 2010. There won’t be too much difference between EMR and HIPAA and EMR and EHR, but EMR and EHR will generally focus on more news items. Also, I’m considering launching another EMR site that just does EMR news. We’ll see how that evolves.

EMR – EHR Conference – I’m working together with a partner to hold an EMR and EHR conference. I’ll be helping to put together the agenda for the conference which will likely be held around September 2010. The focus of the conference will be on providing practical information on selecting and implementing an EMR.

EMR Selection Book – I’ve made really good progress on my EMR selection e-Book. I expect to launch it to the world in early 2010. Then, I’ll start working on an EMR implementation e-Book along with other related e-Books. Hopefully I can add some value to those searching for the right EMR. Not to mention improve EMR implementation success rates. In some respects, I think these books as a cliff notes version of this blog. Other people have called it an “EMR for Dummies” type book.

Attending HIMSS 10 – I’ll be attending the HIMSS annual conference for the first time. If you can’t attend, then we’ll be covering it for you. I’m still deciding the best way to cover the conference. If you have suggestions or ideas, feel free to leave them in the comments. I was told we’ll have a Meet the Bloggers session at the conference also. I’m excited to meet readers of the site and also to talk with potential advertisers. I’m also interested in talking with someone who wants to sponsor all the posts I do at HIMSS. If you’re interested in more details, drop me a note.

I’m sure there’s a lot more, but that’s some of the major things. I’m also working on a side project which deals with online fundraising for organizations. I’d be interested in talking with non-profit hospitals to learn more about what they’re doing to fundraise. If you have a few moments to talk, let me know on my contact us page.

P.S. If you’re looking for my thoughts on the ONC “meaningful use” final rule, it will come in the next couple days. I like to give myself a few days to synthesize the information. It’s 76 pages (or something like that) for goodness sake.

As I usually do, I want to welcome a new advertiser to EMR and HIPAA. I always appreciate those who advertise on EMR and HIPAA and allow me to bring a different perspective to most of those you find in the EMR world. I also want to extend my thanks to those of you who read my blog every day. I’m always amazed at the list of people that comment on my blog and subscribe to the EMR and HIPAA email list. Thanks for making this the best EMR blog on the internet (of course I’m a little bias in this opinion).

Now onto EMR and HIPAA’s new advertiser:
MxSecure – This is a really unique transcription services company compared to the others I’ve seen. They’re really looking at merging the two worlds of transcription and EHR in a variety of ways. See the full description of MxSecure at the bottom of this post.

You can find more details about advertising on EMR and HIPAA on our EHR advertising page. Also, we’re just starting to accept advertisers on my blog partnership EMR and EHR for those looking for an additional EMR advertising option. Just drop me a line on our contact us page for more details.

Read more…

I’ve mentioned a blog partnership that I created with the website EMR and EHR. In fact, you’re certain to notice the striking similarities between the 2 websites. I expect over time that will change to some extent. Although, things have gone well here so why mess with something that’s working right?

Well, I’m really happy to announce that Dr. Jeff has joined on with me and will be piloting the EMR and EHR blog. He’s a passionate guy with some strong opinions about EMR and I hope he doesn’t get shy now that he’ll be sharing those opinions about EMR in public. You can read more about Dr. Jeff on the EMR and EHR About us page. I’ll be posting occassionally on that blog too, but I expect to have a number of good blog “sparring” matches between Dr. Jeff’s blog, EMR and EHR, and this blog, EMR and HIPAA.

Dr. Jeff’s already got 2 blog posts up:
Big Government, Healthcare IT, Our Healthcare System and the Economy – A look at some of the changes happening with government and healthcare.
A Patchwork Quilt of Unique EMR Software – A short discussion of a Big National Data Bank of Healthcare Information

Let’s make Dr. Jeff feel welcome by heading over to the site and posting some good comments on his posts. Also, those who want to hear a doctor’s perspective on EMR can subscribe to EMR and EHR by email or RSS feed.

I’ve had on my list to do a nice post talking about all the people suggesting how meaningful use should be defined. Unfortunately, I’ve been sidetracked by a number of projects in my life. Not the least of which is a website about EMR and EHR that I’ll announce officially on this website shortly. Hopefully I’ll have the time to do a full fledge post on defining meaningful use very soon. I’ve been collecting a lot of perspectives on meaningful use and so it just takes a lot of energy to sort through them all.

The other thing that has really taken my time was this presentation about EMR that I did today at a local medical school. You may remember that I asked for some help in preparing a quality EMR presentation and so I wanted to thank all those who contributed to my presentation. It’s really amazing how much better the readers of this website can make me look in a presentation or article that I’m doing. I must admit that I really enjoy doing presentations and I love talking about EMR. So, it was a lot of fun. I think next on my wish list is to be invited to present at some EMR related conference or even better would be to take part in a panel at some conference.

