HIStalk Practice Interviews Kyna Fong, Co-founder and CEO, Elation EMR

Kyna Fong is co-founder and CEO of Elation EMR of San Francisco.

Tell me about yourself and Elation EMR.

I founded Elation with my brother, Conan. Our dad’s a family doc and so as kids, we helped him build his practice from scratch. We did everything from rooming patients to billing and negotiating with insurance companies, to installing all the equipment in IT. I managed his practice, and hired and trained all his staff for almost a decade. He was a paper hold-out for as long as possible, but we convinced him to let us build the Elation EMR live in his practice, basically using it as a lab.

Prior to Elation, I did something quite different. I was an economics professor at Stanford. A few years ago, I was fortunate to be nominated as a Robert Wood Johnson Foundation Health Policy Scholar. There I saw firsthand the huge chasm between how policy makers and administrators envisioned technology would transform healthcare and what was actually happening on the front lines of care in my father’s practice and in his colleagues’ practices. It was that exposure that made me passionate about creating technology that supported and strengthened the patient-physician relationship.

At Elation, we built a clinical platform from scratch focused on bringing physicians and patients closer together. We’ve optimized our EMR for the clinical needs of the provider, rather than optimizing for compliance or administrative purposes.

As for my job as CEO, I make sure that we’re focused on our key priorities, that we execute effectively, and that, most importantly, we continue hiring passionate, phenomenal people. Along with Conan, I outline our vision and ensure our strategic direction stays true to our mission and values.

Are your typical customers are on the ambulatory side?

Yep, our typical customers are indeed on the ambulatory side. Our typical provider tends to have long-standing relationships with patients and deliver longitudinal care. As a result, she often has a disproportionate number of complex patients with multiple chronic conditions. Communication is a key part of the service she delivers to patients, and she often coordinates care with a lot of other caregivers as well.

Our providers span most specialties. Over 30 specialties are represented in our current client base, which includes a couple of thousand users from across the country. They range from working in solo practices to 20-plus provider practices.

While many of our users have switched from other systems, we’ve actually noticed a substantial number of "paper hold outs" switching over, too. We’re excited by how our product maintains a lot of the benefits they would miss on paper.

How do you see physicians at different-sized practices using the EHR?

Two of our earliest pilot customers were a solo doc and a 15-provider practice. We found there was little difference between the clinical tasks they needed to accomplish. Having a larger staff, however, does mean there are a number of different workflows to consider. That observation made us ensure early on that our product is workflow-agnostic and avoids unnecessarily locking the user into doing specific tasks in a specific order. In addition to improving the user experience, that approach has also minimized our need to customize extensively based on practice size.

It’s true that needs do differ quite a bit between a solo practice and large groups from a reporting and administrative perspective. As long as we have a system that engages providers and is a source of truth, then we have the data needed to address the range of reporting and administrative requirements. We can then make the data available in a flexible, customizable way via our API.

How do you plan to grow the company over the next three to five years?

It’s no secret that the biggest challenge we’re facing as an industry and as a society is the urgent need to deliver higher quality care at lower costs. At Elation, we aim to enable excellent care, particularly for those 20 percent of complicated, chronically ill patients that account for 80 percent of healthcare costs. Typical EMRs are designed as static repositories of information, but from the beginning we’ve been focused on delivering a dynamic, powerful, clinically-focused tool that empowers providers to manage the overall care of even the most complex patients. Elation’s really designed to be the most solid clinical tool in the provider’s arsenal. We feel this clinical focus addresses a fundamental need that nobody out there is positioned to address.

There’s clearly a mounting demand for something more than the first version of EMR that’s been pushed out there, and user surveys have all highlighted the growing provider dissatisfaction with existing systems. The surveys consistently find a third to about half of physicians are looking to switch EMRs. We’ve invested significantly in helping switch practices to Elation with minimal disruption, making sure we’re bringing up the data they need.

In terms of what we anticipate rolling out down the line, ultimately we want Elation to tell the comprehensive story of a patient’s health and make it securely accessible, adjustable, and actionable to anybody involved with the patient’s care so that caregivers and providers can be on the same page regardless of what system they use. We want to make sure that our system is available wherever needed, and that decision making is therefore informed, consistent, and generates the best possible outcome for the patient. The plan down the road is to expand the Elation platform and definitely bring us closer to these goals.

