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Be Skeptical About Health IT Research Reports

Posted on April 26, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Look, I get it. While advice from colleagues is fine, it’s even better to have an objective research organization tell you which vendors dominate the market and which seem to have a lot of fans.

You know some of the headlines, in big bold letters: “Epic has the biggest EMR market share in the US” or “Doctors are very satisfied with eClinicalWorks.” Hey, if nothing else, you can wave the report in your boss’ face if your new system doesn’t work out.

The thing is, are you getting valuable, fair, unbiased feedback from research vendors? Not necessarily.

  • Pay for play: Some research firms are getting paid to promote certain products or organizations in their reports and client notes. The payment can be as subtle as a few introductions to potential customers or a straight up bundle of cash. Sadly, not all analyst firms who engage in this practice will tell you that they do.
  • Lack of experience: While some research reports are written by senior people with a long institutional memory, sometimes they are farmed out to junior staff members with a lot less perspective. I’m not suggesting that the younger people get it wrong, but they simply can’t offer the kind of insight senior people can.
  • Beauty contests: Be warned: sometimes reports are just not about you. It may appear, on the surface, that the research firm is offering you valuable insights, but the truth is that the research isn’t that substantial. In cases like these, the firms simply line up all the vendors in a row and rate them on scales they basically make up in their head.
  • Value of the data: Sure, it’s sort of fun and interesting to know whether Epic has nudged out Cerner or MEDITECH in the battle for US market share. It’s something to share over the health IT water cooler. And it seems to give you a sense of which vendors are offering the most value. But does it really? In most case, it probably isn’t that helpful to track market share unless you hold stock in one of these companies.

For what it’s worth, I’ve written several in-depth research reports of my own, and I feel pretty good about the industry analysis I did. But thankfully, none of the publishers suggested that I was the Oracle of truth. I simply gathered up a pile the facts and tried to fit them together.

In saying all this, I’m not suggesting that health IT industry research is a waste of time. If a report offers context, input from your peers and no-nonsense answers to questions you have, it may well be worth the price. But don’t let one of these firms sell you a bunch of hot air.


How Not to Handle EHR Certification Problems

Posted on February 26, 2018 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I was thinking back on how differently EHR vendors have handled EHR Certification problems. First, take a look at the $155 million whistleblower lawsuit that eCW (eClinicalWorks) suffered thanks to improper EHR certification (amidst other things). They had to have known what they were doing and didn’t come clean.

$155 million is just the first price they had to pay. Since then, providers have filed a class action lawsuit against eCW and the family of a patient also filed a lawsuit against eCW. This a painful and expensive experience for eCW.

Anne Zieger reported in August last year that the eCW settlement hadn’t led to customer defections (yet?), but we’ll see how that plays out over time. It makes me wonder if the eCW founder, Girish Navani, still feels the same about never selling your EHR company. Maybe these lawsuits have made him wish he’d taken a buy out offer after all, but I digress.

Today I remembered a situation where another EHR vendor had issues with how their certified EHR attested to meaningful use data. It was back in 2011, so I’m pretty sure many of you have forgotten it. Plus, I expect many of you have forgotten it because the EHR vendor in this case took ownership of the error and fixed it. Of course, this EHR vendor hasn’t fared quite as well as eCW in the marketplace. However, their choice to hide their certification issue would have no doubt made their market position even worse.

The clear message I see in these two stories is something we see often in the US. If you own up to mistakes and do your best to make them right, humans are surprisingly forgiving. However, if you hide it, then the damage can often be much worse than the crime.

I also loved this question I asked back in 2011 about the meaningful use and EHR certification program which are still relevant today when it comes to these complex programs:

“If a large EHR vendor that’s intimately involved in the meaningful use rule creation process can mess up some of the meaningful use guidelines, how many other EHR vendors are going to do the same?”

I didn’t know about eCW’s issues back in 2011, but I obviously could see how easily the eCW issues could happen. Has anything changed with EHR certification and now MACRA and MIPS to make us think that this has gotten any better? Should we be asking, whose the next EHR vendor that will have issues? Will it be because of deliberate skirting of the law or just overly complex, unclear, and changing government requirements?

