SOAPware Clinical Suite Launched

The official announcement

SOAPware® Launches Integrated EMR/EHR and Practice Management Software; Technology Supports Optimized Delivery of Patient Care Services with an Affordable Price Tag

Final Rules for “Meaningful Use” for Electronic Health Records

This morning, the final regulations to satisfy “meaningful use” were announced. A good summary is available here - The “Meaningful Use” Regulation for Electronic Health Records.
My summary is that the team brought together by the ONC, led by Dr. David Blumenthal, has done a great job in creating a reasonable process to satisfy the requirements in order to receive bonus payments for EHR use. They have obviously worked hard and listened.
This will dramatically increase the level of interest and the number of physicians that participate. It is now within reasonable reach of even small medical practices.
Once testing entities are established for EHR certification, later this year, we intend to obtain the necessary ARRA/HHS Certification so that practices using SOAPware will have all the necessary technical capabilities to satisfy meaningful use.

Are Scylla and Charybdis the Only EMR Implementation Paths?

No.... the 2 sea monsters that Homer described in the Odyssey actually offered Ulysses an enviable situation compared to what today’s physicians assume they face when implementing information technology. The latter seemingly have perceived they must choose a path between one of about 6 monsters. At least with Ulysses, it was only an either/or between Scylla or Charybdis.
There is much angst out in the real world of real doctors actually attempting to deliver care. There is some degree of awareness that current, fee-for-service, volume-based healthcare models will be waning soon. However, future, ”value-based” models (PCMH, ACO, P4P, MU, PQRI, etc.) are little more than unfunded or underfunded alphabet soup at this point. Regardless, there is increased awareness that the future will require dramatically different practice resources based on different information management strategies. The comprehensive EMR usages required for this transformation have been elusive. Only 4-6% of current EMR implementations can meet the requirements, and these typically have up-front costs of $30-80k per clinician. Currently, 20-40% of installed, comprehensive EMRs are subsequently de-installed. Then, add to this that over 50% of comprehensive EMRs that are not de-installed have been implemented in such a fashion they are arguably doing more harm than good with the doctor having to pick between paths that often lead to monsters:

• Doctrolus - This one turns clinicians into distracted data trolls when seeing patients.
• Enslavus - This witch forces clinicians to spend huge chunks of their life, when not seeing patients, feeding her with data.
• Hemsucus - This blood thirsty monster trickles away clinician's productivity life blood.
• Rubishus - A frightfully ugly beast forces clinicians into “Documentation by Exception” which is the auto-entry of a bunch of default, normal findings which creates a lot of garbage. This is probably the most egregious monster as it has forced the widespread proliferation of… “canned” notes. Today, any clinician caring for patients will relate frustration about having to access medical records that contain 90% canned garbage. This makes it difficult and sometimes impossible to get to the useful 10%.

Understandably, a majority of clinicians have either found none of the comprehensive EMR implementation-methodology monsters, above, to be acceptable (so they often bounce around among them), or chose a less comprehensive beast, below. Many clinicians are just now beginning to awaken to the reality they will likely have around a 30% income differential in 2-3 years, and lose “quality” status due to lack of information technology capability. However, most of them are waking up only to choose one of the following:

• Alchemus - This ghoul preys upon clinician's desire to at least get started, so she deceives them into using an EMR as mainly paper-behind-glass (e.g. choose a “simple” EMR product, continue transcription, or move to speech recognition, etc.) that is unable to adequately collect and manage the data to practically meet forthcoming meaningful uses, PCMH, etc. Doctors just hope that some day, some how, some way, their records can magically morph into real data... easier to turn lead into gold. The Sirens may call on you to give up the mineral rights to your property because it is either popular, simple, or free to do so. It might be wiser to look for ear plugs?
  
• Cephinrectumus - This contorter tricks clinicians into "just say no" to EMR altogether. She deludes them into hoping this all goes away.... it won’t. She connives to keep doctors oblivious and in a dark, little world until it is too late. She is deceiving enough to be the most popular path chosen.
  

The good news... new trails are being mapped that bypass these monsters.
Alternative paths are necessary for any EMR product and implementation if a core value of the vendor is to "Do No Harm."

Also see - The Critically Sequential Path to Success and Alternatives to Doctors as Data Trolls?

Hubris in Healthcare Reform?

I am concerned we may be about to enter another cycle in healthcare where the hubris of high managements ultimately brings down another healthcare system restructuring that, again, harms the interface (i.e. patients and their trusted physicians). Borrowing some thoughts from Peter Drucker, management guru, who elegantly identified this “blind” high level forced management as undesirable, and touted the requirement of MWA (management by walking around), I believe it's well known that if you don't ask those that do, you'll do what you shouldn't do. Having lived through several previous failed cycles in healthcare…

• Capitation in the 80’s

• Managed care in early 90’s.

