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Attending the PCCHA Conference

Posted on November 14, 2007 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 currently attending the PCCHA conference which is basically the college health association conference for the west coast. The conference has been quite interesting. A few of the sessions ended up being quite useful, but more than anything it was just fun for me to talk to all of the various people working in the college health community. Most of my conversations centered around EHR and EMR implementation, but it was also fun to see these other college health professionals jealous of the really state of the art facilities we have on our campus.

My presentation on EMR went quite well and I think that many of the people in the audience got some useful information. At least that’s my hope. It was fun to present on EMR and the things we’ve learned. The interesting thing for me was that as I talked to people about EMR and EHR and using it in college health, I realized that over the past two years I’ve really learned a lot about what it takes to implement an EHR into a clinic. It can certainly be a daunting task if you look at all the intricacies.

In the end, my message to most of the people that I talked to was that while implementing an EHR can be overwhelming, it’s important to take small bite size pieces of it and accomplish those. Then, move on to the next problem and the next. The reality is that 2.5 years after implementing our EMR system, we’re still adding, modifying and changing our processes to be more effective.

Is it EMR or EHR…Am I Missing the Boat?

Posted on November 8, 2007 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 looking through my statistics lately (which I actually do most days) and it seems like most people aren’t searching for EMR anymore. It seems like there is a shift going on in people’s minds that they are now starting to search for EHR as opposed to EMR. There’s a whole discussion on wikipedia about whether the Electronic Medical Record (EMR) and Electronic Health Record (EHR) articles should be merged.

In my book they are pretty much the same in most people’s minds. Sure, some people like to argue that EHR has features that reach out to patients and allow patients to enter medical data, but most EMRs have those type of features anyway. I prefer to look at it as an EMR with a patient portal. However, the in thing to do seems to be to call a company’s EMR an EHR. The fact is that most people that have an EMR have a number of patient facing portions of their EMR. Does that make them all an EHR?

Regardless, I’m just wondering if one day I’m going to need to rename my blog to EHR and HIPAA. I’ve kind of grown fond of EMR and HIPAA, but I’m definitely not oblivious to the fact that people are starting to seach for EHR and not EMR. Renaming my blog might be a great thing to help with getting better google searches on the subject. Yes, I do enjoy having a lot of traffic to my blog. It makes me happy to think that people read my stuff and that I’m participating in at least some small way to shape the evolution of EMRs EHRs.

Free EMR by Medicare?

Posted on November 7, 2007 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 working with John Deutsch of EMR Experts, Inc. and I invited him to be a guest blogger on my blog. Here’s an article John sent me about the Free Vista EMR offered by the government. While I think the news about Vista being free came out about 2.5 years ago, the information about adopting it is still VERY relevant. Probably because the EMR adoption level is so low.

Enjoy John’s take on the government’s “Free EMR.”

Is anything ever free these days? Maybe so.

Instigated by the incredibly slow adoption of Electronic Medical Records (EMR) by doctors across the nation, Medicare is announcing it will begin offering doctors free electronic medical record software solutions.

Both upfront and ongoing costs have been critical factors in the lagging EMR adoption rate. Medicare hopes that by providing doctors with a free or very low-cost system, doctors will readily adopt EMR putting healthcare providers in America on a common system, thereby, providing Medicare and the general public with obvious, health, reporting and billing benefits.

The proposed system is VistA, (Veterans Health Information Systems and Technology Architecture) the widely popular system built by the Veterans Administration.

The adoption of VistA has resulted in the VA achieving a pharmacy prescription accuracy rate of 99.997%. Due to the implementation of VistA, the VA also outperforms most public sector hospitals on a variety of criteria.
The VistA system is public domain software, available through the Freedom of Information Act directly from the VA website or through a network of distributors.

Installed in over 1300 inpatient and outpatient facilities, the system is well-established and quite successful by EMR standards.

But can a system designed for a large organization like the VA also work for a solo practitioner family practice office?

A doctor in a New York Time article writes:

“It is one thing to use a system that someone else installed and someone else maintains. It is another to get a set of disks in the mail and do it yourself.”

Those who have tried to install VistA on their own would agree.

“Giving out a version of VistA is a great idea,” said Dr. David Kibbe, director of the Center for Health Information Technology at the American Academy of Family Physicians, a group that has been working on the project. “But at the beginning, there was a lot of wishful thinking. They said, ‘We’ll just release it.’ I said, ‘Where’s the fairy dust?’ ”

The problems with the healthcare sector and its slow adoption of electronic medical records are much deeper than some would like to admit, and viable solutions have been hard to come by.

The healthcare system is extremely fragmented, with thousands upon thousands of practices all practicing differently, using different billing systems, with different levels of computer proficiency, and different workflows.

Building a one-size-fits-all system has failed in the past and will likely continue to fail. The fact that over 300 different vendors currently develop and market EMR software attests to the need for customization.

The need for pre- and post-sale customization is a reality in every practice since every practice operates differently. Even practicing physicians within the exact same specialty do things differently and run their practices differently.

A key challenge for systems with large installation bases is often that the system becomes rigid simply due to the vendor trying to please too many different practices. Customization gets repeatedly delayed or shelved altogether.

Another concern is that when medical records are stored on servers that Medicare can access and control as they please practices may be hesitant to use the system regardless of the benefits to the practices and their patients.

While Medicare’s plan is to offer the software for free, one must ask what free is. Currently, free is software but not training, installation, and ongoing support.

Even if Medicare did make it 100% free, a free EMR is not free if it fails. The costs involved with a failed implementation can far outweigh the costs of purchasing an EMR at market price due to productivity losses, and hardware and implementation costs.

Maybe Medicare could focus more of their resources in the development and promotion of better standards for integrating already proven EMR systems and integrating EMR systems with electronic personal health records, managed by the patient

Why not offer patients a free electronic health record which can easily interface to all the major EMR vendors in the market? Wouldn’t a record they control, that can communicate with all their health providers, and be accessed by any other provider in the event of an emergency be more beneficial?

After all, isn’t the patient’s best interest the goal of healthcare in the 21st century?

For more information about EMR Experts, Inc. and their Medical Software solutions, please visit www.emrexperts.com

Clinical Staff’s Resistance to Change

Posted on November 6, 2007 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 did a presentation recently on an organization’s resistance to change and the effect that has on software implementation. An EHR implementation is definitely no exception. In fact, it seems that many doctors are even more resistant to change than other industries, which is why we have the roughly 10% EHR and EMR adoption rate.

In my presentation I found two images that described the challenge of adopting an EHR and resisting change very well.

Does this remind you of discussing implementation of an EHR?
EHR Resistance to Change

This one is a great one, but might take a second to truly understand.
EHR Resistance to Change
Did you notice the wheels in the wagon? Seems a bit like a $60,000 EHR system sitting on the shelf to me.