EMR

CCHIT on PHRs

CCHIT, the Certification Commission for Health Information Technology, will be certifying personal health records (PHRs) next year. Criteria will be proposed in April, 2009, along with a comment period. Certification will officially start in July 2009.

CCHIT’s certification of EMRs met with mixed reactions early on, with smaller vendors crying foul over the $20,000 fee. Since then, it’s become a somewhat important stamp of approval in large enterprise purchasing decisions.  This will likely happen with PHR certification as well.

PHR vendors should watch criteria development and participate in the comment period to provide your view.

Continue reading "CCHIT on PHRs" »

Posted by Shawn Whalen on June 28, 2008 at 12:45 PM
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Your Premiums at Work

It seems that health plans have a little money left after paying all those healthcare costs. The trend of health plans acquiring technology vendors continues.  Care management vendor MEDecision is to be acquired by Health Care Service Corporation (HCSC), which operates Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas.  HCSC paid $121 million and will keep MEDecision independent.

BlueCross BlueShield of Tennessee and The Regence Group Blue are taking a minority ownership in TriZetto Group, which will be going private.  Others include UnitedHealth’s Ingenix , Aetna’s ActiveHealth Management, and Independence Blue Cross’ AllOne Health Management Solutions.

As I’ve written before, payors will be the major players in pushing technology adoption in healthcare, be it provider side with EHRs or consumer side with PHRs.

Posted by Shawn Whalen on June 23, 2008 at 8:47 AM
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CBO: What Savings?

A recent report from the Congressional Budget Office joins several other reports in asserting that the health IT won’t deliver significant cost savings. The report specifically attacked the often-cited RAND report number of $77 billion in annual cost savings.

According to the report, health IT will only yield cost savings if implemented with broader healthcare reform measures. Also, government-mandated technologies such as e-presecribing could generate savings.

Coming from the Congressional Budget Office, many pundits have said that the report could effect prospects for legislation to boost the use of health IT. I don’t think so, given the number of reports that claim otherwise and the growing political importance of healthcare to the new administration soon to be in power.

Posted by Shawn Whalen on June 16, 2008 at 7:16 AM
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Plans and Progress

Last week at a conference I heard doc Kolodner, head of the Office of the National Coordinator for Health Information Technology (his business card is extra long), talk all about the federal government’s health IT five-year strategic plan for 2008-2012. Kolodner was refreshingly frank about the level of progress given government bureaucracies, but at the same time optimistic.

The plan lays out a road map and milestones in more than 40 areas, including interoperability, security, privacy and IT adoption.  In this last area, the government would like to see PHRs linked to EMRs by 2010.  The full strategic plan is available here.

PR pros should review the plan to see what aspects are applicable to your products and services. Then position yourself with media as helping with the government's efforts by offering solutions today to enable the healthcare future of tomorrow.  Media who write about HHS and government health IT efforts would be good to target.

For those interested in looking back over the last four years since the Office was founded, please hit the “continue to read” link below.

•    2004: Laying the Foundation
•    2005: Initial Steps and Progress
•    2006: Major Accomplishments
•    2007/8: Major Accomplishments/Next Steps

Continue reading "Plans and Progress" »

Posted by Shawn Whalen on June 11, 2008 at 3:15 PM
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Calling All IT Geeks

A new AHIMA study says the HCIT workforce needs to expand considerably in coming years to meet demand. The study states that while there are 108,390 HIT professionals available in the U.S. today, providers will need an additional 40,784 to support widespread EMR adoption. The 40 percent increase is because when hospitals move from having no EMR to having EMRs, they need 0.082 IT staffers per bed compared to 0.2 IT staffers per bed.

Posted by Shawn Whalen on May 23, 2008 at 9:07 AM
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CEOs Support Wired for Health Care Act

Today brings a guest column on healthcare quality and technology by Maria Ghazal, director of public policy with the Business Roundtable, an association of CEOs of leading U.S. companies with $4.5 trillion in annual revenues and more than 10 million employees.

Health IT Will Save Lives and Money - First We Need Policymakers to Wire Us for Health Care Quality

Imagine if every few days a passenger plane crashed while travelling across America. There would be a massive outcry over safety standards and America would want answers…the airline industry would be investigated, held accountable and would make the necessary changes to ensure air travel is as safe as possible. Shockingly, the equivalent is happening in the healthcare space and no one seems to notice. Every year as many as 98,000 people die due to preventable medical errors, the equivalent of a 747 crashing every two or three days, and yet there is no public outcry, no call for reform and no alteration to our current health care system.

This must change. I work for the Business Roundtable – an association of CEOs of leading U.S. companies such as Verizon, Aetna and General Motors – who are pushing Congress to recognize that the cost we currently pay for our outdated system, in both human lives and dollars, is unacceptable. Based on both their business experience and their insights from insuring more than 35 million Americans, Business Roundtable CEOs believe that utilizing health information technology, more commonly known as health IT, will provide better quality of care while saving money and ensuring the security of private medical information.

 

Continue reading "CEOs Support Wired for Health Care Act" »

Posted by Shawn Whalen on May 19, 2008 at 1:46 PM
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Acute EMR Short List

Healthcare IT markers in the acute EMR side may be interested in this upcoming complimentary Webinar from analyst firm Health Industry Insights.

