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HIT Trends Summary for July 2011

Specialty EMRs. There is a market for EMRs that specialize by practice type.  This month, the ophthalmologists tell us what’s required to help them.  They have specialized vital signs, testing and measurement devices.  It is likely all specialties would benefit if EMRs get more specialty-specific.  Some specialty EMR solutions have found a successful niche markets in cardiology, oncology and other segments.  This could be another.

Medscape reports that AAFP’s smaller practice members like EMRs that focus on them.  This report is focused on user satisfaction.  The combination of easy-to-use software and physician involvement is leading to high satisfaction with products from vendors focused on small practices.  And yet, we have also heard from prior KLAS reports that many practices (30%) are abandoning current vendors for market leaders.

A national study also reports that smaller practices are interested in new care models, but may lag implementation because they tend to underutilize needed technology.  The study included 1,344 practices with fewer than 20 physicians each.  The EMR is central to success of emerging collaborative and more accountable care models.  Using registries to help manage patient populations is a core element as is medication management through e-prescribing.   This study confirms that it will take a while for smaller practices to get the utilization required to be effective in the new model.

And MGMA confirms in its annual survey that its members are concerned for the first time about getting ready for the new care models. Planning for risk, incentives, higher costs, ACOs and quality are all new this year.

New care models. There are two reports out this month about HIT and new models for care.  MGMA reports that 70% of its members are interested and are already working on patient-centered medical home projects.  Much of the work includes integrating appropriate HIT tools into the process.  This is additional evidence that providers support transitioning to a new care model and how important HIT is to the move.

Also this month, AHIMA released its thinking on ACOs and HIT and the impact on the changing role of health information management professionals as the patient record moves to electronic.  The report also highlights the changing nature of the HIM role and the concept of the patient record.  This group of professionals has a unique history of running medical records organizations and an appreciation for the challenges around management of patient clinical records.

There is also a report this month that Essence Group Healthcare is combining managed care services with HIT expertise and raising money to compete in this segment to compete with the health plans.  Essence is raising additional money to scale its St. Louis project into other ACO environments.  This model of managed care services combined with health IT, particularly cloud-based services is an emerging bundle.  Large insurers like Aetna, United and Humana are creating products.  Access Health Solutions, in northern CA, is another leading edge solution.  TriZetto also recently announced a new payment bundling solution to help customers create these kinds of services.

Playing games. Games and social media on mobile platforms characterize the new thinking about how to get individuals to engage in their own health.  Healthseeker is a new mobile platform for diabetes that embraces this idea.  It is a nice example of a growing trend toward gamification and social media as key ingredients in mobile consumer health engagement.  In this game you take on missions, like eating veggies, and get achievements, like collectable badges.  Friends add kudos as positive reinforcement.

Humana reports it is integrating gaming ideas with real-world incentives in its JV with Discovery, called HumanaVitality.  This service was validated in a 2010 study from the American Journal of Health Promotion with shorter and fewer hospital stays.  Discovery has been operating for 10 years in the international health market.  The service isn’t yet mobile and there aren’t yet social networking elements.

And Dossia, the employer PHR, announces it will implement more modern gaming and social networking tools into its solutions.  Dossia is moving toward more modern tools to better utilize its PHR platform on behalf of its large employer sponsors.  It adopts virtual visits, like American Well or Hello Health.  And it embraces social games, like Keas or Healthseeker. These are continuing trends.

Innovations. Two innovations seem particularly noteworthy this month.  Mayo and IBM announce a breakthrough in natural language processing allowing deconstruction and analysis of any EMR, irrespective of vendor and file format.  This could be a significant breakthrough in natural language processing.  The ability to pull together records from different EMRs for analysis has been on the wish list for HIT researchers for a long time.  In this release, Mayo announces it is close to a solution working with IBM.

And Proteus got its patent and demonstrated that its ingestible intelligent pills work for adherence. The study confirmed the system performed as expected and was safe and effective in capturing adherence information. The company is working with Novartis, Medtronic and others.  

Art of HIT. This art this month is an untitled piece by SF street artist Chris Johanson.  It seems we are all connected through our social networks which play an important role in engaging in our own health.  And we like to play when we do.

Michael Lake has been a healthcare technology strategist for over 30 years.  He is President of Circle Square Inc., a San Francisco-based strategy, business development and market research firm, focused exclusively on the healthcare information technology market. The company works with healthcare, life sciences and technology companies on developing strategies, products and business models for complex multi-stakeholder healthcare environments.  He publishes the HIT Trends report monthly and the CHaT Trends report quarterly.  For more information, please see www.circlesquareinc.com.

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Is it really news that there are radically different needs among the varying medical specialties for EMRs? Ophthalmology market is already served pretty well by NextGen who absolutely dominates EMR market share in that specialty with a bunch of specialty specific EMR vendors who serve that market holding their respective pieces of the pie. Best sources of data on this are the respective medical specialty societies but in many cases they either don’t collect the information in a timely and updated manner from their members or simply don’t share it with outsiders. Usually a combination of the two but you… Read more »