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INTEROPERABILITY Primary Driver of Fiscal and Clinical Outcomes.research and report provided by ReactionData

© 2014 ReactionData All Rights Reserved | not for resale

A study of the value of interoperability and the best means to implement it.

Table of Contents!Introduction 5

Look Under the Covers 5

Executive Summary 6

A Better Experience 8

A Really Big Deal 11

Why Not a Primary Driver by Vendor 12

Allscripts 12

athenahealth 12

Cerner 12

CPSI 12

Epic 13

Healthland 13

McKesson 13

Meditech 13

NextGen 13

Siemens 14

A Note of Caution 15

If You Build It… 17

�2INTEROPERABILITY

Government as a Solution 18

The Case for Each 20

Why a government-led Initiative? 20

Why a vendor-led Initiative? 20

Why a privately-led Initiative? 21

Who Should Lead the Charge? 23

Allscripts 23

athenahealth 23

Cerner 23

CPSI 24

Epic 24

Healthland 25

MEDHOST 25

McKesson 25

MEDITECH 25

Medsphere 26

NextGen 26

Prognosis Health Information Systems 26

QuadraMed 26

Siemens 26


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In Flux , None, Not Using Anyone Yet, and Other 27

Conclusion 28

Appendix A 29

Survey Participants by Title 29

Appendix B 30

Survey Participants by Vendor 30

Appendix C 31

Participating Facilities 31


IntroductionIn my opinion, the best information is current information. If I’m going to make decisions based on data, I’d really prefer that data not to be 6 to 9 months old, and the research collected for this report is extremely recent. Our Reaction platform collected 350 responses from heads of quality, medical directors, CIO’s, nurse leadership, and other highly relevant healthcare experts the last two weeks of September. That makes the data in this report incredibly current and fresh.

The business world isn’t getting any easier so getting critical data extremely quickly is vital in obtaining a competitive advantage. So, my team and I created ReactionData to do just that.

Look Under the Covers!

Our Reaction platform isn’t a secret, nor is it restricted to the public industry reports we produce. If you would like to join the many other global healthcare companies that already use Reaction to get the data they need, shoot me an email.

!Jeremy Bikman

Email: [email protected]

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Executive Summary

Interoperability’s time has come…at least according to this study of 350 medical professionals. It’s becoming so important to improving healthcare overall that it’s being brought up in Congress and is making news in many of the largest news sources on the planet (WSJ, Fortune, Forbes, HIStalk <wink>). Case in point, the cause of IT systems interoperability has recently been taken up by non-profits like the CommonWell Health Alliance and even the federal government (which is the biggest non-profit of them all). Key government officials like Karen DeSalvo, federal health IT coordinator, have made it clear that interoperability is needed.

"Today's lack of interoperability in health IT systems results in gaps," DeSalvo said at the 4th Annual Consumer Health IT Summit. "Missed handoffs can cause unnecessary inconvenience; it causes children to be stuck twice [with immunizations]; people to lose work because they have to have repeat tests; in some cases, it might even cause harm to consumers."

After our first two reports (Patient Portals, Unnecessary Imaging) we had quite a few comments come to us about what topics we should focus on next and interoperability rose to the top of the pile. This study looks into the minds of healthcare professionals, gleaning their opinions and insights about what interoperability will specifically do to improve healthcare and how they feel it can be best implemented.

As a smart data pioneer, we used our Reaction platform to gather data from VP’s of Quality, CNOs, CIO, CMOs, and other key hospital leaders.

Quickly, here are some of the biggest takeaways from the mountain of data we collected over the past two weeks:

• More than 90% of healthcare leaders feel that interoperability will improve the overall experiences of patients and clinicians alike. Wow.

• 91% of healthcare professionals feel that interoperability is a primary driver in clinical outcomes

• 89% feel that interoperability will be a critical driver of fiscal outcomes

• Some may be too optimistic about interoperability, however. Some of those closest to fiscal and clinical outcomes are more skeptical than the rest of the medical community that was surveyed.

• Nurses were more skeptical about improved clinical outcomes.

• COO’s and IT Directors were more skeptical about improved fiscal outcomes.


http://searchhealthit.techtarget.com/opinion/Where-EHR-interoperability-open-systems-and-data-governance-meet

• Nearly all healthcare providers (97%!) see greater clinician adoption of interoperability services if they were available in their current health IT or EMR system

• A bare majority (51%) of healthcare providers feel that the federal government is the best vehicle to make interoperability a reality

• Clients of various EHR vendors view the solution to interoperability very differently. A vendor-specific analysis is provided for each of the following:

!Allscripts

Cerner

CPSI

Epic

McKesson

MEDITECH

Siemens

athenahealth

Healthland

MEDHOST

MedSphere

NextGen

Prognosis

QuadraMed!!!!!!!!!!