Each of your employees spends time shadowing physicians. How much time, and how does that clinical presence help shape their ability to do their job?

The number of hours varies, but the key for us is what employees see the physician doing during their shadowing sessions. We ensure that every single team member, including engineers, has at least one training session where they shadow a physician for an entire day – from when the doors open and the staff start preparing until the doors close. Shadowing for a complete day sheds light on the diverse context that physicians work in, and fleshes out a much more realistic picture than simply shadowing isolated activities independent of one another, which we found can be misleading.

People ask why we shadow and how it affects the product we deliver. One thing I will say is that it makes a tremendous difference when every single person who takes part in creating not just the product, but also the overall experience, has context for what’s going on in the practice. Even thinking and understanding the difference in context between being inside the exam room versus being between visits makes a huge difference. That ingrained awareness within the company creates so many valuable checks on the end-user experience that we ultimately deliver.

It’s really hard to understand the degree to which providers are constantly clicking, switching, and multi-tasking. With shadowing, you see with your own eyes how physicians deal with documentation while simultaneously returning phone calls, coordinating care with other providers, and communicating internally with staff. I think that seeing that drills into us the importance of details and how frustrating even the smallest details can become. I think we end up having a much more flexible product because of the shadowing and really trying to expose ourselves to the user’s experience.

Why choose the name Elation?

We wanted our focus on user experience to come across first and foremost. It’s the emotion we want users to feel when they’re using our product. We thought it would express our commitment to that as a company.

You made the case recently that Elation has more satisfied customers than Apple – a pretty bold statement. How are you measuring customer satisfaction?

We use the Net Promoter score, a universally recognized method that companies of all types across the world use to measure customer loyalty and experience. The reason we chose the comparison sample is because Apple has really set the gold standard for simple and intuitive user experience, as well as deep customer loyalty. That’s the bar we want to hold ourselves to.

Traditionally, B2B businesses haven’t been held to the same high bar as consumer businesses, because selling to businesses used to mean that you could rely on restrictions and long-term contracts and switching costs to really capture the customer. But the world is changing. We don’t lock our customers into long-term contracts. We have to earn their business month after month, so it’s really important for us that we know whether or not we’re delivering.

We also have deep influence from Ideo, a design consulting firm whom we’re grateful to have as our supporters. We believe if we continue delivering a phenomenal, delightful experience to our users, we’ll come out on top.

Do you see user experience becoming a true differentiator within the EHR market, especially as we’re seeing it continue to consolidate?

Yes, absolutely. As I alluded to before, I think customers in this market increasingly recognize and understand that an EMR whose user experience distracts and encumbers the physician is actually detracting from patient care. As patients become more complicated and costs become more critical to control, you see providers starting to demand an EMR that enables them to become more clinically effective and manage the patient’s overall care.

I think we’ll also see the market responding to systems that not only improve the physician’s user experience, but the patient’s experience as well. Within the EMR market, as data formats become more common and standardized, physicians will be empowered to move from EMR to EMR more easily. We’re already seeing a lot of that happen today, with well over half of our new users switching from other systems.

What’s your take on scribes, and how do you see your customers reacting to them?

Scribes are certainly an indication that EMRs are adding to the burden of physicians rather than lightening it. I can’t think of a single industry where technology makes its users less productive and everyone says, “Oh, that’s okay.” A lot of the EMRs out there, especially the ones practices rush to adopt to get Meaningful Use dollars, are built with the express purpose of shifting administrative and compliance burdens for physicians, which I think drives some of the demand for scribes. We couldn’t disagree more with that approach. At Elation, we’re definitely determined to lighten the physicians’ burden and enable them to keep patients as their first and foremost priority.

What lessons did your team learn from watching Practice Fusion go through its recent downtime?

We use Amazon, so we are a cloud-based service as well. While we do rely on third parties to help deliver our solution, we feel fully responsible for our users’ experiences. Based on our own experiences running a practice, we know access to records is critical, even if it’s only read-only. We make sure we have multiple levels of redundancy to ensure our users have access to their records any time. In fact, our users have access to back-up, read-only versions of our system that we run as a separate site on completely independent infrastructure.

Also, our customers can reach us any time and get a response within 30 minutes for all urgent issues.

