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EHR Expert Jobs, Healthcare Social Media, MU Attestation Data

Posted on March 31, 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.


I guess Cleveland Clinic doesn’t think the government trained EHR workforce. I know a lot of them that can’t get a job in any EHR position.


This story is a crazy one and spiral out of control is the right term. Although, this post by Amanda Blum is the best look at the issues from my point of view. Dr. Nick is right that you do have to be careful. In fact, the case above wasn’t even something that happened on social media. It was something that happened in person at a conference and then social media blew it up. So, I’d actually argue that it’s more important than ever for you to be involved in social media. That way if something does blow up, you see it and can deal with the situation before it spins out of control.

What I do hate most about the story is the lack of civility and not giving people the benefit of the doubt. I hate that part of the way society is heading. Communication can solve a lot of issues if people would just use it. Instead, we assume the worst in people. That’s unfortunate.


Evan’s opening line to the blog post says, “CMS just released the December 2012 attestation data, and one thing is abundantly clear—many EHR vendors will not be around to see Stage 2.” I don’t agree with his conclusion. I expect we’ll have nearly as many in meaningful use stage 2 as we did in stage 1. Meaningful Use stage 3 is likely where we’re going to see fallout. Although, it does beg the question of how many EHR vendors will stay in business without EHR incentive money?

I’ve often said that it’s surprising how good of a business you can run with just a few thousand doctors.

Meaningful Use Feedback for ONC and CMS – Meaningful Use Monday

Posted on November 7, 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.

Today I thought I’d cover some feedback and comments that have recently been posted on some of my previous posts. Some are feedback for ONC on meaningful use. Another suggests that more of us get involved in the meaningful use rule making process. These comments and others that I’ve ready have me wondering if I and others of my readers should be playing a more active role in helping form the meaningful use criteria.

As is evidenced by the 60 Minutes interview with Jack Abramoff last night, there’s so much messed up about Washington and the legislative process. I guess I partially see that with meaningful use and the HITECH Act and I’m sure there’s plenty more happening in Washington DC that I don’t know about.

The problem I see is that the ones interested in being actively engaged in the rule making process are those that have the most financial benefit to gain. Certainly all of us have some reason to care how our government spends money and particularly the health of our healthcare system. Unfortunately, financial benefit seems to be a much stronger motivating force to participate than the greater good.

Look at it this way. If I’m an EHR vendor that’s going to have to comply with meaningful use and use it and EMR certification to sale my product, then I have a reason to pay for someone to fly to Washington DC and be involved in the process. I could even make some reasonable argument for me as an EHR and healthcare IT blogger to make the journey to Capitol Hill to talk about what’s happening. In fact, I’m going to be in DC in December, but I’m not going there to help improve meaningful use. The idea of getting ONC and CMS or other members in Washington DC to talk with me about meaningful use and the HITECH act sounds daunting and I’m not sure it’s worth the effort for a one time event.

Does that basically mean that ONC and CMS are listening mostly to those who have a vested financial interest in meaningful use and certified EHRs?

I like many others would likely be happy to share our voice in the meaningful use stage 2 creation process. It just feels so hard to participate and with little confidence that our voice will be heard above those who are paying a lot more to have their voice played over a proverbial loud speaker. I’m sure most doctors feel this same way. Although, Dr. Koriwchak over at Wired EMR Practice was in Washington DC this last week. I’ll be interested to hear more details on his visit, but I think his visit came as part of a larger health organization. Evan Steele of SRSsoft has a good post requesting other medical organizations become more involved in the meaningful use process. Could they be an independent voice for the physicians they represent?

Enough ranting about the challenge of working with the government to shape policy. Although, a comment from Anthony Subbiah was what prompted my reaction above. The following are Anthony’s comments from my Small EHR Vendor and Specialty EHR post suggesting that EHR vendors get more involved in the process:

As a vendor who works with ONC, and having gotten to know them better, they do have the greater good in mind; and some of these hurdles are un-intended and un-foreseen. The Phase II of the meaningful use requirements are in pilot and this is a good time for the EHR vendors to work with ONC and point out the flaws which ONC will graciously accept and review. It has been interesting working with ONC and understanding their thought process goes a long way in positioning and requesting exemptions. Key here is for the EHR vendors to spend the time and effort and work with ONC helping to meet their objectives.
On another note, while reducing the expenses is the goal, its more about the reduction of wastefull expenses which is being targeted to get the healthcare costs under control.

