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Interview with SRSsoft EMR CEO Evan Steele

Posted on October 1, 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.

I’ve been finding what SRSsoft and in particular their CEO, Evan Steele has been saying about the ARRA EHR stimulus money on the SRSsoft blog called EMR Straight Talk really interesting. They’re an EMR company that I think has taken a different approach to marketing their EMR software. So, I thought it would be interesting to interview Evan on a number of relevant topics related to his EMR and the ARRA stimulus money.

Let me know if you like the following interview and I’ll think about doing more of them.

Describe what you define a hybrid EMR is.

Hybrid EMR satisfies the demands of high performance physicians by providing process efficiency. This benefit is delivered through click minimization, ergonomic design, product flexibility and a non-proprietary, open software platform. The hybrid EMR is not exam note-centric, and therefore spares physicians the onerous data entry requirements associated with traditional EMRs.

Can you describe 3 features and how it’s done in a hybrid EMR versus a traditional EMR?
*Generating a ePrescription with only two clicks
*Reviewing a message, viewing the attached document (like a lab or a radiology report) and signing the document with one click.
*Generating a fully templated exam note from anywhere within the software with three clicks.

Will SRSsoft be participating in the ARRA EMR stimulus money program?

It all comes down to the meaningful use requirements – although, after 3 rounds of meaningful use discussions, the requirements are likely not to change significantly.  As listed in the most current “Meaningful Use” Matrix, they are quite onerous for physicians. The cost associated with reduced productivity that a high-volume, high-performance physician would incur by entering the data to meet the meaningful use requirements dwarfs the incentives being offered and the relatively small penalties which starting six years from now (in 2015).

How come I don’t see a CCHIT certified badge on your website?

CCHIT reached the apex of onerous requirements when it released its 2009 certification criteria which contained nearly 500 items. Since its formation in 2004, CCHIT has layered on more and more criteria each year, and vendors have been on a wild goose chase to program those requirements.  Most of these feature requirements are not used or valued by busy physicians. SRS made a conscious decision not to follow the herd and, instead focuses on features that busy physicians need to make their practices efficient so that they can manage their costs and take better care of patients.  The result is a highly ergonomic, usable EMR that actually meets the needs of high-performance physicians.  Sales have skyrocketed.

Interestingly, the new certification will be an HHS badge and not a CCHIT badge and there will be multiple certifying bodies. In addition, the HHS certification criteria will be only those features that are required to meet the meaningful use requirements.  CCHIT actually eviscerated their almost 500 requirements and announced that 88 requirements will be needed to meet meaningful use guidelines.  I feel sorry for the scores of companies that programmed hundreds of complex features only to find that they were unnecessary (all the while not focusing on what physicians actually want).  I also feel sorry for the physicians that paid for those unnecessarily complex products.

Listening to the voice of the physician is a winning strategy and always will be.

How did the HIT Policy Committee react to your “Voice of the Physician” petition?

Lynn Scheps, our Vice President of Government Affairs, went to Washington to present the “Voice of the Physician Petition” to the HIT Policy Committee in person, because we felt it was so important that the decision-makers understand how private-practice, community-based physicians view the expectations being placed on them. The government’s goal of widespread EHR adoption cannot be accomplished without buy-in from the physicians themselves, and the fact that a relatively small company like SRS could generate such a sizeable response in a short time, with minimal outreach efforts, indicates the deep level of concern among physicians. The “Voice of the Physician” petition was signed by SRS clients and non-clients alike, and over 150 of them feel so strongly that they took the time to submit additional comments.

As the petition was presented to the Committee, a number of members were observed browsing through the comments. I can only hope that all of the members take at least the amount of time to read them as the physicians took to write them. I think they will find them very insightful.

Is the government wasting their $19 billion in EMR stimulus money?

The government actually set aside $36 billion, anticipating $17 billion in costs savings from EMR adoption, so the net cost would be $19.2 billion if all goes as planned.
They won’t be spending it if doctors choose not to participate or if they are not able to meet the onerous meaningful use requirements (similar to their experience with the PQRI program.) In the latter case—a likely scenario—in which high-performance, high-volume physicians purchase the required software but are unsuccessful, the doctors will have wasted their money and the EMR vendor coffers will have been filled.

You claim increased productivity using SRSsoft.  Where does the productivity come from? Have you had any practices that haven’t had an increase in productivity?

It’s such a luxury to wake up in the morning, come to work and have 18 programmers who can carry out the vision of focusing purely on what physicians need to make them more productive. Productivity stems from automating processes and organizing information. The fewer clicks and less mouse movement it takes to store and access information, the better the result. Our mantra for the past 12 years is “DO NOT SLOW PHYSICIANS DOWN.”  We found that by automating the myriad of repetitive, labor intensive processes found in every medical office, massive productivity increases result every time. It’s just like any other business process improvement software that replaces antiquated paper workflows. It’s a big win if software directly addresses process improvement while positively impacting a company’s executives (in this case, the physicians). Employees become more productive and the executives benefit from having key critical information at their fingertips.

