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Study: Health IT Costs $32K Per Doctor Each Year

Posted on September 9, 2016 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 by the Medical Group Management Association has concluded that that physician-owned multispecialty practices spent roughly $32,500 on health IT last year for each full-time doctor. This number has climbed dramatically over the past seven years, the group’s research finds.

To conduct the study, the MGMA surveyed more than 3,100 physician practices across the U.S. The expense number they generated includes equipment, staff, maintenance and other related costs, according to a press release issued by the group.

The cost of supporting physicians with IT services has climbed, in part, due to rising IT staffing expenses, which shot up 47% between 2009 and 2015. The current cost per physician for health IT support went up 40% during the same interval. The biggest jump in HIT costs for supporting physicians took place between 2010 and 2011, the period during which the HITECH Act was implemented.

Practices are also seeing lower levels of financial incentives to adopt EHRs as Meaningful Use is phased out. While changes under MACRA/MIPS could benefit practices, they aren’t likely to reward physicians directly for investments in health IT.

As MGMA sees it, this is bad news, particularly given that practices still have to keep investing in such infrastructure: “We remain concerned that far too much of a practice’s IT investment is tied directly to complying with the ever-increasing number of federal requirements, rather than to providing patient care,” the group said in a prepared statement. “Unless we see significant changes in the final rule, practice IT costs will continue to rise without a corresponding improvement in the care delivery process.”

But the MGMA’s own analysis offers at least a glimmer of hope that these investments weren’t in vain. For example, while it argues that growing investments in technologies haven’t resulted in greater administrative efficiencies (or better care) for practices, it also notes that more than 50% of responders to a recent MGMA Stat poll reported that their patients could request or make appointments via their practice’s patient portal.

While there doesn’t seem to be any hard and fast evidence that portals improve patient care across the board, studies have emerged to suggest that portals support better outcomes, in areas such as medication adherence. (A Kaiser Permanente study from a couple of years ago, comparing statin adherence for those who chose online refills as their only method of getting the med with those who didn’t, found that those getting refills online saw nonadherence drop 6%.)

Just as importantly – in my view at least – I frequently hear accounts of individual practices which saw the volume of incoming calls drop dramatically. While that may not correlate directly to better patient care, it can’t hurt when patients are engaged enough to manage the petty details of their care on their own. Also, if the volume of phone requests for administrative support falls enough, a practice may be able to cut back on clerical staff and put the money towards say, a nurse case manager for coordination.

I’m not suggesting that every health IT investment practices have made will turn to fulfill its promise. EHRs, in particular, are difficult to look at as a whole and classify as a success across the board. I am, however, arguing that the MGMA has more reason for optimism than its leaders would publicly admit.

Traditional Marketing, Drug Companies, and Behavioral Scientists – #HITsm Chat Highlights

Posted on April 20, 2013 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.

Topic One: @bjfogg behavior model has become well known in tech around engagement. How is this or other models applicable to patient care?

Topic Two: Outside #healthcare, “engagement” is largely about marketing. What can traditional marketing teach us about patients?

Topic Three: Engagement is closely tied to influence and by who you are trying to influence. What are biggest drivers of influence in hc?

Topic Four: Drug companies are masters of influence, how can we improve the influence of engagement?

Topic Five: @nationalehealth and @ONC_HIT work with top behavioral scientists. When does a nudge toward behavior change become a shove?

Health IT Hazards, Selecting the Right EHR, and Withings Wireless Scale – Around Healthcare Scene

Posted on December 2, 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.

Hospital EMR and EHR

Health IT Stands Out In Health Technology Hazards List

The Top 10 Health Technology Hazards list was recently released by ECRI. And this year, two of the hazards that made the list are health IT related – patient/data mismatches in EHRs and other HIT systems, and, interoperability failures with medical devices and health IT systems. Anne Zeiger predicts that more HIT issues will top this list in the future.

Patients Accessing Online Medical Records Use More Services

A new study revealed something interesting — patients who use online access to medical records are likely to use more clinical services than those who do not. The Journal of the American Medical Association drew this conclusion after studying members of Kaiser. Kaiser has had a patient portal in place since 2006, which made it an ideal candidate for this study.


10 Tips for Selecting the Right EHR

In the market for a new EHR? Or perhaps just implementing one? This post highlights 10 tips on selecting the right EHR for your practice, as presented by Insight Data Group. Some of the suggestions include making sure the EHR is easy to use and customized, and use the government’s money to pay for your EHR.