ONC maintains an extensive directory and blog of what they do at WIKI and any company interested can join. In order to realize value, the companies interested should be able to dedicate one or two senior resources towards this; there are many pilots that go on related to MU Phase II; the EMR companies can participate in the Pilots, provide their inputs and the ONC group is more than willing to listen. Actually, this is a great group of people to work with and they take the input and integrate that within the initiatives framework. We do not participate in all the Pilots – we are participating in two of them currently.
I believe its better to participate and shape the outcome as opposed to sitting on the sidelines and later on finding fault in such initiatives…………..

Here’s a link to the Wiki that Anthony mentions.

The other comment that prompted this post was a comment made by Julie Lundberg about the meaningful use smoking status requirement:

In an attempt to improve ‘Usability” we are trying to build a smoking status that will satisfy both the Core Measure (which requires CDC smoking status categories) and CQMs (which require SnoMed codes). There is no 1-1 relationship between the 2 lists. In fact, the CDC list makes no distinction between a “Light” cigarette smoker (1-9 cigs/day) and a “Very Heavy” cigarette smoker (40+ cigs/day). Both would be considered a “Current every day smoker”. We can obviously gain this granularity with SnoMed codes but this makes the task more onerous for the provider to capture (selecting from 2 lists of “descriptions”). Let’s give the Providers 1 smoking status to fit all requirements.

It’s an interesting question for which I don’t have the answer to which feels odd since I feel that I’m reasonably well versed with meaningful use and the creation of the meaningful use creation process. The only way to know the answer to this is to have been intimately involved in the creation process in Washington. Something no doctor that sees patients daily can really do.

I love that Julie was willing to offer her suggestion on my EMR blog. Plus, I know that a number of people from ONC read this site, so I’m hopeful that now that I’ve posted Julie’s comment it will get more traction from the people in Washington. However, I still feel there needs to be an easier way for those who can’t spend their days following the latest meaningful use happenings in Washington DC to have their voice heard in the process. Then, they wouldn’t have to resort to blogs like mine to provide comments.

I’m open to other suggestions on how regular people can get involved in the process. Maybe my personal fear of involvement is that I want to actually effect change on something I’m involved in. It seems like casual involvement in the process isn’t enough to be heard. I guess that’s the problem when you want what you said to be meaningful (ie. actually heard and used).

Is Your EMR a Spoon or a Backhoe? – Importance of How an EMR Vendor Implements Meaningful Use

Posted on December 8, 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.

It has become more and more apparent that the way an EMR vendor implements the meaningful use requirements is going to be critically important to a doctor’s successful adoption of the meaningful use criteria which is of course essential to get the $44,000 in EMR stimulus money.

I think it’s easy for doctors and practice managers that aren’t as familiar with the various EMR software and with the details of the EMR stimulus to get confused. On face, it seems that the effort to get the EMR stimulus money shouldn’t be affected by which EMR software you choose as long as it is an ONC-ATCB certified EMR. However, this is just categorically WRONG!

The EHR certification is meant to tell you that it CAN meet the meaningful use guidelines. It doesn’t tell you how easily it is to meet the meaningful use guidelines. It doesn’t tell you how well they integrated the meaningful use guidelines into your regular workflow. It doesn’t tell you how well it lets you delegate the meaningful use tasks to other staff members so you can optimize the doctors time. So, yes, EHR certification should mean it’s possible to show meaningful use. EHR certification does not make any claims to how effective that EHR software will actually accomplish the task.

Here’s a simple analogy:
If I wanted to dig a hole for a footing on a house, I could probably use a spoon to dig the hole. It would take forever to actually dig the hole, but a spoon could work. It would suck to use a spoon to dig the hole and quite honestly I’d probably give up before I finished, but with enough blood sweat and tears I could get the hole dug.

Of course, if I had a shovel, digging the hole would be much easier. I could get it done with just a bit of hard work. It would obviously go a lot faster than a spoon. Now, if I had a backhoe, digging the hole would basically be academic. Achieving the goal would be simple to accomplish, because the tool was designed perfectly to achieve it.

