Common Commercial Electronic Health Record EHR Systems Used

Common Commercial Electronic Health Record (EHR) Systems Used in Ambulatory and Inpatient Care Settings This work is licensed under a Creative Commons Attribution-Non. Commercial-Share. Alike 4. 0 International License. Based on a work at https: //www. healthit. gov/. This workforce product was funded by a grant awarded by the U. S. Department of Labor's Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U. S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. 1

Overview • Describe the mission and vision of HIMSS and KLAS and how their respective resources can be used to research EHR systems. • Describe common and distinguishing features of common EHR systems. 2

HIMSS Healthcare Information and Management Systems Society About HIMSS • Comprehensive healthcare-stakeholder membership organization • Global leadership for optimal use of information technology (IT) & management systems for healthcare • Educational, professional development, & advocacy initiatives • Promotes information & management systems’ contributions to ensuring quality patient care http: //www. himss. org/about-himss 3

HIMSS (cont. ) Founded in 1961 Offices in Chicago, Washington D. C. , Brussels, Singapore, and other US locations 64, 000 individual members 640 corporate members & 450 not-for-profit organizations http: //www. himss. org/about-himss 4

HIMSS (cont. ) Vision • Better health through information technology. Mission • Globally, lead endeavors optimizing health engagements and care outcomes through information technology. http: //www. himss. org/about-himss 5

HIMSS “Products” Extensive collection of industry research reports IT news Topics and Tools • E. g. Tools for EHR Professionals • Materials about factor & trends in the use of HER • Interoperability testing and certification NOTE: Given the mixed membership (providers & vendors), you will not find vendor comparisons and product reviews http: //www. himssinnovationcenter. org/concert-himss 6

HIMSS “Products” (Con. Cert) What is Con. Cert? Con. Cert by HIMSS™ is a comprehensive interoperability testing and certification program governed by HIMSS and built on the work of the HER/ HIE Interoperability Workgroup and IHE USA. http: //www. himssinnovationcenter. org/concert-himss 7

HIMSS “Products” (Con. Cert) • The Con. Cert by HIMSS program streamlines the certification of interoperability in health IT and helps you evaluate vendor claims, simplifying the task of selecting the right information systems for your organization. • The Con. Cert by HIMSS mark means a product is proven to be interoperable with other products. Con. Cert by HIMSS Certified products. • Con. Cert by HIMSS allows vendors to achieve cost-effective, interoperability certification for solutions that facilitate efficient, seamless data exchange. . http: //www. himssinnovationcenter. org/concert-himss 8

KLAS: Quick Facts • Independently owned & operated • Founder is Kent L. Gale • Pronouncedowned like “class” Independently & Founder is Kent L. Gale Pronounced like “class” operated • KLAS is the first initials of the founders' names: – Kent Gale, Leonard Black, Adam Gale, and Scott Holbrook • Headquarters: Orem, Utah; independent researchers throughout the country KLAS is the first initials of the founders' names: • Kent Gale, Leonard Black, Adam Gale, and Scott Holbrook Headquarters: Orem, Utah; independent researchers throughout the country Focus is solely on healthcare technology http: //www. klasresearch. com/about-us/our-story 9

KLAS (cont. ) Mission What They Do • To improve healthcare technology delivery by honestly, accurately, and impartially measuring vendor performance for our provider partners • Help healthcare providers make informed technology decisions by reporting accurate, honest, and impartial vendor performance 10

KLAS MODEL (cont) • Healthcare professional shares with KLAS their experience with the solutions they use. • KLAS compiles and quality checks data from all evaluations. • KLAS team of researchers analyze data to identify key trends and insights. • KLAS shares research findings and data with professionals at verified healthcare organizations. • KLAS works with vendor leadership teams to help them improve solutions based on user feedback. http: //www. klasresearch. com/the-klas-model 11

KLAS: How They Do It Independently monitor vendor performance through active participation of thousands of healthcare organizations Stringent methodology to ensure data and ratings are accurate, honest, and impartial. Research results offered to healthcare providers through: • Performance Database • Specialty Reports • Advisory Services/Custom Research http: //www. klasresearch. com/the-klas-model 12

How Providers use KLAS Findings • Understand products’ & vendors’ strengths & weaknesses • Screen prospective vendors • Create influential proposals with KLAS research that supports your buying decision • Manage risk and exposure: be informed on price, contract issues & common complaints • Set realistic expectations for your organization and your vendor • Save research time and money 13

KLAS Research Focus Solely on the healthcare technology industry. Its main areas of research are: • Software • (Since 1997) ratings for making the best possible purchasing and negotiating decisions • Services Firms • (Since 2004) reports on services markets including implementation, planning and assessment, vendor selection, technical consulting, IT outsourcing, and business process outsourcing • Medical Equipment • (Since 2005) gathering research on medical equipment, including CR/DR and MRI scanners http: //www. klasresearch. com/resources/reports https: //healthinformatics. wikispaces. com/KLAS 14

