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!!

Exposing the Jabba the Hutt EHRs and Finding the Han Solo EHRs

Posted on June 21, 2011 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 had some interesting reactions to my post about the various characteristics of a Jabba the Hutt EHR Vendor. One of the more interesting conversations happened by email with a reader named Richard. Yes, I have lots of interesting back channel discussions.

After a lengthy email exchange, I asked Richard if I could post our discussion on the blog so you could participate as well. He agreed and even commented, “I look forward to an expansion of our discussion.” So, here you go (or at least scroll to the bottom for a short summary of my feelings).

The conversation started with this email that Richard sent me:

I understand your reluctance to name names in your article, BUT… this is exactly what is needed.

I’ve taken a few days to ruminate over what I was going to suggest and I’d like to hear your thoughts on this if you have time.

With your readership, I suspect there are plenty of users and observers of current packages and lots of opinions. Why not set up something like a Wiki-EMR site to provide a resource that will allow everyone to provide input into the details making “Jabba” and “Han Solo” EMR systems and see where it goes? Maybe it could eliminate some of the BS surrounding some of these systems and help others who are trying to sort out there own future needs. I’m sure there are plenty of people out there who want, need and are willing to provide information on the state and future of EMR and what is BS and what isn’t. I certainly would. Let me know your (or your readers) thoughts.

Richard

Here was my response:

Hi Richard,
Yes, this is something I’ve thought a lot about. The key question for me is how to publish some sort of “authenticated” information. Most systems are so easily gamed and/or abused that they basically have no worth. I haven’t figured out a scalable way to be able to provide information that is actual data and not provided with undue influence.

As I read your email, I wondered if some sort of combination of LinkedIn might be the key. At least then any review that’s done would be tied to an individual. Although, by doing so, you’d then discourage many of the most interesting reviews and feedback because their name would be explicitly tied to the review.

Along these same lines I’ve wondered how I could provide a “Meaningful EHR Certification” that wasn’t based on a pass/fail system that has no value. Instead it was a mixture of qualitative and quantitative data that would actually be of value to the reader. Scaling that up is the challenge I have with that idea. Not to mention figuring out the right financial model for it.

So, as you can see I’m with you on wanting more specific information out there, but not sure how to overcome the abuse and the scale that you need for it to be valuable.

As a side note, I do have a wiki page: http://emrandhipaa.com/wiki/Main_Page and it even has an EMR and EHR Matrix of companies. Although I closed registrations since spammers were getting into it.

Richard then provided this response:

It seems to me that user editing must be do-able if Wikipedia has found a way. Additionally, I think that unvarnished truth through comments creditable or not (but differentiateable ) would be a place for insiders or knowledgeable users and IT pros to vent. I realize that it is open to abuse, but a user moderated (or whatever Wikipedia uses) forum will turn upon such miscreants and their abuse might well backfire. I realize it is quite a project, but I’ll bet there are a handful of your readers, if not many more, that would gladly help put something this critical in place. If this can be pulled off, it might create “the world’s foremost authority” * in EMR.

I don’t know much at all about this, but I have a feeling that so much is riding on all of this and that there is a vacuum of useful, meaningful and understandable information that is needed to make this whole thing work. I know there must be something prescient sounding I could offer here, but it might be just indigestion that’s giving me this feeling. John, there must be some other smart guys around; try to round up some and see what they think.

Then I offered this response which shows I’ve been on Wikipedia far too much:

I’ve been rolling around something like this since I first started blogging about EMR. Wikipedia’s a bad comparison because it tries to formulate 1 truth instead of a series of opinions about something. Plus, Wikipedia relies on the masses of people (we don’t have enough mass) and even they get to a point where they regularly lock pages after abuse happens. Wikipedia’s a crazy community once you get into it. There are flame wars and battles on Wikipedia that rage in the background that most people don’t realize are happening.

