A previous note on Lab Soft News discussed physician-office-based practice management systems (PMSs) and the success of a product called eClinicalWorks in this market. PMSs are often referred to as office EMRs to distinguish them from hospital EMRs. Here is the link to the previous note. It is important for lab directors of outreach programs, and obviously commercial reference labs, to understand the PMS market because of the desire of office-based physicians to integrate lab ordering and resulting into their PMSs.
I came across an interview of Girish Kumar Navani, CEO, eClinicalWorks that I thought was very insightful. Here is the link to the interview and below are excerpts from it. The interview begins with the following statement: "It takes a small business to know a small business. That may well be the motto of the approximately 5,500 small physician practices that have chosen eClinicalWorks for their EMR."
Q. Why target this [physician office] market?
A. Well, it's the largest market in the United States, but it's a lot more difficult deploying a product in a small physician practice. A large practice has more infrastructure.
Q. Why isn't EMR adoption higher among small physician practices? Why do your customers number about 5,500 instead of hundreds of thousands?
A. Right now, we can't say that adoption is low. Adoption is on the curve of a trend which is going to go on for seven years. It's not slowing down.
Q. eClinicalWorks provides both an ASP and an installed model. Which one do you see prevailing?
A. A small practice cannot afford to invest in [in-house] data backup. Five years from now, you and I will not be talking about the in-house model.
Q. Would a national health information exchange infrastructure drive massive EMR adoption?
A. I think there will be a jump even without the national network. When these local nodes start coming into being, we're going to find patients gravitating towards doctors that are connected, because they'll have all their histories. That's going to be a catalyst for physicians buying it. The national-level model I think will be an afterthought.
This interview by a knowledgeable CEO of a PMS company reinforces many of my beliefs about IT adoption by small physician practices. Below is my reaction to his remarks:
- Many physicians managing small practices are not sophisticated about IT and wary of capital investments. Their practices are also not large enough to support sophisticated IT consultants. They want simple, inexpensive, and maintainable systems that meet most of their practice and office management needs. Any vendor that can provide such a system will thrive in this market niche.
- I have difficulty understanding why the ASP model has not gained more traction in this market. Small office practices would seem to be ideal venues for this technology. I can only assume that the vendors have not been clever enough in designing such systems or perhaps the physicians are suspicious about technology that they don't understand.
- The only consequences of a national health information exchange infrastructure will be wasted governmental expenditures and large consulting fees. This is a topic guaranteed to put private practitioners to sleep. Their primary concerns are the success of their office operations and perhaps integration with the local hospital to which they admit patients.
- eClinicalWorks has developed links and integration with 34 clinical labs -- both hospital-based and commercial reference labs -- as well as multiple LISs. Here is a list of all of them.
- eClinicalWorks also provides a "patient portal" from which the patients themselves can request lab tests. Here is the link to a description of the feature and following is a quote from the it:
- Patients can request a lab test from the Patient Portal. This is especially helpful if their Health Maintenance Summary indicates that a lab test or series of tests is due. When lab tests are done the patient can see the results. If you prefer to discuss lab results with your patient before posting them on the Patient Portal, just change one setting on the Patient Information window. It is flexible, easy and you can manage the communication.
- Patients can request a lab test from the Patient Portal. This is especially helpful if their Health Maintenance Summary indicates that a lab test or series of tests is due. When lab tests are done the patient can see the results. If you prefer to discuss lab results with your patient before posting them on the Patient Portal, just change one setting on the Patient Information window. It is flexible, easy and you can manage the communication.
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