Yes, you can believe that I’m with those organizations that have called for an end to EHR certification. I’ve been against it since I first heard about it and still don’t see how it’s provided any value since. Pro-EMR I am. Pro-EMR Certification I am not.

eClinicalWorks Settlement Hasn’t Led To Customer Defections, Yet

Posted on August 7, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Loyalty is a funny thing. You’d think that when a vendor let you down spectacularly, you wouldn’t do business with them anymore. But the truth is, when it comes to health IT it’s not that simple. In many cases, vendor-customer relationships are more like marriages than formal agreements. Even if things start to go south, customers have so much invested in their vendor relationship that backing out may not seem like a realistic possibility.

Yes, I’m pontificating here, but not without a point. What I’m responding to here is a recent KLAS survey which found that while many customers of the now-tarnished eClinicalWorks have lost confidence in the company, many are still on board for now.

As many readers will know, in May eCW settled a whistleblower suit against the company for $155 million. The suit, which was brought by the US Department of Justice, asserted that the vendor got certified for incentive payments by putting deceptive kludges in place.

After agreeing to pay a massive penalty to the feds and putting a “Coprrporate Integrity Agreement” in place, it’s little wonder that some customers don’t trust eCW anymore. But the reality of the situation is that they’re not exactly free to jump ship either.

The study, which was reported on in HIT Consultant, found that 66% of customers polled by KLAS said their perception of eCW had moderately or significantly worsened after the settlement. Meanwhile, 34% of current eCW customers plan to look elsewhere when they make their next health IT investment.

Another third of respondents said they felt stuck in their current eCW contract, though they would consider switching vendors when the contract expires or they have more resources to invest. Still, only 4% of KLAS respondents said they were leaving specifically because of the settlement.

Meanwhile, there’s apparently a subset of eCW customers who aren’t that worried about the settlement or its implications. One-third of respondents said that it had little impact on them, and some noted that eCW is probably just the first of many vendors whose meaningful use certification will be called into question.

The reality is that while eCW customers were a bit shaken by the settlement, it didn’t exactly come as a shock that the vendor was playing it close to the edge, with one-fifth noting that the settlement was “unsurprising.”

I would tend to side with the eCW customers who predict that this settlement is the tip of the iceberg, and that it’s likely to come out that other health IT vendors were gaming the certification process. The question is whether these settlements will merely inconvenience providers or lead to serious problems of their own. If the feds ever decide that providers should have known about faked certifications, the game will get a lot more complicated.

eCW (eClinicalWorks) Settles Whistleblower Lawsuit for $155 Million

Posted on May 31, 2017 I Written By

John Lynn is the Founder of the 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 and 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 many of my press panels and other discussions at the Healthcare IT Marketing and PR Conference, I’ve argued that there’s very little “Breaking News” when it comes to healthcare IT. Today is an example where this is not true. The news just broke that EHR vendor, eCW (eClinicalWorks), has settled a whistleblower lawsuit against them for $155 million.

The suit was filed by Brendan Delaney, a software technician formerly employed by the New York City Division of Health Care Access and Improvement, by his law firm Phillips & Cohen LLP against eClinicalWorks. eClinicalWworks and three of its founders (Chief Executive Officer Girish Navani, Chief Medical Officer Rajesh Dharampuriya, M.D., and Chief Operating Officer Mahesh Navani) are jointly liable for the payment of $154.92 million. Separately, Developer Jagan Vaithilingam will pay $50,000, and Project Managers Bryan Sequeira, and Robert Lynes will each pay $15,000. As a whistleblower, Delaney stands to receive $30 million of the settlement.

Here’s the summary of the complaints against eCW from the Justice Department’s press release about the settlement:

In its complaint-in-intervention, the government contends that ECW falsely obtained that certification for its EHR software when it concealed from its certifying entity that its software did not comply with the requirements for certification. For example, in order to pass certification testing without meeting the certification criteria for standardized drug codes, the company modified its software by “hardcoding” only the drug codes required for testing. In other words, rather than programming the capability to retrieve any drug code from a complete database, ECW simply typed the 16 codes necessary for certification testing directly into its software. ECW’s software also did not accurately record user actions in an audit log and in certain situations did not reliably record diagnostic imaging orders or perform drug interaction checks. In addition, ECW’s software failed to satisfy data portability requirements intended to permit healthcare providers to transfer patient data from ECW’s software to the software of other vendors. As a result of these and other deficiencies in its software, ECW caused the submission of false claims for federal incentive payments based on the use of ECW’s software.

