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What’s Behind the Pri-Med Acquisition of Amazing Charts EHR? Posted on November 29, 2012 I Written By John Lynn
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.
For those of you who missed the news, Pri-Med acquired Amazing Charts EHR for a currently undisclosed amount. This was a really interesting move in the EHR industry. Anne Zieger suggested that this and other indicators was a sign of EMR consolidation. Turns out there’s a lot more behind the Pri-Med acquisition of Amazing Charts than most people would see on the surface. In a call I had with Amazing Charts founder and president Dr. Jonathan Bertman, as well as John Mooney, founder and CEO of Pri-Med, I learned a lot about why this acquisition makes sense and how they’re planning to capitalize on the investment. CME Chart Level Review One of the most interesting things I learned was that chart level review was the best way to see the gaps and needs that can be satisfied by CMEs. Considering Pri-Med is a major player in the CME space, you can see the value that having relationships with a bunch of doctors using an EHR can be for them. I didn’t dive into how Pri-Med plans to leverage the Amazing Charts EHR charts, but you can see the possibilities. Although, Amazing Charts is a mostly client-server based EHR, so Pri-Med won’t have any access to do chart level reviews without permission from the doctors using the EHR. Protecting EHR Data In fact, in my discussion I learned that Dr. Bertman and John Mooney both had no interest in using a physician’s EHR data to make money. That philosophy actually seemed to bring Pri-Med and Amazing Charts together to make this acquisition happen. Both believe that their company should make money providing the software and services a doctor needs as opposed to making money off the data in an EHR. This is nothing new since I’ve heard Dr. Bertman espouse this belief many times before, but does contrast with other EHR vendors in the market. EHR Acquisition Options I was also fascinated to hear about Dr. Bertman’s thoughts on Amazing Charts approach to acquisition. He said that he didn’t want Amazing Charts users to experience what other EHR users had experienced when their EHR was acquired by another EHR company. He didn’t want Amazing Charts to be one of many EHR software in a company’s portfolio. Inevitably, EHR software will get sunset to streamline the company and Dr. Bertman didn’t want that for his users. What does the Acquisition Mean for Users? Ont thing users of Amazing Charts can expect is efforts to create clinical training and information at the point of care. John Mooney mentioned their “5 Minute Clinical Consults” as a model of short education that could be integrated into the clinical documentation process. I’ll be interested to see how this evolves. Even 5 minutes seems too long for most doctors to stop their patient workflow. However, it is interesting to bring Pri-Med’s education knowledge, experience and library to the point of care in the Amazing Charts EHR. Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to
I also was fascinated by John Mooney’s suggestion of Amazing Charts possibly integrating a Provider Self Assessment tool into Amazing Charts. Definitely makes sense to have the doctors self assess to get the best CME. While not a perfect match inside an EHR software, it doesn’t seem completely out of place in the EHR if it’s done right. Amazing Charts User Groups at Pri-Med Events I also learned that they’ll be working to hold Amazing Charts user group meetings at the various Pri-Med events. This could be a great boon for Amazing Charts users. I know a lot of doctors and their staff won’t or can’t attend the national user group meetings that most EHR vendors hold. I’m not sure where the 6500 Amazing Charts users are found throughout the country, but if planned well it would be great to leverage the existing Pri-Med events for this and engage more of their EHR users close to home. Post-Acquisition Logistics They told me that Amazing Charts would maintain a separate entity in Rhode Island to continue developing and supporting the EHR software. Their marketing and sales would come out of Boston where Pri-Med is located. For Amazing Charts users, this sounds like it will be mostly business as usual from their perspective. In fact, it could mean Amazing Charts has more resources available to build our their EHR software. All in all, this seems like a smart move for Amazing Charts and their users. Full Disclosure: Amazing Charts is an advertiser on this site, but you can be sure I’d cover every EHR acquisition I can find.
