adoption

Texas EMR resistance shows extent of adoption problem

Mon, 02 Jun 2008 06:59:57 -0400

If Texas is any indication, the EMR adoption movement has more problems in store than many people think. According to a new survey on the subject by the Texas Medical Association, one-third of physicians are using some form of EMR, up from 27 percent in a similar survey in 2005. However, about one-fourth of respondents said that they still have no plans to implement an EMR, the same level as the previous survey. Meanwhile, about 2 percent of respondents had used an EMR in the past, but quit, most often saying that reliability problems, difficulty in using the EMR or insufficient benefits doomed the installation.

Top vendors adopted by EMR-equipped practices answering in the survey included e-MD, used by 15 percent of respondents, followed by eClinicalWorks, with 9 percent.

That being said, those who have adopted an EMR seem to be glad they did, the TMA report said. Eight-one percent of practices with an EMR said that the system is in full use by all of its doctors. Also, roughly three-fourths of practices reported being very satisfied or somewhat satisfied with their systems. Still, even those physicians had plenty of gripes, with 27 percent saying one of the things they liked least about their systems was that costs went up without generating complimentary savings.

To learn more about the study (and other related studies):
- read this Modern Healthcare article (reg. req.)

Related Articles:
Study: Physician EMR adoption up, but systems chosen are limited
Study: EMR adoption held back by multiple issues
Study: Physicians at EMR 'tipping point'
Smaller practices still behind in IT adoption

ALSO NOTED: First also noted headline; second headline; and much more...

Mon, 05 May 2008 06:59:50 -0400

> It looks like information on some 6,000 patients at the University of California San Francisco was accessible via the Internet for more than three months last year. Article

> Federal officials are gearing up for National Health Information Network trials, which should take place in four months. Article

> E-prescribing adoption is slow across the U.S., but for some reason, it's particularly slow in Texas. Article

> Wondering if you should install kiosks in your hospital? Here's how one Tennessee hospital did it. Article

And Finally... Somehow, the words "electric" and "sports car" don't go together in my mind--but this company wants to prove me wrong. Article

SPOTLIGHT: Exec argues that EMRs show quality commitment

Mon, 28 Apr 2008 06:59:52 -0400

Many of the biggest supporters of EMR adoption pitch them as a huge productivity improvement tool. But to Laura Adams, president and CEO of the Rhode Island Quality Institute, they're central to improving quality, too. Her organization, which hosts the state's RHIO, is built on the notion that not having having access to digital health information causes harm, not just delays or waste. Article

HIT shortage can only get worse

Mon, 21 Apr 2008 06:59:59 -0400

IT is a complex profession in and of itself, and health IT management even more so. While I'm not an IT recruiter, I'd wager that you wouldn't want anyone with less than a decade of hard-core experience under their belt to take a top position in your organization (with most, if not all, directly in health organization). The problem is, there's just not enough of such people to fuel the great health IT revolution we're seeing today.

As the study outlined in today's issue suggests, we'll need more than the 40,000 professionals we've got on duty within a short stretch--say, three to five years max--or the whole EMR adoption movement will stumble badly.

Sure, some folks in Congress have begun to notice the big professional shortage their pro-EMR policies will create. For example, Rep. David Wu (D-OR) is backing the "10,000 trained by 2010 Act," which helps fund health IT education. While that falls far short of the 40,000 or so HIT staffers we'll need, it's at least a start. However, those 10,000 will include at least some very green folks, which doesn't quite fit the bill.

What's even scarier about this is that not only are we going to need HIT pros to keep the EMR ship on course, we'll need more such pros with deep clinical skills. If it's hard to recruit a seasoned health IT expert, recruiting physician or nurse IT specialists will be even more costly and difficult. My guess is that there will be an even more painful shortage in this job category. Unfortunately, healthcare just isn't an industry that can easily hand off high-profile jobs to junior people in the 20s. Sure, they'll do some of the work, as they do in every IT organization. But given the depth of skills and experience HIT leadership requires--even for middle management, much less C-level jobs--it's pretty risky to promote talented young folks too quickly.

I wish I could tell you I had suggestions for solving problem, but I don't--other than, perhaps aggressively retraining top pros from other industries. I do know that if providers don't want their plans to grind to a halt for lack of support, they're going to have to get creative, and fast. Maybe your health system isn't rolling out an EMR today, but if you don't do anything to address the HIT talent shortage, good luck getting it implemented in 2010.- Anne

States show growing interest in health IT

Mon, 14 Apr 2008 06:59:56 -0400

A new study suggests that state interest in health IT investment has been mounting steadily in recent times. In fact, health IT projects are high on many state governors' agendas, according to a new report from government business research firm Input. So far this year, 27 percent of governors delivering state-of-the-state speeches mentioned health IT benefits, up from 14 percent last year, according to the firm. Governors are expressing strong support for EMRs, e-prescribing and health data interchanges, despite facing budget crunches and a faltering national economy, hopeful that these technologies can actually save money. And they're not just talking. For example, Minnesota has set aside $18.5 million for HIT projects in its 2008-09 budget, and Missouri $15 million.