Most people are writing about how eCW didn’t fully integrate the RxNorm codes, but instead hard coded the 16 codes that the certification process used. That’s embarrassing so it’s not a surprise that so many people are sharing that part of the story. However, I think the bigger part of the violation is probably around the data portability requirements. I bet a lot of EHR vendors are sweating right now as they look at the way they implemented those requirements. Not to mention the EHR audit logs which are poor in many EHR. Plus, the scariest claim is eClinicalWork’s inability to reliably record diagnostic imagine orders or perform drug interaction checks. Those are patient safety issues and exist in many EHR software.

If you want to dig into the weeds like I did, then you can see the government complaint against eClinicalWorks that was filed May 12, 2017 and the final settlement agreement with eClinicalWorks. Even more insightful was looking at the original complaint from Delaney against eClinicalWorks. Comparing the original whistleblower complaint to the government complaint against eClinicalWorks is very interesting. You’ll see that the government didn’t grab on to everything that was originally filed by Delaney. I imagine that’s a standard legal practice to file as many areas as possible and see what the government decides to use. It seems like Phillips & Cohen have represented a number of whistleblowers so I’m sure they were expert at this.

Girish Navani, CEO and Co-Founder or eClinicalWorks, offered this statement about the settlement:

“Today’s settlement recognizes that we have addressed the issues raised, and have taken significant measures to promote compliance and transparency. We are pleased to put this matter behind us and concentrate all of our efforts on our customers and continued innovations to enhance patient care delivery.”

Looking at the bigger picture, I’m certain that every EHR vendor is going through their EHR certification process and looking at all the statements they’ve made to make sure they’re not going to be in a similar situation. Not to mention the anti-kick back laws that were mentioned in the settlement. I’m sure there are other EHR vendors that are in violation of both of these items just as much as eCW.

Former ONC National Coordinator, Farrzad Mostashari seems to agree with me. Farzad tweeted, “Wow!! I hope this changes the attitude of the EHR vendor space more broadly.” Then, he later tweeted, “Let me be plain-spoken. eClinicalWorks is not the only EHR vendor who flouted certification /misled customers
Other vendors better clean up.”

Farzad then nailed it when he tweeted “There are a LOT of doctor’s office staff looking at their EHR today and wondering if there’s $30M worth of false promises hidden there”

I do wonder if Farzad Mostashari feels a little guilty of the role he played in this process since he oversaw such a porous EHR certification process. I’ve been against EHR certification for a long time because I thought it provided so little value to providers. The fact that it can be gamed by 16 codes being hard coded is a perfect example of why EHR Certification is a waste. Although, one could argue that without EHR certification, this suit would have never happened and maybe eClinicalWorks could still be selling the same product today.

I do find this quote from the US Attorney’s Office for the District of Vermont press release a little over the top (which I think is common on these things):

“Electronic health records have the potential to improve the care provided to Medicare and Medicaid beneficiaries, but only if the information is accurate and accessible,” said Special Agent in Charge Phillip Coyne of HHS-OIG. “Those who engage in fraud that undermines the goals of EHR or puts patients at risk can expect a thorough investigation and strong remedial measures such as those in the novel and innovative Corporate Integrity Agreement in this case.”

Another topic I haven’t seen anyone else cover is the impact that this settlement will have on eCW’s customers that used eCW to attest to meaningful use. Technically it shows that eCW wasn’t appropriately certified, so that means that they weren’t using a certified EHR and therefore shouldn’t have been eligible for meaningful use incentives. I asked one friend about this and he suggested that CMS had previously said that it would not hold eligible providers and eligible hospitals responsible for EHRs that calculated the meaningful use measures the wrong way. So, we’ll probably see this same approach with eCW users that got EHR incentive money on what we now know was not appropriately certified.

I was also intrigued by the Corporate Integrity Agreement (CIA) that eClinicalWorks entered into with HHS-OIG. There are a lot of details and oversight that eCW will get from OIG, but it also required eClinicalWorks to “allow customers to obtain updated versions of their software free of charge and to give customers the option to have ECW transfer their data to another EHR software provider without penalties or service charges. [emphasis added]”

Free updates is pretty clear and ironic since not wanting to update all their clients is one possible hypothesis for why they didn’t really push the proper upgrades. Hopefully all eCW users will do it now or they might be facing their own violations for using outdated software that has known clinical issues. However, the kicker in the CIA detail above is that eClinicalWorks has to give customers the option to have eClinicalWorks transfer their data to another EHR without penalty or service charges. I wonder how many will take them up on this requirement and what the details will be. I still wish this was required of all EHR vendors, but that’s a story for another day.