A Better Experience

Interoperability is great in theory but do those in charge of medical facilities feel that it would truly improve operations and services at their respective organizations? We asked healthcare providers, “Will improved interoperability create a better patient and clinician experience?” with a 1 being absolutely not and a 10 being absolutely yes.

More than 90% of respondents answered with a 7 or higher. Exactly 38% answered 10 and only 1% gave the lowest response … a 3. Not a single respondent answered with a 1 or a 2, which shows that leaders from around the country see advantages coming from interoperability.

Simply put, interoperability will improve the experience of patients and clinicians.


Would Interoperability Create a Better Experience

Num

ber o

f Par

ticip

ants

10

20

30

40

Absolutely Not Absolutely Yes

1 2 3 4 5 6 7 8 9 10

Figure 1: When asked on a scale of 1-10 if interoperability would create a better experience, 90% answered 7 or higher

Armed with the extra information we had about respondents, the vendor they use and the title they hold in their hospital, we decided to dig deeper into the numbers and see if we could find additional trends.

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Figure 2: Average rank on scale of 1-10 by EHR vendor.

Would Interoperability Create a Better Experience

Allscripts

athenahealth

Cerner

CPSI

Epic

Healthland

MEDHOST

McKesson

Meditech

NextGen

QuadraMed

Siemens

Other

No Vendor

In Transition

0 1 3 4 5 6 8 9 10

Absolutely Not Absolutely Yes

When we broke this down into smaller groups, the top line trend mostly held. Most individual groupings (by vendor used and by title of respondent) still held a mean of above an 8. There were a couple outliers that came from smaller groupings.

The respondents who represented Healthland (6.25) and QuadraMed (7.33) reported means lower than an 8. There was no specific reason we could ascertain for why these respondents gave lower rating to interoperability than others. It might speak to the functionality of their systems, but this data doesn’t provide a specific answer.

Those whose EHR used was in transition (7.17) or who aren’t using an EMR yet (5.67) each had lower means than an 8, which meant it was substantially lower than the average. This makes sense, as an entity not using a consistent EMR will probably have less appreciation for the value of interoperability.

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A Really Big Deal

It is no secret that improving healthcare’s clinical and fiscal outcomes is a [very] hot topic in the United States today. Since improving interoperability seemed to be a very well received idea, we asked how positive could it really be. Could it be a “primary driver of clinical and fiscal outcomes?”

Healthcare providers overwhelmingly said yes.

Precisely 91% of providers said that interoperability was a primary driver for clinical outcomes, while 89% said the same about fiscal outcomes.

If you have followed political debates on just about any topic imaginable, you know that getting this type of agreement on anything is close to a miracle. To do so on any topic related to healthcare… well it must be a really big deal.

How big of a deal was it? If the top line numbers haven’t impressed you, this probably will. The majority of respondents who said interoperability was not a primary driver of either fiscal or clinical outcomes still acknowledged the benefit of interoperability, they just didn’t consider it to be the main driver.

“It will [improve fiscal and clinical outcomes] but it isn’t the primary driver,” one medical director said. “Provider decision making is the primary driver [aided] by improved interoperability.”


Figure 3: Percentage who think interoperability drives clinical and fiscal outcomes

Fiscal Outcomes

11%

89%

Clinical Outcomes

9%

91%

Why Not a Primary Driver by Vendor

When individuals suggested that improved interoperability isn’t a primary driver of clinical and fiscal outcomes, we asked them why. The answers they gave suggest differences in the clientele (and possibly functionality) of the various EHR vendors that exist.

The following is a description of answers individuals gave based upon the EHR vendor of their organizations. (Unfortunately, there wasn’t enough information from some EHR vendors’ customers to identify a pattern so those EHRs have been omitted.)

Allscripts !

More than just about any other group, Allscripts customers agreed that improved interoperability is a primary driver of clinical and fiscal outcomes. Those few who dissented still agreed that interoperability is useful; however, they indicated that other considerations might be larger.

“It will help, but isn't necessarily a primary driver,” one CMIO wrote. “Operational issues trump technology, which is just a tool to help achieve desired outcomes.”

athenahealth!

The lone athenahealth customer who provided commentary noted that fiscal software is less complex and therefore less likely to benefit from interoperability between systems.

Cerner!

This study interviewed many Cerner customers and so many different comments were made. The most unique, which was repeated multiple times, argued that improved interoperability would cost them more. This meant that improved interoperability would not help on the financial side.

