I’m sure that many of you probably don’t know the story and history of EMR and HIPAA. Some day I’ll have to share the entire story, but EMR and HIPAA has been around for about 6 years and about two years ago during a panel at HIMSS I announced that I was going to quit my job and become a full time blogger. I must admit that it is pretty much a dream for me that I’m able to be a full time blogger doing something that I love. A long time ago I chose advertising as my model for making this happen. Thankfully there have been a lot of great companies that have supported me and this blog. Many of them for many years.

As I do every couple months I like to recognize the new EMR and HIPAA advertisers and recognize those advertisers that have renewed their ads. Many of the ad renewals have been doing so for a lot of years. I might have to go back and research how long many of these advertisers have been renewing on EMR and HIPAA and recognize them for this in the future.

Also, we have a NEW service we’re offering, so read to the bottom to learn more.

New EMR and HIPAA Advertisers
Medical Mastermind – I’ve been talking with Medical Mastermind for a while now about advertising, so I’m glad that not only did they decide to advertise on EMR and HIPAA, but they’re advertising across the entire Healthcare Scene blog network. They are offering a special Buy 2 EMR licenses, Get 1 Free offer right now for readers of this blog. One thing I really like about Medical Mastermind is that over the past year or so they’ve come under new management that’s really taking them to the next level as a company. Plus, they have a bunch of clients that have been with them for a long time. It’s always great for a company to have a base of existing users that have been with them for a while.

PTS Consulting Group – PTS Consulting Group is a multi-national consulting group with offices in Boston, New York and London (to name a few). I know a number of the consultants out of Boston and they are some of the most pleasant and professional people you can meet. They have some great war stories and you might remember the meaningful use tool they created. If you’re looking for an EMR consultant, they offer a free phone consultation so you can see if they’re a good fit for your organization. Plus, one of their best resume items is that they’re regular readers of EMR and HIPAA (Sorry, I couldn’t help myself).

Valant Medical Solutions – Valant Medical Solutions offers an EHR focused solely on the mental health profession. No doubt they agree with me that there’s a huge opportunity available to specialty specific EHR software. I think few would argue that the mental health space has unique needs where they can benefit from a specialty specific EHR. Turns out investors seem to agree since Valant Medical recently closed an almost $1 million funding round. This is a good sign for mental health professionals looking for a mental health specific EHR that’s going to be around for a while to come.

Dynamic Vault – One of the things that I think clinics do incredibly poorly is making sure that they have a quality backup of their EHR system. I’ve done a whole series on EHR backups before and I should do it again. Dynamic Vault offers a service to help solve a lot of the EHR backup problems. They handle Access Controls, Audit Controls, Data Integrity and provide a contingency plan. I’d encourage every clinic to evaluate their EHR backup plan and make sure it is sound. Otherwise, you should check out a service like Dynamic Vault.

Renewing EMR and HIPAA Advertisers
Now a big thanks to the following advertisers that have renewed their ad on EMR and HIPAA: Cerner, Practice Fusion, SOAPware, EMR Consultant, and Sequelmed. There are a bunch more in the process of renewing too. Watch for another batch coming soon.

New Healthcare Scene Service
Over time Healthcare Scene has gotten a lot of requests from companies to create content for them. My normal response was that I really didn’t have time to create content for other places. As I’ve grown Healthcare Scene to now something like 10 writers (depending on how you count), I realized that we do have a bunch of talented people who could create content for other companies as well.

With this as inspiration, I got together with one of my writers, Anne Zieger to put together a new Healthcare Scene Content Service. In fact, we already have 3 clients we’re working with now on content creation with more in discussion. While we certainly are great at creating blog posts, Anne Zieger also has years of experience creating whitepapers, case studies, surveys, webinars and other custom content.

Besides our experience in the healthcare and healthcare IT space, our content creation service has the unique ability to also be able to distribute the content that’s created across the Healthcare Scene network. This makes for a really compelling opportunity for companies with a story to get their voice heard.

