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Why BIDMC Is Shunning Epic, Developing Its Own EMR

Posted on July 31, 2013 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Though its price tag be formidable and installation highly complex, the Epic EMR is practically a no-brainer decision for many hospitals.  As Beth Israel Deaconess Medical Center CIO John Halamka notes, things are certainly like that in the Boston metro, where BIDMC’s competitors are largely on Epic or in the process of installing Epic.

Why are Halamka’s competitors all going with Epic?  He proposes the following reasons:

*  Epic installs get clinicians to buy in to a single configuration of a single product. Its project methodology standardizes governance, processes and staffing in a way that hospitals might not be able to do on their own.

* Epic fends off clinicians’ request for new innovations that the hospital staff might not be able to support. IT merely has to tell clinicians that they’ll have to wait until Epic releases its next iteration.

* Epic is a safe investment for meeting Meaningful Use Stage 2, as it has a history of helping hospitals and providers achieve MU compliance.

* CIOs generally don’t get fired for buying Epic, as it’s the popular move to make, despite being reliant on 1990s era client-server technology delivered via terminal services that require signficant staffing to support. (Actually, it does happen but it’s still rare.)

*  These days, hospitals have moved away from “best of breed” EMR implementations to the need for integration across the enterprise.  As Halamka notes, such integration is important in a world where Accountable Care/global capitated risk is becoming a key factor in reimbursement, so having a continuous record across episodes of care is critical. Epic seems to address this issue.

But BIDMC is a holdout. As Dr. Halamka notes in his blog, BIDMC is one of the last hospitals in Eastern Massachusetts continuing to build and buy components to create its own EMR. He’s convinced that going with the in-house development method — creating a cloud-hosted, thin client, mobile friendly and highly interoperable system — is ultimately cheaper and allows for faster innovation.

In closing, Halamka wonders whether his will end up being one of the very last hospitals to continue an ongoing EMR development program.  I think he’s answered his own question: it seems likely that BIDMC’s competitors will keep jumping on the Epic bandwagon for all of the reasons he outlines.

Will they do well with Epic?  Will they find later on that the capital investment and support costs are untenable? I think we’ll have the answers within a scant year or two. Personally, I think BIDMC will have the last laugh, but we’ll just have to see.

Hospitals Like Modular EHR, Ambulatory Likes Complete EHR

Posted on July 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

For those reading this site that don’t know Dr. Robert Rowley, you should. He’s the original Chief Medical Officer (CMO) at Practice Fusion that recently parted ways with Practice Fusion to work on some other projects along with still practicing medicine. Along with this background, he’s a really smart guy that has a lot of knowledge about the EMR and EHR industry. Plus, he’s a downright nice guy.

The good thing is that he got addicted to blogging while working at Practice Fusion and now he’s carried over that love to his own blog (linked above). I’m sure I’ll be referencing Dr. Rowley and his blog many more times in the future. The title of this post came from a blog post he wrote about Mass Consolidation of EHR software. Here’s a quote from that post:

If one carries out a detailed analysis of 2011 Meaningful Use data, some patterns emerge. Firstly, ambulatory clinicians nearly always choose Complete EHRs – 95% of ambulatory Meaningful Use attestations were done using Complete EHRs. Hospitals, on the other hand, represent a different pattern – only 48% of hospitals attested for Meaningful Use using a Complete EHR, whereas 52% used Modular EHR components.

I found this to be a really interesting observation. It’s not all that surprising when you think about it, but it’s very interesting.

I know there’s a strong group of people that participate in the Collaborative Health Consortium that have been proponents of using modular EHR components. It looks like this is definitely happening in the hospital environment. I think that’s a very good thing.

What a Difference a Day Makes

Posted on July 12, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

Excuse a bit of personal musings in this post.

Yesterday I was cruising along thinking that all was well. I was doing the grind and making things happen. Life was good. I had a lot to do, but I was accomplishing a lot. Then, my wife came into my office and told me that her contractions weren’t stopping.

Off to the hospital we go after dropping the kids off at a friends house. The hard part was that the 2 friends we were planning to have watch our kids were out of town. I guess that happens when your baby decides to come 8 days early. Luckily we had a bunch of good backup plans. Maybe that’s a good lesson for those going through an EHR implementation.

