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The first electronic medical record (EMR) was developed in 1972 by the Regenstreif Institute and was viewed as a major advancement in medical practice.

Electronic records evolved beyond capturing patient history to a more comprehensive view of a patients health and now are known as electronic health records (EHRs). They were seen as a critical tool to improve the quality and efficiency of clinical care such that legislation was introduced to encourage their adoption. The Health Information Technology for Economic and Clinical Health (HITECH) Act, a component of the American Recovery and Reinvestment Act of 2009 (ARRA), provided incentives and disincentives that led to wide-scale adoption and use of EHRs.

As of 2021,88% of office-based physicians and essentially all acute-care hospitals were using EHRs. U.S. EHR expenditures grew an average of 5.4% annually from 2015 to 2019, totaling $14.5 billion in 2019. And spending growth is forecast to reach $19.9 billion in 2024, $9.9 billion of that for hospital EHRs.

Yet, EHRs are a source of growing frustration in several areas. One concern is the burden they have created for clinicians. In a Stanford Medicine poll, 71% of physicians reported that EHRs contribute to burnout, and 59% think EHRs need a complete overhaul. Moreover, clinician burnout already costs the U.S. health care system more than$4.6 billion annually. In 2020, the U.S. Department of Health and Human Services (HHS) released an overarching strategy to reduce clinician burden associated with entering information into EHRs, meeting regulatory requirements and improving EHR ease of use.

Over the decades, health care organizations have invested heavily in technology that has not delivered its full expected value, making the current environment ripe for change. Health systems, hospitals, and providers are all challenged by five common pain points EHRs create. As organizations look ahead, there are proven approaches to addressing these pain points.

High costs with questionable returns

As evidenced by the historical and projected growth in EHR expenditures noted above, health care providers have invested billions in them along with countless hours, encouraged by federal policies and regulations, yet realizing real return on their investment remains a challenge.

Many health care organizations feel intimidated by the time, effort and money needed to complete an EHR conversion. Narrowing margins following the COVID-19 pandemic have forced them to carefully weigh the value of every health IT dollar spent. While many recognize the potential of EHRs to improve clinical and financial outcomes, the current transaction-based EHR models often fail to accomplish those goals.

An alternative is a system-as-a-service (SYaaS) subscription model that includes all hardware, software, and ongoing support services. This approach centralizes all implementation, optimization, and system monitoring services to manage reliability and performance.

Health systems using a SYaaS model have a predictable cost that includes all current and future interfaces and continuous IT and implementation training support, reducing labor costs and significantly lowering the total cost of ownership. With ongoing IT support and lower overall costs, health care organizations can focus on optimizing care processes and workflows to achieve improved clinical and financial outcomes.

Interoperability challenges

Interoperability is at the heart of much of the frustration with EHRs, from the inability to easily share patient data to suspected data blocking. Its a problem that makes day-to-day life for clinicians harder. Seven out of 10 PCPs (67%) think solving interoperability deficiencies should be the top priority for EHRs in the next decade, according to a Stanford Medicine poll.

Many initiatives seek to tackle the issue. The U.S. government has been instrumental in pushing for advancement through several initiatives.

Recently, the Office of the National Coordinator for Health Information Technology (ONC) released a notice of proposed rulemaking, Health Data,Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing.

This rule seeks to build upon progress made through the Trusted Exchange Framework and Common Agreement (TEFCA) and other initiatives to support patients and providers across the care continuum. It includes proposals for electronic movement of health information, new data exchange standards, electronic case reporting for both public health and emergency responses, and algorithm transparency for certified technology.

Health systems have options for EHRs that embrace interoperability standards, but EHRs need to do more than just keep pace with advancing standards, such as the Fast Health Care Interoperability Resources (FHIR) Application Programming Interface (API). They also need an adaptable and scalable database to incorporate workflows and functionality that enable organizations to integrate care processes across all care settings, making care more efficient and reducing the burden on clinicians.

