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EMR and Health IT Development – Interview with Chetu

Posted on April 25, 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.

Craig Schmidt - Chetu
Craig Schmidt is the Director of Global Sales for Healthcare & Pharmaceuticals at Chetu. Craig’s focus at Chetu is understanding the top healthcare industry challenges, creating relationships with HIT leaders and developing Information Technology solutions to address those challenges. Craig has, for over 15 years, held a variety of Sales and Sales Management positions with increasing responsibility in the Healthcare and Information Technology Industries.

Tell us more about Chetu and your work in the healthcare market.

It would not be an exaggeration to say that Chetu has experience in nearly every section of Healthcare IT. In our 13 years we have developed solutions for Providers, Payers, HIT Vendors and others. Just a few of the things with which we have helped customers include: complete EMR and Practice Management design and development, ePrescribing, Drug Database integration, Revenue Cycle Management (835/837 & 270/275 engines).

When does someone in healthcare look to Chetu versus doing the work in house?

The two main reasons are: they do not have the particular HIT experience in-house & they do not have enough “bandwidth” to develop in-house and do not want to hire and train permanent staff.

What’s the most challenging thing about developing applications in healthcare?

Healthcare in general and Healthcare IT are bound by many Federal, State and other rules and regulations, e.g., Meaningful Use, Affordable Care Act, HIPAA, etc. There are also a variety of standards for interoperability such as HL7, CCD/CCR.

Do you mostly do one off projects or long term contracts with your clients?

We strive to be the “Back End, Long-term” IT Partner for our clients. We offer complete solutions from application development and support to maintenance and management of applications and systems. In Healthcare we have many (over 60%) clients that have been working with Chetu for multiple years. Many of these have been with Chetu for over 5 years – which is very long-term in this market

What’s your view on SaaS vs. in house client server applications? Do you have a preferred technology stack? What do you see being used most in healthcare?

For the past several years organizations have been rapidly moving to the “Cloud.” And, there are obvious advantages for being cloud based. However, client server applications have advantages of speed and stability that can’t always be achieved with SaaS. We are now seeing a slight movement to applications that are hybrids – combining the best of both approaches.

In healthcare, there is no clear preferred technology stack. It is all over the place. We have worked in .NET, HTML5, Java, PHP, Native Mobile Apps (iOS, Android), Python, C++, Foxpro, VB, Mirth. Cobol, MUMPS and many more. Healthcare IT has traditionally seen a very fragmented approach. Chetu has the great advantage of being agnostic. We can and will work with nearly any platform or tool.

EMR usability (or lack thereof) has been a major topic of discussion. How do you manage this with your EHR clients?

We have had the opportunity to work with dozens of different EMRs; ambulatory and hospital based. Many of these EMRs are the product of individual physicians or physician groups that are unhappy with their current EMR and have not seen any existing EMRs that meet their usability needs. They have come to us with their ideas about developing an EMR from scratch. We have developed ENT, Ophthalmology, Plastic Surgery and other specialty focused EMRs stemming from this issue.

What are you seeing happening with mobile in healthcare?

There is a tremendous rush to mobile in Healthcare right now. Over the past several years our Healthcare mobile development has grown tenfold. There are many, many great mobile applications developed with patients, physicians, nurses, home health providers and others in mind. These apps have been and will continue to make providers, payers and patients lives easier and make delivering healthcare more efficient and productive.

You’ve worked with a lot of the various healthcare standards. How do they compare to the standards you work with in other industries?

There really is no parallel to the standards that guide healthcare in other industries. From my limited experience I would say that the Banking/Financial industry comes closest. But even then the amount and complexity of the standards are a fraction of what is found in Healthcare and Pharma.

Tell us about some of your work on the major hospital platforms like Siemens Soarian, Meditech and Epic. Is it a challenge working with these large companies?

These large companies have invested millions of dollars building and improving the very complex systems. So, they are rightfully concerned and selective about how and who is allowed to work in their systems. It can be a challenge, but not impossible to work with these companies. An added challenge comes from the hospitals themselves. There is the attitude that these systems are so unique that only company trained personnel have the capability to work in them.

Chetu, having worked in the Soarian, Meditech, Epic, Cerner, McKesson and other hospital platforms understands that the underlying technology in all of these systems are the same or very similar. Although each system may have unique capabilities – we recognize that the goal is the same for each. And, in getting past the UI or getting “under the hood” so to speak, we see mostly the same technologies at work.

What are the most innovative healthcare IT projects you see out there that you like working on?

Right now we are seeing a rush to capitalize on the tremendous amount of data that EMRs are generating. Data analytics using this great resource is helping pharmaceutical companies, scientists and researchers, Accountable Care Organizations – nearly everyone on the healthcare continuum provide better and less expensive patient care. This is an area that is in its infancy but we see growing rapidly.

What types of data analytics projects have you done in healthcare? Do you do just the programming component or can you do every part of a data analytics project?

Chetu has been involved in numerous healthcare analytics projects. We have helped our customers with data warehousing, data mining, OLAP, business analysis, automated report generation, multi-dimensional information “cubes”, custom reporting solutions using tools like Informatica, DTS / SSIS, Datastage and SSRS, SSAS, Cognos, Microstrategy, Crystal, OBIEE.

We have developed solutions across the complete data analytics process. From data mining and ETL to data cube and data modeling and report generation we have the experience and the people that can handle nearly any healthcare analytics project.

Full Disclosure: Chetu is an advertiser on EMR and HIPAA.

Top Five ICD-10 Pitfalls – “Top 10” Health IT List Series

Posted on December 30, 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 is going to be the last day looking at other people’s “Top Health IT Lists” since tomorrow I think I’ll create my own Top 10 Health IT 2011 List and then for the New Years I’ll see about doing a Top 10 Health IT in 2012 list. However, today let’s look at something that will likely make the Top 10 2012 Health IT issues: ICD-10. Government Health IT recently wrote an article what they call the Top 5 ICD-10 Pitfalls.

1. Reporting: I’m sure that many think that ICD-10 is just going to happen and be fine. They’ll assume that their reports are just going to work with ICD-10 since they worked with ICD-9. Don’t be so sure. Test the reports so you know one way or another. Diving a little deeper beforehand is a lot better than learning about the problems after.

2. Overlooking impacted areas: Much like an EHR implementation, don’t forget the other people that are affected by ICD-10. Involve everyone in the process so that they can share their concerns so they can be addressed. Plus, by having them involved you’ll get much better buy in from the staff.

3. Teaching old dogs new tricks: ICD-10 is a different beast and will require significant training even if you have an expert ICD-9 coder with years of experience. Don’t underestimate the cost to train your coders on ICD-10.

4. Preparing for impact on productivity: The article mentions Canada’s loss of productivity during their implementation of ICD-10. Do we think we’re going to be any different? Remember also that productivity loss can come in a lot of different places (which is kind of a repeat of number 2 above).

5. Communicating with IT vendors: It’s one thing to trust that your EHR and other health IT vendors are prepared to deal with ICD-10. It’s another to blindly follow whatever you’re being told. Remember at the end of the day it’s your organization that will suffer if your health IT vendor is not ready. I like to use the phrase, trust but verify.

Be sure to read the rest of my Health IT Top 10 as they’re posted.