“Most interoperability projects require additional costs, resources, etc,” one IT director wrote. “Thus, the increased costs associated will not necessarily drive DOWN expenses short term. Long term it is still unknown.”

CPSI!

A few CPSI customers noted their concern was with the data that is in the EHR in the first place. These problems might prevent any value of interoperability from being realized.


“The primary processes have too many issues,” one CMO said. “It will be ‘garbage in, garbage out.’”

Epic!

The Epic customers interviewed gave a wide variety of reasons as to why interoperability might not be a primary driver of fiscal or clinical outcomes. These responses did not coalesce around any specific topic though the most frequent was that it would help, though it wouldn’t be a “primary driver.”

Healthland!

The one Healthland customer who commented noted that interoperability could be useful; however, the current solutions were not helpful.

“’Improved’ interoperability would help,” this individual wrote. “However, the current systems offered are just making healthcare more difficult and increasing the opportunity for errors.”

McKesson!

Few McKesson customers gave feedback on this subject; however, a few of those that did brought up an interesting and unique concern – that interoperability inherently relies on doctors trusting one another’s judgment. This could limit the benefits of interoperability in rural areas where there are few doctors or where doctors don’t trust others.

“Doctors will not always want to rely on another docs opinion or results, sometimes for liability reasons,” one CIO said. “They will still perform their own tests and use their own opinion and results.”

Meditech!

The Meditech customers who responded indicated a variety of reasons for the limitation of interoperability but the most frequent reason given was that technology, while powerful, is still just a tool in the healthcare process.

“[Technology] is just a tool or instrument, not the primary driver,” one CIO said.

NextGen!

The NextGen customers who answered nearly unanimously found that interoperability is a primary driver of fiscal and clinical outcomes. The lone dissident noted that fiscal and clinical outcomes are still “mainly [a] doctor patient [issue].”


Siemens!

Siemens customers gave little criticism of interoperability although one did sound a familiar theme on the limits of technology.

“[Interoperability] will help improve outcomes, but it's not the ‘primary’ driver,” a COO wrote. “The primary driver is really the physician relationships and cooperation of the care team.”

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A Note of Caution

While it would be easy to look at these results and decide that improved interoperability is a cure-all, we found some need for caution when we dug deeper into the data.


Interoperability Would be a Primary Driver for

Average

Nurse Directors

Nurse Managers

CNOs

COOs

IT Directors

IT Managers

0% 25% 50% 75% 100%

ClinicalFiscal

Figure 4: Percentage of respondents that said interoperability is a primary driver of fiscal and clinical outcomes.

IT directors, nurses, and COOs were more skeptical about the benefits of interoperability. The curious part of this dissent is not who dissented but why they dissented. Each group thought the benefits would be felt in areas where these individuals have less of an impact.

In other words, the people closest to the action on clinical outcomes are more skeptical than the medical community at large the benefits of interoperability for clinical outcomes. The same is true for fiscal outcomes. This might simply be a product of individuals protecting their respective turf, but it might also suggest that the benefits will be more limited than the broad results of this study suggest.

Over 87% of Nurse Directors said that improved interoperability would be a primary driver to improve fiscal outcomes, but only 62.5% felt the same way about interoperability being a primary driver in improving clinical outcomes. For nurse managers, the same trend appeared but it was starker. (100% fiscal, 50% clinical) CNOs did not share this opinion with their subordinates; however. 100% of CNOs said improved interoperability would be a primary driver of clinical outcomes and 92.9% of CNOs said the same of fiscal outcomes.

On the other side, 80% of COOs agreed that interoperability would be a primary driver of clinical outcomes, while only 60% thought it would be a primary driver for fiscal outcomes. The same was true for IT Directors (95% yes to clinical, 72% yes to fiscal). Again, the trend did not go all the way down as IT Managers were optimistic. (100% clinical, 83% fiscal)

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If You Build It…

Imagine healthcare vendors, providers, and everyone in between invests millions into developing real IT system interoperability and then nobody really took to it. That would be a major waste, right? That’s why we asked if healthcare leaders thought interoperability would be adopted if it were really available.

Let’s just say we aren’t very worried about adoption anymore.

Healthcare providers were nearly unanimous – 97% expect to see adoption of interoperability services if they were available. This means that if vendors were willing and able to collaborate effectively to produce products that were truly interoperable, almost every professional in the nation would benefit from it.


Do You Foresee Greater Clinician Adoption if Natively Available in IT or EHR System?