A few hours later and the latest edition to the literal Healthcare Scene family has arrived! I posted an early picture for those that love brand new babies.

What a difference a day makes. Now I’m blogging from the hospital internet (which wouldn’t connect when I arrived, but is doing pretty good now). Baby and mom are healthy and happy which is the most important thing. The early arrival of baby is going to throw a few things off, but we’re excited to have him.

Being at a hospital in some ways it still feels like work. The nurses told me next week they’re going to training for Cerner. I’m sure I’ll do some more posts on some of the things they told me. It was quite interesting to hear their perspective. I saw a monitor with an error message that had McKesson in the title bar. I was walking past, but I think I’ll go back and see what the error is and what McKesson product is being used.

Then, of course I had to talk some EHR with my wife’s OB. When she comes tomorrow I want to invite her to lunch with me so I can hear more of her perspectives on EHR. This is our 4 child with her and so we go way back. I’m sure she’d tell it to me straight also which I’d love. We’ll see if she accepts. She’s insanely busy.

Don’t be surprised if the next week or so is observations from the hospital on this site and possibly Hospital EMR and EHR. What could be better than first hand experience?

Yes, a lot has changed since yesterday, but so far all for the better. I’m a very blessed man to have such a wonderful wife and now 4 children.

Top Healthcare IT Vendors by Revenue

Posted on May 2, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

For those of you who aren’t familiar with the now a year old Hospital EMR and EHR, you should check it out and subscribe to the email list. The site has been growing like gang busters and people are loving the content on that site. I’d wanted to do a hospital EHR focused website for a long time. Certainly there’s a lot of cross over between ambulatory EHR and hospital EHR, but there are also unique differences in the hospital EHR environment that were definitely worthy of their own discussion platform. Plus, we like to cover other aspects of hospital IT.

One of the recent series that Anne Zieger started on Hospital EMR and EHR is called the Top Hospital HIS Vendors by Revenue. She’s already covered the top 3: McKesson, Cerner, and Siemens. She’ll be going through the rest of the Top 10 Hospital HIS vendors by revenue over the next weeks.

It’s really fascinating and amazing to see the enormous revenue numbers that each of these companies produce. Even more amazing is that we’re really only at the beginning of EHR adoption. There is so much of the EHR market that still is out there waiting to implement an EMR solution.

Of course, the real question is which vendor is going to capture this market share and which company will eventually be created that will take the market share from the incumbents. I’m sure it’s hard for many to believe that some upstart company could take down these large companies, but it will happen. That’s the cycle that occurs over and over again. Although, I will make the prediction that we won’t see much jostling in the hospital EHR space during the HITECH EHR incentive money time frame. The opportunity to take market share will likely happen post EHR incentive money.

Despite Focus On Security Compliance, Provider Data Still Isn’t Secure

Posted on April 26, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

It looks like we’ve got a billion-dollar mismatch between rules and reality here. An established security research firm has released a study suggesting that while providers are working hard on meeting HIPAA and other security regs, their data isn’t any more secure than when it was before

Kroll’s 2012 HIMSS Analytyics Report: Security of Patient Data, concludes that the rate of  provider data breaches has been rising over the past six years, despite pressure on providers to conduct more security audits and otherwise tighten up their data ship.

What’s scary about this trend is that the healthcare institutions surveyed by Kroll don’t seem to be aware of the problem.  Health IT execs rated themselves at 6.4 out of 7 (seven being “extremely prepared’) on their readiness to address data security. That’s up from 6.06 in 2010 and 5.88 in 2008.

But the data Kroll gathered suggests that they’re overconfident at best. It found that 27 percent of respondents had reported a breach during the past twelve months, up from 19 percent in 2010  and 13 percent in 2008. Worse, of those who saw breaches, 69 percent of providers had seen  more than one breach.

Now, it would be easy to say that regs like HIPAA, Meaningful Use standards and the Red Flags rules are malformed, and that this is just another case of government getting it wrong to industry’s detriment. If there’s any truth to this notion, I do hope CMS leaders take notice and adjusts some of its requirements;  Heaven knows they’d get plenty of credible, carefully thought-out feedback if they ask.

Unfortunately, though, I suspect far from being that easy. We’d all love it if we could just follow the rules, get government approval then say “stick a fork in it, security’s done.”  But as readers know,  security is such a complex mix of implementing technologies and changing inappropriate behaviors that it’s hard to tease out just what went wrong sometimes.

