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First Day of HIMSS 10

Posted on February 28, 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.

Well, I must admit that I’m a bit overwhelmed by everything I’ve seen and heard at HIMSS 10 in Atlanta. This thing is enormous. Although, I think I’m also trying to overcome the lack of sleep. Taking the Red-Eye from Las Vegas was the right choice, but I’m paying the price today for not having much sleep. Not that any of you really care.

What I’ve quickly realized is that I’ve over scheduled my time at HIMSS. This really isn’t too much of a problem for me since I LOVE being busy. The only problem with it is that it means that I won’t be able to create nearly as much content from the show as I’d like to create.

No worries though, I’m taking good notes and I’ll have plenty of great content to share with you over the next few weeks after HIMSS as well as during HIMSS. I have posted quite a few updates on my twitter account, @ehrandhit, and plan to do a lot more. Take a look through my updates to see some interesting items I heard during a briefing.

As I’ve talked with people at the conference, as expected, the EMR stimulus, meaningful use, certified EHR and everything related to those subjects is the main focus of discussion. I think that’s actually exciting. It’s a topic that everyone is kind of unified around. It creates a nice energy at the conference and is a topic that you can talk about with anyone.

Interoperability is also a really major discussion at this conference. I’m not sure how much real progress has been made, but there’s a lot of talk. I know I’m interested in a meeting I have setup with a person at ONC that works on the NHIN and CONNECT. I’m looking forward to hearing what he has to say.

Another interesting thing will be all the false information related to the EMR stimulus. It’s amazing how many professionals in the industry don’t even understand the details of the EMR stimulus. This is a problem and could have some ugly consequences down the road.

Watch for some more specific coverage of the conference tomorrow. Tomorrow is a very full day for me with some really exciting events including: the CCHIT town hall meeting, my Meet the Bloggers Session, an interview with one of my favorite EMR CEO bloggers, Evan Steele, and then of course the New Media Kick Off Event tomorrow night.

The CCHIT town hall should be quite lively since you know how much I love them. I’m thinking I might try and live blog it, or at least lots of tweets about the event.

One EMR Blogger Down

Posted on February 27, 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.

The EMR blogging world is pretty small. There really aren’t that many of us that write about EMR. There are quite a few blogs that will occasionally write about EMR, but very few that give really good practical advice on EMR implementations.

Well, today I was happy to notice that EMR and HIPAA was listed first on a search for EMR Blogs, and as I looked through the list I saw a lot of really great blogs that I enjoy. One of my favorites from all the way back when I first started blogging as an EMR blog by Dr. Griever.

Michelle, or Dr. Griever if you prefer, was amazingly detailed in her analysis of what she experienced during an EMR implementation. Her initial blogs were a really strong influence on my EMR blogging. I just hoped that I could offer the same sort of detailed analysis and clarity that she did. She was so well written I even forgave her for being Canadian (which isn’t really a problem except for the differences in medicine/insurance).

So, I was sad to come across her blog again today and find a post entitled “Signing Off.” No doubt publishing a blog is a lot of work, so I understand the need to be refocused, but I will miss Michelle’s insights into EMR implementations. She did EMR implementation the right way. My only regret now is that I didn’t read and participate on her blog more regularly. Here’s a portion of what she’s accomplished and some insights from the experience:

The EMR has now been implemented; my practice has been redesigned to meet goals for patient access (wait times for appointments are now routinely same day or next available clinic day; time sitting in the waiting room is <1/2 hour, we use email with patients), quality (routine measurement and monitoring, regular team meetings), and efficiency. We work as an interdisciplinary team now; these are not just “buzz words”, we actually are doing it.

All of us in this primary care team have traveled far along the road to better care for our patients in the past four years, and the EMR has been a key part of this redesign. We will not stop, but I do feel that a large part of the work has now been done. The key issue remaining is that those of us using EMRs continue to function as electronic islands in a sea of paper and systemic inefficiency. We cannot change this from our practices; such a change will take leadership and vision from the people managing our health care system.

The good news is that Michelle will be working on researching EMR implementation and use. I look forward to seeing the research she produces.

Various Clinical Workflows – Oncology in Particular

Posted on February 26, 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.

I’m always interested in interacting with the readers of this blog. Plus, I like to help people out that email me asking questions. Plus, I’m swamped preparing for HIMSS and putting the finishing touches on my EMR selection e-Book. So, here’s one that I think was more than worthy of a discussion:

I am concerned with some of the specialty medicine aspects of EMR, specifically those of Oncology. Do you think there would be room for discussion of the different types of workflows different types of practices face? I would love some outside views of how different Oncology practices plan to convert their workflows to an electronic form.