No 3%

Yes 97%

Figure 5: Responses to question “Do you foresee greater clinician adoption to interoperability services if they are available natively in your current health IT or EHR system?”

Government as a Solution

Currently there are three sources people look to in hopes these can make interoperability a reality: government, vendors and private entities.

1. Vendors can work together to make their individual systems interoperable, allowing every facility, no matter their vendor, to share critical information.

2. Private initiatives work to make systems interoperable by developing standards and tools that ideally will work for across all healthcare vendors and providers.

3. The Federal Government has the ability (and the teeth) to demand certain standards or create a task force to come up with a solution.

Healthcare professionals were asked which of these three options would be the best to bring interoperability to America’s healthcare system and we found that just over half (51%) believed a government-led initiative would be most effective.


Best Venue to Bring Interoperability

Vendor-Driven!23%

Private Entity-Led!26%

Government-Led!51%

Figure 6: Response to question “Which of the following is the best venue to bring interoperability to America’s health care system?”

This noticeably changed depending upon which core EHR vendor the respondent used and the title of the respondent.

IT professionals, nurses, informatics managers, and managers of quality were all far more skeptical of government as the solution than respondents as a whole. All of these cohorts were more likely to suggest a private entity-led initiative than did the rest of the respondents.


Figure 7: Best venue for interoperability broken down by title

Best Venue for Interoperability by Title

Administrator

CEO

CFO

Chief/VP of Quality

CIO

CMIO

CMO

CNO

COO

Department Head

Nurse Director

Director of Quality

EMR Specialist

Informaticist

Informatics Director

Informatics Manager

IT Director

IT Manager

IT Specialist

Manager of Quality

Nurse Manager

Average

0% 100%

GovernmentPrivateVendor

The Case for Each

We wanted to dig a little deeper though. We asked why each person thought the option they selected would be best to facilitate interoperability. As expected, their responses revealed a great deal. In order to give a quicker view of what these participants focused on in their responses, we have provided a word cloud and a short explanation describing the main themes for each category.

Why a government-led Initiative?!

Many of the respondents who preferred a government-led initiative shared a common belief that government is the only organization with enough power to to make everyone work together on interoperability. The government initiative of Meaningful Use has shown that government has the wherewithal to force change in healthcare. One facility’s CIO explained his reasoning why Government is his preferred option.

“We need to ensure standards are defined and all vendors that choose to participate are implementing consistent solutions across the healthcare system regardless of which EMR that is used,” he said. “A government sponsored initiative gets everyone engaged and focused on the same goals at the same time allowing for significant progress in as short a time possible.”

Regulations from government are seen as a need in order for adoption of interoperability to take place. Respondents also state government’s ability to make changes happen in a timely manner where vendors and others may not be able to do so or lack the proper incentives.

Why a vendor-led Initiative?!

These respondents explained that vendors know the industry better than any other entity and as such this makes them more qualified to successfully address the interoperability issue. More than anything


though, healthcare professionals felt that a government-led initiative would create unneeded financial pressures on their organizations. Some respondents, however, remained skeptical about vendors’ ability to work together.

“I just feel [vendors] have a great handle on what the capabilities are. I think it is naive to assume vendors would come together to solve the issue without pressure from a governmental initiative,” one CIO said. “However, their capability to create standards and expand EHR interoperability offerings could quickly outpace the directive of the federal government.”

Why a privately-led Initiative?!

These respondents felt that government does not understand the daily needs of facilities well enough to lead the initiative and that vendors are simply too competitive to work towards the greater good. In short, they feel that a privately-led initiative will have the purest and most informed motives.

“Government policies mean well but are rarely well executed in quality space and vendors are for profit and generally not incentivized to invest in such an initiative that will perhaps require significant changes to their most profitable products,” said one director of performance improvement. “A private-government partnership might work but it has to start as a private, provider and consumer driven effort.”

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Figure 8: Best venue for interoperability broken down by vendor

Best Venue for Interoperability by Vendor

Allscripts

athenahealth

Cerner

CPSI

Epic

Healthland

MEDHOST

In Flux

McKesson

Meditech

NextGen

None

Not Using Anyone Yet

Other

QuadraMed

Siemens

Average

0% 100%

GovernmentPrivateVendor

Who Should Lead the Charge?The vendors whose clients responded to this study gave a variety of reasons for what they thought is the best way to achieve interoperability. We’ve broken them down into groups by vendor and tried to find a pattern among each. If you would like the full comments related to your business, feel free to email Jeremy Bikman at [email protected].

Allscripts!

