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Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social. > hospitals use EHR to maximize billing As a person who has worked extensive

Typing in ALL CAPS does not make your argument stronger, this isn't Truth Social. > hospitals use EHR to maximize billing As a person who has worked extensively with hospitals and CHCs helping them integrate technology, this is false. EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source.

epcoa 1y ago
I dunno, QuadraMed that was used by at least NYC H&H for years before their imperiled transition to Epic prominently displayed “Revenue Cycle Management” on the splash screen of its decrepit provider facing frontend. Both of you are overstating your cases. That said, it’s hard to overstate how heavily charge capture and billing are prioritized to the detriment of other aspects. > I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source. There were major EHR deployments in the 80s through early 00s, before most government mandates. Surely later mandates were an incentive This reflects a lack of tenure.
- leakycap 1y ago
  > There were major EHR deployments in the 80s through early 00s, before most government mandates. Examples?
  - deleted 1y ago
    [deleted]
  - epcoa 1y ago
    One example was already given. Epic dates back to 1979, certainly they were doing something prior to 2009 (as was Cerner and Meditech). Other than HITECH, what other major regulation in the US are you referring to? https://international.kaiserpermanente.org/wp-content/uploads/2019/07/EHR_Journey_final.pdf https://international.kaiserpermanente.org/wp-content/upload... Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.
bonsai_spool 1y ago
> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source. Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.
- nradov 1y ago
  Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.
  - leakycap 1y ago
    > They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules Yep, and more and more payors - government and private - are demanding systems that are both interoperable and audiable Internal, bespoke systems are notoriously nightmarish for auditing
    - vintermann 1y ago
      As opposed to the Epic MUMPS pile? Epic has been sold in in Denmark and Finland, where it was a disaster, and then in Norway, where they failed to take lessons from the disasters. I don't think it's federal requirements which is the selling point there, though I wonder what the hell the selling point is, or what the Epic sales people put in acquirers' coffee.
  - bonsai_spool 1y ago
    I'm not talking about bespoke EHRs - the GP made the claim that only governmental insistence compels EHR decisions. If that were true, there wouldn't ever be a change from one EHR system to another. But these get announced all the time, so the premise is false.

epcoa 1y ago

I dunno, QuadraMed that was used by at least NYC H&H for years before their imperiled transition to Epic prominently displayed “Revenue Cycle Management” on the splash screen of its decrepit provider facing frontend. Both of you are overstating your cases. That said, it’s hard to overstate how heavily charge capture and billing are prioritized to the detriment of other aspects. > I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source. There were major EHR deployments in the 80s through early 00s, before most government mandates. Surely later mandates were an incentive This reflects a lack of tenure.

leakycap 1y ago
> There were major EHR deployments in the 80s through early 00s, before most government mandates. Examples?
- deleted 1y ago
  [deleted]
- epcoa 1y ago
  One example was already given. Epic dates back to 1979, certainly they were doing something prior to 2009 (as was Cerner and Meditech). Other than HITECH, what other major regulation in the US are you referring to? https://international.kaiserpermanente.org/wp-content/uploads/2019/07/EHR_Journey_final.pdf https://international.kaiserpermanente.org/wp-content/upload... Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.

bonsai_spool 1y ago

> EHR is being used because it's required - both by payors and regulation/law. I can think of zero instances where an organization switched to EHR without being forced by a deadline from an outside source. Your argument fails in cases where hospitals switch from bespoke EHRs to use one large EHR that has better revenue features. This is quite trivially discovered if one follows the news of large hospital chains who have moved to Epic recently.

nradov 1y ago
Revenue cycle issues are important but not the only factor. It's simply no longer economically feasible for provider organizations to maintain bespoke EHRs. The costs have gone up too much. They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules compliance and escalating user expectations.
- leakycap 1y ago
  > They can't afford to pay developers to build and maintain all of the functionality now required due to federal interoperability rules Yep, and more and more payors - government and private - are demanding systems that are both interoperable and audiable Internal, bespoke systems are notoriously nightmarish for auditing
  - vintermann 1y ago
    As opposed to the Epic MUMPS pile? Epic has been sold in in Denmark and Finland, where it was a disaster, and then in Norway, where they failed to take lessons from the disasters. I don't think it's federal requirements which is the selling point there, though I wonder what the hell the selling point is, or what the Epic sales people put in acquirers' coffee.
- bonsai_spool 1y ago
  I'm not talking about bespoke EHRs - the GP made the claim that only governmental insistence compels EHR decisions. If that were true, there wouldn't ever be a change from one EHR system to another. But these get announced all the time, so the premise is false.