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EMR Jobs, Olympic EMR, EMR O/S, EHR Dictation, and EMR Purchasing

Posted on May 27, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

You can see we have a jam packed weekend Twitter round up. There were a lot of interesting topics being discussed this week in healthcare social media. As usual, we’ll do our best to provide some of the more interesting tweets. Not to mention we’ll add a bit of our own commentary to provide some background and understanding about the tweets as well.

Now without further ado, a few EMR and healthcare IT tweets for your reading pleasure:


I saw this job tweeted. I didn’t necessarily find this job all that unique, but it’s an interesting contrast to see all the EMR jobs tweeted out, posted on the EMR and EHR Job board, and posted to the Healthcare Scene LinkedIn group. Compare that with experiences like this one posted on EMR Thoughts. It’s such a conundrum that so many don’t have jobs while many can’t find qualified EMR talent.


GE Centricity has been the choice of the USOC for a few years now. I’d love to go to London to see it in action first hand. Anyone want to sponsor that? I do LOVE watching the Olympics!


Does operating system really matter anymore? I’m finding that the operating system is mattering less and less. Ok, with most client server products you need a certain operating system, but with most well done SaaS EHR it doesn’t matter. I’ve reinstalled a few computers recently myself and all I do is reinstall my browser, hook up dropbox and I have probably 90% of what I need.


The sub head on the article describes the link of EHR and dictation better: “Doctors who dictate their clinical notes before they’re entered into an EHR have lower quality of care scores than those who type or enter structured data directly into the EHR, according to Partners Healthcare researchers.” I’m always suspect of these studies. Particularly because they usually have a much narrower focus, but provide for a great headline.

Plus, I think it’s still early on NLP (natural language processing) and CLU (clinical language understanding) technology that will extract more data from unstructured text in real time to support quality care measures. Let’s look at this in 3 years and we’ll see if voice and narrative text is common place or gone the way of the dinosaurs.


I’m sure that this number is lower than many ambulatory EMR companies expect. It’s certainly much less than ONC would predict. I personally predict the number is a bit low. I expect we’ll see a few more EHR purchases than 7-8%, but probably not more than 15%.

Meaningful Use Attestation Issues for EHR Companies

Posted on October 26, 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.

Many of you have probably read about the problems that GE Centricity EHR software had with a few of the meaningful use guidelines. If you haven’t read about it, go and check out that link to read Priya Ramachandran’s post about what happened. Plus, you can read a GE representative’s additional comments and clarifications. I actually had the chance to talk with GE in person at MGMA about these issues. While there’s no doubt that GE is taking heat for these problems (and they should), I personally believe it just highlights a bunch of possible problems with meaningful use attestation and raises a lot of unanswered questions.

My first premise is this, “If a large EHR vendor that’s intimately involved in the meaningful use rule creation process can mess up some of the meaningful use guidelines, how many other EHR vendors are going to do the same?”

This is a serious issue. Imagine you’re using an EHR software that runs into this problem. How quickly will that EHR vendor respond? Will they even know that they have an issue with meaningful use attestation before it’s too late? At least GE caught it early and can now address the issue for all of their doctors that are affected and get their EHR stimulus money. Even if they don’t get it resolved this year (which wouldn’t be a good outcome), then they do have next year which pays the same amount of money.

I’m not sure the same outcome will occur for some doctor who instead of proactively realizing a meaningful use attestation mistake gets “caught” with some mistake in some sort of meaningful use attestation audit. I guess we’ll see how those play out, but I imagine it won’t be as pleasant for MU attestation issues to be caught in an audit.

Plus, I think there’s very little doubt that there are other EHR companies which haven’t implemented the meaningful use attestation requirements quite right. I’m sure it’s just a matter of time before we hear of more issues. In fact, I have a feeling that EHR vendors that are reading this post are ready to forward it to their meaningful use expert/development staff to evaluate if they’re at risk for such a problem. The answer is that many EHR vendors likely are at risk. I imagine part of the risk is due to laziness in implementing the meaningful use guidelines (I guess they haven’t been reading our Meaningful Use Monday series), but the other part is that it’s not like meaningful use is that simple. It’s not quite the tax code, but it’s not always that straightforward.

This incident does bring up a whole new set of questions for CMS to answer. For example, what happens if a doctor attests to meaningful use and then realizes that for some reason (their fault, their EHR vendor’s fault or some other situation) they actually didn’t meet the meaningful use guidelines as required? Do they need to show another 90 days of meaningful use? Do they need to return their EHR stimulus check? Will CMS take the money back out of future payments? Can a physician go back and fix any mistakes that were made (this will likely depend on what went wrong)?

I’ll be keeping an eye on this discussion and we’ll do our best to post what GE and others learn from CMS when it comes to mistakes in meaningful use attestation. I have a feeling this could get a little messy. Based on my own experience with CMS in the past, I have a feeling they’re going to be as lenient as they possibly can be. However, they’re still going to have to follow whatever legal guidelines they’ve been given.