We’re putting the finishing touches on a PDF describing the various services we can offer and as webpage describing those services as well. Until then, if you’re interested in more details, drop me a line on our Contact Us page and we’ll get right back to you with more details.

As most of you know, the way I’m able to run EMR and HIPAA and the rest of the Healthcare Scene blog network is thanks to the great EMR & Health IT advertisers that support the work we do. Luckily, we and our advertisers have done really well. In fact, I just noticed last night that a couple weeks ago EMR and HIPAA itself just passed 5 million pageviews (5,062,416 if you’re keeping count). Thankfully readership continues to increase across the whole network.

One challenge that some advertisers have with my current advertising is that it’s a flat rate for the month. In order to solve this problem, I’m launching a new advertising option that’s done on a CPC (cost per click) basis. This is the same model that Google Adwords uses, but you’ll be able to do it on a set of very targeted EMR, EHR and healthcare IT websites. I’m doing my initial tests for this on EMR Thoughts & EMR and EHR videos. If you’re interested in trying out this performance based advertising, drop me a line on our contact us page and I’ll send you more details.

If you like this type of performance based advertising and you have an important EMR or healthcare IT message to get out, wait until you see what I have brewing at Influential Networks.

Enough about the exciting changes to the EMR and HIPAA advertising. Now a look at the new Advertisers on EMR and HIPAA.
EHR Selector – As some of you might remember, I wasn’t a big fan of EHR Selector in the past, because I didn’t think many doctors would want to pay what they were charging to use their service. However, EHR selector came to me wanting to advertise their special 6 month free offering to use their EHR selection service and that was something I could get on board and support. EHR Selector has some of the most granular EHR company filtering that’s out there. They’ve added nice filters like the EHR Certification status of each EHR software. Sign up (It’s free after all) if you’re looking at selecting an EHR or helping others select an EHR.

Elsevier – This is a very large company with a wide variety of healthcare products. I’ll just focus on the one that they’re advertising on EMR and HIPAA: Gold Standard Drug Database. I believe most parts of an EMR should be built in house, but the one part of an EMR that is definitely better to get from a third party provider is the drug database. Gold Standard Drug Database is one option that EMR and EHR vendors should consider. It combines current, accurate content along with intelligent decision support for your drug database. The best part is that as an EHR company you don’t have to keep it up to date since Elsevier is already doing that for you and pushing you the updates.

Cerner – Many of you might remember my previous interviews with Cerner meaningful use physician #23 and Jan Patterson. Cerner has been a major player in the EHR industry for quite a while despite many people not really knowing much about them. A simple example of how large they are is that Cerner Ambulatory clients have secured more than $3.3 million in Meaningful Use incentives. Divide that by the $18,000 per provider and that’s a lot of providers using Cerner ambulatory EHR.

Also, as always, I don’t want to forget to thank those advertisers that have renewed their EMR and HIPAA ad. Since the last time I posted, SOAPware, Mitochon, HIT Forum, and Sequelmed have all renewed their ad. Thanks for supporting us. If you enjoy the content I create, then please take a second to check out these advertisers.

Now on to the next 5 million pageviews on EMR and HIPAA. A big thanks to all those that read our work.

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.

Every couple months I like to take a bit of an inventory on EMR and HIPAA along with recognizing new advertisers to the EMR and HIPAA family along. Not to mention send out a big thanks to all those advertisers who have renewed during that time period as well.

EMR and HIPAA is still doing more amazing than I ever thought it could. During the slow summer months we’re still averaging about 4500 pageviews per day. In fact, we’re inching ever closer to 5 million pageviews since we first started tracking the stats. I think I might have to celebrate the day we reach that landmark.

This will be the 1,139th post on EMR and HIPAA and we’ve had 5,590 comments made. That’s roughly 5 comments per post. So thank you to all those who contribute to the amazing community that exists around EMR and HIPAA. Much of the best information happens in the comments.

