Special Topics in Vendor-Specific Systems

1. Special Topics in Vendor-Specific Systems Unit 1: Common Commercial Electronic Health Record (EHR) Systems This material (Comp14_Unit1) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003. This material was updated by Columbia University under Award Number 90WT0004. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

2. Common Commercial Electronic Health Record (EHR) Systems Learning Objectives • Objective 1: Describe the mission and vision of HIMSS and KLAS and how their respective resources can be used to research EHR systems • Objective 2: Describe common and distinguishing features of common EHR systems

3. Healthcare Information and Management Systems Society (HIMSS) • Comprehensive health care stakeholder membership organization • Global leadership for optimal use of information technology (IT) and management systems for health care • Educational, professional development, and advocacy initiatives • Promotes information and management systems’ contributions to ensuring quality patient care

4. HIMSS • Founded in 1961 • Offices in Chicago, Washington D.C., Brussels, Singapore, and other U.S. locations • 52,000 individual members, of which more than 2/3 work in health care provider, governmental, and not-for-profit organizations • 600 corporate members and 250 not-for-profit organizations

5. HIMSS (Cont’d – 1) • Vision • Advance the best use of information and management systems for the betterment of health care • Mission • To lead health care transformation through the effective use of health information technology

6. HIMSS “products” • Extensive collection of industry research reports • IT news • Topics and tools • E.g. Tools for EHR professionals • Materials about factors and trends in the use of EHR • Note: Given the mixed membership (providers and vendors), you will not find vendor comparisons and product reviews

7. KLAS: quick facts 1.1 Figure (Sideli, R., 2012)

8. KLAS • Mission • To improve health care technology delivery by honestly, accurately, and impartially measuring vendor performance for provider partners • What they do • Help health care providers make informed technology decisions by reporting accurate, honest, and impartial vendor performance

9. KLAS: how they do it 1.2 Figure (Sideli, R., 2012)

10. How providers use KLAS findings • Understand products’ and vendors’ strengths andweaknesses • Screen prospective vendors • Create influential proposals with KLAS research that supports your buying decision • Manage risk and exposure: be informed on price, contract issues, and common complaints • Set realistic expectations for your organization and your vendor • Save research time and money

11. KLAS research focus • Software • Ratings for making the best possible purchasing and negotiating decisions (since 1997) • Services firms • Reports on services markets including implementation, planning and assessment, vendor selection, technical consulting, IT outsourcing, and business process outsourcing (since 2004) • Medical equipment • Gathering research on medical equipment, including CR / DR and MRI scanners (since 2005)

12. KLAS methodology • How overall performance rating is calculated with software: • Scores for 25 questions • Rating scale of 1 to 9 (1 = poor and 9 = excellent) and “yes” or “no” • Each question weighted equally • Total score is based on 100-point scale

13. KLAS methodology (Cont’d – 1) • Questions allow health care providers to rate the product / vendor in the areas of: • Sales and contracting • Implementation and training • Functionality and upgrades • Service and support • General

14. KLAScriteria in evaluations • Contracting experience • Product works as promoted • Money’s worth • Avoids nickel and diming • Quality of implementation • Implementation on time • Quality of training • Overall product quality • Delivery of new technology • Ease of use • Product response time • Supports integration goals • Product has needed functionality • Quality of phone / web support • Proactive service • Executive involvement • Lives up to expectations • Keeps promises • Part of long term plans • Overall communication • Recommend to peer / friend • Overall satisfaction • Forecasted overall satisfaction • Would you buy again • Ranked client’s best vendor

15. KLAS ratings for acute care EHR • Software products that provide core inpatient functionality: • Clinical data repository (CDR) • Order entry including computerized provider order entry (CPOE) • Results reporting • Clinical charting and documentation • Large: over 200 beds • Small: 200 or less beds

16. 2015 to 2016 EHR product rating: over 200 beds 1.1 Table (Sideli, R., 2012)

17. 2015 to 2016 EHR product rating: under 200 beds 1.2 Table (Sideli, R., 2012)

18. KLAS ratings • Ambulatory EHRs • Software solutions for clinic and practice management, providing charting, orders, prescriptions, and / or EHR functionality • Divisions of physician organization • Over 100 physicians • 26-100 physicians • 6-25 physicians • 2-5 physicians • 1 physician

19. Top 10 ambulatory EHR: over 100 physicians 1.3 Table (Sideli, R., 2012)

20. Top 10 ambulatory EHR: 26 – 100 physicians 1.4 Table (Sideli, R., 2012)

21. Top 10 ambulatory EHR: 6 – 26 physicians 1.5 Table (Sideli, R., 2012)

22. Summary of inpatient vendors • Epic • Cerner • Allscripts • MEDITECH • Evident

23. Epic • http://www.epic.com • Software for mid-size and large medical groups, hospitals, and integrated health care organizations • Customers: • Community hospitals • Academic facilities • Children’s organizations • Safety net providers • Multi-hospital systems • Spans clinical, access, and revenue functions and extends into the home