Meaningful Healthcare IT News

Social and Mobile Continue to Converge in Healthcare

An interesting infographic is shown and discussed in this post. It is called “How Health Consumers Engage Online,” and reveals some interesting facts about the digital and health world. According to it, more people in the United States own a smart phone than a tooth brush, and 23 percent of people use social media to follow the health experiences of a friend. This definitely presents some fascinating data that is worth reading.

Smart Phone Health Care

New Withings Wireless Internet Scale Hits the Market

A new scale was recently released, and it does more than just tell a person how much they weigh. It tracks numerous variables, including BMI, and can be synced to various mHealth apps. There is also an app that goes along with the scale as well. It is a bit pricey at over $100, but it definitely “tips the scales” when it comes to scales.

Smart Phone Enabled Thermometer Approved By FDA

The “Raiing” is the newest in smart phone technology. It’s a high-tech, yet easy-to-use, thermometer, designed for iOS devices. It is placed under the armpit, and can actually track a person’s temperature over time. If a temperature reaches a certain number, an alarm will go off on the connected smart phone. This can help give parent’s peace of mind, as a sick child sleeps.

The Role of Health IT in ACOs — #HITsm Chat Highlights

Posted on December 1, 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.

Because of Thanksgiving weekend, the #HITsm chat took a break. However, it was back this week, and there were five questions, rather than the usual four. The topics came from @2healthguru, and revolved around the role of HIT in ACOs.

The first question asked was: Many accept at face value that HIT is essential for effective #ACO implementation, do you agree? Why? Why not?  There weren’t a lot of responses to this first question Many accept at face value that HIT is essential for effective #ACO implementation, do you agree? Why? Why not?

There weren’t as many responses to this question as there sometimes are, but here are a few of the tweets that seemed most popular:


The next topic focused on this: Where does culture fit in the mix? Can you graft ‘coordinated care’ onto a cowboy (or cowgirl) referral network? This question sparked a lively discussion with a lot of good points made. It was hard to pick just a few, but here is a conversation I feel is worth noting. Another participant called out for @BangorBeacon’s thoughts on this topic, because apparently it’s his area of expertise. Although he didn’t seem to have a lot of time during the chat today, he did have something to say. Here is one of the conversations I saw.






The next item on the agenda was, how important is understanding culture and organizational workflows to achieve coordinated, seamless care? This was another interesting topic, with equally interesting responses. I thought this way a unique way of expressing the idea.

I also thought this tweet went well with the topic:

Topic four was: What will it take for the #ACO and #HealthIT system to work as developed? When I saw this, I predicted there would be a lot of different answers, and I was right. Here are a few of the suggestions that stood out to me:

And finally (still with me?), the extra question — which is a little more up my alley: Can social media ‘detect and amplify’ (preconfigure) preferred community referral interactions to grease the skids of an #ACO? 

I think that most everyone had checked out by this point, but this is my favorite response:


Will EMR Adoption Bankrupt Medicare?

Posted on November 27, 2012 I Written By

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Much hullaballoo is made over the 47% increase in Medicare payments from 2006-2010, which some seem eager to attribute to the adoption of EMR. The outcry is understandable; a 47% increase is a big dang deal, and taxpayers should be concerned. But haven’t we all heard that statistics lie?

“Hospitals received $1 billion more in Medicare reimbursements in 2010 than they did five years earlier, at least in part by changing the billing codes they assign to patients in emergency rooms,” cited the New York Times based on analysis of Medicare data from American Hospital Directory. Indeed, billing codes have changed from 2006-2010, in accordance with the HCPCS (Health Care Procedure Coding System) reform of CPT (Current Procedural Terminology) application and inclusion guidelines, cited here: HCPCS Reform from CMS. Healthcare industry growth and care advances drove an increase from 50 – 300 new CPT code annual applications between 1994-2004, leading to sweeping change in the review and adoption process starting in 2005 – including elimination of market data requirements for drugs.

Think about that for a second. If Pharma no longer has to submit 6 months of marketing data prior to applying for an official billing code, how many new CPT codes – and resultant billing opportunities – do you think have been generated by drugs alone since that HCPCS process change adoption in 2005? Which leads me to my next correlating fact: the most significant Medicare Part D prescription drug provisions did not start until 2006.

Let’s put two and two together: Medicare Part D prescription drug coverage (2006) + change in HCPCS billing code request process to speed drugs to market adoption (2005) = significant increase in Medicare reimbursements. To use the NYT analyst language, “in part”, administration of those drugs occurs in an emergency room. And who might be in the ER on a regular basis? I’ll give you a hint: “I’ve fallen, and I can’t get up!”

