News 9/18/14

Top News

Congresswoman Renee Ellmers (R-NC) introduces the Flexibility of Health IT Reporting Act of 2014, which if approved would allow providers to report HIT upgrades in 2015 through a 90-day reporting period as opposed to a full year. In addition, providers would have the option to choose any three-month quarter for the EHR reporting period in 2015 to qualify for Meaningful Use. Introduction of the act coincides with a letter to HHS Secretary Sylvia Burwell from 16 industry groups calling for similar adjustment.

HIStalk Practice Announcements and Requests

Thanks to all of the HIStalk sponsors that have requested to be a part of our annual MGMA “Must-See" Exhibitors Guide. Don’t worry, there’s still time to participate. Fill out this brief form by September 30 to ensure a spot in the digital guide. We’ll also include contact information for companies not exhibiting but looking to schedule one-on-one meetings.

Webinars

Today (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 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. Business intelligence capabilities are becoming critical for healthcare organizations as ACOs and population health management initiatives evolve in the new healthcare marketplace. The presenters will explain how BI maturity models can help optimize clinical, financial, and operational decisions and how organizations can measure and mature their analytics capabilities.

September 26 (Friday) 1:00 ET. Data Governance – Why You Can’t Put It Off. Presented by Encore, A Quintiles Company. Presenters: Steve Morgan, MD, SVP for IT and data analytics and CMIO, Carilion Clinic; Randy Thomas, associate partner, Encore, A Quintiles Company. In this second webinar in a series, “It’s All About the Data,” the presenters will review the pressing need for data governance and smart strategies for implementing it using strained resources.

Acquisitions, Funding, Business, and Stock

Doc Halo and American Messaging Services enter into a revenue-sharing agreement and partnership that will deliver a combined suite of mobile health, secure communication, and critical messaging technologies to healthcare providers. American Messaging will also acquire a 25-percent equity interest in Doc Halo.

The CEO Council on Health and Innovation, which includes leaders from Verizon, Walgreens, Coca-Cola, Aetna, and Bank of America, challenges business leaders to formally quantify and share ideas and data on company wellness practices and outcomes. Their advocacy ties into the release of a similarly themed report and initiative at the Bipartisan Policy Center.

Government and Politics

This article predicts that former U.S. CTO Todd Park will be subpoenaed by Washington, D.C. lawmakers in order to force him to testify about Healthcare.gov’s security flaws before a subcommittee of the House Science, Space, and Technology Committee. Park has refused to testify before the Science Committee on multiple occasions without a subpoena. I’m sure the use of one will make him that much more willing to “come clean” about the security failings of the federal insurance marketplace.

U.S. Digital Service Administrator Mikey Dickerson shares Healthcare.gov war stories with the O’Reilly Velocity New York Conference audience: “Amazingly, there was no sense of urgency, because this was just like any other government project. Government IT contracts fail all the time. There was almost no place where we could point to a decision and say we’d made the right one. We didn’t expect to fix this. We just gave it our best shot, because somebody had to. Most of this was labor-intensive, but not very hard.”

Announcements and Implementations

Madison Radiology Medical Group implements Meaningful Use-certified eRAD RIS with Speech Recognition. The group, which has been an eRAD PACS customer since 2001, plans to start attestation for Meaningful Use right away.

IDC Health Insights launches Healthcare IT Services Strategies, an advisory service that provides data and analysis to suppliers and purchasers of IT services to help them save time, reduce cost, and mitigate risk.

An investment group affiliated with Goldman Sachs invests $400 million to fund the expansion of Privia Health, a physician-led ACO and population health technology company. Investors have set up holding company Brighton Health Group to align with Privia and help prioritize its expansion into eastern U.S. markets.

Wide River partners with 4Medapproved to offer its customers 4Medapproved’s online education and certification resources. 4Medapproved’s customers will, in turn, be introduced to Wide River’s healthcare IT consulting services.

