Next Steps: Making EHR Meaningful Use a Reality

Right now there are hundreds, even thousands, of Greenway customers using a certified electronic health record (EHRs) with the functionality and product strategy capabilities to meet the objectives and requirements of the EHR Meaningful Use Final Rule released July 13.

Now armed with a definitive checklist of the requirements, eligible professionals (EPs) in ambulatory settings and those within eligible hospitals can evaluate automation needs and address patient demographics and population to determine whether the Medicare incentive pathway offering up to $44,000 per provider, or the Medicaid pathway offering up to $63,750 per provider, is the optimal choice.

Even for providers already accomplishing integrated, automated workflows and of course for those considering their implementation choices – and there is time to do so – and given the nearly 1,100 pages of regulation, there are some important fundamentals to understand that speak to timeframes, EHR reporting requirements and certification toward making EHR/EMR Meaningful Use a reality.

Foremost to keep in mind is that as of January 1, 2011, organizations seeking the EHR adoption incentives must register with the Centers for Medicare and Medicaid Services (CMS) for either pathway.

Also keep in mind that:

            The Final Rule is comprised of two documents. The 864-page CMS rule speaks to the automated functions and in some cases thresholds EPs and eligible hospitals must meet, while the more than 228-page rule by the Office of the National Coordinator for Health Information Technology (ONC) addresses the companion functionality EHRs must meet and enable.

            The rules largely speak to EHR Meaningful Use Stage One requirements, which are the reporting standards for 2011 and 2012. But, at the same time, EHR Meaningful Use Stage Two is also addressed. The core set of 15 requirements speak to Stage One. The menu set of 10 requirements allow providers to select five for Stage One, and then defer five to Stage Two. That way EPs and hospitals can begin to establish attainable Stage Two requirements based on patient and clinical needs.

In regards to the scaling up of functionality stages – and up to possibly five are planned over time – and therefore the sophistication of EHRs that translate into enhanced patient outcomes and population health, there does still need to be legislative and regulatory attention to the timeframes between stages and the ability for EPs and hospitals to adjust, concerns that organizations like the Electronic Health Record Association will be addressing.

But let’s not get too far ahead of ourselves.

What’s also important right now is to also keep in mind that both the Medicare and the Medicaid pathways require just a 90-day continuous reporting period within the first calendar year of EHR/ EMR Meaningful Use incentive capture to attain that year’s maximum incentive.

That means equipped EPs or those seeking implementation in the ambulatory care setting can begin as of January 1, 2011 and receive incentives payments as early as May of 2011. Or those needing more time to implement can begin as late as October, 2011 and still receive the maximum first-year incentive.

In terms of EHR certification – and EHRs must be certified by ONC Authorized Testing & Certification Bodies (ONC-ATCBs) for providers using them to qualify for Meaningful Use – ONC began the process of identifying certification bodies on July 1, knowing that entities must be approved and test scripts finalized and then of course EHRs certified in time.

Do not be shy about pressing your EHR solution provider to address the core and menu sets of requirements, and to detail their current certification level and plans to address Meaningful Use certification.

During the release of the Final Rule, officials from the federal Department of Health and Human Services (HHS) also noted the intent to construct an EHR implementation surveillance structure to also gauge the timing and success of implementation if any adjustments are needed to the Meaningful Use Rule in the future.

Additionally HHS took steps on July 8 to fortify the security and privacy of patient records, another high-profile step to empower and bring patients into the process.

Taken as a whole, and with regards to the balance between the importance of EHR adoption and the presenting of attainable Stage One goals that ONC and CMS clearly understood following some 2000 public comments that greeted the original proposals, the foundations and even the cornerstones are in place to make EHR Meaningful Use a reality for providers and patients nationwide.

System Replacement is Trending in the Industry: Avoid a Second-Time-Around EHR

I have been doing this “Healthcare IT” operations thing now for quite some time – going on 16 years, and I am truly amazed with how far this industry has come. Early on practices focused on automating the scheduling and billing functions solely. The likelihood of finding a practice even willing to discuss “EMR,” much less actually trying to implement one, was as likely as finding the Loch Ness Monster, a living breathing jackalope, or successfully capturing one of those “snipes” my granddad sent me hunting for.  Yes, the “market” was all about the efficiency and speed we could bring to an office in getting the patients in the door and the claims out. 