56.25% of Allscripts customers surveyed said a government initiative is the best solution to interoperability. Allscripts clients mentioned they do not feel that vendors are willing to work together. They mentioned over and over again that vendors competing against each other had only pushed them farther from interoperability.

“The vendors have already demonstrated that they don't want to do it on their own,” said one CMO. “They would rather compete for the market.”

athenahealth!

All athenahealth customers believed that the government is the best option as well. The common belief among these professionals is that government is the only entity that can force interoperability to happen.

“As much as we did not like meaningful use and the requirements to comply, it did move the industry forward,” said one CIO. “Vendor's agree that interoperability is important but there is still a great amount of competition that leads to limited functionality.”

Cerner!

Cerner had the most customers in this study. Nearly half of their customers said that a government led initiative was most plausible. They explained that vendors do not have the incentive to cooperate on this issue and that a federal push would be the only thing that would require all healthcare organizations to participate.

“Mandating interoperability is the only way to get compliance,” said one Informatics Director. “Vendor or privately led venues will not have the authority to force compliance.”

“Only the government will have the ability to create standards that are enforced,” said another Informatics Director. “We have already seen what happens when each vendor creates their own standard and that has led to incompatible EMRs even though most of the data in each EMR is very similar.”


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However, 27.27% of Cerner customers felt a private-entity-led initiative would be most effective and 24.24% felt a vendor-led initiative was best. The reason being, a private or vendor initiative would provide a system of interoperability that worked better for the customer and could be produced faster than the government’s timeframe, according to these customers.

“If the vendors all get together and agree to standards, it will be more effective and have less governmental regulations to deal with,” said one CMO. “A private endeavor might also work, but I don't know how they would create the standards needed.”

CPSI!

With 51.72% of CPSI customers saying they want a government led initiative, these respondents stated that a government mandate is best. Interoperability would require all facilities to use the same system in order to make the process of sharing information smooth. These respondents say that government is the only entity that could mandate the use of all the same system.

“I believe that unless all healthcare organizations use a standard system, the EHR initiative will not flow seamlessly from one healthcare provider/organization to another,” said one Director of Quality. “Unless mandated by the government, there will be no incentive for Healthcare organizations to standardize across the country.”

CPSI also had one of the higher percentages (31.03%) of customers who said a vendor-led initiative was preferred. They felt that a vendor initiative would cater more to individual needs.

“They will hopefully build the initiative around our hospital which is smaller and not put us in the same box as the bigger hospitals. Personalize it better.”

Epic!

Interestingly, the same number of Epic customers responded preferring a government-led initiative as preferring a private-led one. 38.30% said that government was best and that vendors could not work together well enough on this issue. Another 38.03% felt that private initiative would work because they would have a better feel for the needs of the individual organizations but they also do not have the competition holding them back like vendors have.

“Government would be nice, but seems they don't do a good job,” said one IT Director. “Vendor often is revenue and product sales specific. Private usually leads to the best result for the organization.”

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Healthland!

Healthland was represented by four respondents and half of them chose government-led initiative. One of those two indicated afterward that they didn’t much mind either way. The last two split on vendor and private-entity led solutions.

MEDHOST!

Of the few MEDHOST customers that responded, two felt a government-led initiative would be most effective because, like one IT Director said, “It will be standards based and all will be required to comply.”

McKesson!

McKesson hospitals were more critical toward vendors than other customers. Just over half (51.35%) wanted government to lead the initiative and the other half were split between private and vendor. Those that wanted government-led said directly that they felt vendors were too self-supporting.

“Vendors are driven by their own priorities and interoperability may not be considered in their best interest,” a CIO said. “The private sector can only carry interoperability as far as the vendors are willing to take it. I feel it will only happen when driven by government.”

The other half who liked the idea of a private or vendor led initiative felt that would be effective because they have been in the industry working with organizations already.

“The vendor will already have resources and systems that support interoperability and can incorporate the governmental and private entity requirements,” a Director of Quality said.

MEDITECH!

A government-led initiative was the selected response for 55.17% of MEDITECH’s customers. Many of these customers felt that vendors and government collaboration would be best but that vendors would not be motivated to do it on their own. They feel that government should mandate it and vendors should be required to create the system.

“We need to ensure standards are defined and all vendors that choose to participate are implementing consistent solutions across the healthcare system regardless of which EMR that is used,” said one CIO. “A government sponsored initiative gets everyone engaged and focused on the same goals at the same time allowing for significant progress in as short a time possible.”


Medsphere!

The one Medsphere respondent felt a vendor-led initiative would be best.