There is a huge difference when a company is not shackled by someone else’s vision (e.g., the government, certification bodies, etc.) of how technology should be applied in a medical practice.  Plain and simple: physicians know what they want for their practices and know what works, non-physician bureaucrats do not.

Every EMR company will claim that they focus on process and workflow improvement in medical practices. Not true! Just count the clicks required for simple, repetitive tasks and it becomes crystal clear what happens when companies cater to non-physician stakeholders. Any company can slap together a lab management module, an ePrescribing module, a messaging and tasking module, or a forms module, but it takes tremendous focus and dedication to integrate it tightly with the core software, make it intuitive to use and make it ‘fly’ in a medical practice. Clicks are the biggest source of lost productivity for physicians using EMR. Most private practicing physicians’ income is tied to productivity, so time is money. Therefore, every click costs money.

If EMR vendors focused 100% of their resources on usability, click-reduction and module integration rather than on hundreds of pie-in-the-sky features dreamed up by bureaucrats, adoption would flourish.

What are your thoughts on open source and open APIs in EMR software and how does your OpenPath technology fit into it?

SRS is a strong proponent of open architecture software.  At SRS, we have built the web right into the core parts of the software so anyone can customize it. They don’t have to rely on SRS to customize the software for them. SRS has many clients that have talented, tech-savvy employees who have used our Software Development Kit (SDK) to customize their SRS in amazing ways.

SRS spent a great deal of time developing its OpenPath™ technology so clients aren’t beholden to us for customizations. Many other vendors do just the opposite and require that clients go through them for customizations. It’s analogous to buying a house and then a few years later, when you want to add a new room, you find that you are handcuffed because you have to go to the builder for the addition and accept his design, his pricing and his timing. If SRS were the builder, we would be happy to build the addition, but you would also be free to choose your own builder, your own design and negotiate pricing and timing. That level of client control is sorely lacking in the EMR industry. For example, we have many prospective clients that have a strong desire to switch from an antiquated, traditional point-and-click EMR to SRS and they are petrified to ask the legacy vendor for assistance in moving the data from their system to ours. Over the short term, this is good for the legacy vendor, but it puts the medical practices’ long-term IT plans in jeopardy – they feel like the legacy vendor has put them in a straightjacket.  With the SRS OpenPath™ SDK, our clients have a document with our database schema clearly outlined so as to facilitate customizing our software or having the option to migrate to another software package should they want to at any point in the future.

What other customizations have been done by end users using your OpenPath™ technology?

SRS and its clients have created a myriad of customizations that leverage our OpenPath™ technology. Here are some examples:
*Using the SRS software development kit (SDK), a 100 provider primary care group completely rewrote their Clinical Summary web page that resides on the SRS desktop. In addition to a detailed summary of a patient’s key clinical information, the new Clinical Summary includes custom alerts and information fetched from their practice management software database (e.g., balance, alerts when balance is past due, etc.).
Ophtalmology-Clinical-Summary-Screenshot
*A solo practicing ophthalmologist had SRS rewrite the Clinical Summary to match, perfectly, his thought process when reviewing clinical information before an exam.
*A 52 provider multi-specialty group had SRS customize their Clinical Summary so that with one click, they log the date and time a dictation was completed. They also created a custom transcription exception report that flags all transcriptions that have not been received within a certain timeframe.
*A 20 provider orthopaedic group also leveraged the SRS SDK to self-create a “PowerTab” that pulls up a fully integrated web page (right inside SRS) where the physician orders prescriptions for the patient which is then sent to the in-house drug dispensary.

What do you see happening in the future with EMR software?  What’s going to happen and what’s likely to happen?

Physicians are going to get hurt when they are “incented” to buy systems without being fully aware of what will be required and the lost productivity that they will incur. This will lead to non-use, and the consideration and purchase of more usable alternative solutions in the future. This is exactly what we are seeing in the marketplace today with legacy point-and-click EMRs.

Is EMR and HIPAA part of your daily reading?  If not, why not?  Lol

Of course, I love the writing and commentary!

Killer EMR Features According to EMR Vendors

Posted on May 13, 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.

I previously posted a request to hear about the “killer” EMR features that set an EMR vendor’s software apart from the other 400 EMR vendors out there. As expected, some of the people who sent me a message didn’t understand what I mean. However, a few of the responses we’re pretty interesting. I think we’ve barely scratched the surface on EMR features, so please keep submitting your best EMR feature on the contact us page.

Here’s a quick look at three of the responses from EMR vendors. I’ve added strikethroughs when it’s not a killer feature and my commentary is in italics.

First up is SRSSoft‘s killer EMR feature:
The SRS hybrid EMR is a killer EMR, with the prime killer feature being “speed.” Speed is built into the hybrid EMR throughout, and is delivered in three primary ways—click minimization, OpenPath™ technology, and robust messaging.Speed is a killer featuring and an EMR company focusing on speed and calculating clicks makes it a killer feature.