The Kentucky Health Information Exchange unveils the myhealthnow patient portal, developed in collaboration with NoMoreClipboard. The portal rollout is in pilot phase with an unspecified number of healthcare facilities across the state. It is expected to be available to the public for use later this year.

Surescripts adds four pharmacy benefit management companies and six EHRs to its electronic prior authorization service.

GlobalMed introduces the ClearSteth Digital Stethoscope, which is capable of sending sounds within the body to an off-site healthcare provider. The digital stethoscope can then save the audio file in a patient’s EHR.

Research and Innovation

A new study finds, not surprisingly, that consumers who use social networks – especially those with chronic diseases – are more likely than those who don’t to search for health information online. It also found that there is still a significant gap between the online health information gathering habits of older men with low incomes and minorities, and those of women and people with higher incomes. None of this is particularly revealing in and of itself. Study results should, however, temper the enthusiasm of those who think Apple’s entry into healthcare will be the game changer that patients truly need. There are too many consumers who are not sporting the latest smartphone or overly interested in quantifying themselves to provide Apple with the critical mass it needs to shake up healthcare outcomes.

New research estimates that the global  mobile health market will account for over $13 billion in 2015, and could represent up to $290 billion in annual healthcare cost savings worldwide by the end of next year. It also predicts that wearable devices will account for over 150 million unit global shipments by the end of 2020. That kind of prediction may not represent critical mass, but it does prove that Apple can make a significant impact if it plays its cards right.

Other

Steven Waldren, MD, director of the American Academy of Family Physician’s Alliance for eHealth Innovation, breaks down the Meaningful Use final rule and the definition of certified EHR technology. He notes that “The AAFP has articulated to CMS and ONC that not changing the 2015 reporting requirements means this is still a large stretch for many physicians.”

Epic has been in the news this week thanks to its gigantic user group meeting in Verona. While the company mainly grabs hospital-centric headlines, I can’t help but comment on the contrast between the amount of money in the room above, and recent headlines that the state of Wisconsin needs $760 million more to pay for healthcare for the needy over the next two years. Epic may be partly to blame: Part of the added cost to taxpayers for the state’s needed Medicaid programs also comes from automatic decreases in federal aid that are being triggered because of Wisconsin’s improving economy.

Family physician Eugene Heslin, MD reacts to recent reports that physicians lose 48 minutes each day due to EHR use:

“Efficiency need not be measured solely in terms of minutes required to use the electronic record. It should also be evaluated in terms of the quality of care and savings derived from reducing the number of costly, redundant lab tests and X-rays and reducing the number of patients who need to be admitted or re-admitted to a hospital. This level of efficiency requires electronic health records, and importantly, requires the ability to interconnect these electronic systems.”

Ruth Ann Crystal, MD tweets a picture of either the latest physician fashion accessory, or a bold statement on the current state of reimbursement.

Sponsor Updates

• Flagler Hospital (FL) chooses Allscripts dbMotion to connect community EHRs.
• Billian’s HealthDATA makes its searchable Vitals hospital news and RFP feed available at no charge. 
• Allscripts offers a short list of dos and don’ts of clinical IT deployment based on a new Alberta Health Services case study.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

Last Minute Preparation Tips for the HIPAA Omnibus Deadline

“You may delay, but time will not.”
― Benjamin Franklin

This famous quote reminds us that another HIPAA Omnibus deadline is fast approaching. Covered entities (CEs) and Business Associates (BAs) that did not update their Business Associate Agreements (BAAs) in 2013 must do so by Monday, September 22, 2014. There’s no more wiggle room for delay. The final deadline is here.

What You’ll Need
Practices, clinics, and other CEs are responsible for auditing all their BAs and subcontractors, and for ensuring receipt of an updated BAA. The modified BAAs must state, in writing, that the BA has achieved the following:

• Full compliance with the HIPAA Security Rule.
• Execution of BAAs with any of their subcontractors that create, receive, maintain, or transmit protected health information on behalf of the BA.
• Reporting of all security incidents, including breaches of unsecured health information.
• Full compliance with the Privacy Rule requirements applicable to covered entities if and to the extent the BA is to carry out a CE’s obligations under the Privacy Rule.