There was a lot of turnover back then as well.  It was not uncommon to speak to an office manager that had “installed” multiple Practice Management systems – each new system providing the practice with a new widget or promised “ease of use.” But at the end of the day, they all pretty much did the same thing – allowing for patients to be registered, scheduled and billed for services; all the time allowing clinicians to live freely in their paper world. 

Then, enter the EMR, and the initial wave of early adopters (a.k.a. techno-geek docs and bleeding edge physician offices). 

For the past few years we have seen very few customers “changing” EMR/EHR systems. The majority of our work (approx. 95%) has been with physician practices implementing for the first time. However, over the past 12 to 18 months we have seen the number of 2^nd timers increase dramatically – 30% of the implementations done have been with customers converting from another EMR/EHR solution.  A dramatic shift for sure! 

What we’ve seen are practices that chose their initial EMR/EHR solution based solely on price, or functionality or promise of “all the interfaces” needed. Many of these practices chose products with great features from sound organizations – so why change? Well, they found out that it’s not all about functionality and features. 

Implementing any mission-critical application has to be looked upon as “change management.” It would be my recommendation to all practices that you consider the following when choosing any software vendor (or better said – partner)…

1. Project Leadership – the project must have physician buy-in and leadership
2. Detailed Project Plans and Communication – have a plan and methodologies for communicating it to all staff
3. Don’t try and “re-invent” the software until you fully understand how to use it – Getting a vendor to make changes to the software before it is fully implemented and optimized sets you up for failure.
4. Training, Training, Training – Get your staff plenty of training, and then get them more.
5. Flexibility – choose a vendor with a flexible platform to ensure adoption by all physicians.
6. Don’t skimp on hardware – Don’t buy a Lexus and then try and drive it on bicycle tires – invest in quality hardware.

Luckily, our “2^nd timers” understand these and are widely successful in a much quicker timeframe.  They understand it is about functionality AND Service AND understanding workflows AND change management. 

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

The Balance of Meaningful Use

Meaningful use has become a big part of the jargon in health information technology. As the industry waits for the final provisions of electronic health record functionality and physician reporting requirements needed to achieve it both in terms of capturing incentive funds and finding standards for quality care – which I expect will come by mid July – I think that overall meaningful use is a question of balance.

Despite a lot of preparation for this change in the ambulatory practice world, we still don’t know the full impact on all the different stakeholders.  Again, balance comes into play between what is needed by doctors to document a clinical encounter, and what the government wants to get from the providers to assure meaningful use and therefore justify paying the stimulus money. Certainly, getting practices up and running on a certified EHR should be the focus. 

So, as we wait for the final ruling, the anxiety is mounting for everyone.  Can EHR providers get the results of the ruling, code and get their solutions ready and certified in a timely fashion for the practices to have it installed and running to qualify for the stimulus money?  The recent final rule on the EHR certification program means that side of the equation begins taking shape this month.  I know from our perspective, we are as prepared and current as we can be.

A successful REC Strategy? Call it Esprit de Core

Every time I’m asked about Greenway’s Regional Extension Center strategy or what I think about the sustainability of RECs, or how is it that Greenway’s PrimeSuite has been chosen as a preferred solution by every REC that has so far made EHR recommendations public, I remind myself to focus on core objectives, core values and what’s at the very heart of improved healthcare outcomes through a national health information network.

The REC funding acts is a long document, but I’ve long since memorized this passage: “The ultimate measure of a regional center’s effectiveness will be whether it has assisted providers in becoming meaningful users of certified EHR technology.”

We’ve guaranteed and based our certification levels on meaningful use, and we’ve based our solutions on usability, standard exchanges and wide-reaching interoperability or full data liquidity. When the Alaska EHR Alliance, New York City and then New York State RECs made their preferred EHR choices, these were the common denominators, the same factors we believe will surface during selection by the more than 50 remaining RECs finalizing their programs.

We know this because the REC administrators provided good feedback: “We were impressed with Greenway’s easy-to-use interface, their implementation and training, as well as their positive user reviews.” That from Amanda Parsons of the New York City REC. “Setting providers on the path to meaningful use … requires high quality, highly functional systems that offer integrated practice and clinical management functions, interoperability, standard data exchange, and the opportunity to achieve meaningful use. Greenway’s PrimeSuite exceeded our qualification standards for preferred REC status.” That’s from Paul Wilder of the New York State REC.

