If you haven’t yet seen this video that DrFirst created for HIMSS 2012 and the HIMSS Healthcare Hero, then you need to watch it now. It’s a really beautiful video: http://bit.ly/AnNvzU

After seeing such a well made video, I definitely wondered what was up DrFirst’s sleeve at HIMSS 2012. So, I reached out and today I had the chance to talk with Cam Deemer President of DrFirst about the transition that’s happening at DrFirst.

I think that most of us have known DrFirst as an ePrescribing company. Since about 2004 they have been extremely focused on the ePrescribing area and that shows in the fact that DrFirst is the “ePrescribing Inside” 230 EHR companies. That’s a really impressive number and includes a client list with such names as GE and Greenway.

DrFirst is ready to make a shift which they’ll be talking about at HIMSS in Las Vegas. What I think makes DrFirst’s ePrescribing platform really interesting is that they can provide it using the DrFirst interface or an EHR vendor can customize it to their liking using a series of API calls. It takes a unique company and a unique set of skills to be able to do this effectively. Now imagine they provide these same functions and features across a whole array of EHR related products and services. By doing so, DrFirst becomes a really interesting EHR Platform.

You can find DrFirst at HIMSS to get the entire list of the products and services that they’ll be offering to EHR software vendors beyond just ePrescribing. However, I was really intrigued when they talked about their EHR platform providing compliance programs, patient education, and even co-pay discounts which help with medication compliance. I wouldn’t say that any of these things on their own are all that interesting. They are however things that a small EHR vendor wouldn’t have the time or the resources to be able to execute properly. For those EHR vendors who use the DrFirst interface, they can be turned on with the flip of an online switch.

Now just imagine a whole suite of other EHR services that DrFirst could provide EHR vendors as well. It becomes a really interesting value proposition. Plus, DrFirst also has a number of interesting solutions in the hospital market that also leverages this platform. Things like medication history for hospitals and a lab platform.

At the end of the day, EHR vendors are going to decide if this is a value added service or not. Many larger EHR vendors are going to develop a number of these features themselves and that should be expected. I just see it as a really healthy thing to have these type of EHR platform services available. Many EHR vendors have been so swamped with meaningful use and EHR certification, it’s great that a third party integration could continue to add real value to an EHR software.

The real challenge for DrFirst is going to be around how well they integrate these new EHR service offerings into the various EHR software vendors. If the integration is clean and adds value, they’re going to do very well. If it’s kludgy (a software term for messy) and doesn’t integrate well, then we won’t see much adoption. I think their current 230 EHR integrations are one sign that it will go smooth, but we’ll see.

My next question to consider is how DrFirst could extend their platform next. I can think of a number of mobile health companies that could benefit from the right connection to prescription data or to doctors. I’ll be pressing them at HIMSS to find out what’s next. I hope you will too and come back and share what you find out.

On a side note, I just got the list of things DrFirst is doing at their HIMSS 12 booth. It’s extensive and will be a can’t miss booth. Watch for the details in my upcoming HIMSS 12 exhibitor post.

Full Disclosure: DrFirst is an advertiser on EMRandHIPAA.com.

I’m sure many of you are recovering from the Super Bowl right now. I got exactly what I wanted from the Super Bowl: a great game. I didn’t care too much either way, but I am glad that I predicted the Giants to be the winners. Too bad I’m not a betting man. Although, I guess that’s the trick with betting….but I digress.

Time for my regular weekend round up of interesting things happening in the healthcare IT and EMR twittersphere. We’ve got some really interesting tweets this week. Here we go.

@NateOsit We also have a webinar of @eCollab12 for those that wont’ be able to make it to #HIMSS12.ecollab12.eventbrite.com #hitsm

— Leonard Kish (@leonardkish) February 3, 2012

When I created and posted my list of HIMSS 12 sessions, they hadn’t created the agenda for the eCollaboration Forum at HIMSS and so I couldn’t add any sessions. However, the eCollaboration Forum at HIMSS 12 agenda is up now, so check it out. I know there are a number of sessions I’m going to add from the forum. I also love that they have the online option linked in this tweet for those not attending HIMSS 2012.

Yes, stage 2 #meaningfuluse NPRM will be out before #HIMSS12. meaningfulhitnews.com/2012/01/30/yes… #healthIT #ONC #CMS #hitpol #EHR #EMR

— Neil Versel (@nversel) January 31, 2012

This is really important news. I think a lot of us are REALLY interested to see the final meaningful use stage 2 details. Good find by Neil Versel.