A more detailed checklist for BAA compliance is here.

Know the Gotchas
While many BAs and subcontractors will confess to HIPAA compliance, they must put it in writing by September 22. This may include such business partners as cloud storage companies, EHR vendors, PM software firms, coding and billing services, and release of information processors. Even copy services and testing modalities must update their BAAs and their subcontractor BAAs — if they haven’t already done so.

CEs should verify that they’ve identified each BAA and subcontractor by conducting a thorough self-audit of their practices — logging every device that captures, stores or submits PHI. Even C-arms can store and submit data. Create an inventory of all systems and equipment to identify gaps in BAA documentation.

Four Basic Steps
Beyond updated BAAs, there are four basic ways practices and clinics can protect the privacy and security of their patients:

• Establish a solid privacy and security program for PHI.
• Document your program within strong HIPAA policies and procedures that are reviewed and updated at least annually.
• Ensure staff receives initial and ongoing education regarding HIPAA and your overall privacy and security program with documentation of their attendance and any disciplinary actions.
• Define steps to react quickly if a breach occurs — including investigation of the event, mitigation of potential harm, and notification of patients.

The HIPAA Omnibus rule changed your BAA requirements. Under the rule, all BAs and subcontractors are now also liable for breach penalties and fines. You’re no longer alone – but you’re also responsible.

Alisha R. Smith, RHIA is the Health Information Management Compliance Educator for HealthPort Corp. of Alpharetta, Georgia. 

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

DOCtalk with Dr. Gregg 9/16/14

When Meaningful Isn’t

There are just so many times in a physician’s life when Meaningful Use just doesn’t mean anything.

Picture this:

A beautifully pregnant mother is preparing for the birth of her very first child. The pregnancy is uncomplicated, except for the fact that the child is now breech. Despite the best efforts of a wonderful obstetrician, the infant remains in breech position and the decision is made to deliver the baby via Caesarian section.

The surgical suite is fully prepped and the procedure proceeds with no untoward signs. The fetus’ vital signs are being monitored closely and show no indications of any distress. The section proceeds uneventfully until …

… until the moment of delivery, the moment when everyone expects a beautiful, normal, well-developed fetus to be delivered as a beautiful, healthy, well-developed new baby. Only …

… only it isn’t.

It isn’t beautiful. It isn’t normal. It isn’t well-developed.

The wonderful expectation is a flaccid, blue, non-responsive handful of tissue that appears, for all intents and purposes, as if it was intended for something, anything, other than the beautiful life for which it was anticipated. It looks bloated. It looks lifeless. It looks almost other-worldly in its exposure to life outside of the womb.

The neonatal team, fully ready, is nonetheless aghast. This is not the delightful new entry into the world that was expected. This is trauma. This is drama. This is a potentially horrific outcome to a marvelous prospect.

The lifeless form is handed over from the obstetric surgical team to the awaiting neonatal resuscitation crew. Drying. Bagging. Intubating. Chest percussions and every life-inducing mechanism are begun. The lifeless form remains lifeless.

One minute. Two minutes. Five. And more.

The form looks abnormal, but the abnormalities are indescript. There is normalcy amidst gross abnormality. There is life despite blatant lifelessness. There is something that calls the team to heroic measures despite protocols that call for cessation of all heroism.

The team persists.

And, thank God, the team prevails.

Spontaneous breaths are induced. Heart sounds begin where no heart sounds had been. Movement and facial expressions show that life has emerged where no life had once been. Stabilization ensues.

The nearest tertiary care neonatal center mobile team arrives via life flight and begins its superb “assess, address, and de-stress” routine. They load the non-diagnosed, non-normal , non-categorizable newborn into a now-safe haven of neonatal nurturing in their life flight-enabled neonatal incubator. They roll out, fly off, and proceed to care for this newborn child that only moments ago was a mass of nondescript protoplasm incapable of independent life.