Clinician burnout

The key reason that EHRs are named as a contributor to clinician burnout is time. Clinicians express frustration that they spendnearly twice as much timedoing manual, EHR-related tasks as they spend with patients. Hospital-based physicians reported spending 37 minutes on behalf of each patient 25 of which was spent in the EHR, according to a Stanford Medicine poll. And, by some estimates,75% of health care workers may leave the profession by 2025, making it more urgent for health care organizations to seek higher performing solutions.

A recent JAMA Network editorial states that clinicians are burdened with EHRs that prioritize administrative, financial, and regulatory needs over clinical workflow. Clinicians and their patients, it says, deserve a patient-centered, technology-enhanced health care ecosystem that is designed to significantly improve outcomes at a lower cost.

When EHRs take a human-centered, clinician-first design approach, offering intuitive workflows and a seamless user interface, the EHR can stop being the focus of clinicians days, and instead support them as they provide care to patients, with documentation resulting as a natural by-product of patient care interactions.

For example, with human-centered design and advanced integrations, nurses working with monitored patients report saving as much as 15 to 20 minutes per patient per shift. Its just one example of how giving clinicians measurable efficiency gains can have a material, positive impact that reduces burnout.

Lack of reliability and downtime

The news is full of headlines about health care organizations experiencing system unavailability, increasingly due to cyberattacks. In 2022, U.S. health care organizations suffered an average of 1,410 weekly cyberattacks per organization, up 86% from 2021.

But cyberattacks are just one cause. Most EHRs require planned downtime for system maintenance and upgrades. And almost all organizations, 96% in one study, reported at least one unplanned EHR system downtime, while another study found that 70% of organizations experienced at least one unplanned downtime lasting eight hours or more.

In response to the growing threat, the U.S. Department of Health and Human Services recently released its Hospital Cyber Resiliency Initiative Landscape Analysis and new resources for health care organizations intended to help improve cybersecurity. EHRs built upon modern foundational architectures that focus on security and reliability, such as those designed to meet stringent U.S. government security requirements, can deliver the performance and data protection health systems require, while eliminating both scheduled and unscheduled downtime.

Long implementation times

Because of their inherent complexity, EHR implementation projects for hospitals are a heavy lift for staff across the organization and often require a year or more to complete. The implementation involves a wide range of areas, including clinical functions, billing processes, regulatory compliance, quality measuring tools, and more. The time and resources required to replace an EHR hinders many organizations from considering a change, even if their current system doesnt meet their needs.

An implementation alternative that emphasizes a partnership approach and includes required resources can accelerate the implementation timeline while alleviating the burden on facility resources, resulting in a successful implementation with high user adoption and satisfaction.

For example, in the inpatient environment, the implementation process should ensure that hospitals do not have to decrease patient census during go-live, thus preventing a reduction in productivity and lost revenue. In addition, the implementation process should not require the organization to add staff, but include experienced resources that extend their team, taking responsibility for building, maintaining, training, optimizing everything needed to deliver an effective implementation.

With dedicated subject matter experts tasked with tailoring the EHR to the organizations policies, procedures, and workflows implementations can be completed in months rather than years. For example, a large national health system brought 36 hospitals live on a new EHR in just 18 months at a pace of two hospitals each month.

Disrupting the status quo

With health care organizations heavy investments in EHRs, its possible for them to realize more return on those investments. Its time for disruption from EHRs that use proven technology to make costs reasonable and predictable, shorten the time to value, leverage interoperability while improving security and reliability, and focus on making work easier for clinicians.

Ultimately, this will shift the focus to clinician wellness and bringing the joy back to their work while enabling organizations to achieve better clinical and financial outcomes.

Holly Urban is vice president of clinical product design for CliniComp.

See more here:
It's time to expect more from EHRs - Medical Economics

Adebukola Ajao is an online digital marketing guru equipped to help small businesses with the tools to compete.