Inpatient EMR – The IT Supplier Short List
May 1, 2008
3:00-4:00 pm
Register Here

According to Health Industry Insights, market factors have driven strong demand for implementation of inpatient clinical electronic medical record (EMR) systems and hospitals are in a constant cycle of installing, replacing, upgrading or adding functionality to support inpatient EMRs. The questions faced by EMR implementers include:

•    What functionality matters - and what doesn't?
•    What tradeoffs need to be made?  And what tradeoffs should be avoided?
•    Does spending less mean getting less?
•    How do I tell if my organization and the vendor are a good fit?
•    How can I prepare my organization for EMR implementation?  What needs to happen first? 
•    How do I get stakeholders on board?

While all organizations will face initial implementation hurdles, the fit of the application, vendor and implementation process with the organization can dramatically lessen this impact, and drive early benefits.

According to Health Industry Insights, it's becoming increasingly clear that EMRs are not one-size-fits-all, and that taking the specific needs of an organization into account is essential to making projects successful. Alignment of the provider's strategic goals with that of the vendor and making smart tradeoffs during the selection process can drive the success or failure of EMR implementation. 

Join Health Industry Insights’ analyst Judy Hanover for a complimentary web conference covering Health Industry Insights’ new Healthcare Provider Industry Short List – a look at 9 IT suppliers and their inpatient EMR systems.

Health Industry Insights’ Short Lists are fact-based tools designed to help IT and business executives to review a short list of IT suppliers that best address the industry-specific needs of the business, to facilitate a technology buying-decision process. The EMR Shortlist tool is designed to provide a customized, fact-based analysis for individual projects that can help guide decisions for stakeholders.

Posted by Shawn Whalen on April 16, 2008 at 2:19 PM
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Medical Record Paparazzi

Ahnald is angry and calling for tighter medical record security after his records, his wife’s and those of 32 other celebrities were breached.  The ex-Terminator told the Los Angeles Times that he’s been a victim of unauthorized snooping following heart, hip and shoulder operations.

Is that any surprise? I’m sure it happens all the time, whether it be medical, police or other public institution records. It’s politically convenient to raise the issue as part of a broader healthcare platform.

The former Conan the Barbarian said that every time he left the operating room he was told that people were going through his file. They had white coats on and snuck into the hospital, "They had nothing to do with the hospital staff at all," he told the Times.

California's health department said the agency would sanction the UCLA Medical Center after confirmation that improper hospital workers had accessed medical records of more than 60 patients.  In the past, a handful of UCLA employees were fired after an audit showed patients medical records had been violated. 

Posted by Shawn Whalen on April 11, 2008 at 1:55 PM
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NY Loves RHIO

In a vote of confidence in regional healthcare information organizations (RHIOs), the state of New York gave out  $105 million in grants recently. Among the 19 grants, Brooklyn’s Health Information Exchange snagged the largest grant of $12.7 million.

The Empire state's HCIT goals include supporting Medicaid providers, streamlining public health reporting and monitoring, increasing patients’ involvement in their care, and improving the quality of care.

In a press conference, New York pointed out how they are giving more money out than the Federal government office headed by Kolodner. This financial support by New York is an example of how state governments can help increase adoption of technology.

From the healthcare IT marketers perspective, any vendors with New York customers part of these grants should consider ways of promoting their involvement, from a simple congratulations letter to a press release. Others ideas include pitching such customers to the media as case studies, as part of RHIO trend stories, for joint bylines with your executives or as speaking engagement case study submissions.

Posted by Shawn Whalen on April 7, 2008 at 2:54 PM
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PHR Privacy?

As summer rolls around so will the general availability of Google Health and Microsoft HealthVualt’s Personal Heath Records (PHR). These major players, plus the offerings from WebMD, Revolution Health, ActiveHealth Management and a dozen other PHR players raises the question of privacy and HIPAA.

These third-party PHR technology vendors are not covered healthcare entities according to HIPAA. Hospital and managed care associated PHRs do fall under the HIPAA privacy and security mandates.

As most readers of this blog know, HIPAA provides strict standards that classify medical information as a privileged communication between a doctor and patient. If the medical records aren't protected by HIPAA, the information could be used for marketing purposes.

In most cases, each health profile, including medical history, prescriptions and allergies, will be password protected. Vendors will likely have their own privacy policies which could match HIPAA laws, however they are just policies and not laws. 

Smart PHR vendors will go the extra mile to assure customers that their data is private and secure. This issue should be proactively addressed by PHR vendor PR people.
 

Posted by Shawn Whalen on March 26, 2008 at 11:44 AM
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A European Perspective

Research and consulting firm Health Industry Insights (HII) released its 2008 Western European Top 10 Predictions. According to HII analysts Jan Duffy and Silvia Piai, European healthcare providers are facing an "inconvenient truth": the traditional healthcare service delivery model — based on big box hospitals set up to deal with acute episodes, doctors as the only owners of clinical information, and little attention dedicated to wellness and prevention — is no longer sustainable. New patterns of demand, resource constraints, and glitches in the quality of service have brought this model to the point of no return. Health Industry Insights foresees common patterns of transformation of both the service delivery model and information technology modernization in Western Europe.

