How EHR Vendors Are Making Productive Use of Regulatory Downtime

The hard work of thrashing through requirements and building new features for meaningful use (MU) stage 2 has come to an end for most electronic health record (EHR) vendors. Analysis of what must be done for stage 3 has begun, but those features won’t be needed until 2017. In addition, there have been numerous stops and starts for the use of the International Classification of Diseases, 10th edition (ICD-10), the new compliance date for which has been put off until Oct. 1, 2015. That’s a long hiatus from what are essentially regulatory requirements, and savvy EHR vendors have an opportunity to use that time wisely.

We wondered what EHR vendors plan to work on in the interlude between MU stages and ICD-10.  At the recent annual meeting of the Medical Group Management Association (MGMA) in Las Vegas, we learned that many EHR vendors are using their time productively to:

  • Address customer-requested enhancements. Those we spoke with for this article lament the good old days when the majority of product enhancements came from users. That hasn’t been the case since HITECH. You see, despite its benefits, MU has taken up the vast majority of development bandwidth, first in a rush to incorporate functionalities and later to optimize them. It’s not clear who struggles more with this pace of change – the EHR vendors or their clients. One thing is certain – the delays have presented an opportunity to focus anew on customer-requested enhancements.
  • Tackle usability. It’s no secret that many physicians are dissatisfied with their EHRs.  This has been confirmed by many studies, most recently one by the RAND Corporation. It found that EHRs worsen physicians' satisfaction in areas such as increased time performing data entry, interference with face-to-face care, interfaces that don't match work flow, poor health information exchange and a mismatch between MU and clinical practice—all of which may adversely affect patient care. Smart vendors are using this hiatus to make work flows more efficient and optimize their products for usability.
  • Revisit outsourced functionalities. Many vendors have outsourced functionalities for ePrescribing as a shortcut to achieve MU stage 1 or 2 certification. While these bolt-on applications have served their purpose, vendors are now revisiting the need to outsource them and developing native functionalities that are more cohesive with the overall product offering.
  • Avoid sharing revenue with other vendors. Two considerations of outsourcing EHR functionalities are cost of goods and sharing revenue with third parties. Some vendors are evaluating what they can do or change to cut out the middle man. When pass-through costs for partner products are reduced or eliminated, revenue opportunities increase. For example, one EHR vendor is replacing a consolidator for prescription co-pay coupons and working directly with sponsors’ direct physician messaging.
  • Improve patient engagement capabilities. MU stage 1 introduced a need for physicians to provide patients electronic access to their medical information. Stage 2 added the need for physicians to conduct secure messaging with patients. Now that the baseline functionalities have been built and the rush toward MU certification has passed, vendors are doubling down on their offerings for patient engagement. Some are beefing up web portals.  Some are adding or improving functions to make them more patient friendly, such as the ability to schedule appointments electronically, refill prescriptions, access and update their information and pay bills. Others are exploring innovative ways to provide educational materials and adherence programs, which are important toward improving outcomes and managing costs for patients with such chronic conditions as diabetes.

EHRs are, after all, a product offered by a business. It’s clear in our discussions with vendors that their focus during this cycle is on improving the usability of features that already exist rather than adding new functionalities.  During this hiatus of MU-related development, they have an opportunity to listen to what that their clients want, which is to be able to more easily use features that they already have, and not add new ones. This strikes us as a very productive way for EHR vendors to differentiate themselves, create demand for products and increase market share.   

Edited by Alisen Downey

CenturyLink Provides Quick SDN Update

When we hear about software-defined networking, the names that most commonly come up are AT&T, BT, DT, NTT, and Verizon. But Monroe, La.-based CenturyLink also has been hard at work implementing software-defined networking.

A recent report about CenturyLink talks about how the company this year is catering to its channel partners with new tools that will enable them to more easily deliver their own services, and that all of the above will be enabled in part by SDN.

So SDNzone thought now would be a good time to check in with CenturyLink about the details of its SDN build out and self-provisioning efforts. Here’s a quick update based on an interview SDNzone did this week with James Feger, vice president of network strategy and development at CenturyLink.

Tell us about CenturyLink’s SDN effort.