How many EHR vendor marketing groups are putting together their eClinicalWorks Rescue Plan to take in the downtrodden eCW users? I’m not sure these will be as successful as other EHR switching marketing efforts like those we see when an EHR is being shut down.

I’m sorry to say that I think this is likely only the beginning of such lawsuits. In fact, it’s probably already woken up a lot of potential whistle blowers. Hopefully it’s woken up a lot of EHR vendors as well.

Integrating Telemedicine And EMRs

Posted on May 17, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Have you considered what an EMR would look and feel like if it integrated telemedicine? Rashid Bashshur, director of telemedicine at the University of Michigan Health System, has given the idea a lot of thought.

In an interview with InformationWeek Healthcare, Bashshur tells IW’s Ken Terry that it’s critical to integrate HIEs, ACOs, Meaningful Use and electronic health records.

Makes sense in theory. How would it work?

To begin with, Bashshur said, healthcare providers who have virtual encounters with patients via a telehealth set-up should create an electronic health record for that patient.  The record could then be ported over to the patient’s PHR.  The physician can also share the health record via an HIE with other providers.

When providers attempt mobile and home monitoring, it steps the complexity up a notch, as such activities generate a large flow of data. The key, in this situation, is to use the EMR to sensitively filter incoming data.

Unfortunately, few EMRs today can easily pinpoint the information providers need to process, so most organizations have nurse care managers sift through incoming monitoring data. That’s the case at University of Michigan Health System, where care managers sift data manually to determine whether patients seem to be seeing changes in their conditions.

Unfortunately, even attentive care managers can’t catch everything a properly-designed system can, Bashshur notes.  To integrate EMRs and telemedicine/remote monitoring, it will be important for EMRs to have sophisticated filters in place which can pinpoint trouble spots in a patient’s condition, using a standard protocol which is applied uniformly.

According to InformationWeek, vendor eClinicalWorks has promised a new feature which can pick out relevant data from a large data stream. But until eCW or another EMR vendor produces such a feature, it seems that remote monitoring will be labor-intensive and expensive.

My First (Actual) Experience With A Patient Portal

Posted on October 8, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

During my time of writing about mHealth, I have had the opportunity to discover many apps, patient portals, and PHRs that have been created. However, I haven’t been able to use them beyond my initial review, for the most part. Why? Because most of the physicians my family aren’t really into the whole mHealth trend. I mean, my OB/GYN doesn’t even have a website (granted, he’s about 70 years old, and very much set in his ways). I’ve been kind of disappointed by the lack of technology that my son’s pediatrician’s office has, however. Until recently. A few weeks ago, when we were visiting with one of the PAs in the office, I was absolutely thrilled to see him using a tablet as he talked with us. He quickly pulled up information about our past appointments, and it was neat to actually see this new “era” of medicine in work. Well, besides this, I hadn’t seen much else available.

However, today I heard that the office had launched a patient portal feature to their website. Well, you’d better believe I called the office right away and got set up on it. I wasn’t expecting much, especially because it is still very new, but I have to admit, I’m impressed so far.

It has all the features I look for — the ability to message staff, set up appointments, refill prescriptions, and view information from past appointments. The format of the website is also very impressive. Here are a few screenshots I took (note, I did take out some of the identifying details, so that’s why there are some big blank spaces at times):

This is the main page for the patient portal. As you can see, it’s powered by eClinicalWorks. The front page has some essentials, such a appointment reminders and a quick link to a PHR. On the left, there is an easy to use menu.

I really liked the clinical information section. Because we’ve forgotten to bring my son’s immunization card with us a few times, it isn’t totally updated. Instead of going through the hassle of going to the office to get it figured out, all of the information can be found easily, and I also can find out the names of different problems that had been identified in the past. This did cause me to worry a bit, as there were some issues cited that the doctor never told us concerning our son

And finally, here is the last section I wanted to highlight. I’m someone who loves to keep records, and it’s nice to be able to see the history of the our appointments in the past, and who they were with. There are about 6 or 7 different physicians at this practice, and it sometimes is hard to keep track of who we’ve seen. We were wanting to switch my son’s PCP to one that we saw when he was first born, and I found out who that was easily just by looking at this chart.