For their predictions for 10 key changes taking place in 2008, please click the "Continue Reading" link.

Continue reading "A European Perspective" »

Posted by Shawn Whalen on March 18, 2008 at 9:05 AM
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What Can Brown Do For You?

Privacy advocates wring their hands over medical records in the electronic ether, but a more frequent culprit of compromised records is UPS.  

The Associated Press reported that the medical records of 28 Central Florida Regional Hospital patients were sold last month at a Salt Lake City surplus store for about $20. The records were sold to a local school teacher looking for scrap paper for her fourth-grade class. The records contained addresses, Social Security numbers, medical histories, phone numbers and insurance information.

The hospital shipped the records via UPS to a Las Vegas company for a Medicare audit. One of the boxes was lost and ended up in a Utah surplus store for sale, according to the A.P. The confusing part is the package containing the records had a document indicating it was sold because the shipping company could not deliver it or find its owner.

Shipping companies often sell off packages that cannot be delivered. The A.P. reported that a UPS spokesman said his company keeps packages for at least three months before liquidating them.

Did UPS loss the box label, so the package floated in their system before being sold to the surplus store?  Last year a CD-ROM with thousands of medical records was “lost” by UPS. It turned up a few weeks later when a private citizen realized he had received the wrong disk and returned it.

It doesn’t take data flowing on the information superhighway to get lost or stolen. A majority of fraud and data loss in financial services still happens the old fashion way, and it isn’t any different in healthcare.

Posted by Shawn Whalen on March 12, 2008 at 9:33 AM
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EMR Blues

I thought it progressive of Blue Cross Blue Shield of Massachusetts to give out $50 million in grants a few years ago to medical practices to adopt EMRs. So it was interesting to see BCBSMA suggest that the financial ROI wasn’t worth the cost to doctors in medical practices.

Citing studies including an AMA report saying docs get only 11 cents of every dollar saved through the use of an EMR, BCBSMA decided not to require physicians to install an EMR to participate in its bonus program. They still however offer financial incentives to medical groups to adopt EMRs.

BCBSMA’s own cost-benefit analysis showed that CPOE made financial sense in the hospital setting. So they will require health systems to install CPOE by 2012 to participate in the bonus program.

The BCBSMA news came after a local study by the New England Healthcare Institute. It found that that CPOEs could help prevent 55,000 medication errors in MA and provide an annual cost savings of $170 million, or $2.7 million per hospital.  No surprise there, given medication errors are one of the more easily addressed problems with IT.

BCBSMA estimates it would take five to six years for an EMR to recoup its cost in an office-based practice. AMA policy supports EMRs but does not support requiring physicians to purchase them.

While I think the financial ROI aspect of EMRs is important, especially if you’re the doc paying for the system, there are other quality, safety and pay-for-performance benefits that should be considered. Understandably however, the small and medium sized medical practice has a tough time swallowing the cost of the typical EMR.

Industry is responding with cheaper, simpler, hosted solutions. Insurers continue to support and provide financial assistance.  Changes in the Stark Law are allowing hospitals to provide free or discounted systems to their network practices. And perhaps government will start providing tax incentives.

Massachusetts may pass legislation that would provide $175 million in grants to physicians to adopt EMRs.  This may change MA insurers perspective on EMRs and bonuses.

Posted by Shawn Whalen on March 10, 2008 at 10:17 AM
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Report from HIMSS

Another year, another HIMSS.  Florida was a nice break from the cold of Massachusetts. We had about 10 clients at the show, fielding a combined 100 media interviews.  Plenty of others whose job it is to analyze have covered the show, such as Healthcare IT News.  So I’ll just share some photos.
 

Sniffing out prospects. Attendance seemed lighter than last year, though HIMSS claims otherwise.
 

Klaatu barada nikto. The aliens have landed, and they come bearing interoperability.
 

This doc looks smart enough to buy an EMR.
 

Hyland not only had the most popular booth - a sports pub serving beer - but also a novel marketing idea using baseball cards.
 

Vroom, vroom. Driver decision support and PHR come standard.
 

The GE Kingdom. Will they follow Cerner and not return next year?
 

These sleek filing cabinets hold up to 200 patient records per drawer ;)
 

Organic, green, enviro-styling booth, though I can’t recall what they do.
 

R2-D2-EMR. Good for carting around rebel IT secret plans.
 

The wheeling and dealing home base.

Posted by Shawn Whalen on February 27, 2008 at 3:15 PM
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Mo' Money Mo' Money

Picking up from the Jan. 3 post about the 2008 budget for the Federal Office of the National Coordinator for Health IT, the 2009 budget proposal came in at $66 million. A whopping $4.7 million more than 2008’s $61.3 million.

On the positive side, beyond the Office budget are several other budget proposals including $45 million for the Agency for Healthcare Research and Quality to advance health IT to boost patient safety; $26 million to continue trial implementations of the Nationwide Health Information Network; $3.8 million for CMS to fund the second year of a EHR demonstration project; and $3 million for the Office of the Assistant Secretary for Planning and Evaluation to conduct independent evaluations of EHR adoption
 
The complete Health & Human Services 2009 budget proposal is here.

