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Build Your Own EHR, EMR Patient Satisfaction, and Social Media in EMR

Posted on August 18, 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.


It looks like Dr. Rob Lamberts is crazy. It’s nice of Farzad to support him. I think Dr. Lamberts response to Farzad was enlightening as well: “Thanks. More endurance than luck, though.” He’s right. None of the individual components of an EHR are technically very hard, but the number of components you have to build is HUGE.


This is a perception thing for sure. We are trained that technology improves whatever it touches. So, when a patient sees a doctor with an EMR, they believe it will mean better quality care. Reminds me of the “Got EMR?” campaign I talked with people about 7 or 8 years ago.


I question the value of having a patient’s social profile in your EMR. However, I think the concept of looking at your EMR as a CRM for patients could become a very important concept over the next 5 years. I think it will take more than just putting in a patient’s social profile though.

EMR Under Construction (Implementation) Sign

Posted on September 22, 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.

I saw a tweet of a picture from the front desk of a doctor’s office that’s implementing an Electronic Medical Record in their office. I’ll embed the image below, but since it’s a little hard to read, here’s the text from the sign:

UNDER CONSTRUCTION
Pardon us while we improve your visit.

In order to provide you with the most efficient visit possible, MedExpress is installing an EMR (Electronic Medical Records) system.

This technology enables MedExpress to provide you even more convenient care, and ensures that your records will hold more accurate documentation, in a safer, more concisely stored location.

By 2012, it is federally mandated that healthcare providers initiate electronic health records. MedExpress is keeping up with the current health information technology. In addition, this promotes “green practices” to lower our paper usage.

Please bear with us, as we are currently in training with this system.

This sign brings up a lot of interesting talking points. The first one that hits me is back about 5 years ago when I heard someone propose (mostly jokingly) the idea of having a “Got EMR?” sign for offices. This isn’t quite the same, but does use some of the same idea of the value of EHR to patients.

I’ll set aside the part of the sign that talks about the government EHR mandate since we’ve talked about it plenty of times before (and how it’s not really a mandate). I’ll also avoid commenting on the “green practices” section of the sign, but it’s amazing how green has infiltrated marketing.

Instead, does anyone else find it amazing that the anticipated slow down for this clinic’s EHR implementation was so big that they typed and printed up a sign explaining the slow down? Maybe it’s just during the time that the doctors are training and not actually a slow down that has to do with actual use of the EHR after training. Although, I know many EHR vendors that are now rolling their eyes when they hear about the EHR training and implementation time and its effect on physician productivity.

I can’t help but wonder which EHR software this clinic is implementing. That would be interesting to know.

Doctors and Patients as Customers

Posted on May 11, 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.

I’m not sure where I came up with the following idea. I had stored it in my list of future posts and I didn’t have any reference for it. So, if I forgot to acknowledge who provided me the comment I’m sorry.

This is the comment that I received from someone, “EMR provides benefits to the patient (better patient care) and payers (cost savings).”

Of course, we could argue these two points until we’re blue in the face. In fact, feel free to argue either point in the comments below. That will be interesting. I’ll just say that there’s the potential for better patient care and the potential for cost savings to the payers. Whether the potential will become a reality will be a fun discussion in the comments.

When I saw the above statement I started to consider the impact of “better patient care” from a doctor’s perspective. Better patient care seems like something that should benefit the doctor. Pretty sad to consider that the customer (patients) getting better service has little effect on a doctor’s business. Certainly there are some hyper competitive markets where this isn’t true. However, I believe that most patients (myself included) aren’t very good (shall I say knowledgeable) enough to be able to distinguish between good patient care and great patient care. Sure, there are outlier cases, but what measures do patient use to distinguish the quality of care their doctor provides?

If you assume the above statement of EMR software providing better patient care (Clinical Decision Support, Drug to Drug and Drug to Allergy interaction checking, etc etc etc), then why as patients (customers) aren’t we asking future doctors if they use these features? Maybe a few people are, but there’s far from an outcry of patients leaving doctors who are refusing to use an EMR.

