I finally had a few moments to watch the Matthew Holt interview of Glen Tullman, Allscripts CEO at HIMSS. Allscripts is no doubt a large player in the EHR industry (like it or not). This is especially true after Allscripts acquisition of Misys. So, Glen Tullman will have a large effect on the EHR industry so it’s worth listening to hear what he has to say. I’ll include a few quick comments of my own below the video.

Overall a pretty low key video. There were a few things that are worth commenting on.

The first thing that hit me was that Glen Tullman thought that the controversy over CCHIT was that CCHIT certified over 300 EHR vendors. Glen makes the argument that government wants a smaller footprint of EHR vendors and that 300 was too many. I guess I can kind of see why government might not want to certify 300 EHR providers since doctors just don’t have time to look through that many. However, it was the first I’d heard of that CCHIT controversy.

What does make a lot of sense is why the CEO of one of the largest EHR vendors would want the certified EHR vendor list to be a really small list that includes them. So, it would make sense for him to lobby the government to keep the list small.

I’m glad that Matthew Holt brought up at least another reason that CCHIT as the EHR certification is a problem. How about you just start with the controversy that CCHIT certification doesn’t provide benefit to doctors. Solve that one and we can find a way to deal with any other CCHIT controversies.

Of course, at the end Glen Tullman also said “CCHIT has done it [EHR certification] very effectively.” Effectively? Seriously? Can he provide me some data on how effective it is? It might be effective for his organization’s interests. So, maybe that’s what he meant.

Glen Tullman did make a great comment about SAAS EHR versus client server EHR. He basically said that most users don’t know the technology behind SAAS EHR and client server EHR. Glen suggested that most users just know the financing model of the two EHR options. A very fine point. I’d just add that they know the financing part AND the IT support part of the equation (ie. SAAS EHR means you [the EHR vendor] do the IT. Great!) Glen does seem to understand how to sell an EHR product to his customers.

There you go, there’s my quick comments. What can I say? I type fast.

I recently posted my belief that the EMR and EHR industry is about to shrink. This can happen in a number of ways, but will most often happen through either a merger or a company just closing its doors.

There are definite challenges associated when your EMR or EHR company gets merged into another company. I’ll save those discussions for a future post (or would welcome a guest blogger to write about their experience with it), but in this post I just wanted to raise awareness about what could happen if the company hosting your SAAS EHR goes belly up.

When selecting an SAAS EHR, it is important to learn how the EHR company is funded. Depending on how your company is funded will give you a good idea of how long they’ll be around. A company that is running off of venture capital funding or new sales could run into real troubles in this current economic crisis. Once an EHR company runs out of money they’ll generally have the choices listed above: sale/merge the company and assets or shut down the company. Of course, an EHR company that is structured to survive on reoccurring revenue is in a much stronger position financially and will weather the economic crisis better.  In a future post I’ll discuss some warning flags that might indicate that your EHR company is in trouble.

Imagine what effect it would have on your clinic if your hosted SAAS EHR were to close their doors.  An EHR becomes as integral to a practice as breathing.  You can only hold your breathe so long before you start experiencing some major consequences.  Have you thought about a plan in case this happens to your EHR company?  Do you even have the rights to the data in your SAAS EHR company?  What would you do with that data if God forbid, the company was going to shut down?

The good news is that I believe most SAAS EHR companies will try to give you at least some notice before shutting down the company.  However, you shouldn’t expect more than a month’s notice.  If a company is shutting its doors, then every month their in business their losing more and more money.  So, you better be prepared with a plan of what you’ll do in the event this happens.

Unfortunately, mergers or sales aren’t that much better than a company shutting down.  Depends on the merger or sale, but often the software from the company being purchased goes from being highly developed to mostly maintained.  Help requests will often go unanswered or at least a delayed response while the companies figure out the best way to merge the two companies.

Planning for this even is even more serious when using a SAAS EHR software.  In a hosted EHR situation, even if the company goes under you can still use the EHR for as long as you want.  You just won’t get support if something goes wrong with the software.  This gives you a longer runway to be able to plan the move to another EHR system.  An SAAS EHR software has a much shorter runway to make a change.

I wish these things weren’t a reality.  It would be nice to think that every EHR company is going to do great and be around forever.  However, it’s just not the case.  EHR companies of any sort are still a software company.  In fact, many are startup software companies and the statistics don’t lie that the majority of software startup companies fail.  Are you prepared in case your EHR company fails?

I recently invited the President and Owner of Great Acclaim LLC to do a guest post for this blog talking about the benefits of switching to a web based medical practice management. The hope was to illustrate the increased reimbursement that can be achieved by using a well managed practice management software (or SAAS – Software as a Service).

This blog has focused a lot on EMR and EHR, but hasn’t focused enough on the benefits of an electronic practice management service. The following guest post from Dan Williams will hopefully shed some more light on the benefits of a web based medical practice management implementation.

Guest Post by Dan Williams
Physicians face an array of options linked with the decision to switch to Web-based practice management solutions. Like EMR implementation, some doctors are reluctant to make the switch, citing reasons such as fear of change, fear of commitment to a provider, or fear of investment (“it’s just too costly”). However, once practice managers understand the value of a Web-based solution, and how that solution can easily and immediately lower claim rejection percentages, the fears will be seen as unwarranted.

With an industry average of nearly 30% in third party claims rejection, a client-server model cannot keep up with the constant process and coding changes the insurance companies are introducing into the reimbursement system. There are millions of coding combinations and they change regularly. Many doctors hire out to manage the business aspects of their practices, and may not even realize how much money they are losing through poor management, security threats, or simple ignorance of the solutions available. Medical professionals are accustomed to trusting in the newest proven advances to solve medical problems for their patients. It’s time they trust proven technological advances to solve business problems as well.

After firing their previous outsourced billing providers, several Seattle-area physicians’ practices recently hired Great Acclaim, a specialized outsourced medical billing firm, to handle billing functions. The firm had selected AdvancedMD practice management software based on its Web-based model and customer average of fewer than 5% rejected reimbursement claims. Using this Web-based practice management software, client monthly deposits and reimbursements increased by 50%, as fewer claims were denied and electronic financial transfers (EFTs) now account for 75% of insurance company payments.

Practice management software simplifies staff workflow by combining billing, scheduling and EMR functions. With no need to purchase additional hardware, install server-based software or perform manual data back-ups, initial investment is low, while ROI is maximized. Many practices and billing services find that the need for human review of claims and therefore, the number of man hours required to perform office functions is reduced, leading to greater efficiency and higher profits.

After initial setup and training all of its clients’ staff with the same software, Great Acclaim has eliminated integration obstacles. Nothing gets lost in paper transfers. From a new patient’s first appointment, physicians and their staff have access to the same information as Great Acclaim does through the Web-based model – anytime and anywhere.

Not only have client practices’ workflows improved since making the switch, but they no longer face a high financial security risk, as those receiving payments aren’t the same individuals who manage the billing. The software is designed to inhibit fraud. All of this equals less risk and more rewards for physicians. Or, as Great Acclaim’s clients have concluded: 50% higher returns for the same effort on the part of doctors—a great deal.

Dan Williams, a former software industry expert, is the President and Owner of Seattle-area outsourced medical billing firm Great Acclaim LLC.