Speaking doctor-to-doctor(s) using healthcare social media bit.ly/wiqbyu #hcsm #hcsmeu

— H2Online (@H2Ohu) January 30, 2012

I’m sure we’re going to continue seeing the trend of more and more doctors gleaning value from engaging in social media. At a minimum doctors are going to start finding more and more new patients using social media including things like physician blogging. A well done practice website and social media effort is going to be really valuable for the doctor of the future.

3 reasons why you should start a blog for your hospital bit.ly/ypCE78 #hcsm #blogging

— Mark Ragan (@MarkRaganCEO) January 30, 2012

Yes, blogging will also help hospitals in a number of ways too. Social media can benefit hospitals, doctors, practices, etc.

@DonRosenthal Tablets are for content consumption. PCs are for content creation. Much more intellectual flexibility w/ PCs. #HITsm

— Erica V. Olenski (@TheGr8Chalupa) February 3, 2012

I was fascinated by this tweet. First because I wonder what changes will make tablets more than just great for content consumption. Second, the idea of PCs being more intellectually flexible.

RT @patientslikeme: “my healthcare data is not nearly as portable/accessible as my financial data.” @jeff_cole #hcsm

— Jacqueline Thong (@jacthong) January 30, 2012

I know there are reasons why financial data is more portable and accessible than healthcare data, but it still irks me that we haven’t overcome those reasons…yet!

REGISTER NOW!!

I’m really excited to announce the 3rd annual New Media Meetup at HIMSS 2012. Last year’s event had an amazing turnout in Orlando and I expect this year’s will be even better with a whole bunch of interesting new and old faces. It’s quite frankly my favorite part of HIMSS thanks to the amazing people who are there.

Everyone is welcome at the event. Maybe you participate in New Media (Blogger, Tweeter, LinkedIn, Facebook, etc) or maybe you just enjoy consuming other people’s media (like this blog) or maybe you’re interested in using New Media for yourself or your company. Everyone is welcome to attend and network with others interested in New Media. I’m excited this year to welcome the #HITsm and #hcsm crowd that will be out in full force I’m sure.

If that isn’t enough reason to attend, I’m really happy to have teamed up with simplifyMD to sponsor the New Media Meetup at HIMSS Las Vegas. The event will be on Wednesday 2/22 7:00-9:00 PM at the awesome BB King’s Blues Club in the Mirage Hotel (A short walk across the street from the Venetian/Sands). That’s right: an open bar, Live Music with a dance floor, and amazing people.

UPDATE: Ozmosis has come on board again this year to sponsor the giveaways at the Meetup. They’ve provided 3 Kindle Fire that we’ll give away to 3 lucky people who attend. Read more about Ozmosis and see pictures of the awesome BB King venue for the event on EMR and EHR.

REGISTER NOW!!

Please register for the event so we know how many to expect. I expect we’ll max out registrations for the event like we did last year, so register now before it’s too late.

Be sure to tell all your Blogger, Twitter and other new media friends about the event so we have the best and brightest in the healthcare IT social media world at the event.

About Our Sponsors

simplifyMD – Founded in 2006 and headquartered in Atlanta, thousands of end-users benefit from simplifyMD every day as they manage millions of electronic health records for physicians in 27 specialties and on two continents. simplifyMD was created specifically to lower operating costs, increase revenue, and provide relief to overworked physicians and administrators. Offering a cloud-optimized SaaS solution for one low monthly price, that costs less than traditional paper folders, makes simplifyMD’s EHR software as easy to buy and implement as it is to learn and use. At simplifyMD we believe the EHR experience does not have to be so complicated. All EHR companies promise efficiency, simplifyMD guarantees it.

Ozmosis, Inc. brings the power of “Social Business” to the healthcare industry. Our collaborative care platform, OzmosisESP, accelerates clinical transformation by enabling hospital systems to coordinate treatment, manage clinical content, deliver virtual training and communicate more effectively.

HealthcareScene.com – The premiere healthcare IT and EMR network of websites. HealthcareScene.com consists of 14 different EMR, EHR and Healthcare IT websites having generated over 7+ million pageviews and includes over 3500 article and 9000 comments. HealthcareScene.com works to promote the interesting independent voices in healthcare. HealthcareScene.com also recently launched a content creation division for third parties.

