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Are EMR Vendors Really This Clueless?

Posted on August 24, 2017 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.

I know that EMR vendors don’t always understand their end-users as well as they should. That’s a shame, but it’s likely to happen given how far apart their day-to-day lives are. Still, I was truly taken aback by the following.

In the introduction to a report on nurse perceptions of EHRs, researchers shared some words on their market research philosophy. I don’t think the writers intended to criticize anyone, but nonetheless, the vendors don’t come out looking very good in the process.

“Some (mainly vendors) have questioned why we conduct research to front-line users of core HIT systems, such as physicians, nurses, billers, schedulers etc.,” they wrote. “They argue that only the high-ranking decision-makers matter when it comes to tracking customer satisfaction (NPS) and winning a greater piece of the market. We’ve had senior leaders among prominent vendors essentially tell us that they don’t care about what frontline users have to say.”

Okay. (Taking a breath, letting out the bad air, taking in the good.) I don’t wanna go off on a rant here, but are those vendors completely stupid?  Are they trying to destroy whatever credibility they have left among end users?  Are they hinting that we should just sell their companies’ stocks short and live in the Bahamas the rest of our days?

To be clear, the researchers actually put a reasonably cheerful spin on all of this. They suggest, ever so politely, that if vendors pay attention to end users, they will “unlock a competitive gold mine.”  “Yes, it would require additional development resources, adjusting some roadmap goals, and resetting internal expectations, but the payoff is a quantifiable Unique Selling Proposition that just doesn’t exist very often in HIT – having a highly-rated platform among users,” they note, quite reasonably.

Being me, however, I’ll be a bit less nice. Vendors, I’m amazed we still have a health IT industry if that’s really how your leaders really think. It takes a uniquely dumb organization to keep selling products the actual users hate, and an even dumber one to ignore user feedback that could fix the problem.

While healthcare organizations may have rammed a jerry-rigged mess down users’ throats for a while, that can’t last forever — in fact, the day of reckoning is coming soon. As EMR users become more confident, wired and demanding, they’ll demand that their systems actually work for them. Imagine that!

This reckoning won’t just impact your future plans, it will come to bite you now.

If you were hoping to turn your multi-year contract into a nice, fat revenue stream, forget it. Users will scream (and inflict some pain) if the EMR is lousy to use. In a population health-based world calling for everyone to be clinical data power users, they’ll have far more clout. You’ll either spend tons of time fixing and updating things or lose your contract if your customer has an out. Either way, you’ve hollowed out your revenue stream. Good luck with that.

Healthcare Communication Cartoon – Fun Friday

Posted on July 7, 2017 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.

Happy Friday Everyone! This feels like a short week because of the holiday. Time for some fun Friday. I really like this first one because it has so many layers of humor. IT people like myself will see the humor from the tech angle, but nurses will see the humor from the overworked nurse angle. Tech will hopefully help with situations like this.

And the importance of communication in healthcare. Another area where tech should help, but in many cases it’s hindering us.

Nursing and Healthcare Reform Cartoons – Fun Friday

Posted on June 30, 2017 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 again for some Fun Friday cartoons. This week’s comics are more general healthcare cartoons, but they were both too funny to not share. I hope you enjoy them.

If you don’t love nurses, then we can’t be friends. They are some of the most amazing people in the world and undervalued and underappreciated in healthcare.

This one might be a little too close to home for many in the current healthcare reform environment. Humor that borders on reality are my favorite.

Vocera Aims For More Intelligent Hospital Interventions

Posted on November 14, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Everyday scenes that Vocera Communications would like to eliminate from hospitals:

  • A nurse responds to an urgent change in the patient’s condition. While the nurse is caring for the patient, monitors continue to go off with alerts about the situation, distracting her and increasing the stress for both herself and the patient.

  • A monitor beeps in response to a dangerous change in a patient’s condition. A nurse pages the physician in charge. The physician calls back to the nurse’s station, but the nurse is off on another task. They play telephone tag while patient needs go unmet around the floor.

  • A nurse is engaged in a delicate operation when her mobile device goes off, distracting her at a crucial moment. Neither the patient she is currently working with nor the one whose condition triggered the alert gets the attention he needs.

  • A nurse describes a change in a patient’s condition to a physician, who promises to order a new medication. The nurse then checks the medical record every few minutes in the hope of seeing when the order went through. (This is similar to a common computing problem called “polling”, where a software or hardware component wakes up regularly just to see whether data has come in for it to handle.)