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Posted on September 5, 2012 I Written By John Lynn
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I want to take a minute to say a big Thank You to all the advertisers that support EMR and HIPAA. If you enjoy the content on EMR and HIPAA, then take a minute to look through this list and get an idea of the companies that support what we do. The following are the new advertisers since I last posted about EMR and HIPAA advertisers, and then the list of renewing advertisers. New Advertisers Digital Health Conference – I wrote previously about how much I like the Digital Health Conference in New York City. So, you can imagine I’m happy to have their event advertised on EMR and HIPAA. I hope that I see many of you at the event. It’s a great one and seems to have even gotten better this year.
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The Move to Cloud EHR Posted on August 21, 2012 I Written By John Lynn
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.
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I’m pretty sure that many people missed the announcement that Amazing Charts now offers a Cloud EHR. For those who don’t eat, sleep and breathe EHR like me, you probably don’t realize that this is a pretty significant announcement on Amazing Charts part and I think represents a larger shift in the EHR industry. I know the SaaS EHR purists will say that not all “Cloud EHR” are created equal. This is highlighted in the Amazing Charts press release where it says “without a web browser.” It’s an ironic statement when you consider that most SaaS EHR happily say, “with only a web browser.” (Although, the web browser only EHR software companies should read this post by Dr. West) However, my goal here isn’t to highlight the various nuances of hosted or cloud EHR software. Instead, I wish to highlight how one of the popular, established, client server EHR software vendors was getting enough requests from doctors for a hosted EHR solution that they now offer a cloud based EHR. The reality is that many physician practices want to have to deal with as little IT support as possible. This is the major reason I’ve heard over and over again that many practices want to have a hosted EHR.
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Physia – For those of you who haven’t yet seen me talk about Physia on Twitter, this is a new venture I’m doing with Shahid Shah. Physia does really low cost physician websites. However, that’s just the beginning of what we have in mind. We plan to layer a whole set of services on top of those websites that turn your website from a glorified yellow page ad into an integral part of your office. It’s an exciting project that is going to bring physician websites into the next century.
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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.
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Mike Semel: Barry- Thanks for your comment. While what you said may seem logical to an IT security professional, your... New Study Suggests That HIEs Deliver Value by Aggregating Patient Data (2) Tom Giannulli: Anne, I agree with your introductory statement, HIEs are flawed. Beyond that not so much. There are... Tom Giannulli: Anne, I agree with your introductory statement, HIEs are flawed. Beyond that not so much. There... Nokia May Exit Digital Health Business (1) AXEO MED: No commitment. The big money goes to easy stuff like facebook, instagram, snapchat and other big time sinks. CES Really Scared Me. Will HIMSS Make Me Feel Any Better? (4) Robert Waters: Having been in IT for 2 decades I have seen protocols arise for all sorts of data privacy and... Karen Demerly: All good questions, and ones I wonder about as well. I am not attending HIMSS, but I hope it’s... John Lynn: Barry, Thanks for the kind words about the article. We have shared it but also appreciate others sharing... Cerner $10 Billion VA Contract Comes To Screeching Halt (5) Brian: Cerner likes to promise and can’t deliver. Their EMR is overpriced. I’d choose Epic hands down, any day of the...
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It’s worth pointing out that Amazing Charts focuses on the small physician practice market. It’s always been clear that the larger physician practices or hospital owned practices have better capabilities and a greater interest in hosting their EHR in house. While there are strengths and weaknesses to a hosted EHR vs an in house EHR, the hosted EHR is the compelling choice for the IT averse clinic.
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Very soon we’re going to see almost all new EHR installs in small ambulatory practices using some sort of hosted EHR software. This doesn’t necessarily spell the death of client server EHR software. Many large practices will continue using and implementing client server EHR software. Not to mention many long time EHR users will continue with their existing client server installs. However, the shift to hosted EHR is happening and will start to really pick up pace in the next couple years.