Influential Networks – Influential Networks is one of the largest networks of healthcare IT influencers combined with a premium healthcare IT ad network. Through the Influential Network, we help both marketers and publishers reach their goals within this powerful niche market. Influential Networks goal is to connect influencers with publishers beyond just advertising.

If you have any questions about the event, feel free to drop us a line on our Contact Us page. See you in Las Vegas!

I recently started to think about some of the implications associated with multiple languages in an EHR. One of my readers asked me how EHR vendors correlated data from those charting in Spanish and those charting in English. My first response to this question was, “How many doctors chart in Spanish?” Yes, this was a very US centric response since obviously I know that almost all of the doctors in Latin America and other Spanish speaking countries chart in Spanish, but I wonder how many doctors in the US chart in Spanish. I expect the answer is A LOT more than I realize.

Partial evidence of this is that about a year ago HIMSS announced a Latino Health IT Initiative. From that today there is now a HIMSS Latino Community web page and also a HIMSS Latino Community Workshop at the HIMSS Annual Conference in Las Vegas. I’m going to have to find some time to try and learn more about the HIMSS Latino Community. My Espanol is terrible, but I know enough that I think I could enjoy the event.

After my initial reaction, I then started wondering how you would correlate data from another language. So, much for coordinated care. I wonder what a doctor does if he asks for his patient’s record and it is all in Spanish. That’s great if all of your doctors know Spanish, but in the US at least I don’t know of any community that has doctors who know Spanish in every specialty. How do they get around it? I don’t think those translation services you can call are much help.

Once we start talking about automated patient records the language issue becomes more of a problem. Although, maybe part of that problem is solved if you use could standards like ICD-10, SNOMED, etc. A code is a code is a code regardless of what language it is and computers are great at matching up those codes. Although, if these standards are not used, then forget trying to connect the data even through Natural Language Processing (NLP). Sure the NLP could be bi-lingual, but has anyone done that? My guess is not.

All of this might start to really matter more when we’re talking about public health issues as we aggregate data internationally. Language becomes a much larger issue in this context and so it begs for an established set of standards for easy comparison.

I’d be interested to hear about other stories and experiences with EHR charting in Spanish or another language. I bet the open source EHR have some interesting solutions similar to the open source projects I know well. I look forward to learning more about the challenge of multiple languages.

Today my inbox was flooded with people congratulating @techguy and @ehrandhit for being part of the Top #HITsm Contributors of 2011. It’s very kind of them to recognize both of my active Health IT Twitter accounts. Officially @techguy was in the Top Individual #HITsm Contributors and @ehrandhit was in the Top #HITsm Organizations. I think @ehrandhit could have gone in organizations or publications, but either way I appreciate the recognition.

I think the comment at the top of the list describes the awards quite well:

By no means is the following lists all-inclusive. It does, however, represent some fantastic #HITsm voices on Twitter who regularly participate in weekly #HITsm TweetChats and share valuable Health IT information.

I always have a bit of a challenge with “Awards.” However, I think that #HITsm made a really great choice when they decided that instead of saying that this list is the “Best” or some other sort of magnanimous statement about the authority of their list, they instead said that these are some quality and valuable voices in #HITsm. No doubt there are a lot of others out there.

For example, I’d have loved to see @nversel and @john_chilmark on the list as well. They don’t use the tag #HITsm that often, but they definitely discuss those topics often on their various social media outlets. There are quite a few others that I could include in this category as well.

One thing I loved about the Top #HITsm Contributor list was how many familiar faces made it on the list. The great part is that there are so many smart minds on the list and social media makes them completely open and available to you. Without social media I’d likely know very few of those people and would have missed out on the tremendous interactions I’ve had with them at many a conference.

Maybe next year I should work with HL7 Standards and make the announcement of the awards part of the New Media Meetup at HIMSS. Might be kind of cool to get to meet all the great people in person. Yes, social media isn’t just about online connections, but taking those connections offline as well. As I often say:

Social Media (and Twitter in particular) is about connecting people!

In true social media fashion, the list of winners is also available as an embed, so you’ll find the list of Top #HITsm Contributor Awards embedded below as well. Here’s to another great year of Social Media in Healthcare.