• Physician Management Organizations and hospitals buying medical practices in late 90’s

…I have real concerns the healthcare reform initiatives (PCMH, ACO, bundled services, etc.) are at risk for failure for the same reasons these other cycles failed. Those making decisions are not getting appropriate input from the interface. I continue to be amazed at the gap between the visions of policy makers (and administrators at all levels) and the realities at the point of care.
I see a strong need for a trusted, respected true physician’s guild to advise those administering healthcare delivery. This needs to be an entity that can truly represent the interface between healthcare and the patient. Its membership needs to be inclusive of all the major medical professional organizations, but its leadership needs to be filled by true representatives from the interface.
What might provide the nidus for just such a guild?
It is a bit frustrating that I visit with enlightened physicians almost daily who want to promote patient-centered care, yet can identify that their organizations and heathcare reform initiatives do not yet adequately understand or address the real obstacles. Many of these organizations and initiatives are close, but not close enough. A guild to advise organizations that is led by individuals that do not have to answer to organizational bureaucracies could actually strengthen many of these organizations for the very reasons they have weakened.
Otherwise, what evidence is there that we are not just entering another cycle, and are about to do more harm than good?
For patients and their physicians, I really would rather see reform float than sink. At least we don't have to worry about the captains, as history confirms their ability to just jump over to the next passing ship.

SOAPware Value Statements

What we are about is - Improving Healthcare and Quality of Life

Who we serve are - Medical professionals and patients

How we do it is via - Innovative technology and services


Mission Statement:

Improving healthcare and the quality of life, by empowering medical professionals and patients with innovative technology and services.


Our Core Values:

Be Accountable – We believe people should do what we say we are going to do. It requires a level of ownership that includes making, keeping, and proactively answering for personal commitments. We believe it’s acceptable to respectfully hold each other accountable. Organizational results come from collective, not just individual, activity. We believe in both individual and joint accountability.

Continuously Improve – We believe being great at something is a starting point, not an endpoint. Whether it is, personal skill sets, processes, services or applications, we believe we have the responsibility to continuously grow and improve.

Be Truthful – We believe truthfulness is a foundation to building trusting relationships. We must be honest and open about all our actions and motives. It holds us to legal limits and makes us play fair because we are being transparent and accountable to both ourselves and our customers.

Be Healthy – We believe people should maintain a healthy mind, body and spirit. Keeping this balance will translate into both our personal and work lives. We encourage people to enjoy their work life, and help others do the same. We encourage caring for one another and laughing together.

Do No Harm – We believe, as a company that holds Patient Information for millions across the globe our first responsibility is to “do no harm”. We should protect their data, taking measures to keep its integrity and privacy during all operations. We want our technology solutions to add value to the patient / provider relationship.

SOAPware, Inc. Quality Metrics

I have been alluding a bit to a transformation that is taking place at SOAPware, Inc. Several very talented people, including a new COO, Don Butcher, and CTO, Kyle Rogers, have joined an already talent-laden team. A key directive has been to implement metrics in order to promote quality improvement. Our support manager, Ryan Petty, and Brad Hampton, our key "community" developer, really took the lead on this and created an online survey to ask users of their experience when they engaged support. They started doing this last January, and 2452 surveys have been completed to date. Currently, the survey asks 4 questions:

1. Please rate your SOAPware experience: Excellent, Good, Mediocre or Disappointing.
2. Please rate your remote support experience: Excellent, Good, Mediocre or Disappointing.
3. What’s the status of your problem? Solved, Partially Solved or Not Solved.
4. Any additional comments






The negatives that we currently see in the comments are most often about appointments with support that were late, or return calls that had delayed response times. These are part of our growing pains, and we are taking actions to address these issues.
I wish to extend our gratitude to everyone who contributed to this survey, and a special thanks to those taking the time to offer comments as to how we can improve.
I also wish to express my gratitude to the Support and Implementation-Training teams here at SOAPware for their efforts. They really do a great job, even when challenged by not being able to respond in as timely a fashion as they sometimes prefer.

Word Cloud of This Blog

I thought this was interesting, a word cloud derived from my blog. Compliments of http://www.wordle.net/create ...

SOAPware Status Report, July, 2010

This has been another incredibly busy and productive month at SOAPware. We have quietly released SOAPware v2010.2 containing our first phase billing software. It is now in use in more than 20 sites. We are doing this quietly until we are confident there are no significant flaws. All of the advanced e-prescribing within v2010.1 released a couple of months ago has been merged with the billing development in order to create v2010.2. The SOAPware billing project has been a parallel effort for almost 3 years, and the merge into v2010.2 has been huge. In spite of this, there have been few reports of quality issues to date.
Toward the end of this month, we will make announcements and reengage some marketing efforts to notify everyone that we now have a fully integrated (not just interfaced) clinical and practice management system that is all written in one language, one database, one installer, etc. This is fairly unique as most systems that claim integration are really only interfaced. The interfaced approach is going to be increasingly problematic in the future for multiple reasons that I will be explaining in the near future.
We have also made great progress on our open-platform SDK/API that opens our point of care solution to other entities. It is likely to be a couple of months before formal announcements regarding its capabilities are forthcoming.