SRS conducts time-motion studies to minimize the number of clicks and the number of seconds it takes for physicians to accomplish their most frequent clinical tasks. For example, a prescription can be written and approved with 2 clicks, and an image can be viewed with only one click. Additionally, the SRS nonproprietary OpenPath™ technology foundation allows the seamless “plug-in” of other applications—physicians can access a myriad of programs containing patient information directly from within the patient chart, without having to waste time toggling back and forth between SRS and other applications.I would have liked to see a list of applications which are already integrated, but an API(Application Interface) in an EMR is a really cool feature.

Furthermore, SRS Messaging automatically attaches the complete patient chart to every message between staff members, which means that when key information is needed to make a quick clinical decision and respond to a message, the information is only one click away.One click access to the patient chart is nice. I wonder how many clicks it takes to tie the message to the chart in the first place.

Speed, Fewer Clicks and an API are definitely killer features of an EMR. I’d be interested to try SRSsoft to see if they can really deliver these features. Regardless, I wish every EMR company was as focused on the number of clicks and the speed of their application.

XLEMR.com said the following:
Simplicity – Built on the single most widly used small business software in the world (Microsoft Office), XLEMR is as simple as Outlook, Word, and Excel. It’s not uncommon for doc’s to sit down and start using XLEMR with no training…I’d like to see how well a doctor uses this EMR with no training. No doubt office is a familiar application to many. However, I’m surprised how often doctors need to be trained on simple things in Word like saving a file to a specific location. Assuming a doctor can sit down and use it with no training, that’s a killer EMR feature.

Inexpensive – XLEMR works on your old hardware and software you already own. There is no server or database to crash and maintain. There is no dependence on the internet. There is no annual maintenance agreement and because it’s Microsoft you can improve it yourself or hire your nephew…Some might argue that these are all reasons why you should not implement this EMR. For example, there’s some benefits to having a database that anyone can access anywhere you have internet (which is everywhere these days). Not to mention more reliable server hardware compared to desktop hardware. However, this could be a killer EMR feature for certain practices.

Efficient – Chart established patients in 3 minutes including the exam, the orders, the labs, the coding, the note is faxed out to referring physicians, the prescription is faxed or printed or e-prescribed or all of the above, the bililng is done…I had to strike this one out for now. Every EMR vendor makes this claim more or less. I just don’t see that happening for most visits using just Word. I’d love to see some proof of this in a video or something. It also seems to contradict the “no dependence on internet” point above since so many of those things require internet to be done well.

Easy Implementation – Download, Install, Configure, and chart your first patient in 1hr or less…An hour is a seriously short period of time, however, a number of other EMR are claiming 5 minute EMR installs. I personally think that it’s all a bit of marketing spin. There are just far too many customizations people have to make and things people have to learn in order to implement an EMR.

Nice work XLEMR. Simplicity and inexpensive are both really killer features of an EMR. Executing on those two things will make a lot of doctors really happy. I can’t help but wonder what you might be missing as far as reporting and accessibility of records, but that’s not the point of this. The point is to learn about and share killer features that every EMR can try to obtain.

Next up, BennPenn:
Our program, BennPen, is different from most EMR systems because:
1. Our is simple to use. I believe many Drs. who have tried EMRs have rejected them
because they are complicated and difficult to use and the Drs find it takes longer to use
the program than to write the notes as they always have.
This could be a really killer EMR feature, but I’d need to know a specific example of how it’s simpler than other EMR. It’s not just enough to say it’s simple.
2. Our program is customized for each Dr. We load the templates, forms, letters the Doctor
uses into BennPen so he or she continues to chart with the forms they are familiar
with.This is an awesome feature. Many doctors love to chart the way they’re use to charting. I’m sure that many EMR purists will argue that it’s not a real EMR if you don’t capture granular data. However, I think there’s a middle ground that should be considered. Also, what makes this description a killer EMR feature is that the EMR vendor loads the templates for the doctor.
3. The Doctor can use voice, drop-down lists, or a combination of the two. Every EMR vendor can do this, no?
4. Our program is less expensive than many – $3,000 plus $500 for each Dr. over 1 in the
office.I’m always happy to help inform people that the price of EMR doesn’t have to be in the hundreds of thousands of dollars. That’s what makes lower priced EMR a killer feature.
So, BennPenn added customized EMR templates (loaded by the EMR vendor) and low cost EMR. Two really great features.

I think we’re just barely scratching the surface on what makes an EMR vendor special. Although, maybe the lesson here is that it’s the core features that every EMR claims to offer that makes them special. Maybe I should rephrase the question. Instead of asking about a killer feature, maybe I should be comparing the same feature across multiple EMR systems and highlighting what makes each EMR systems implementation of that feature unique, different and/or better. I’m going to have to think on this one.