To echo past advice, these budget discussions give healthcare IT vendors a PR opportunity to highlight how they are making the government’s vision a reality. Consider thought leadership PR for your executives to comment on the government fiscal short-comings, and how private sector companies such as yourselves are solving healthcare's problems today.

Posted by Shawn Whalen on February 12, 2008 at 10:36 AM
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Such Dedication

It's safe to say this isn't a doctor's plate ;)

Posted by Shawn Whalen on January 26, 2008 at 5:03 PM
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Lists, Grids and Quadrants

Our Next Installment in a Continuing Series on Healthcare IT PR Tactics and Strategies

Industry analyst relations are always a popular topic, one which I've blogged on before. With the New Year underway, vendors look forward to the industry analyst leadership grids, wondering how they can get good placement on them. In this post, we'll look at the top three grids. In part two we'll look at how to get good grid position.

Gartner's Magic Quadrant is the best known, followed by Forrester's Wave. IDC has sporadic leadership grids; the Health Industry Insights group will be starting "Short Lists" soon. These highly coveted reports rank IT solutions using detailed technical standards, end-user feedback and analyst opinion. Excluded from this discussion are the popular survey-based KLAS rankings (arguably more valuable than all the analyst grids put together) and juried best-in-show contests from the likes of TEPR and HIMSS.

According to Gartner, the Magic Quadrant is a graphical representation of a marketplace at and for a specific time period. It depicts Gartner's analysis of how certain vendors measure against criteria for that marketplace. Gartner is careful to say the quadrant does not endorse any vendor, product or service depicted (and relationship between paid clients of Garner and rankings is purely coincidental ;) Similarly, they coyly do not advise technology users to select only those vendors placed in the "Leaders" quadrant.

A list of Magic Quadrants to be published in '08 is here. In October there was a Magic Quadrant for U.S. Enterprise CPR, and the previous year a Quadrant for U.S. Physician Office Systems. Check with analysts, as the Quadrant schedule isn't always final.

The Forrester Wave is similar in intent but more interactive and, I think, useful. Forrester says their Forrester Wave is a detailed analysis of vendors' products and services based on "transparent, fully accessible criteria." It includes an Excel spreadsheet that allows you to easily compare products and get in-depth data and analysis about each one. In addition, there are tools to develop a custom shortlist based on your company's requirements.

For a schedule of upcoming Forrester Waves click here.
Check with analysts however, as some healthcare topics aren't on this though they may be covered.

A recent example of a Forrester Wave is their Jan. 17, 2008, Healthcare Claims Platforms Q1 2008. To continue reading about this and Health Industry Insights/IDC's Short List, click the "Continue Reading" link.

Continue reading "Lists, Grids and Quadrants" »

Posted by Shawn Whalen on January 24, 2008 at 4:41 PM
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2008 Trends to Watch

Industry analyst firm Health Industry Insights released their 2008 healthcare IT predictions. Business intelligence tops the list.  Their announcement discusses how data integration and interoperability will continue to drive major shifts in IT spending. These initiatives will be sharpened by an industry focus on cost containment, process improvements, and improved patient outcomes. Listed below are key highlights from their provider and payer top ten trends.

U.S. Provider 2008 Top 10 Predictions identifies major trends that will impact the provider IT landscape in 2008. The industry is approaching a critical turning point whereby delivery models and applications are increasingly accessible and easier to use providing much needed data exchange and interoperability. Providers need to examine opportunities to expand EMR investments as this is becoming a key requirement in the inpatient and ambulatory care setting. Health Industry Insights also predicts that providers should keep an eye on Health 2.0 as it is changing the way consumers interact with healthcare information.

U.S. Payer 2008 Top 10 Predictions reflect a volatile and changing business and technology environment, with investment planned in multiple traditional areas and new initiatives, rather than the more single-themed focus of some previous years (e.g., HIPAA, consumerism, the collaborative business model). Business intelligence, prioritized investment on consumer information management and transaction tools, as well as "extra-enterprise" technology investment emerge as overarching themes and areas of the greatest investment in the next 12-18 months. Fragmentation and high technology costs will continue as the U.S. healthcare payer market technology investment encompasses over 50% of the total worldwide healthcare payer IT spend.

Health Industry Insights’ Top 10 predictions across the industry sectors include:

- Business intelligence and related information management are leading categories of technology spending increases in 2008 across all segments
- Outsourcing seen as instrumental as the focus on cost reduction continues to increase
- Drug safety will remain front and center as a primary concern in 2008
- SaaS (software as a service) will spur adoption of EMR's for small providers
- Healthcare/financial services interface and competition will heat up in 2008 as healthcare payers shift costs and payment responsibilities to consumers
- "Extra-enterprise" investments become mainstream as over 40% of healthcare payers report technology investments for use by consumers and providers
- Retail clinics and their technology will proliferate, increasingly disrupting healthcare delivery

"We predict there will be accelerated investment in 2008 in the Business Intelligence segment with spending growing more than 13% over the next 12-18 months," said Scott Lundstrom, vice president of Research, Health Industry Insights. "In addition, the healthcare industry should anticipate more innovative use of Web 2.0 technologies in healthcare by mainstream technology vendors and niche companies over the next 12-24 months."

