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TRANSPARENCY: Should you let patients read their notes?

Advantages and disadvantages of allowing patients to read the notes that physicians and other providers write about their office visits and hospital care are explored in this short Modern Healthcare article.  The movement towards greater transparency of care is explored further on the website OpenNotes.  Here are some of the providers that are exploring this concept.

Who is doing this?

  • Geisinger Health System (Danville, PA)
  • Beth Israel Deaconess Medical Center (Boston)
  • Sutter Medical Foundation (Sacramento, CA)
  • MUSC Health (Charleston, SC)
  • Harborview Medical Center (Seattle)
  • Mayo Clinic
  • Kaiser Permanente Northwest
  • Department of Veterans Affairs
  • UCHealth (Denver)

Sources:  Livingston, S. (2017, Jan. 2). Growing number of doctors allowing patients to read their notes. Modern Healthcare, 47(1), 14-15.  Click here for publisher’s website: http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319982; and, OpenNoteswww.opennotes.org   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Largest Hospital and Ambulatory Care EHR Vendors

The Office of the National Coordinator for Healthcare Information Technology (ONC) tracks the vendors used by providers that participate in its electronic health record (EHR) incentive program. ONC has released a list of all certified health IT vendors used by providers along with how many hospitals and ambulatory care professionals are using each vendor’s technology.

There were 175 certified health IT vendors supplying technology to 4,474 non-federal acute care participating hospitals as of June 2016. These ten vendors, ranked by the number of hospitals with certified EHR technology, were the largest suppliers:

  1. Cerner Corporation (1,029 hospitals)
  2. MEDITECH (953)
  3. Epic Systems Corporation (869)
  4. Evident (636)
  5. McKesson (462)
  6. MEDHOST (359)
  7. Allscripts  (235)
  8. Sunquest Information Systems (200)
  9. FairWarning Technologies (172)
  10. Iatric Systems (161)

On the ambulatory care side, 632 vendors supplied certified health IT to 337,432 ambulatory primary care physicians, medical and surgical specialists, podiatrists, optometrists, dentists, and chiropractors also participating in the Medicare EHR Incentive Program. These were the top ambulatory care EHR vendors based on the number of participating health care professionals using each vendor’s technology:

  1. Epic Systems Corporation (83,673 professionals)
  2. Allscripts (33,127)
  3. eClinical Works LLC (25,524)
  4. Next Gen Healthcare (19,676)
  5. GE Healthcare (17,704)
  6. Cerner Corporation (15,104)
  7. athenahealth Inc (14,570)
  8. Greenway Health LLC (12,407)
  9. Practice Fusion (8,523)
  10. McKesson (7,347)


Hospital EHR vendors: certified health IT vendors and editions reported by hospitals participating in the Medicare EHR Incentive Program. Office of the National Coordinator for Healthcare Information Technology, June 2016. http://dashboard.healthit.gov/quickstats/pages/FIG-Vendors-of-EHRs-to-Participating-Hospitals.php

Health care professional EHR vendors: certified health IT vendors and editions reported by ambulatory health care professionals participating in the Medicare EHR incentive program. Office of the National Coordinator for Healthcare Information Technology, June 2016. http://dashboard.healthit.gov/quickstats/pages/FIG-Vendors-of-EHRs-to-Participating-Professionals.php

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Update: Physician Office Adoption Rates of Certified Electronic Health Record Systems

A new data briefing from the National Center for Health Statistics reports on the progress physician offices have made in adopting EHR systems. Here are the latest key findings for 2014:

  • Nationally, nearly three-quarters of office-based physicians now have a certified electronic health record system, but adoption rates vary among states.
  • A third of physician offices with an EHR system were electronically sharing patient health information externally with other providers.

The report also provides data on adoption rates by state and by primary vs non-primary care physicians. Electronic data exchange is analyzed by type of provider the patient record is shared with externally.

Source:  Jamoom EW and others. Adoption of certified electronic health record systems and electronic information sharing in physician offices: United States, 2013 and 2014. NCHS Data Brief [National Center for Health Statistics], no. 236, Jan. 2016. http://www.cdc.gov/nchs/data/databriefs/db236.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Apple Watch and Hospitals Using It in the News

The new Apple Watch has been in the news this week, but so have several hospitals that are using it with patients. Apple’s HealthKit mobile app is available with its Watch.

Cedars-Sinai Medical Center has linked its electronic medical records system to Apple’s HealthKit software, giving patients the option for adding their data to their health records. Ochsner Health System will be using the Apple Watch to manage hypertension in patients initially, but may add other patients with chronic diseases.

Mayo Clinic, Stanford University Hospital, and Duke University Hospital are also among the first hospitals or health systems connected to HealthKit system. Reuters news service has reported that 14 of 23 major hospitals it contacted have pilot programs using Apple’s HealthKit mobile software. Competitive services from Google and Samsung have also begun reaching out to some hospitals and others in the medical field..


