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Value Based Reimbursement Research Results in Time for #AHIPInstitute

Posted on June 15, 2016 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.

McKesson Health Solutions has commissioned a new National Research study on Value Based Reimbursement. Here’s a quick summary of some of the findings:

The rapid pace of change in healthcare payment continues unabated, with payers reporting they are 58% along the continuum towards full value-based reimbursement, a 10% leap since 2014. Hospitals aren’t far behind, reporting they’re now 50% along the value continuum, up 4% in the past two years.

Those numbers were a bit shocking to me. It doesn’t feel like we’ve gotten that far in the shift to value based reimbursement. Does it feel like it to you? I knew we were headed that direction, but definitely thought we had just begun. These numbers paint a much different story.

This week I’m excited to attend my first AHIP Institute. I’ll be exploring this shift in all its gory details.

Along with this study and with AHIP starting tomorrow, McKesson has been sharing a number of cartoons about the healthcare industry. Here are a few of them they tweeted out:

Healthcare Costs

Healthcare Payment Pathway

HL7 Backs Effort To Boost Patient Data Exchange

Posted on December 8, 2014 I Written By

Anne Zieger 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.

Standards group Health Level Seven has kicked off a new project intended to increase the adoption of tech standards designed to improve electronic patient data exchange. The initiative, the Argonaut Project, includes just five EMR vendors and four provider organizations, but it seems to have some interesting and substantial goals.

Participating vendors include Athenahealth, Cerner, Epic, McKesson and MEDITECH, while providers include Beth Israel Deaconess Medical Center, Intermoutain  Healthcare, Mayo Clinic and Partners HealthCare. In an interesting twist, the group also includes SMART, Boston Children’s Hospital Informatics Program’s federally-funded mobile app development project. (How often does mobile get a seat at the table when interoperability is being discussed?) And consulting firm the Advisory Board Company is also involved.

Unlike the activity around the much-bruited CommonWell Alliance, which still feels like vaporware to industry watchers like myself, this project seems to have a solid technical footing. On the recommendation of a group of science advisors known as JASON, the group is working at creating a public API to advance EMR interoperability.

The springboard for its efforts is HL7’s Fast Healthcare Interoperability Resources. HL7’s FHir is a RESTful API, an approach which, the standards group notes, makes it easier to share data not only across traditional networks and EMR-sharing modular components, but also to mobile devices, web-based applications and cloud communications.

According to JASON’s David McCallie, Cerner’s president of medical informatics, the group has an intriguing goal. Members’ intent is to develop a health IT operating system such as those used by Apple and Android mobile devices. Once that was created, providers could then use both built-in apps resident in the OS and others created by independent developers. While the devices a “health IT OS” would have to embrace would be far more diverse than those run by Android or iOS, the concept is still a fascinating one.

It’s also neat to hear that the collective has committed itself to a fairly aggressive timeline, promising to accelerate current FHIT development to provide hands-on FHIR profiles and implementation guides to the healthcare world by spring of next year.

Lest I seem too critical of CommonWell, which has been soldiering along for quite some time now, it’s onlyt fair to note that its goals are, if anything, even more ambitious than the Argonauts’. CommonWell hopes to accomplish nothing less than managing a single identity for every person/patient, locating the person’s records in the network and managing consent. And CommonWell member Cerner recently announced that it would provide CommonWell services to its clients for free until Jan. 1, 2018.

But as things stand, I’d wager that the Argonauts (I love that name!) will get more done, more quickly. I’m truly eager to see what emerges from their efforts.

4 Reasons U.S. EMR Firms Won’t Try China

Posted on October 23, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

If you have something to sell, chances are you’ve thought about selling it in China.

With a population of 1.35 billion, it’s become an attractive market for U.S. companies pushing everything from athletic shoes to light trucks to Tide. Given the natural limits of their home market, you’d assume that American EMR firms would eventually size up China’s nascent health IT scene.

And it’s likely they have. In a report a few years ago, 100 percent of vendors surveyed told the consulting firm Accenture that they saw global markets as an opportunity in the long term.

But health IT doesn’t export quite as easily as Pringles and KFC. I’ve seen China’s healthcare system up close several times, and if you ask me, making headway in the world’s most populous nation will be beyond difficult.

China, which is in the midst of its own health care reform, could certainly be tempting for companies such as Epic, McKesson and Cerner. As Benjamin Shobert wrote for Forbes, the country in 2009 extended basic health coverage to 97 percent of its citizens. It also promised to build 31,000 hospitals, upgrade 5,000 existing ones and train 150,000 new primary-care doctors.