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Posted on March 14, 2012 I Written By John Lynn
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 use to do this a lot more when I started blogging, but I’m so busy with all the Healthcare Scene blogs that I don’t do it nearly as much. Although, I think it’s interesting to take a quick look at some of the stats for EMR and HIPAA and also take a minute to recognize the new and renewing advertisers on the site. I hope you’ll indulge me for a minute and you’ll take a look at those companies that support the work I do here on EMR and HIPAA. Most of them are not only sponsors of the site, but also readers. That means a lot to me. First, let’s take a look at some stats for EMR and HIPAA. This will be the 1,318th post and there have been 6417 comments on those posts. That’s about 5 comments a post which is pretty incredible. According to WP.com stats, we’ve had 5,920,478 pageviews since I started using that stats program in July 2007. Since my first blog post was back in December 2005, that puts us well over 6 million pageviews. This is astounding to me. I remember when I thought that maybe 1000 pageviews a day was the entire EHR market online. I’m glad I was wrong. Thanks for everyone that’s been reading. In fact, in another milestone, the EMR and HIPAA email subscription just blew by 4000 subscribers (now at 4,079). Considering I mistakenly didn’t start this email list until 2009, I’m happy that 4000 people want a daily email from EMR and HIPAA. Add in the 15,538 twitter followers on @ehrandhit and I’m humbled beyond belief.
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Speaking of humbling experiences, this list of new and renewing EMR and HIPAA sponsors is really humbling as well. I’m very appreciative of their support.
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New EMR and HIPAA Advertisers Greenway – I’d been talking with Greenway for about a year about advertising on my network of websites. They might have been a little busy with something called an IPO (GWAY) that slowed the discussion. Now that the IPO is out of the way, we were able to finally finish up the details of Greenway advertising. For those who don’t know Greenway, they provide an integrated EHR and clinical research solution to more than 40,0000 providers in 30 specialties. Greenway has a single-database EHR, PM and interoperability solution called PrimeSUITE®. As one Greenway partner said to me at HIMSS, “Greenway is a good company with good people trying to do good for healthcare.” I can’t say I’ve seen anything to say otherwise.
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NoMoreClipboard – The President of NoMoreClipboard, Jeff Donnell, was my first ever meeting at HIMSS. NoMoreClipboard has been doing some really interesting things since then including it’s most recent partnership with iMPak (see my interview with NoMoreClipboard and iMPak). I’d label iMPak as the most creative technology that I found at HIMSS 2012. Once I get a good demo video of the product, I’ll be doing a full post about it. It makes a lot of sense for the iMPak technology to be put together with the NoMoreClipboard technology. I’m looking forward to see what else they do together as well.
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Renewing EMR and HIPAA Advertisers Now to those companies that have renewed their ads on EMR and HIPAA since my last update: Sequelmed (Advertising Since November 2009) Ambir (Advertising Since January 2010) Mitochon (Advertising Since December 2010) Amazing Charts (Advertising Since May 2011) Elsevier (Advertising Since September 2011)
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As you can see, a number of them have been supporting EMR and HIPAA for a lot of years. I look forward to many more years working together with them.
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No doubt this list and the numbers above set a high bar for me which I don’t take lightly. I’m sure I often don’t measure up, but I’ll keep doing what I can to provide value to people. Thanks for reading.
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Posted on February 16, 2012 I Written By John Lynn
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.
As many of you know, I posted my HIMSS 2012 session schedule on EMR and EHR a few weeks back. Sadly, many of those sessions have been taken off my schedule, but a number of really good ones still remain. I just counted 27 other meetings with vendors the week of HIMSS. I think it’s fair to say I’m doing my part to see as many as I can to provide you some really interesting coverage.
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Outside of that hectic schedule, you’ll also be able to find me at a number of events (mostly social media related): Meet the Bloggers Panel – This is happening Wed 2/22 4:00-5:00PM at the HIMSS Social Media Center. This will be a fun panel for me with two people I know quite well and love: Jennifer Dennard and Neil Versel. Plus, Carissa Caramanis O’Brien who I don’t know that well, but look forward to meeting as well. If you like social media or blogging, you’ll enjoy this.
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HIMSS Social Media Center Genius Bar – I’ll be there Tuesday, 11:30 am-12:00 pm, Wednesday 10:30 am-11:00 am, and Thursday 11:30 am-12:00 pm at the HIMSS Social Media Center. Stop by and ask any question you want. You can make an appointment for it here.
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New Media Meetup at HIMSS Sponsored by simplifyMD – We’re almost out of space for this event so I’ve stopped any major promotion of it. It amazes me the wonderful people on the list. Soon I’ll probably have to change it to a wait list signup once we reach capacity.
