Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Mobile PHRs On The Way — Slowly

Posted on October 24, 2013 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.

On-demand mobile PHRs are likely to emerge over time, but not until the healthcare industry does something to mend its interoperability problems, according to a new report from research firm Frost & Sullivan.

As the paper notes, mobile application development is moving at a brisk clip, driven by consumer and governmental demands for better quality care, lower healthcare costs and improved access to information.

The problem is, it’s hard to create mobile products — especially a mobile PHR — when the various sectors of the healthcare industry don’t share data effectively.  According to Frost  & Sullivan, it will be necessary to connect up providers, hospitals, physician specialty groups, imaging centers, laboratories, payers and government entities, each of which have operated within their own informational silos and deployed their own unique infrastructures.

The healthcare industry will also need to resolve still-undecided questions as to who owns patient information, Frost & Sullivan suggests.  As things stand, “the patient does not own his or her health information, as this data is stored within the IT  protocols of the EHR system,  proprietary to providers, hospitals and health systems,” said Frost & Sullivan Connected Health Senior Industry Analyst Patrick Riley in a press statement.

While patient ownership of medical data sounds like a problem worth addressing, the industry hasn’t shown the will to address it.  To date, efforts to address the issue of who owns digital files has been met with a “tepid” response, the release notes.

However, it’s clear that outside vendors can solve the problem if they see a need. For example, consider the recent deal in which Allscripts agreed to supply clinical data to health plans.  Allscripts plans to funnel data from participating users of its ambulatory EMR to vendor Inovalon, which aggregates claims, lab, pharmacy, durable medical equipment, functional status and patient demographics for payers. Providers are getting patient-level analyses of the data in return for their participation.

Deals like this one suggest that rather than wait for interoperability, bringing together the data for a robust mobile PHR should be done by a third  party. Which party, what it will it cost to work with them and how the data collection would work are the least of the big problems that would have to be solved — but might be that or nothing for the foreseeable future.

Is The Cloud The Best EHR Model For Small Practices?

Posted on June 5, 2013 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.

Over the last few years, the use of EMRs in medical practices has grown dramatically, with over 50 percent of office-based physicians now using such systems.  However, physicians still face major barriers in adopting EMRs, including costs, usability issues and impacts on doctor productivity.

One way of reducing the complexity of EMR installations — doing more for less — is to go with a Web-based model of EMR  use, argues “The Cloud: The Best EHR Solution for Small Practices.”

This model, also known as “software as a service” (SaaS) stores patient data in the cloud, accessible from any secure device connected to the Internet.

Not only does the cloud/SaaS model make it easy to access patient data,  it saves practices having to come up with a large up-front installation fee to set up software on site. Instead, practices pay a monthly fee which is predictable (and usually, manageable).

The price difference is very striking. The average cost of a client-server implementation over five years ranges from $30K to a whopping $80K per provider, not including the cost of training, interfaces, patient portals and conversions from other systems, the white paper notes.

But cost isn’t the only reason for small practices to go with a cloud/SaaS EHR. Increasingly, physicians are going mobile with care, via smartphone and tablet. As the Bring Your Own Device phenomenon explodes, practices are going to want an EHR which can easily be accessed and used via the Internet.

Read this paper to learn more about mHealth and how a cloud/SaaS solution can support your small practice’s mobile strategy while protecting critical data offsite in the event of a disaster; being sure that your data is encrypted at rest as required by Meaningful Use; and even how doctors can use voice to chart notes.

Of course, there are many who still argue against a cloud based EHR. They have their reasons that are worthy of consideration. An in house client server EHR does have its advantages over SaaS EHR. You have to weigh the pros and cons of each. Then, you can make a great decision for your organization.

EHR Backlash, Patient Interaction, Smart Phone Use, and Dell Think Tank

Posted on March 17, 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.


