Images from the HIMSS14 Trade Show Floor

HIMSS by the numbersTravelers through the trade show floor at HIMSS14 continue to find themselves in the city of senses that is the HIMSS conference. From flashy devices, bright lights, loud music, champagne by the glass and interesting architecture, in many ways this show reminds me of the last time the show was in Orlando. Same energy and excitement, and much the same feel from the show floor. Though it seems like little has changed from the exhibitor perspective, it’s still a nearly overwhelming experience here.

This year, more than 35,500 are here in Orlando, up from 32,500 last year.

The following are some images of the more than 1,200 vendors at the show.

Alere has one of the most visually interesting booths at the show:

Alere
Alere
Alere
Alere

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Report: Patient Portals Surging, Hospitals Still Faxing, and Cloud EHRs with Integrated Billing Key to Practice Success

Michael Lake
Michael Lake

One of the greatest sources of information that depicts the changes in health IT trends across the industry landscape is from Michael Lake, healthcare technology strategist. Through his monthly reports on the state of health technology, published by his company Circle Square, he provides succinct highlights from throughout the last month. Possibly, what’s best about these reports is that they cover such a diverse segment of the ecosphere.

For example, in one of his most recent reports, the focus was the EHR vendor sphere, cloud EHRs and their importance to independent practices, the use of faxes in hospitals, vendor news and transactions and practice portal insight, among other news.

According to his most recent report, cloud-based EHRs with integrated billing are quickly becoming a key to a practice’s future success as an independent practice. In his report, he cites Black Book as ranking solutions that seamlessly integrate electronic health records (EHR), revenue cycle management (RCM) and practice management (PM). Kareo tops on the list, per KLAS.

However, most practices feel that billing and collections systems and processes need upgrading (87%) and more than 40 percent (42%) are considering an upgrade to RCM software in in the next year . Most practices (71%) are considering a combo of new software and outsourcing services for improvement.

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Three Essentials for Selecting Your Next EHR, According to KLAS?

KLAS EnterprisesAccording to a new KLAS blog post, there are three essentials for selecting your next EHR. The post is pithy at best, and designed for the company to gain more physician leads, but I thought I’d feature some of the information here.

Why?

Perhaps it’s for no other reason than to be snarky. Readers of this site know that I am suspicious, at best, of KLAS, its reports and its centralist, self-centered approach. Fact is, the numbers of respondents of KLAS’ surveys just don’t add up for the claims that they make.

I know this because I’ve worked with an EHR vendor that often was the subject of the “research firm’s” multiple sales attempts.

As part of my role with the company, I worked with a legitimate research department and based on their reviews of the KLAS data, there’s simply no way the data presented by KLAS – for the price of a king’s ransom to vendors – is legit. For example, 48 physician responses (or 52 or 46 or two dozen) to its surveys does not accurately reflect the thoughts of several hundred thousand physicians across the market.

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With EHR Vendor Review Sites, Might All of Us in Health IT Lose Just a Little Bit?

EHR review sites seem to have taken hold. Press releases and announcements galore, they proliferate the web like nearly other consumer review-based site. In the latest round, one of the newest sites, EMR-Matrix, essentially announced its existence and that its staff and leadership would be present at one of healthcare’s largest tradeshows – HIMSS.

What better a place to try to sell its product where the very companies that it will likely hold hostage through its so-called independent review will be present.

According to the company’s release, “The new website offers a way for doctors and health systems to evaluate, test and read reviews of electronic medical record software systems, as well as provide feedback on their own experiences with their existing EMR and practice management systems. Unlike other sites, EMR-Matrix is user content driven and strives to provide the most candid feedback possible about each EMR system.”

I absolutely believe that the (free) market needs dedicated resources that help consumers find the best products at the best prices while exposing a company’s weaknesses and touting its greatest successes, but I’m not in favor of sites bent on trying to manipulate the system.

I may be in the minority, but I don’t believe in review sites, and I don’t use them. Too often, the reviews are skewed toward the negative, the sounds of the blathering loudmouth without a better venue to employ turns to the web and spouts off. They do almost nothing to keep me from experiencing something I want to experience. Certainly, I don’t believe an un-vetted review site about electronic health records is going to do much to sway my opinion one way or another about the quality of a product being professionally produced by a software vendor, but it may sway the opinions of others.

Essentially, the site is taking the business model that Software Advice utilizes and is trying to position itself as another unbiased source of information that also uses aggregated customer reviews to provide the “true” sentiment of a system and its capabilities.

If nothing else, this is just another form of KLAS, which I’ve always been suspect of. Based on my experiences in house at an EHR vendor, I’ve seen the data used to compile the reports and with the conclusions these types of reports drawn, there is a great deal left to the imagination. Companies – Allscripts is an example – that choose not to subscribe to the KLAS and, therefore, forgo receiving the KLAS reports should earn everyone’s respect. They don’t bow to the peer pressure of inclusion and they understand that for the most part, the reports or worth far less than the paper they’re printed on (even though vendors pay upwards of $60,000 to see them). Nevertheless, the data in the reports are suspect and thin, and given the strangle hold KLAS has on vendors, to not subscribe is virtual suicide for the vendor (Allscripts is big enough not to have been too deeply affected, though its products are never anywhere near the top of the rankings in the KLAS reports).