McKinsey & Co. last year said health care spending in China would grow to $1 trillion in 2020 from $375 million in 2011.

Meanwhile, U.S. EMR companies are going to need new markets to conquer. Estimates of how much growth potential is left are many and varied. But no matter how you look at it, at some point every American healthcare organization of any size will have an EMR. Millennium Research Group last month predicted declining EMR-industry revenue from this year on because of “market saturation.”

Of course, plenty of IT firms, including Oracle and IBM, have a major presence in China. But the China market won’t happen in a significant way for U.S. health IT companies any time soon, and here’s why:

  • China’s healthcare is different. The private physician’s office that Americans are used to is more or less nonexistent. You go to a hospital-based clinic and see the doctor who’s available. Patient privacy hasn’t taken hold, so there could be other clinic-goers and family members milling about near — or in — your exam room. Chinese traditional medicine is practiced alongside the “Western” variety. Even with insurance, you typically pay up front and get reimbursed later. A U.S.-centric EMR would not map neatly onto China’s workflows. There’s an overview of China’s system here. I’ve written about a Chinese dental clinic here.
  • No one understands China’s health IT. OK, I’m sure some people do, and I hope they comment. But it’s a challenge. The health information firm KLAS Enterprises isn’t even attempting to cover China. A KLAS executive vice president, Jared Peterson, told Modern Healthcare, “The Chinese market, that’s a big mystery.” Meanwhile, Accenture omitted China from its 2010 report “Overview of International EMR/EHR Markets” because of “conflicting opinions of overall EMR maturity.”
  • The language barrier will be formidable. Epic CEO Judith Faulkner told Modern Healthcare how her company had adapted its system for another language. “We’ve only done it once, for Dutch,” she said in January 2012. “It’s a lot of mapping. It’s a task, but it hasn’t been that bad of a task.” But Dutch is not Chinese, and Chinese doesn’t use the Roman alphabet. I’m betting that when you throw Chinese characters into the mix, the conversion will be “that bad of a task” and then some.
  • Cloud-based systems could raise security issues. Some experts expect cloud-based services to play a significant role as health IT spreads to developing countries. But according to a U.S.-China Economic and Security Review Commission report, “Regulations requiring foreign firms to enter into joint cooperative arrangements with Chinese companies in order to offer cloud computing services may jeopardize the foreign firms’ information security arrangements.”

It’s worth mentioning that three years ago, China was mentioned as Cerner announced plans to develop global markets. It wanted to get into emerging regions before its U.S.-based competitors did.

There’s not much sign of life now in any China-related plans the company might have had, though. According to a message from Chad Haynes, managing director for Cerner Asia, on the firm’s website: “We look forward to improving the health of communities in ASEAN, China, and beyond.”

In the case of China, that could be a while.

CommonWell Health Alliance – The Healthcare Interoperability Enabler?

Posted on March 4, 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.

The biggest news that will likely come out of HIMSS was the big announcement that was made about the newly formed CommonWell Health Alliance. They’ve also rolled out a website for the new organization.

This was originally billed as a Cerner and McKesson announcement and would be a unique announcement from both the CEO of Cerner and McKesson. Of course, the news of what would be announced was leaked well before the press briefing, so we basically already knew that these two EHR companies were working on interoperability.

In what seemed like some final, last minute deals for some of the companies, 5 different software products were represented on stage at the press event announcement for CommonWell Health Alliance. The press event was quite entertaining as each of the various CEOs took some friendly jabs at each other.

Of course, Jonathan Bush stole the show (which is guaranteed to happen if he’s on stage). I think it was Neal Patterson who called Jonathan Bush the most articulate CEO in healthcare and possibly in any industry. Jonathan does definitely have a way with words.

One of Jonathan’s best quote was in response to a question of whether the CommonWell Health Alliance would just be open to any health IT software system, or whether it was just creating another closed garden. Jonathan replied that “even a vendor of epic proportions” would be welcome in the organization. Don Fluckinger from Search Health IT News, decided to ask directly if Judy from Epic had been asked about the alliance and what she said. They adeptly avoided answering the question specifically and instead said that they’d talked to a lot of EHR vendors and were happy to talk to any and all.

Although, this is still the core question that has yet to be answered by the CommonWell Health Alliance. Will it just be another closed garden (albeit with a few more vendors inside the closed garden)? From what I could gather from the press conference, their intent is to make it available to anyone and everyone. This would even include vendors that don’t do EHR. I think their intent is good.