It’s worth asking yourself whether the EMR you use or the EMR you choose is a golden spoon or a powerful backhoe when it comes to achieving meaningful use. Maybe both can achieve the goal of meaningful use, but is it just made to look nice and shiny or was it really designed to make achieving meaningful use as painless as possible?

Thanks to Randall Oates from SOAPware and Evan Steele from SRSsoft for inspiring this post.

I was talking with Randall recently about SOAPware’s approach to EHR certification and meaningful use. He told me that SOAPware could have thrown something together quickly and been easily certified against the EHR certification criteria when it first opened. However, he didn’t like that approach. Instead he wanted SOAPware to take its time and make sure that the criteria were implemented in a usable and useful way.

Evan just posted a blog post about not all meaningful use EMR being equal. Here’s one portion of what he said that prompted this post:

Demonstrating meaningful use will still demand additional work, and certified—or to-be-certified—EMRs are not alike in how they facilitate doing this. It is critical for physicians to understand and evaluate the differences among EMRs in terms of how they deliver meaningful use capability and the impact on the time it takes to meet the requirements with each.

Evan also offers a few suggestions on things you might ask your EMR vendor:
*How easy is it to enter the required data? (This is particularly important as requirements become more demanding in future stages of the program.)
*What changes will you have to make to the way you see patients?
*How will you document the care you provide?
*Does the system effectively allow delegation of tasks to staff members to minimize the time physicians must spend doing data entry?
*Does the vendor’s software platform enable keeping up with evolving requirements?

There you go! Now you have a list of questions you can ask SRSsoft (and other EMR vendors) when you’re evaluating them.

I’d love to hear other ways people are evaluating an EMR vendor’s implementation of meaningful use. Not to mention ways that EMR vendor’s have implemented meaningful use that differentiates themselves from other EMR vendors.

One EMR Vendor’s View of Meaningful Use

Posted on August 5, 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’m always interested in the reactions of EMR vendors to various news. Granted, much of it is very predictable. They obviously want to sell more EMR software and so their reaction is usually a positive one when we’re talking about billions of dollars of stimulus money.

This is why I was so interested in hearing Evan Steele, CEO of SRSsoft’s response to the final meaningful use rule. Evan has been a strong proponent of maintaining the productivity of the practice and no doubt government regulations like meaningful use can stand in the way of that goal. The following is Evan’s response to the meaningful use final rule:

While the final rule on meaningful use contained some changes from the proposed rule, these modifications are only deferrals, not permanent changes. Everything that was taken out of the proposed rule will be added back in, according to Farzad Mostashari, and the flexibility granted for Stage 1 will be removed in Stage 2, just two short years away. The bottom line for physicians has not changed:

  • Compliance with meaningful use will result in a significant decrease in productivity because the demands on physicians are still onerous and because it requires use of an EMR that is data-driven (traditional, point-and-click EMR) rather than workflow/productivity-driven (like the SRS hybrid EMR).
  • The meaningful use measures are still not particularly relevant to specialists, as HIT Policy Committee member Gayle Harrell pointed out during the recent committee meeting.
  • Participation in the government program is voluntary, as David Blumenthal made clear during the press conference announcing the release of the final rule. Physicians can choose to follow the compliance path or they can elect to pursue the productivity path.

SRS remains committed to physician and practice productivity and will continue to focus our development resources on our flagship product—the unique, productivity-enhancing hybrid EMR. Most high-performance specialists recognize that the cost of complying with meaningful use far outweighs any incentives that might possibly be earned or any penalties that might be imposed.

As you referenced in a recent post, SRS has entered into an alliance that will ensure that physicians have all the options they need. With SRS, they can reap the significant benefits of the productivity path, with the assurance that if at some point in the future they decide to pursue meaningful use, they will be able to do so as clients of SRS.

Looks like Evan is still preaching the EMR productivity message, but there’s a small sliver of hope for meaningful use with SRSsoft. I’m pretty sure every EMR salesperson is going to be so tired of hearing about meaningful use that Every EMR vendor will need a solid meaningful use strategy. Meaningful Use is here to stay. At least until the EMR stimulus money runs out.

Think About the Problems with Paper Charting

Posted on June 8, 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.