“The government can't pull their heads out of their butts long enough to overcome bureaucracy and actually get something done right. Single entity software providers can only seem to get one thing right, but never most things right. However, a vendor can work with their software and hardware providers to get an ecosystem that works well and places them in a better position to sell. It’s a win/win for all.”

NextGen!

Half of the NextGen customers that responded felt that government was the best initiative because they have the power to change healthcare across the board.

“In healthcare, sadly it takes the gov't intervention to make things happen across the board,” said one Director of Quality. “It doesn't happen with individual accountability.”

Prognosis Health Information Systems!

Prognosis Health respondents were split right down the middle with one half opting for government to lead the interoperability charge while the other half felt that private entity would be the preferred option. They suggested a private entity would best understand the needs of the industry.

QuadraMed!

All respondents from QuadraMed chose government-led initiative. They said that this was the best way to make all vendors comply.

“[Government] sets standards required by all that ensures vendors or other entities don't try to garner market share by creating standards that might provide them with a marketing edge, even temporarily,” one CIO said.

Siemens!

61.11% of Siemens customers thought it best to have a government-led initiative. The reasons they gave were varied but one common reason was that they feel the medical industry resists change and only does so when government steps in.


“Healthcare is more responsive to the pressures applied by the government than any other form of influence,” this Chief/VP of Quality said.

In Flux , None, Not Using Anyone Yet, and Other!

50% of respondents who were not tied to any particular vendor felt a government-led initiative would be best because it would be standardized.

“This has a broader spectrum of coverage with better possible enforcement and deployment,” one IT Director said.

There were 33% who wanted private entities to take on the issue for various reasons like cheaper implementation, less government infringement and more personalized systems. The 17% who wanted a vendor-led initiative said they just didn’t want another government “intrusion.”

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Conclusion

It is pretty rare when you find an issue on which almost everyone can agree. Yet, the extremely high value improved IT system interoperability can bring to the most essential elements (clinicians, patients, and the almighty dollar) of the healthcare delivery continuum has proven to be one of those few things. That, in and of itself, is exceptionally noteworthy.

But how do we get there? There isn’t widespread agreement on the best solution. That is no surprise. But the value of improved interoperability seems to be so big that maybe, just maybe, people can put aside their differences, roll up their sleeves, and get it done.

Ok healthcare in America. The ball is in your court. We’ve told you what you apparently already knew, but this is a big deal, and if you build it, it will work. So to steal a phrase from that thespian extraordinaire Larry the Cable Guy, “let’s get ‘er done”!

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Appendix A

Survey Participants by Title!

Unfortunately, many research firms spend their time getting input from people who can't make decisions. That's not the ReactionData model. Rather, we try to get feedback from decision makers and key leaders whose opinion can actually have an impact. For that reason, and in an effort to be transparent, this is a breakdown of the participants in our survey by job role.

Rest assured, the data that we collected is valuable and accurately reflects the opinions of key decision makers in healthcare.

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Participants by Title

CEODepartment Head

Nurse ManagerOther

AdministratorCOO

Informatics ManagerInformaticistIT Manager

Informatics DirectorNurse Director

Chief/VP of QualityManager of Quality

CNOCMIOCMO

IT DirectorCIO

Director of Quality

Number of Participants

0 10 20 30 40 50 60 70 80 90

Appendix B

Survey Participants by Vendor!

To deliver as much information as possible we have provided a breakdown of the vendors that our participants use. Those vendors with less than three respondents were included in the “other” category. A select few respondents were either in the process of finding another vendor or did not have an EMR vendor yet.

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Participants by Vendor

Cerner

Meditech

Epic

McKesson

CPSI

Allscripts

Siemens

Other

In Transition

Healthland

NextGen

No vendor

athenahealth

MEDHOST

QuadraMed

Number of Participants

0 20 40 60 80

Others totaling the 3.2% include MediSoft, MedSphere, MetaCare, Prognosis, and non-vendor systems build in house

Appendix C

Participating Facilities!

The personal information provided by individual providers is anonymous and will not be shared. In addition, we want to maintain the privacy of those who individually chose to respond. That said, we felt it appropriate to list the institutions represented in this study. These institutions include:!Acuity Hospital of South Texas, LLC Adirondack Medical Center Alameda Health System Albany Medical Center Hospital All Children's Hospital Allenmore Hospital Anthony Medical Center Arnot Ogden Medical Center Athens-Limestone Hospital Avera Heart Hospital of South Dakota Avera Sacred Heart Hospital Avoyelles Hospital Bakersfield Heart Hospital Banner Health Baptist Health Baptist Health Medical Center - Heber Springs Baptist Memorial Hospital - Memphis Baptist Memorial Hospital - North Mississippi Baraga County Memorial Hospital Barnabas Health Bates County Memorial Hospital Baxter Regional Medical Center Baylor Scott & White Health Baystate Health Beaumont Hospital - Troy Ben Taub General Hospital Benefis Health System Bennett County Healthcare Center Berkshire Medical Center Blue Mountain Hospital District Boca Raton Regional Hospital Bonner General Hospital Boone County Health Center Boone County Hospital Bowdle Hospital Braxton County Memorial Hospital