What I’m not so sure about is whether they’ll put up artificial barriers to entry that stop an innovative startup company from participating. This is what was done with EHR certification when it was started. The price was so high that it made no sense for a small EHR vendor to participate. They could have certified as well, but the cost to become certified was so high that it created an artificial barrier to participation for many EHR vendors. Will similar barriers be put up in the CommonWell Health Alliance? Time will tell.

With this said, I think it is a step forward. The direction of working to share data is the right one. I hope the details don’t ruin the intent and direction they’re heading. Plus, the website even says they’re going to do a pretty lengthy pilot period to implement the interoperability. Let’s hope that pilot period doesn’t keep getting extended and extended.

Finally, I loved when Jonathan Bush explained that there were plenty of other points of competition that he was glad that creating a closed garden won’t be one of them. I hope that vision is really achieved. If so, then it will be a real healthcare interoperability enabler. Although, artificially shutting out innovative healthcare IT companies would make it a healthcare interoperability killer.

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 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.

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 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.

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.

EMRs, ICD-10 Pave the Way to Business Intelligence

Posted on June 16, 2011 I Written By

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.

 

Different Methods to Become a Top EMR Company

Posted on December 20, 2010 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.

A few months ago, the blogger over at Health Finch wrote blog post which analyzes 3 of the top health care IT companies and how they were started. It is very interesting to see the evolution of the large health care IT companies. Here’s the summary of the 3 companies Health Finch looked at:
Epic Systems – Started with Scheduling and Billing
Cerner – Started as a Laboratory Information System
McKesson – Started dong Rx Management

As a PS to the post, they point out Epocrates working on the same model with their Epocrates EMR. That is one of the most interesting things I’ve noted when attending the various EMR related conferences that I attend. There’s a whole variety of ways that EMR companies are approaching the market.

Another example of this trend is the Care360 EHR from Quest. Think about all the benefits that Quest has over many other providers. Sure, the most obvious one is that they have easy access to the lab data. You can be sure that an interface with Quest labs will be free (unlike most other EMR vendors). Although, certainly it also could be a challenge if you want your EMR to interface with another lab. That could be interesting.

However, Quest has a number of other advantages over a new EMR company. They have an entire sales force (which I think they prefer to call consultants) that already have existing relationships with thousands and thousands of doctors. Quest could literally only sell EMR software to their existing lab customer base and do fine. Of course, that’s probably not the best strategy, but that’s a powerful advantage over the other EMR companies.

There are a ton of other companies that we could talk about. Those entering ePrescribing first. Those transcription companies that are offering an EMR solution. I find it absolutely fascinating. So, if you know of others, I’d love to hear your EMR vendor’s story in the comments.

Suffice it to say that we’re in the middle of an all out war by EMR vendors. The good part is that it’s not likely to be a winner takes all affair, but there will be many many EMR vendors that will end up on the winning end.

Another Example Why Small EHR Companies Face Tough Challenges

Posted on May 27, 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.

No doubt many small EHR companies have been looking at themselves in the mirror long and hard and asking themselves how they’re going to survive this rough market. Not only did the HITECH act slow purchasing of EHR systems, but between “certified EHR” and “meaningful use” many are questioning where the small EHR vendor will fit into the EHR market.

I could (and probably will at some point) expound on each of the topics above, but I think that EHR vendors have an even more difficult challenge on their hands. The challenge comes in the form of incredibly large number of marketing dollars and splashy partnerships.

Here’s just one simple example of what I’m talking about. It was just announced that HEALTHeLINK, The Western New York Clinical Information Exchange, now has formal agreements in place with Allscripts, eClinicalWorks, McKesson, MedAppz, NextGen Healthcare Information Systems and Pulse Systems. [Hailing out of Buffalo, I’d love to meet up with the people at HEALTHeLINK sometime when I’m visiting family in the area.]

I’m not sure how much of an impact this particular partnership will have on EHR adoption in upstate New York. However, that’s not really my point. My point is that this is just one small example of a partnership that the “big boy” EHR companies are going to use to market their product. Consider that the marketing budget for these large EHR companies is quite possibly larger than some smaller EHR companies entire budgets. That’s pretty formidable.

I’m not saying that small EHR companies should close their doors and stop competing. In fact, I hope just the opposite happens. I’m all for innovation and the most innovative products usually come from small companies who have to be innovative to survive. I’m just saying that these small EHR companies better come ready to fight. It’s not going to be a pretty couple months in the EHR industry. Only the strong will survive.

Of course, all is not lost for small EHR vendors that survive. Assuming EHR implementation failure rates continue at their current dismal rates, then there will be a tremendous opportunity for a number of companies to take care of those who fail to implement unusable EHR systems.