Back in April, Evan Steele, CEO of SRSsoft, wrote an interesting post about EMR adoption and he asked the question, “Why Are You Still on the Fence?” It’s a very good question. Plus, he adds some value to the conversation by listing some of the problems with paper charts versus an EMR. Here’s a section of his post:

So why are these physicians, who have determined that government incentives are not relevant or achievable, still on the fence about adopting an EMR solution that will deliver measurable benefits? Staying with paper charts is not a good business strategy because there is nothing more inefficient!

  • The costs associated with the excess staff needed to manage these medical records are massive and wasteful—these positions can be eliminated or the employees can be more effectively used in revenue-generating or patient-care roles.
  • Paper charts hinder practice growth because adding physicians requires a proportional increase in support staff—medical records, billing, nurses, and medical assistants—and because physicians can’t see more patients without lengthening their work hours.
  • Slow responsiveness to primary care physicians limits referral volume.
  • Profitability is further affected by billing bottlenecks that delay revenue collection.
  • The chaos associated with trying to manage paper charts has a damaging effect on staff morale and creates rampant frustration among patients, physicians, and staff.
  • Paper charts are a malpractice nightmare—prescriptions are not consistently documented, orders are not easily tracked, and medical decisions are often made without complete clinical information.

So, why are doctors on the fence with EMR? The sad thing for me was the pre-EMR stimulus money, I felt a shift in the tone of conversation around EMR adoption. Doctors had mostly moved from wondering if they should implement an EMR to how they should implement an EMR and which EMR they should implement. They were off of the fence and I saw the tide shifting.

And then in one anti-stimulative swoop, the HITECH act rolled out and doctors decided to go back to the sidelines and see this government incentive play out. Now they’re waiting for meaningful use to be defined. While the HITECH act has increased EMR awareness 10 fold, it’s also done much damage on the short term EMR adoption. I’m not sure that the increased awareness will overcome the damage that it’s caused.

Of course, the damage is done and so we have to go forward from here. I suggest we go back to pre-EMR stimulus times and focus more effort back on the benefits of EMR and the costs of paper instead of the government handouts. If we do that, we’ll see a fantastic shift to more widespread EMR adoption.

Video Interview of Evan Steele, CEO of SRSsoft EMR

Posted on March 18, 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 must admit that one person that I was very excited to meet at HIMSS was Evan Steele, the CEO of SRSsoft. Evan and I had interacted a number of times online. Plus, I love an EMR vendor CEO that has a blog. Not just any blog, but one that broadens the discussion about EMR software and provides an alternate view to EMR adoption.

Turns out that many people at HIMSS don’t like the hybrid EMR style of software that Evan Steele and SRSsoft are trying to create. There is certainly an argument to be made against it, but personally I like to see people approaching the challenge of clinical documentation in different ways. I also love how SRSsoft focuses so much effort and energy on the physician. If more EMR vendors had this focused, we’d have much better EMR software.

Now this kind of sounds like a sales pitch for SRSsoft. It’s not. SRSsoft has its flaws and weakness like every other EMR software out there. I do think that they’ve done a good job broadening the discussion so I knew for sure that I had to talk with Evan Steele on video. In this video, he makes a really interesting point about CCHIT certification, now HHS certification, the new ICD 10, etc all working to make many EMR vendor’s software clunky (my word, not his).

Enough talk, check out my interview with Evan Steele, CEO of SRSsoft.

I should also mention that Evan and I were on a Meet the Bloggers panel together. That was a good time too.

HHS Evaluating Harmful Unintended Consequences of HITECH Act

Posted on February 4, 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.

Looks like HHS and ONC have been hearing less than rave reviews about the ARRA EMR stimulus program. About a week ago, HHS posted a presolicitation asking to evaluate the “potential harmful unintended consequences” of the EMR Stimulus. Here’s a few excerpts from the notice that describe the problem:

“While we expect for these programs to help achieve the many desirable outcomes envisioned by Congress,” the notice said, “a sense of responsibility for activities we support, historical experience, as well as mounting evidence of unexpected problems, demand that we consider potential downsides,” the notice said.

“By ‘unintended consequences’ we mean outcomes that are not intended, even though, upon investigation and reflection, they are, at least in part, a natural consequence of the activities. While some unintended consequences are desirable, the purpose of this contract is to identify and address those that are undesirable and potentially harmful.”