We definitely place support and responsiveness as top priorities, ensuring our practices always have access to their records in order to deliver care. Those qualities are the two most frequently referenced in our customer testimonials.

Any concluding thoughts?

Our first resolution is simple: Focus on physicians so they can focus on their patients. We all know technology has enormous potential to enhance patient care and reduce costs, and to make that a reality, we need to start with an intuitive, clinically-focused tool that physicians can actually use and rely on for care, even for the most complicated patients. The rampant productivity loss and provider distraction we see today only hurts patients in the end. We’re determined to work with providers to change that and really enable them to focus on delivering excellent care to their patients.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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From the Consultant’s Corner 9/12/14

Onboarding Financial Systems: Three Strategies for Mitigating Risk to Revenue

For the past several years, healthcare organizations have invested significantly in EHRs given the Meaningful Use incentive opportunities. Another driver for EHR implementations and upgrades has been expanding clinical integration and alignment activities, which often involve deploying a common EHR to coordinate care and share clinical information across the continuum of patient care.

Although organizations are still focusing on EHR optimization and other clinical informatics initiatives, including MU Stage 2 and ICD-10, they are also starting to replace revenue cycle applications as part of a broader IT strategy that involves using a core vendor to support patient access, clinical, and revenue cycle requirements.

A single platform capable of reporting clinical and financial information provides efficiencies for managing patient populations and competing in value-based reimbursement arrangements. A core vendor platform also allows organizations to reduce their dependence on interfaces, providing cost efficiencies and limiting potential workflow bottlenecks. Moreover, these integrated systems can reduce the likelihood of lost charges and improve overall claim lag.

Beyond a Software Upgrade
Replacing revenue cycle technology – such as patient financial accounting and practice management software- is not just an IT exercise. In fact, I recommend taking the opportunity to redesign business processes to gain efficiencies, improve effectiveness, and also enhance the patient experience. New systems should not merely replicate manual or other outdated processes, but also reflect redesigned workflow and optimized staffing levels and structure.

In my experience, an effective implementation requires robust change management to help people understand and adapt to both the new system and the new way of doing business. For instance, some organizations choose to create a single business office that marries hospital billing and professional billing, resulting in one statement and one point of contact for customer service. To be successful with this model, organizations must appreciate and respond to the risks involved, as people are being asked to do things they have never done before. Whether implementing a system change or a broader organizational redesign, these organizations must proceed in a manner that minimizes the impact on revenue cycle productivity and limits cash flow disruption.

Three Strategies to Minimize the Risk to Revenue
As healthcare organizations consider replacing their revenue cycle applications, executives must pay careful attention and develop ways to mitigate risk to revenue. Here are three strategies to keep in mind.

1. Build a business intelligence model that parallels the change.
I strongly recommend collecting, monitoring, and responding to key metrics before, during, and after implementation to quickly catch problems and head off potential cash flow implications. When identifying critical performance indicators, think about comparing current metrics to future needs and determine which measures will fully demonstrate organizational performance. During this process, be sure to understand how the new system’s measurements compare with previous indicators to ensure apples-to-apples comparisons. It may be helpful to create a baseline measure of the new metrics using the old system to accurately measure change and monitor future performance.

Once you begin collecting data, be sure to report metrics to the right people at the right time, establishing who needs to receive reports and checking they understand the data’s meaning. I find it helpful when determining reporting frequency to look at the data recipient’s role in the organization – i.e., executive, manager, supervisor. For instance, patient access managers should have daily access to claim denial information to quickly identify and resolve issues, and lessen any negative effects to the revenue cycle. If these individuals do not receive reports until month end, it could have a major impact on revenue and workflow.

2. Create a comprehensive training plan.
When training staff on a new system, be sure to focus on operational and workflow changes, not simply new IT screens or functions. Training should cover the concepts behind a switch, the individual’s changing role in the department, and revised workflows as well as the system’s various nuances. Note that when designing a training plan, it can be helpful to evaluate vendor-suggested models against operational changes to support a more organization-specific approach.

3. Make sure the vendor’s implementation strategy can be tailored to meet the organization’s specific needs.
Most revenue cycle vendors have an established implementation plan that is based on best practices from current clients. While these plans have merit, you should not accept them at face value. Make sure you fully understand the impact of the vendor’s pre-configured strategy and system design. In most cases, organizations will have to balance an efficient implementation with risk to revenue, personalizing the vendor’s approach with organization-specific requirements.