Travel and hotel sites are a better comparison actually. Since reviews of hotels are more similar to a review of an EMR. The hotel owner wants to put the best reviews on there and can plant good reviews amongst many other ways to game the ratings and review systems. I read an interesting story about how Trip Advisor tried to deal with this. Unfortunately, it put on the image of successfully battling it, but didn’t do that well. Matters much less when you’re talking about a hotel versus an EMR.

I agree that it could become the authority on EMR software if it’s done right. Although, for me to do it, I have to find a model that’s authentic, honest, reliable, scalable and that makes sense economically. At least until I sell off a company for a few million. Then, maybe I can cut out the economical requirement.

Then Richard commented:

I didn’t realize that abuse was that rampant and that a fix was so difficult. I think I see some of the problems. You almost need a cadre of “fair witnesses” to explore the opinions and observations of users and provide incorruptible analysis. Not a promising outlook.

I’d be happy to assist this enterprise in any way I can, but don’t think I would bring anything very useful to the table. I feel you may be the right person to bring something like this to fruition, but the resources needed may be out of reach. It’s too bad there isn’t a Consumer Reports -like group out there for something like this. Maybe some group has enough vested in the outcome of shake-out to fund independent assessment and provide a forum for users.

I know very little about the technology involved in EMR, I am more aware of the medical business and needs for improvement in record and information management. Additionally, if cost containment can’t be managed and a “best practices” can’t be incorporated into every patient’s care then our society may be doomed economically (even morally). You’re doing something valuable, so keep it up, there must be a way to sort out the players and the technology so we can get on with the real need which is getting something useful and beneficial installed for quality patient care. Even getting this discussion broadened is worthwhile.

Well, there you go. If you made it through that, then you must really care about EHR and healthcare IT like I do.

In summary, I think it’s quite clear that it’s an incredible challenge for those searching for EHR software to find reliable information. The need for good EHR vendor information is extraordinary and no one has cornered that market…yet? There is no “consumer reports” for EHR software.

I haven’t yet identified a model that’s authentic, honest, reliable, scalable and that makes sense economically to deliver said “consumer reports for EHR software.” (or maybe I’m just too lazy, scared, busy, etc to try)

I do think that this site and the other members of the Healthcare Scene blog network provide a valuable independent resource for those selecting and implementing an EMR. My free EHR selection e-book was one effort to help providers in the EHR selection process in a very targeted way.

Are there other things that I (we) could do to help even more? I’m sure. If you have ideas, I’m interested to hear. You see my off the top of my head criteria above.

If nothing else, we can reach Richard’s goal of “broadening the discussion”

EMR Pricing Comparison Website

Posted on October 8, 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.

In a number of my recent posts and conversations the idea that providers need a way to filter through the plethora of EHR vendors that exist out there (Between 300-600 EHR vendors) has become a really compelling theme.

I think some of the challenges with filtering EHR vendors include:

1. Getting truthful information about an EHR vendor. This is especially true when it comes to pricing. There’s just a lot of bad information out there. On top of that, there’s a lot of partial information that doesn’t tell the full story of how much an EHR costs.

2. Having a way to compare the pricing of various EHR vendors. Let’s be honest, price is ALWAYS a part of the EMR selection process. However, it’s definitely a challenge for providers to try and compare prices across EHR vendors. Comparing the cost of a SaaS EHR versus a Client Server EHR takes some analysis.

I’m considering the idea of creating a website or section of one of my existing websites that’s devoted to getting truthful and complete EHR pricing information. I’m not exactly sure the right approach to do this in a successful way that’s accurate and scalable.

One direction is to go to the EHR vendors themselves and get the pricing info. Over time I think that EHR vendors would start coming to me to be listed on the price list. The key would have to be asking the EHR vendors the right questions so that we got ALL the pricing information and not just part.

The other way is to talk to doctors who’ve recently implemented a specific EHR vendor and get the pricing details that they actually incurred implemented that EHR software. This would obviously be some very interesting data. The question here is whether doctors would be willing to collect and provide that data. Plus, would there be phony “doctors” deployed by the EHR vendors to skew things?