A 2021 graduate of Northeastern, Ajao was recently honored with a Women Who Empower Innovator Award in the young graduate alumnae category for her creation of For All Things Digital.

Born and raised in Boston, Ajao grew up across the street from Northeasterns campus. As an undergraduate student, she worked with the universitys John D. OBryant African American Institute to start a social justice activist coalition.

During that time, she also started BDY Consult, an online marketing company. But she quickly realized she needed to further her education if she wanted to grow her business. So she applied to Northeasterns graduate program in digital marketing. She was accepted and received a scholarship.

That program allowed Ajao to combine her passion for marketing and helping underserved Black-owned businesses.

During my time as a business owner, as a student, I also wanted to leverage my digital marketing knowledge to impact Black lives, Ajao says.

Ajao is currently balancing three jobs. During the day, she works at Brookline High School as a project manager, helping students explore their entrepreneurial opportunities and secure college scholarships.

At night, she works as an adjunct professor at Northeastern, teaching in the same program she earned a degree from.

In between, Ajao works on her business. She has a team of six people located all over the country. BDY Consult works to help small business owners see themselves as marketers.

My slogan is, if youre in business, marketing is your business, Ajao says. Its essential for every small business owner to have a working, walking knowledge of marketing at all times.

The internet provides boundless opportunities to grow a business, Ajao says. Even brick-and-mortar businesses are digital. What a business does online shadows what it does in person, she says. Having an online presence allows people from around the world to touch a business.

BDY Consult, unlike larger online companies, helps clients build a business concept from the ground upfrom brainstorming a name to registering the company to even legal paperwork.

Once the foundations are in place, BDY Consult helps build a marketing campaign, social media and personal relationships.

In seven years, Ajao has had about 150 clients. Her projects range from one-offs to regular work for long-term clients. The Women Who Empower grant will help Ajao expand her business and take her marketing campaigns to the next level.

Working with small business owners can be limiting, but very rewarding, Ajao says. Small businesses often cant afford a marketing team. That is why she started a platform with free tips to help them find grants to support their efforts.

I fundamentally believe that to create an equitable, accessible world, small-business owners, especially from disadvantaged communities, need the tools, capital, funding and support to even be able to compete, Ajao says. Its not a good level playing field if people dont have that.

Beth Treffeisen is a Northeastern Global News reporter. Email her at b.treffeisen@northeastern.edu. Follow her on Twitter @beth_treffeisen.

Read more:
Digital Marketing Expert Empowers Small Business Owners - Northeastern University

Google Analytics 4 hasnt exactly got off to the best start with marketers.

In fact, its getting pretty awkward some advertisers are so disappointed with the new program that theyve even been hosting funerals for its predecessor, Universal Analytics.

But what is it about GA4 thats got the world of digital marketing so riled up?

We decided to ask our readers in a GA4 readiness poll to find out. Below, weve put together a list of the most common complaints. Let us know if you and your team can relate

GA4s user interface was hands-down the biggest issue our readers reported.

The UI was described as slow, laughable and a few other adjectives were opting not to publish.

Independent sales and marketing contractor, John Erikson, told us:

Another major concern for marketers has been the delay of same day data on GA4.

Advertisers have stressed that they need the ability to monitor performance constantly and are confused as to why the new analytics platform doesnt appear to have this function.

Ron Weber, Sr Director at Actian, explained:

Marketers raised concerns about discrepancies on GA4 too.

Differences in information had resulted in some worrying that the data being served therefore couldnt possibly be accurate, resulting in people questioning if they can trust GA4.

Sabine Walton, Senior SEO Manager at Handlerbund Marketplace, told us:

Marketers across the board have been reporting that GA4 is incredibly difficult to use.

Even seasoned advertisers are finding it challenging trying to navigate their way around the new platform.

SEO and marketing consultant Jason McDonald told Search Engine Land:

With so many marketers struggling as they try to figure out GA4, many are questioning why Google hasnt provided more educational resources explaining how the new tool works.

