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How Will APIs Change Health IT? – #HITsm Chat Topic

Posted on May 23, 2017 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’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/26 at Noon ET (9 AM PT). This week’s chat will be hosted by Chad Johnson (@OchoTex) on the topic of “How Will APIs Change Health IT?.”

First, let’s define API: An application programming interface (API) is a set of standards that enable communication between multiple sources, most typically software applications. More specifically, an API is a set of routines, protocols, and data standards defined by a software vendor (an EHR for example) that specify how other vendor applications can contribute to or remove data from their database.

Other industries have profited from modern API integration, driven by the boost of internet technologies such as cloud applications and smart phones. Almost every consumer-facing technology runs on modern APIs – facebook, Twitter, Waze, Mint, etc. Facebook’s internal API, for example, pulls in data from all your friends’ FB feeds and displays it onto your feed. FB’s external API allows you to post items to your facebook feed using other applications, such as Instagram or Twitter.

Can you think of a popular/widespread/well known example of APIs in healthcare? No? Not surprisingly, healthcare has some catching up to do with APIs.

The good news for healthcare is that providers and vendors are realizing the potential impact modern APIs have on workflows, patient care, and… profits. The HL7 FHIR healthcare standard, along with Meaningful Use Stage 3 API requirements, have solidified the hype and marked API and cloud integration almost essential to understand.

Let’s discuss that in this week’s #HITsm chat.

T1: What barriers do you see for API adoption in hospitals? #HITsm

T2: Will EHRs eventually allow two-way API connectivity (read & write)? #HITsm

T3: Can API connectivity change perceptions about ‘siloed’ EHR patient databases? #HITsm

T4: Will APIs motivate hospitals to store their patient data in the cloud? #HITsm

T5: Will APIs open up the door to other vendors and applications? Or just broaden current EHR footprint? #HITsm

Bonus: What innovative solutions do you predict creative IT teams can employ for patients and caregivers? #HITsm

Upcoming #HITsm Chat Schedule
6/2 – Patient Stories, Not Just for Story Time Anymore
Hosted by the #WTFix Community

6/9 – TBD
Hosted by TBD

6/16 – TBD
Hosted by Danielle Siarri (@innonurse)

6/16 – TBD
Hosted by Megan Janas (@TextraHealth)

We look forward to learning from the #HITsm community! As always let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

The EHR Market – #HITsm Chat Topic

Posted on May 17, 2017 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.

Note: We’re sorry to share that Anne Zieger (@annezieger) who was suppose to host this week’s chat had some health issues and so we had to change the topic and host. Anne is doing ok and we’ll be sure to have her back as host of a future chat.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/19 at Noon ET (9 AM PT). This week’s chat will be hosted by John Lynn (@hospitalEHR) on the topic of “The EHR Market.”

The EHR market has gotten very mature. Thanks to $36 billion in stimulus money fromt he government, most organizations have adopted an EHR. Depending on who you check for EHR market penetration numbers, in the hospital world EHR adoption looks to be well over 90%. The ambulatory world is further behind, but it’s well over 50% adoption now.

Given the maturity of the EHR market, I thought it would be fun to hold an #HITsm chat to discuss the future of the EHR market. Let’s talk about where it’s at today, where it’s going in the future, and what else we can expect from EHR vendors that will now be working in a largely saturated market. What does this mean for the industry and for you as a customer of these EHR vendors?

Join us on Friday May 19th at 12:00pm ET as we discuss the following questions on #HITsm:

The Questions
T1: How would you describe the state of the EHR market today? (specify ambulatory and/or hospital) #HITsm

T2: In what ways will the EHR market evolve over the next 5, 10, 20 years? #HITsm

T3: How much EHR switching do you expect to see in the future? What will be the impact to vendors and customers? #HITsm

T4: Where will we see EHR vendors expand as the market for EHR sales dries up? #HITsm

T5: What must have products will form alongside the EHR or even replace the EHR? #HITsm

Bonus: Which EHR vendors will be gone (or basically gone) in 10 years? #HITsm

Upcoming #HITsm Chat Schedule
5/26 – How APIs Will Change Health IT
Hosted by Chad Johnson (@OchoTex)

6/2 – TBD
Hosted by TBD

6/9 – TBD
Hosted by TBD

6/16 – TBD
Hosted by Danielle Siarri (@innonurse)

6/16 – TBD
Hosted by Megan Janas (@TextraHealth)

We look forward to learning from the #HITsm community! As always let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Video Interview with Helen Waters, VP at MEDITECH

Posted on January 29, 2016 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.