I’m also really excited to say that we just passed 3000 email subscriptions to EMR and HIPAA as well. Pretty amazing since I only started the email newsletter a short while ago.

New Advertisers
A number of advertisers started their ad campaign on EMR and HIPAA since I last posted. Many of them are really benefiting from the rotating sidebar ads that I announced last post. You can find more details on EMR and HIPAA advertising.

GFI – FaxMaker – GFI offers a number of interesting services for small to medium size businesses. One that’s particularly interesting in the healthcare space is called the GFI FaxMaker. If you don’t already have a fax server in your office, go and read my post about the virtues of a fax server in healthcare.

Quest – Care360 – I’ve long been intrigued by the Quest EHR model. I think that having an EHR from your lab company provides some interesting benefits that can’t be realized by other EHR vendors. Plus, I love the idea that their EHR is already setup for thousands of doctor’s offices who already use Care360 for their labs. All they have to do is turn on the EHR module. That’s a compelling reason for many clinics to consider the Care360 EHR.

Amazing Charts – Amazing Charts has become not only an advertiser on EMR and HIPAA, but you’ll see them across the entire network of Healthcare Scene websites. Amazing Charts was one of the first EHR vendors to offer a relatively inexpensive EHR product. They were one of the first companies to move the EHR cost needle while still providing a high quality product. Amazing Charts was started by a practicing family physician, you can read about his and the Amazing Chart journey here.

Health Informatics Forum – A great health informatics forum that’s run by the incredibly interesting Chris Paton. The forum has over 5,000 members discussing a variety of healthcare informatics topics. One of the things I like most about the forum is the real international flavor. I love learning from healthcare informatics in other countries. This healthcare informatics forum is a good place to start.

Renewing Advertisers
Of course, I’m always overwhelmed by the number of companies that continue to renew their advertising on EMR and HIPAA. Thanks this time to Practice Fusion, EMR Consultant, MxSecure, Mitochon Systems, Nuesoft, Sequelmed, Scantronix, Medical Web Experts, and GE Centricity Advance for all renewing their ads. Almost everyone on that list has been long time supporters of what we do at EMR and HIPAA.

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.

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.”

I can’t remember exactly where I saw someone talk about the “WIIFM” (What’s in it for Me) principle, but it really is an important principle that when understood can have an amazing impact for good. This post isn’t about whether you should live a life asking WIIFM. I’ll leave that question to people much smarter than me. Instead, I want to look at how applying the WIIFM principle to others can help those working on a successful EHR implementation.

In most cases I’m talking about, the WIIFM should be changed to “What’s in it for Them?” Understanding the answer to this question can help you as an EMR consultant, an EMR vendor or even a practice manager or doctor that’s trying to work through an EMR implementation.

One of the first things I cover in my e-Book on EMR selection (It’s free, check it out) is the idea of getting buy in from those that will be affected by the EHR implementation (that’s usually everyone). One of the best ways to get EHR buy in from people is to understand the WIIFM. It’s not fool proof, but it’s one good strategy for getting people on the same bus, going the same direction.

Let me tell you that there’s always a way to find a WIIFM in an EHR implementation. This list of EMR and EHR benefits is a great place to start. However, many of those benefits can be extrapolated in ways that will show what’s in it for every person in the clinic.

Let’s say for example, that your goal for implementing an EHR is to increase clinic revenue by freeing up chart storage space so you have an extra exam room for another provider. You can then talk about what that new revenue can be used for to improve the clinic. Maybe it could include bonus checks or other incentives. These become tangible things that staff can use to better understand WIIFM in an EHR implementation.

I’m sure many of the nay sayers out there are thinking, but an EHR doesn’t provide those benefits. That’s why it’s so important that you define which benefits your clinic is striving to achieve before you select or implement an EHR. The list of benefits you use to show WIIFM ends up being your goals for your EHR implementation. They can be used to define your EHR selection process. They can be included in the EHR contract so you have some assurance or protection if the EHR vendor can’t deliver on their sales promises. Not to mention, after the EHR implementation you have a way to measure if it was a success or not based upon those goals.