Bristol Hospital Broadlawns Medical Center Bronson Healthcare Bryan Health Buchanan County Health Center Butler Health System Camden-Clark Medical Center Cape Cod Hospital Cape Coral Hospital Carilion Roanoke Memorial Hospital Carolina East Medical Center Carroll County Memorial Hospital Carthage Area Hospital Cascade Medical Center Catholic Health Initiatives Catholic Health System Cheyenne County Hospital Children's Hospital of Orange County Chippewa County - Montevideo Hospital City of Hope Clifton Springs Hospital & Clinic Columbia Basin Hospital Columbus Community Hospital Comanche County Memorial Hospital Community Health Network Community Heart & Vascular Hospital Community Memorial Hospital Confluence Health Cook Children's Health Care System Cooper University Hospital Copley Hospital, Inc. Cozad Community Hospital Crook County Medical Services District Crouse Hospital Daughters of Charity Health System Day Kimball Hospital


Dayton Children's Hospital Dayton Children's Medical Center Deaconess Health System DeKalb Health Delano Medical Center Doctors Hospital Doylestown Hospital Duke University Hospital Duncan Regional Hospital East Jefferson General Hospital Eastern Connecticut Health Network Eastern Niagara Hospital - Lockport Ellsworth County Medical Center Ephraim McDowell Regional Medical Center Erie County Medical Center Essentia Health Fargo Evans Memorial Hospital Excela Frick Hospital Faulkner Hospital Fawcett Memorial Hospital Fisher-Titus Medical Center Fletcher Allen Health Care Forest Hills Hospital Forest Park Medical Center Frisco Fort Memorial Hospital Frank R. Howard Memorial Hospital Franklin General Hospital Fremont Area Medical Center Fresno Surgical Hospital Georgetown Community Hospital Gerald Champion Regional Medical Center Gifford Medical Center Glens Falls Hospital Gnaden Huetten Memorial Hospital Good Samaritan Regional Medical Center Good Shepherd Medical Center - Marshall Gothenburg Memorial Hospital Grand Itasca Hospital Granite County Medical Center Grant Medical Center Great Lakes Specialty Hospital - Grand Rapids Campus Great Plains Health Great River Medical Center Greene County General Hospital Grundy County Memorial Hospital Gwinnett Hospital System

Hardin Medical Center Harrison County Hospital Harrison Memorial Hospital Hayes Green Beach Memorial Hospital HCA - Hospital Corporation of America Health First Higgins General Hospital Hillsboro Community Hospital Holy Cross Hospital Holy Family Memorial Holy Name Medical Center Holy Spirit Health System Holzer Gallipolis Campus Holzer Medical Center - Jackson Hudson Hospital & Clinics Hunt Regional Community Hospital Iberia Medical Center Illini Community Hospital Inova Medical Group Inspira Health Network Intermountain Healthcare Jackson Purchase Medical Center Jameson Hospital Jane Phillips Medical Center Jasper County Hospital Jefferson Regional Medical Center - AR Kaiser Permanente Kaweah Delta Health Care District Kennedy Health System Kindred Hospital - Atlanta Kindred Hospital - Tarrant County - Arlington Kingman Regional Medical Center King's Daughters Medical Center Kiowa County Memorial Hospital Knox County Hospital Kootenai Health La Rabida Children's Hospital Lander Regional Hospital Latimer County General Hospital Lawrence Memorial Hospital LifeCare Hospitals of Plano Logansport Memorial Hospital Loma Linda University Medical Center - Murrieta Louisiana Extended Care Hospital of Lafayette Lourdes Medical Center of Burlington County LSU Health Care Services Division