Still, it’s good to have an organization like Kroll remind us that meeting HIPAA requirements isn’t the be all and end all.  Unfortunately, it’s really just the beginning.

Interoperability versus Usability in Best of Breed or All-in-One HIS Systems

Posted on January 31, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

In a number of my online conversations we’ve been having really in depth discussions about the idea of whether it’s better for a hospital HIS system is better as an All-In-One system or whether Best of Breed healthcare IT systems are better. Much of this discussion has been sparked from posts done on my Hospital EMR and EHR blog. So, if you’re in the hospital space and are not following that site, you should. You can even sign up for the Hospital EMR and EHR list if you’d like. Anne Zieger writes most of the content there and she doesn’t mince words.

In all of these discussions, something became really clear to me:

The best reason to use Best of Breed healthcare IT systems is for usability.

The best reason to use an All-in-One system is for interoperability.

Some people may see this as too simplistic, but I loved a quote I read recently that said you don’t truly understand something until you can describe it in a simple form. I actually heard Bill Belichick do this talking about what he looks for in receivers for his Football team (Anyone excited for Super Bowl Sunday?). He said he likes a receiver that can Get Open and Catches the Ball. Seems far too simplistic, but it’s so simplistic it’s genius.

I think the same could be said for evaluating hospital IT systems:

The thing I like most in a healthcare IT system is one that’s Usable and Integrates Well.

Meaningful Use 2012 Predictions – Meaningful Use Monday

Posted on January 2, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

As I mentioned in my last post, I’m going to take some time over the next week or so to look ahead to 2012 and discuss what I think is going to happen in the world of EMR and health IT. Since today is the regularly scheduled Meaningful Use Monday, I decided that it would be appropriate to take a look forward at Meaningful Use in 2012.

In many ways, 2012 is not going to see any major public shifts in meaningful use. Sure, we’re going to learn more about meaningful use stage 2, we’re also going to finally get out of the temporary EHR certification to the permanent EHR certification (unless something crazy happens). Although, I don’t think either of those things are going to make much real difference in the lives of doctors. Instead, there’s going to be an undercurrent of other trends that shape the future of EHR incentives and meaningful use.

Here we go:

Doctors First Hand Experiences – As Dr. Koriwchak notes in his physician perspective on meaningful use, there aren’t that many first hand experiences out there from physicians discussing their experience with meaningful use. Most of what you find out there are physicians that have been asked by their EHR vendor to be the face of that EHR vendor’s meaningful use efforts.

In 2012, whether published publicly or heard through the grapevine, doctors first hand experience with EMR implementations, EHR incentive and meaningful use are going to start filtering through the medical community. I bet Dr. Koriwchak isn’t going to be alone in his assessment that basically, I survived meaningful use, but recommend staying away. If this is the message about meaningful use that spreads, then expect more people like Dr. West opting out of Medicare or just accepting the possible EHR penalties.

Meaningful Use Audits – We know that audits of those who took EHR incentive money are coming. I think that CMS (I think they have authority over this, right?) will be generous with their audits. They won’t make it easy and fun for the person who gets audited and fails. However, I don’t think they’re going to try and make a public disgrace of those that have their meaningful use attestation audited. Doing so would set back the entire program. Instead I think CMS will try and spread the message that they’re serious about honest meaningful use attestation, but that they’ll be reasonable in their approach.

Checks Flowing Ok, so it won’t really be checks since most of the payments are going to be wired into doctors bank accounts, but you get the idea. Either way, there’s going to be a lot of doctors that are finally going to get paid for their EHR effort in 2012. This will no doubt invoke some portion of envy in their physician peers. I know I’d hate having my doctor friend getting a check and me not getting it. I felt this same way when people were buying houses and getting the government money for buying a house a couple years ago. Doctors won’t be immune to this sort of “jealousy” of their peers.

The real question is whether the money flowing will be a stronger force on EHR adoption or whether the above mentioned meaningful use pains will be stronger. As you see in my next two predictions, I think it is a split verdict.

Hospitals Capitalize – My best prediction is that hospitals will see the money flowing and be unable to resist following the money line. We’ve already largely seen this shift in hospitals IT projects. I know a number of healthcare entrepreneurs who have said that hospitals aren’t really doing any major IT projects outside of meaningful use. Hospitals will continue this trend and will likely end up taking the majority of the EHR stimulus money that’s being paid out.