Fast forward eight years. Standing in a coffee shop queue. A beautiful woman approaches, an amazing smile upon her lips. She greets you with the warmth of a thousand suns as she proclaims, out loud and to no one in particular, that you are the one who saved her child’s life. Her child. The now-diagnosed “gifted” wunderkind of third grade. The remarkably abnormal, normal girl who astonishes her teachers on a daily basis.

Think back. Did you document every moment? Did you record for an auditor who may never come the minute details of the indescribable moments of non-life before life? Did you capture the essential details that would allow for appropriate upcoding and enhanced reimbursement? Did you ensure transition of care documentation? Did you check off all the bullet points that insurance company column-and-row counters seek? Did you show Meaningful Use via “meaningful” digital documentation detail?

Seriously … does any of that matter when this mother stands before you with her look of indescribable gratitude?

From the trenches…

“Do not let your grand ambitions stand in the way of small but meaningful accomplishments.” – Bryant H. McGill

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 9/16/14

Top News

IT, consulting, and outsourcing services firm Cognizant agrees to acquire TriZetto, a developer and licensor of IT services for healthcare providers and payers, for $2.7 billion in cash. The deal will create a combined company with over $3 billion in revenue from its healthcare operations. Cognizant posted a total revenue of $8.8 billion in 2013.

HIStalk Practice Announcements and Requests

HIStalk sponsors, don’t miss out on the chance to be a part of our annual MGMA “Must-See Exhibitors Guide.” Fill out this brief form by September 30 to ensure a spot in the digital guide. I’ll also include contact information for companies not exhibiting but looking to schedule one-on-one meetings. I’ll be reporting from the exhibit hall, plus as many great after-show networking events as I can squeeze in. Hopefully, I’ll also find time to sneak away to marvel at the most decadent chocolate fountain on the Strip.

Webinars

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 an 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 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. Business intelligence capabilities are becoming critical for healthcare organizations as ACOs and population health management initiatives evolve in the new healthcare marketplace. The presenters will explain how BI maturity models can help optimize clinical, financial, and operational decisions, and how organizations can measure and mature their analytics capabilities.

September 26 (Friday) 1:00 ET. Data Governance – Why You Can’t Put It Off. Presented by Encore, A Quintiles Company. Presenters: Steve Morgan, MD, SVP for IT and data analytics and CMIO, Carilion Clinic; Randy Thomas, associate partner, Encore, A Quintiles Company. In this second webinar in the “It’s All About the Data” series, the presenters will review the pressing need for data governance and smart strategies for implementing it using strained resources.

Announcements and Implementations

Pacific Medical Data Solutions launches a comprehensive revenue cycle management service to help physicians streamline front and back office billing practices, and medical coding.

New Jersey Physicians ACO selects the eClinicalWorks Care Coordination Medical Record for population health management. Founding ACO member Vinod Sancheti, MD noted that the eCW solution was chosen in part for its strong track record with primary care-focused ACOs.

Amazing Charts parent company Pri-Med releases the InLight EHR, featuring a Watson-like technology that enables the EHR to learn from its users, and then organize and offer information in a manner that best suits physician workflow.

NextServices and Quantta partner to offer new mobile and Web enterprise solutions for multispecialty groups, ambulatory surgery centers, and hospitals; data-oriented apps for remote healthcare delivery; and integration of Quantta’s analytics services into NextServices’ enki EHR.

Government and Politics

The App Association and a consortium of startups including CareSync, AngelMD, and AirStrip send a letter to Representative Tom Marino (R-PA) expressing frustration with HHS over the lack of developer-friendly online resources related to HIPAA privacy rules. Some developers are apparently relying on government information last updated in 2006, well before the release of the iPhone and other mobile devices. The group also asked that HHS provide better guidance on how health data can be stored in the cloud.