One Part of a Greater Goal
Implementing new financial accounting and PM software inherently involves added risk to revenue across your organization. Combined with an EHR strategy, this investment can yield a broad, transformational change, which helps organizations report on clinical and financial information to manage population health and sustain financial viability. Organizations that pursue a well-considered implementation approach can reduce risk and optimize revenue, ensuring they remain nimble during these changing times.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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Point-of-Care Apps: Next Generation

To make the most of the shrinking window of time physicians spend interacting directly with patients (as few as eight minutes these days), more doctors and clinicians are turning to point-of-care applications. According to a report from Epocrates, 86 percent of physicians have adopted various digital health applications to support patient education and interaction. With new apps debuting almost daily, it seems the very best distinguish themselves in two ways.

The patient education piece 
A clear, specific function
Physicians need a way to simplify complicated medical information, using tools and templates customized for each patient across a broad population. Visual tools should clearly demonstrate a patient’s condition, and enable secure sharing with the patient and other healthcare team members.

Apps should also fit the “80/20 Rule.” There is no “one-size-fits-all” solution. They should cover as much of the content needed as possible while still leaving sufficient flexibility for customization to fit the specific needs of the physician.

Usable and fast
Waiting more than a few seconds for a point-of-care app to load during an appointment won’t work. Even worse, if the app crashes and needs to be pulled back up, a significant portion of the available time in the physician-patient interaction is lost. These things have to work, every time, and quickly.

Traditional software measures success by keeping users in their apps as long as possible. The best point-of-care app, however, strives to minimize the time users spend within it on a per-patient interaction basis, while effectively achieving its goals.

High-value, clinically valid content
Peer-reviewed, painstakingly researched clinical guidelines based on the latest science take years to develop. They are the gold standard for content by which care is administered. But they don’t need to take years to deliver or operationalize in the field. Physicians and clinicians across the globe need access to the latest clinical guidelines at the point of care to ensure treatment decisions are informed by the best science has to offer.

The differentiator: synchronizing patient education with decision support (the digital health PB&J)
Simultaneously operationalizing clinical-practice guidelines and delivering patient education through physicians and clinicians at the point of care is what’s next. It’s time to put the peanut butter and jelly together.

The best patient care plan won’t work if the patient doesn’t understand how the plan works, doesn’t understand the implications of adherence (or, more importantly, non-adherence), and doesn’t confidently follow through. Similarly, a 100-percent compliant patient doesn’t produce desired outcomes if the treatment plan doesn’t follow consistent guidelines.

Within the interaction between physician and patient exists an information exchange of the highest importance. It sets the wheels in motion for all of the possible treatment choices and courses. The common goal (especially in cases like prostate cancer treatment), is to maximize the odds of success. The best way to do that is to enable physicians to make choices based on sound science with an educated, confident patient. The patient needs to understand the course of treatment and precisely how important it is to adhere to the plan to achieve the best outcome. Combined with implementation of the latest evidence-based protocols, the most efficient course of care for all involved (including payers) should materialize.

In the broadest sense, digital health apps do not solve a technical problem, but often a human problem. How then does the healthcare team as a whole humanize complicated material including the latest clinical guidelines and care planning? How do they communicate it to the patient and improve outcomes for the entire continuum of parties concerned?

The answer can only be found, and the PB&J enjoyed, when physicians, clinical associations, researchers, and manufacturers partner to find solutions to that problem in a mutual quest for better healthcare outcomes and experiences.

John Cox is the president and CEO of  Visible Health.

News 9/11/14

Top News

CMS Principal Deputy Administrator Andy Slavitt updates the House Ways and Means Health subcommittee on preparations for a second round of Healthcare.gov open enrollment. He noted the application process will be more streamlined and that transparency about potential problems will be a top priority, a comment echoed by HHS Secretary Sylvia Burwell earlier this week. He did not promise a seamless experience, instead emphasizing, as one reporter put it, “improvement but not perfection.” Surprisingly, just one subcommittee member asked him about the recently announced Healthcare.gov hack. Could the federal government really be ready to stop splitting partisan hairs and focus on a successful go live?