Feger: CenturyLink is passionate about NFV and SDN. CenturyLink will continue focusing in this area because it will help us automate operations, reduce our overall cost, remove barriers to entry for new markets, and reduce time to market. We started our journey in 2012 and since then have expanded SDN capabilities deeper into our network in the U.S. and internationally. This service delivery fabric is called the Programmable Services Backbone; it is an enablement platform for CenturyLink’s transformation with NFV and SDN.

AT&T and NTT have both in recent months made available to customers self-provisioning solutions that leverage SDN. And recent reports indicate CenturyLink is preparing to offer this same kind of thing for its partners. What is CenturyLink doing on this front?

Feger: CenturyLink did significant work on back-office optimization in 2014 to enable self-provisioning network capabilities in addition to the capabilities of our CenturyLink Cloud assets, which already offer self-provisioning today for most services. 

Ericsson’s website talks about CenturyLink’s SDN implementation. Is Ericsson CenturyLink’s only named SDN supplier to date?

Feger: CenturyLink has publicly mentioned a supplier company that contributed to an early NFV solution called network-based security. That supplier is Fortinet, a security service company.

To learn more about SDN, join TMC and its partners next week at Software Telco Congress: The NFV & SDN Event, which will be co-located with ITEXPO Miami at the Miami Beach Convention Center.

Edited by Alisen Downey

Take a Lesson or Two from Hyper-startups

Take a Lesson or Two from Hyper-startups

January 22, 2015

By Michelle Amodio, Virtual PBX Contributor

There’s an actual term for businesses that get up and running in a flash, and these types are called “hyper-startups.” The idea is that instead of going through the painstaking process of traditional business planning and launching, the fast entrepreneur does it in what seems like in the blink of an eye. Of course, just by their very nature, these kinds of startups can be volatile, but there are some good lessons to learn from The Flash of the startup world.

Virtual PBX provider Nextiva does a nice roundup of the lessons one could take from a hyper-startup. These focused types are good at reaching the customer right away, are mobile and ready to go, and plan for success. Of course, in terms of communicating, maybe the hyper-startup could learn a thing or two from other businesses?

Being mobile is a key element to communication, and behind mobile communications one can usually find IP services and virtual PBX services.

Virtual PBX VoIP is also a good choice when a company or organization can’t be bothered with complicated phone systems. There is no longer any need to worry about scalability and upgrades due to capacity requirements. Managing line cards, trunk cards or space in your capacity is not required.

In addition, with a virtual PBX solution, you not only get to keep your number, but there is absolutely no coordination required with your service provider. With a virtual PBX, it’s already there for you, in the cloud, so no physical movement is necessary.

When you rely on a virtual PBX system, where you have your office can be on your own terms, not on someone else’s. And if you need to move? No problem. It’s already waiting for you before you’ve even packed your first box.

A virtual PBX will provide your business with flexibility, mobility, and cost savings without compromising quality, reliability and advanced features, and even those are important to the ever-ready and volatile hyper-startup. 

Edited by Alisen Downey

NetMotion Announces Self-Diagnosing VPN Software

It is essential for enterprises to support their operations with networks that are consistent in their reliability and speed – wasted seconds due to downtime translates directly to a loss of revenue. A network that can diagnose its own problems may seem out of reach, but the latest announcement from NetMotion, a developer of mobility management software, says it has done just that.

The new NetMotion Diagnostics software can operate in tandem with NetMotion Mobility, the company's virtual private network platform, or as a stand-alone application. In either case, Diagnostics can provide analysis of VPNs to automatically determine what may be causing connection problems within enterprise networks. The announcement suggests that this is the first self-diagnosing mobile VPN software because it places diagnostic tools in the hands of mobile enterprise workers and gives IT departments necessary information they need to resolve network issues. John Knopf, the vice president of product management at NetMotion Wireless (News - Alert), spoke about the issues that face enterprises and the benefits of using Diagnostics with Mobility.

“Slow and unreliable mobile connections are the most common problems our enterprise customers deal with on a daily basis,” Knopf said. “Companies are making significant investments in wireless access and mobile solutions, and they need their employees to be able to access their corporate resources wherever they are for those investments to pay off. Our solution eliminates frustration and guesswork in troubleshooting connection problems.”