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I also wanted to point out some of the interesting things that sponsors of EMR and HIPAA are doing at HIMSS. I just asked them for info late, so a number of my advertisers haven’t been able to get me anything yet. If they send me their info, I’ll update the post.
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NoMoreClipboard, in collaboration with iMPak Health, will launch and demo a new comprehensive solution for achieving a successful medical home or accountable care organization. This new device, ideal for technology adverse patients, will help health systems and employers improve clinical outcomes, reduce ER visits and hospital readmissions and reduce chronic disease costs. See, feel, touch and participate in product demonstrations conducive to real-world scenarios and enter to win a $500 Best Buy gift card at HIMSS Booth #7902. Location: Booth #7902
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DrFirst is presenting the HIMSS Hero at this year’s event. DrFirst will be doing Chair and foot massages, a Caricature artist turning you into our Superhero, Collapsible water bottles, House Footies (DrFirst branded hospital socks), and Giving away an iPad 2. Stop by to learn more about DrFirst’s shift to an EHR platform company. Location: Booth #5456
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Cerner is excited to expand our presence at HIMSS12. The Cerner booth #476 will provide HIMSS attendees the opportunity to connect with peers, interact with Cerner associates and learn about Cerner solutions. Multiple Cerner clients will be in the booth to offer peer perspectives to physicians in attendance and to present how they are progressing in their journeys toward achieving Meaningful use, high quality measures and greater efficiency. Cerner associates will talk through complete workflow and documentation solutions for interdisciplinary teams, medications management, device connectivity, quality reporting, revenue cycle management and leading-edge services. In addition to the show floor, 15 Cerner clients will present in the general HIMSS educational tracks. Cerner will also participate in the Interoperability Showcase and IDC-10 Knowledge Center, where we will showcase specific solutions in respective areas. Location: Booth #14542-, 476
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GE Healthcare IT delivers workflow solutions for specialists and tools which provide insights for hospital leadership to enable healthcare systems to run more effectively and efficiently- resulting in better quality care for more patients at a lower cost. At HIMSS12, we’ll showcase highlights of our extensive portfolio featuring numerous new product introductions. Now available, Centricity Patient Portal 13 is a flexible, scalable, customizable portals that extends the provider workflow to the patient’s home. With a range of easy-to-use self-service tools, Patient Online enhances patient communications, optimizes staff and provider productivity, and can help strengthen the provider’s market and competitive position. It helps customers meet Meaningful Use Stage 1 patient and family engagement criteria and prepare them for expected Stage 2 requirements. Centricity Perinatal-Connect provides the ability to correlate data from disparate Hospital Information Systems (HIS) and other sources onto the fetal strip. It enables access to multiple fetal monitoring strips while allowing documentation in the HIS all at the same time, without obstructing any clinical information, helping clinicians deliver their best care all while maximizing current hospital investment in perinatal IT. GE Healthcare IT will also demonstrate planned capabilities of its 50-50 joint venture with Microsoft, Caradigm, launching later this year. Location: Booth #2635
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This year, Practice Fusion has teamed up with Fitbit and our blogger friends Brian Ahier and Don Fluckinger to kick off our contest. Brian and Don will be competing for the most number of steps for a chance to win a charitable donation made by Practice Fusion in their name. HIMSS attendees interested in winning a Fitbit of their own can simply tweet their response to “Why do you want a Fitbit?” using the hashtags #fitbit and #HIMSS12 Unable to attend HIMSS12 but still want to experience the action? Virtual HIMSS12 is for you. Our Chief Medical Officer, Dr. Robert Rowley and Las Vegas hand surgeon, Dr. Andrew Bronstein will be presenting an on-demand session titled Interoperability on the Front Lines: It’s Already Here. Location: Booth #4074
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HITR.com will exhibit at booth 7707 with its affiliates Billian’s HealthDATA and Porter Research. The HITR team is looking forward to meeting attendees and showing them the benefits a free membership in the HITR.com community can bring – healthcare IT benchmarking surveys and results, social networking opportunities, and more! Register at the booth to win one of our twice-daily Kindle drawings. Location: Booth #7707
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EHR Scope will be exhibiting in booth 13756. We’ll be doing video interviews for www.EHRtv.com, including some walk-in interviews. At the booth we’ll also be showing other activities of EHR Scope, including www.EMRConsultant.com, as well as Dragon Medical Spanish, which is now available for Latin America. In addition to the activities at the booth, we’ll have 2 roaming camera crews doing interviews of exhibitors, by appointment only. Location: Booth #13756
