Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

More Vendors, Providers Integrating Telemedicine Data With EHRs

Posted on April 27, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

One of the biggest problems providers face in rolling out telemedicine is how to integrate the data it generates. Must doctors make some kind of alternate set of notes appropriate to the medium, or do they belong in the EHR? Should healthcare organizations import the video and notate the general contents? And how should they connect the data with their EHR?

While we may not have definitive answers to such questions yet, it appears that the telehealth industry is moving in the right direction. According to a new survey by the American Telemedicine Association, respondents said that they’re seeing growth in interoperability with EHRs, progress which has increased their confidence in telemedicine’s future.

Before going any further, I should note that the surveyed population is a bit odd. The ATA reached out not only to leaders in hospital systems and medical practices, but also “telehealth service providers,” which sounds like merely an opportunity for self-promotion. But leaving aside this issue, it’s still worth thinking a bit about the data, such as it is.

First, not surprisingly, the results are a ringing endorsement of telemedicine technology. The group reports that 83 percent of respondents said they’ll probably invest in telehealth this year, and 88 percent will invest in telehealth-related technology.

When asked why they’re interested in delivering these services, 98 percent said that they believe telehealth services offer a competitive advantage over those that don’t offer it. And 84 percent of respondents expect that offering telehealth services will have a big impact on their organization’s coverage and reach.

(According to another survey, by Avizia and Modern Healthcare, other reasons providers are engaging with telehealth is because they believe it can improve clinical outcomes and support their transition to value-based care.)

When it comes to documenting its key thesis – that the integration of EHR and telehealth data is proceeding apace – the ATA research doesn’t go the distance. But I know from other studies that telemedicine vendors are indeed working on this issue – and why wouldn’t they? Any sophisticated telemedicine vendor has to know this is a big deal.

For example, telemedicine vendor American Well has been working with a long list of health plans and health systems for a while, in an effort to integrate the telehealth process with provider workflows. To support these efforts, American Well has created an enterprise telehealth platform designed to connect with providers’ clinical information systems. I’ve also observed that DoctorOnDemand has made some steps in that direction.

Ultimately, everyone in telehealth will have to get on board. Regardless of where they’re at now, those engaging in telehealth will need to push the interoperability puck forward.

In fact, integrating telehealth documentation with EMRs has to be a priority for everyone in the business. Even if integrating clinical data from virtual consults wasn’t important for analytics purposes, it is important to collecting insurance reimbursement. Now that private health plans (and Medicare) are reimbursing for telemedical care, you can rest assured that they’ll demand documentation if they don’t like your claim. And when it comes to Medicare, arguing that you haven’t figured out how to document these details won’t cut it.

In other words, while there’s some overarching reasons why integrating this data is a good long-term strategy, we need to keep immediate concerns in mind too. Telemedicine data has to be seen as documentation first, before we add any other bells and whistles. Otherwise, providers will get off on the wrong foot with insurers, and they’ll have trouble getting back on track.

Patients Message Providers More When Providers Reach Out

Posted on April 26, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that patients use secure electronic messaging more when their primary care providers initiate and respond to secure messages.

To conduct the study, the research team worked a large database stocked with information on health care transactions and secure messaging records on 81,645 US Army soldiers. The data also included information from almost 3,000 clinicians with access to a patient portal system. The dataset encompassed the 4-year period between January 2011 and November 2014.

The data, which appears in a paper published in the Journal of Medical Internet Research, suggests that current provider-patient exchanges via secure messaging aren’t that common. For example, during the study period just 7 percent of patients initiated a secure message during a given month. Meanwhile, Providers initiated an average of 0.007 messages per patient each month, while responding to 0.09 messages per patient during a month.

That being said, when physicians got more engaged with the messaging process, patients responded dramatically.

Patients who knew their providers were responsive initiated a whopping 334 percent more secure messages than their baseline. Even among patients whose providers responded infrequently to their messages, the level at which they initiated messages to their clinicians was 254 percent higher than with PCPs who weren’t responding. (Oddly, when PCP response rates were at the “medium” level, patients increased messaging by 167 percent.)

