MResult Healthcare Insights

As part of our involvement with HIMSS I’ve been participating in that organization’s review and comment on the proposed HIT certification criteria. In last week’s panel review the topic of “Site” vs. “Product” certification came up.  A “Site” certification would certify that a provider or hospital site is able to demonstrate all of the  required criteria – not necessarily through a single product but potentially through a set of individual modules or standalone applications. This would give them the flexibility to assemble systems based on individual “best of breed” components, or leverage technology investments they’ve already made, rather than invest in a single vendor’s product.

I was surprised by how much push back there was to this on the call. And the push back did not come from the vendors, who you would think would be vested in pushing their “all in one” solutions. The push back came from the physicians who complained that a lack of interoperability between components would make any kind of “hybrid” solution like that completely unworkable. One doctor called it a “consultant’s dream”.

He’s right about the difficulties, though I do think that requiring a single product solution is the wrong way to go. We recommend our clients engage in a discovery phase before spending any money on a HIT solution. Before beginning you need to have your arms around your specific business and clinical goals as well as the ongoing “hidden” costs of training and support. For institutions considering a “best of breed” approach, mapping requirements against systems and identifying all of the potential data exchanges can help guard against unpleasant surprises.

- Chris Shafer

The MGMA recently sent Department of Health and Human Services’ Blumenthal a set of recommendations around how to ensure that compliance with “meaningful use” criteria don’t lead to undue burdens on physician practices. The recommendations are sound and worth reading. It’s not hard to imagine how the cost of compliance could quickly outstrip any savings you might achieve by implementing such a system.

From our standpoint, this underscores the need to really understand how an EMR will help your practice, what areas you wish to automate, where you can realistically expect savings and what your real cost of ownership (database maintenance, hardware, support) are going to be.

Read the letter here ».

From the New York Times – an article describing a study that compared 3,000 hospitals at various stages in the adoption of computerized health records. The study found little difference in the cost and quality of care after implementing the EMR.

““The way electronic medical records are used now has not yet had a real impact on the quality or cost of health care,” said Dr. Ashish K. Jha, an assistant professor at the Harvard School of Public Health, who led the research project.”

There have been a number of stories on this theme of late, and this is consistent with our experience. EMRs do have great potential for streamlining your operations and improving your care, but not if you think of them as a piece of software. We encourage our clients to view electronic medical records as a process improvement tool. Take the time up front to map out how you want an emr to help you practice medicine, then use that vision to drive your emr selection.

Read the article here (registration may be required)

Our good friends and partners at PatientOS are committed to open source as a part of the overall solution to reining in healthcare costs. Back in October Greg Caulton, one of the principles with PatientOS, had a chance to speak with a group of consular officials from over 20 countries at a meeting of The Center for International Business & Education. You can read about it here.