That’s a vital set of core functionalities, but there’s a deeper core at play. Together, the Alaska and New York RECs seek to aid almost 13,000 physicians. Nationally the REC program wants to connect 100,000 physicians, and the many of those targeted treat patients at rural health centers and public and critical-access hospitals, where patients are among the most in need of care plans and preventive medicine that automation can easily establish.

That’s a core meaning and a core reason why we are in the healthcare industry, and I always make sure that our company’s core values: Service, Innovation, Leadership, and Partnership, are adhered to in everything we do. Those four strengths mirror just what RECs need and are looking for if this national effort is going to succeed.

That’s why we’ve devoted ourselves to the REC programs and we’re gratified at the results so far. Now we will go about making good on the factors that got us chosen. And when the national REC program is underway and the ONC puts its last elements in place – a centralized HIT Research Center of shared learning, HIT workforce development and coordination with state Health Information Exchange programs, we expect to again be at the core of these advancements. What, is there an Esprit de Core pun here? It is a government program, so even Esprit de Corps makes sense. I try not to get too preachy about the benefits to healthcare and the real difference we all can make, but I suppose it’s part of my core values too. What do you think?

Respectfully,

Tee

How Do You Define Success?

As we are still very early and new to this “blog” thing, you would expect that I have lots of topics to discuss and comment on, but many of you will be shocked to know that I really struggled coming up with a subject for this post. Yes, that’s right, I had writer’s block. One would think that 10 days on the beaches of South Carolina would break the block and allow the words to flow, but alas, no such luck.  (It was a great vacation, though.)

Ironically, it was returning to the action packed days of Greenway that finally led me in the direction for this post. 

As many of you know, our annual national users conference, PrimeLeader is rapidly approaching (less than 70 days away)!  PrimeLeader is THE most important event we do all year. The event itself only lasts four days, but the planning, preparation, design and setup takes more than eight months – IT IS NOW CRUNCH TIME! The PrimeLeader team members are rock stars. Their ability to pull off the industry’s best user group meeting is truly amazing to watch. Which brings me to the subject of this post…

This year’s PrimeLeader theme is “Ensuring Success.” Of course with all the press and fever pitch around meaningful use, it’s pretty easy to see how we arrived at this theme. Not a day goes by without a customer or prospect calling me to ask how Greenway is going to “ensure” they meet all the criteria for meaningful use. Without a doubt our customers are positioned to achieve meaningful use – our products, services and support will ensure our customers are successful. But at Greenway – that’s not good enough. Why just “meet” meaningful use? Why not ensure MORE! That’s what this year’s PrimeLeader conference is about.

It’s important to understand that there is a difference between “going live” on an EMR and doing enough to achieve meaningful use, and “adopting” an EMR and using it to improve patient care and profit margins. I worry that practices will start to focus too much on the single go-live event and checking off the meaningful use criteria and not truly implementing an EMR throughout the practice – addressing workflows, physician-patient encounters and true performance metrics to measure success.

The great thing about PrimeLeader for our customers is that it provides the perfect continuing education event. The ability to interact with other users, attend in-depth and specific training sessions, workflow discussions and getting industry updates, allows our customers to be MORE successful. They are not just focusing on the initial training and go-live, but also investing in their adoption. 

If you would like to learn more about PrimeLeader and/or are interested in attending, please go to www.greenwaymedical.com/primeleader2010.

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

Timing Gets its Due in ONC’s Final Rule on Certification Process

National Health IT Week capped with another milestone on the path to EHR meaningful use with the issuance Friday by the Office of the National Coordinator of Health Information Technology (ONC) of the final rule for initial or temporary electronic health record (EHR) certification.

With the final qualifying and quality reporting criteria that eligible practice and hospital providers and EHRs must meet to achieve stimulus funds also expected this month for stimulus capture to begin in earnest in 2011, Friday’s rule provides reassurance that ONC understands that timing is on the minds of practices needing to secure a certified EHR, and on the minds of EHR software providers desiring to offer that service.

Friday’s final rule establishes a temporary certification process that the 206-page document states will transition into permanent certification status in 2012, minus any recertification that evolving stages of meaningful use reporting criteria demands. The temporary certification, itself established with timing in mind, will for the most part lead to permanent status.

The final rule also waives the normal 30-day delay of taking effect that documents put into the Federal Register usually allow.

The document states that ONC plans to begin accepting applications from temporary certifying bodies on July 1, and even offers applicants an estimated timetable they would need to become certifying bodies.

