The expectation, supported by the experience of other Medsphere customers, is that 319-bed Cooper Green will receive substantially more in federal reimbursement than Jefferson County’s initial five-year costs to acquire the system. Alabama’s largest county has faced significant financial challenges in recent years, making the improvement of both patient care and financial performance crucially important.

“What Cooper Green Hospital is accomplishing in the face of Jefferson County’s extreme budgetary challenges is nothing short of remarkable,” said Medsphere President and CEO Irv Lichtenwald. “Hospital CEO Dr. Sandral Hullett and county leaders should be commended for improving patient care without adding to budgetary shortfalls. The successful implementation of the OpenVista EHR at Cooper Green is a compelling example of responsible decision-making. Especially in these troubled economic times, public hospitals can still improve care without making financial matters worse for local government.”

Cooper Green selected the OpenVista EHR and Stockell Healthcare’s Insight CS financial and patient accounting solution as a replacement for Meditech. In addition to the ability to cover their initial five-year health IT costs through federal reimbursement, the hospital also looks forward to more financially manageable operating expenses as all upgrades, enhancements and support are included in Medsphere’s subscription-based pricing model.

“I want to express my deep gratitude to Cooper Green clinicians and staff for the hard work they’ve put in on our OpenVista implementation project. They’ve really embraced the change, which is essential to making the system work,” said Dr. Hullett. “These are tough times in Jefferson County, and we feel fortunate that we were able to implement a comprehensive EHR without paying multimillions of dollars. Honestly, we could not have done that, so the OpenVista EHR was both timely and welcome.”

In partnership with Medsphere, Cooper Green will soon begin using OpenVista to closely track Meaningful Use requirements such as use of Computerized Provider Order Entry (CPOE) for medication orders, drug-drug and drug-allergy interactions, and electronic prescribing. Medsphere and Cooper Green collaborated during implementation and training on workflow process redesign, which will continue to ensure improved clinical efficiency and Meaningful Use success.

As providers continue to seek ways to do more with fewer resources, the limited hardware expenses, ease of use, and growing confidence in cloud storage continue to make Software as a Service (SaaS) solutions more enticing. The recent KLAS SaaS EMR 2012: Is It For You? report discusses the performance of SaaS EMR products from vendors such as AdvancedMD, athenahealth, Bizmatics, CureMD, MedPlus/Quest Diagnostics, MIE, OptumInsight, Practice Fusion, Sevocity, and Waiting Room Solutions.

Research director and report author Erik Bermudez said, “The SaaS EMR deployment model is becoming more popular for providers who want minimal up-front cost and prefer to give the responsibility of the care and feeding of the software to the vendor. Luckily for providers, there are plenty of good options.”

KLAS spoke with nearly 300 healthcare providers that are currently using SaaS EMR to better understand which vendors offer the most comprehensive solution. Providers identified four key areas that differentiated the vendors: EMR response time, customer support, product quality, and bang for the buck.

EMR response time compared to overall performance score

The KLAS SaaS EMR 2012: Is It For You? report is available to healthcare providers online for a significant discount. Both healthcare providers and vendors can visit  www.KLASresearch.com/KLASreports to purchase the report. KLAS members can learn more about the SaaS ambulatory EMR products by logging in to their account at www.KLASresearch.com. Providers can share their experiences with SaaS solutions confidentially online with KLAS at www.KLASresearch.com/eval.

SOURCE:  KLAS

“Meaningful Use is the basis for health information exchange in the U.S. and will become the core workflow for physicians,” said Jeff Surges, CEO of Merge Healthcare. ”With the recently proposed Stage 2 requirements that focus heavily on the viewing of diagnostic images, it’s clear that specialties like radiology and orthopaedics are very much so included in Meaningful Use. Now is the time for specialty physicians to adopt a Meaningful Use strategy so they can qualify for Stage 1 funding, while preparing for Stage 2.”

“While there are financial reasons to focus on Meaningful Use, the driver for us is that it is going to build a foundation upon which we can provide even better care to our patients,” said Ellis Keitt, Administrator, Radiology Associates, LLP. ”With Merge RIS™, we are going to be able to collect and share valuable information, automatically trend clinical data and report on MU measures.”

