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The year of the community

By Lee Shapiro, president, Allscripts Healthcare Solutions

If 2010 was the year of the electronic health

record – a time of adjusting strategies to fi t federal incentives for EHR adoption – then 2011 will be the year of the community. As hospitals and physicians move from considering an EHR to actually implementing one, they’ll confront the problem of connecting their system to the community of providers around them, most of whom will use someone else’s system. In a true healthcare community, information fl ows

securely but freely between providers, enabling them to work as a team, regardless of their setting. Hospitals and physicians are working to build this community by adopting EHRs and leveraging connectivity to build accountable care organizations (ACOs) that reward quality, outcomes and high-value care. This trend will accelerate in 2011 as hospitals continue

to purchase physician practices. Already the owners of 55 percent of American physician practices, in 2011 hospitals

Year of the underdog: Cloud-based EHRs

By John Haughton, M.D., chief medical information officer, Covisint

As the new year dawns, physicians face a daunting list of resolutions: meaningful-use deadlines, e-prescribing incentives and penalties, accountable care organizations (ACOs), medical homes and quality initiatives. While predicting increased electronic health-record (EHR) adoption to address these mandates doesn’t demand a crystal ball, unknowns still persist.

Physicians are still deliberating how to minimize potential negative impacts of traditional EHR deployment, including: 1. Productivity and revenue losses during and after installation;

2. Offi ce disruption from lack of interoperability with existing practice-management systems and limited data exchange; and

3. Negative long-term impact due to inadequate functionality and future costly upgrades and maintenance.

In response, providers will seek alternatives to traditional,

pre-packaged EHRs that roll out with a “big bang” and equally big disruptions. There will be growing interest in

will cement their position as the biggest drivers of change in the environment.

But their vision of integrated healthcare communities will fail if information is bottled up in a closed EHR that cannot connect with third- party systems.

It’s easy to see why health systems want an integrated EHR. Most hospital IT departments manage hundreds of interfaces with enormous complexity. Unfortunately, in 2011 more hospitals

will confront the cost of integrating using a closed EHR system – ripping out and replacing tens of millions of dollars of third-party applications, a gross waste of scarce healthcare resources. Thankfully, there is an alternative. A truly open EHR system not only is more affordable and quicker to adopt than a closed EHR, but it spares hospitals and physicians the expense of a rip-and-replace strategy.

In 2011, the choice will become clear. Closed EHR systems make the problems of American healthcare worse. Open systems initiate the future of connected communities, leading to better, more cost-effective patient care for everyone.

modular EHRs that allow physicians to choose which applications they want and when they want them. Using this incremental approach, physicians can avoid practice-wide disruptions by leveraging existing technology investments, selecting “best-of-breed” modules that meet their specifi c needs and opening a low-cost migration route for satisfying meaningful-use requirements and other incentive programs. Additionally, physicians will become more acquainted with the newest kid on the block: the cloud- based EHR. Cloud-based, modular EHRs provide the advanced connectivity required to pull data from many disparate sources into a secure, single view of patient information while maintaining the autonomy of each practice’s data. Physician practices and hospitals will seek out cloud-based options with a proven track record for security that also enable deep productivity gains: users only need to log in once to access multiple applications and patient views, tapping into both internal and external data sources and systems.

Although still the underdog in healthcare, cloud computing has gained widespread adoption in many industries, and for good reason. With low upfront costs, budget-friendly monthly fees, auditable security, easy- to-use interfaces and the ultimate in accessibility via Internet-enabled devices, the cloud-based EHR isn’t the future. It’s now.


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