Healthcare Scene was lucky to sit down with Helen Waters, VP at MEDITECH, to talk about the EHR market and MEDITECH’s place in that market. Plus, we dive into the culture and history of MEDITECH and how it’s changed. We also explore MEDITECH’s plans around innovation, integration, and value along with MEDITECH’s efforts to deploy cloud and mobile solutions. Finally, we had to talk about healthcare interoperability. We hope you’ll enjoy this wide ranging interview with Helen Waters:

After the formal interview we did above, we allow people watching live to be able to ask questions and even hop on camera to offer their insights or ask questions of Helen in what we call the “after party.” In this “after party” discussion we talk to Helen about her thoughts on the changing healthcare reimbursement landscape and what MEDITECH is doing to prepare for it. We also talk about integrating telemedicine into MEDITECH. I also ask Helen about MEDITECH’s views on EHR APIs.

We hope you’ll enjoy this look into EHR vendor, MEDITECH.

Meaningful Use EHR Adoption Charts – EHR Market Analysis

Posted on June 12, 2015 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.

ONC continues to push out more data when it comes to meaningful use, EHR adoption, RECs, and related areas. As a data addict, I could spend forever looking through and analyzing this data. So, I’ll probably do a series of posts across Healthcare Scene over the next couple weeks looking at the charts and data that ONC has made public about meaningful use and EHR adoption. I know some of the charts have been out for a while, but the analysis should still prove useful.

If you want to join in on the analysis of this data, I welcome you in the comments of each post. Plus, if you want to find your own nuggets to share, I’d suggest starting with their quick stats and dashboards pages.

First up in our look at the ONC EHR data is a look at the meaningful use participation chart for ambulatory EHR vendors (eligible providers if you prefer):
Ambulatory Practice EHR Adoption - Meaningful Use Participation
The most important part of this chart to me is that the two largest bars on the chart. The largest bar is the 749 “Other EHR Vendors” category at the bottom of the chart. It’s easy to miss this bar, but I believe it’s extremely important to note how big the long tail is when it comes to ambulatory EHR adoption. I’ve often said that it doesn’t take that many doctors to make yourself a decent EHR business. This chart illustrates how many EHR vendors are still in the game. There are only 3 EHR vendors that have over 40,000 providers. I know that many think that EHR vendor consolidation is bound to happen. Some certainly will, but I don’t see it happening at a massive scale in the ambulatory EHR world.

The second largest bar on the chart is the Epic EHR adoption. What’s important about this bar is that this totally represents that hospital owned ambulatory EHR adoption. Epic does not and will not sell Epic directly to a small ambulatory provider. All of these “eligible providers” for Epic are in hospital systems. I take away two important things from this. First, we see in plain sight how big the roll up of ambulatory practices is by hospitals. Second, this chart illustrates the opportunity that Cerner and Meditech have available to them. As you’ll see in the next chart, Cerner and Meditech have more hospital installs than Epic, but they’re much farther down on the ambulatory side. A look at history explains why they’ve had trouble penetrating the ambulatory market, but I believe it’s a huge opportunity for them going forward.

I’ll be interested to see how this chart continues to evolve over time. Will we doctors leaving hospitals to go back on their own shift the balance of power? Will we see massive EHR consolidation? I also can’t help but note that Mitochon Systems Inc shows up on the list and they don’t even sell an EHR to doctors directly any more. I assume this must be their white label business? I’ll have to follow up with them to get an update on their business.

Now let’s take a look at the chart for Hospital EHR vendors participating in the EHR incentive programs:
Hospital EHR Adoption - Meaningful Use Participation
This chart illustrates really well the 3 horse hospital EHR race which we’ve all known for a while. Although, given healthcare IT’s love affair with Epic (kind of like Apple in the IT world), I think some will be a bit surprised that Cerner and MEDITECH are both listed ahead of Epic. If you looked only at large hospital systems, I think the chart would look very different though.

It’s worth also mentioning the other horses in the race: McKesson, CPSI, MEDHOST, Healthland and Allscripts. They’ve all carved out their niche in the hospital space. We’ll see if they can continue to defend their territory. Hospital EHR switching is not easy.

My favorite observation from this chart versus the ambulatory chart is how well it illustrates the importance of secondary EHR vendors (the brownish gold color) in hospitals. I’ll never forget when Alan Portela of Airstrip told me that the EHR world will be a heterogenous environment. That absolutely resonated with me and this chart proves out what he said. Health systems are going to have multiple EHR vendors even if some EHR vendors would like it to be otherwise.