Posted by Shawn Whalen on January 14, 2008 at 10:32 AM
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Tax Cut an Answer

There are almost 20 different proposed government bills for healthcare IT. I personally think the most sensible solution is the one endorsed by the American Medical Association. It's a full, refundable federal tax credit for the cost of purchasing and implementing clinical IT, including EMRs.

Small and medium sized medical practices can't afford this technology, so a tax break makes sense. About 12% of office-based physicians used a comprehensive EMR system in 2006, according to an October Centers for Disease Control and Prevention report. That figure fell to 7% and 9% for solo and two-physician practices, respectively.

For EMR and PPM vendors, this situation lends itself to PR that highlights the plight of small physician groups. These make up a majority of the care continuum in the U.S., yet are the least able to afford the technology. Trade reporters may respond to trend stories or case studies on low cost solutions that demonstrate ROI. The software-as-a-service model is gaining steam. Illustrate your customer's story in a problem-solution-benefit format to gain the attention of healthcare media.

Posted by Shawn Whalen on January 10, 2008 at 12:02 PM
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Putting Money Where Your Mouth Is

All the Presidential hopefuls are singing from the same hymnal that EMR is part of the solution to improve healthcare quality and cut costs. I wonder if the next President will put his money where his mouth is and better fund the Office of the National Coordinator for Health IT.  The current administration set the '08 budget at $61.3 million, the same as last year, which was down from $125 million the previous year. 

This anemic amount will further slow efforts such as the National Health Information Network (NHIN), pilot programs and an architecture standard for personal health records (PHR).  Obviously government won't make reality Bush's EHR-for-every-citizen-by-2014 pipedream.

This gives healthcare IT vendors a PR opportunity to highlight how they are making this vision a reality. Consider thought leadership PR for your executives to comment on the government fiscal short-comings, and how the private sector led by companies such as yourselves are solving healthcare's problems.

Posted by Shawn Whalen on January 3, 2008 at 5:04 PM
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KLAS Acts

 2007 Best in KLAS Awards

General Market Software

Some new names in some top spots. eClinicalWorks and athena are dislodged from some of their previously held top spots.

Acute Care CDR, Orders and Charting (Large, 200+ Beds) - Epic

Acute Care Reg., Sched., PA (Large, 200+ Beds) - Epic Hospital

Cardiology PACS (Acute Care) - Emageon

Decision Support - Business - EPSi

Document Management and Imaging (Acute Care) - Perceptive Software

Emergency Department Systems - Wellsoft

Enterprise Scheduling - USA RMS

Financial/ERP (GL,AP,MM,Payroll,HR) - McKesson

Financial/Materials Management/Laboratory (Larbe, 200+ beds) -  Sunquest Lab

PACS (Large, 200+ Beds) - DR Systems

Pharmacy (Large, 200+ Beds) - Epic EpicRx

Radiology (Large, 200+ Beds) - GE Centricity RIS-IC

Surgery Management - USA ORMS

Transcription and Back-End Speech Rec.- eScription EditScript

Community Hospital Software

Community HIS - Overall McKesson Paragon Community HIS (Small - 200 or Less Beds)

Community Clinical Ancillary Software - Overall DR Systems Unity (Small - 1-200 Beds)

Physician Practice Software

Ambulatory Billing and Sched. (Over 100 Physicians)- Epic

Ambulatory Billing and Sched. (26-100) - athenahealth

Ambulatory Billing and Sched. (6-25) - AdvancedMD

Ambulatory Billing and Sched. (1-5)- DoctorsPartner

Ambulatory EMR (Over 100)- Epic EpicCare Ambulatory

Ambulatory EMR (26-100) - Allscripts 

Ambulatory EMR (6-25) - Greenway Medical 

Ambulatory EMR (1-5) - MedcomSoft

Professional Services

Clinical Implementation Principal- IBM Healthlink

Clinical Implementation Supportive - Coastal Healthcare Consulting

Financial Implementation Principal- ACS

ITOutsourcing (Extensive)- Eclipsys IT Outsourcing

Outsourced Transcription - Encompass Outsourced Transcription

Planning and Assessment - Hayes Management

Revenue Cycle Consulting-Transformation - Stockamp & Associates

Technical Consulting - Hayes Management

Medical Equipment

Computed Radiography (CR) - Konica Xpress CR Dual Bay

Computed Tomography (CT) - Toshiba Aquilion 64-slice CT

Hand-Carried Ultrasound - ZONARE z.one

Magnetic Resonance (MR) - Toshiba Vantage 1.5T MR

Smart Pumps - B. Braun Outlook

Ultrasound - Toshiba Xario

Other Software

Home Care - McKesson Horizon Homecare (Home Health)

Posted by Shawn Whalen on December 28, 2007 at 10:05 AM
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KLAS Acts

 2007 Best in KLAS Awards

General Market Software

Some new names in some top spots. eClinicalWorks and athena are dislodged from some of their previously held top spots.