Merge RIS v7.0 provides a radiology-specific EHR with complete certification that enables radiologists to capture and report on the metrics required to demonstrate Meaningful Use of electronic health records, without disrupting their traditional workflow. With Merge RIS v7.0, radiologists can qualify to receive up to $44,000 in stimulus incentives, per eligible provider, and more importantly, avoid future penalties that will come from not meeting Meaningful Use.

Merge RIS v7.0 functionality includes ePrescribing, enhanced reporting that enables physicians to automatically trend clinical data and report on Meaningful Use measures, new clinical decision support, the clinical exchange of health information through industry standard formats, and a patient portal that empowers patients to access their records at their convenience. This new functionality was built natively within the intuitive, web-based Merge RIS so that any radiology practice can achieve Meaningful Use attestation in a manner that works for their specialty.

“With Merge OrthoEMR™ we can meet Meaningful Use criteria and earn stimulus incentives,” said Vickie Shuler, Clinic Administrator, Western Carolina Orthopaedic Specialists. “Using Merge OrthoEMR also means we’ll avoid financial penalties that are coming to those not using MU-certified solutions. The most important aspect of Merge OrthoEMR for us is that it will help us provide better care, streamline our workflow and improve operational efficiencies.”

Merge OrthoEMR has received complete EHR Ambulatory certification and provides orthopaedic physicians the tools needed to achieve Meaningful Use and qualify for incentive funds. By providing instant access to images at all locations, Merge’s OrthoEMR eliminates the need for transporting images, improves workflow and speeds patient care.

In addition to Merge OrthoEMR, Merge provides an integrated suite of products developed for the specific needs of the orthopaedic practice, from patient information to image management including digital templating. Developed by orthopaedic specialists, our systems and tools mirror charting and patient care today, increasing the long-term adoptability and satisfaction of users. Plus, with imaging and data sharing they promote interoperability, without forcing conformance to non-specialty hospital-based solutions.

“We appreciate the emphasis that the 2014 Edition places on interoperability, patient engagement and flexibility with respect to product composition,” said Karen M. Bell, MD, MMS, chair, CCHIT. “It has always been CCHIT’s intent and belief that certification programs should be designed to ‘raise the bar’ with each iteration and we are pleased to see that ONC also is moving in that direction.”

“Our comments and recommendations are based on a thorough, collaborative review of the proposed rule by our Commissioners and staff, all of whom have long experience in the field of HIT,” Bell said. “We believe that CCHIT’s experience as an Office of the National Coordinator Authorized Testing and Certification Body (ONC-ATCB), as well as our nearly eight-year history of developing criteria and testing tools in our independently developed electronic health record certification programs, can provide valuable insight as ONC moves forward with its program.”

The full set of comments and recommendations can be found here.  (PDF File)

The Electronic Health Records (EHR) Association today submitted its detailed comments on the two Notices of Proposed Rule-Making (NPRMs) on Meaningful Use Stage 2 – one from the Centers for Medicare and Medicaid Services (CMS) for healthcare providers laying out revised Meaningful Use objectives and measures for use of certified electronic health records (EHRs); and the second from the Office of the National Coordinator for Health IT (ONC) on EHR certification criteria and Standards related to Stage 2.

“This was truly a collaborative effort that engaged more of our members than any of the previous public comment opportunities,” said Leigh Burchell, Vice President of Government Affairs for Allscripts and Chair of the Association’s Public Policy Leadership Workgroup. “Seven of our eight standing workgroups focused on specific sections of the NPRMs, ultimately collecting feedback from 138 individuals representing 25 member companies. We’re delighted with the level of participation, which represents the majority of operational EHRs in the US and, most importantly, their users, lending credibility and weight to these comments.”

The Association provided many specific recommendations on proposed certification criteria and standards as well as on Stage 2 meaningful use requirements for providers. It praises CMS’ confirmation of a one-year delay in the start of Stage 2 in order to allow more time for development, testing and implementation of EHRs updated for Stage 2, which had been requested by a wide variety of stakeholder organizations.

