Interview with SRSsoft EMR CEO Evan Steele

I’ve been finding what SRSsoft and in particular their CEO, Evan Steele has been saying about the ARRA EHR stimulus money on the SRSsoft blog called EMR Straight Talk really interesting. They’re an EMR company that I think has taken a different approach to marketing their EMR software. So, I thought it would be interesting to interview Evan on a number of relevant topics related to his EMR and the ARRA stimulus money.

Let me know if you like the following interview and I’ll think about doing more of them.

Describe what you define a hybrid EMR is.

Hybrid EMR satisfies the demands of high performance physicians by providing process efficiency. This benefit is delivered through click minimization, ergonomic design, product flexibility and a non-proprietary, open software platform. The hybrid EMR is not exam note-centric, and therefore spares physicians the onerous data entry requirements associated with traditional EMRs.

Can you describe 3 features and how it’s done in a hybrid EMR versus a traditional EMR?
*Generating a ePrescription with only two clicks
*Reviewing a message, viewing the attached document (like a lab or a radiology report) and signing the document with one click.
*Generating a fully templated exam note from anywhere within the software with three clicks.

Will SRSsoft be participating in the ARRA EMR stimulus money program?

It all comes down to the meaningful use requirements – although, after 3 rounds of meaningful use discussions, the requirements are likely not to change significantly.  As listed in the most current “Meaningful Use” Matrix, they are quite onerous for physicians. The cost associated with reduced productivity that a high-volume, high-performance physician would incur by entering the data to meet the meaningful use requirements dwarfs the incentives being offered and the relatively small penalties which starting six years from now (in 2015).

How come I don’t see a CCHIT certified badge on your website?

CCHIT reached the apex of onerous requirements when it released its 2009 certification criteria which contained nearly 500 items. Since its formation in 2004, CCHIT has layered on more and more criteria each year, and vendors have been on a wild goose chase to program those requirements.  Most of these feature requirements are not used or valued by busy physicians. SRS made a conscious decision not to follow the herd and, instead focuses on features that busy physicians need to make their practices efficient so that they can manage their costs and take better care of patients.  The result is a highly ergonomic, usable EMR that actually meets the needs of high-performance physicians.  Sales have skyrocketed.

Interestingly, the new certification will be an HHS badge and not a CCHIT badge and there will be multiple certifying bodies. In addition, the HHS certification criteria will be only those features that are required to meet the meaningful use requirements.  CCHIT actually eviscerated their almost 500 requirements and announced that 88 requirements will be needed to meet meaningful use guidelines.  I feel sorry for the scores of companies that programmed hundreds of complex features only to find that they were unnecessary (all the while not focusing on what physicians actually want).  I also feel sorry for the physicians that paid for those unnecessarily complex products.

Listening to the voice of the physician is a winning strategy and always will be.

How did the HIT Policy Committee react to your “Voice of the Physician” petition?

Lynn Scheps, our Vice President of Government Affairs, went to Washington to present the “Voice of the Physician Petition” to the HIT Policy Committee in person, because we felt it was so important that the decision-makers understand how private-practice, community-based physicians view the expectations being placed on them. The government’s goal of widespread EHR adoption cannot be accomplished without buy-in from the physicians themselves, and the fact that a relatively small company like SRS could generate such a sizeable response in a short time, with minimal outreach efforts, indicates the deep level of concern among physicians. The “Voice of the Physician” petition was signed by SRS clients and non-clients alike, and over 150 of them feel so strongly that they took the time to submit additional comments.

As the petition was presented to the Committee, a number of members were observed browsing through the comments. I can only hope that all of the members take at least the amount of time to read them as the physicians took to write them. I think they will find them very insightful.

Is the government wasting their $19 billion in EMR stimulus money?

The government actually set aside $36 billion, anticipating $17 billion in costs savings from EMR adoption, so the net cost would be $19.2 billion if all goes as planned.
They won’t be spending it if doctors choose not to participate or if they are not able to meet the onerous meaningful use requirements (similar to their experience with the PQRI program.) In the latter case—a likely scenario—in which high-performance, high-volume physicians purchase the required software but are unsuccessful, the doctors will have wasted their money and the EMR vendor coffers will have been filled.

You claim increased productivity using SRSsoft.  Where does the productivity come from? Have you had any practices that haven’t had an increase in productivity?

It’s such a luxury to wake up in the morning, come to work and have 18 programmers who can carry out the vision of focusing purely on what physicians need to make them more productive. Productivity stems from automating processes and organizing information. The fewer clicks and less mouse movement it takes to store and access information, the better the result. Our mantra for the past 12 years is “DO NOT SLOW PHYSICIANS DOWN.”  We found that by automating the myriad of repetitive, labor intensive processes found in every medical office, massive productivity increases result every time. It’s just like any other business process improvement software that replaces antiquated paper workflows. It’s a big win if software directly addresses process improvement while positively impacting a company’s executives (in this case, the physicians). Employees become more productive and the executives benefit from having key critical information at their fingertips.

