EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Patient portals and EMRs: Each requires a different skillset

Patient portals and EMRs: Each requires a different skillset | EHR and Health IT Consulting |

Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information.

I’ve written at length about the differences between B2B software and B2C software and how B2B software is generally not very good (particularly from a usability perspective). And it’s not very good simply because it can get away with not being very good. B2B companies often just need a good salesperson that can lock-in long-term contracts to be successful. Once the software is purchased, it’s not easy for users to switch.

B2C companies, on the other hand, need an incredible product to be successful. If your user experience isn’t flawless, you cannot survive in the B2C space. The switching costs for consumers are near zero — the user experience must be incredible. Product is much more important than distribution. B2C user satisfaction scores are significantly higher than B2C scores.

Applying this to health care, if you’re a hospital and your EMR is hard to use, your employees will still use it because they have to — they can’t easily switch to a competitor.

But if your patient portal is bad you will lose patients instantly. It’s too easy for patients to switch to something else.

The Healthcare Information and Management Systems Society (HIMSS) published a good report talking about patient portals.  They noted that despite the difficulty of building a wonderful online consumer experience and the totally different skill set required to execute on it, 80 percent of hospitals surveyed chose their patient portal vendor simply because it was the same vendor that provides their EMR (the top three portals were made by Epic, Cerner and McKesson). All of these vendors have been building B2B enterprise software systems for more than 30 years. They’re all wonderful companies. But they have no idea how to build a patient facing product. Their management, engineering talent, sales force, culture and DNA is all about B2B. They have almost no chance of building a world class consumer product. That’s not a knock on these companies; it’s just reality. You can’t be good at both.

As we transition to a world where the patient is in the driver’s seat, exposing patients to old-fashioned enterprise software code and interfaces is not a good idea. Hospitals shouldn’t let a piece of software touch their customers unless it’s been vetted and tested fully, and it’s clear that patients love it. If you check out the satisfaction scores for most patient portal apps, you’ll find that most patients despise them (one of them I looked at last week had 2,000 reviews in the iOS app store and more than 1,500 of them were only 1 star).

Patients are becoming consumers. They want slick, easy, mobile, beautiful, simple and seamless web experiences. If the software that touches patients doesn’t give them that they’re going to go somewhere that does.

Now, in defense of these hospitals let it be known that there aren’t a lot of great consumer-focused software companies building-out patient portals. So in the short term, they might have no choice. But I’d encourage CIOs that are making patient portal investments to consider the consumer and to cautiously enter into flexible and short term contracts with these patient portal vendors.

You should be careful about buying groceries from the company that fixes your car. And you should be careful about buying consumer-facing software from the company that built your EMR.

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Patients want online access to records | Healthcare IT News

Patients want online access to records | Healthcare IT News | EHR and Health IT Consulting |

More than half of people with chronic conditions say the ability to get their electronic medical records online outweighs the potential privacy risks, according to a new survey by Accenture.

Two-thirds, meanwhile, believe patients should have the right to access all of their healthcare information.

The results of the poll suggest a public increasingly frustrated by lack of sovereignty over their own health data.

The vast majority people surveyed by Accenture – 87 percent – say they want to control their health data. But 55 percent report they don't have very much or any control over their medical information.

Accenture polled 2,011 individuals – 918 of them healthy, and 1,093 with either asthma, arthritis, cancer, chronic obstructive pulmonary disease, depression, diabetes, heart disease, hypertension, clinically diagnosed obesity, osteoporosis and stroke.

The survey found chronic patients to be less concerned about the privacy of their electronic health records, 65 percent, than they were about other personal information stored digitally, such as online banking (70 percent), in-store credit card use (69 percent) and online shopping (68 percent).

Still, although they're eager to have access to their records online, roughly half of those with chronic conditions said the top barrier to seeing the data was not knowing how to do so.

Accenture's findings also suggest, depending on the type of chronic illness they have, there are differences in a patient's ability to exercise control over his or her healthcare data. For example, 65 percent of consumers with heart disease reported having some level of control, compared to just 49 percent of individuals with COPD.

The U.S. Centers for Disease Control and Prevention estimates that 47 percent of Americans have at least one chronic disease, but they account for 76 percent of all physician visits.

Nonetheless, these individuals are some of the most actively engaged patients at most stages of patient care, according to the poll – including during medical diagnosis (91 percent), managing treatment (87 percent) and maintaining general health on a day-to-day basis (84 percent).

"Healthcare will need to adapt to a new generation of individuals who are taking a more proactive role in managing their health and expect to have transparency," said Kaveh Safavi MD, who leads Accenture's global health business, in a press statement.

