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The Shifting Health Care IT Markets

Posted on November 5, 2015 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’m at the end of my Fall Healthcare IT Conference season (although I’m still considering attending RSNA for my first time) and besides being thankful to be done with all the travel, I’m also taking a second to think about what I’ve learned over the past couple months as I’ve traveled to a wide variety of conferences.

While the EHR market has been hot for so many years, I’m seeing a big shift in purchasing to three areas: Analytics/Population Health, Revenue Cycle Management, and Privacy/Security. This isn’t a big surprise, but the EHR market has basically matured and now even EHR vendors are looking at new ways to market their products. These are the three main areas where I see the market evolving.

Analytics and Population Health
I could have easily added the other buzzword “patient engagement” to this category as well. There’s a whole mixture of technologies and approaches for this category of healthcare IT. In fact, it’s where I see some of the most exciting innovations in healthcare. Most of it is driven by some form of value based reimbursement or organizations efforts to prepare for the shift to value based reimbursement. However, there’s also a great interest by many organizations to try and extract value from their EHR investment. Many are betting on these tools being able to help them realize value from their EHR data.

Revenue Cycle Management
We’re seeing a whole suite of revenue cycle solutions. For many years we’ve seen solutions that optimized an organization’s relationships with payers. Those are still popular since it seems like most organizations never really fix the problem so their need for revenue cycle management is cyclical. Along with these payer solutions, we’re seeing a whole suite of products and companies that are focused on patient payment solutions. This shift has been riding the wave of high deductible plans in healthcare. As an organization’s patient pay increases, they’re looking for better ways to collect the patient portion of the bill.

Privacy and Security
There have been so many health care breaches, it’s hard to even keep up. Are we becoming numb to them? Maybe, but I still see many organizations investing in various privacy and security programs and tools whenever they hear about another breach. Plus, the meaningful use requirement to do a HIPAA Risk Assessment has built an entire industry focused on those risk assessments. You can be sure the coming HIPAA audits will accelerate those businesses even more.

What other areas are you seeing become popular in health care IT?

EMR and Health IT Development – Interview with Chetu

Posted on April 25, 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.

Craig Schmidt - Chetu
Craig Schmidt is the Director of Global Sales for Healthcare & Pharmaceuticals at Chetu. Craig’s focus at Chetu is understanding the top healthcare industry challenges, creating relationships with HIT leaders and developing Information Technology solutions to address those challenges. Craig has, for over 15 years, held a variety of Sales and Sales Management positions with increasing responsibility in the Healthcare and Information Technology Industries.

Tell us more about Chetu and your work in the healthcare market.

It would not be an exaggeration to say that Chetu has experience in nearly every section of Healthcare IT. In our 13 years we have developed solutions for Providers, Payers, HIT Vendors and others. Just a few of the things with which we have helped customers include: complete EMR and Practice Management design and development, ePrescribing, Drug Database integration, Revenue Cycle Management (835/837 & 270/275 engines).

When does someone in healthcare look to Chetu versus doing the work in house?

The two main reasons are: they do not have the particular HIT experience in-house & they do not have enough “bandwidth” to develop in-house and do not want to hire and train permanent staff.

What’s the most challenging thing about developing applications in healthcare?

Healthcare in general and Healthcare IT are bound by many Federal, State and other rules and regulations, e.g., Meaningful Use, Affordable Care Act, HIPAA, etc. There are also a variety of standards for interoperability such as HL7, CCD/CCR.

Do you mostly do one off projects or long term contracts with your clients?

We strive to be the “Back End, Long-term” IT Partner for our clients. We offer complete solutions from application development and support to maintenance and management of applications and systems. In Healthcare we have many (over 60%) clients that have been working with Chetu for multiple years. Many of these have been with Chetu for over 5 years – which is very long-term in this market

What’s your view on SaaS vs. in house client server applications? Do you have a preferred technology stack? What do you see being used most in healthcare?

