Comment by doctorpangloss 2 days ago
No… hospitals use EHR to maximize billing. That is the value.
Private practices are generally shrinking in number, so there IS NO EHR that is growing in the long term to serve them, so there CANNOT BE a trend where hospitals are exceptional, their IT buying trends are the NORM and their purpose is to code for billing. It is NOT about having or not having IT resources strictly speaking.
I dunno, QuadraMed that was used by at least NYC H&H for years before their imperiled transition to Epic prominently displayed “Revenue Cycle Management” on the splash screen of its decrepit provider facing frontend.
Both of you are overstating your cases. That said, it’s hard to overstate how heavily charge capture and billing are prioritized to the detriment of other aspects.
> I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.
There were major EHR deployments in the 80s through early 00s, before most government mandates. Surely later mandates were an incentive This reflects a lack of tenure.
One example was already given. Epic dates back to 1979, certainly they were doing something prior to 2009 (as was Cerner and Meditech). Other than HITECH, what other major regulation in the US are you referring to?
https://international.kaiserpermanente.org/wp-content/upload...
Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.
> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.
Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.
> This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.
Epic is one of the few providers who can meet a larger organization's overall needs
The competitors, like eClinicalWorks, are a shadow in comparison
No doubt companies increase revenue with more efficient capture of services, costs, labor factors, etc, but I've actually been in the room with people from Epic and have heard the sales presentation. I'm betting I have a decent grasp on both what they're selling and what the buyers are asking for.
> but I've actually been in the room with people from Epic and have heard the sales presentation. I'm betting I have a decent grasp on both what they're selling and what the buyers are asking for.
This may be true but it is different from your earlier claim about an upcoming deadline forcing any change in EHR, which was clearly false.
Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.
> They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules
Yep, and more and more payors - government and private - are demanding systems that are both interoperable and audiable
Internal, bespoke systems are notoriously nightmarish for auditing
As opposed to the Epic MUMPS pile?
Epic has been sold in in Denmark and Finland, where it was a disaster, and then in Norway, where they failed to take lessons from the disasters. I don't think it's federal requirements which is the selling point there, though I wonder what the hell the selling point is, or what the Epic sales people put in acquirers' coffee.
I'm not talking about bespoke EHRs - the GP made the claim that only governmental insistence compels EHR decisions. If that were true, there wouldn't ever be a change from one EHR system to another.
But these get announced all the time, so the premise is false.
Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social.
> hospitals use EHR to maximize billing
As a person who has worked extensively with hospitals and CHCs helping them integrate technology, this is false.
EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.