Perhaps the most profound contributor to this Medicare reimbursement increase is a recent dramatic rise in the Medicare-eligible population. Per the National Institute on Aging’s 65+ in the United States: 2005, the 65+ population is expected to double in size between 2005 and 2030 – by which point, 20% of the US will be of eligible age. The over-85 age group, as of 2005, was the fastest-growing population segment. Elderly people who are prone to chronic conditions as well as acute care events just might lead to higher Medicare reimbursements.

Of course, there are myriad contributing factors. Some industry analysts attribute the rise in Medicare claims cost to fraud, citing that the workflow efficiencies that the EMR technology provide allow for easy skimming. Activities such as “cloning”, or copying and pasting procedures from one patient to the next with minimal keystrokes within the EMR software, might contribute to false claim filing for procedures that were never performed. While the nefarious practice of Medicare fraud long predates EMR, the opportunity to scale one’s fraudulent operations to statistically relevant proportions increases significantly with automation. And as my mother always told me, it only takes one bad apple to spoil the bushel.

But how many bad apples would it take to spoil a multi-billion dollar bushel to the tune of a 47% cost increase? According to the NYT article, “The most aggressive billing — by just 1,700 of the more than 440,000 doctors in the country — cost Medicare as much as $100 million in 2010 alone,” and the increase in billing activity for each of those 1700 occurred post-EMR adoption. After all, “hospitals that received government incentives to adopt electronic records showed a 47 percent rise in Medicare payments…compared with a 32 percent rise in hospitals that have not received any government incentives.”

Wait, did that statistic just indicate a significant increase in Medicare reimbursements, across the board? So the differential between those providers who have received government incentives for EMR adoption, and those who have not, is 15%. The representative facilities and providers responded to the “aggressive billing” accusation by indicating that they had 1) more accurate billing mechanisms, 2) higher patient need for billable services. I’ll buy that. Sure, it’s likely that there is Medicare fraud happening, but that’s not new – it’s unfortunate that there will always be ways to game the system, whether manual or electronic. But is the increase in “fraud” pre and post-EMR adoption statistically relevant?

Considering the complex variables involved, I’ll chalk up the 15% increase to the combination of more specific billing practices, Medicare Part D drug provisions, an aging population and the health issues which accompany it, and not vilify the technology which facilitates further advances. Let the EMR adoption expansion continue!

SCOTUS Decision and Healthcare IT

Posted on June 28, 2012 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.

For those living in a hole that haven’t read about the SCOTUS supreme court decision that was issued today, here’s a good one paragraph summary of their decision from a post by The Atlantic:

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

There have been a lot of interesting reactions to the SCOTUS decision. Many of them revolve around the politics of the decision. We’ll obviously avoid the political side of the discussion for the most part. I did find HIMSS response to the ACA Supreme Court decision quite interesting. They are mostly grateful that some of the uncertainty is gone so we can move forward in healthcare. Plus, they remind people that health IT has had bipartisan support in Washington despite Obamacare’s obviously partisan issues.

Personally, I think that this decision (regardless of which way it went) will not have a major effect on the healthcare IT and EHR world. Most of the major happenings in healthcare IT and EHR aren’t related to Obamacare. There are a few places that impact it, but most are relatively innocuous.

My biggest concern with the SCOTUS decision is how it will impact healthcare reimbursement in general. Plus, the ACA uncertainty is still there since if the Republicans take control in Washington, then you can be sure that they’re going to repeal ACA as one of the first things they do. This uncertainty could affect the health IT decision making by many institutions.

I’d be interested to hear what other impacts people think the SCOTUS ruling will have on healthcare IT. I do agree with HIMSS that I’m glad we have a decision and can at least move forward with that knowledge.

Health IT Twitter Roundup – Healthcare IT Company Edition

Posted on April 15, 2012 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.

As you know, every Sunday I like to round up some of the various tweets I’ve seen out there talking about EMR, EHR, Healthcare IT and related subjects. Some are funny. Some are insightful. Some are interesting. Some are awkward. Some are way out there. In fact, isn’t that the beauty and the beast of Twitter? It includes all of those things from anyone who wants to participate. The nice thing is that you can always ignore someone if you don’t like what they’re saying.