For some reason this isn’t working:
EMR Use -> Better Patient Care -> Happy Patients -> Better Business for Doctors

I’m sure that some will come and say that it’s just not clear that the EMR benefits to patient care are tangible enough for this “customer demand” to occur. I remember about 5 years ago when on the EMR Update forum someone suggested a “Got EMR?” (similar to Got Milk) ad campaign for doctors to advertise the fact that they had an EMR. So, of course this topic isn’t new. Although, it’s still very relevant.

Although, even beyond EMR, I wonder what a company or website could do to help consumers/customers (patients if you prefer) to better evaluate the quality of healthcare that’s being provided. I don’t have any ideas on this regard. I’m as bad as the next person at figuring it out. However, whenever there’s a lack of good information I think there’s an opportunity. As you’ve probably figured out, I’m all about good information and accountability.

2014 EHR Mandate

Posted on January 13, 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.

I have often found doctors talking about the 2014 mandate for adoption of EHR software. In fact, this post was inspired by a bunch of people searching online for the term “2014 EHR Mandate.” I think that they found my site because I previously did this post about Obama’s goal of Full EHR adoption by 2014.

If I’m remembering right, this was actually just an extension of Bush’s goal of having 100% EHR adoption by 2014. Obama took Bush’s original EMR aspiration and kept it going.

Although, I do have a real problem with people who like to call it an EHR mandate. It’s really not a mandate. A mandate for me implies that you are required to do it or there’s some grave consequence to it. It’s not like you’re going to be thrown in jail for not using an EHR or not be able to practice medicine if you don’t use an EHR (although some have hinted at this idea). Certainly the HITECH act has provided some Medicare penalties that could be considered a grave consequence to not adopting an EHR. Although, when you consider this example of the Medicare penalties it doesn’t look all that grave of a concern to me.

What other penalties are there to not adopting an EHR by 2014?

There certainly are other potential issues with not adopting an EHR that are worth considering:
1. Ability to Sale Practice – I don’t think we know all the details of how this will play out, but be sure that many younger doctors are going to want to purchase a practice that has an EHR. The common thinking I’ve seen going around is that a practice will be more valuable if it is electronic.

2. Government Mandated Reporting – While the government can’t really mandate the use of an EHR, it seems reasonable that the government could require certain reporting be done. Of course, you could manually do this reporting, but at some point the manual way will be much harder than using an EMR where the reporting can be automated.

3. Reimbursement Requirements – At some point the insurance companies are going to require their data electronically. So, if you’re going to want to keep accepting insurance, then you’re going to need to be electronic. I think the insurance companies are still watching and waiting to see what happens with meaningful use before they decide how they’ll approach it. However, you can be sure that they want more data and electronic is the way to make that happen. Of course, you could always go back to cash pay if you don’t like it.

4. Patients – It hasn’t happened quite yet, but get ready for a new patient base that wants their doctor to be electronic. No, you won’t have a “Got EMR?” sign outside your office to market to patients like we once talked about on EMRUpdate. It will come in more subtle things like the ability to schedule an appointment online. The ability to request refill requests electronically. Not having to carry (and possibly lose) their prescription to the pharmacy and then wait for it to be filled. Not having to fill out the same paperwork over and over and over again. Once patients get a real taste for these features, they’re going to be more selective in the doctors they choose to use.

5. ROI for Your Practice – There are plenty of arguments for and against the use of an EMR from an ROI perspective. I personally side on the positive ROI side based on this list of potential EMR benefits. Certainly it takes a smart EMR selection process and a well done EMR implementation to achieve the ROI, but I know a lot of people who’ve saved a lot of money thanks to their EMR. Add in things to come like doctor liability insurance discounts and the ROI will get even better over time. I know one practice who was having tough times financially. Their implementation of an EHR helped to solve some of those financial issues.

I’m sure there are plenty of other reasons that could “force” you to move to using an EMR. Of course, this CDC study on EHR adoption says Physician EMR use is at 50%. Although, in that link I use their study to show that it’s probably closer to 25% EHR adoption. Either way, we still have a long way to go to achieve Obama’s dream of 100% EHR adoption by 2014.