ONC plans to sunset temporary certification on December 31, 2011, to allow permanent certification to take over. Meanwhile ONC reiterated its plan to publish a list of certified EHR solutions on federal websites and to administer temporary certification before allowing the private sector to run permanent certification once the foundations are in place.

The rule also states that certification will be standard for ambulatory and inpatient settings, and will not call for separate certification as proposed during the comment phase. (The bulk of the final rule categorizes areas of public comment, summarizes comment and then phrases final rulings.)

Finally, the rule re-emphasizes that ONC plans to work closely with the National Institute of Standards and Technology (NIST) to formulate the tenets of certification both temporary and permanent.

Now it’s a matter of timing to see how many entities come forth to apply as certification bodies. The current “gold standard” in EHR certification, The Certification Commission for Healthcare Information Technology (CCHIT), has committed to early application guidelines.

What resounded Friday is that overall ONC is to be applauded for its recognition that for EHR meaningful use to truly be meaningful, quality reporting leading to the capture of stimulus funds must begin as planned, with the first full year of allowable 90-day reporting on track for 2011.

The National Agenda

The fifth annual National Health IT Week kicked off Tuesday in Washington, D.C., and this also marks my fifth year of attendance, and I don’t know if I’ve ever seen as much attention and anticipation throughout the nation’s capital on healthcare and specifically health information technology.

As the wealth of interested and integral parties here watch the price tag for healthcare reform – what I really believe is better termed “healthcare transformation” – and have worked through the Medicare payment fixtures that has also led to the discussion and need for new payer models, I pointed out to the assembled media the inexhaustible accomplishments dedicated members of Congress and particularly members of the 21^st Century Healthcare Caucus have achieved.

As Electronic Health Record Association chairman I felt proud to represent the majority of the commercially available, installed and operational EHRs in the country, as the mood here is clearly one that has moved from “if” to “when” in terms of the concrete beginnings of a national health information network.

Consider that in just the span of 16 months since the HITECH provisions of the ARRA legislation were passed, this month we are expecting the final meaningful use Stage 1 criteria for eligible professional and hospital providers as well as for EHR functionality and certification.

For those in Washington and around the country who have been directly involved in this process for many years, I will speak for them and myself in that I wish you could be here this week to feel the sense of progress being realized, tempered of course by the work to come.

It’s easy to criticize any admitted or tangible omissions still to be filled from ARRA, but there’s no denying the importance of finalizing the criteria in time for the first full incentive year of 2011.

Every time I come here I seem to have my Jimmy Stewart Mr. Smith Goes to Washington moment, or even moments, when I realize all of the hard work has a purpose, and that the politics of public policy can be a necessary means for positive change. It’s re-energizing to know that these efforts, instilled by summits like Health IT Week, are foundational aspects toward achieving the shared goals of improving the nation’s healthcare system.

National Health IT Week Press Statement- Justin Barnes

The Ways of Interaction – Tee Green

Earlier this month I visited a seven-provider ENT practice using Greenway’s electronic health record platform. I don’t know how many of my peers visit customer practices but I travel pretty consistently and ask customers one main question: What is your experience with Greenway? It’s a very simple and very open-ended question. It’s part of our corporate culture and has been at the heart of our mission since day one.

Asking in person and in their environment gives customers a chance to directly tell me the good, the bad and the ugly. And believe me they do. While I don’t like getting the ugly, and yes it can be uncomfortable, it is part of our growing process – a process we respond to that I believe is proven by our consistent wealth of KLAS awards.

Many companies are hesitant to directly seek out customer feedback for fear of the “ugly.” Executives are often shielded from bad news, but at Greenway it makes us stronger and makes our customers stronger so that’s why it makes sense for me to do it.

What was their experience? This practice is performing well and reaching its goals. What are we doing best? Greenway’s service capabilities and support portal. What do we need to improve? I was told we need to do a better job of training the competencies of new services or applications we release after a practice has successfully implemented PrimeSuite and moves into go live. The capabilities of our platform do continue to grow, and we need more efficient ways for customers to learn to leverage them. That holds true for our clinical research capabilities, emerging DNA evaluation and speech understanding, our mobile capabilities and much more.

Thankfully I was able to tell this practice that we are providing some progressive and pretty cool interactive training tools that will greatly improve their experience in this area.

These visits often lead me to examine our mission: are we a technology or a service? Are we and our customers ready for the coming age of “Data Liquidity”?