New Zealand announces it will invest US$2.5 million in a nationwide initiative to encourage patient portal adoption amongst physician practices. The portals, currently used by 35,000 New Zealanders, are part of that country’s eHealth vision that aims to introduce e-prescribing, care plans, and a clinical data repository of patient information in 2014. For perspective, New Zealand is home to 4 million residents, while the U.S. is home to over 317 million.

National Health IT Week enters its second day of festivities. The ONC Consumer Health IT Summit kicked things off in Washington, D.C., yesterday, highlighting such themes as the Blue Button initiative, and policies and programs fostering patient and consumer engagement. You can view the official agenda for the rest of the week here.

People

Alan Santos is promoted to CEO of Pyramid Healthcare Solutions, and Manoj Malhotra (Salient Business Solutions) is appointed chairman of the company’s board.

James Prowant (Lehigh Valley Physician Group) joins the Mount Nittany Physician Group (PA) as COO.

Andrew Ferrier is appointed chairman of Orion Health.

Media outlets report that Lana Moriarty (HRSA) joins ONC as acting director for consumer e-health. Apparently one of her first duties as a digital consumer healthcare advocate was to create a Twitter account, just in time for National Health IT Week festivities. ONC continues to look for a permanent director. Check out this job listing to see if you qualify.

Research and Innovation

Tute Genomics launches MyGene, a cloud-based  patient results portal that enables healthcare organizations to share validated clinical genetics findings directly with patients. The technology may help primary care physicians overcome their hesitancy to incorporate genetics services into their care routines, among other barriers to adoption noted in new research. They include insufficient knowledge and competence related to genetic medicine, lack of knowledge about genetic risk assessment, concern for patient anxiety, a lack of access to genetics, and a lack of time. I have to assume that physicians already having trouble coming to grips with EHRs may not jump on the genomics portal bandwagon.

Global Kinetics Corp. receives FDA clearance for its wearable that helps detect Parkinson’s disease symptoms. The wrist-worn Personal KinetiGraph also offers medication reminders, and creates automated reports that neurologists and other caregivers can use to identify signs of neurological disorders.

The 2014 Survey of America’s Physicians finds that 85 percent of physicians surveyed have adopted EHRs, up from 69 percent in 2012. However, 46 percent indicate the technology has detracted from their efficiency, and just 24 percent say it has improved their efficiency. The survey findings tie into the American Medical Association’s call for an overhaul of the EHR, particularly as it relates to usability and higher-quality patient care. I’d love to hear how these results correlate with the experience of HIStalk Practice readers who are working “in the trenches,” as Dr. Gregg likes to say. Let me know if you’re interested in sharing your take with our audience.

Other 

Azalea Health donates its EHR software, services, and training to a dozen rural school clinics in Coffee County, Georgia. The donation is part of its commitment to the Rural School-Based Telehealth Center Initiative.

Pediatrician Charles McCormick, MD makes an interesting comparison between EHRs and the No Child Left Behind program:

“The use of templates is what makes an EMR so much like the public school use of No Child Left Behind, where children were taught to memorize information that would later appear on a test rather than teaching children how to think independently. As a physician, I do not want my thinking to be limited in any possible way by a template that I need to fill out in order to create a note. Every patient is different, and not a single one of us fits into the same box. We are, unfortunately, dumbing down medical care providers just like we dumbed down our teachers.”

Central Utah Clinic notifies 31,677 patients that one of its servers was “compromised” by unauthorized intruders in June. The server held some patient information, and a subset of written imaging and radiology reports dating back to 2010 and earlier. There has so far been no indication that patient information was stolen.

Doximity partners with U.S. News & World Report to offer the online Residency Navigator tool to help fourth-year medical students objectively assess residency programs. The tool ranks top programs based on physician survey results, and sub-specialization and board-pass rates, among other data points.

Sponsor Updates

• PerfectServe will discuss methods for improving healthcare at four leading industry events this fall.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

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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