I don’t completely understand the government process, but I wonder if this request isn’t a means to an end. For example, maybe HHS and ONC want to modify the requirements for meaningful use and certified EHR, but are strapped because of the details of the legislation. By doing a study that shows major unintended consequences to the legislation, maybe it will open the door for them to be able to make changes to how you gain access to the stimulus money even if it doesn’t match the initial legislation perfectly.

I could be all wrong here, but otherwise why would you do a study of the harmful unintended consequences? So, you can say we told you so after those harmful events happen?

The always interesting Evan Steele, CEO of SRSsoft, has taken this idea and listed his top three unintended consequences of the HITECH Act on his blog (Side Note: Evan and I are going to be on a bloggers panel together at HIMSS. That will be a lively panel.):

  • There will be more EMR failures than successes, particularly among high-performance specialists.
  • “Certification” will stifle innovation.
  • Alternatives such as hybrid EMRs will lead the market among high-performance physicians.

I agree with the first 2 items. I’d just clarify the first one to say, “more EMR failures by those trying to get EMR stimulus money” For those not going after the EMR stimulus money “windfall,” I predict we’ll have an increase in successful EMR adoption. Of course, Evan’s final point is a little self serving since he’s the CEO of a “hybrid EMR.” Although, I do think the EMR software companies (hybrid or otherwise) that stay focused on a physician’s productivity and reimbursement will be the big winners in the long run.

Back to the study by ONC, I’ll be interested to hear who wins the contract for this work, if we’ll ever be a part of the study and if we’ll get to see the results of the work that’s done. Looking through the list of interested vendors, I wonder if any of them really have any expertise in EMR or healthcare.

Interview with SRSsoft EMR CEO Evan Steele

Posted on October 1, 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’ve been finding what SRSsoft and in particular their CEO, Evan Steele has been saying about the ARRA EHR stimulus money on the SRSsoft blog called EMR Straight Talk really interesting. They’re an EMR company that I think has taken a different approach to marketing their EMR software. So, I thought it would be interesting to interview Evan on a number of relevant topics related to his EMR and the ARRA stimulus money.

Let me know if you like the following interview and I’ll think about doing more of them.

Describe what you define a hybrid EMR is.

Hybrid EMR satisfies the demands of high performance physicians by providing process efficiency. This benefit is delivered through click minimization, ergonomic design, product flexibility and a non-proprietary, open software platform. The hybrid EMR is not exam note-centric, and therefore spares physicians the onerous data entry requirements associated with traditional EMRs.

Can you describe 3 features and how it’s done in a hybrid EMR versus a traditional EMR?
*Generating a ePrescription with only two clicks
*Reviewing a message, viewing the attached document (like a lab or a radiology report) and signing the document with one click.
*Generating a fully templated exam note from anywhere within the software with three clicks.

Will SRSsoft be participating in the ARRA EMR stimulus money program?

It all comes down to the meaningful use requirements – although, after 3 rounds of meaningful use discussions, the requirements are likely not to change significantly.  As listed in the most current “Meaningful Use” Matrix, they are quite onerous for physicians. The cost associated with reduced productivity that a high-volume, high-performance physician would incur by entering the data to meet the meaningful use requirements dwarfs the incentives being offered and the relatively small penalties which starting six years from now (in 2015).

How come I don’t see a CCHIT certified badge on your website?

CCHIT reached the apex of onerous requirements when it released its 2009 certification criteria which contained nearly 500 items. Since its formation in 2004, CCHIT has layered on more and more criteria each year, and vendors have been on a wild goose chase to program those requirements.  Most of these feature requirements are not used or valued by busy physicians. SRS made a conscious decision not to follow the herd and, instead focuses on features that busy physicians need to make their practices efficient so that they can manage their costs and take better care of patients.  The result is a highly ergonomic, usable EMR that actually meets the needs of high-performance physicians.  Sales have skyrocketed.

Interestingly, the new certification will be an HHS badge and not a CCHIT badge and there will be multiple certifying bodies. In addition, the HHS certification criteria will be only those features that are required to meet the meaningful use requirements.  CCHIT actually eviscerated their almost 500 requirements and announced that 88 requirements will be needed to meet meaningful use guidelines.  I feel sorry for the scores of companies that programmed hundreds of complex features only to find that they were unnecessary (all the while not focusing on what physicians actually want).  I also feel sorry for the physicians that paid for those unnecessarily complex products.

Listening to the voice of the physician is a winning strategy and always will be.