HIStalk Practice Announcements and Requests

Register today for upcoming HIStalk webinars:

September 11 (Thursday) 1:00 p.m. ET. Electronic Health Record Divorce Rates on the Rise — The Four Factors that Predict Long-term Success. Presented by The Breakaway Group, A Xerox Company. Presenters: Heather Haugen, PhD, CEO and managing director, The Breakaway Group, A Xerox Company; Bill Rieger, CIO, Flagler Hospital, St. Augustine, FL. Many users are considering divorcing their EHR as dissatisfaction increases. Many are spending 90 percent of their time and resources on the wedding  (the go-live) instead of the long-term commitment to new workflows, communication, education, and care outcomes (the marriage). Hear more about the findings of research published in “Beyond Implementation: A Prescription for Lasting EMR Adoption” about EHR adoption and success factors.  Registrants get a free electronic or paper copy of the book.

September 18 (Thursday) 1:00 p.m. ET.  DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project. Presented by HIStalk. Presenters: Dim-Sum, an anonymous expert in government healthcare IT, military veteran, and unwavering patriot; Mr. HIStalk. The Department of Defense’s selection of a commercially available EHR will drastically change the winning bidders, the health and welfare of service members all over the world, and possibly the entire healthcare IT industry. The presentation will include overview of the military health environment; the military’s history of using contractors to develop its systems vs. its new direction in buying an off-the-shelf system; its population health management challenges in caring for nearly 10 million patients all over the world, some of them on the battlefield; and a review of the big players that are bidding. This presentation will be geared toward a general audience and will be freely sprinkled with humor and wry cynicism developed in years of working in two often illogical industries that hate change.

September 25 (Thursday) 1:00 p.m. ET. Using BI Maturity Models to Tap the Power of Analytics. Presented by Siemens Healthcare. Presenters: James Gaston, senior director of maturity models, HIMSS Analytics; Christopher Bocchino, principal consultant, Siemens Healthcare. As ACOs and population health management initiatives evolve, Business Intelligence (BI) capabilities are becoming a critical part of healthcare organizations’ successful forays into the new healthcare marketplace. This event is designed to provide an understanding of BI maturity models and how they can be leveraged to optimize clinical, financial, and operational decisions. This session will cover how analytics maturity is measured and how organizations can use this information to create an effective roadmap for maturing their analytics capabilities to an advanced state.

Acquisitions, Funding, Business, and Stock

PM and technology services company PracticeMax acquires medical billing and PM services firm Optimum Medical Management. PracticeMax plans to use the acquisition as a springboard to further expansion.

Preventice and eCardio Diagnostics announce they will now operate as wholly owned subsidiaries of new holding company Preventice Inc. The companies hope the strategic combination will better enable them to strengthen offerings in the areas of remote monitoring systems and mobile health applications.

Announcements and Implementations

NVoq announces the 2014 SayIt Healthcare Productivity ShowcaseFest, where 12 chosen healthcare professionals will work with the company’s SayIt speech recognition product to build and record a voice-optimized EMR Showcase. Nominations are due September 26.

Multispecialty medical group ABQ Health Partners (NM) launches the FollowMyHealth patient portal from Allscripts. ABQ implemented an EHR from Allscripts in 2007.

Anesthesia Partners Services (WI) implements the Anesthesia Touch anesthesia information management system from Plexis Information Systems at The Center for Digestive Health, Mayfair Digestive Health Center, Lake County Endoscopy Center, and Wisconsin Digestive Health Center. APS is also partnering with Plexis Management Group for a variety of PM services.

ChartSpan launches a free iOS app that automates the conversion of medical records from paper to digital data. If you need a good laugh, spend a few minutes on their website. It combines a unique blend of ‘80s nostalgia (New Kids on the Block collector cards!) with modern-day snark.

Government and Politics

ONC releases a 187-page update on EHR certification criteria, adding 10 new optional criteria to its standards and revising two mandatory points in an effort to offer vendors flexibility and clarity in the name of better health information exchange. It drops a plan to create a set of voluntary certification standards for 2015, and breaks CPOE intro three optional components – laboratory, medications, and diagnostic imaging orders. It also offers vendors the ability to use any electronic transmission method for sending syndromic surveillance data from their EHRs to public-health agencies.