The marketing team at Storis told us:

Some advertisers explained that marketing doesnt wear a one size fits all hat.

While some of the more complex settings may suit some, other professionals, such as bloggers, would just like access to basic tools on GA4 and are wasting time and money trying to understand features they dont need to use.

Eb Gargano from Productive Blogging told us:

Another common complaint from marketers responding to our poll was the lack of features GA4 has to offer in comparison to Universal Analytics.

Marketers seemed particularly bothered by the removal of attribution features.

Elizabeth Rule, account manager and local SEO analyst for Sterling Sky, told us:

Get the daily newsletter search marketers rely on.

Clients and marketers alike have desperately been trying to recreate reports in GA4 that they previously relied upon when using Universal Analytics.

Unfortunately, it seems for many that this task has proved far more difficult than it should have been.

Tom Demers, co-founder and managing partner of SEO and PPC agency Measured SEM, told us:

Marketers also complained that they were struggling to simply create reports in GA4 an issue that didn't impact them when they were working with UA.

According to many marketers who took part in our poll, Google has made many unnecessary changes when it comes to building reports, making their workload more difficult.

Eric Bushaw, search engine optimization manager at G5, told us:

Several marketers contacted Search Engine Land to report bugs within GA4, claiming many features weren't working as intended. Issues being flagged included syncing issues with Looker Studio Dashboard and AMP new script not working.

SEO consultant John McAlpin told us:

Marketers have found the enforced migration from Universal Analytics to GA4 tough, so it can be reassuring to know this challenge is being felt across the industry.

But regardless of how difficult the adjustment has been, search marketing expert and SMX Advanced speaker Kayle Larkin told Search Engine Land it's important marketers get on board with Google's latest analytics program as it will likely be around for a long time. She said:

Larkin went on to explain that change within any platform and any industry can cause people to panic. But as time passes, confidence and familiarity increases, causing attitudes to change. She concluded:

If you're struggling to navigate GA4, why not sign up for a GA4 training course?

Alternatively, for free information and resources on how to use GA4, read the Google Analytics 4 account training guide and support guide

Read the original post:
10 things we hate about Google Analytics 4 - Search Engine Land

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Pay in primary care is going up, compared with other specialties, according to a survey by AMGA Consulting.

Primary care compensation went up an average of 6.1%, beating pay raises of 1.5% and 1.6% for medical and surgical specialties, respectively, according to AMGAs 36thannual2023 Medical Group Compensation and Productivity Survey. Rates were 6.1% for family medicine, 6.4% for internal medicine, and 5% for general pediatric and adolescent medicine, according to the survey.

Work relative value units also increased in primary care at rates of 3.4% for family medicine, 1.8% for internal medicine, and 8.9% for general pediatric and adolescent medicine, AMGA said.

It appeared the increase in compensation levels is evidence that organizations are raising compensation based on 2021 evaluation and management coding changes implemented by the U.S. Centers for Medicare and Medicaid Services (CMS), AMGA Consulting Director Elizabeth Siemsen said in a news release announcing the figures.

Survey results indicate that the gains for primary care are evident as the smoke clears from the slow transition to the utilization of new wRVU weights for compensation calculation and the volume swings of the pandemic, Siemsen said.

Among medical specialties, cardiologists saw a 2.1% increase in compensation; gastroenterology decreased by 0.6%; hematology and medical oncology rose by 3.2%; and neurology grew by 1.9%. For surgical specialties, general obstetrics-gynecology rose by 2.4%; emergency medicine dropped 0.7%; general surgery increased by 2.5%; and orthopedic surgery grew by 4.6%, according to the AMGA figures.

As physician salary goes up, median compensation follows the same trend for advance practice clinicians. Primary care nurse practitioners (NPs) saw a 6.1% increase in compensation; physician assistant (PA) compensation grew by 7%. For NPs in medical specialties, compensation grew by 6.2%, while PAs in surgical specialties rose by 5%, according to the AMGA figures.