Mobile workers can use the Diagnostics application to initiate a series of pre-configured tests which can determine the cause of their slow or dropped connections. Diagnostics analyzes local area connections, network routers, company servers, and other applications that may reveal the root of users' problems. Furthermore, instead of forcing mobile workers to contact IT themselves, Diagnostics can automatically notify IT of network problems through the software's platform or through SMS or email.

What this means for enterprises is that they can expect faster problem resolution due to a better transfer of information to IT staff. The quicker IT knows about issues, and the more accurate information IT staff has to handle issues, the more efficient their troubleshooting efforts can become. As a result, enterprises should experience less downtime when routers or servers malfunction, and their employees, as a result, can concentrate on their own work without having to worry about the state of their networks.

Edited by Alisen Downey

New Workforce Seen Up and Coming in Central America

New Workforce Seen Up and Coming in Central America

January 22, 2015

Despite all the noise about India and the Philippines grabbing the lion’s share of the call center market, a surprising newcomer is making its presence felt, and might well be a force to reckon with in the very near future.

A recent report from the Everest Group, “Central America and the Caribbean Answer the Call for English-Language Contact Center Services”, takes a closer look at the this nascent region and draws some strong conclusions about its viability as a new call center destination.

Industry publication Nearshore Americas dove into the research in depth, and spoke with the report’s authors, Anurag Srivastava and Aditya Verma about their findings, and what the area’s strength and weaknesses are.

“While operating costs vary significantly – driven by difference in wages across the region – all the locations offer 35-75 percent cost arbitrage compared with tier-two locations in the United States such as Dallas,” Nearshore Americas said. “Most locations have low wage inflation (4-7 percent), but ‘the cost arbitrage is likely to decrease slightly in the next five years, as depreciating currencies counter the effect of inflation,’” they said the report predicts.

Among the most striking findings, Verma told Nearshore Americas, was that “the size of the market in these locations surprised us. Many of these locations are still emerging so we were not expecting the size of the industry to be as big as it is.”

Which leads to the next logical question: Given the small size of countries in the region relative to the rest of Latin America, and equally limited populations, how long will it be before the market becomes saturated and the talent pool is exhausted? Fortunately, it’s not really a concern at all.

“We’ve analyzed the continuity of cost and it’s actually quite good in almost all of the locations,” Verma said. “As for talent, there are some concerns because most of these locations are not big and the talent pool is limited. So there is obviously some concern around scalability and how long the talent pool is going to last,” but, “I think there is some time left before these locations reach saturation point.”

One item the report did note is how Central America is well positioned to serve the Canadian and Brazilian markets.

“Canada and Brazil … represent realistic markets,” Nearshore Americas said. “Serving Canada’s French-speaking population is ‘definitely’ more viable than serving France because of Canada’s geographic proximity to the region and the aligned time zones,” Srivastava said. “I think French support is something that is becoming more important in the Canadian market, so that may be something that companies will have a look at more closely.”

With a growing workforce, lower costs and geographic proximity, the only surprise is that no one has jumped on this bandwagon before now. All that would seem to be ready to change.

WebRTC Start-up Hookflash Turns to ECN Capital Crowdfinancing Platform for Investors

January 22, 2015

How hot is WebRTC?  In a word, VERY! 

One indicator of just how hot is that established private investment firms looking to get a piece of the burgeoning crowdfinancing arena have gazed on WebRTC start-ups are prime targets due to the buzz surrounding the technology. In fact a case in point is the announcement from ECN Capital that as part of it launch of its new online investment platform for the private capital markets one of its first offerings is Calgary's Hookflash, which ENC Capital describes as “an emerging technology leader in video chat, voice and messaging for mobile and the web.”

Hookflash, which is WebRTC-based, is raising $1 million via a common share offering. And, in its pitch, ENC Capital points out that WebRTC is forecast to be running in over six billion endpoints including wearables, smartphones, tablets and Web browsers within the next four years.

Source:  Hookflash

“We've made private investing easier by simplifying everything from the discovery of new opportunities to due diligence to execution and share distribution.” comments Neal Gledhil, CEO of ECN. Registered investors can view deals, interact with companies and make investments all within ECN’s secure online environment.