Acute Care CDR, Orders and Charting (Large, 200+ Beds) - Epic

Acute Care Reg., Sched., PA (Large, 200+ Beds) - Epic Hospital

Cardiology PACS (Acute Care) - Emageon

Decision Support - Business - EPSi

Document Management and Imaging (Acute Care) - Perceptive Software

Emergency Department Systems - Wellsoft

Enterprise Scheduling - USA RMS

Financial/ERP (GL,AP,MM,Payroll,HR) - McKesson

Financial/Materials Management/Laboratory (Larbe, 200+ beds) -  Sunquest Lab

PACS (Large, 200+ Beds) - DR Systems

Pharmacy (Large, 200+ Beds) - Epic EpicRx

Radiology (Large, 200+ Beds) - GE Centricity RIS-IC

Surgery Management - USA ORMS

Transcription and Back-End Speech Rec.- eScription EditScript

Community Hospital Software

Community HIS - Overall McKesson Paragon Community HIS (Small - 200 or Less Beds)

Community Clinical Ancillary Software - Overall DR Systems Unity (Small - 1-200 Beds)

Physician Practice Software

Ambulatory Billing and Sched. (Over 100 Physicians)- Epic

Ambulatory Billing and Sched. (26-100) - athenahealth

Ambulatory Billing and Sched. (6-25) - AdvancedMD

Ambulatory Billing and Sched. (1-5)- DoctorsPartner

Ambulatory EMR (Over 100)- Epic EpicCare Ambulatory

Ambulatory EMR (26-100) - Allscripts 

Ambulatory EMR (6-25) - Greenway Medical 

Ambulatory EMR (1-5) - MedcomSoft

Professional Services

Clinical Implementation Principal- IBM Healthlink

Clinical Implementation Supportive - Coastal Healthcare Consulting

Financial Implementation Principal- ACS

ITOutsourcing (Extensive)- Eclipsys IT Outsourcing

Outsourced Transcription - Encompass Outsourced Transcription

Planning and Assessment - Hayes Management

Revenue Cycle Consulting-Transformation - Stockamp & Associates

Technical Consulting - Hayes Management

Medical Equipment

Computed Radiography (CR) - Konica Xpress CR Dual Bay

Computed Tomography (CT) - Toshiba Aquilion 64-slice CT

Hand-Carried Ultrasound - ZONARE z.one

Magnetic Resonance (MR) - Toshiba Vantage 1.5T MR

Smart Pumps - B. Braun Outlook

Ultrasound - Toshiba Xario

Other Software

Home Care - McKesson Horizon Homecare (Home Health)

Posted by Shawn Whalen on at 10:05 AM
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Whew!!, Honey I Can Get that 750i This Year

Despite the recommendations of Health and Human Services' Mike Leavitt and the hopes of EHR industry vendors, Congress approved Medicare legislation that does not include the adoption of healthcare IT as a means for doctors to increase their Medicare reimbursements.

With all the bad publicity around cutting doctors Medicare reimbursement by 10% and the impact on seniors who would get turned away from doctors (hey, Bimmer prices aren't going down), it was inevitable that Congress would do away with the cut and add a .5% increase. Bad boy Bush will sign.

But there are enough proposed bills out there for HCIT to stuff the big mouths of all the candidates. Among these bills, Sen. John Kerry has one to require docs to do e-prescribing or face financial penalties. Esteemed imbiber Sen. Edward Kennedy has the Wired for Healthcare Quality Act.  I suspect none of these will get through. HHS will continue to blow the HCIT horn. EMR PR folks can continue the dance.

Posted by Shawn Whalen on December 27, 2007 at 3:05 PM
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The RHIO Reality?

According to a study by Harvard researchers published this month in Health Affairs, achieving electronic clinical data exchange across the United States is still a distant reality. From the abstract: In early 2007 we surveyed 145 RHIOs. Nearly one in four was likely defunct. Only 20 efforts were of at least modest size and exchanging clinical data. Most early successes involved the exchange of test results. To support themselves, 13 RHIOs received regular fees from
participating organizations, and eight were heavily dependent on grants. Our findings raise concerns about the ability of the current approach to achieve widespread electronic clinical data exchange. [Health Affairs 27, no. 1 (2008): w60-w69 (published online 11 December 2007; 10.1377/hlthaff.27.1.w60)]

Posted by Shawn Whalen on December 12, 2007 at 4:41 PM
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Is It This Bad?

A recently survey on EMR adoption from the Medical Records Institute (sponsors of the TEPR show) revealed that:

• Nearly 19% of respondents indicated they either have in the past experienced the de-installation of an EMR system (12%) or are now going through a de-installation (7%).

• Slightly more than 8% of those surveyed indicated they'd removed their EMRs and gone back to paper, with 6% indicating the removal occurred in the past, while another 2% responded that they were now experiencing the reversion to paper.

• 30% of respondents indicated they either have had an EMR in the past (12%) that not all clinicians used because some refused to do so, or that they now have a system (18%) and are experiencing the same recalcitrance by some clinicians.

• When switching systems, the trend has been to downgrade to less-expensive, less-complicated EMRs than to more-expensive, complicated ones.  

If you add up the number of negative responses and divide it by the total number of respondents it shows that a bit more than 50% of the respondents have had a negative experience with EMR. That's technology for you, whether it's an EMR or PC.

Posted by Shawn Whalen on November 2, 2007 at 12:16 PM
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Is It This Bad?

A recently survey on EMR adoption from the Medical Records Institute (sponsors of the TEPR show) revealed that:

• Nearly 19% of respondents indicated they either have in the past experienced the de-installation of an EMR system (12%) or are now going through a de-installation (7%).

