Discuss News 06/13/07

[Mr. HIStalk]

Post your thoughts about items in today's HIStalk.

[Inga]

Are we going live tonight?

[Mr. HIStalk]

Are we going live tonight?

I think so. Are you ready? Say hi to your adoring public!

[Inga]

Hello fans! As my mentor, Paris Hilton said in Confessions of an Heiress, "The only rule is don't be boring." I will take that to heart...

[Mr. HIStalk]

Hello fans! As my mentor, Paris Hilton said in Confessions of an Heiress, "The only rule is don't be boring." I will take that to heart...

Well, you never bore me.

Adam posted a well thought out message on your EMR piece. He echoes sentiments nearly identical to those I posted in an Inside Healthcare Computing editorial:


So, the question for the outside practice is: is it worth it to get an almost free but poor ambulatory EMR system, but to create privacy concerns for your patients, and jeopardize the future of your practice as your patient data becomes semi-public information? Somehow, I doubt it.

I'm always amazed at the simmering hostilities and open distrust between hospitals and physicians in practice (whether owned or not.) If physicians see hospital-provided EMRs as yet another attempt at control, will they pass, even though they'll get a free system?

I'd say yes. Reason: physicians don't really want EMRs and have little direct benefit from them. They reduce productivity in many cases. I'd say they'll either decline to implement or will take the system, but use only the billing and scheduling parts.

[Mr. HIStalk]

Here's another just-posted comment from Old Gomer on the "original" HIStalk:


Do the big Hospital venders have useful ambulatory EMR Products? These are two very different workplaces. Will the big hospital vendors keep an ambulatory system current if the ambulatory product is but a small percent of their volume. Do the big Ambulatory EMR vendors have any hospital systems or influence on enterprise systems? Interconnectivity will add to the expense and further slow down the hospital decisions. One reason why physicians are slow to adopt EMRs may well be Inga's take on hospital territorial approach, making any physician EMR decision moot if Hospitals A & B's systems don't talk and the physician and/or hospitals have to interconnect before any system provides an electronic means to improve provider communication.

[Inga]

Adam commented that his understanding of the Stark relaxation ruling "forces outside practices which accept the systems to take the same system that the hospital already uses (or, at least, a system provided by the same vendor)." I glanced through the IRS ruling (http://www.health-itworld.com/newsletters/2007/05/15/irs) and don't see anything that makes using the same vendor a requirement. Interoperability is required...

Does someone know differently?

[Art_Vandelay]

A few points:
1. There is nothing saying the hospital has to use their EMR (from my read - echoing Inga's interpretation)

2. This will drive the need for integration applications like Medicity, Axolotl, dBMotion or NovoGrid. Interface engine companies - wake-up!!!!

3. Hospitals will move slow but a first mover will force the others' hands in a local marketplace - can anyone say arms-race?

4. Hospital-focused vendors (i.e., Eclipsys, Cerner, GE LastStand, Siemens) all have abysmal OPD products. The flip-side is Epic with a good generalist OPD product but a weak specialist OPD product and a new inpatient product. That is why the integration software will be required to stitch these applications together. Hospitals should take a standard product, configure the areas required for integration (applicable code sets, look-ups), and provide it.