What I did find really interesting with the medical students was what it was like to explain the HITECH Act and $18 billion of EHR stimulus money to a bunch of students. They were all just laughing at the way the HITECH act is set up and trying to promote EHR usage. I was laughing myself thinking about how silly it sounds when you talk about why a doctor might not want to worry about the possible EHR stimulus money. I don’t think they were fooled by the pile of EHR stimulus money.

What’s really amazing is that I just checked and this will be my 400th post on EMR and HIPAA. I don’t usually sit there and look at how many posts I’ve done. I just try to create some good content that people will find useful. Then, I look back and think about what 400 posts involves and I must admit that I’m pretty proud of what I’ve created here.

I also find it funny that while this will be my 400th post to this blog, I still have 168 drafts of ideas that I just have never had the time to post about. I really should go back and see what’s in there. I rarely ever look past the last 10-20 draft posts. I’m sure there’s some real gems that I just never found the time to write about. So, if you start seeing some references to older items, then you’ll know I’m just doing some spring cleaning on the blog.

I’ve got a lot of other things I’d like to do with this blog including creating some really pointed e-books on EMR implementation, EMR selection, EMR features, EMR consultants, etc. I also hope to have some more time to flesh out the EMR, EHR and HIPAA wiki. It definitely needs some more love if you want to participate. I know I’ve used the information a couple of times and it’s starting to grow more and more useful as people add information to the wiki.

Ok, that’s enough rambling for now. Thanks for being a reader and here’s to the next 400 EMR and HIPAA posts.

I know that I have a number of EHR consultants that regularly read this blog. Plus, many of my readers have used, are looking to use or have heard stories about EHR consultants. I’m currently working on an article about EHR Consultants and so I’m interested in hearing people’s feedback about their experience with or as an EHR consultant. Here’s some things i’m interested in hearing about:

• Benefits of an EHR Consultant
• Challenges of an EHR Consultant
• Finding a good EHR Consultant
• Making the most of an EHR Consultant
• Does an unbiased EHR Consultant exist?
• etc…

Basically, I’m interested in answering the question of whether an EHR consultant has your best interest in mind and things you can do to ensure a quality experience with a consultant.

Also, you might look back at my five part series on EHR consultants to get you thinking.

Think about how wonderful the ability to send a discharge summary by email to a patient straight from your EMR. I think it’s pretty easy to see the tremendous benefits of this type of communication. Send the patient information to one place they probably visit every day and where they can read and process the information away from the hustle and bustle of the clinic. Certainly many doctors have been doing this with little pamphlets or handout sheets with clinical information. Unfortunately, too many of these sheets never get read. Certainly that same thing could happen with an email, but at least the next generation of patients are going to want this information in their email box.

Of course, the problem with sending this information in an email is that email is not secure. Email encryption hasn’t taken hold fast enough to make it encrypted. Is a user’s email box really a secure location where they want their health information? I personally don’t have a problem with it, but I would expect that many people wouldn’t want their health information in their email any more than their regular mailbox. Either way, without the encryption it wouldn’t be difficult for someone to sniff out what’s being sent in an Email containing for example a patient’s discharge. It would be going across the internet in basically plain text.

This situation actually happened in Austrailia a little while back in an article I read called “Unsecured email sparks dispute.” I know I wouldn’t be happy if a clinic just decided to send these unsecured emails. Not so much because I was personally worried about my information being lost. I personally have nothing to hide (yet anyway). However, I would feel uncomfortable patronizing an organization that would deal so flippantly with my information.

I’m sure that someone will chime in that this is the whole purpose of a Patient Portal or EHR interface that allows people a secure method to receive and send protected health information. This is all well and good, but from what I’ve seen this usually requires the doctor’s EMR company to support this type of interaction. Plus, even more serious of an issue is that you’re giving your patients one more login and password that they’ll need to remember. Certainly not a deal breaker, but one more inconvenience for our users and the staff that have to support our users when they forget their password. Unfortunately, I think that this is the future of secured messaging, but I can always hope that there’s something better that we’re just missing.

We should also realize that this isn’t going to get any easier. In fact, I think we can reasonably say that this is going to get harder and harder. Don’t be surprised if soon some patient would like their health information somehow incorporated into some site like Facebook. It’s really only a matter of time until some developer creates a health interface into Facebook.

It might not make sense to most people, but the next generation of patients are going to grow up living and breathing their online life in some sort of social network (Facebook is just one example of these). They are very comfortable with transparency and will be interested in being able to track and compare health information with other people. Not to mention interact in a social network with other people who have similar conditions. It seems like this isn’t a question of if, but when this type of interaction will happen.

Even if you think that health information on a social network like Facebook is far fetched, we are already seeing health information propagating to the web in Microsoft’s HealthVault and Google Health. Is this going to be ok? Will it become as synonymous as online banking has become to the banking world? It’s not that far of a stretch to think that Google Health could easily be tied into Google’s OpenSocial platform which would allow a patient’s health information to do all sorts of cool things.

The convergence of Health Care and IT is going to be really interesting. It’s taken health care a while to get going with IT, but I think almost everyone agrees that IT could do amazing things to better the health care a person receives.