Research and Innovation

The American Telemedicine Association releases its State Telemedicine Gaps Analysis, which grades states on telemedicine reimbursement and physician practice standards. Star states include Maryland, Maine, Mississippi, New Hampshire, New Mexico, Tennessee, and Virginia. Strugglers include Connecticut, Iowa, and Rhode Island.

A study finds that a proactive and customized patient portal implementation strategy designed by primary care practices resulted in 25.6 percent of patients using a personal health record. The study also found the adoption rate increased 1 percent each month over 31 months, and that nearly 24 percent of PHR users signed up within one day of their office visit.

Researchers from the Garvan Institute of Medical Research and Australian National University win the Eureka Prize for developing a lens that turns a smartphone into a microscope. The lens, which costs less than a cent, can magnify up to 160 times. It’s refreshing to think that mobile health innovations can unfold without Apple-level hype.

Other

Apple unveils the iPhone 6, iPhone 6 Plus, a mobile payments system, and the long-awaited iWatch (formally known as Apple Watch). Observers, for the most part, seem nonplussed when it comes to the ability of the new devices and technologies to truly change healthcare. Dr. Travis at HIStalk Connect noted in his review that the watch is “a middle-of-the-road activity tracker submerged within an overall above average smartwatch.” Manny Alvarez, MD, however, enthusiastically said that, “As more developers begin to write new software, and health care companies like GE begin to integrate their diagnostic tools with some of these devices, physicians will have no choice but to embrace this world.” Whether patients and physicians will truly embrace a watch that retails for $349 remains to be seen. I stand by my prediction that Apple Watch will be the coveted giveaway at HIMSS 15. (And I prefer pink watchbands, in case anyone is wondering.)

The local paper covers the roll out of VITL Access health information exchange by Vermont Information Technology Leaders. Nine years in the making, implementation of the HIE began last month, and stakeholders hope to have it operational throughout the state sometime next year. VITL also plans to launch the VITL Direct secure messaging system and VITL Notify notification system over the next 12 months.

Sponsor Updates

• PerfectServe President and CEO Terry Edwards writes a blog post titled “Learning from the Airlines and Banks.”
• Frost & Sullivan recognizes GE Healthcare IT with the 2014 North America Frost & Sullivan Award for New Product Innovation Leadership.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

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Comparing EHRs for Small and Medium-Sized Practices

A summary of the TechnologyAdvice EHR System Comparison Guide

Throughout the wave of EHR adoption in the past five to six years, it’s become clear that larger providers are having an easier time purchasing and implementing software. The consistently lagging adoption rates of small practices also seem to indicate that the HITECH Act may indeed have been the nail in the coffin for small, private practices, particularly solo providers.

According to a 2012 study conducted by the Commonwealth Fund, only 50 percent of physicians in solo practices were using EHRs. For practices of 20 or more, EHR usage was around 90 percent. Clearly the lack of resources has posed a steep obstacle for smaller providers.

Although the Commonwealth Fund’s study looked like a harbinger of dark days, there’s reason to think that things may have changed since 2012. SK&A found in its annual market study this year that single physician practices experienced the largest jump in EHR adoption. Their usage rates increased 11.4 percent from 2013-2014, reaching 53.7 percent. Additionally, the adoption rate for practices with three to five physicians jumped 9.4 percent during the same time.

There’s a disparity between the Commonwealth Fund’s and SK&A’s numbers, but the point of lagging adoption is still clear for smaller providers (though EHRs are appearing more frequently in solo and small practice offices).

Providers and office managers in small practices understand the difficulty of choosing from the numerous EHR products on the market. That’s why TechnologyAdvice carefully reviewed several of the best options for small and medium-sized practices.

Our research included calculating user satisfaction scores averaged from multiple, reputable review sites, as well as a functionality score that indicates the capabilities of the EHR platform. Each product compared is ONC-ACB certified and offers an integrated patient portal.

Let’s dive in.

Amazing Charts

Ranked number 10 for market share in SK&A’s report, Amazing Charts was founded in 2001 and was subsequently acquired in 2012 by Pri-Med. This platform may not have an eye-catching interface, but its main advantage is that physicians and other EHR users love the simplicity of entering information. It’s precisely this ease of use that has won Amazing Charts so many awards in the last several years, including the highest ambulatory EHR for 1-10 physicians in the 2011 KLAS awards, number one in Medscape/WebMD’s 2012 survey, and so on.