In fact, when clinicians communicated more, there seemed to be spillover effects. Specifically, the researchers found that patients messaged PCPs more if that provider was very responsive to other patients, suggesting that there’s a network effect in play here.

Meanwhile, when PCPs were the ones prone to initiating messages, patients were 60 percent more likely to send a secure message. In other words, patients were more energized by PCP responses than clinician-initiated messages.

Of course, for secure messaging to have any real impact on care quality and outcomes, a critical mass of patients need to use messaging tools. Historically, though, providers have struggled to get patients to use their portal, with usage levels hovering between 10 percent and 32 percent.

Usage rates for portals have stayed stubbornly low even when doctors work hard to get their patients interested. Even patients who have signed up to use the portal often don’t follow through, research suggests. And of course, patients who don’t touch the portal aren’t exchanging care-enhancing messages with their provider.

If we’re going to get patients to participate in messaging with their doctor, we’re going to have to admit that the features offered by basic portals simply aren’t that valuable. While most offer patients access to some details of their medical records and test results, and sometimes allow them to schedule appointments, many don’t provide much more.

Meanwhile, a surprising number of providers haven’t even enabled a secure messaging function on their portal, which confines it to being a sterile data receptacle. I’d argue that without offering this feature, portals do almost nothing to engage their typical patient.

Of course, physicians fear being overwhelmed by patient messages, and reasonably fear that they won’t have time to respond adequately. Even though many organizations including the research of Dr. CT Lin has shown this just isn’t the case. That being said, if they want to increase patient engagement – and improve their overall health – secure messaging is one of the simplest tools for making that happen. So even if it means redesigning their workflow or tasking advanced practice nurse with responding to routine queries, it’s worth doing.

Where Did You Start and How Did You Get Here? The Story of Your Healthcare Career Path – #HITsm Chat Topic

Posted on April 25, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 4/28 at Noon ET (9 AM PT). This week’s chat will be hosted by Lizzie Barrett (@eliztbarrett) on the topic of “Where Did You Start and How Did You Get Here? The Story of Your Healthcare Career Path”.

I’ve found that there is no ‘one answer’ when the question ‘What led you to a career in health IT?’ is asked. The paths that got each of us here are singular, and I think that point is best proven in hearing your stories.

Passions and pursuits are often times changed, molded, and shaped by experiences. We may all be in a similar place now, but the journeys that brought each of us here are our unique stories. The variety of these stories is what gives our industry its depth. The common interests and motivators are what create community. So let’s hear your story!

Join us on Friday April 28th at 12:00pm ET as we discuss the following questions on #HITsm:

The Questions
T1: Did you start your career in the healthcare IT space? If so, where? If not, where else? #HITsm

T2: What was the initial goal you set out to achieve once you found yourself in the healthcare industry? #HITsm

T3: Share a catalyzing moment/person that influenced the trajectory of your career. #HITsm

T4: What about your career has been (is) the biggest source of energy/inspiration for you? #HITsm

T5: Which curiosities continue to motivate you and drive your work? #HITsm

Bonus: If you weren’t working in healthcare, where would you be working? #HITsm

Upcoming #HITsm Chat Schedule
5/5 – Precision Health 101: Understanding the Keys to Value
Hosted by Bob Rogers (@ScientistBob) from @IntelHealth

5/12 – Accelerating Decision-Making in Healthcare: How Health Systems Choose Innovative Decisions
Hosted by Bruce Brandes from Lucro Solutions

5/19 – Patient Education Using Healthcare Social Media
Hosted by Anne Zieger (@annezieger)

5/26 – TBD
Hosted by Chad Johnson (@OchoTex)

We look forward to learning from the #HITsm community! As always let us know if you have ideas for how to make #HITsm better.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Where HIMSS Can Take Health 2.0

Posted on April 24, 2017 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

I was quite privileged to talk to the leaders of Health 2.0, Dr. Indu Subaiya and Matthew Holt, in the busy days after their announced merger with HIMSS. I was revving to talk to them because the Health 2.0 events I have attended have always been stimulating and challenging. I wanted to make sure that after their incorporation into the HIMSS empire they would continue to push clinicians as well as technologists to re-evaluate their workflows, goals, and philosophies.