Test the WIIFM principle. Not from an arrogant Me Me Me approach. Instead, step into the other people’s shoes and ask WIIFM. This approach can really help improve any EHR Implementation if applied correctly.

I’ve had some interesting reactions to my post about the various characteristics of a Jabba the Hutt EHR Vendor. One of the more interesting conversations happened by email with a reader named Richard. Yes, I have lots of interesting back channel discussions.

After a lengthy email exchange, I asked Richard if I could post our discussion on the blog so you could participate as well. He agreed and even commented, “I look forward to an expansion of our discussion.” So, here you go (or at least scroll to the bottom for a short summary of my feelings).

The conversation started with this email that Richard sent me:

I understand your reluctance to name names in your article, BUT… this is exactly what is needed.

I’ve taken a few days to ruminate over what I was going to suggest and I’d like to hear your thoughts on this if you have time.

With your readership, I suspect there are plenty of users and observers of current packages and lots of opinions. Why not set up something like a Wiki-EMR site to provide a resource that will allow everyone to provide input into the details making “Jabba” and “Han Solo” EMR systems and see where it goes? Maybe it could eliminate some of the BS surrounding some of these systems and help others who are trying to sort out there own future needs. I’m sure there are plenty of people out there who want, need and are willing to provide information on the state and future of EMR and what is BS and what isn’t. I certainly would. Let me know your (or your readers) thoughts.

Richard

Here was my response:

Hi Richard,
Yes, this is something I’ve thought a lot about. The key question for me is how to publish some sort of “authenticated” information. Most systems are so easily gamed and/or abused that they basically have no worth. I haven’t figured out a scalable way to be able to provide information that is actual data and not provided with undue influence.

As I read your email, I wondered if some sort of combination of LinkedIn might be the key. At least then any review that’s done would be tied to an individual. Although, by doing so, you’d then discourage many of the most interesting reviews and feedback because their name would be explicitly tied to the review.

Along these same lines I’ve wondered how I could provide a “Meaningful EHR Certification” that wasn’t based on a pass/fail system that has no value. Instead it was a mixture of qualitative and quantitative data that would actually be of value to the reader. Scaling that up is the challenge I have with that idea. Not to mention figuring out the right financial model for it.

So, as you can see I’m with you on wanting more specific information out there, but not sure how to overcome the abuse and the scale that you need for it to be valuable.

As a side note, I do have a wiki page: http://emrandhipaa.com/wiki/Main_Page and it even has an EMR and EHR Matrix of companies. Although I closed registrations since spammers were getting into it.

Richard then provided this response:

It seems to me that user editing must be do-able if Wikipedia has found a way. Additionally, I think that unvarnished truth through comments creditable or not (but differentiateable ) would be a place for insiders or knowledgeable users and IT pros to vent. I realize that it is open to abuse, but a user moderated (or whatever Wikipedia uses) forum will turn upon such miscreants and their abuse might well backfire. I realize it is quite a project, but I’ll bet there are a handful of your readers, if not many more, that would gladly help put something this critical in place. If this can be pulled off, it might create “the world’s foremost authority” * in EMR.

I don’t know much at all about this, but I have a feeling that so much is riding on all of this and that there is a vacuum of useful, meaningful and understandable information that is needed to make this whole thing work. I know there must be something prescient sounding I could offer here, but it might be just indigestion that’s giving me this feeling. John, there must be some other smart guys around; try to round up some and see what they think.

Then I offered this response which shows I’ve been on Wikipedia far too much:

I’ve been rolling around something like this since I first started blogging about EMR. Wikipedia’s a bad comparison because it tries to formulate 1 truth instead of a series of opinions about something. Plus, Wikipedia relies on the masses of people (we don’t have enough mass) and even they get to a point where they regularly lock pages after abuse happens. Wikipedia’s a crazy community once you get into it. There are flame wars and battles on Wikipedia that rage in the background that most people don’t realize are happening.