I am also interested in learning more about different in-house architectures.

-Nick

I’d love to hear people’s comments about this as well. You know I think workflow is one of the keys to a successful EMR implementation. So, what type of special workflows have you created to make EMR work for a specific specialty? Has anyone had experience implementing an EMR in oncology? Let’s hear your thoughts.

Offsite Backup Services for an EMR

Posted on February 25, 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.

I’ve been seeing a number of new offsite backup services for EMR software. They are becoming quite sophisticated and are an option that I think many doctors offices should consider. I know that in one doctors office I setup a USB hard drive which they could take home with them in order to have some semblance of an off site backup.

This is far from perfect and even harder to secure the right way. Not something that most doctors offices will want to take on alone. However, the real problem with this type of “off site” backup is that they too often forget to take the backup offsite. They don’t verify that the backup was done. I’m sure there’s more, but you get the picture.

Seems like many of these off site backup services provide a really great service that solves a lot of these problems. Not all of them (like verifying that the backup can be restored), but they are becoming quite sophisticated.

I’m interested to hear other people’s experiences with these type of offsite backup services. What do you like? What do you dislike? What do you wish they’d do?

I have a feeling these type of really useful services won’t be in rich supply on the HIMSS vendor floor, but I’ll be keeping my eyes out for useful and practical services like this at HIMSS. If you’re a vendor of a service like this that will be at HIMSS, let me know so we can meet. Same goes for any ambulatory EMR vendors. I’d love to meet with you at HIMSS too.

My Major HIMSS 10 Event Plans

Posted on February 23, 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.

I’ll admit that I’m having an interesting challenge figuring out how to manage all of the various things I can do at HIMSS. I’m sure that many others have the same problem. Not to mention managing the mix of all the content that’s coming out and planning my own visit to HIMSS. A great problem to have I think.

For those who are interested in meeting me, here’s a couple places where you will be sure to find me at HIMSS 10:
HIMSS Meet the Blogger Panel – I’ll be on the panel on Monday, March 1st from 3-4:30. This is an incredible panel of people that I highly respect. This should be a really lively discussion.

New Media Meetups at HIMSS 10 – These events are shaping up to be really incredible events. Looking through the list of people who have RSVP’d for the kick off event, it’s going to be a really interesting mix of people. Not to mention Colbie Caillat singing, free food and some great free giveaways. Make sure you Register for the Kick Off Event on Monday, March 1st at the MEDecision party. Thanks to MxSecure and Pervasive for also sponsoring the other meetups.

I’d love to meetup with other people or if you’re an EMR vendor that’s doing something innovative let me know in the comments or drop me a note on my Contact Us page.

There are so many events I’m interested in attending. However, no doubt I’ll have some fun at the CCHIT Town Hall Meeting and I’ll be hoping that the David Blumenthal’s HIMSS Keynote is meaningful.

Are there any must see sessions or events? Let me know of any events you think I should attend and cover on this blog.

Also, if you’re interested in following my HIMSS 10 coverage, you can sign up for my EMR and HIPAA email list, check out my posts on EMR and EHR, and follow my tweets on my @ehrandhit and @techguy twitter accounts. It will basically be like you’re there with me.

Need for additional guidance…The Meaningful Use Mantra

Posted on February 22, 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.

John Halamka wrote some interesting comments about the various feedback he’s heard on the meaningful use guidelines on his blog. He gives some interesting insight into why ONC’s interim final rule is so vague (basically regulation/rule making mess). However, I couldn’t help but see how many times John Halamka used the words:

Need for additional guidance

This is no news to people like myself who’ve been writing about this since the beginning. There is a great desire for information on how to get the EMR stimulus money.

The real problem is that when things are vague and not well defined, then misinformation starts to take its place to satisfy our need for information and guidance. We want to be informed and so people start informing us even if the information is incorrect.

Today I got an email from someone stating that “We have the EMR already installed by a certified institution” and so they wanted to know how they could get the EMR stimulus money.

I felt so bad for this emailer. Someone (likely their EMR vendor) had either told them a lie about certification or more likely is that this person didn’t understand the details of the “certified EHR” component of the stimulus money. This is going to be a major challenge going forward as doctors who don’t have time to follow all the stimulus money movement get bad information. Plus, it’s only going to get worse if we continue to get partial pieces of information.

Sadly, most of the people emailing me about the EMR stimulus will continue to get the “Need for additional guidance” response from me. At least until ONC provides some additional guidance.