KLAS Methodology How overall performance rating is calculated with software: • • Scores for 25 questions Rating scale of 1 -9 (1=poor and 9=excellent) and “yes” or “no” Each question weighted equally Total score is based on 100 -point scale Questions allow healthcare providers to rate the product/vendor in the areas of: • • • Sales & Contracting Implementation & Training Functionality & Upgrades Service & Support General 15

KLAS Methodology (cont. ) Criteria in Evaluations: • • • • Contracting experience Product works as promoted Money’s worth Avoids nickel and diming Quality of implementation Implementation on time Quality of training Overall product quality Delivery of new technology Ease of use Product response time Supports integration goals Product has needed functionality • • • Quality of phone/web support Proactive service Executive involvement Lives up to expectations Keeps promises Part of long term plans Overall communication Recommend to peer/friend Overall satisfaction Forecasted overall satisfaction Would you buy again Ranked client’s best vendor https: //healthinformatics. wikispaces. com/KLAS 16

KLAS Ratings Acute Care EHR • Software products that provide core inpatient functionality: • Clinical data repository (CDR) • Order entry (including computerized provider order entry (CPOE)) • Results reporting • Clinical charting & documentation • Larger: over 200 beds • Small: 200 or less beds 17

Top 10 Acute Care EHR: Over 200 Beds Vendor Product Overall Score Epic. Care Inpatient EHR 87. 59 Cerner Care. Net 78. 06 Mc. Kesson Paragon Clinicals 75. 49 MEDITECH MAGIC Patient Care Inquiry 73. 41 Siemens Soarian Clinicals 73. 09 MEDITECH C/S Enterprise Medical Record 72. 85 Cerner Power. Chart/Powerorders/Care. Net 72. 79 Eclipsys Sunrise Clinical Manager 72. 76 Cerner Power. Chart/Powerorders 72. 50 Mc. Kesson Horizon Expert Orders/Documentation 70. 89 18

Top 10 Acute Care EHR: Under 200 Beds Vendor Product Overall Score Mc. Kesson Paragon Clinicals 81. 11 MEDITECH C/S Enterprise Medical Record 78. 01 Siemens Soarian Clinicals 71. 39 MEDITECH MAGIC Patient Care Inquiry 70. 97 Cerner Power. Chart/Powerorders/Care. Net 70. 78 Eclipsys Sunrise Clinical Manager 70. 49 Cerner Power. Chart/Powerorders 70. 15 HMS Clinicals 68. 28 Siemens Med. Series 4 Clinicals 67. 76 CPSI Clinicals 67. 70 19

KLAS Ratings Ambulatory EHR – software solutions for clinic and practice management, providing charting, orders, prescriptions, and/or EHR functionality. • • • Over 100 physicians 26 - 100 physicians 6 - 25 physicians 2 - 5 physicians 1 physician 20

Top 10 Ambulatory EHR: Over 100 Physicians Vendor Product Overall Score Epic. Care Ambulatory EHR 88. 75 Next. Gen EHR 73. 68 GE Centricity GE 70. 97 Cerner Power. Chart/Powerorders/Care. Net 66. 66 Eclipsys Sunrise Ambulatory Care Manager 63. 95 Allscripts Enterprise EHR 62. 91 MED 3000 IC-Chart 60. 97 e. Clinical. Works EHR 60. 52 Mc. Kesson Horizon Ambulatory Care 59. 71 21

Top 10 Ambulatory EHR: 26 - 100 Physicians Vendor Product Overall Score Epic. Care Ambulatory EHR 84. 01 Sage Intergy EHR 78. 82 Cerner Power. Chart Office/ Power. Works EHR 75. 16 athenahealth athena. Clinicals 72. 29 Greenway Medical Prime. Suite EHR 72. 19 Allscripts Professional EHR 69. 54 Next. Gen EHR 68. 49 MED 3000 IC-Chart 67. 51 LSS (Meditech) MPM 67. 32 GE Centricity GE 67. 24 22

Top 10 Ambulatory EHR: 6 - 26 Physicians Vendor Product Overall Score Greenway Medical Prime. Suite EHR 89. 80 SRSoft hybrid EHR (Lite EHR) 89. 32 athenahealth athena. Clinicals 83. 87 e-MDs Chart 83. 61 LSS (Meditech) MPM 79. 01 Optimed CHARTCARE EHR (CLINICARE) 79. 01 Allscripts Professional EHR 76. 91 Sage Intergy EHR 76. 06 Next. Gen EHR 68. 49 g. Med g. Cage Partner EHR 75. 84 23

Summary of Inpatient Vendors Epic Cerner MEDITECH Mc. Kesson Eclipsys 24

Epic http: //www. epic. com/software Software for mid-size & large medical groups, hospitals and integrated healthcare organizations Customers: • community hospitals • academic facilities • children's organizations • safety net providers • multi-hospital systems Spans clinical, access and revenue functions and extends into the home http: //ehrsoftware. us/epic-emr-software-review/ 25