Yep, the government shutdown talks were in the air again. We heard all about this back in April, we just heard about it again and now they’ve pushed the discussion out until November. I have a feeling that we’re going to continue to hear about it for a while to come. I’m just a passive political sideline observer, but I’d say the chance of a government shutdown is still very little. For all the drama of the media, I have a feeling that the drama won’t actually lead to a shutdown. A last minute deal will be reached…again and again like it did this time and the last.

However, it’s interesting to consider how a government shutdown could affect healthcare IT. In similar situations I’ve seen budgets have usually seen healthcare as an essential function and so they’ve been fine. Although, that’s really talking about the short term possibility of a government shutdown. Who knows what the long term budgets could hold for the government related entities.

Medicare and Medicaid are constantly in the cross hairs of cuts. Most doctors I know talk about how those two government programs pay them the least amount of money. Plus, they talk how many of the cuts to Medicare and Medicaid basically get passed on to them as doctors. I wonder what the super committee that’s required to cut $1.5 trillion of the federal deficit over the next decade will do with Medicare and Medicaid.

We’ve discussed many times the potential impact of the workings in Washington on meaningful use and the EHR incentive money (most think it’s safe).

For those that think what happens in Washington DC won’t really have much impact on healthcare IT, you might want to consider the email I got today announcing the keynote speakers for HIMSS 12 in Las Vegas. Donna Brazile (Democrat) and Dana Perino (Republican) will be on stage for what will no doubt be a spirited debate about the 2012 presidential elections, the political landscape and healthcare reform.

It’s going to be an interesting next couple years to see how changes in government affect healthcare IT and EMR.

I must admit that I’m not much of a book guy. Especially since there’s so much free information available on the internet about just about any subject you could want. However, I’ve been quite intrigued by the number of healthcare IT related books that I’ve seen coming out of late. Here’s a quick roundup of some of the ones I’ve seen.

Getting to Meaningful Use and Beyond: A Guide for IT Staff in Health Care by Fred Trotter and David Uhlman – I’ve been a big fan of Fred Trotter for a while. So, I’m glad he’s working on this book. Turns out the book isn’t even published, but in Fred Trotter open source style fashion, the book is available for free online right now. Of course, they’re hoping you’ll provide feedback.

The HITECH Act Made Easy: A Simple Guide to the Federal EHR Incentive Programs – I had this book sent to me. It’s a short book which I think is good. It tries to tackle not only the details of the Medicaid and Medicare stimulus program, but also has a number of sections on EHR selection and implementation as well. I love it’s question format where many of the chapters are a question and the chapter offers the answer.

Health Information Exchange Formation Guide: The Authoritative Guide for Planning and Forming an HIE in Your State, Region or Community – I haven’t really had a chance to dig into this book yet. It’s brought to you by HIMSS. It’s a pretty thick book which I think describes well the challenge that is forming an HIE. Without reading the book, I’m a little torn just by the subtitle of the book, “The Authoritative Guide for Planning and Forming an HIE in your State, Region or Community.” I guess it’s hard for me to imagine it being the “authoritative guide” when I think we’re still trying to figure out the right HIE business model. I don’t think we’ve found it yet. I guess I should read the book to find out.

Jim Tate’s EHR Incentive Roadmap – Ok, this is an e-Book, but I think it’s as good a value as any hard cover book. So, it’s worth mentioning. I wrote a whole post on Jim Tate’s EHR Incentive book before.

Any other books about EMR, Meaningful Use, and/or healthcare IT that are out that we should know about?

UPDATE: User EHR and Meaningful Use Recommendations from the comments below:
Electronic Health Records For Dummies – Recommended by Nate Osit

Electronic Health Records: Transforming Your Medical Practice, second edition – “This is a book from MGMA and was recommended to me by a coordinator from the REC (Ohio) that I have been shadowing.” – Mary Ellen Weber

I’m pretty sure that many readers of this site haven’t found my new EMR related website called EMR and EHR Thoughts and so you might have missed the post I did about Greenway Medical filing to go public. This is obviously big news for Greenway, but I also think it’s a sign of things to come. I believe that Greenway is likely the first of many EHR companies that we’ll see go public over the next year or so.

I’m sure that many of you haven’t followed the trends of tech company IPO’s and I’m far from an expert on this. However, the IPO window which was generally closed for tech companies now seems to be open after a number of successful public offerings from tech companies. I’m not sure why it took me so long to realize this, but I believe that we’re going to see a number of IPO’s from the larger privately held EHR companies during this period as well (Don’t be surprised if even Epic can’t resist).