With that said, this week’s edition of my healthcare IT Twitter roundup is focused on comments and announcements from a number of healthcare IT companies. Hopefully you’ll find them interesting.

This article is written by Dave Chase. I had the chance to see a demo of his Avado product last week. I’ll do a full writeup on it at some point in the future. Let’s just say I was impressed with Dave and his view of the healthcare IT world. I’m not sure I agree that meaningful use 2.0 is about talking to patients. Sure, it cracks the door open a little bit, but doctors can easily shut it again.

This won’t be a surprise to those who work in the industry. Although, this was from a survey of professionals in healthcare IT. Doesn’t seem like the best methodology for making this conclusion.

I first learned about these services from Dell at HIMSS. I’d been meaning to write about them and just never have been able to fit it into my publishing schedule. Until I do, I think it’s interesting to note that Dell’s offering these clinical help desk services to hospitals.

I’ve been a fan of Practice Fusion’s culture ever since the “scrappy” part was exhibited by their PR person trying to get me to write about them on my site a number of years back. It’s been quite interesting to see the company evolve. In the past I described them as the most “silicon valley” startup EMR company out there. I’ll be interested to see what “silicon valley” path the company takes from here. Startup companies are a hobby of mine and so it will be quite interesting to see Practice Fusion evolve as they continue to grow the company. Considering the amount of funding they’ve taken on, they’re going to have to grow the company really big in order to provide their VC’s the required return. When you grow that big that fast it’s a challenge to keep the culture.

Full Disclosure: Practice Fusion is an advertiser on this website.

9 Ways IT is Transforming Healthcare – “Top 10” Health IT List Series

Posted on December 27, 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.

As is often common at the end of the year, a lot of companies have started putting together their “Top 10” (or some similar number) lists for 2011. In fact, some of them have posted these lists a little bit earlier than usual. This week as people are often off work or on vacation, I thought it might be fun to take one list each day and comment on the various items people have on their lists.

The first list comes from Booz Allen Hamilton and is Booz Allen’s Top 9 ways IT is Transforming healthcare. Here’s their list of 9 items with my own commentary after each item.

Reduces medical errors. I prefer to say that Health IT has the potential to reduce medical errors. I also think long term that health IT and EMR will reduce medical errors. However, in the interim it will depend on how people actually use these systems. Used improperly, it can actually cause more medical errors. There have been studies out that show both an improvement in medical errors and an increase in medical errors.

My take on this is that EMR and health IT improves certain areas and hurts other areas. However, as we improve these systems and use of these systems, then over all medical errors will go down. However, remember that even once these systems are perfect they’re still going to be run be imperfect humans that are just trying to do their best (at least most of them). Even so, long term health IT and EMR software will be something that will benefit healthcare as far as reducing medical errors.

Improves collaboration throughout the health care system. I’m a little torn as we consider whether health IT improves collaboration. The biggest argument you can make for this is that it’s really hard to be truly interoperable in really meaningful and quick ways without technology. Sure, we’ve been able to fax over medical records which no one would doubt has improved health care. However, those faxes often get their too late since they take time to process. Technology will be the solution to solving this problem.

The real conundrum here is the value that could be achieved by sending specific data. A fax is basically a mass of data which can’t be processed by a computer in any meaningful way. How much nicer would it be to have an allergy passed from one system to another. No request for information was made. No waiting for a response from a medical records department. Just a notification on the new doctor’s screen that the patient is allergic to something or is taking a drug that might have contraindications with the one the new doctor is trying to prescribe. This sort of seamless exchange of data is where we should and could be if it weren’t for data silos and economics.

Ensures better patient-care transition. This year there was a whole conference dedicated to this idea. No doubt there is merit in what’s possible. The problems here are similar to those mentioned above in the care collaboration section. Sadly, the technology is there and ready to be deployed. It’s connecting the bureaucratic and financial dots to make it a reality.

Enables faster, better emergency care. I’m not sure why, but the emergency room gets lots of interesting technology that no one else in healthcare gets. I imagine it’s because emergency rooms can easily argue that they’re a little bit “different” from the rest of the hospital and so they are able to often embark on neat technology projects without the weight of the whole hospital around their neck.

One of the technologies I love in emergency care is connecting the emergency rooms with the ambulances. There are so many cool options out there and with 3G finally coming into its own, connectivity isn’t nearly the problem that it use to be. Plus, there are even consumer apps like MyCrisisRecords that are trying to make an in road in emergency care. I’d like to see broader adoption of these apps in emergency rooms, but you can see the promise.

