In This Issue:
  • Healthcare more susceptible to privacy attacks than other industries
  • VoIP (Internet Phone System) For Your Practice?
  • How satisfied are you with your EHR? 2015 Satisfaction Survey results
  • 14 fast facts about Apple's iPhone on the eve of the iPhone 6S launch
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Healthcare more susceptible to privacy attacks than other industries

Aug 22, 2015, 10:06pm EDT


The global healthcare industry is much more susceptible to hacking and other privacy attacks, according to a new report.

The report, published by Raytheon | Websense Security Labs, notes that compared to the average industry, healthcare entities are plagued by 340 percent more incidents. What's more, the industry is 400 percent more likely to be impacted by advanced malware attacks and 74 percent more likely to be impacted by phishing schemes, according to the report.
The authors also note that so far in 2015, nearly 84 percent of all "Dropper incidents"--in which malware is deposited via open "backdoor" channels to electronic systems--have occurred in the healthcare industry.

"It's clear that with the amount of personally identifiable and proprietary information available and inherent as part of the healthcare industry, it will remain an attractive target to attackers and a potential weak point for untrained employees," the authors say. "As healthcare continues to avail itself of the technology and advantages of the Internet of Things, it's crucial that its practitioners and executives become more cognizant of how to protect their organizations and the individuals who use their services."

A survey published last month from consulting firm KPMG found that 81 percent of 223 healthcare executives said their organizations have been the target of cyberattacks during the past two years. Only half of those executives said they thought their organizations were adequately prepared to thwart such attacks. Several providers and payers have announced large hacks in 2015, including UCLA Health, in which information for 4.5 million individuals was compromised, and Anthem, which impacted close to 80 million current and former customers.

Seattle Children's Hospital Chief Information Security Office Cris Ewell, at a healthcare security conference in the District of Columbia earlier this month, called the elimination of cybersecurity threats an impossible goal, and urged organizations to be flexible in its privacy efforts. Specifically, he said, asset profiling and inventory management should be top-of-mind efforts. "This is all about minimizing your electronic attack surface," Ewell said. "Reconnaissance is one of the first things our adversaries do. You'd be amazed at the amount of information I could gather on all of you, as well as your institutions, down to the actual systems you use."
To learn more: - download the report (registration required)

If you would like more information on how to be secure, contact Tier3MD at 855-698-4373 or info@tier3md.com

VoIP (Internet Phone System) For Your Practice?

Chances are, if you are not using an internet phone system, you have heard about it. Tier3MD has been working with clients to recommend and help set up internet phone systems, also known as VoIP (voice over internet).

The traditional copper based landline is becoming a thing of the past. Cell phones had a lot to do with that. The market for VoIP has grown mostly because of the bandwidth. As the bandwidth increased, so has the ability to switch over to Voip, hence quite of bit of cost savings. One of the many reasons a VoIP system saves a practice money is because you don’t have to pay the phone company excise taxes anymore.

Tier3MD works with all VoIP vendors, but does have a partnership with Jive Communications.This is for smaller practices that do not want to, or need to invest large amounts of money into a physical VoIP system. We can easily install the Jive system in your practice, at very little cost to you.

Just as the Internet has revolutionized the way we get our information, voice over IP (VoIP) is helping make our voice communication more cost effective and efficient. It fits into this world of wireless and cellular. It gives a lot of functionality that a regular POTS (plain old telephone service) is not able to give. For example, web browser management.

Some practices are not sold on VoIP systems. The number one reason is “what if there is a power outage?” It is suggested to talk to Tier3MD about putting in a redundant fail over internet connection. The cost is minimal in comparison to downtime. If you are interested in a VoIP system, contact Tier3MD for more information. You can email us at info@tier3MD.com.

