Tips & Tricks
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eCWusers at the Users Conference
Tuesday, November 04, 2008

This afternoon we had a scheduled Meet and Greet for the users of It was great putting some faces to names. Above, for example, you’ll see Laura Nasipak, Reddy Biggs, Renee Holland, Brad Block, Bob Holman, Jen Moore, and yours truly.

We had a good mix of long-standing users, new users, lurkers, and people interested in learning more about how to sign up. Hopefully, we’ll see some of these fresh names posting soon.

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Obama and Girish

The afternoon session began with a talk by Dr. Farzad Mostashari, the Chair of the Primary Care Information Taskforce of the New York Department of Health and Mental Hygiene. (I’m hoping to get one of his cards, to see if that title fits on the card itself.)

He highlighted the Take Care New York Build and Implementation of eClinicalWorks.

At the beginning of his talk, however, he paid tribute to the historical significance of this day (Election Day) by comparing the meteoric rise of eCW with Obama’s campaign, and produced one of the funnier slides of the conference:

The Top Ten Reasons Why eCW and Girish are Similar to Barack Obama:

10. Both have funny names.

9. Girish is also NOT a muslim.

8. Competitors say they will both raise your user’s fees.

7. The number two guy is a hothead (Mahesh)!

6. Detractors say that both just tell you what you want to hear.

5. Detractors say that neither actually care about the little guy.

4. Both campaigns depend on the support of strong ground troups (showing a picture of eCW staffers present at the conference).

3. Both campaigns are run by a bunch of kids (showing a similar picture of staffers, highlighting their youth).

2. The company is about as old as Obama’s campaign.

And the number one reason…

1. What once seemed risky, is now the safe choice!

The New York project is huge, depending on money from the city and providers, they chose eCW as their vendor in 2007 and now have signed up 193 small practices (representing 393 physicians), 22 CHCs (398 physicians), and 4 hospitals (527 physicians). They subsidize and provide training and support to the small practices (and CHCs) that service the underserved.

When I started using eCW in 1997 (it might’ve been later, but it seems like it that was long ago), the company really focused on small practices. This was a brilliant business plan, because it allowed them to mature the product and gave them a niche, because the small practices were generally unable to buy an EMR of the quality of eCW. (Now most of their competitors have migrated down to eCW’s price point.) Once the company began to really grow quickly, they begin to test the waters with large practices and implementations. I worried that such increases in the number of physician users, as well as now there being a subset of users that meant a lot more money to the company, would weaken their support for the little guy.

But watching Dr. Mostashari demo the Take Care NY build, it is apparent that most of the great features I have seen in version 8, including the enhance registry functions, CDSS, complex order sets, all came out of eCW’s work with the New York project. These were features they demanded, and soon these will all be features we will depend on. Especially in the setting of reimbursments becoming more and more dependent on P4P and registry reporting.

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I Came to Orlando and I Got to See Micky!

This morning’s Keynote Speaker was Micky Tripathi, the President and CEO of the Massachusetts eHealth Collaborative (MAeHC), a non-profit collaboration of the state’s leading healthcare organizations. With a large investment from BCBS-MA, this organization is overseeing a project to deploy community-wide EMR in three different communities in the state. Hopefully they will extend this to four in the near future—MINE. The organization pre-approved 7 different EMR providers for the hospitals and physicians to sign with, free of charge, including NextGen, GE, Allscripts, and PMS. Even though money was no object, 90% if the practices representing 550 or so physicians chose eCW. These physicians all went live in 18 months and are actively using the EMR for roughly 95% of their encounters (Primary Care, specialists was using it for about 80% of their encounters). In North Adams, MA, specifically, the project is making good use of eCW’s eEHX product, tying all of the practices together and allowing them to share selected information.

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eClinicalMobile—New Product

eClinicalMobile is eCW on the iPhone. That’s it. And that’s enough to make me go buy an iPhone. (For you Blackberry lovers, it will work on the upcoming Blackberry Storm as well, but then you won’t be able to switch between eCW and the game Cro-Mag Rally.)

You will be able to access the system anywhere AT&T has its 3G service, or via WiFi. It will not be the full EMR, and this is a good thing, since the service will use a hosted gateway and not directly access the EMR, for security purposes. But you will be able to do charge entry, view your schedule, look at patient summaries and information, review labs, telephone messages and other tasks, and communicate via telephone and web encounters.

The preliminary word is that the service will cost $50/month.

As someone that tried to use the PocketPC option back in 2003, this sounds like a superb addition!

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eClinicalMessenger—New Product

As hinted at below, eClinicalMessenger is a new product that the company announced at the National Users Conference. It is a messaging service that utilizes VoIP (Voice-over-Internet Protocol) to enable its practices to send messages, in batches or singularly, to patients for aspects of care including appointment reminders, lab results, diagnostic imaging and statements. It will be embedded into the EMR, and not a stand alone product, and it is a bi-directional product. This means that patients can respond to a message (“Press 1 to confirm that appointment…”) and have their response be recorded in or change a status in the EMR. Lastly, eClinicalMessenger will be tied into the new version of the Portal for even more streamlined communication.

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National Users Conference Day 2

John Halamka, MD is the CIO of Caregroup Health System and Harvard Medical School and the Chair of the US Healthcare Information Technology Standards Panel. He gave a Keynote speech today about “Connecting Patients, Payers, and Providers.”