As you might have noticed on some of these pictures, there is a mobile app in the works for this medical practice, which I’m so excited about. In just the past few months, this doctor’s office has really stepped up their game — first an awesome Facebook page, next the physicians are using tablets, and now the patient portal.

To be honest, I’m not a big fan of calling people and talking on the phone, so the ability to do a lot of that (schedule appointments, request information, refill prescriptions) is very nice. And just as a side note, as I’ve looked through the portal tonight, I discovered a few errors in some of the information that the office had on our family (as in, they listed my son as the emergency contact…for himself. And no phone number was listed for our family,) that I wouldn’t have noticed otherwise.

Anyways, I just wanted to share a little bit of my excitement to see how doctors and physicians are starting to embrace the digital world, and realize that’s what patients want. Now if only I can get my OB to get on board, I’ll be a happy camper.

Does your doctor’s office offer a service like this? What do you like about it?

Private Payers Need to Join Humana, CMS With EHR Subsidies

Posted on June 30, 2011 I Written By

Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider.

Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers could go out and buy technology. As the country’s largest purchaser of  healthcare services, CMS wanted some value for its money (not exactly something you hear every day when it comes to government spending).

I’d been hearing for years that major commercial health insurers also were willing to share some of the savings from EHR adoption, but not until the largest payer of them all, Medicare, did so first. The private sector usually does follow Medicare’s lead when it comes to major policy shifts. Medicare now has done so, but private payers have been mostly silent. Mostly.

This month, as InformationWeek reports, Humana teamed up with Allscripts Healthcare Solutions to offer physician practices financial incentives for purchasing Allscripts EHR systems. The deal is similar to one Humana cut last year with Athenahealth. A few Blue Cross and Blue Shield plans, notably in Massachusetts and Rhode Island, have led similar programs at the state level, with eClinicalWorks the main partner.

But unless I’m forgetting something, Humana is the only big payer that has jumped into the game. Where are the UnitedHealthcares, Aetnas, Cignas and WellPoints of the world?

Payers, it’s time to make good on the lip service you gave years ago and start passing on some of the savings you will realize from Medicare, Medicaid and hundreds of thousands of providers spending billions of dollars on EHR technology and health information exchange efforts.


EMR Companies Holding Practice Data for “Ransom”

Posted on January 19, 2011 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: JamesNT sent me an update to his comments in this post. It’s interesting to see the EHR vendors’ evolution on the question of openness.

JamesNT wrote a really interesting forum post recently about how a number of EMR vendors are holding doctor’s patient information “ransom” (his word) from them. Here’s his whole description and he even names a few EMR vendors and the challenges related to getting the EMR data out of their systems:

To many EMR’s lock up the practice’s data and hold it for ransom. The data entered into an EMR belongs to the practice, not the EMR. It is not fair for EMR’s to not provide ways to interface or export data from the database. If a doctor wants to hire an IT person or developer such as myself to write custom reports or export data from the EMR, then it should be possible. Consider the following examples:

Amazing Charts: They use SQL Server 2005 Express as their database but they remove the built-in Administrator account from the SQL instance and change the SQL Server SA password. This means anyone hoping to interface or export data is at a loss – and Amazing Charts will not share the SA password. Amazing Charts also does not publish a database diagram.

eClinicalWorks: Overly complicated database. Does not publish mySQL password (you can find it, though). Does not publish database schema. If you ask them for help, they want to charge $5000 to build an interface.

PODMED (now TrakNet): Kudos for sharing the SQL Server SA password – but does not offer a published database schema.

GE Centricity: Database schema available – if you are willing to tell a bold-faced lie to someone to get it.

Medinotes: Even after sunsetting the product, Allscripts refuses to give out the ODBC driver and database password.

MD Logic: Uses a pathetic HL7 file interface. You can place only one patient demographic in each file – so if you have 200 patients to update that means sending 200 files.

Officemate: Uses SQL Server and it is easy to get to their database – but they do not offer the schema.

I find this situation deplorable. Every EMR should make it easy to get to the data and not try to hide it or charge outrageous amounts for an interface. Seriously – who here would pay $5000 to make an interface?

Of course, he’s just highlighting the EMR software he’s used. I’m sure there are hundreds more EMR vendors like this.

Then, there’s also EMR vendors that don’t hold your EMR data for ransom like Medtuity. Here’s what Matt Chase from Medtuity said about what they provide to users of their EMR:

At Medtuity, we provide open access to the SQL database. We also provide an export facility under Options. You can export each and every encounter, years and years worth if you wish, to a PDF file for each visit, neatly labeled with the date of the encounter and pt’s name to keep it from colliding with other PDF documents. You can also export a CCR for each pt.