Many people in silicon valley are suggesting that we’re in a startup internet bubble that in some ways is similar to the initial dot com (or bomb if you prefer) bubble. When you look at startup company valuations, I believe this is definitely the case. In some similar ways, we are also in an EHR bubble. However, I don’t believe this EHR bubble is going to pop for a couple years.

The obvious reason we’re in an EHR bubble is the EHR stimulus money. That’s going to continue to hold the EHR bubble up for at least another 2-3 years. Then, the real fun (or sadness depending on your position) is going to start to set in. However, until then HIMSS, MGMA and other EHR related conferences are going to have some really great parties.

We’ll see what the post EHR bubble looks like, but I can see a number of EHR companies enjoying the benefits of an IPO during the current bubble.

Two articles I’ve written in the last 24 hours have gotten me thinking that we’ve already entered the post-implementation era of EMRs, even as implementation remains in progress at so many healthcare organizations. While the vast majority of hospitals and physician practices in the U.S. still don’t have full-featured EMRs in place, many are already looking well into the future.

As you may already know, HIMSS on Tuesday released its first-ever survey on “clinical transformation.” According to HIMSS and survey sponsor McKesson, “Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and IT implementation. By effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise”

As I reported for InformationWeek, 86 percent of organizations surveyed had a plan for clinical transformation in place or at least under development, and just 12 percent of respondents called organizational commitment a barrier to reporting on quality measures. And though nearly 8o percent indicated that they still gather quality data by hand and 60 said they don’t capture data in discrete format, more than half already had software specifically for business intelligence. This tells me that analytics is here to stay.

I kind of knew that anyway, since the bulk of the program at last week’s Wisconsin Technology Network Digital Healthcare Conference was devoted to BI, data governance and advanced analytics tools, even in the context of Accountable Care Organizations. (My story about this for WTN News appeared this morning.)

“I’m ready to declare the era of business intelligence,” said Galen Metz, CIO and IS director for Madison-based Group Health Cooperative of South Central Wisconsin. Though he criticized the proposed ACO rules for being too “daunting” for the average provider, Galen and other speakers said that it’s time to harness all the new, granular data being generated by EMRs and, soon, ICD-10 coding.

It may seem “daunting” now in the midst of all the preparations for ICD-10 and meaningful use, but it’s good to know that many healthcare organizations see a light at the end of the tunnel and know that the future bring better healthcare information in exchange for all the hard work and investment today.

I’m sure like many of you, I was completely intrigued by the demonstration of the Watson computer competing against the best Jeopardy! stars. It was amazing to watch not only how Watson was able to come up with the answer, but also how quickly it was able to reach the correct answer.

The hype at the IBM booth at HIMSS was really strong since it had been announced that healthcare was one of the first places that IBM wanted to work on implementing the “Watson” technology (read more about the Watson Technology in Healthcare in this AP article). Although, I found the most interesting conversation about Watson in the Nuance booth when I was talking to Dr. Nick Van Terheyden. The idea of combining the Watson technology with the voice recognition and natural language processing technologies that Nuance has available makes for a really compelling product offering.

One of the keys in the AP article above and was also mentioned by Dr. Nick from Nuance was that the Watson technology in healthcare would be applied differently than it was on Jeopardy!. In healthcare it wouldn’t try and make the decision and provide the correct answer for you. Instead, the Watson technology would be about providing you a number of possible answers and the likelihood of that answer possibly being the issue.

Some of this takes me back to Neil Versel’s posts about Clinical Decision Support and doctors resistance to CDS. There’s no doubt that the Watson technology is another form of Clinical Decision Support, but there’s little about the Watson technology which takes power away from the doctor’s decision making. It certainly could have an influence on a doctor’s ability to provide care, but that’s a great thing. Not that I want doctors constantly second guessing themselves. Not that I want doctors relying solely on the information that Watson or some other related technology provides. It’s like most clinical tools. When used properly, they can provide a great benefit to the doctor using them. When used improperly, it can lead to issues. However, it’s quite clear that Watson technology does little to take away from the decision making of doctors. In fact, I’d say it empowers doctors to do what they do better.

Personally I’m very excited to see technologies like Watson implemented in healthcare. Plus, I think we’re just at the beginning of what will be possible with this type of computing.