Small Doctors Offices Stay Away – As I wrote about previously, most EHR incentive money is being paid to existing EHR users. In 2012 we’ll be moving past those existing EHR users and I predict that most small doctors offices will continue to sit on the sideline of EHR. The money isn’t large enough for small doctors to overcome all the work required for them to implement an EHR and the EHR penalties are a drop in the bucket for most of these doctors.

I imagine that many will be thinking, “What about the other EHR benefits beyond EHR stimulus money?” To that I’d say, you’re absolutely right. There are plenty of other benefits to having an EHR that don’t include government money for EHR. Unfortunately, the free government money has created this myopic view of the world where those other benefits have lost all their appeal.

Ok, you’re turn. Any other things you see happening with meaningful use in 2012? Any of my meaningful use predictions that you disagree with?

Practice Acquisitions By Hospitals Causing Issues with EHR Adoption

Posted on October 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

The readers of EMR and HIPAA have been incredible lately in sending in great commentary on the EMR industry. The following is one such commentary about the issues associated with the now widely seen trend of Hospitals acquiring practices. The person asked to remain anonymous and for the names of the specific EHR vendors to be removed. I agreed since I think the trend is more important than the specific companies.

One trend that I find extremely (and personally) troublesome is the migration from homegrown EMR’s to less functional Hospital based EMR’s – a migration that is occurring frequently now that most small practices are being purchased by Hospitals.

In our case, our small hospital administration decided unilaterally (without MD input) to implement a poorly designed EMR from it’s IT vendor. This has been a colossal failure, as none of the doctors were able to use the EMR. Hospitals are easily seduced by their IT vendors, and think that they can have only one software vendor. They think that all EMR’s are basically the same, either a Ford or a Chevy mentality. They don’t want the docs interfering with the decision process. They don’t have any idea of information and work flow in a doctor’s office. And now they are getting ARRA stimulus funds, and sometimes grant money from local endowments.

We doctors have asked that administration find us one practice that is successfully using the EMR they selected. I think they found 1 doctor 1,300 miles away who was able to make it tolerable. The hospital EMR is CHIT certified, so that doesn’t mean much. Hospital Software vendors have quickly tacked together some sloppy EMR’s in order to save their customer base, and have easily deceived administrators into buying these inferior products.

Our administration has pulled back from implementation, just having us use the scheduler, nursing putting in vitals/meds, and we just enter the ICD-9’s and charges. But another push to MU is coming soon. I have told admin that they must cut my daily schedule from 20 to 10 patients per day. I think that the ARRA stimulus funds and this whole Medicare push for EMR is having a negative effect so far, as least for me. I was using [EMR Vendor] (and still am unilaterally) to organize my data, and generate notes. It’s light years ahead of the EMR the software vendor selected.

I have heard my story repeated many times. The trend of Hospital owned practices may be inevitable, but it has severe negative consequences for EMR, in my opinion.

John’s Comments: While I don’t necessarily agree with the broad ranging comments about administrators not caring or listening to doctors, I’ve heard it far too many times to disagree completely. There’s little doubt from my experience that many hospitals don’t do a great job listening to doctors in selecting an EMR software. However, I’ve also seen many doctors who are terrible to work with when it comes to any discussion of an EMR. So, let’s not kid ourselves into thinking that the doctors are completely blameless either.

One important point that is made is that doctors like using EMR software that they select. As more and more hospitals acquire practices, this issue is going to come to a head. I won’t be surprised if it’s actually a major part of the reason that the cycle of independent doctors starts again.

EPOWERdoc and Unique Features of ED EMR Software

Posted on October 11, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

As many of you know, when an EMR or EHR vendor wants to show me their system, instead of getting a full demo of their EMR I instead ask them to show me the unique features of their EMR. Basically, I’m interested in seeing the features, functions, approach, etc that makes an EMR or EHR vendor unique from the 300+ other EMR companies in the market today. This was my approach when EPOWERdoc approached me with a request to take a look at what they’ve created with their EMRDoc software.