The system is targeted at small private practices, and its pricing reflects that. Buyers can download a free trial of the software and demo it before making a final purchase decision. In addition to its straight-forward interface, which limits drop-down menus and allows physicians to enter data as they would on a paper chart, this EHR also features speech recognition and is interoperable with several state immunization registries.

Amazing Charts does miss several key ingredients though, which prevent it from scoring higher on functionality. The lack of practice management add-ons certainly seems strange for a product geared toward small practices. Ideally, a small practice would want a fully integrated solution, in order to save resources. Amazing Charts does offer integration with a number of PM solutions, however, and is rolling out its own option in November.

The lack of a bridge to translate ICD-9 codes into ICD-10 codes also hurts this system. Again, small practices would ideally like to have a solution that minimizes the amount of necessary ICD-10 training.

Overall, this system is excellent, especially where it counts: usability. You can’t argue with the price either, but a lack of a few key features lowers its overall score.

Satisfaction score: 9/10

Functionality score: 7/10

MediTouch by Healthfusion

MediTouch is a prime example of newer, cloud-based EHRs that focus on usability. MediTouch focuses on empowering users to chart quickly and easily, thereby answering perhaps the main complaint about most EHR systems. Of the three products, MediTouch is the only one to support Mac’s OS system, making it an appealing choice for physicians who use Apple computers in their practice.

This product focuses heavily on tablet functionality, and includes a full-fledged app with each subscription. Tablet compatibility not only lets physicians enter data into a chart while on the move, but can also improve their interactions with patients at the point of care. In fact, tablets are quickly becoming providers’ favorite tools in the exam room. A study by Medical Economics estimates that 51 percent of physicians use a tablet when accessing their EHR, and other research has shown that patients respond favorably to physicians using tablets during an exam.

Besides their iPad app, MediTouch also offers small practices a solid EHR system, complete with an ICD-10 conversion feature that helps users prepare for the 2015 transition. Customizable templates allow physicians to easily mold this EHR to fit the most common charts and diagnoses in their practice. MediTouch also features a strong revenue cycle management function that helps small practices capture data during a patient visit, automate billing, optimize codes to reduce denials, and auto post electronic remittance advice when necessary.

MediTouch can be deployed as a standalone platform or in conjunction with Healthfusion’s PM system. The detailed iPad app, which is somewhat rare in the EHR space, particularly for small practices, helps set this system apart.

Satisfaction score: 8.6/10

Functionality score: 8/10

athenaClinicals

Ranking just above Amazing Charts at number nine in overall market share by SK&A, athenahealth’s EHR athenaClinicals seems to be slowly transitioning to enterprise level clients, but still makes its living among practices with between one and 10 physicians. Athena placed first in KLAS’s 2012 survey for the most usable EHR, and certainly places an emphasis on usability. The slick design of the software stands in stark contrast to many of its competitor’s gray interfaces. Athena features all of the same capabilities that most quality EHRs have, such as customizable templates, adaptable clinical workflow, and revenue cycle management, so let’s focus on what sets this EHR apart.

Athena also won a KLAS award for the best EHR for helping providers meet Meaningful Use, largely because of its dashboard. This module helps providers visually track their progress toward meeting MU incentive goals. And since Athena keeps all of its providers’ information on the same network, the MU dashboard helps users track their progress against other athenaClinicals users around the country.

Clinical decision support is another benefit of athena’s network, or rules engine. Information regarding current best practices and protocols is easily accessible, and coding assistance is another big benefit. For example, if a certain procedure or code begins to see routine denials throughout their network, athena can alert its users and even change the recommended codes to reflect current trends.

Athena isn’t perfect, though. Despite its focus on usability, users have complained about the amount of drop-down menus in the charting modules. These setbacks dock the score of what is an otherwise robust system geared toward smaller practices.

Satisfaction score: 8/10

Functionality score: 9/10

The three products we’ve highlighted here are safe bets for private practices. At the very least, they offer a template of what buyers in this market should look for in an EHR.

Zach Watson is a senior research analyst at TechnologyAdvice.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

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