How did the HIT Policy Committee react to your “Voice of the Physician” petition?

Lynn Scheps, our Vice President of Government Affairs, went to Washington to present the “Voice of the Physician Petition” to the HIT Policy Committee in person, because we felt it was so important that the decision-makers understand how private-practice, community-based physicians view the expectations being placed on them. The government’s goal of widespread EHR adoption cannot be accomplished without buy-in from the physicians themselves, and the fact that a relatively small company like SRS could generate such a sizeable response in a short time, with minimal outreach efforts, indicates the deep level of concern among physicians. The “Voice of the Physician” petition was signed by SRS clients and non-clients alike, and over 150 of them feel so strongly that they took the time to submit additional comments.

As the petition was presented to the Committee, a number of members were observed browsing through the comments. I can only hope that all of the members take at least the amount of time to read them as the physicians took to write them. I think they will find them very insightful.

Is the government wasting their $19 billion in EMR stimulus money?

The government actually set aside $36 billion, anticipating $17 billion in costs savings from EMR adoption, so the net cost would be $19.2 billion if all goes as planned.
They won’t be spending it if doctors choose not to participate or if they are not able to meet the onerous meaningful use requirements (similar to their experience with the PQRI program.) In the latter case—a likely scenario—in which high-performance, high-volume physicians purchase the required software but are unsuccessful, the doctors will have wasted their money and the EMR vendor coffers will have been filled.

You claim increased productivity using SRSsoft.  Where does the productivity come from? Have you had any practices that haven’t had an increase in productivity?

It’s such a luxury to wake up in the morning, come to work and have 18 programmers who can carry out the vision of focusing purely on what physicians need to make them more productive. Productivity stems from automating processes and organizing information. The fewer clicks and less mouse movement it takes to store and access information, the better the result. Our mantra for the past 12 years is “DO NOT SLOW PHYSICIANS DOWN.”  We found that by automating the myriad of repetitive, labor intensive processes found in every medical office, massive productivity increases result every time. It’s just like any other business process improvement software that replaces antiquated paper workflows. It’s a big win if software directly addresses process improvement while positively impacting a company’s executives (in this case, the physicians). Employees become more productive and the executives benefit from having key critical information at their fingertips.

There is a huge difference when a company is not shackled by someone else’s vision (e.g., the government, certification bodies, etc.) of how technology should be applied in a medical practice.  Plain and simple: physicians know what they want for their practices and know what works, non-physician bureaucrats do not.

Every EMR company will claim that they focus on process and workflow improvement in medical practices. Not true! Just count the clicks required for simple, repetitive tasks and it becomes crystal clear what happens when companies cater to non-physician stakeholders. Any company can slap together a lab management module, an ePrescribing module, a messaging and tasking module, or a forms module, but it takes tremendous focus and dedication to integrate it tightly with the core software, make it intuitive to use and make it ‘fly’ in a medical practice. Clicks are the biggest source of lost productivity for physicians using EMR. Most private practicing physicians’ income is tied to productivity, so time is money. Therefore, every click costs money.

If EMR vendors focused 100% of their resources on usability, click-reduction and module integration rather than on hundreds of pie-in-the-sky features dreamed up by bureaucrats, adoption would flourish.

What are your thoughts on open source and open APIs in EMR software and how does your OpenPath technology fit into it?

SRS is a strong proponent of open architecture software.  At SRS, we have built the web right into the core parts of the software so anyone can customize it. They don’t have to rely on SRS to customize the software for them. SRS has many clients that have talented, tech-savvy employees who have used our Software Development Kit (SDK) to customize their SRS in amazing ways.

SRS spent a great deal of time developing its OpenPath™ technology so clients aren’t beholden to us for customizations. Many other vendors do just the opposite and require that clients go through them for customizations. It’s analogous to buying a house and then a few years later, when you want to add a new room, you find that you are handcuffed because you have to go to the builder for the addition and accept his design, his pricing and his timing. If SRS were the builder, we would be happy to build the addition, but you would also be free to choose your own builder, your own design and negotiate pricing and timing. That level of client control is sorely lacking in the EMR industry. For example, we have many prospective clients that have a strong desire to switch from an antiquated, traditional point-and-click EMR to SRS and they are petrified to ask the legacy vendor for assistance in moving the data from their system to ours. Over the short term, this is good for the legacy vendor, but it puts the medical practices’ long-term IT plans in jeopardy – they feel like the legacy vendor has put them in a straightjacket.  With the SRS OpenPath™ SDK, our clients have a document with our database schema clearly outlined so as to facilitate customizing our software or having the option to migrate to another software package should they want to at any point in the future.