He reviewed the latest efforts to create regional and national health data exchanges using interoperable standards and generally tried to “give [us] and idea of what this will look like in the Obama Administration.”

He also discussed the new Personal Health Records products from Google and Microsoft, and how they will one day interact with eCW. (With eCW’s portal, it’s closer then you think.)

I bounced around the rooms the rest of the afternoon spending some time learning about a new Voice Reminder option from a company called Veeda Software. I attended an overview of Version 8.0 and the Patient Portal 3.0 by Girish, mostly for the nostalgia of watching Girish in the demo role again. He is unflappable with the laptop open in front of him and can fly through the features. EWith the new version out, it’s definitely time for me to reconsider actively using the portal in my practice! Lastly, Laura led a breakout group regarding “Clinito,” the nickname for the new Smart Phone Browser product. Watching it on iPhone screenshots was a little like watching a Steve Jobs Keynote speech at MacWorld.

The evening ended with a nice dinner under the tents outside, adjacent to the golf courses.

GregHinson's avatar
National Users Conference Day 2
Monday, November 03, 2008

This morning’s conference started off with a Keynote Presentation from Girish. He began things by letting us know how well the company is doing. And eCW is doing quite well, thank you. They have had a 6,000% growth in the last five years. They’re profitable, investor free and debt free. Girish told us an amazing stat (and if I wrote it down wrong, someone please let me know, because as I am typing it right now, it almost sounds unbelievable). He said that in the last five years, 60,000 physicians have started using EMRs. And 20,000 of them installed eClinicalWorks!

They’ve now installed over 5,000 locations, representing 20,000 physicians and 80,000 users. The company now has over 750 employees.

And better yet, he bragged about a 98.9% renewal rate on maintenance contracts, implying a very nice rate of ongoing use of the product.

Girish discussed current product enhancements, giving an overview of v8.0 and eBO (Enterprise Business Optimizer). Version 8 has some great new features, which have been discussed on our site. Order sets, enhanced structured date (balanced with free form entry) for Registry and P4P purposes, and clinical decision support systems. He also gave us a preview of v8.1 when he talked about the development of a Payer Rulebook (so you never get a denial twice from a specific payer).

Regarding eBO, he discussed the “Studios” that the software will feature for Reports, Events, Query and Analysis. For example, using the Event Studio will not require time-based reporting. You can set up a report that will, for example, run when the days in AR for BCBS-MA reach 20 days. Or, for example, a report that will run once “my average panel of diabetics with A1C’s of >7.0 reach more then 20% of my diabetic patients,” which will be great for P4P, as well as good medicine.

He gave an overview of eClinicalWeb v3.0, the latest version of the Patient Portal and discussed new features for pre-registration, the possibility of structured questionnaires that could integrate with the EMR, and the use of the Portal as an online PHR for patients.

eClinicalEHX (eEHX) v2.0 is a feature especially important to hospital systems implementing EMRs in their ambulatory practices, allowing connectivity and interoperability between multiple practices.

And Girish announced two new products. eClinicalMobile v1.0, an upcoming version of the software that will work on any Smart Phone that features a full browser (e.g., iPhone and the new Blackberry Storm). This will allow mobile access to your schedule, patient chart summaries, ePrescribing, charge entries, and tasks such as message and lab review. The technology for this—using a hosted gateway and not direct access to the EHR—will also facilitate browser access to eCW from any computer hooked to the internet (without the need for the eCW Smart Web Client).

eClinicalMessenger v1.0 will add bi-directional VoIP to the product, allowing us to send messages to patients via VoIP, AND the patient to respond with key entry on their phone. This should help with med adherence, reminders for appointments, etc.

(a picture of my daughter enjoying the Orlando sun)

GregHinson's avatar
eCW Premier National Users Conference 2008
Sunday, November 02, 2008

I am happy to be at the eCW 2008 Users Conference in Orlando, FL. Flying down from the Northeast and leaving 40 degree and blustery weather makes it even nicer to be in the palm trees and tropical breezes.

I am hosting an eCWusers get together Tuesday afternoon and hope that all of you eCWusers attendees will drop in. It will be great to put a few names with faces. I am also hoping to blog a little from the conference. Update everyone on the new features and announcements. I heard a sneak preview tonight of an exciting new feature that I cannot wait to announce here (once it becomes official).

The first thing to report is that the conference is huge! There are 1,200 users here, and they were turning people away that were trying to register online. We started things off tonight with a reception that was in a tent the size of football field. It was nice to see old friends and new faces.

It should also be reported that this thing is hosted at an absolutely fabulous resort. The Orlando Omni Resort at ChampionsGate. Do NOT look at this link, especially the part about the Swimming Pools if you are stuck in the Northeast and unable to make it down here.

Some faces from the opening reception:

Jen Moore and Laura Nasipak

Doctors Raj & Kavita Dharampuriya

Girish and Dr. Cunningham

GregHinson's avatar
Category: Practice Management
Sunday, August 03, 2008

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Category: EMR
Welcome to the Tips & Tricks Blog

Pretty soon (as soon as a few kinks are worked out) we’re going to use this page to archive valuable posts from the forum, categorized as shown on the right. So when someone creates a post that explains a beautiful shortcut or a valuable workaround, the moderators can mark that post for T&T fame. It will be categorized and searchable. Your office manager will be able to log in and read through the practice management tips, for example.

Stay tuned, and begin thinking of posts that deserve such recognition.


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