• Slightly more than 8% of those surveyed indicated they'd removed their EMRs and gone back to paper, with 6% indicating the removal occurred in the past, while another 2% responded that they were now experiencing the reversion to paper.

• 30% of respondents indicated they either have had an EMR in the past (12%) that not all clinicians used because some refused to do so, or that they now have a system (18%) and are experiencing the same recalcitrance by some clinicians.

• When switching systems, the trend has been to downgrade to less-expensive, less-complicated EMRs than to more-expensive, complicated ones.  

If you add up the number of negative responses and divide it by the total number of respondents it shows that a bit more than 50% of the respondents have had a negative experience with EMR. That's technology for you, whether it's an EMR or PC.

Posted by Shawn Whalen on at 12:16 PM
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Presidential Candidates on HCIT

The EMR Medical Software Information and Resources blog has a useful summary of the Presidential candidates position on healthcare IT. For the convenience of the healthcare IT marketers and PR folks that read this blog, I'll include it here.
 
Election day is more than twelve months away, but the contest for president of the United States is already shaping up to be a fierce one. Many presidential candidates have either released or announced their intention to release a comprehensive plan for health care reform. Following is an attempt to summarize each candidate's position on health care information technology such as e-prescribing and electronic medical records. You are encouraged to visit each candidate's Web site on your own, as their positions may change in the future. Please hit "Continue Reading" for the details...

Continue reading "Presidential Candidates on HCIT" »

Posted by Shawn Whalen on October 19, 2007 at 2:52 PM
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Presidential Candidates on HCIT

The EMR Medical Software Information and Resources blog has a useful summary of the Presidential candidates position on healthcare IT. For the convenience of the healthcare IT marketers and PR folks that read this blog, I'll include it here.
 
Election day is more than twelve months away, but the contest for president of the United States is already shaping up to be a fierce one. Many presidential candidates have either released or announced their intention to release a comprehensive plan for health care reform. Following is an attempt to summarize each candidate's position on health care information technology such as e-prescribing and electronic medical records. You are encouraged to visit each candidate's Web site on your own, as their positions may change in the future. Please hit "Continue Reading" for the details...

Continue reading "Presidential Candidates on HCIT" »

Posted by Shawn Whalen on at 2:52 PM
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Hospital IT Spend Trends

We represent here Leerick Swann & Company, a boutique healthcare equity research company. From time to time I'll share research of interest to healthcare IT marketers.

Healthcare IT - Hospitals Remain Committed to IT Spend Through 2008

·  HCIT Investment Remains a Top Priority at Hospitals - A recent MEDACorp survey indicates that 24% of surveyed hospitals maintained that healthcare IT and related spending will be their top capital expenditure priority in 2008. The survey of 61 hospitals asked the hospitals to rank-order their priority for capitals expenditures in 2008 -- 24% ranked IT and technology-related spending as their No. 1 priority, 23% of hospitals ranked IT at No. 2, and 21% of hospitals ranked IT at No. 3. On average, hospital IT budgets are expected to increase 6% in 2008, compared with 12%E in 2007.

•  Where We Believe the Money Will Go - We believe that hospitals will continue to spend significant portions of their budget on information technology. Beginning in 2008, we believe investors could begin to see a shift in dollars spent by hospitals on inpatient systems to outpatient systems as a result of the relaxation of the Stark law. We believe that some of this spending has already begun to occur and that the mix shift should accelerate through 2008.

·  We Expect Increasing Levels for Inpatient IT - We believe that we are coming to the end of a major hospital IT cycle, as most hospitals throughout the country have invested heavily over the last 5-6 years in clinical technology systems. However, we believe that inpatient spending on IT should continue to be robust as hospitals that have previously invested in IT raise their ongoing operating expense level dedicated to IT. We recently observed this trend at Cerner's leadership forum and expect this effect to impact other incumbent vendors as well. 

·  Maintain Ratings & Estimates - We maintain our ratings and estimates on the inpatient IT systems vendors. We maintain our Outperform rating on CERN, which we view as one of the best-in-class healthcare IT vendors. We maintain our Market Perform ratings on CPSI, ECLP (Eclipse) and MCK (McKesson) shares. We continue to fear that larger vendors will move down-market, negatively impacting CPSI's competitive position. We believe the recent run in ECLP shares already reflects the improved operations of the business. And we believe that the value of MCK's IT business will be difficult for investors to fully realize while the company's valuation is largely tied to the drug distribution segment.

Posted by Shawn Whalen on October 15, 2007 at 5:29 PM
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EMR Contrarian

To continue the contrarian voice on such things as EMR, here is an interesting article by Evan Steele, CEO of client SRS Software. It originally appeared in HealthcareITNews.

Contrary to media and government rhetoric, today's medical practices can survive without implementing an electronic health record. The EHR is simply a basic undoing of the way physicians customarily practice medicine.

It's an extremely costly approach and has even been shown to reduce productivity in the first year after implementation.

Hospital- and office-based physician groups that implement an enterprise document management solution not only survive - but also thrive - without an EHR.