One other question that still makes me wonder is why didn’t the CCHIT EHR certification catch this mistake too? This would obviously require a pretty good dive into the EHR certification guidelines and the implementation of these guidelines. To me it highlights how little value the EHR certification process adds to the EHR market.

I have a feeling that this post has people like Dr. West enjoying their Meaningful Use Freedom even more.

EMR Companies Holding Practice Data for “Ransom”

Posted on January 19, 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.

UPDATE: JamesNT sent me an update to his comments in this post. It’s interesting to see the EHR vendors’ evolution on the question of openness.

JamesNT wrote a really interesting forum post recently about how a number of EMR vendors are holding doctor’s patient information “ransom” (his word) from them. Here’s his whole description and he even names a few EMR vendors and the challenges related to getting the EMR data out of their systems:

To many EMR’s lock up the practice’s data and hold it for ransom. The data entered into an EMR belongs to the practice, not the EMR. It is not fair for EMR’s to not provide ways to interface or export data from the database. If a doctor wants to hire an IT person or developer such as myself to write custom reports or export data from the EMR, then it should be possible. Consider the following examples:

Amazing Charts: They use SQL Server 2005 Express as their database but they remove the built-in Administrator account from the SQL instance and change the SQL Server SA password. This means anyone hoping to interface or export data is at a loss – and Amazing Charts will not share the SA password. Amazing Charts also does not publish a database diagram.

eClinicalWorks: Overly complicated database. Does not publish mySQL password (you can find it, though). Does not publish database schema. If you ask them for help, they want to charge $5000 to build an interface.

PODMED (now TrakNet): Kudos for sharing the SQL Server SA password – but does not offer a published database schema.

GE Centricity: Database schema available – if you are willing to tell a bold-faced lie to someone to get it.

Medinotes: Even after sunsetting the product, Allscripts refuses to give out the ODBC driver and database password.

MD Logic: Uses a pathetic HL7 file interface. You can place only one patient demographic in each file – so if you have 200 patients to update that means sending 200 files.

Officemate: Uses SQL Server and it is easy to get to their database – but they do not offer the schema.

I find this situation deplorable. Every EMR should make it easy to get to the data and not try to hide it or charge outrageous amounts for an interface. Seriously – who here would pay $5000 to make an interface?

Of course, he’s just highlighting the EMR software he’s used. I’m sure there are hundreds more EMR vendors like this.

Then, there’s also EMR vendors that don’t hold your EMR data for ransom like Medtuity. Here’s what Matt Chase from Medtuity said about what they provide to users of their EMR:

At Medtuity, we provide open access to the SQL database. We also provide an export facility under Options. You can export each and every encounter, years and years worth if you wish, to a PDF file for each visit, neatly labeled with the date of the encounter and pt’s name to keep it from colliding with other PDF documents. You can also export a CCR for each pt.

We also have our own proprietary format in XML. For a group with a huge number of records, they may wish to hire a consultant to write a program to consume that xml into a new system. Our xml format is most complete and includes the stuff you would not usually wish to transfer (the audit trail on that chart, for example). But it is there. We also have CSV format, but let’s face it, you cannot export sophisticated data in a CSV format. It’s fine for demographics.

How “liquid” is the data in your EMR software? This discussion is a very important one between you and your EMR vendor when you’re selecting an EMR. Make it part of your EMR contract.

More EMR vendors need to voluntarily step up to the plate and provide this type of EMR data liquidity.

$100 Million in Interest Free EHR Loans from GE

Posted on June 20, 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.

Today I came across this coverage of an announcement that GE Capital will be providing $100 million of loans to “accelerate adoption of electronic health records (EHR).” The loans from GE will carry no interest until the institutions obtaining these loans begin receiving government money, typically in 2012.

Does anyone see a problem with this?

GE Capital isn’t giving EHR loans to you because they are doing charity work. They are a business and they know that in 2012 a large number of these loans will start earning them a bunch of interest. This could easily happen because a doctor’s office was unable to implement the GE Centricity EHR software in the alloted time frame or maybe they couldn’t get GE Centricity EHR to show meaningful use (through GE Centricity’s fault or their own). Either way, GE is banking on the fact that many of these loans won’t be repaid. What better debtors could they have than high earning doctors?

Doesn’t this sound a lot like those 0% interest credit cards? The credit card companies have been making a killing getting people into debt over their head and down the road charging incredible interest rates when a large number of the people can’t repay. Seems like GE Capital is trying to do the same with this EHR financing plan. Of course, if someone does pay it off, then GE health is still making a nice chunk of money from selling an expensive EHR platform.

There are so many different EHR pricing models and financing options available. EHR selection should focus on what’s best for the office. I’ve never known EHR financing to be a problem with purchasing an EHR. There are lots of options out there.

People who choose to go with a no interest loan in the hopes that the EHR stimulus money from ARRA will repay those loans are playing with fire. No doubt some people are going to get burned.