How satisfied are you with your EHR? 2015 Satisfaction Survey results
Our readers weigh in on what works (and what doesn't)

September 18, 2015

by Erin McCann,
Managing Editor

Erin McCann is Managing Editor at Healthcare IT News. She covers healthcare privacy and security, meaningful use, ambulatory care and healthcare policy. Follow Erin on Twitter @EMcCannHITN and Google+

Want to talk big-ticket purchases? Those behemothelectronic health record systems so many hospitals and medical practices have rolled out in recent years are easily near the top of the list.

According to data from the Office of the National Coordinator for Health IT, in fact, health organizations can expect to spend up to $70,000 per provider on EHRs.

The 24-hospital Sutter Health in California has paid out more than $1 billion for its EHR. The 38-hospital Kaiser Permanente has invested a whopping $4 billion for its system.

But while providers spend so many many millions – or billions – to purchase, implement and maintain these massive health IT products, reviews and rankings of how well they actually work can often be difficult to find. How interoperable is the EHR with mobile devices? What about with billing systems? On the user end, how would you describe the user experience? Is it easy to navigate and use?

Then there's the support piece of it all. EHR rollouts not only require serious financial investment, but they also can present huge workflow and training issues, diverting time and attention away from the other IT projects. Healthcare organizations need their EHR vendors to be available for not only installation support but also ongoing platform support.

HIMSS Analytics tracks EMRAM progress, worksite installations and health IT RFPs. But there's very little data on user satisfaction.

So we took our questions to the people who know more than a little something about EHR platforms – our readers. Specifically, we reached out to those in IT management, physicians and clinician end-users who are actively involved with EHRs. We wanted to hear strictly from individuals working in hospital, health system and ambulatory settings, so we eliminated consultants, payers, ancillary providers, students and vendors from our list. By using the HIMSS Enterprise Unified Database, which is verified through a variety of opt-in channels – newsletter signups, print subscriptions, event registrations, target list acquisitions – we sent this survey to those who could offer the most relevant and valued insight.

The 396 individuals we heard back from didn't hold anything back. We heard their biggest gripes with their EHR platforms, features they'd like to see improve. We also heard what makes them most satisfied about their EHR vendor. We asked our readers to rate their EHR vendor across nine different metrics, from one to 10, in addition to two open-ended responses on vendor limitations and positive features. The nine metrics ranked in the survey include: EHR/visual appeal; user experience/ease of use;
interoperability: with medical devices; interoperability with other clinical systems; interoperability with billing systems; quality of installation support; quality of support for ongoing operations; downtime; and overall satisfaction with the product. For the first time around, we're focusing specifically on vendors, not individual products or versions.

All EHR vendors with a limited number of user reviews – 12 or fewer – were excluded from our list, which brought us to a total of nine EHR vendor companies included overall.

See what EHR Satisfaction Survey respondents had to say here

The big takeaways? Well, according to respondents, Epic is the all-around best – in every category our readers rated. Overall satisfaction with Epic averaged to 8.1 out of 10.0. The Verona, Wisconsin-based developer may have lost its bid for the Department of Defense's multi-billion-dollar EHR modernization project, but its customers are, for the most part, satisfied with the product – more so than customers of any of the other eight vendors we included on this list. Epic currently has just over 20 percent of the hospital EMR market share, according to data from HIMSS Analytics, edging out MEDITECH by fractions of a percent.

Infographic: EHR Satisfaction Survey overall results

Other overall high performers included eClinicalWorks, billed as the largest cloud-based EHR in the U.S., which earned the No. 2 spot. Both Allscripts and Cerner tied for No. 3 overall.

And the lowest rated? That designation went to Siemens, averaging an overall satisfaction score of 4.1. It's no surprise, really, and considering Cerner acquired the health IT business unit of Siemens last summer, in a deal valued at $1.3 billion in cash, there's some serious opportunity to improve customer satisfaction.

Now, we'll break it down by three categories to drill down even further into the numbers. Each of the three categories has multiple sub-categories that go into the overall number.

This is a big one. And our survey respondents had a lot to say about it.