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At HIMSS, Amazing Charts is introducing Version 6.2, with the ability to connect with HIEs and PHRs automatically. On signing a note, the patient’s CCD is automatically uploaded to the patient selected PHR or HIE (See Screenshot). In 2011, Amazing Charts received the Best In KLAS Award for #1 EMR for 1-10 Physicians. Location: Booth #13316
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Mitochon is the first FREE ONC-ATCB Certified, web-based Electronic Health Record (EHR) Health Information Exchange (HIE) and Patient Health Record (PHR) solution for medical professionals. The FREE EHR platform combines Scheduling, Charting, ePrescribing Labs and Collaboration of Care. This year at HIMSS Mitochon has a major announcement taking place on Monday February 20th. Dr. AndreVovan, Founder and Chief Medical Officer for Mitochon stated “all roads are leading to Accountable Care Organizations (ACO)/Integrated Delivery Systems and Mitochon is positioned to enable organizations to reach that destination.” Look for this announcement to learn more about Mitochon’s new offering and check out Mitochon’s Booth #265. Location: Booth #265
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Dr. Lynn Ho Interview – Micropractice Working Towards Meaningful Use Posted on August 10, 2011 I Written By John Lynn
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.
This is the next in a series of EMR and EHR interviews that will be done on EMR and HIPAA and EMR and EHR. The full EMR interview with Dr. Ho can be found on the new EHR and EMR interviews website. The following is a summary of that interview written by Kathy Bongiovi. After completing a family practice residency at the University of Rochester in 1989, Dr. Ho worked in a variety of settings before making her decision to open her no-staff “micropractice” in 2004. Ho defines micropractice as being “a small, low overhead, no staff, hightech-high touch practice.” Because Ho believes the current financing model of delivering primary care by cranking up the volume of visits in order to meet overhead and salary is broken she wanted to move to a model that would be better for patients and give her more professional satisfaction. Ho realized that one of the keys to running a successful micropractice is maintaining a low overhead. Her overhead is 25-30% of gross collections instead of the typical 60% that arises from paying staff salaries and for multiple work stations. Amazing Charts was her choice of EHR and she has found the company very responsive to user requests. All of the software pieces needed to integrate well with her EMR, both via formal interfaces and in her informal workflow. Ho has been able to make her office completely “paperless.” She accomplished this by having all patients send her their clinical histories using Instant Medical History from her website. She also has all new patients sign a laminated “HIPAA consent, for both billing and emailing, with one signature. Then she scans the page along with a copy of their insurance card to a file. She erases the patient’s information from the laminated sheet and reuses it for the next patient. She uses EDI interfaces for most labs and some x-rays and consults. Most consultants fax her their information electronically. Dr. Ho had no formal training in using a computer and, in fact, had only used a Mac for accessing her email prior to opening her practice in 2004. She felt that with a laptop, an all-in-one, an internet connection and an EHR as the centerpiece of her technology stable, she was set for life. She was unaware of what her technology configuration would evolve into and she became mindful of just how many of her devices would have to successfully interact to properly implement the EHR system. As of the writing of this article she was in the process of attesting for Meaningful Use and was on course to achieving MU within three months of starting the process. She updated her EHR to the latest version (Amazing Charts version 6) in order to use the “wizards” that would count the necessary data. Ho commented that it was taking only 2-5 minutes more, per encounter, to include the required documentation. Although she would prefer not to have to spend the extra time filling in the boxes, Ho did admit the MU wizard in her EMR makes it rather simple and not too painful to collect the necessary data. She had the following thoughts on whether MU certification is proper for any given practice. “If you are already leveraging your EMR to help you in your practice in a meaningful way, then depending on your Medicare/Medicaid revenues/patient mix, it may be worth it to apply”. She felt the questions to be asked “are the monies received – or the penalty that you would incur, worth the time it will take you to: 1)learn about the MU program, 2) learn how to use the MU features of the EMR, and 3) actually do the documentation?” She also feels that a provider needs to consider his or her payor mix and practice volume. However, if a provider doesn’t use the EMR to collect demographic data or to E-prescribe, there will be additional work to adopt these processes into one’s workflow. Dr. Ho feels that attestation is not proper for everyone. Smaller practices with very tight profit margins which lack breathing room may not be able to succeed because the benefits of certification may be outweighed by the efforts necessary to becoming schooled in MU deployment. Read the full transcript of Dr. Ho’s EMR and Meaningful Use interview. Share this: Tweet
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Dr. Lynn Ho – Ultra-Solo Doc: Meaningful EHR User With Amazing Charts Posted on August 2, 2011 I Written By John Lynn
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.