"As consumers continue to demand more access to their personal data online, we expect that patients will gain more power to manage some aspects of their own care," said Safavi. "This will not only make healthcare more effective but also more affordable, as consumers doing more for themselves will free up the system to be more productive."

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Patient Engagement Rises with Consumer EHR Satisfaction |

Patient Engagement Rises with Consumer EHR Satisfaction | | EHR and Health IT Consulting |
Patient engagement helps consumers view EHRs more positively and encourages them to take charge of their health.

The overwhelming majority of patients believe that electronic health records (EHRs) are useful for physicians and valuable for their care, according to a newly released survey by the National Partnership for Women and Families.  Patients were more likely to rate EHRs as a positive development when they had online access to personal health information through a portal or if they could perform routine administrative tasks like making appointments through the internet.  The survey illustrates the importance of patient engagement while highlighting the spread of health IT and its potential impact on the nation’s health.

The survey reassesses questions about health IT usages and attitudes that were first posed in 2011.  At that time, only 64% of patients had a primary care doctor who used an EHR, but that number has increased to 80% in 2014.  Patients are significantly more likely to see EHRs as a useful tool for care delivery than they are to say the same thing about paper record keeping.  They are also more likely to think that EHRs are helpful for their physicians, and believe that EHRs are also helpful to achieve their own personal tasks and goals.

Online access to EHRs or patient portals has doubled in the past three years, the data found.  Half of patients can now view or share their information online, and more than half of those patients use the ability three times per year or more.   Patients continue to place a premium on the ability to conduct important tasks through their portals.  Access to online scheduling and prescription management features boosted patient opinions of EHRs by 31 percent.  Fifty-six percent of respondents desired email communication with their provider, while 58% wanted to review physician documentation and a similar number wanted the ability to look at their treatment plans.

Patients who frequently accessed their information online also reported higher levels of motivation to improve their own health.  However, survey participants complained that they did not have the right tools to track personal progress towards their goals, which may indicate an opportunity for developers to better integrate lifestyle and chronic disease management into the patient engagement experience.

“As the National Partnership’s new data show, more consumers are accessing, sharing and using their health information, underlining the importance of interoperability of health data and systems. We are focusing our efforts in these areas to empower individuals to address not only gaps in information exchange and interoperability, but also enable them to take steps to improve their health and better manage their health needs,” said National Coordinator for Health IT Karen DeSalvo in a press release.

“The views of patients must be front and center as we take the next steps in implementing health IT,” added Sandra R. Hernández, President and CEO of the California HealthCare Foundation, which funded the new survey. “As we as a nation become more diverse, the imperative to address disparities grows. We need the kind of robust information EHRs provide and the genuine patient engagement they can facilitate.”

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Linking patient-reported data to EMRs | Healthcare IT News

Linking patient-reported data to EMRs | Healthcare IT News | EHR and Health IT Consulting |

Flatiron Health, the oncology analytics company, has partnered with Vector Oncology on a new project that lets cancer clinicians view patient-reported symptoms at the point of care.

OncoEMR, an ONC-certified, cloud-based electronic medical record developed by Flatiron subsidiary Altos Solutions, is designed specifically for cancer treatment.

Vector Oncology's Patient Care Monitor is a Web-based platform that collects data from patients at the point of care – and between visits – about more than 80 physical symptoms related to treatment side effects, impairment, acute distress and mood.

By linking the two technologies, cancer care providers can gain additional insights to inform their treatment, officials say, helping support better quality of life and alleviate symptom burden for cancer patients.

"The integration of Flatiron's OncoEMR with our Patient Care Monitor will create an unmatched source of real world clinical and patient reported outcomes intelligence to improve the quality of cancer care and demonstrate the effectiveness and value of treatments," said Mike Choukas, chief executive officer of Vector Oncology, in a press statement.

Flatiron and Vector are also collaborating on new studies related to health outcomes and economic endpoints in support of clinical research efforts and real-world evidence generation, officials say.

"We are excited to partner with Vector Oncology, as we share a similar goal of leveraging technology to improve the quality of cancer care for patients," said Nat Turner, co-founder and chief executive officer of Flatiron Health, in a press statement. "This alliance will enable us to further support oncology providers with additional insights at the point of care."

Lee Schwartzberg, MD, president and chief medical officer for Vector Oncology, will serve as a medical advisor to Flatiron Health as it works to develop new technology for the oncology community.

"The partnership between Vector Oncology and Flatiron Health creates a transformative opportunity to leverage our rich experience collecting PRO data with Flatiron's comprehensive EMR platform to achieve meaningful improvements in cancer care," said Schwartzberg in a statement.

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