Continue reading "EMR Contrarian" »

Posted by Shawn Whalen on October 6, 2007 at 10:23 AM
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Dead Canaries & RHIO Tech Survey

RHIOs has been a topic of interest on this blog, with a dozen or so posts. The research firm Healthcare Industry Insights released a survey on RHIO technology solutions. Results highlighted in a press release:

From an extensive survey of 20 software products that service regional health information organizations (RHIOs) and health information exchanges (HIEs), including assessments of their features and capabilities, indicate no "one size fits all" solution yet exists for this rapidly evolving market. Key findings from the Health Industry Insights survey include the following:

• RHIOs vary widely in their business models and technical architectures; vendor products have been built around re-usable frameworks that can serve as the foundation for multiple, custom deployments.

• Vendors with products that were originally introduced to support Enterprise Master Patient Index (EMPI), clinical messaging, HL7 messaging, and clinical portal functions had more experience connecting to external clinical applications.

• Although HL7 standards have been in place for many years, direct vendor experience with the specific external source clinical applications is an important consideration when selecting a vendor's HIE solution.

• Most vendors are betting that surviving RHIOs will migrate to more robust architectures and will have the financial resources to do so.

To read more on the survey and HII's opinions on RHIOS, hit the "Continue Reading" link.

Continue reading "Dead Canaries & RHIO Tech Survey" »

Posted by Shawn Whalen on October 1, 2007 at 11:21 AM
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Healthcare IT Timeout?

There is much sound and fury over healthcare IT adoption, but in the end is it signifying nothing? Some would say yes, including the president of the National Alliance for Health IT. This past summer Scott Wallace told his membership at their annual meeting that health IT advocates should focus their efforts on just a few areas in which policy and true operational changes can make an impact. "We are at a point where we have run out of adrenaline," said Wallace.

Wallace said the fact that the few models of successful health IT systems are big academic medical centers can be limiting to the overall effort. I agree, considering most healthcare is delivered by small and medium sized medical groups.

On the positive side, continued efforts at standards and interoperability are helping open up health IT to more doctors. If the various proposed government health IT bills actually get passed in '08 or '09, that could help move EMR adoption from hype to reality.

From the PR perspective, health IT and particular areas like EMR are going through the natural hype curve. Time and again, for topics in all industries, there is this slow build before the damn breaks and the firehouse of media coverage floods everyone. Then they get tired of being wet and it collapses to a small but steady stream, quenching the thirst of only the truly interested. For you healthcare IT marketers and PR folks, take full advantage of the current media thirst. But be prepared with powerful ROI case studies showing the value and affordability of your solutions for medical practices and small hospitals, not just the "wealthy" academic or large network hospitals.

I think that the new President, whoever he is, will bring focus and more funding to the issue, just in time to coincide with new levels of standards and ROI shown by small and medium sized practices. The hype will have moved to more thoughtful consideration.

Posted by Shawn Whalen on September 24, 2007 at 12:30 PM
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A Smart PHR Vision

Continuing the discussion of PHRs started on Aug. 28, this week brings a guest blog post from Dr. Lonny Reisman, CEO of client ActiveHealth Management. Dr. Reisman explores what to look for in a PHR solution.

Fulfilling the PHR Vision: Analytical Interactivity Empowering the Consumer

In today's fragmented healthcare system, patient data is scattered among physicians, hospitals, lab companies and pharmacies. This can lead to medical errors, adverse patient outcomes, costly hospitalizations and disabilities. Efforts are now underway by leading health plans and employers to aggregate patient information into personal health records (PHRs). This aggregation of data into a patient-centered and patient-controlled record can empower consumers of healthcare and enhance care optimization among physicians, other caregivers and patients.

PHRs can help enable the consumer-driven health movement, and support President Bush's federal priority to provide Americans with electronic health records by 2014. They are a centerpiece for public and private sector initiatives for healthcare IT connectivity to improve care, reduce medical errors and lower costs. PHRs also offer an opportunity to tailor information to the unique needs of the individual and support patients as they play an increasing role in managing their health.

The Model for an Ideal PHR: Analytical Interactivity is the Key

Continue reading "A Smart PHR Vision" »

Posted by Shawn Whalen on September 17, 2007 at 10:27 AM
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A Smart PHR Vision

Continuing the discussion of PHRs started on Aug. 28, this week brings a guest blog post from Dr. Lonny Reisman, CEO of client ActiveHealth Management. Dr. Reisman explores what to look for in a PHR solution.

Fulfilling the PHR Vision: Analytical Interactivity Empowering the Consumer

In today's fragmented healthcare system, patient data is scattered among physicians, hospitals, lab companies and pharmacies. This can lead to medical errors, adverse patient outcomes, costly hospitalizations and disabilities. Efforts are now underway by leading health plans and employers to aggregate patient information into personal health records (PHRs). This aggregation of data into a patient-centered and patient-controlled record can empower consumers of healthcare and enhance care optimization among physicians, other caregivers and patients.

PHRs can help enable the consumer-driven health movement, and support President Bush's federal priority to provide Americans with electronic health records by 2014. They are a centerpiece for public and private sector initiatives for healthcare IT connectivity to improve care, reduce medical errors and lower costs. PHRs also offer an opportunity to tailor information to the unique needs of the individual and support patients as they play an increasing role in managing their health.

The Model for an Ideal PHR: Analytical Interactivity is the Key

Continue reading "A Smart PHR Vision" »

Posted by Shawn Whalen on at 10:27 AM
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