I will continue to use this platform (if any are interested) to relay my experience and interactions, and therefore those of this industry. This is an interactive blog as well, so I welcome all comments and will do my best to address.

Respectfully,

Tee

Finding Meaning in Meaningful Use – Justin Barnes

I spend a lot of time traveling to conferences and engagements around the country speaking on meaningful use (MU) in my role as chairman of the Electronic Health Record Association. In these travels it’s been gratifying to see that everyone invested in healthcare has not lost sight of the goals of improved patient care that is driving this national endeavor.

By increasing the capacity of health information technology (HIT) and the adoption of electronic health records (EHR), these patient-centric goals are no less than increasing access to quality care, improving care coordination and stabilizing rising healthcare costs by reducing waste, fraud and abuse. While these are lofty goals to attain in the next five to six years or so during the meaningful use incentive payment periods, they are certainly achievable.

A great foundation of HIT and interoperability standards has already been created by organizations such as Integrating the Healthcare Enterprise (IHE) and the Health Information Technology Standards Panel (HITSP). A great base for EHR certification has been built by the Certification Commission for Health Information Technology (CCHIT) and its volunteer workgroup structure. All of these entities have a strong public and private collaboration and have drawn active leadership participation from thousands of dedicated industry leaders.

As we await the final Stage One meaningful use criteria, I also hope (and see so far) that the standards have been created at a level that eligible professionals (care providers) and eligible hospitals can achieve without significant issue. There needs to be a healthy balance of goals and criteria that propel our nation’s healthcare system forward in the electronic age, but also not so high in the first stage that our nation’s care providers and hospitals fail and give up on adopting EHRs and other healthcare technology innovations.

This is a delicate balance that can be achieved if we build upon the past six years of EHR functionality and workflow progression already in use such as electronic prescribing, computerized physician order entry (CPOE) and quality reporting. The challenge now is to advance functionality and reporting within reasonable but increasable thresholds of provider use.

We also need to keep an eye on avoiding new burdens onto care providers and hospitals during this process, such as impractical accounting of disclosure reports that are of no value to patients. We need to ensure a safe and secure healthcare system but not interfere with daily workflows and a care provider’s ability to offer the highest quality of care.

As we close in on understanding the final rules for EHR meaningful use, the EHR certification process and related HIT standards, I hope the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) build from the base already created to afford all care providers, hospitals, patients, consumers, vendors and other key stakeholders the best runway to achieve our main HIT adoption and meaningful use goal: that of enhanced patient outcomes.

Flexibility and the Razor’s Edge – Eric Grunden

Well I am, without a doubt, very new to this whole “BLOG” thing – can’t say as I have ever even read one, much less written one.  On top of that my family assures me that there can’t be too many people out there that are interested in what I have to say.

To be honest though, I expected there to be more fanfare around the launch of my first official BLOG!  For those of you that know me, you know that I love to hear myself talk – and this BLOG thing is just another opportunity!  So imagine my surprise when I was asked to “add a few more paragraphs” to my first post. I was trying to pace myself I guess – rather than come out of the gates at a sprint I was going to start slow and take this first one “easy.” Now … not so much.

I want to start with a few guidelines for my BLOG in an effort to let you know what to expect from my posts.

1. Life is too short to take everything so seriously, so I will try and add some humor to my posts.  I think of myself as a funny guy; no guarantees you will though.
2. This won’t just be for Greenway customers. I want to share my thoughts and Greenway’s mindset on service and support in an effort to ensure everyone’s “experience” is a positive one.
3. My opinion … I’ve been doing this for more than 15 years now, so I have a few opinions on things and can’t wait to share them.
4. No guarantees around the “grammatical correctness” of my posts.  My wife, mother and sister are all phenomenal writers, so I expect to get plenty of critiques and corrections.
5. Subject matter – just about anything. Of course I will try to focus on training, implementation and deployment of “mission critical software,”  but don’t be surprised to see posts about college football, golf, politics, the weather, music, TV, movies or any other subject that might somehow tie into how Greenway focuses on service!

Speaking of service…

I thought I would start by ensuring everyone is familiar with what makes Greenway’s Client Services team unique. Our approach is focused on service, innovation, leadership and partnership.  This focus is in effort to ensure the success of our customers.  We understand we are only as successful as our customers. Whether you are a Greenway employee, customer, partner or prospective employee, we are committed to providing you with a positive and successful “experience.” Our client services team consists of resources that represent more than 850 years of combined experience in healthcare and technology.  While we are only as successful as our customers, the Client Services success is built around the knowledgeable and experienced resources that are part of this team.