To learn more about this study:
- read this Government Health IT article

Related Articles:
Louisiana may subsidize health IT adoption
Minnesota backs statewide HIE
Study: RHIOs/HIEs backed by states will win
NY kicks off final phase of RHIO funding

Study: Almost half of MDs say EMRs are key to reform

Mon, 07 Apr 2008 06:59:54 -0400

Physicians may be reluctant to spend big bucks on EMRs, but when backed into a corner, they admit that such automation is important. In fact, a new survey found that 46 percent of doctors believe that automating patient records is critical to improving efficiency and moving reform forward. The survey, which was conducted by healthcare recruiters Jackson & Coker, focused on doctors' opinions on presidential candidates' healthcare positions. When asked to how healthcare delivery could be streamlined under reform schemes, EMRs ranked at the top, with "doctors spending more quality time with each patient" coming in a close second at 43 percent.

To learn more about the study:
- read this Healthcare IT News piece

Related Articles:
Study: Physicians at EMR "tipping point." Report
Bill would pay for physician health IT costs. Report
MD group asks for federal help with EMRs. Report
Smaller practices still behind in IT adoption. Report

Despite benefits, telemedicine barriers remain high

Mon, 10 Mar 2008 07:59:59 -0400

Despite benefits, telemedicine barriers remain high

Increasingly, it's become obvious that telemedicine has a place in the healthcare system, not only to improve care but also to conserve resources. Consider some of the useful applications we've described just in this publication:

* A cellphone-based solution which monitors blood sugar levels and transmits them to monitoring physicians.

* Cellphone-based disease management services that provide patients with a diary, reminders and reports on their condition.

* eICUs, allowing scarce intensivist physicians to monitor several units or even several hospitals' worth of critically-ill patients from one location.

* Technology allowing one healthcare provider to remotely monitor blood pressure levels for its own employees.

Research continues to mount suggesting that telemedicine applications both are clinically useful and cost-effective, particularly for chronically-ill patients who otherwise consume large amounts of resources.

The problem is, at present healthcare organizations face a huge up-front risk if they invest in telemedicine. For one thing, payers aren't reimbursing for most services delivered this way. Then if you add the time and money involved in integrating telemedical data with existing in- and outpatient data, the problem looks far too daunting to approach for all but the best-funded institutions.

Heck, yes, Newt Gingrich and the Center for Health Transformation are onto something when they say government should help along the process of telemedicine adoption. Let's start by seeing Medicare offer some meaningful payment for such services (not just pilot projects).

Turning loose tons of grant money to organizations that upgrade to create a telemedicine infrastructure, or giving them big tax breaks, would be a fine idea too.

The bottom line is that until something gives, telemedicine will remain one of the most effective technologies not being used in the healthcare system. Let's hope that changes over the next year or two. - Anne

ALSO NOTED: MA mulls EMR mandate; Nashville hospitals create HIE; and much more...

Mon, 10 Mar 2008 07:59:50 -0400

> A Massachusetts state Senate leader has proposed a plan, including some subsidies, which would require statewide EMR adoption by 2015. Article

> A group of Nashville hospitals are coming together to create their own health information exchange. Article

> A Canadian telemedicine program is linking remote patients with cancer services via videoconferencing. Article

> The University of Pittsburgh has begun using patient-monitoring technology to train nurses working in step-down units. Article

And Finally... Could Sonic the Hedgehog be killing the environment? Article

HIMSS08: Kolodner expects increase in EMR use

Mon, 03 Mar 2008 06:59:56 -0500

Just in case you haven't had your fill, here's more optimism from the feds on HIT adoption. (As for me, it's getting a bit grating, as I don't see enough going on to actually make adoption happen.) At least in this case, the optimism is driven by the likelihood that hospitals will step up, which seems a bit more realistic.

In his HIMSS speech last week, Dr. Robert Kolodner, national coordinator of health information technology, said that he hopes that to see a 50 percent increase in the use of health information technology this year. He's also predicting that the Nationwide Health Information Network will become operational this year, and that EMR vendors will begin incorporating federal standards into their products. Dr. Kolodner contends that an increased use of EMRs will be driven partly by a growth in hospital donations of such software to physicians who practice at their facilities. Thanks to this and other trends, he says, by 2012 at the outside half of all doctors will use EMRs. My question is, how will everyone pay for this?

To get more of Kolodner's predictions:
- read this Government Health IT piece

Related Articles:
Groups say IT changes must be part of national reform. Article
CCHIT invites vendors to apply for EMR pilot. Article

ALSO NOTED: HIT execs want data security standards; AT&T, Tennessee create health data exchange; and much more...

Mon, 03 Mar 2008 06:59:50 -0500

> A new survey concludes that HIT execs would like to see the industry adopt a uniform way for verifying healthcare data security. Article

> AT&T and the state of Tennessee have created the state's first health data exchange. Article

> New York plans to give some of its area physicians a push toward EMR use, by paying part of the cost of EMR adoption for physicians whose practice include 30 percent uninsured or Medicaid-eligible consumers. Article

> It's another victory for e-prescribing, however incremental. Aetna and Cigna have agreed to reimburse the physicians and dentists with upstart medical association the International Association of Dental and Medical Disciplines. Article

And Finally... Here's a controversial view. This large health plan says EMRs could turn out to be a waste of money. Article