A few other challenges with this idea. The first challenge is that EHR vendors will often change prices. Keeping up with the EHR price changes would be a challenge. The second challenge is that many EHR vendors pricing is a negotiated price. Obviously, if I’m buying software for 100 doctor practice I have more leverage to negotiate price. Maybe the key for this second challenge is to just focus on the 1-5 doc practice EMR pricing. They have much less leverage in negotiating price anyway. Plus, wouldn’t it be interesting to see which EHR vendors have drastically different pricing?

What do you think of this idea? Does it have merit? What things would I have to do to ensure that the data was interesting and useful? Would having something related to EHR pricing be better than what we have now (very little)?

What data elements would be useful to have from an EHR vendor when you’re evaluating pricing? What’s on your list of pricing questions?

Would you as a doctor or EHR vendor be interested in sharing your pricing info?

If I decide to take this on, my goal would be to provide truthful information that was valuable to providers in their filtering of EHR vendors. To make it worth my time, I’d likely put ads on the site. In fact, both things are basically what I do here on EMR and HIPAA.

Rating Top EMR Companies

Posted on April 21, 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.

Lately I’ve been really intrigued by the concept of trying to rate the long list of EMR vendors in order to identify the “Top EMR Companies.” I guess I’ve been intrigued by this idea for a number of reasons.

First, tons of people are searching the internet and finding this website in their search for the top EMR vendors. Makes a lot of sense that doctors would want to narrow down their search for an EMR since it’s just unreasonable for them to try and review 300+ EMR vendors. Although, I do think it’s a little bit funny that they think they can just enter “top EMR vendors” into Google to find the answer.

Second, I’ve seen a number of groups touting an EMR vendor showcase with the “top EMR vendors.” The problem I have with this is that how can they say that they’re the top EMR vendors. More than likely these organization took the EMR vendors they had connections with and allowed them to present. In fact, in this case, I know one EMR vendor gets to present because they’ve made those connections. This is all well and good, but that’s not really “top EMR vendors” in my book.

Finally, a number of EMR vendors are interested in having some sort of “top EMR vendor” rating. Kind of a stamp of approval that they have a high quality EMR system. EHR certification has attempted to give this assurance. The problem there is that EHR certification doesn’t actually rate the top EMR vendor. It just tests a list of criteria which can easily be gamed and does little to measure the usability or actual clinical acceptance of that software product.

No doubt there’s a desire to try and have a “top rated EMR comany” list. The real question is how do you go about making a list like this?

I don’t know all the details around JD Power and Associates, but I think that many EMR vendors and physicians alike would love to give that type of stamp of approval that an EMR vendor’s software meets some standard level. However, I think just a general stamp with no other data just feels empty to me. It’s almost like you need to rate and provide qualitative feedback on various rating areas. Otherwise, the stamp of approval has little value to doctors and clinics trying to select an EMR.

Beyond that, it almost seems like there needs to be an evaluation or verification with existing users of the EMR. They’re the ones who really know how well an EMR functions, how responsive the support people are, and how usable the EMR system really is. Of course, this would require talking to multiple users of an EMR system and not just the company shills (excuse the term). Definitely a challenge.

Beyond that, it seems wrong to just provide a general rating for an EMR. For example, one EMR vendor might be great for general medicine, but might be horrible for an OB/GYN. It’s almost like you need to rate the EMR vendor based on various specialties to provide real value. Not to mention, adding in things like size of the organization, location of the organization, etc. There’s a lot of factors that would drastically change the rating of an EMR vendor.

Of course, the other problem with the concept of “top EMR companies” is that any EMR company could be the top. What are they the top of? Are they the top implemented EMR vendor? Are they the top customer support EMR vendor? Are they the top specialist EMR vendor? Are they the top SaaS based EMR vendor? etc etc etc

Obviously, I don’t yet have all the answers to this problem. Although, I’m very interested in the idea. More importantly, I’m interested in finding ways to provide valuable information like “top rated EMR vendors” that could help doctors select the right EMR. Seems like RECs could benefit from this information as well.