24. Epic: company highlights • On-time, on-budget track record is one of the best in health care • Quick to implement and easy to use • Information shared in two ways: • Care Everywhere (doctor controls flow of data) • Lucy PHR (patients control their own health information) • Develop, install, and support all applications in-house • Leadership team includes clinicians, developers, and process experts

25. Epic: details • Founded in 1979 • Private and employee-owned • 190 customers • 150,000 physicians (1 in 4 U.S. physicians)

26. Cerner • http://www.cerner.com • Global supplier of health care solutions • Makes sure the right people have the right information at the right time • Founded 1979 (Neal Patterson, Cliff Illig, Paul Gorup) • Create a new generation of intelligent medical devices • Leverage clinical and pharmaceutical data for new discoveries • Collaborate with employers to eliminate administrative waste and friction

27. Cerner (Cont’d) • 21,000 associates worldwide • Cerner solutions are licensed at more than 20,000 facilities in more than 30 countries • 2014 revenues: $3.4 billion • 2014 net earnings: $525.4 million • Ticker symbol: CERN - NASDAQ

28. Allscripts • http://www.allscripts.com • More than 7,000 employees • 20 locations worldwide • 2015 revenues: $1.4 billion • Ticker symbol: MDRX - NASDAQ

29. Allscripts: clients • 180,000 physicians • 45,000 physician offices • 2,500 hospitals • 19,000 post-acute facilities • 100,000 electronic prescribing physicians • 40,000 in-home clinicians

30. Allscripts: products • Full suite of health solutions: • Offers health care providers, payers, and life sciences companies globally a complete portfolio of clinical, financial, population health management, transaction and managed IT services, as well as other solutions

31. Allscripts: history • History: • 1986: founded • 2008: merged with the health care systems operations of Misys • 2010: Allscripts-Misys merged with Eclipsys • March 2013: Allscripts acquired dbMotion, Ltd., a supplier of community health solutions and Jardogs LLC, a patient engagement solution provider

32. Meditech • Mission statement: • To provide software that enables physicians, nurses, and other clinicians to orchestrate and deliver patient care in a safe, effective, and efficient manner. Our software is integrated in a manner that fully optimizes the financial and business potential of the health care enterprise • Information is available whenever and wherever clinicians need it • Ensure access to a full electronic record with data from across the continuum

33. Meditech (Cont’d – 1) • http://www.meditech.com/ • Over 40 years developing, installing, and supportinghealth care information systems • Founded in 1969 by the developers of MUMPS • A. Neil Pappalardo and Curt W. Marble developed MUMPS technology on a DEC PDP at Mass General Hospital from 1964 to 1968 • Markets: United States, Canada, United Kingdom, Ireland, South Africa, Latin America, Mexico, Spain • 2,200 customers worldwide • 4000 staff members • Revenue (2011): $545.2 million • Privately-held

34. Evident • http://www.evident.com/ • Since 1979, as CPSI, developing, installing, and supporting health care information systems for rural communities • CPSI is a leading provider of health care information / EHR solutions for community hospitals • http://www.cpsinet.com

35. Evident (Cont’d – 1) • Over 1,400 technical, health care, medical, and business professionals provide system implementation and continuing support services as part of a comprehensive program • Software solutions: • Evident Community HIS • Evident Patient Care / Clinicals • Evident Patient Management

36. Unit 1: Common Commercial Electronic Health Record (EHR) Systems, Summary • HIMSS is a valuable starting resource to acquire detailed information about features and functions of EHR technology • KLAS is resource that can be used to assist with selecting a specific EHR system • There is wide variation in the corporate history and product offering of commercial EHR system vendors

37. Common Commercial Electronic Health Record (EHR) Systems References References Allscripts. Retrieved March 28, 2016 from http://www.allscripts.com Cerner. Retrieved March 28, 2016 from http://www.cerner.com/ Epic Systems. Retrieved March 28, 2016, from http://www.epic.com/ HIMSS. Retrieved March 28, 2016 from http://www.himss.org/ KLAS. Retrieved March 28, 2016 from http://www.klasresearch.com/ Meditech. Retrieved March 28, 2016 from http://www.meditech.com/

38. Common Commercial Electronic Health Record (EHR) Systems References (Cont’d – 1) Chart, Tables and Figures 1.1 Table: Sideli, R. (2012). Top 10 acute care EHR: over 200 beds. Department of Biomedical Informatics, Columbia University Medical Center. 1.2 Table: Sideli, R. (2012). Top 10 acute care EHR: under 200 beds. Department of Biomedical Informatics, Columbia University Medical Center. 1.3 Table: Sideli, R. (2012). Top 10 Ambulatory EHR: over 100 physicians. Department of Biomedical Informatics, Columbia University Medical Center. 1.4 Table: Sideli, R. (2012). Top 10 ambulatory EHR: 26 – 100 physicians. Department of Biomedical Informatics, Columbia University Medical Center. 1.5 Table: Sideli, R. (2012). Top 10 ambulatory EHR: 6 - 26 physicians. Department of Biomedical Informatics, Columbia University Medical Center.

39. Unit 1: Common Commercial Electronic Health Record (EHR) Systems This material (Comp 14 Unit 1) was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000013. This material was updated in 2016 by Columbia University under Award Number 90WT0005.