There is a huge difference when a company is not shackled by someone else’s vision (e.g., the government, certification bodies, etc.) of how technology should be applied in a medical practice.  Plain and simple: physicians know what they want for their practices and know what works, non-physician bureaucrats do not.

Every EMR company will claim that they focus on process and workflow improvement in medical practices. Not true! Just count the clicks required for simple, repetitive tasks and it becomes crystal clear what happens when companies cater to non-physician stakeholders. Any company can slap together a lab management module, an ePrescribing module, a messaging and tasking module, or a forms module, but it takes tremendous focus and dedication to integrate it tightly with the core software, make it intuitive to use and make it ‘fly’ in a medical practice. Clicks are the biggest source of lost productivity for physicians using EMR. Most private practicing physicians’ income is tied to productivity, so time is money. Therefore, every click costs money.

If EMR vendors focused 100% of their resources on usability, click-reduction and module integration rather than on hundreds of pie-in-the-sky features dreamed up by bureaucrats, adoption would flourish.

What are your thoughts on open source and open APIs in EMR software and how does your OpenPath technology fit into it?

SRS is a strong proponent of open architecture software.  At SRS, we have built the web right into the core parts of the software so anyone can customize it. They don’t have to rely on SRS to customize the software for them. SRS has many clients that have talented, tech-savvy employees who have used our Software Development Kit (SDK) to customize their SRS in amazing ways.

SRS spent a great deal of time developing its OpenPath™ technology so clients aren’t beholden to us for customizations. Many other vendors do just the opposite and require that clients go through them for customizations. It’s analogous to buying a house and then a few years later, when you want to add a new room, you find that you are handcuffed because you have to go to the builder for the addition and accept his design, his pricing and his timing. If SRS were the builder, we would be happy to build the addition, but you would also be free to choose your own builder, your own design and negotiate pricing and timing. That level of client control is sorely lacking in the EMR industry. For example, we have many prospective clients that have a strong desire to switch from an antiquated, traditional point-and-click EMR to SRS and they are petrified to ask the legacy vendor for assistance in moving the data from their system to ours. Over the short term, this is good for the legacy vendor, but it puts the medical practices’ long-term IT plans in jeopardy – they feel like the legacy vendor has put them in a straightjacket.  With the SRS OpenPath™ SDK, our clients have a document with our database schema clearly outlined so as to facilitate customizing our software or having the option to migrate to another software package should they want to at any point in the future.

What other customizations have been done by end users using your OpenPath™ technology?

SRS and its clients have created a myriad of customizations that leverage our OpenPath™ technology. Here are some examples:
*Using the SRS software development kit (SDK), a 100 provider primary care group completely rewrote their Clinical Summary web page that resides on the SRS desktop. In addition to a detailed summary of a patient’s key clinical information, the new Clinical Summary includes custom alerts and information fetched from their practice management software database (e.g., balance, alerts when balance is past due, etc.).
Ophtalmology-Clinical-Summary-Screenshot
*A solo practicing ophthalmologist had SRS rewrite the Clinical Summary to match, perfectly, his thought process when reviewing clinical information before an exam.
*A 52 provider multi-specialty group had SRS customize their Clinical Summary so that with one click, they log the date and time a dictation was completed. They also created a custom transcription exception report that flags all transcriptions that have not been received within a certain timeframe.
*A 20 provider orthopaedic group also leveraged the SRS SDK to self-create a “PowerTab” that pulls up a fully integrated web page (right inside SRS) where the physician orders prescriptions for the patient which is then sent to the in-house drug dispensary.

What do you see happening in the future with EMR software?  What’s going to happen and what’s likely to happen?

Physicians are going to get hurt when they are “incented” to buy systems without being fully aware of what will be required and the lost productivity that they will incur. This will lead to non-use, and the consideration and purchase of more usable alternative solutions in the future. This is exactly what we are seeing in the marketplace today with legacy point-and-click EMRs.

Is EMR and HIPAA part of your daily reading?  If not, why not?  Lol

Of course, I love the writing and commentary!

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

11 Comments

  • Your interview with Evan was most enlightening!

    How refreshing to hear someone speak plainly about how an EMR should work properly for the provider rather than merely adhere to some bureaucratic specification. Just “doing what needs to be done” will always win out in the long term versus merely “meeting the specs”. The specs will eventually come around to the better way.

    It’s also refreshing that at least one EMR vendor allows the customer to “roll his own” — to enable customization of the interface with minimal vendor assistance. This actually saves the vendor money in the longer term, while encouraging new customers.

  • John, this is an excellent idea (interviewing CEOs of top EMR companies about their philosophy of EMRs and what makes their EMR different and better). I hope you do more of this.

    I have used SRSsoft and it is a great EMR. It will be certified (by an approved organization) and it will satisfy the meaningful use criteria (whatever they are). If I was going to buy an EMR today, SRSsoft would be one of my top 3 choices and perhaps THE top choice.