I’m not sure there is such a thing as a typical Health 2.0 event, but I generally see in such events a twofold mission. Sometimes they orient technologists to consider the needs of doctors and patients (as at a developer challenge). Other times they orient clinicians and health care institutions to consider the changes in goals and means that technology requires, as well as the strains caused by its adoption (as in a HxRefactored conference). Both of these activities disturb the cozy status quo in health IT, prodding its practitioners to try out new forms of research, design, and interaction. Health 2.0 was also happy to publish my own articles trying to untangle the standard confusion around health care.

For HIMSS, absorbing Health 2.0 is about as consequential as an ocean liner picking up a band of performing musicians along its ports of call. For Health 2.0, the impact could be much larger. Certainly, they gain the stability, funding opportunities, and administrative support that typically come with incorporation into a large, established institution. But can they keep their edge?

Subaiya and Holt assured me that Health 2.0 maintains its independence as part of HIMSS. They will be responsible for some presentations at the mammoth annual HIMSS conferences. They also hope to bring more buyers and sellers together through the HIMSS connection. They see three functions they can provide HIMSS:

  • A scanner for what’s new. HIMSS tends to showcase valuable new technologies a couple years after Health 2.0 discovers them.

  • A magnet to attract and retain highly innovative people in health IT.

  • A mechanism for finding partners for early-stage companies.

Aside from that, they will continue and expand their international presence, which includes the US, Japan, South Korea, China, and India. Interestingly, Subaiya told me that the needs expressed in different countries are similar. There aren’t separate mHealth or IT revolutions for the US and India. Instead, both call for increased used of IT for patient education, for remote monitoring and care, and for point-of-care diagnostics. Whether talking about busy yuppies in the city or isolated rural areas lacking doctors, clinicians find that health care has to go to the patient because the patient can’t always come to a health care center. If somebody can run a test using a cheap strip of paper and send results to a doctor over a cell phone, health coverage becomes more universal. Many areas are also dealing with the strains of aging populations.

HIMSS leadership and Health 2.0 share the recognition that health happens outside the walls of hospitals: in relationships, communities, schools, and homes. Health 2.0 will push that philosophy strongly at HIMSS. They will also hammer on what Subaiya calls health care’s “unacceptables”: disparities across race, gender, and geographic region, continued growth in chronic disease, and resulting cost burdens.

Subaiya and Holt see the original mission of HIMSS as a beneficial one: to create technologies that enhance physician workflows. Old technologies turned out to be brittle and unable to evolve, though, as workflows radically changed. As patient engagement and collaboration became more important, EHRs and other systems fell behind.

Meanwhile, the mobile revolution brought new attention to apps that could empower patients, improve monitoring, and connect everybody in the health care system. But technologists and venture capitalists jumped into health care without adequate research into what the users needed. Health 2.0 was created several years ago to represent the users, particular patients and health care consumers.

Holt says that investment is still increasing, although it may go into services instead of pure tech companies. Some is money moving from life sciences to computer technologies such as digital therapeutics. Furthermore, there are fewer companies getting funded than a few years ago, but each company is getting more money than before and getting it faster.

Subaiya and Holt celebrate the continued pull of health care for technologists, citing not only start-ups but substantial investment by large tech corporations, such as the Alphabet company Verily Life Sciences, Samsung, and Apple. There’s a particularly big increase in the use of data science within health care.

Some companies are integrating with Alexa to make interactions with consumers more natural. Intelligent decision support (as seen for instance in IBM’s Watson) is taking some of the burden off the clinician. For mental health, behavioral health, and addiction, digital tech is reducing stigma and barriers to those who need help.

In short, Health 2.0 should not be constrained by its new-found partner. The environment and funding is here for a tech transformation of health care, and Health 2.0’s work is cut out for it.