What other customizations have been done by end users using your OpenPath™ technology?

SRS and its clients have created a myriad of customizations that leverage our OpenPath™ technology. Here are some examples:
*Using the SRS software development kit (SDK), a 100 provider primary care group completely rewrote their Clinical Summary web page that resides on the SRS desktop. In addition to a detailed summary of a patient’s key clinical information, the new Clinical Summary includes custom alerts and information fetched from their practice management software database (e.g., balance, alerts when balance is past due, etc.).
Ophtalmology-Clinical-Summary-Screenshot
*A solo practicing ophthalmologist had SRS rewrite the Clinical Summary to match, perfectly, his thought process when reviewing clinical information before an exam.
*A 52 provider multi-specialty group had SRS customize their Clinical Summary so that with one click, they log the date and time a dictation was completed. They also created a custom transcription exception report that flags all transcriptions that have not been received within a certain timeframe.
*A 20 provider orthopaedic group also leveraged the SRS SDK to self-create a “PowerTab” that pulls up a fully integrated web page (right inside SRS) where the physician orders prescriptions for the patient which is then sent to the in-house drug dispensary.

What do you see happening in the future with EMR software?  What’s going to happen and what’s likely to happen?

Physicians are going to get hurt when they are “incented” to buy systems without being fully aware of what will be required and the lost productivity that they will incur. This will lead to non-use, and the consideration and purchase of more usable alternative solutions in the future. This is exactly what we are seeing in the marketplace today with legacy point-and-click EMRs.

Is EMR and HIPAA part of your daily reading?  If not, why not?  Lol

Of course, I love the writing and commentary!

EMR Company Blogs

Posted on July 11, 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.

Many people don’t even realize that this website is a blog. The fact is that blogs have become so powerful that you can create an entire website powered by blog software and no one would know the difference. As you can imagine I’m a huge fan of blogs. What readers of this blog don’t realize is that beyond this blog I actually have 3 other major blogs and probably a dozen other minor ones.

Blogs have so many benefits that I won’t even begin to list them. However, I still find it amazing that I haven’t spent a penny on marketing this blog (although I did just do my first advertising trade) and yet I’m getting about 5,000 pageviews a day. On some of my other blogs with larger niches I reached over 47,000 pageviews in one day with $0 spent on marketing. It still astounds me how much traffic a well done blog can create.

As such, I’m always a fan of EMR companies that do a good job with their EMR company blog. Let me give you two examples of EMR company blogs that I think do a pretty good job on their EMR company blogs:
Straight Talk – A blog by Evan Steele the CEO of SRSsoft, a hybrid EMR company
XLEMR – An EMR company blog

Now these examples are far from perfect. I could quickly create a long laundry list of changes that wouldn’t be hard to implement that would improve their blogs substantially. They’re missing even more opportunities. However, what I like about these two blogs is some of the content they’ve created and the fact that they’re engaged in the discussion of EMR. A well done blog can not only market your EMR software, but can also be an amazing way to engage with your customers both future and current.

I’m sure there are a lot of other EMR company blogs. If you know of one, please let me know about it in the comments. I’d love to see some of the other EMR companies that are out there in the blogosphere.

More EHR Company Lines

Posted on June 4, 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 previously wrote about the reasons EHR companies use to get you to buy an EHR Now. Today I came across a post that’s really similar to my idea. The post is by Evan Steele, CEO SRSsoft and it’s entitled “From EMR Vendors: Fact or Fiction?” I think that Evan does a really good job covering some of the misconceptions/lies that are being spread by overzealous EHR salespeople in regards to the HITECH act’s EHR stimulus money. My favorite one was this:

“You must act now—buy an EHR now because in order to get the money from the government, you must be using the EMR by 2011.” As with used-car salesmen, “buy now” is always popular, but you actually have until 2013 to implement and potentially qualify for the lion’s share of the incentives.

Even if you do not implement until 2014 (5 years from now), you would still be eligible for almost 80% of the money.