    If you have any interest in SRSsoft, make sure you do a demo! It is hard to understand how they do things from reading their website, but the way they track critical clinical data is ingenius. Their “Order Entry Module” and Summary Charts are excellent. It has all the functionality of a drop-down, pick-list, point and click EMR.

    If you are considering an EMR, SRSsoft should be one of the EMRs that you investigate.

  • When I saw the headline I was really excited to read the post but about a third of the way through, it started feeling more like sales pitch, then about halfway through it felt more like you were talking to a PR rep.

    Record your conversations John, post them transcription style, they will feel more candid and what I think the readers really want is to feel like you’re being honest with them.

  • John,
    I too think it is an excellent idea to post interviews similar to the one with Evan Steele. There has been quite the buzz about SRS in general and I believe Mr. Steele’s Straight Talk blog has given the company exposure that other EMR vendors have not tapped into. Similary, if you believe you are getting “straight talk” (for lack of a better term) from these executives when you interview them then by all means I would be interested in reading what they have to say. Many of us would like to pick their brains some about EMRs, their approach, philosophy, etc., but simply do not have the opportunity. We can all talk to the sales and marketing people because they are easily accessible but there is something about talking tothe person who drives the direction and sets the tone for the company.

  • Andrew,
    No doubt a phone interview would be much better than this. Email interviews just require less time. I can understand how part of it is sales pitchy. I mean I’m talking with the CEO of a company. That’s his basic job. I think that would happen even in a live interview. That said, I think that it did provide some interesting perspectives from one vendor on the stimulus money and what they consider the advantages of their product.

    My plan is to do a bunch of things like this on video at the HIMSS conference in person. In person I’m sure I can ask more pointed follow up questions than what was available in this interview format.

    Thanks for the feedback.

  • Thanks Rena. This was a first run at it. I’m sure we’ll get better over time. I’m with you that I think that having access to CEO type people at an EMR company can be really interesting and informative. We’ll see how it all develops.

  • The key to getting a great EMR is to find 3-5 EMRs that are very good and then take them for a test drive. Blogs like this should be able to help you eliminate the “bad” EMRs so you can investigate a few good EMRs and then make a decision.

    Another way to eliminate “bad” EMRs is to see the physician feedback on the American College of Family Physician Website.

    Andrew, if you are seriously looking into EMRs, don’t take John or my word about SRSsoft, check out their website and then arrange an online demo (this will take an hour).

    I am not paid by SRSsoft and I don’t work for them. I just know that of all the EMRs that I have checked out (and I have checked out about 15), they are one of the best. I really liked what they offer and I like how they do it.

    My big thing is usability! It has to be easy to use, simple to learn, affordable and it must make the physician MORE productive.

    This is not easy to do. SRSsoft is very good.

  • Actually, you shouldn’t consider anything on this site as my endorsement of a particular EMR. I’m currently EMR vendor agnostic.

    People ask me all the time which EMR system they should look at. My response is almost always “I can’t answer that question without knowing more about your clinic and its needs.” There are some EMR software that I like, but I rarely talk about it.

    The reality is that I could list a bunch of good things and a bunch of bad things about every EMR system.

    Long story short, this interview isn’t meant to be a recommendation for SRSsoft. Just a way to provide some interesting information about an interesting EMR vendor.

  • Thanks for a wonderful discussion- simplicity and functionality are essential, but seem to be missing in many systems.You seems to be going in that direction.

    A major problem is that there is no uniform system- they don’t talk to each other. Our hospital has four or five systems which apparently work somewhat independently.

    I am looking forward to a product geared to an ohthalmology practice.

    Keep up the discussions.

    Frank J. Weinstock, MD, FACS

    Professor of Ophthalmology- NEOUCOM
    Affiliate Clinical Professor in the Charles E. Schmidt College of Biomedical Science at Florida Atlantic University
    Volunteer Professor of Ophthalmology – The University of Miami Leonard M. Miller School of Medicine

    Canton Ophthalmology Associates, Inc.

  • PaperPort is an off-the-shelf scanning software. SRS is an EMR.

    PaperPort does not generate prescriptions or connect to the Surescripts network. Without this, physicians cannot qualify for the 2% Medicare ePrescribing bonus payments.

    SRS is connected to the Surescripts network and is fully compliant with CMS program requirements, identifies drug-to-drug interactions, and reduces the potential for errors providing a higher quality of care.

    PaperPort does not collect discrete data or share/connect with regional health information exchanges.

    SRS allows physicians to collect, store, and report on clinical data. This makes it easy for physicians to earn Medicare pay-for-performance bonuses i.e PQRI, and speeds up research and outcomes analyses.

    These are just a few ways that SRS differs from PaperPort. You can read more about the differentiating features of SRS at http://www.srssoft.com/product-and-services.

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