The EHR Association represents a community of software developers with many decades of experience creating successful electronic health records and related modules. Their collaborative response to the NPRMs is intended to provide input from both EHR companies and their customers based on this unparalleled experience. Comments and suggestions sent to ONC and CMS represent the consensus of companies that bring many points of view, including small ambulatory systems to large enterprise systems, software-as-a service models to traditional software, and software module suppliers.

“Through our comments, we try to highlight many of the initiatives from ONC and CMS that we agree with and offer our comments on how to fine tune other areas for best adoption by our users,” added Carl Dvorak, Vice President at Epic and Chair of the EHR Association.

The Daybreak Venture management team including Mike Rich (CEO), Mike Wallace (CFO/CIO), and Larry Snow (Director of Clinical Services) has worked to improve the organization over the last five years, making it a contemporary long-term care leader. Daybreak Venture selected Matrix to help manage changes in the eldercare climate, which include falling reimbursement rates and ever-changing regulatory rules. They also selected Matrix because its delivery model improves clinical workflow and provides increased oversight through better management tools.

“In the current climate of reimbursement challenges, it was imperative that we found a solution that optimized reimbursement and also improved quality of care,” said Mike Rich. “After several discussions and demonstrations with MDI Achieve, we know that Matrix is that solution and we look forward to realizing business efficiencies and utilizing the system to help keep our business competitive.”

Daybreak Venture used MDI Achieve’s QuickCare product for many years before deciding to move to the Matrix EHR platform. “We have had a productive relationship with MDI Achieve and look forward to continuing it for many years to come,” said Mike Wallace. “The innovative tools on the Matrix EHR platform ensure that we will provide the best quality of care to our residents.”

“We are enthusiastic that Daybreak Venture is continuing their relationship with us,” notes Dennis Jakubowicz, Senior Vice President of Sales for MDI Achieve. “By moving forward with the Matrix, the organization will be recognized as an innovative thought leader in not just the state of Texas, but all across the country.”

Daybreak Venture, headquartered in Denton, Texas, will implement the Matrix EHR platform in over 60 facilities across the state of Texas.

Matthew Swindells, Chair of BCS Health explains: “We’re delighted to be working with HIMSS Analytics Europe on this project. We believe information and technology are crucial to the challenge of transforming our healthcare service. The HIMSS Analytics EMRAM model will enable hospitals to measure their progress in the implementation of health IT and benchmark themselves against the rest of the NHS and internationally. This is particularly important as the NHS moves from the top down direction of NHS Connecting for Health to local decision making.  As the Chartered Institute for IT, we believe that through the expertise of our members and partnerships such as this one, we can help support and enable the NHS to deal with the challenges and changes that it is experiencing as it embraces information technology.”

BCS will work with HIMSS Analytics Europe and a number of leading organisations to test the EMRAM model for suitability in the UK and assist with any modifications that are required. A number of hospitals, covering the acute and mental health sectors are being recruited to assist. BCS Health and HIMSS Analytics Europe are establishing a steering committee to ensure the smooth running of the project. It consists of key health informatics and healthcare professionals including: Luke Readman, CIO at Wirral University Teaching Hospital FT, Peter Dyke from the Department of Health, Jon Lindberg from Intellect, Professor Iain Carpenter from the Royal College of Physicians and Kathy Mason.

Mr Readman said, “I am pleased to support BCS and HIMSS Analytics in their efforts to bring EMRAM into the UK.  As the CIO for a hospital that has made great efforts to digitise healthcare over many years, I look forward to the opportunity to measure our progress against an external benchmark and am confident that this will inspire us to try even harder to be one of the best in Europe.”

H. Stephen Lieber, President and CEO, HIMSS adds: “The EMR Adoption Model and its underlying database provide healthcare organisations, governments, and other decision makers with critical information about the adoption and use of information technology. Globally, we find a significant correlation between stages of IT adoption and improvement in patient care metrics; through this project we will bring new knowledge to the table in support of continuous patient care improvement in the UK.”