Travel and hotel sites are a better comparison actually. Since reviews of hotels are more similar to a review of an EMR. The hotel owner wants to put the best reviews on there and can plant good reviews amongst many other ways to game the ratings and review systems. I read an interesting story about how Trip Advisor tried to deal with this. Unfortunately, it put on the image of successfully battling it, but didn’t do that well. Matters much less when you’re talking about a hotel versus an EMR.

I agree that it could become the authority on EMR software if it’s done right. Although, for me to do it, I have to find a model that’s authentic, honest, reliable, scalable and that makes sense economically. At least until I sell off a company for a few million. Then, maybe I can cut out the economical requirement.

Then Richard commented:

I didn’t realize that abuse was that rampant and that a fix was so difficult. I think I see some of the problems. You almost need a cadre of “fair witnesses” to explore the opinions and observations of users and provide incorruptible analysis. Not a promising outlook.

I’d be happy to assist this enterprise in any way I can, but don’t think I would bring anything very useful to the table. I feel you may be the right person to bring something like this to fruition, but the resources needed may be out of reach. It’s too bad there isn’t a Consumer Reports -like group out there for something like this. Maybe some group has enough vested in the outcome of shake-out to fund independent assessment and provide a forum for users.

I know very little about the technology involved in EMR, I am more aware of the medical business and needs for improvement in record and information management. Additionally, if cost containment can’t be managed and a “best practices” can’t be incorporated into every patient’s care then our society may be doomed economically (even morally). You’re doing something valuable, so keep it up, there must be a way to sort out the players and the technology so we can get on with the real need which is getting something useful and beneficial installed for quality patient care. Even getting this discussion broadened is worthwhile.

Well, there you go. If you made it through that, then you must really care about EHR and healthcare IT like I do.

In summary, I think it’s quite clear that it’s an incredible challenge for those searching for EHR software to find reliable information. The need for good EHR vendor information is extraordinary and no one has cornered that market…yet? There is no “consumer reports” for EHR software.

I haven’t yet identified a model that’s authentic, honest, reliable, scalable and that makes sense economically to deliver said “consumer reports for EHR software.” (or maybe I’m just too lazy, scared, busy, etc to try)

I do think that this site and the other members of the Healthcare Scene blog network provide a valuable independent resource for those selecting and implementing an EMR. My free EHR selection e-book was one effort to help providers in the EHR selection process in a very targeted way.

Are there other things that I (we) could do to help even more? I’m sure. If you have ideas, I’m interested to hear. You see my off the top of my head criteria above.

If nothing else, we can reach Richard’s goal of “broadening the discussion”

This is the second in a series of EMR and EHR interviews that will be done on EMR and HIPAA and EMR and EHR. The full EMR interview with Dr. Muir can be found on the new EHR and EMR interviews website. The following is a summary of that interview written by Kathy Bongiovi.

If you’re a doctor, nurse, practice manager, EHR consultant, CEO or executive of an EHR vendor, etc with EMR experience that’s interested in being interviewed, let us know on our http://www.emrandehr.com/contact-us/“>Contact Us page.

Dr. Peter Muir of Springfield Center for Family Medicine was interviewed recently concerning his acquisition of the maximum Medicare Incentive for showing Meaningful Use of a Certified EHR. The Ohio based primary care practice has been using NextGen Ambulatory since 2003 and NextGen Management since 2006.

Dr. Muir stated that their practice chose NextGen EHR because the company focused on clinical offices. Dr. Muir and NextGen EHR share the philosophy of always searching for ways to improve the product. Dr. Muir not only believes in this philosophy but also attended a development think tank along these lines at NextGen’s headquarters. He was also drawn to NextGen because he wanted the capability of customizing his templates.