Empowers patients and their families to participate in care decisions. Many might argue that with Google Health Failing and Microsoft HealthVault not making much noise, that the idea of empowering patients might not be as strong. Turns out that the reality is quite the opposite.

Patients and families are participating more and more in care decisions. There just isn’t one dominant market leader that facilitates this interaction. Patients and families are using an amalgamation of technologies and the all powerful Google to participate in their care. This trend will continue to become more popular. We’ll see if any company can really capture the energy of this movement in a way that they become the dominant market leader or whether it will remain a really fluid environment.

Makes care more convenient for patients. I believe we’re starting to see the inklings of this happening. At the core of this for me is patient online scheduling and patient online visits. Maybe it could more simply be identified as: patient communication with providers.

I don’t think 2011 has been the watershed year for convenient access to doctors by patients. However, we’re starting to see inroads made which will open up the doors for the flood of patients that want to have these types of interactions.

Helps care for the warfighter. This is an area where I also don’t have a lot of experience. Although, I do remember one visit with someone from the Army at a conference. In that short chat we had, he talked about all the issues the Army had been dealing with for decades: patient record standards, patient identifiers, multiple locations (see Iraq and Afghanistan), multiple systems, etc. The problem he identified was that much of it was classified and so it couldn’t be shared. I hope health IT does help our warriors. It should!

Enhances ability to respond to public health emergencies and disasters. I’ve been to quite a few presentations where people have talked about the benefits and challenges associated with electronic medical records and natural disasters. They’ve always been really insightful since they almost always have 5-6 “I hadn’t thought of that” moments that make you realize that we’re not as secure and prepared for disasters as we think we are.

It is worth noting that moving 100,000 patient records electronically to an off site location is much easier in the electronic world than it is in paper. With paper charts we can’t even really discuss the idea of remote access to the record in the case of a natural disaster.

Possibly even more interesting is the idea of EMR and health IT supporting public health emergencies. We’re just beginning to aggregate health data from EMR software that could help us identify and mitigate the impact of a public health emergency. Certainly none of these systems are going to be perfect. Many of these systems are going to miss things we wish they’d seen. However, there’s real potential benefit in them helping is identify public health emergencies before they become catastrophes.

Enables discovery in new medical breakthroughs and provides a platform for innovation. Most of the medical breakthroughs we’ve experienced in the last 20 years would likely have been impossible without technology. Plus, I don’t think we’ve even started to tap the power that could be available from the mounds of healthcare data that we have available to us. This is why I’m so excited about the Health.Data.Gov health data sharing program that Priya wrote about on EMR and EHR. There’s so many more medical discoveries that will be facilitated by healthcare data.

There you have it. What do you think of these 9 items? Are there other things that you see happening that will impact the above items? Are there trends that we should be watching in health IT in 2012?

Be sure to read the rest of my Health IT Top 10 as they’re posted.

Healthcare IT on Stack Exchange

Posted on November 6, 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.

I’m always on the lookout for new online communities around Healthcare IT. I test drive them for a little while and then decide how I’m going to incorporate them into my daily routine. I evaluate what benefits I get from participating. Sometimes the benefits of participating are just helping someone out. There’s something really satisfying about doing something for someone else.

My latest test drive has been the Healthcare IT Question and Answer site on Stack Exchange. I’ve used Stack Exchange a bunch before when I needed some programming help. However, I’m guessing that most people in healthcare IT (unless you’re a programmer) probably aren’t that familiar with Stack Exchange. Well, they created such an interesting community around question and answers that they got a whole bunch of VC funding and they’ve been growing their network into all sorts of new niches. Thus, the launch of the Healthcare IT Stack Exchange community.

You can go and check out my techguy profile on the HIT Stack Exchange site if you want to see what I’ve done. I’ve already got a reputation of 46 (whatever that means). I’ve already answered 9 questions on the site and a few people have been nice enough to vote up my answers.

For example, if you are a MUMPS lover, you can see my answers on this MUMPS replacement question and this NoSQL in Healthcare IT one. I couldn’t resist answering a question about CCHIT. I also took a swing at the PHR question, but I’m sure I could have dug a little more on that one to mention some other PHR software. Instead, I opted for the two most popular ones. I even hopped in the chat room, but it wasn’t that exciting since I was the only one there. You can check out the chat room, but you won’t be able to chat until you have enough reputation. Keeps out spammers, but makes for a boring chat room until you get some critical mass.