If you want to look at the potential disruptors in the world of EHR, I’d take a look at these secondary EHR vendors. Their foothold in hospitals provides them a really great opportunity to disrupt the status quo as we know it. Most of them won’t, but they’re all sitting on an opportunity. I’d start with the companies that make up the “Other Vendors” brownish gold bar. I bet there are some really interesting ones in that list.

I’d love to hear your observations from these charts in the comments. Anything I missed? Do you disagree with my observations? I look forward to hearing your thoughts.

An EHR Focused On Customer Requests, Not MU

Posted on February 4, 2015 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 love taking email exchanges I have with practicing doctors and making their comments into posts. This is one of those cases. The following is a quote from an email I got from a physician friend of mine about his EHR (EHR name removed):

Every time we turn around these days our EHR vendor is adding some new update. Sometimes the updates change the format of how the system appears and functions, sometimes they don’t. Unfortunately, the people who are still chasing after all the crazy government hoops to jump through and those who are not are all forced to deal with the same EHR software system. I really wish there was a separate system with no crazy upgrades that would function the same way that the system did two years ago. That was a much simpler and more commonsensical system. It’s a really sad case of the government says jump and software systems say how high?

I believe this physician has stopped taking Medicare patients and has happily avoided meaningful use. However, as the above comments illustrate, he hasn’t avoided a lot of the impact that meaningful use has had on the design of his EHR system. Plus, that doesn’t even count all the great new features that this doctor could have gotten from his EHR if they weren’t busy turning on all the MU requirements including the MU reporting and tracking.

His comments about wanting a system that isn’t influenced by MU requirements is quite interesting since Pri-Med (the company that acquired Amazing Charts) has announced an EHR product called InLight EHR that’s not certified and doesn’t do MU. The press release says the EHR is designed for Direct Primary Care. This is a really interesting move by them, and my doctor friend above illustrates why an EHR software that’s not MU certified could work.

One challenge to this idea is that a lot of doctors can’t shun Medicare and meaningful use. So, they’ll need to continue with the EHR that are still chasing the government carrot and avoiding the stick. We’ll see how these different EHR markets evolve.

Integrating Watson with EHR – Daniel Cane and Michael Sherling, MD

Posted on June 2, 2014 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 our latest Google Plus hangout, we sat down with the founders of Modernizing Medicine, Daniel Cane and Dr. Michael Sherling to discuss their latest integration of the Modernizing Medicine EHR with IBM’s Watson. Plus, we take some time to talk about Modernizing Medicine’s unique EMA Outcomes and EMA Grand Rounds products and how they impact the way a doctor treats a patient. We finish off by dipping into the ICD-10 and Meaningful Use Stage 2 delay.

About Daniel Cane
Daniel Cane is the CEO and co-founder of Modernizing Medicine. Since founding the company in 2010, Daniel has led his team to raise a total of nearly $30M in funding and to hire almost 185 employees as he works towards his stated goal to “Modernize Medicine.” Before founding Modernizing Medicine, Daniel co-founded Blackboard Inc., raising over $100M in venture capital and in 2004 helped take the company public on the NASDAQ. In 2011, Blackboard was sold for $1.6B.

About Dr. Michael Sherling
Dr. Michael Sherling is the co-founder and Chief Medical Officer of Modernizing Medicine. A Harvard and Yale trained dermatologist, he’s led Modernizing Medicine to gain almost 25% of the US EHR market share in dermatology. Dr. Sherling is responsible for developing and designing the dermatology-based Modernizing Medicine software, and supervising the medical arm of ophthalmology, orthopedics, plastic and cosmetic surgery, otolaryngology, gastroenterology and urology software.

mHealth and Where It’s Heading with Alan Portela

Posted on May 22, 2014 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 was excited to sit down with Alan Portela, CEO of AirStrip, in our latest installment of Google Plus Hangouts with top healthcare IT leaders. Along with telling a little bit about the AirStrip story, we talk a lot about what differentiates AirStrip as a mobile health company over the tens of thousands of mobile health applications out there. We also dive into the current EHR market and where it’s headed. Plus, we talk about FDA regulation and its impact on mobile health and what its impact on mobile health and EHR will be in the future.

About Alan Portela
Alan Portela has more than 25 years of experience in bringing groundbreaking medical technology solutions to market. Alan Portela became CEO at AirStrip in 2011. Prior to joining AirStrip, Alan Portela was CEO and principal of Hybrid Clinical Transformation, LLC, where he developed successful EHR adoption strategies for the U.S. Military Health System and much of the Veterans Health Administration. He also served as President and Chief Strategist at CliniComp, Intl., and in senior executive roles in several innovative healthcare technology and service organizations.