"For the first time, ECN is making private venture capital investment opportunities in companies like Hookflash available to a broad market of investors who typically wouldn't see these kinds of investments,” states Gledhil.

As a disclaimer, I am not a financial advisor and do not play one on the Internet.  Therefore, please do not construe my enthusiasm for WebRTC as a technology as an endorsement of any company, especially in regards as to whether it is something to invest in. Plus, you do have to be mindful of the fine print as to what it means to be an investor on a crowdfunding platform should you choose to take the plunge on  this or any other offering. 

That said, if you are a private investor and want to get involved in WebRTC, this is certainly an avenue to explore. And, the nice thing is you can even kick the tires before making up your mind as to whether to invest or not.  It may only be January, but based on the momentum for WebRTC this is likely to be the first of several companies looking to catch the WebRTC wave via some type of crowdfinancing resource which will be one of many ways to play in this exciting field. 

Edited by Maurice Nagle

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Healthcare Industry Requires Proper Data Management for Optimal Analytics

Regardless of what kind of business you’re running, chances are you rely on data to perform day-to-day functions. If you’re a one-person operation, you’ll use data in the form of contacts, services rendered or products purchased. If you’re part of a large-scale operation like a hospital, then data can be a bit more complex and requires proper data management to keep it all neat and tidy.

The healthcare industry faces a unique set of challenges when it comes to data management. Healthcare IT executives are being tasked with developing and operating solutions that integrate data from a range of patient, clinical, and back office systems to healthcare providers, patients, payers, technology and pharmaceutical companies. Federal regulations mandate that data and systems are interoperable and can be used for electronic health records (EHR) and health information exchanges (HIE). Of course, all of this must also be HIPAA compliant, too.

Important and redundant data will pile up over time, and this is the part where management comes in. This data can be transactional, customer-related, or with hospitals, patient-related. But when the point of heightened redundancy is reached, hospitals start to suffer from operational and efficiency challenges. The need for data consistency, accuracy, coherence, accessibility, uniqueness, and searchable storage becomes crucial, highlighting the significance of data management.

Data management means redundancy elimination, data consistency, flexibility, and easy back up. Neat and tidy data also means effective data analysis; similar, redundant, un-coherent and unrelated data can only give half the benefits; or even worst, wrong data analysis, which can have awful consequences. With proper management, hospital administration can get smart and decision-enabling data analysis, which is crucial.

With ever-changing healthcare laws and healthcare reform, hospitals and other care facilities must develop effective data management strategies, otherwise they could face major challenges in successfully navigating federal initiatives and operational improvements in the years ahead.

Edited by Alisen Downey

Data Analytics Key to Proper HR Investment and Workforce Optimization

Data Analytics Key to Proper HR Investment and Workforce Optimization

January 22, 2015


The myriad benefits of big data have long been touted and yet data analytics were not always accessible, affordable or practical for many organizations. But now a clear-cut link between analytics and workforce optimization and management has been defined, making use of big data a compelling and valuable proposition for many companies.

A recent blog post in ITBusinessEdge examines this phenomenon from a research standpoint. Cost control, as is typically the case, is one of the most compelling reasons companies are taking a closer look at data analytics in 2015 as they relate to workforce management. According to Mark Huselid, director of the Center for Workforce Analytics at Northeastern University and also a business professor, employees represent 60 to 70 percent of all expenses for an organization. Using analytics to refine the workforce in a meaningful way is crucial to keeping human resource costs under control.

“Most organizations tend to invest in talent hierarchically, where senior-level talent gets the most pay, best development opportunities and other professional perks,” said Huselid. “However, organizations should be managing vertically in who and what really matters – and in measuring and managing the outcomes associated with these processes.”

Getting paid based on merit and contributions to the organization instead of position on the corporate ladder? What kind of heresy is this? And yet, analytics tell the tale, directly correlating output and production with individual workers’ contributions, enabling companies to make better decisions when it comes to allocating human resources funds. Ensuring that data is readily available and structured in a meaningful way is an important component in properly utilizing it for workforce management and optimization.

The easiest way to do this is to conduct a formal cost analysis of at least one of the five pillars of human capital management. These include payroll, administration of employee benefits, talent management, time and labor management and human resources administration. This type of data is typically readily available to your organization and relatively easy to analyze and glean insights from.