1. Please tell us about your background and training and when you became a sole practitioner? I graduated from NYU School of Medicine and finished a family practice residency at the University of Rochester in 1989. Before opening my micropractice, I had worked in a variety of different settings, including an HMO, community health centers, a university health center and a typical private office practice. I opened my no-staff micropractice in 2004 after reading Gordon Moore’s groundbreaking articles on solo-practice and seeing a local colleague succeed with a similar type of practice in Rhode Island. 2. I understand your practice is defined as a “micro practice”. Can you explain what you mean by that and how it differs from a traditional practice? In my particular case, ‘micropractice’ refers to a small, low overhead, no staff, high tech – high touch practice. – a small practice (850 patients vs. the usual patient size panel of 1500-3000 patients) – that because of low overhead (25-30% of gross collections vs. usual 60%, attributable to not paying staff salaries and leveraging computers to run an efficient and effective practice) – is able to spend adequate amounts of time with the patient during each patient encounter (30-60 minutes vs. the national primary care average of about 7.5 minutes) – which leads one to be able to better provide the cardinal primary care functions of supplying “access, continuity over time, coordination and comprehensiveness” in a patient centric manner. 3. What led you to make the change from traditional to micro practice? The current financing model of delivering primary care – cranking on volume of visits to meet overhead and salary – is bankrupt and broken. I wanted to move to a model that would be better for patients and lead to more professional satisfaction for myself. I wanted more control over the way I practiced medicine. 4. When did you start using Amazing Charts (AC) and why did you choose them over other EHR vendors? One of the key underpinnings of running a micropractice is achieving and maintaining low overhead, (around 30% of gross earnings). I did know that I did NOT want to work just to have to pay for my EHR. When I first started my practice my AC license cost me just $500. Back in 2004, AC did not have a lot of bells and whistles but as a startup I was nowhere near using the program to its fullest capacity. Starting out is tough! I had the naive idea that with a laptop, an all-in-one, an internet connection and an EHR as the centerpiece of my technology stable, I was set for life. I was blissfully unaware of what my burgeoning technology configuration (see list below) was going to evolve to include, and how many other pieces of technology were going to have to ‘play nice’ with my EHR. Luckily for me, and because AC is very responsive to requests from users, all of the software pieces that I use integrate well with my EMR, both via formal interfaces and in my informal workflow. To reiterate, low cost, ease of set up, maintenance and use, and ability to easily integrate with other workflow processes are the EMR qualities that I’ve found to be essential in my micropractice, and I find that AC meets and often delightfully exceeds these criteria. Instant Medical History – automated patient entered histories Updox – document management and patient portal Paperport – document management Appointment Quest – online patient entered appointments EZ Claim – practice management Zyantus (clearing house) – electronic billing Shortkeys – macro for documentation HowsYourHeath – web based patient entered practice quality tool Brinkster – website hosting 5. Did you have any prior experience using EMRs? No – actually I had never really used a computer (except for email, and that was a Mac!) before opening my practice in 2004. 6. I understand you are in the process of attesting to Meaningful Use. Was it necessary to upgrade your current EHR in order to meet requirements for MU? I had to upgrade to the latest version – version 6 to use the wizards that would count up my data. 7. How long have you been working towards MU? I’ve been counting data for about 2 months, and am on track to “pass” by month 3. 8. How much additional time is it taking to meet the criteria for attestation? It takes about 2-5 more minutes per encounter to include the documentation for Meaningful Use. 9. Can you give us an overview of what the process has been like thus far? Generally speaking, I find it exceptionally vexing to have to spend extra time documenting what I already do for bean counters. I could be using this extra time to actually improve patient care instead of just filling in boxes. Luckily, on a visit by visit level, the MU wizard in my EMR makes it mindless, simple and not too painful to collect the required data and document the required work processes. 