Brief EHR Notes, 40% EHR Replacement, and $23 Billion EHR Market

Posted on May 4, 2014 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.


It’s amazing how this has shifted. When I first started blogging about EMR, it was all about the lengthy note to justify the higher billing. We’re still dealing with the impact of that choice. I’m still not convinced that everyone believes a brief EHR note is the best. They all want to read brief EHR notes, but when they’re billing I don’t think they all agree. We need a change from the payers to solve this problem.


I have no idea how someone comes up with a percentage of EHR replacement. Although, you can be sure that there will be a bunch of EHR switching in the years to come. What is interesting is that ERP systems have been going through this process for a long time. I wonder what we could learn from the ERP switching process that will apply to EHR.


I always find the EHR market number interesting. $23 billion in EHR spending. Where are we at in EHR stimulus spending? As I recall we’re somewhere around $13 billion $22.9 billion.

The EHR Market Isn’t Like Other Markets

Posted on March 18, 2014 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.

Today at a healthcare IT meetup I attended in Dallas I ran into a former contact at an EHR vendor. He no longer works at that EHR company and has moved on to two other companies. In our discussion we had an interesting discussion about the market. Having moved on, he’d lost touch with the EHR market. He asked me, “Are there still 700 EHR vendors?” I told him there were probably 300, but I’ve contended that their have been 300 EHR vendors for a while. I’m not counting the hundreds of ancillary companies that are “certified EHR” but only perform 1-2 EHR related functions.

Over and over again I hear people talking about consolidation of EHR vendors. They say it’s going to happen and we’re going to get down to a really small number of EHR vendors. Some go as far as saying that there will be 2-3 EHR vendors after EHR consolidation happens.

I think this idea is ridiculous. At HIMSS, I figured out why I don’t think it’s going to happen. Someone told me, “Ambulatory healthcare is fragmented. It’s second only to florists when it comes to market fragmentation.”

This to me illustrates exactly why there can and will be so many EHR vendors. The ambulatory market is completely fragmented with thousands of really small businesses (ie. solo doc) doing just fine. Think about it. There are very few businesses that could survive at the size of a solo doctor practice. In every other industry, the businesses the size of a solo doc practice get eating up as the big boy competitors kill them with their buying power. The same can’t be said in healthcare. A solo doctor practice is a very viable business. Thus we see the market fragmentation and the plethora of EHR companies.

The above analysis does make you wonder why the solo doctor practice is still a viable business and if something in the future will make that option unreasonable from a business perspective. Although, that’s a subject for a future blog post.

Of course, when you think about the hospital EMR market there’s a much different story. We’ve seen EHR consolidation. The hospital market is much less fragmented and becoming less so every day. However, I’ll still be surprised if we go below 100 ambulatory EHR vendors.

EMR Divide Remains Between Larger And Smaller Practices

Posted on January 31, 2014 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.

A new study finds that while physicians’ adoption of EMRs has grown substantially between 2009 and 2012, there’s still a big “digital divide” between large and small medical practices, according to a Commonwealth Fund study reported by iHealthBeat.  But it also concluded that there are ways to close the gap, largely through cash incentives and tech help.

According to the study, EMR adoption by primary care physicians increased from 46 percent in 2009 to 69 percent in 2000.  What’s more, Commonwealth Fund found that most doctors are using core health IT functions, including clinical decision support, e-prescribing and electronic ordering of lab tests.  This is clearly a sign that Meaningful Use Stage 1 has had a large impact. (We’re still waiting to see whether doctors continue to drop out and avoid Stage 2’s tougher criteria.)

The study also found that as of 2012, 33 percent of doctors could electronically exchange clinical summaries, and 35 percent could share lab or diagnostic tests with physicians outside their practices electronically.

But these results were not distributed evenly.  Specifically, researchers found that practice size substantially affected EMR adoption.

For example, the research found that 90 percent practices with 20 or more doctors had adopted EMRs, but that just 50 percent of solo physician practices were on board. That being said, the study found higher rates of EMR adoption among small practices that were sharing resources or that took advantage of Meaningful Use incentives.

All told, researchers concluded that technical assistance programs that incentives close the digital divide regarding EMRs between large and small practices.  This just makes sense. If such programs can make it easy and even lucrative to adopt EMRs, we could see the digital gap close soon.