Of course, the real challenge with any site like this is the standard chicken and egg problem. You need a large number of people to ask and answer questions. However, in order to get a large number of people asking and answering questions, you need a lot of good questions and answers. I guess we’ll see how it evolves over time. The sidebar of the site says they’ve had 113 questions, 241 answers, 319 users and 147 visitors/day. A pretty small community, but a pretty good response rate considering the number of users. I just wish there was more discussion of EMR & EHR on the site since that’s what interests me most.

Let me know what you think and if you see any good questions or answers on the site that you think I should see. I’ll be keeping an eye on it to see how the community develops. I’d hate to have my 46 reputation points go to waste.

Watch for EMR Company Consolidation but Not EMR Software Consolidation

Posted on December 21, 2010 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.

I’ve regularly talked about my belief that there isn’t just one major EMR market. Instead, I firmly believe that there are a number of EMR markets that are divided by clinic size, medical specialty, and possibly even location. In fact, there’s likely even other factors. There are just far too many EHR companies for this to not be the case.

I think this was also well illustrated in this blog post on Kevin MD about the “Perfect EMR Traits.” Here’s the perfect EMR trait #1:

Perfect EMR Trait #1: The ideal medical record would be tailored to the specific needs of a clinician, only exposing them to portions of the record which are relevant to their work.

Knowledge within healthcare is rapidly changing. Possibly more so than another other industry. Techniques which were considered state-of-the-art, can change in a matter of weeks. The electronic medical record has the potential to be the tool which disseminates those changes down to the clinician, through point-of-care decision support. EMR software should facilitate the clinician decision making, rather than requiring clinicians to keep track of the latest and greatest. This individualistic attitude creates discrepancies in care, which inherently leads to imprecise care.

While it is certainly technically feasible for an EMR vendor to be able to create software that satisfies Perfect EMR Trait #1, it’s just not practically feasible for an EMR vendor to satisfy every clinic size, medical specialty, and in many cases locale. This means that we’re going to see a wide variety of EMR software that satisfies the various EMR market needs.

With this as a preface, consolidation of EMR companies is going to become a very very real thing. However, I’d caution EMR companies that choose to just directly sunset an EMR software acquisition. In some cases, this is a reasonable solution based upon the EMR company’s existing EMR software. Plus, in many cases EMR vendors will be acquiring the EMR market share for their existing EMR software. I’m sure we’ll see more of this.

My recommendation for EMR vendors acquiring EMR software, is to be more selective in the types of EMR software that you acquire. It’s definitely worth considering the idea of sustaining the EMR software development of multiple EMR products. Is it really that hard to see a large EMR company that has an ED EMR software, a General Medicine EMR software, an OB/GYN EMR software, a Pediatric EMR software, etc etc etc.

An EMR vendor making a decision to act in this manner will require them to change how they look at EMR acquisitions. The EMR acquisition targets will dramatically change. Instead of looking for failing EMR companies where they can cheaply buy more EMR market share, EMR companies with this approach should be focusing on a quality EMR software that hasn’t yet achieved the EMR market share that they deserve.

The cool part about the strategy of maintaining multiple EMR software instead of the strategy of sunsetting one or the other is that you purchase a bunch of happy EMR users instead of alienating a whole mass of EMR users that’s software is no longer supported. Of course, this will require proper communication of your goals and objectives so that current EMR users see the benefit of the acquisition and aren’t left wondering what the acquisition means to them. I’m not just talking about standard PR spin. I mean real tangible communication and interaction which demonstrates your plans for the acquired EMR going forward.

An EMR company with this method of EMR software acquisition, also needs a different set of skills. After sunsetting an acquired EMR, you need to have a strong set of integration and transition services to make the change to your EMR as smooth as possible. You also require a unique sales force that can sell the transition to your EMR over a transition to an altogether new EMR software. None of these services are needed if you continue to maintain the acquired EMR. Instead, your company must focus on other redundant services like marketing that could be leveraged across companies.

Of course, this isn’t an easy task to do well. Acquisitions rarely are an easy process. However, I think this is a lesson that was recently learned by Google as well. There’s value after an acquisition to keep autonomous business units. In fact, doing so opens up a whole new set of acquisition targets in a less competitive environment.

If I were a board member at an EMR company, this is the type of stuff I’d be considering. Certainly not every EMR vendor is 1. in a position to do these things and 2. has the culture to make it happen. However, I predict that the EMR company of the future will be a conglomerate of multiple specialty specific EMR software and not just a one size fits all atrocity.