Before I call this first BLOG complete, I want to share my first “tip” to anyone deploying a complex piece of software under the guidance of a professional services team.

I’m often asked what “complaint” I hear most from customers. This question usually comes from prospective customers, new employees or other shareholders. The answer is easy – it’s a tie.  First, “Greenway was too flexible.  I was given too many options for my implementation; too many different workflows or experiences.” Second, “Greenway was too rigid in how we should implement the functionality.  We weren’t given options during training.”  Crazy, huh?

So I will say this about communicating with a project manager or project team: be very specific during the project initiation and training events. When you want “options” or “experiences from other customers” from your trainer, ask for them.  When you don’t and it “must be this way,” make sure they know as well. All trainers, project managers and deployment specialists walk a razor blade between being a “trainer” and/or a “consultant.”  Most are qualified and experienced to be both,  you just need to decide when you need one or the other.

Thanks and God Bless,

E

To learn more about Greenway’s Client Services or what Greenway Client Services can mean to you, click here http://www.greenwaymedical.com/service/client-services/.

APPetite for Distraction and the Practical APPlication – Johnathan Samples

A few months ago I decided I was ready to make the change.  I decided to give up my BlackBerry and switch to an iPhone.  We were preparing for an iPhone application and I wanted to embrace the platform I was asking my users to take up.

As I purchased my Apple gear I waited patiently for my transformation from geek to ultracool Mac guy.  At first I was unimpressed with the iPhone and all the buzz that had surrounded this device. Then I discovered an application that could tell me what song was playing in the restaurant.  After guessing the song that it just heard I could then watch the video for the song or buy it from iTunes. Then I found an application that could tell me what I was looking at through the camera. If you want to know what building is in front of you just point the camera at the building and like magic you now know. I was hooked!  Forty Apps and a few hundred dollars later I understood the iPhone experience and wanted to apply it to our application design strategy.

There were three things that had made the iPhone a success that needed to be applied to healthcare applications:

• Centralized content management -Any song, app, video, or podcast I needed could be easily downloaded from the iTunes store. I did not have to copy files to storage devices, they were simply pulled down from the cloud.

• Applications that required no training - I never downloaded an application from the App Store that had a user manual or help files. The user interface was simple and intuitive.  Applications were designed with a consistent interface that targeted the common user.

• There’s an App for that – It was the plethora of add-on applications that made the device a hit. The phone was simply a platform that enabled others to build programs that solved complex problems or provided niche services.  If you are not interested in golf or the complexities of calculating what club you need based on your GPS location, distance from the hole and wind speed, then you do not have to download it. Apple provided the platform and the software development kit and the community took care of the rest.

I never became the cool Mac guy but I did walk away with a better sense of what it would take to offer a successful mobile EHR application.

Hot Jobs in a Cool Economy – Wendy Lucio

Current Ice Age

The overall job market is bleak, achingly bleak in cloud covers of black and gray: 9.9 percent unemployment in April with 46 percent deemed “long-term unemployed,” meaning jobless for 27 months or more, according to the Bureau of Labor Statistics. In the past two years unemployment rates have doubled. Unfortunately this is not news to the millions of Americans affected; this job market resembles an ice age and we’re all wondering when the thaw is coming.

There is some sunshine in this otherwise frigid landscape: health services has seen a steady increase in employment over the past year with expectations for even faster growth. Thanks to the HITECH Act within the February, 2009 American Recovery and Reinvestment Act (ARRA), there are billions of dollars of stimulus money available to eligible physicians who demonstrate meaningful use of an electronic health record (EHR) system. Currently only about 20 percent of physician offices and 10 percent of hospitals have a minimally functioning EHR / EMR solution. Do the math. The Bureau of Labor Statistics is predicting a shortfall of more than 51,000 qualified healthcare IT professionals to meet the needs of physicians and hospitals as they move to implement EHRs / EMRs. So where are these qualified healthcare IT professionals coming from?

Health IT Workforce Development

The Office of the National Coordinator for Health Information Technology (ONC) is providing more than $120 million in funding for the Health IT Workforce Development Program. This program is responsible for developing curricula and programs to produce highly qualified HIT professionals. Greenway is well aware of the challenge, and is, for example, donating its technologies to leading higher education healthcare informatics programs like that of Northern Kentucky University earlier this year.