We also have our own proprietary format in XML. For a group with a huge number of records, they may wish to hire a consultant to write a program to consume that xml into a new system. Our xml format is most complete and includes the stuff you would not usually wish to transfer (the audit trail on that chart, for example). But it is there. We also have CSV format, but let’s face it, you cannot export sophisticated data in a CSV format. It’s fine for demographics.

How “liquid” is the data in your EMR software? This discussion is a very important one between you and your EMR vendor when you’re selecting an EMR. Make it part of your EMR contract.

More EMR vendors need to voluntarily step up to the plate and provide this type of EMR data liquidity.

Dell EMR

Posted on September 10, 2009 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today, CNET posted an article that talked about a Dell EMR. Yes, we’re talking about the Dell that makes computers (and sells everything else under the sun).

We’ve known for a while about Dell’s partnership with eCW and Walmart-Sam’s Club to sell EHR, but the thing that’s interesting about the CNET article is that it calls it “Dell’s EMR software.” I’m certain that Dell didn’t create it’s own EMR software package. I assume it has to just be eCW’s EMR right?

To add to the fun, I even found the page which talks about Dell’s foray into the EMR world. However, on that page it links to the Sam’s Club/Walmart/eCW EHR partnership as well.

I have a feeling that the CNET article is just an extension of Dell’s partnership with eCW and Walmart. I’m sure eCW wants to market their EHR as much as possible and Dell is a respected brand on which to market your product.

UPDATE: The following is an excerpt from Healthcare IT News about the Dell EMR:

The Round Rock, Texas-based computer maker on Thursday introduced an electronic medical record system for hospital-affiliated physician practices. The intent, said Dell executives, is to accelerate the sharing and meaningful use of digital patient information among hospitals and physician practices.

Dell executives say their EMR solution is sponsored by hospitals for their affiliated physicians and designed to make it affordable and practical for physician practices to transition from paper to electronic records.

So, it looks like it’s hospitals that will choose to partner with Dell in order to get doctors to buy an EMR from Dell? It still doesn’t say where Dell got this EMR. I think we can rule out them developing their own. So, the question remains: Is this an extension of the partnership with eCW or did Dell purchase another EMR software company?

In summary, a doctor will be buying an EMR sponsored by their hospital association who has an associate with Dell who has an association with some EMR software? Sounds like the perfect recipe for finger pointing.

Another Example Why Small EHR Companies Face Tough Challenges

Posted on May 27, 2009 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

No doubt many small EHR companies have been looking at themselves in the mirror long and hard and asking themselves how they’re going to survive this rough market. Not only did the HITECH act slow purchasing of EHR systems, but between “certified EHR” and “meaningful use” many are questioning where the small EHR vendor will fit into the EHR market.

I could (and probably will at some point) expound on each of the topics above, but I think that EHR vendors have an even more difficult challenge on their hands. The challenge comes in the form of incredibly large number of marketing dollars and splashy partnerships.

Here’s just one simple example of what I’m talking about. It was just announced that HEALTHeLINK, The Western New York Clinical Information Exchange, now has formal agreements in place with Allscripts, eClinicalWorks, McKesson, MedAppz, NextGen Healthcare Information Systems and Pulse Systems. [Hailing out of Buffalo, I’d love to meet up with the people at HEALTHeLINK sometime when I’m visiting family in the area.]

I’m not sure how much of an impact this particular partnership will have on EHR adoption in upstate New York. However, that’s not really my point. My point is that this is just one small example of a partnership that the “big boy” EHR companies are going to use to market their product. Consider that the marketing budget for these large EHR companies is quite possibly larger than some smaller EHR companies entire budgets. That’s pretty formidable.

I’m not saying that small EHR companies should close their doors and stop competing. In fact, I hope just the opposite happens. I’m all for innovation and the most innovative products usually come from small companies who have to be innovative to survive. I’m just saying that these small EHR companies better come ready to fight. It’s not going to be a pretty couple months in the EHR industry. Only the strong will survive.

Of course, all is not lost for small EHR vendors that survive. Assuming EHR implementation failure rates continue at their current dismal rates, then there will be a tremendous opportunity for a number of companies to take care of those who fail to implement unusable EHR systems.