Having demographics, scheduling, clinical and billing information all on one database has had a huge impact on Muir’s practice. He feels that having a centralized database “makes reporting much easier and more comprehensive than those EHRs with separate databases or separate vendors”. The doctor admitted the conversion from paper charts to EHR was stressful for the first year but well worth it in the long run.

Since Muir’s office has been using EHRs (since 2003), there have been relatively few changes needed for Meaningful Use and any required upgrades to the system came as part of the standard NextGen maintenance fees. There was data that had to be added which was not normally collected by his practice as it had little relevance to his patients but from the patients’ perspective, there was no change in the attention patients received from Springfield Center.

The family practitioner Muir credits the CMS web site and NextGen Healthcare for not only the upgrades to their EHR software but also for their pathway documents and webinars which helped them show meaningful use. He also credits GBS of Youngstown, Ohio (his NextGen vendor for hardware, software) who also helped them implement security upgrades in 2010 in anticipation of the process.

Additionally, being a part of the ONC Meaningful Use Vanguard Program was a benefit to Dr. Muir because “it provides recognition which may allow a greater input in system design and operation.” Muir is concerned, though, that the Program’s flow of information may be difficult if multiple database silos remain in service and a lack of standardization isn’t addressed.

Especially with respect to Meaningful Use Stages 2 and 3, the doctor believes it is critical to have professional health providers utilizing some form of regional system – versus individual systems – in order to have a seamless flow of information. Muir has begun such a system within his own state of Ohio.

The doctor was intricately involved in starting CCHIE (Collaborating Communities Health Information Exchange) in Springfield, Ohio. CCHIE chose HealthBridge as their data engine and together they have partnered with other healthcare providers to provide electronic access to patients’ lab and radiology results as well as to admissions, discharges and transfer information. They have added regions in Southern Indiana and two regions in Northern Kentucky.

Dr. Muir’s advice to fellow doctors is that unless they are planning to retire within the next couple of years they should not delay in the implementation of an EHR. The longer they wait, the more difficult and time consuming the transition will be because, with time, the activities of daily practice will be much broader and more demanding. Additionally, he suggests providers select a system that does not just meet Meaningful Use requirements. His advice is to “select a system that assists you in providing better medical care”.

Read the full transcript of Dr. Muir’s interview.

Many long time readers of EMR and HIPAA will know I like to call big, bulky, old EMR software systems, Jabba the Hutt EMR. I think comparing these old legacy EMR software to Jabba the Hutt is a great comparison. For those that don’t know Star Wars that well (and I’m no expert), Jabba the Hutt was a very powerful figure. Although, over time he’d grown so big that he wasn’t very nimble (to say the least). So, despite his power and prestige, there was little to admire about him.

Does that sound a bit like some legacy EMR software? They’re big and powerful figures in the industry. However, their software has grown to the point that it’s clunky and not very nimble. Getting something changed on it is difficult and it’s built on a platform that makes it hard to add new features. Thus, they are Jabba the Hutt EMR.

Without naming names, here’s a list of things that will help you identify the Jabba the Hutt EMR software.

You might be a Jabba the Hutt EMR if…
your interface looks like it’s from the 80′s.

You might be a Jabba the Hutt EMR if…
you use a non SQL database.

You might be a Jabba the Hutt EMR if…
you’re better at marketing than programming.

You might be a Jabba the Hutt EMR if…
you cludged together your PMS that you bought from someone else.

You might be a Jabba the Hutt EMR if…
your interface looks more like DOS than Windows.

You might be a Jabba the Hutt EMR if…
your diagnosis description is restricted to 50 characters.

You might be a Jabba the Hutt EMR if…
your EMR salespeople don’t know your EMR developers who don’t know your EMR customer service people.

You might be a Jabba the Hutt EMR if…
iPad interface….what’s that?

I think it’s worth noting that having one or two of these things doesn’t absolutely mean an EMR vendor is a Jabba the Hutt EMR vendor. Although, the more of the above characteristics an EMR vendor has, the more you should look into it.

I hope others will add to this list in the comments.