10. What changes have you had to make in your practice as a result of meaningful use? I have not materially had to change office processes, though I have had to change documentation procedures so that items are compiled correctly for MU. For example: I used to send patient summaries via email to most patients. 5 clicks: copy content – return to demographics screen – open email to patient – paste – send, about 30 seconds. Now, in order to document that I am sending these summaries for MU, I have to click on the MU box, print that to a secure email, click( 2x )and type (2x ) within the secure email program to attach label and send, wait for the CCD to print and then click to return to the note. 8 steps and some are slightly more than just a click. It all takes about 90 seconds. Another example – Smoking documentation requires a formal reassessment of the data as MU needs it, but it’s usually not the way I’ve previously free texted it. It’s just a little more cumbersome, might take about 2-5 minutes more per patient encounter. 11. Word is that you’re a “paperless office.” How do you handle things like the patient intake paperwork to avoid having lots of paper lying around? Patients send me their clinical histories before every visit electronically using Instant Medical History from my website or from an office kiosk, so I don’t use paper for those forms at all. I do have new patients sign a laminated “HIPAA-consent to bill-consent to email form” – one signature gets it all. Then I scan in the page along with a copy of the insurance card to a file. I rinse off the marker from the laminated sheet under the tap and am ready for the next new patient. I use EDI interfaces for most labs and some x Rays and consults, and most consultants fax me their information electronically. Other non interfacing labs and radiology reports come in via paperless fax to a folder on my computer. If there is a particular consultant or facility that mails me information more than twice, I will call them and ask them, going forward, to fax their information to me. There are a number of tricks to minimizing use of paper in the office. Having paper embedded into your office routine requires extra labor (opening mail, scanning, shredding, filing, retrieving files) and the expense of storage space and materials. 12. Who has been helping you through the meaningful use process (consultant, your EHR vendor, your REC, etc.)? Mostly the EHR folks- attended a webinar and then had some back and forth with the developers, as I was an early beta tester for the MU process. The REC folks came by, but since the processes were in place they just encouraged me to actually decide to apply for MU by dangling the financial rewards in front of me. 13. What would you offer as guidance to your fellow doctors regarding EHR’s and obtaining MU status? If the processes that MU is supposed to document are already in place – if you are already leveraging your EMR to help you in your practice in a meaningful way, then depending on your Medicare/Medicaid revenues/patient mix, it may be worth it to apply. The question there is, are the monies received – or the penalty that you would incur, worth the time it will take you to: 1) learn about the MU program, 2) learn how to use the MU features of the EMR, and, 3) actually do the documentation? Payout is also dependent on your payer mix and volume of the practice. For example, because my straight Medicare income was about $10K last year, I stand to get, over 4 years, about $22K so, coupling the payment with the curiosity factor of seeing what our cutting edge HIT people are up to, I decided it was almost ‘worth it’ for me. If the processes are not in place – items such as, ‘you don’t use the EMR to collect demographic data’ to ‘your EMR does not support E-prescribing’, then there’s the additional work of adopting these processes into your workflow. Again you’d have to weigh the payment against the work of adopting new workflows AND becoming schooled and practiced in MU deployment. This work is not an insignificant burden and many small primary care practices that run with very tight margins and lack breathing room will not be able to succeed. Of course, if you work for Kaiser or another large group, I would imagine that they would deploy both IT and clinical staff to do this work for you. Share this: Tweet
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EMR Companies Holding Practice Data for “Ransom” Posted on January 19, 2011 I Written By John Lynn
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.
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. Share this: Tweet
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