Lubbock Heart Hospital Mad River Community Hospital Magnolia Regional Medical Center Maimonides Medical Center MaineHealth Manati Medical Center Marlette Regional Hospital Marshall County Hospital Mary Washington Hospital Matagorda Regional Medical Center Maury Regional Hospital Mayo Clinic McLaren - Northern Michigan Meadows Regional Medical Center Medical Center of Central Georgia Medical Center of Southeast Texas MedStar Southern Maryland Hospital Center Memorial Health System of East Texas - Lufkin Memorial Hospital at Gulfport Mercy Medical Center Meridian Health Methodist Hospital Methodist Hospital of Chicago Metro Health Hospital Millcreek Community Hospital Miners' Colfax Medical Center Mission Hospital Mizell Memorial Hospital Monongahela Valley Hospital Monroe Carell Jr. Children's Hospital Monroe County Hospital & Clinics Morgan Memorial Hospital Mountain View Hospital Munroe Regional Medical Center Nassau University Medical Center Ness County Hospital New Hanover Regional Medical Center Orthopedic Hospital Newton Medical Center Northeast Georgia Medical Center Northern Hospital of Surry County Norton Suburban Hospital NYU Langone Medical Center Ochsner Baptist Medical Center Ochsner Health System Oconomowoc Memorial Hospital Ohio Valley General Hospital

OSF HealthCare System Oswego Hospital Otis Health Care Center Owatonna Hospital Palmdale Regional Medical Center Palomar Health Park Ridge Health Partners Healthcare Passavant Area Hospital PeaceHealth Southwest Medical Center Pella Regional Health Center Peninsula Regional Medical Center Penn State Milton S. Hershey Medical Center Peterson Regional Medical Center Phillips County Hospital Piedmont Healthcare - NC Plains Memorial Hospital Pocahontas Memorial Hospital Pocono Medical Center Preston Memorial Hospital Princeton Community Hospital Promise Hospital of Miss Lou Promise Hospital of Salt Lake Punxsutawney Area Hospital Putnam General Hospital Ray County Memorial Hospital Redington-Fairview General Hospital Rice Memorial Hospital Riverside Health System Riverside Medical Center Riverwood Healthcare Center Rochelle Community Hospital Rockville General Hospital Roosevelt General Hospital Roosevelt Memorial Medical Center Roper Hospital Roundup Memorial Hospital Rush University Medical Center Sacred Heart Hospital Salem Memorial District Hospital San Juan County Hospital San Juan Regional Medical Center San Luis Valley Health Santa Clara Valley Medical Center Sarah Bush Lincoln Health System Saratoga Hospital


Seattle Children's Hospital Select Specialty Hospital - Charleston Shenandoah Medical Center Shriners Hospital - Honolulu Sibley Memorial Hospital Sierra Vista Regional Medical Center Skagit Regional Health SLV Health Conejos County Hospital South County Hospital South Nassau Communities Hospital Southern Ohio Medical Center - Main Campus St. Claire Regional Medical Center St. Dominic - Jackson Memorial Hospital St. Francis Hospital St. Francis Hospital - Bartlett St. Francis Hospital - SFDE St. John's Riverside Hospital - Andrus Pavilion St. Joseph Hospital St. Joseph Martin St. Joseph Regional Medical Center - Mishawaka St. Joseph's Hospital St. Jude Children's Research Hospital St. Luke's Community Medical Center - The Woodlands St. Luke's Cornwall Hospital - Cornwall Campus St. Mary Good Samaritan Hospital St. Mary Medical Center St. Mary's Good Samaritan Inc. - Centralia Campus St. Peter's University Health System St. Vincent's Blount Stanton County Hospital Steele Memorial Medical Center Stellaris Health Network Stillwater Medical Center Stony Brook University Medical Center Swedish Medical Center Sweeny Community Hospital Syringa General Hospital

Texas Health Presbyterian Hospital Plano Texas Scottish Rite Hospital for Children The Callahan Eye Foundation Hospital The Children's Hospital of Philadelphia ThedaCare Timpanogos Regional Hospital Trinitas Health TriStar Summit Medical Center UK HealthCare University of Kentucky Hospital UM Rehabilitation & Orthopaedics Institute UM St. Joseph Medical Center Uniontown Hospital UnityPoint Health University Medical Center of Princeton at Plainsboro University of Arkansas for Medical Sciences Medical Center UW Health Partners Watertown Regional Medical Center Vail Valley Medical Center Valley Regional Hospital Vanderbilt University Hospital VCU Medical Center (MCV Hospitals, MCV Physicians, CHoR, etc) Virtua Health WA Foote Memorial Hospital /Allegiance Health Washington County Hospital Washington Hospital Washington Regional Medical Center Webster County Memorial Hospital West Park Hospital District West Shore Medical Center Wickenburg Community Hospital Williamson Medical Center Willis - Knighton Medical Center Winn Parish Medical Center Woman's Hospital Wray Community District Hospital Yuma District Hospital

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interoperability - reaction data · interoperability’s time has come…at least according to this...

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