For the past several years organizations have been rapidly moving to the “Cloud.” And, there are obvious advantages for being cloud based. However, client server applications have advantages of speed and stability that can’t always be achieved with SaaS. We are now seeing a slight movement to applications that are hybrids – combining the best of both approaches.

In healthcare, there is no clear preferred technology stack. It is all over the place. We have worked in .NET, HTML5, Java, PHP, Native Mobile Apps (iOS, Android), Python, C++, Foxpro, VB, Mirth. Cobol, MUMPS and many more. Healthcare IT has traditionally seen a very fragmented approach. Chetu has the great advantage of being agnostic. We can and will work with nearly any platform or tool.

EMR usability (or lack thereof) has been a major topic of discussion. How do you manage this with your EHR clients?

We have had the opportunity to work with dozens of different EMRs; ambulatory and hospital based. Many of these EMRs are the product of individual physicians or physician groups that are unhappy with their current EMR and have not seen any existing EMRs that meet their usability needs. They have come to us with their ideas about developing an EMR from scratch. We have developed ENT, Ophthalmology, Plastic Surgery and other specialty focused EMRs stemming from this issue.

What are you seeing happening with mobile in healthcare?

There is a tremendous rush to mobile in Healthcare right now. Over the past several years our Healthcare mobile development has grown tenfold. There are many, many great mobile applications developed with patients, physicians, nurses, home health providers and others in mind. These apps have been and will continue to make providers, payers and patients lives easier and make delivering healthcare more efficient and productive.

You’ve worked with a lot of the various healthcare standards. How do they compare to the standards you work with in other industries?

There really is no parallel to the standards that guide healthcare in other industries. From my limited experience I would say that the Banking/Financial industry comes closest. But even then the amount and complexity of the standards are a fraction of what is found in Healthcare and Pharma.

Tell us about some of your work on the major hospital platforms like Siemens Soarian, Meditech and Epic. Is it a challenge working with these large companies?

These large companies have invested millions of dollars building and improving the very complex systems. So, they are rightfully concerned and selective about how and who is allowed to work in their systems. It can be a challenge, but not impossible to work with these companies. An added challenge comes from the hospitals themselves. There is the attitude that these systems are so unique that only company trained personnel have the capability to work in them.

Chetu, having worked in the Soarian, Meditech, Epic, Cerner, McKesson and other hospital platforms understands that the underlying technology in all of these systems are the same or very similar. Although each system may have unique capabilities – we recognize that the goal is the same for each. And, in getting past the UI or getting “under the hood” so to speak, we see mostly the same technologies at work.

What are the most innovative healthcare IT projects you see out there that you like working on?

Right now we are seeing a rush to capitalize on the tremendous amount of data that EMRs are generating. Data analytics using this great resource is helping pharmaceutical companies, scientists and researchers, Accountable Care Organizations – nearly everyone on the healthcare continuum provide better and less expensive patient care. This is an area that is in its infancy but we see growing rapidly.

What types of data analytics projects have you done in healthcare? Do you do just the programming component or can you do every part of a data analytics project?

Chetu has been involved in numerous healthcare analytics projects. We have helped our customers with data warehousing, data mining, OLAP, business analysis, automated report generation, multi-dimensional information “cubes”, custom reporting solutions using tools like Informatica, DTS / SSIS, Datastage and SSRS, SSAS, Cognos, Microstrategy, Crystal, OBIEE.

We have developed solutions across the complete data analytics process. From data mining and ETL to data cube and data modeling and report generation we have the experience and the people that can handle nearly any healthcare analytics project.

Full Disclosure: Chetu is an advertiser on EMR and HIPAA.

Where is the Value in Health IT?

Posted on August 10, 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.

What a powerful question that I think hasn’t got enough attention. Everyone seems to be so enamored with EHR thanks to the $36 billion in EHR incentive money. I seem to not be an exception to that rule as well. Although, at least I was in love with EHR well before the government started spending money on it.