That said, EMR-Matrix and others that come along might do more damage than good. If nothing else, in my opinion, at face value, they seem to be out to capitalize on the market. Let’s hope the consumers of health IT and EHRs see through this thinly veiled attempt, but there’s still some skepticism on my part that this will be the case. My blogger colleagues have agreed with me so I hope those in the market for a new EHR will actually do a little shopping around and testing rather than simply relying on a site such as this.

Unfortunately, some of the collateral damage of a site like this is like that of a “bad” restaurant — once the review hits the web, it pretty much lives there forever. For people like me in PR, and those around me who are actually dedicating their lives to developing what we believe are good, solid, high-quality products to better healthcare, physician’s practices and patients’ lives, we lose because of sites like this. We’re the ones who lose sleep. We’re the ones that lose our jobs. We’re the ones who lose – because of a site that’s pairing the information provided with those seeking it, as relevant.

Suggestions to Purchase the Right EHR System for Your Practice

There’s a special place in my heart for electronic health records. Having worked with one of the largest vendors (at the time; the company has since shed about 20,000 of its physician users) I understand their capabilities and how they can benefit a practice beyond just how they are marketed. EHRs are one of the reasons I started this blog, in fact. If I could spend more time on them and keep people interested in this site, I would, but not everyone feels that way I do about them so I’m forced to broaden my horizons and cover a variety of other topics.

Alas, I also feel we’re entering their final days glory days. I believe 2013 will be the year of transition in which we as a market decide that EHRs are foundational and that other, new technologies are emerging that will either make EHRs better or render them essentially useless. Until then, though, I’ll allow myself to continue to focus on them from time to time and hopefully you’ll find the information relevant, which brings me to today.

Found an interesting piece in Executive Insight magazine by Meditab’s VP of Marketing, Kirk Treasure. Though Treasure makes the claim (like most EHR vendors continue to do) that EHRs are increasingly important to the continued streamlining and delivery of patient services, but he says, because of a recent KLAS report, that practices and health systems are becoming dissatisfied with their EHR vendors and their systems.

This really comes as no surprise and has been expected. Some of this has to do with vendors trying to get by on the status quo while some of this has to do with crippling meaningful use regulation. Some of it has to do with promises not kept or promising too much (which is usually the case), but again, there’s nothing surprising here. It’s where we are in the market.

According to Treasure, there are two reasons for this wave of provider dissatisfaction.

One: “Many physicians are basing their decision primarily on cost factors, not realizing that cheaper is not necessarily better.”

Two: “Many practices are not 100 percent comfortable with their own internal processes, and as a result, purchase an EHR system that does not satisfy their needs.”

Treasure warns those in the market for an EHR to take their time to evaluate their needs and future goals of the practice then look at what they can realistically afford to invest in a system. “It’s important to weigh out whether or not a perceived expensive initial cost will save you money in the long-run,” he said.

“Next, analyze your workflow to see which processes you would like to maintain and what areas you would like to improve,” he added. “This will help in cultivating efficiency and organization throughout the practice, while ensuring that your EHR system supports your goals.”

Treasure continues his golden advice. Vendors need to look for systems that meet the specific requirements of their practice and to understand that there is no “one-size-fits-all solution,” even within the same medical specialty. Once a list of vendors has been narrowed down, check references (this is an absolute must) and try to speak with several clients that have been using the system for at least a year. According to Treasure, “They can tell you about any obstacles encountered during the implementation, their support experience and the benefits from making the switch.”

Here are some other suggestions to purchase the right EHR system for your practice and avoid a costly mistake, from Treasure:

• Understand the total cost of ownership of each vendor’s pricing structure. For example, some cloud-based vendors provide EHR services on a subscription basis. Paying $400-$600 a month for a five-year contract period would result in a $30,000 commitment plus the initial investment for implementation and training. Alternatively, the total cost of ownership for a server-based office system with a $10,000 upfront cost and a $200 monthly maintenance would only be $22,000.

• Look for hidden costs in the contract, such as additional fees for in-person training, document management services, EDI setup, or annual maintenance fees in addition to the monthly support costs. Also, watch for provisions that allow the vendor to increase fees during the course of the contract.

• Ask the vendor if the system will accommodate any potential changes in your practice model. This could include, for example, joining an accountable care organization (ACO), adding telemedicine services or expanding upon the practice concentration in the future (i.e. bariatric, weight management, etc.).

• Consider the EHR system from the point of view of the patient, as well as the physician and office staff. For example, is the EHR system easy to use in the examination room? Does it provide reports on waiting times or other service delivery issues?

• Be sure that you “own” the data under the terms of the contract. Some vendors charge a fee for exporting the data to a new system before the contract expiration date.

• See if there are provisions that would allow you to get out of a contract after six months or a year. This is essential if the system ends up not working for you.

• Finally, be sure you are comfortable with the vendor. In many cases, a smaller or mid-size company can provide a higher level of personal service. That’s an important consideration in helping physicians and office staff take advantage of the many potential benefits of deploying an EHR system customized to the needs of the practice.