Epic Company highlights: • On-time, on-budget track record is one of the best in healthcare • Quick to implement, easy to use • Information shared in 2 ways: • Care Everywhere (doctor controls flow of data) • Lucy PHR (patients control their own health information) • Develop, install and support all our applications in-house • Leadership team includes clinicians, developers & process experts http: //ehrsoftware. us/epic-emr-software-review/ 26

Epic Founded in 1979 Private and employee-owned 190 Customers 150, 000 physicians (1 in 4 US physicians) https: //en. wikipedia. org/wiki/Epic_Systems https: //www. essentiacommunityconnect. org/Main/FAQs. aspx#. WXTJSk 3 rs 5 s 27

Cerner http: //www. cerner. com Global supplier of healthcare solutions • Makes sure the right people have the right information at the right time • Founded 1979 (Neal Patterson, Cliff Illig, Paul Gorup) Create a new generation of intelligent medical devices Leverage clinical & pharmaceutical data for new discoveries Collaborate with employers to eliminate administrative waste and friction https: //en. wikipedia. org/wiki/Cerner 28

Cerner Associates: • Worldwide: 24, 000 • Kansas City: 4, 800 Clients: • Over 25, 000 hospitals, physician practices, ambulatory facilities, home health facilities, and retail pharmacies in more than 30 countries. 2015 Revenues: $4. 4 billion Ticker Symbol: CERN – NASDAQ https: //www. cerner. com/uploaded. Files/Fact%20 Sheet_2016 Q 3. pdf 29

Mc. Kesson’s Vision Help create a health care system where quality is higher, mistakes are fewer and costs are lower Help prevent 330, 000 medication errors every week through bar-code scanning technology Provide pharmaceuticals, medical supplies and information technologies for safer healthcare & cost reduction Decision support software for clinical diagnosis & treatment plans Online access to patient information Electronic systems that eliminate paper prescriptions and medical records http: //www. mckesson. com/about-mckesson/who-we-are/ 30

Mc. Kesson http: //www. mckesson. com/en_us/Mc. Kesson. com/ • Ranked 5 th on the FORTUNE 500 (2017) • Revenue $190. 9 billion annually • Delivers medicines, medical supplies and health care information technology solutions • Largest pharmaceutical distributor in North America • Software & hardware technology in 70% of the larger hospitals Customers: • 200, 000 physicians • 26, 000 retail pharmacies • 10, 000 long-term care sites • 5, 000 hospitals • 2, 000 medical-surgical manufacturers • 750 homecare agencies • 600 health care payors • 450 pharmaceutical manufacturers http: //fortune. com/fortune 500/mckesson/ http: //www. mckesson. com/about-mckesson/newsroom/press-releases/2016/mckesson-reports-fiscal-2016 -fourth-quarter-and-full-year-results/ 31 https: //mms. mckesson. com/content/our-story/customers-we-serve/medical-practices/

Meditech Mission Statement: • To provide software that enables physicians, nurses, and other clinicians to orchestrate and deliver patient care in a safe, effective, and efficient manner. Our software is integrated in a manner that fully optimizes the financial and business potential of the health care enterprise. Information is available whenever and wherever clinicians need it Ensure access to a full electronic record with data from across the continuum https: //www. meditech. com/aboutmeditech/pages/mission. htm 32

Meditech • http: //www. meditech. com • 40 years developing, installing, and supporting health care information systems • Founded in 1969 by the developers of MUMPS – A. Neil Pappalardo and Curt W. Marble develop MUMPS technology on a DEC PDP at Mass General Hospital from 1964 to 1968 • Markets: United States, Canada, United Kingdom, Ireland, South Africa, Latin America, Mexico, Spain • 2, 200 customers worldwide • 3700 staff members • Revenue (2015) $475. 5 million • 5 A 1 Dun & Bradstreet credit rating • Privately-held https: //en. wikipedia. org/wiki/Meditech 33

Eclipsys http: //www. eclipsys. com 40 -year history of delivering advanced healthcare IT solutions to affect the quality, safety and cost-effectiveness of healthcare worldwide Leader in CPOE solutions (Computerized Physician Order Entry) https: //en. wikipedia. org/wiki/Eclipsys 34

Eclipsys • Incorporated: 1995 with more than 40 -years of healthcare IT solutions experience • Headquarters Atlanta, GA • Employees: 5500+ worldwide • Clients: 6, 000 hospitals, healthcare systems, clinics and physician practices • Stock Symbol (NASDAQ): ECLP • Allscripts announced on 6/9/10 that it would buy Eclipsys for $1. 35 B. • Eclipsys merged with Allscripts 8/2010. https: //en. wikipedia. org/wiki/Eclipsys 35

Summary • HIMSS is a valuable starting resource to acquire detailed information about features and functions of EHR technology • KLAS is resource that can be used to assist with selecting a specific EHR system • There is wide variation in the corporate history and product offering of commercial EHR system vendors 36