Turns out that EPOWERdoc has been around for 12 years and is already in 250 hospitals in 40 states. That’s a pretty good footprint for an Emergency Department comnpany. In fact, I read that they’ve done 17 million Emergency Department visits in North America in their 12 year ED EHR history. Of course, these numbers come from EPOWERdoc and we know how good EMR install counts are from EMR vendors. However, even if that numbers bloated it’s a decent sized install base. Update from EPOWERdoc: The client numbers and ED visits are correct, we started out as a Paper Template system from software printing and that is where the large client base is predominantly. We are 36 months into the EDIS market with the product you looked at and have 18 live and another 9 by first qtr 2012.

During the short demo, EPOWERdoc showed me 3 or 4 interesting things about their Drummond Group modularly certified EHR. However, the feature that hit me most was the EMRDoc prose generator. In fact, this demo was one of the reasons that I’ve started predicting an EMR documentation revolution against hard to read, bulky, clinical notes.

I wish EPOWERdoc had a video of their EMR notes prose generator to demo it. If they create a video, I’ll post it to my EMR, EHR and Healthcare IT videos website. Until then, here are before and after screenshots of the EPOWERdoc interface which shows the granular data entry and the note that was created (click on the image to see the full image).

And now the image of the outputted documentation:

We could certainly debate the finer points of the user interface for inputting the data. Plus, a screenshot doesn’t show some of the other elements they’ve created to be able to quickly handle the input of the granular data elements. What hit me was how much the second image read like a clinical note. To be honest, as I read it I felt like I was hearing someone dictating a clinical note. Are their subtle differences where dictation is better, definitely. However, they seem to have done a good job of taking the granular data and turning it into clinical prose. I’ll be interested to hear some doctors thoughts on the above to see if they agree or disagree.

There were a few other interesting EMRDoc features that stood out to me in my short EMR demo.
-As an ED EMR, you have a different workflow than an ambulatory practice. As such, you need the ability to manage multiple open records at the same time. What I think EMRDoc does really well is switching between patients, but then also tracking your last documentation location for that patient.
-Related to seeing multiple patients, EMRDoc documentation feedback tool provides the user (doctor, nurse, etc) with a real time feedback as to the status of the level of documentation for medical coding as well as what has been completed in the note. In the ED where you’re regularly pulled away to deal with a pressing problem, the feedback statuses are a great little feature.
-EMRDoc has a feature that forwards clinical information and data from the Nursing Record to the Physician Record and from various sections of the Physician Record to other sections. Pretty slick implementation that reduces having to document that same thing multiple times.
-One of the big questions for an ED EHR like EPOWERdoc is how they deal with the hospitals large HIS system. EPOWERdoc’s answer was a partnership with Iatric who uses technology allowing data insertion into non accepting systems such as Epic, Cerner, McKesson or Meditech. I’d seen Iatric (They had the amazing trick shot pool table guy at HIMSS), but it sound like I should get to know them a little more. Maybe I can get Katherine Rourke to cover them over on Hospital EMR and EHR as well.

As I said, I didn’t do a full scale top to bottom demo of the EMRDoc ED EHR system, but I thought these were some interesting features of their EHR that were worth sharing. I’d love to hear some first hand experiences from any EPOWERdoc users. Let’s hear what you think in the comments.

Amazing Epic Discussion on Google Plus

Posted on August 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

As many of you probably know, I started a new Hospital EMR and EHR website that follows a similar pattern to EMR and HIPAA & EMR and EHR, but focused on the technology used in a hospital with the EHR being at the center (most of the times). The site has been growing like crazy with the wonderful Katherine Rourke posting most of the content.

However, one thing I found really interesting was that I took this post about Epic Possibly Being Victim of its Own EMR Success and posted it on Google Plus (UPDATE: You’ll need to add me to your Google Circle so I can add you to my EMR circle to see it. I forgot I only shared it with my EMR google circle and I can’t see how to make it public). I’ve just been dabbling around in Google Plus, and so I was surprised by the results.

In the post itself, there have been 6 comments about Epic EMR’s success. That’s really not a bad number of comments for such a new Hospital EMR blog.

However, the astounding part is that my thread on Google Plus that links to the post has already had 40 comments on it with some amazing insight from those commenting.

It’s still really early in the life of Google Plus. Maybe it’s early and the novelty of Google Plus is what’s currently providing the great discussion. I’ll have to seriously consider how I can incorporate that discussion into future blog posts.