Currently, HIMSS Analytics collects data from hospitals and other healthcare delivery organisations 25 countries worldwide. EMRAM is an eight stage model (Stages 0 to 7) which classifies an institution’s level of IT adoption. Thus far, 68 Stage 7 hospitals have been identified globally. A Stage 7 is a full digitised, virtually paperless environment with a broad range of interoperability and data exchange capabilities with other organisations.

The company also announced that both the Chief Financial Officer and the Chairman of the board are resigning.

The stock closed yesterday, before the announcement, at $16.02.  It opened this morning at $9.44 – a drop of nearly 42%.

Earnings estimates are currently being slashed by brokerage houses.  Here’s a sampling of  new stock price targets  and comments (via thestreet.com)

• Credit Suisse – Reduced it’s price target to $8.00 per share saying the company is facing higher integration challenges
• UBS – Reduced its price target to $10.00 per sharing saying that bookings, revenue and EPS (earnings per share) all missed
• Jeffries – Reduced its price target to $10.50 saying Poor operating results and weak bookings
• William Blair – Stock Downgraded -with the comment “Company is currently in disarray”
• Piper Jaffray – Downgraded, new price target $11.00 saying Company cut guidance and lost several executives

This does cause one to wonder  – Is this an Allscripts specific problem tied to recent mergers  or should we expect to see disappointing results from other EHR companies?

You can read the earnings report here.

Image By Mykl Roventine

“Ellen thrives on creating and packaging solutions to challenging market dynamics,” said Deborah M. Gage, president and CEO of MEDecision. “In a room full of clinicians, technologists, marketers and salespeople, she brings people and ideas together, developing and executing on real opportunities to drive the business forward. We are so fortunate to be able to count on her as a permanent addition to our team.”

Donahue-Dalton is actively involved in the healthcare arena, and has partnered with global, national, and emerging healthcare service and technology organizations to help define, segment, and penetrate markets, as well as build and deploy leading products. Prior to joining MEDecision, Donahue-Dalton founded and led the Dalton Marketing Group, where she served as a consultant and coach to high-growth organizations in verticals including healthcare, manufacturing, security and entertainment.

A passionate supporter of innovation through entrepreneurialism, Donahue-Dalton has served on the board of Social Venture Partners – RI, a state affiliate of an international organization that helps non-profits grow revenue- and job-producing businesses. She continues to coach social entrepreneurs who are building world-changing businesses. Donahue-Dalton holds a B.S. from Dickinson College, an M.S. from Boston University, and has done post-graduate work at the Wharton School of the University of Pennsylvania.

“The physician segment will likely drive growth and it’s the part of the market where new entrants can realistically stake a claim,” said Bruce Carlson, publisher of Kalorama Information. “It takes infrastructure and legacy relationships to support hospital conversion.”

The revenue growth occurs at the same time as increased physician usage. Statistics from the National Ambulatory Medical Care Survey (NAMCS) indicate that 56.9% of office-based physicians used partial or full EMR systems in 2011, an increase from 2010. More than $1.3 billion in Medicare EHR Incentive Program payments were made between May 2011 and the end of December 2011, and more than $1.1 billion in Medicaid EHR Incentive Program payments have been made between January 2011 and the end of December 2011. Incentives have played a role in convincing doctors to convert to electronic documentation.

There are large competitors who sell to physician offices, according to Kalorama information, including GE Healthcare, Cerner, Allscripts Healthcare Solutions, Epic, and McKesson. These firms compete along with EMR specialists such as eClinicalWorks, E-MD, NextGen and Practice Fusion. Many of these companies have already established a presence and recognition, if not domination of the market.

“Some of these smaller companies have been branding for years and dominating Google searches, so even in the physician and web-based EMR market there will be some challenge for startups to launch,” said Carlson. “It’s likely that a new entrant would need to find a niche or better address usability issues.”

In its full report, EMR 2012: The Market for Electronic Medical Records, Kalorama Information breaks out the market for large hospital EMR sales, as well as for physician and web-based sales. It also profiles large and medium-sized players in the market, and offers market share and important trends that could change growth estimates.