Looking For a Warm Front

The HIT job market is definitely heating up, so if you’re looking for an employment warming trend, slip over to the HIT realm and don’t forget your flip flops – the sun is definitely shining.

The Clinician and the World of HIT – Dr. Jim Ingram

For most of us who have been in the practice of medicine starting in the 20^th century, our world has dramatically changed.  From the clinical perspective, we have embraced much of the technology that has allowed us to offer our patients a significant benefit in diagnostic testing and treatment.  However, electronic health records have caused us some concern.  Obviously, there are several factors involved:  reluctance to give up a paper workflow we grew up with; skepticism of the efficiency of EHRs / EMRs; difficulty dealing with change management within a practice; and disbelief of the return on investment for the purchase.

I did not come from a medical informatics or computer science background, but I was frustrated with the paper world and felt that we doctors needed to drive the modernization of our medical records.  I was seeing the banking and financial arenas moving to secure electronic systems, so why can’t medicine?

That was in the early 1990s when EHRs / EMRs were still more of a concept than a reality.  Despite the early stage of the concept, it was possible to find like-minded physicians and practice administrators – and a visionary software management team that would listen to the idea of an EHR / EMR.  Greenway Medical was born out of the collective frustration of “doing it the old way,” and now along with other vendors are on the precipice of a fundamental change in the delivery of healthcare. I cannot say that I foresaw a multi-billion-dollar government incentive program for the adoption of EHRs, but it was obvious we couldn’t keep doing what was done for the previous decades.

Tee Green

President and Chief Executive Officer, Greenway Medical Technologies, Inc.

Wyche T. Green, III, or Tee, as he is known within Greenway and throughout the industry, leads the company’s strategic direction and daily operations. Greenway is his second successful startup, having been integral in taking the financial firm Greenway Corporation to acquisition before the founding of Greenway Medical Technologies.

“Managing the priorities of a company that provides mission critical services, and in such an obviously critical endeavor, has been more rewarding than we anticipated. We are reminded of this every time I talk to customers who have transformed their practices into thriving deliverers of healthcare.”

Green has demurred a wealth of suitors for Greenway’s infrastructure and intellectual capital while becoming one of the EHR industry’s most admired leaders in clinical innovations and business growth, as recognized by Deloitte and Inc. magazine among other standards of excellence.

“I recognize that it’s every member of our staff of more than 300 people who set our standards and realize the possibilities of healthcare technology innovation.”

The only limitation Green has encountered came via a broken ankle that led to his retirement from competitive motorcycle racing. “That’s not the kind of healthcare I planned to pursue.”

Here he blogs on industry futures, trends and innovations, and managing the business of healthcare.

Video:

• Tee Green on EHRtv

Justin Barnes

Vice President of Marketing, Corporate Development and Government Affairs

Justin Barnes is another of Greenway’s leaders who saw the future of health information technology early on. After co-founding the PHR firm Healinx/ Relay Health in 1998, Barnes saw Greenway on the horizon. “I recognized in 2003 when I joined the company that Greenway had created an integrated EHR platform that would afford care providers and practices a superior solution for long-term success.”

Along with his abilities leading the company’s public profile and branding growth, Barnes also brought his expertise in government affairs, shown through his successive chairmanships of the national HIMSS Electronic Health Record Association. In that role, Barnes has advised presidential campaigns on healthcare public policy, and has testified before Congress, the Bush and Obama administrations on a dozen occasions since 2005.

“Assisting Greenway and this entire fast-evolving healthcare IT industry that is affected more every day by legislative and regulatory action is a challenging task. The number of interactions with Congress and the administration has increased dramatically the past 18 months, increasing the need for an expertise in handling the influx and communicating back to the industry to further a healthy dose of public and private collaboration.”

Barnes is up for the task, shaped by his eight years of service in the U.S. Army as an Infantry School graduate even before he went to college. “Most people I meet probably would not guess that I spent eight years in the Army and dug foxholes.”

Nor would they that his brief respites are in part spent “watching mindless TV shows like ‘Fringe,’ ‘CSI Miami’ and ‘Modern Family.’”

Here he blogs on the industry’s strategic future, Capitol Hill updates and the legislative and regulatory insights critical to achieving a sustainable healthcare system.