Wasteful, nerve-racking situations such as these have caught the attention of Vocera over the past several years as it has rolled out communications devices and services for hospital staff, and have just been driven forward by its purchase of the software firm Extension Healthcare.

Vocera Communications’ and Extension Healthcare’s solutions blend to take pressures off clinicians in hospitals and improve their responses to patient needs. According to Brent Lang, President and CEO of Vocera Communications, the two companies partnered together on 40 customers before the acquisition. They take data from multiple sources–such as patient monitors and electronic health records–to make intelligent decisions about “when to send alarms, whom to send them to, and what information to include” so the responding nurse or doctor has the information needed to make a quick and effective intervention.

Hospitals are gradually adopting technological solutions that other parts of society got used to long ago. People are gradually moving away from setting their lights and thermostats by hand to Internet-of-Things systems that can adjust the lights and thermostats according to who is in the house. The combination of Vocera and Extension Healthcare should be able to do the same for patient care.

One simple example concerns the first scenario with which I started this article. Vocera can integrate with the hospital’s location monitoring (through devices worn by health personnel) that the system can consult to see whether the nurse is in the same room as the patient for whom the alert is generated. The system can then stop forwarding alarms about that patient to the nurse.

The nurse can also inform the system when she is busy, and alerts from other patients can be sent to a back-up nurse.

Extension Healthcare can deliver messages to a range of devices, but the Vocera badge and smartphone app work particularly well with it because they can deliver contextual information instead of just an alert. Hospitals can define protocols stating that when certain types of devices deliver certain types of alerts, they should be accompanied by particular types of data (such as relevant vital signs). Extension Healthcare can gather and deliver the data, which the Vocera badge or smartphone app can then display.

Lang hopes the integrated systems can help the professionals prioritize their interventions. Nurses are interrupt-driven, and it’s hard for them to keep the most important tasks in mind–a situation that leads to burn-out. The solutions Vocera is putting together may significantly change workflows and improve care.

Dear Nurses – Fun Friday

Posted on June 17, 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.

This week my cousin sent me a message late at night on Facebook. She’s a nurse and had just experienced her first patient who coded on her. Needless to say it was a traumatic experience and she was reeling from the experience. I’m not sure how much I helped her, but I tried to show some empathy and at least be there to listen to her in her time of need.

This experience reminded me of what a challenging job it is to be a nurse. We certainly don’t show them enough appreciation. With this in mind, it seemed fitting for this Fun Friday post to share ZDoggMD’s “Dear Nurses” parody of Tupac Shakur’s “Dear Mama.”

A big thank you to all the nurses out there that make healthcare great and don’t get nearly the recognition they deserve.

National Nurses Day Tribute

Posted on May 6, 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.

Today is National Nurses Day and this week is a celebration of all the amazing nurses in healthcare. I think nurses are the unsung heroes of healthcare. They do an extraordinary job and get very little recognition.

When I think about EMR in general it impacts nurses as much or more than anyone in the clinic. Yet in most cases, nurses have very little involvement in the EMR purchase process. Sure, most places do some sort of meeting with the nurses and they take a little feedback from them, but from my experience they have little involvement in which EMR is chosen.

This means that most nurses just have to deal with whatever EMR their clinic or hospital chooses. Most of them do it with the grace of a nurse.

My favorite nurse story comes from my experience with this wonderful nurse I worked with named Shelley. She is a vivacious and passionate nurse that loved her job. She wasn’t afraid to tell you what she really thought and had a heart as big as I’ve ever seen. Plus, she gave the best bear hugs!

When it came to the idea of going to EMR, Shelley was one of the biggest critics. She was not looking forward to the change and was vocal about it. Despite her and others fear of EMR, we pressed forward. One of the very first days after we implemented the EMR I came into the nurses station where I saw one of the nurses struggling with some EMR function. Next thing I know, EMR averse Shelley is reaching over the nurse’s shoulder and teaching her how to fix her EMR problem. It became a kind of running joke in the clinic that Shelley could go from EMR critic to EMR trainer.

I think this highlights the beauty of so many nurses. First, the ability to adapt to challenging situations. Second, the concern and care for fellow nurses and patients. Shelley was such a great representative of nursing to me.

On this National Nurses Day, I want to honor my friend Shelley and all the other caring, professional, wonderful nurses out there. This video from RWJF highlights the greatness of nurses.