Ultimately, big data analytics show that employees should be treated as an asset instead of a cost. By properly investing in human resources based on actionable data and proven value, companies can realize a return on investment in their employees, just like any other resource.

Edited by Alisen Downey

Working Remotely Can Benefit Employers as Well as Employees

January 22, 2015

By Laura Stotler,
TMCnet Contributing Editor

As a young journalist fresh out of college, my first job was at a daily newspaper. This was before the Internet exploded and print media was still the name of the game, so despite not making much money, my work was considered valuable. Soon after I started the job we had a snowstorm, typical for our area of New England. And like all the other employees, I dutifully drove to work despite the Governor’s warning to stay off the roads. My car ended up in a ditch with a nice dent in it (thankfully I didn’t get hurt), but I got it back on the road and went to the office that day.

I wasn’t so eager to drive when our next snowstorm hit, and working from home was simply not an option as far as my employer was concerned. So I had to use up valuable time off and was also reprimanded for failing to show up to work because of my fear of driving on dangerous roads. Clearly, my work output was more valuable to my employer than my safety and well being.

The workforce has come a long way since those days and I’d like to think that most employers have a better attitude about the safety of their employees. Technology has obviously made working from home a viable and attractive option in a lot of cases and remote workers are growing in number at a rapid rate. According to the American Community Survey, telecommuters now make up 2.6 percent of the U.S. workforce, representing 3.2 million workers including full-time employees.

There are massive benefits to letting employees telecommute, particularly during weather events and other emergencies. When Washington, D.C. was officially shut down for four snow days last year, remote federal workers saved the government around $32 million. Employers are definitely coming around to the advantages of letting employees work from home, sometimes on a regular basis. But some have misgivings and that’s largely because they feel they can’t measure productivity and output of remote workers.

“We ran into this situation the last few days with school closings,” said Neil Shah, founder and CEO of workforce management consulting company The WFC Group. Shah told BizTimes that his company tries to accommodate employees when they are impacted by weather events and other unforeseen circumstances by being flexible. “People’s stress increases tremendously when things like this happen. As an employer we try to make sure we’re aware of that and we find ways to lessen that stress. We get it. We understand that that’s what you need to do, and we think flexibility is a very important concept.”

Shah added that a proper work-life balance is critical to optimizing the workforce, something he is well acquainted with in his line of work. As more and more companies figure this out and develop policies and procedures for remote workers, the result will be happier and more productive employees, which translates into better business performance overall. 

Edited by Rory J. Thompson

Philippines Expected to Host 700,000+ Call Center Workers

January 22, 2015

If you listen to all the “accepted common wisdom”, call centers around the world are shutting their doors, packing up and headed back to the U.S. It seems that years of frustrated American customers trying to make themselves understood to those whose first language isn’t English has had an impact, and overseas call centers started shipping the work back home. That’s what many believe, anyway.

But if a new report in the Philippines’ Manila Standard Today is to be believed, call centers are doing just fine there, thank you very much. The report says that the country will add another 100,000 workers this year to its current 686,000-strong call center workforce.

“The Call Center Association of the Philippines [CCAP], which groups more than 100 call center companies, said revenues were expected to grow 15.4 percent in 2015 to $13.5 billion from about $11.7 billion in 2014,” according to the report. Call centers were described as the biggest contributor to the country’s thriving information technology and business process management industry.

CCAP chairman and President Benedict Hernandez said in a news briefing that despite expectations of slower employment generation in the sector, call center operations continued to grow in line with the group’s target range of 15 percent to 18 percent.

“We just ended a high-growth year. We’re on our way to another,” Hernandez said. “Headcount has grown 17 percent. Revenue is pretty much still on the growth path.” Hernandez made the remarks at a pre-event briefing ahead of next week’s 10th International Call Center Conference and Expo. The conference will take place at the SMX Convention Center in Pasay City Jan. 27 and 28.

According to Hernandez, the Philippines eclipsed India as the call center capital of the world last year, and added that the group would maintain its growth guidance until 2016, when total employment was projected to reach 1.3 million.

Not bad for an industry that many thought was ‘dying.’