Videos:

• Justin Barnes on EHRTV Part 1
• Justin Barnes on EHRTV Part 2

Eric Gruden

Vice President of Client Services

Eric Grunden spent nearly two decades in healthcare project management and administration before becoming Greenway’s client services vice president in 2004. For Greenway, he directs the implementation, training and deployment “go live” of the company’s range of technology solutions for a diverse customer base of nearly 30,000 providers in far-reaching specialties and practice settings.

“I’ve worked in this industry for a long time and see many organizations give lip service to customer care, but Greenway truly believes it. Don’t get me wrong, we are not perfect and have our share of struggles, but what sets us apart is the fact that we always make it right.”

No lip service that, as Grunden’s team has realized an unprecedented set of customer survey-driven industry KLAS awards in recent years: in three different categories in 2008 and 2009, and nine overall since 2004.

As a married father of two, Grunden perfects a fair amount of customer service at home, and is so sympathetic to service it’s been said he never sends back a suspect meal.

Here he blogs on trends and innovations in healthcare delivery models and customer expectations.

Johnathan Samples

Vice President of Research and Development, PrimeSuite

Johnathan Samples is one of many at Greenway who has been with the company from day one, 1998. “When I came to Greenway there were only three people, and we were working in the basement of an insurance building, and it was my job to answer the phone for everyone.”

Not an auspicious beginning for this 1997 graduate of Georgia Tech, but one that suited him. “I believed in Chairman Tommy Green’s vision for healthcare, and I also came because I believed I had the opportunity to do something great.” Greenway’s growth to its current stature in the industry mirrors Samples’ own. From software developer to VP of development and quality assurance to his current role of assuring the very sophistication of Greenway’s flagship electronic health record, all from a Carrollton native who feels quite at home.

“The healthcare industry is rapidly changing and that presents opportunities every day to come up with a better solution. It is like a great chess game.” And no doubt Samples is the Greenway staff’s go-to for everything technology, social media and gizmo.

For all he’s done, Samples was recently rewarded by getting the company’s first iPad.

Here he blogs on technological advances, insight and commentary

Wendy Lucio

Vice President of Human Resources

When Vice President of Human Resources Wendy Lucio joined Greenway nine years ago, the company boasted 50 employees. Since then she has added more than 300 and populated 30 states in the diverse areas of coding, R&D, customer service, sales, marketing, administration of all walks and the C suites.

“I came to Greenway from a large company of more than 20 facilities and tens of thousands of employees. A great company, but while intellectually I could understand my contribution, emotionally I just didn’t feel that I was making a difference or a contribution to the world at large. Here I knew I could contribute not just to the company but to help improve healthcare.”

As a Magna Cum Laude in political science and Spanish, Lucio understands, and has seen much of, the world at large as an avowed “experience junkie” who has lived in Mexico City, swam with sharks, learned karate and eaten grasshoppers, just to name a few.

Staffing an ever-growing market leader in a redefinable and increasingly technology-centric industry is also a challenge. “Finding the right people to meet our customer needs is a challenge. It’s not enough to have the right technical skills, be it healthcare workflow, software development or sales, it’s having the right attitude to serve our customers.”

In Spanish, eating grasshoppers translates to…yuk. She notes it is not a job prerequisite.

Here she blogs on building a 21^st century HIT workforce, the needs, solutions and collaborating with higher education.

Dr. Jim Ingram

Chief Medical Officer

Dr. Jim Ingram was one of healthcare’s progressive advocates of electronic health records (EHR / EMR) when his interest was piqued in the early 1990s while in private practice in Carrollton, Ga., the corporate headquarters of Greenway. By mid-decade, while serving as Chief of Surgery at Tanner Medical Center, Ingram turned his faith in EHRs and EMRs into a financial and consultative investment in Greenway’s eventual founding in 1998.

Then, as now, he pursues the design, development, medical content and physician’s-eye usability of PrimeSuite, and became one of its earliest users before joining Greenway in full in 2003. Since then the challenges have only grown. “I realized early on what the potential of EHRs and EMRs could be, and that potential has today evolved into a national healthcare initiative. For me, the daily challenge is balancing the needs and requirements of a rapidly growing and changing industry in determining how the meaningful use and certification requirements apply to our company and to patient care.” He does so in part while serving on the Ambulatory Work Group of the Certification Commission for Healthcare Information Technology (CCHIT).

Ingram’s ahead of the curve in many ways. For example, he shot his first hole-in-one on just his 32^nd ever tee-off.

Here he blogs on the physician perspective and clinical balance with HIT.

Video:

• Dr. Ingram at HIMSS 09