Stempniak M. New Orleans Health System harnesses Apple Watch to manage chronic disease. H&HN Daily, April 27, 2015. http://www.hhnmag.com/display/HHN-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Daily/2015/April/Oschsner-Health-Apple-Watch-chronic-disease-blog-stempniak

Bowman D. Cedars-Sinai goes all-in on Apple HealthKit. FierceHealthIT.com, April 27, 2015. http://www.fiercehealthit.com/story/cedars-sinai-goes-all-apple-healthkit/2015-04-27

Comstock J. Apple Watch already has 264 health apps, unused pulse ox functionality, and a hospital pilot. MobiHealthNews.com, April 27, 2015. http://mobihealthnews.com/42900/apple-watch-already-has-264-apps-unused-pulse-ox-functionality-and-a-hospital-pilot/

Higgins T. Apple’s HealthKit linked to patients at big Los Angeles hospital. BloombergBusiness, April 26, 2015. http://www.bloomberg.com/news/articles/2015-04-26/apple-s-healthkit-linked-to-patients-at-big-los-angeles-hospital

Diamond D. A hospital is already giving Apple Watch to its patients. Forbes.com, April 24, 2015. http://www.forbes.com/sites/dandiamond/2015/04/24/can-apple-watch-make-patients-healthier-how-one-hospital-is-trying-to-find-out/

Farr C. Exclusive: Apple’s health tech takes early lead among top hospitals. Reuters, Feb. 5, 2015. http://www.reuters.com/article/2015/02/05/us-apple-hospitals-exclusive-idUSKBN0L90G920150205

Dvorak K. mHealth Summit 2014: HealthKit, EHR pilot programs show great promise, execs say. FierceMobileHealthcare.com, Dec. 20, 2014. http://www.fiercemobilehealthcare.com/story/mhealth-summit-2014-healthkit-ehr-pilot-programs-show-great-promise-execs-s/2014-12-10

Goldstein P. Apple moves into mobile healthcare with HealthKit software. FierceWireless.com, June 2, 2014. http://www.fiercewireless.com/story/apple-moves-mobile-healthcare-healthkit-software/2014-06-02

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Update: EHR Adoption by U.S. Community Hospitals, 2008-2014

How have hospitals progressed in adopting electronic health records? New data from a survey conducted by the American Hospital Association for the Office of the National Coordinator of Health Information Technology points to significant progress:

  • Three-quarters of hospitals had adopted at least a basic EHR system in 2014, up 27% from 2013.
  • Almost all hospitals [97%] had a certified EHR technology, up 35% over the previous year.
  • Over a third of hospitals had adopted a comprehensive EHR system by 2014.

Hospitals have made major inroads towards interoperable exchange of health information.


Source: Dustin C. and others. Adoption of electronic health record systems among U.S. non-federal acute care hospitals: 2008-2014. ONC Data Brief [Office of the National Coordinator for Health Information Technology], no. 23, April 2015. http://www.healthit.gov/sites/default/files/data-brief/2014HospitalAdoptionDataBrief.pdf 

Related: AHA Annual Survey IT Database is available for purchase, and the 2015 release with 2014 data should be available soon. For further background on the survey, see http://www.ahadataviewer.com/about/it-database/  Call (866) 375-3633 or email ahadatainfo@healthforum.com for more information.

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

2014: Health Care Year in Review

The Commonwealth Fund has posted an online overview of the past year in health care. The following health care highlights from 2014 are identified and briefly discussed:

  • Uninsured rate drops
  • Spending slowdown continues
  • Republicans gain control of Congress and more
  • Supreme Court takes up an ACA challenge
  • Sovaldi draws attention to specialty drug prices
  • Ebola is a wake-up call on global health security
  • Delivery system reform gathers steam
  • Wiring of the health system continues

Source: Blumenthal D and Squires D. 2014: the health care year in review. Commonwealth Fund Blog, Dec. 23, 2014. http://www.commonwealthfund.org/publications/blog/2014/dec/2014-health-care-year

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

What is a medical scribe? How many are there?

Medical scribes are unlicensed employees of physician practices or hospitals who have been hired to key-in information into patients’ electronic health records.  This is a new and growing job category – there are at least 22 companies who provide scribe service.  In this short opinion piece, the authors argue that the use of medical scribes is a workaround for physicians frustrated with the limitations of today’s EHR systems.  But, because the workaround works, there is less market pressure on EHR vendors to improve their products.  The author also argues that the possibility of “use creep” is high, that is, that medical scribes may be asked to do order entry, which is a patient safety concern.

How many medical scribes are there?

  • “The chief executive officer of ScribeAmerica, the largest US scribe company, estimates that 10,000 scribes are working in hospitals and medical practices across the country.”

Source: Gellert, G.A., Ramirea, R., and Webster, S.L. (2014, Dec. 15). The rise of the medical scribe industry: implications for the advancement of electronic health records. JAMA.  Click here for access to the publisher’s website: http://jama.jamanetwork.com/journal.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org