I realize this first tweet might be controversial for many. Any time you bring a bit of politics (Obamacare in this tweet), there’s a risk of bringing out the crazies. Hopefully we can avoid that, but I was intrigued by this tweet also because it had 17 Retweets by other people. That’s a crazy number of retweets for healthcare IT. I think this view is also part of the EHR backlash that we’ve written about before. Whether you agree with the tweet or not, there are a lot of doctors that feel similar to Dr. Kris Held and they’re starting to make their voice heard.


I love how many people have a focus on increasing patient interaction. An EMR can get you away from it if you’re not careful. The article in this link has some decent suggestions to consider. The most important advice is to be aware of it. Awareness does a lot to improve it.


The killer mobile app in healthcare has been Epocrates and largely is today. A well done EHR mobile app could see similar adoption. Although, there are 300 EHR vendors that aren’t focused on mobile (many of them at least), and so that’s why we don’t hear as much about it.


I’m going to be part of the Dell Healthcare Think Tank that’s mentioned in this tweet. They are doing a live online stream of the event and are even opening it up for questions from Twitter I believe. So, it should be a great opportunity to hear from a lot of smart people on the subject of healthcare IT and to participate online as well. Check it out Tuesday if you want to participate.

EHR Benefit – Accessibility of Charts

Posted on January 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s time for the second installment in my series of posts looking at the long list of EHR benefits. In case you missed the first post, go and check out the EHR benefit of legible notes.

Accessibility of Charts
The second EHR benefit is similar to the Legibility of Notes benefit in that it is easily forgotten as a benefit to EHR and it can be hard to quantify the value of the benefit in dollar amounts. Plus, it is really easy to see how nice accessible charts are to an organization.

There are a number of ways to look at the EHR benefit of accessible charts. The most obvious one is when you think about the number of times a chart has gone missing in a clinic. In most cases, the chart isn’t really missing. It’s in the clinic somewhere, but no one can find it. Remember all those special places that a chart could hide: exam room, physician’s desk, front desk, nurse’s desk, lab sign off box, physician’s car, hospital, physician’s home, etc etc etc. Oh yes, I didn’t even mention HIM not being able to find the chart because someone (probably someone other than HIM) misfiled the paper chart.

I’m sure most HIM people who read this will have a visceral reaction. I’m sure many are likely thinking, “But we do an amazing job keeping track of all those paper charts.” I agree with them 100%. A good HIM person has done an amazing job keeping track of paper charts. It would be 100 times worse if they weren’t there. The problem is that if a dozen people are using the paper chart, the reality is that charts are going to go missing.

Now think about the concept when it comes to EHR. None of those lost chart locations exist. The nurse can’t accidentally take the chart and forget to file it. The doctor can’t forget the chart at home or in his car. No one can misfile the chart.

Think about it. An EHR solves 100% of the problem of missing paper charts.

Besides misplaced paper charts, the idea of chart accessibility is an important one when you consider the idea of accessing an EHR remotely. Even if you use a less than ideal remote desktop solution, a physician can access an EHR anywhere they have an internet connection. For web based EHR, you get exactly the same experience accessing the EHR remotely as you would in the office.

I’ve heard horror stories (at least their pretty horrible to me) of doctors getting late night patient calls which require them to get dressed, go into the office, open the medical records room to access a patient chart. With an EHR, that same workflow has the doctor booting his computer and logging into the EHR. This doesn’t apply to all doctors, but for those that do it’s a dramatic difference.

The biggest fear I’ve heard from doctors in this regard is they often equate chart accessibility with their accessibility. The argument goes that if they can access the chart 24/7, that it also means they have to work 24/7. I think this is a myth that doesn’t match most realities. Just because you had a key to your office and could go and work on paper charts 24/7 doesn’t mean you had to do it. The same is true with remote access to EHR. You choose when is appropriate and important to access and work on the EHR and when not to do so.

The key difference between EHR and paper charts is that when you do want to access a patient’s record remotely you have that option available to you. That doesn’t mean you always have to do so, but it is nice to have that option available.

When talking about EHR accessibility, I think also about the landscape of connected mobile devices (smart phones, tablets, etc). All of these devices are connected to the internet at all times and could provide a doctor access to their EHR almost anywhere in the world. Try doing that with paper.