ONC Standards Make CCHIT Process Irrelevant

Posted on 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.

FierceEMR has really hit the healthcare IT arena in force over the past 6 months. They even have a big party planned for HIMSS. I’ll probably be stopping by since it’s the day after the New Media Meetup at HIMSS. Well, one of my favorite healthcare IT writers, Neil Versel wrote an article for FierceEMR that really caught my eye. It was titled, “Kibbe: New ONC standards make CCHIT process ‘irrelevant'”

If you’ve read this blog for any time you know that I’m an enormous fan of CCHIT (that was in the sarcasm font in case you couldn’t tell). I even declared the Marginalization of CCHIT back in July of last year. So, obviously I agree with David Kibbe’s assertion that the CCHIT process is irrelevant thanks to the HITECH act. A section of the article linked above describes some of the major problems with CCHIT:

Kibbe long has said the CCHIT certification process discourages innovation by being too complicated and costly for new, small companies that otherwise might shake up the EHR market with lower-priced, easier-to-use products. He also has held that the certification body was too closely tied to the health IT establishment. “CCHIT in effect acted as judge and jury for its own industry’s definition of EHR software, inhibiting alternative approaches that would embrace component or modular architectures, web-based delivery also known as ‘software-as-a-service,’ and practical means of achieving interoperable data exchange between applications from different vendors,” he says in a recent blog post.

No doubt the CCHIT criteria is no longer meaningful. The only problem is that a question still haunts my mind, “Did we just move the flawed process from CCHIT to ONC?”

Designing an EMR as More Than a Paper Chart

Posted on February 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.

EMR Quote of the Day comes from a comment on one of my most popular posts:

“An EMR is not a paper chart on the computer screen and as long as users think that way, complain when it doesn’t work that way, and vendors design that way… there will be issues with electronic medical records.”

Cost of EHR Certification

Posted on February 20, 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.

We’ve had a lot of discussion in the past about the cost of EHR certification. It’s been one of the biggest complaints about CCHIT and their EHR certification. One of my readers wanted me to post again about the costs and how this will be such a challenge for new EHR vendors.

First, the problem isn’t that a new EHR vendor couldn’t afford the cost if they wanted to pay it. The problem is that it provides very little benefit to the end users and at the end of the day the cost of the EHR certification would be passed on to the doctors who purchase the EHR.

I’m going to use round numbers, but you can see the detailed CCHIT EHR certification costs on my previous post. Basically as it stands today, full CCHIT EHR certification will run a vendor $37k or more to become certified. Of course, if you just want to be Preliminary ARRA Certified (although we don’t even know if that’s true yet either), then it’s only $33k. Yes, you can certify fewer modules, but that won’t make much sense for most EMR vendors.

Yep, that’s right. $33k that an EMR vendor will have to pay for certification which will add little value to end users and decent marketing value for the EMR vendor.

Of course, this doesn’t take into account the development costs to meet the standards (which I should remind you are still not finalized). I read one EMR vendor say that to become CCHIT certified (this was back in 2006 or so) it cost in the six figure range. That’s a lot of money for what?

We know that the Drummond Group and possibly other organizations are planning to certify EHR as well. In fact, the Drummond Group just launched an EHR Certification blog. In the first comment on their blog, they got a question about how much they’re planning to charge for EHR certification.

I’m sure that these organizations will try to undercut CCHIT as far as EHR certification pricing. I’m just not sure it will be enough to make much difference. Why would they undercut them too much?

ARRA Q&A: When will you get the EMR stimulus checks?

Posted on February 19, 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.

EMR and HIPAA Answer to EMR Stimulus Questions
When will they send the EMR stimulus checks?
I already posted about when the first EMR stimulus checks will go out. This question is a little different since it is about when during the year will you get paid the EMR stimulus once you’ve shown “meaningful use” of a “certified EHR.”

I honestly didn’t know the answer to this question until a few days ago. I’m still not completely sure on the process. Plus, I’m not sure if all the details have really been answered for this question. With that said, Justin Barnes from Greenway said during a webinar that you’ll receive your EMR stimulus check once you reach the max for that year. So, according to Justin, you’ll receive the check once you reach the $18k the first year.

This was pretty surprising to me. I would have thought they’d pay you out a little at a time as you went once you’d satisfied the meaningful use requirement. However, I guess it makes for easier accounting if you just do it all at once. Does anyone else have information on this part of it? It was the first time I’d heard someone describe when the money would actually be paid.