For all the talk about Epic's lack of interoperability lately, its user ratings placed the vendor at the top of the list, with an average interoperability rating of 7.2.

Its highest marks under this category were for medical device interoperability at 7.4, followed by interoperability with billing systems at 7.2.

That's not to say there weren't some Epic users unhappy with the vendor's interoperability state – would be great to "increase support for interoperability, particularly with existing data warehouse/analytics capabilities external to Epic," said one user, for instance – but for the most part, they're positive.

The vendor coming in at No. 2 for interoperability? Considering DoD officials cited interoperability and data blocking as among the biggest reasons they chose Cerner for the $4.2 billion EHR modernization deal, one might anticipate it being Cerner. But it's not. Rather, NextGen earned the spot, with the score of 6.2 overall. Cerner, however, was a close third, coming in at 6.0.

The least interoperable vendor systems, according to our readers, were Siemens, rated a 4.8 out of 10; GE Healthcare, 4.9 out of 10; and McKesson, rated a 4.6 out of 10.

For this category, we asked survey participants to rate interface/visual appeal and user experience/ease of use. This one's important, too. It's not just how visually appealing the EHR interface looks, it's how well are clinicians and other users able to navigate it, access it. For instance, one survey respondent said their EHR needed to be more "user friendly for clinicians in the field. Too many clicks are required to get anything accomplished." Another user said their EHR interface was "too chaotic."

In this category, again, Epic snagged the No. 1 spot, earning an overall score of 7.5 across the two categories. Epic users rated the interface/visual appeal a bit higher (7.7) than the user experience/ease of use category (7.4).

eClinicalWorks took the No. 2 spot in this category, with its users giving it a 7.1 overall.

And the low performers on the list? Again Siemens earned the lowest score, at 5.0 in the category, followed by MEDITECH and McKesson who both saw scores of 5.5. In the open-ended response "What would you change…" section of our survey, many customers of MEDITECH and McKesson said they wanted to see big improvements with ease-of-use and interface.

No surprise: Epic took the No. 1 spot in this category too. But what made it more of an outlier is that this is the category where Epic essentially shattered the competition. They were rated nearly 20 percent better than all the other vendors rated here. MEDITECH and eClinicalWorks also fared well, earning the No. 2 and No. 3 spots, respectively, receiving scores of Low performers in the support category were Siemens, at 4.1; McKesson, earning a 4.6 score; and NextGen at 5.3.

14 fast facts about Apple's iPhone on the eve of the iPhone 6S launch

by Upstart Business Journal editors September 24, 2015 1:15pm EDT

Here comes the iPhone 6S

Used to be, folks would look forward to the new model year for cars. Now, that kind of anticipation is captured by the release of the latest iPhone. Friday's the big day, with the iPhone 6S going on sale at 8 a.m. With that in mind, we're taking a look at the features on the iPhone 6S, and delving into a little of the history behind the device.

Message from CEO

I am very proud to support the MGMA (Medical Group Managers Association). Over the years we have participated in many of the events and find the peer interaction to be very helpful for all practice administrators. This past month I contributed the MGMA Newsletter. The articles can be found via this URL on page 12 and 14 or by accessing the MGMA web site www.gmgma.com and looking under member services. I encourage all practice administrators to become members of MGMA in your markets.

Sheryl J. Cherico,
CEO/COO, Co-Founder

Sheryl is the CEO of Tier3MD and one of the leading Healthcare IT Consultants in the country.

TIER3MD Partner Notes:

Hi Sheryl,

It was good meeting you as well. Thank you for sending the policy and procedure manual – I truly appreciate that. It’s always nice when you don’t have to reinvent the wheel.

I meant every word of praise for the staff at Tier3. Your staff has been a godsend on so many occasions.

Thanks again for creating a great company and keep up the great work!!


Michele Gaudette
Practice Manager
Mayes Internal Medicine
35 Bill Fries Drive, Building L
Hilton Head, SC 29926
843.342.4455, option 5


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