The problem here is that most EHR don’t do well on mobile devices. Remote desktop from a smart phone or tablet works, but is a pretty terrible user experience. A native mobile app provides a much better experience for users, but we’re still in the early days of EHR mobile app development. As this matures, the accessibility of charts will become an even bigger EHR benefit.

Mobile EHR as a Solution for EHR Downtime

Posted on October 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.

After a couple major EHR vendors had some EHR downtime, there’s been a lot of interesting discussion about how to deal with EHR downtime. It’s also worth taking a look at my previous posts on: Cost of EHR Down Time, My EMR is DOWN!!!, Reasons Your EHR Will Go Down, SaaS EHR Down Time vs. In House EHR Down Time, and Working Offline When Your EHR Isn’t Available. Obviously, there’s a lot to think about when it comes to your EHR going down.

I recently got a demo of a new free mobile EHR app offering from Mitochon. When they asked me if I wanted to see the product, I wasn’t sure what I’d see. I’ve obviously seen hundreds of different mobile EHR apps and so I thought I knew what I’d likely see. Instead, I was quite surprised with the unique approach they’d taken with their mobile EHR app.

They warned me up front that this is the first iteration of their mobile EHR app, but I found what they had created to be a nice innovation on what I’d seen elsewhere. Instead of trying to cram the whole EHR into a mobile app, they decided to leverage the CCD documents they could already create into an EHR app that worked on the mobile, anytime, anywhere.

When you think about EHR downtime, the mobile is a perfect solution. The device can run applications without any internet connectivity. Plus, it can endure power outages better than any other computing device. I’m sure many of you are wondering how the EHR data makes it to the mobile if there’s no internet connectivity.

This is what I think makes the Mitochon mobile EHR app so unique. They securely cache your top patient info on your mobile phone so that if your mobile has no connectivity, then the data is still there and available to you. Sure, it’s not the full EHR data and you can’t do all the functionality of your full EHR, but in an emergency situation (ie. EMR downtime) it could be incredibly valuable to have the clinical summary information available to you in your mobile app. Not to mention if you’re at a hospital doing rounds and the big cement wall hospital makes it so you have no cell signal.

Now that the health data of your patients is stored on the device, security becomes a big question mark. Mitochon showed me this slide which does a good job showing the mobile security they’ve put in place with their mobile EHR app:

I think this is a pretty creative mobile EHR solution. Plus, I find it fascinating that they built a large portion of their app on the back of CCD. Makes me wonder what other cool things could be done with CCDs.

Here are some other screenshots of the Mitochon mobile EHR app (these are from the iPad):

Do you like this approach to dealing with access to your patient records even during EHR downtime? Is the CCD enough information for you to care for a patient?

Full Disclosure: Mitochon is an advertiser on this site.

EMR Landmine, Mobile EMR Access, and Patient Advocates

Posted on August 5, 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.

While it seems that many people are coming out with distaste for the Olympics, I am still on the side of enjoying the Olympics thoroughly. I’ve watched as much of the coverage as possible. What can I say, I’m a sucker for pretty much any sporting event. I hope everyone else has been getting as much joy out of the Olympics as I have gotten, but I digress.

As you know, each week I take a quick look at some interesting tweets that have been posted around the EMR, EHR and Healthcare IT twittersphere. Plus, I’ll add a little commentary that will hopefully start some interesting conversations and help you as a reader.


What a perfect way to describe the issue: an EHR Landmine. Jane Shuman is exactly right too. In fact, a local doctor recently told me the same thing. The challenge of checking and re-checking patient information from a previous patient visit is a huge problem waiting to happen. I think the doctor I talked to said that EMR perpetuates mistakes. It’s so true. I wonder what other EMR landmines are out there.


My readers agree with Melissa. As long as the iPad is a native iPad app and not just some remote desktop access to EMR software that isn’t optimized for a tablet environment.


You have to love Regina Holliday. A tireless patient advocate. Years down the road I hope that Regina will be able to stop her patient advocacy. Not because she gets tired of doing it, but because we embrace the patient in healthcare.