Healthcare // Electronic Health Records
News
5/8/2014
12:50 PM
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EHR Swaps Coming For Many Healthcare Organizations

Healthcare organizations look to replace early electronic health records packages with new systems that perform better, integrate across departments, and tap cloud computing.

EHR Jobs Boom: 8 Hot Health IT Roles
EHR Jobs Boom: 8 Hot Health IT Roles
(Click image for larger view and slideshow.)

The honeymoon period didn't last long for some healthcare providers and their electronic health records (EHRs). As providers become more sophisticated and informed, and IT departments grow more comfortable recommending alternatives to long-established vendors, demand for replacement electronic health record (EHR) systems continues to expand.

By 2016, almost 50% of large hospitals will replace their current EHR, health IT research firm KLAS reported. In the first quarter of this year, 40% of buyers said they want to swap out their EHRs, according to a survey by Software Advice. Twelve months prior, 30% sought alternate EHRs, the review and consulting site found. Most providers wanted better performance and integration, the study showed.

"We're building portals of information for our patients but they're not interconnected," said Dereesa Reid, CEO of Southern California's Hoag Orthopedic Institute, in an interview. "We can log into any number of banks in which we have deposits and even move money around. Why can't we do that with our health information? Once that happens we enter a whole new frontier of empowerment. Then, suddenly a patient can gather up all their information and know what it is. It totally changes what we can do in population management and research."

Hoag Orthopedic is not switching from its Allscripts EHR; instead, it's expanding the software's capabilities by adding a portal and increasing its use of mobile devices, especially smartphones, she said.

[Is your EHR meeting your patients' needs? See Chronic Disease Patients' Top Online Privacy Worries.]

Hospital management company Universal Health Services once used a best-of-breed approach, purchasing separate EHRs for its various departments, recalled CIO Mike Nelson in an interview. Integrating these disparate systems was difficult, and accessing data was challenging for physicians and nurses, he said. Over the past three years, UHS has steadily replaced these separate systems with a Cerner EHR, said Nelson.

"I do think the major vendors improved their functionality. What we found was, having an integrated system, as we created orders in the emergency department, the naming conventions were the same. We had the same syntax for an order in the emergency department as in the radiology department," he said. "Clinicians could communicate in the same language. We could exchange information more readily."

To drive maximum efficiency, leverage shared insight and best-practices, and integrate systems, newly affiliated providers typically standardize on one EHR, he said.

Having used EHRs for a while, clinicians and executives realize the potential these applications hold for improving care, reducing costs, and driving new discoveries, said Edwin Miller, VP of product management at medical software and services company CareCloud, in an interview. "They're a couple of years into it," he said. "Now they're a more savvy customer and so they're going back to the market with a different point of view. [The pressure] is in continuing to get excitement around health IT because a lot of the market's become disenchanted with it after the past two or three years."

Mergers and acquisitions fuel some replacement sales, Bill Fera, principal at EY, told InformationWeek. Yet healthcare executives recognize EHRs are only the beginning of their IT -- and business -- strategy, said Fera. They want to ensure they've got the strongest, most integrated basis for analytics, big data, mobility, and other vital initiatives.

"You don't see any or many new implementations. They're almost all conversions now, with the major trend of consolidation. We see organizations that have had looser affiliations or were not affiliated, [and] as they move to population health they need to have the same systems in place," said Fera.

In fact, about 93% of hospitals were "in possession" of an EHR with MU certification in late 2013, according to the US Office of the National Coordinator (ONC) for Health Information Technology. But only 61% of all physician practices used EHRs, a January 2014 study by SK&A determined. A year ago, 50.3% used the software, the research firm found.

The push to meet Meaningful Use mandates created an artificial market and deadline -- as well as surplus providers and some uninformed buyers. Over

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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Gary_EL
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Gary_EL,
User Rank: Ninja
5/8/2014 | 7:53:20 PM
Re: Islands of automation
I've noticed over the generations of technologies that standards always seem to emerge - a sort of invisible hand! But something like this, where human lives are at stake, maybe we can't afford to wait. And, after all, the government is a big player in this arena, so maybe this a case where it IS the government's job.
Alison_Diana
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Alison_Diana,
User Rank: Author
5/8/2014 | 5:09:08 PM
Re: Islands of automation
I really think cloud has a huge advantage here too, @Gary. Although we see a lot of smaller practices adopting cloud for the usual reasons -- price; staffing; security, etc. -- some larger organizations are reportedly beginning to review and, in some cases, adopt cloud-based EHRs as well. When we know healthcare providers hunger for analytics, when treatment often demands fast access to data, when patients are fed up with repeating the same old forms over and over, it really is up to developers to do a better job of integrating sytems -- their own AND other vendors. The lack of standards is sad and if the industry doesn't figure it out, guess who'll figure it out for healthcare? The government, I'd bet.
Gary_EL
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Gary_EL,
User Rank: Ninja
5/8/2014 | 2:01:42 PM
Islands of automation
Islands of automation was a term back in the 1980's used to describe interrelated systems that were locally automated, but still could not communicate with each other. That term might be used even today to describe much of EHR. A system that can't communicate what the ER does in an easily accessible manner to physicians is of little use, and a system where the ER can't access the patient's record at his physician's office can be a disaster. And, of course, it has to be EASY to use, because doctors and nurses are too busy studying medicine to have much time left over for studying computers. In addition to all the other oft-described benefits of cloud-based systems, they can't help but to enforce compatibility and universal access.

 

 

 
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