Those results may demonstrate the impact of the post-pandemic hiring market for APCs and the increased APC utilization to address access by medical groups as patient demand rebounded, according to AMGA.

For the 2023 survey, median net collections grew by 5.2%, showing a larger disconnect between collections and physician compensation than in previous years.

It is clear from the data that revenue gains are not going directly to physician compensation, AMGA Consulting President Fred Horton, MHA, said in a statement.

Rather, groups are using that revenue to address non-provider expense increases, Horton said. A lower compensation-to-collections ratio suggests that a higher percentage of revenue is going to cover all the expenses that have seen an increase in the past few years. These include staff expense, supply expense, and the like. Basically, we see that this data reflects that organizations are focusing on the management of the changing financial demands for medical group operations.

The 2023 survey was announced at the end of June. It contains data from 446 medical groups representing more than 193,000 physicians and other providers from 194 specialties, according to AMGA.

Read the original:
Physician compensation going up in primary care - Medical Economics

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Navigator Multimedia is one of Kelownas longest-standing digital marketing agencies and is celebrating its big 3-0 this year.

With its long history in the digital game, Navigator not only witnessed some of the internet's biggest leaps but also helped guide businesses through those technological evolutions. A company with humble beginnings, one of its early tasks was transferring media files from older storage devices such as CDs and floppy disks (very popular back in the day). But today, the company is at the forefront of web design and marketing businesses online.

Navigator Multimedia is celebrating its thirtieth anniversary, which is not a small feat for the digital marketing world, CEO Rob Raybould says. Were proud of how far the company has come and where its going.

To commemorate its 30th birthday, Navigator put together the top 30 digital strategies it has learned from three decades in the industry. It is a way to inform the community of its milestone and to share some of its knowledge. Whether its creating a mobile-friendly website thats easy to navigate or using fine-tuned brand voices to create emotional connections for its clients customers, Navigator knows how to get the job done.

By partnering with Navigator Multimedia, businesses not only stand to gain an amplified online presence but also benefit from ongoing support, analytics and updates, ensuring their digital strategies remain effective and relevant in an ever-evolving digital landscape.

But no two businesses are alike, and Navigator knows exactly how to tailor their services to the clients they partner with. Its small but mighty team of 10 employees and contractors each have a specialized role within the organization, from SEO experts to developers and project managers, to help its clients with their particular business needs. Raybould says his employees impress me every day with what they produce.

Navigators ability to deliver high-quality websites and digital services for its clients comes from the relationships it has built since 1993. Its not a traditional business-client connection but a partnership of understanding, and a passion to help its clients become successful. Navigator gets to know each of its clients and their needs so well that it can offer suggestions that will take its clients vision from a hazy dream to a successful reality.

Weve been here for 30 years, and were planning on being here for at least another 30 years, Raybould says. We attribute a lot of our 30 years of success to the partnerships we build. We intimately know the companies that we help, and we can strategize with them.

Navigator specializes in marketing for tourism industry and housing service industry clients, such as property managers, developers, landscapers, and interior designers. Ready to partner with anyone who needs to be noticed, who needs to drive traffic to their website or who is looking for an improvement to their bottom line, Navigator wants to help guide your business on its path to success.

Navigator Multimedia stays on top of the ever-evolving algorithms and digital trends, applying the best strategies to enhance each clients online presence and help it outrank competitors in search engine results. Its holistic approach includes business branding, web design, content creation, search engine optimization, email marketing and pay-per-click advertising, ensuring a well-rounded and impactful digital footprint.

Were always testing and proving strategies, Raybould says, and then were able to share that with our partners to build a network of success.

More information about Navigator Multimedia, as well as its 30 digital strategies for businesses online, can be found on its website.

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This article is written by or on behalf of the sponsoring client and does not necessarily reflect the views of Castanet.

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Here's to 30 years of navigating the digital seas with one of ... - Castanet.net