While so many are distracted by the government money I think it’s worth asking the question of where the value is in healthcare IT.

Practice Management software has a ton of billing benefits. Is there a practice out there that doesn’t use some sort of practice management software? I don’t know of any.

Health Information Exchange (HIE) has a ton of value for reducing duplicate tests. Certainly we have challenges actually implementing an HIE, but the value in reducing healthcare costs and improving patient care seems quite clear. Having the best information about someone clearly leads to better healthcare.

Data Warehouse and Revenue Cycle Management (RCM) has tremendous value. RCM is not really sexy, but after attending a conference like ANI you can see how much money is on the table if you deal with revenue integrity. I add data warehouse in this category since they’re often very closely tied together.

Since this is an EHR site, where then does EHR fit into all this? What are the really transparent benefit of using an EHR. I know there are a whole list of EHR benefits. However, I think it is a challenge for many doctors to see how all of those benefits add up. EHR adoption would be much higher if there was one big hair benefit to EHR adoption. Unfortunately, I don’t yet think there’s one EHR benefit that’s yet reached that level of impact. I hope one day it will. Not that it matters right now anyway. Most practices wouldn’t see the benefit between the EHR incentive weeds.

The Real Money is in the ACO, Not Meaningful Use

Posted on May 24, 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.

John Moore from Chilmark Research offers this great insight for those of us in the healthcare IT and EHR industry:

The MU requirements have become little more than a “spec-sheet” for vendors, consultants and IT shops and departments. These requirements have nothing to do with innovation and have little to do with the dramatic changes that will occur in this industry in the next decade. Quoting that oft-used phrase, “follow the money” one can quickly see that the billions in funding for incentivizing providers to adopt EHRs under the HITECH Act is relative chump change to the dramatic fortunes that may be won or lost under the new value-based payment models that are proliferating throughout the industry – payment models that commonly fall under the rubric of ACO or PCMH. In each of these models, EHRs are important to a degree, they are part of the basic infrastructure. But it is what one does with the data that matters (collect, communicate, collaborate, synthesize, analyze, measure and improve). Therefore, if you want to see innovation look beyond today and the tactical push to effectively adopt and meaningfully use EHRs and towards the future of how that data will be used to drive quality improvements, better outcomes and lowering risk exposure.

As the title says, I translate this to mean: The Real Money is in the ACO (Accountable Care Organizations), Not Meaningful Use

Of course, his description of the current healthcare IT landscape also reminds me of two posts I did previously: EHR is the Database of Healthcare and Is Revenue Cycle Management Sexy?

Both of those posts highlight many of the the observations that John Moore makes. First, if the EHR is nothing more than a repository of data, then it has value (Oracle did pretty well as a database) but it’s limited. Those who can take the data stored in EHR and other healthcare data sources and do something amazing with it are going to be the big winners in healthcare IT. Could an EHR vendor be the one to do this? Possibly, but looking at other industries, I think this is unlikely. That’s why I describe EHR’s similar to databases.

The answer to the question posed in the second post linked above is “Yes, if you like money.” Sure, healthcare isn’t all about money, but money can be a tremendous driving force for doing good as well. It turns out that dealing with revenue cycle problems provides tremendous value to a clinic. However, many people for some reason look past it since they think it’s not “sexy.”

The ACO model that is fast approaching is also going to make this even more important. It’s still too early to describe exactly how it’s all going to play out, but many who don’t have a handle on the business side of their practice are going to miss out.

I’ve heard some describe meaningful use as a high bar to achieve. I disagree. Meaningful use is prescriptive and simple for EHR software to achieve. Sure, it takes some time and effort, but any one with time and effort can achieve it. I don’t think we’ll be able to say the same for ACOs. That’s why the value of the ACO is going to be much higher than meaningful use. It’s the traditional higher risk leads to higher reward.

Real-Time Analytics and Dashboards for Streamlining Revenue Cycle Automation

Posted on January 25, 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.

Last month CareCloud announced a new real-time analytics dashboard to help doctor streamline revenue cycle automation. The core of their product is what they call CareCloud Analytics. As I think about the announcement, I wondered if it was really a big deal or not and why we hadn’t seen more of this in the various practice management systems and EHR software on the market today.

Is Data Analytics important in Healthcare?
I think this type of information is a big deal. Information is power and this is never more true than in healthcare. The press release does a great job of describing how real-time analytics and dashboards provide information which provides transparency and accountability to a practice. One quote from the article says, “The practice can now manage the productivity of the office staff, monitor in real time the productivity of billers, and gain transparency into the business side of operations to help form better decisions through data, instead of intuition.”

I’m a huge fan of analytics in my business. I call myself a stats addict. I have 2-3 stats programs running on my websites at all times. I get stats from my ad server, from Google’s ad server, and from every other stats engine I can find that has reliable data. Much of my success with my websites is because of my passion for knowing what’s happening with my websites. To me, Data is power! The same can be said for a practice. Data is the power to make important decisions that are needed for the success of your practice.

Why don’t more EHR and PMS vendors provide these analytics?
I’m sure there are a number of reasons why we don’t see real time analytics happening very often in the small practices. Hospitals are a bit different. There are whole companies devoted to just providing these types of services to hospitals that can pay for a full scale data warehouse environment to provide this type of data. A hospital that doesn’t do this type of data mining is missing out as well, but they have a number of options. Although, I don’t think many hospital HIS vendors offer this info by default.

The key reason I think real-time analytics and customizable dashboards are missing in the small practice environment has to do with doctors demand (or lack thereof) for such a feature. This will surprise some, but most will agree that the majority of doctors don’t care much for the business side of the practice. Sure, they care that the business side of the practice effects how much money they take home at the end of the day, but a large portion of doctors would love their lives a lot more if they didn’t have anything to do with the business of a practice. Yes, I know there are exceptions to this, but most doctors want to practice medicine not business.

With this as background, if you ask most doctors what they want from their EHR and Practice Management software, they’ll start to list off all of the clinical and workflow needs that they have. Very few of them will even venture into the business requests like real time analytics. Plus, even if they did venture into the business side of things, would they know how to request such a feature?

EHR and Practice Management Vendors have to show them why it matters to have these real time analytics. It reminds me of the famous quote attributed to Henry Ford. “If I had asked people what they wanted, they would have said faster horses.” This can often be taken too far, but I think it applies well when it comes to things like real-time analytics of a practice.

One other reason that a number of companies are missing the analytics and its relationship with revenue cycle management is that they’re too focused on EHR. Many just consider the PMS a standard thing that everyone has already and that there’s no room to innovate. Last I checked meaningful use didn’t have any practice management elements and that’s taken up at least one development cycle for most companies. Too many doctors later dismay, the EHR selection process often puts the practice management side of the puzzle on the backseat. This is a mistake that many practices are paying for today.

As one PR rep for a major EHR company said to me, “Revenue Cycle Management isn’t sexy.” Although, she said this directly after telling me how beneficial it was to their bottom line.

Pervasive’s Revenue Cycle Management Solution Video at HIMSS

Posted on March 11, 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.

For one of the New Media Meetups at HIMSS we met at the Pervasive booth on the exhibitor floor. I must admit that I wasn’t quite sure what I’d find at the Pervasive booth, but I’d had a few interactions with the people behind the company and so I was excited to meet them in person.

Turns out when I first got there I was told about how Pervasive was taking the data stuck in EMR software or other healthcare software and was helping revenue cycle management companies extract that data out. I thought what they were doing was pretty interesting and so I caught this video explaining a little bit more about Pervasive:

This video coverage of HIMSS 10 sponsored by Practice Fusion and their Free EMR.