Legacy Health IT Systems – So Old They’re Secure

Posted on April 21, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been thinking quite a bit about the ticking time bomb that is legacy healthcare IT systems. The topic has been top of mind for me ever since Galen Healthcare Solutions wrote their Tackling EHR & EMR Transition series of blog posts. This is an important topic even if it’s not a sexy one.

I don’t think we need to dive into the details of why legacy healthcare IT systems are a security risk for most healthcare organizations. Hospitals and health systems have hundreds of production systems that they’re trying to keep secure. It’s not hard to see why legacy systems get forgotten. Forgotten systems are ripe for hackers and others that want to do nefarious things.

Although, I did hear someone recently talking about legacy health IT systems who said that they had some technology in their organization that was so old it was secure again. I guess there’s something to say about having systems that are so old that hackers don’t have tools that can breach such old systems or that can read old files. Not to mention that many of these older systems weren’t internet connected.

While I find humor in the idea that something could be so old that it’s secure again, that’s not the reality for most legacy systems. Most old systems can be breached and will be breached if they’re not considered “production” when it comes to patching and securing them.

When you think about the costs of updating and securing your legacy systems like you would a production system for security purposes, it’s easy to see why finding a way to sunset these legacy systems is becoming a popular option. Sure, you have to find a way to maintain the integrity of the data, but the tools to do this have come a long way.

The other reason I like the idea of migrating data from a legacy system and sunsetting the old system is that this often opens the door for users to be able to access the legacy data. When the data is stored on the legacy system it’s generally not used unless it’s absolutely necessary. If you migrate that legacy data to an archival platform, then the data can be used by more people to influence care. That’s a good thing.

Legacy health IT systems are a challenge that isn’t going to go away. In fact, it’s likely to get worse as we transition from one software to the next. Having a strategy for these legacy systems which ensures security, compliance, and extracts value is going to be a key to success for every healthcare organization.

Staying Connected Beyond the Patient Visit

Posted on April 20, 2017 I Written By

The following is a guest blog post by Brittany Quemby, Marketing Strategist for Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle
I see it everywhere I go – heads down, thumbs flexing. We live in an era where our devices occupy our lives. When I’m sitting at the airport waiting for my flight, standing in line at the grocery store, waiting to be called at my doctor’s office, I see it – heads down, thumbs flexing. Although I wish we weren’t always heads down in our phones, it is inevitable, we rely on our smartphone to stay connected.  As it stands today, roughly two-thirds of Americans own a smart phone, meaning they have access to email, voice, and text at their fingertips.

The increase in connectivity that the smartphone gives its user provides physicians a whole new way to communicate beyond the patient visit. Below are some tips that can help healthcare professionals stay connected while improving engagement, behaviors, and revenue outcomes.

Consider the patient’s preferences
Quite often only one piece of contact information is gathered for a patient and it is typically a home phone number. Patients expect to be communicated with where it is convenient for them, and in a recent survey on preferred communication methods, 76 percent off respondents said that text messages were more convenient above emails and phone calls.  If you are looking to connect with patients in a meaningful way, consider asking them their preferred method of contact to help maximize your engagement.

Use a various methods of communication
Recently we surveyed over 400 healthcare professionals to learn about the ways they are communicating and engaging with their patients. Our findings revealed that 41 percent of physicians and healthcare professionals utilize various methods to connect and communicate with their patients.  Long gone are the days when you could reach someone by a simple phone call. Today, if I need to get in touch with someone this is how it goes down: I will email them, then I will call them to let them know I emailed them, and then I text them to tell them to go read my email.  A recent report shows that on average 91 percent of all United States consumers use email daily and that text messages have a 45 percent response rate and a 98 percent open rate. Connecting with patients through multiple channels of communication can show a significant change in patient responsiveness and behavior, including an increase in healthcare ownership, a decrease in no shows, and a substantial increase in revenue.

Automate your patient communication messages
Investing in an automated patient communication solution is a great way to connect with your patients beyond the doctor’s office. It will not only increase patient behaviors, efficiencies, satisfaction and convenience, but will also dramatically impact your bottom-line.

A comprehensive automated patient communication platform allows include regular and frequent communication from your organization to the patient in a simple and easy way.  Consider implementing some of the following automated communication tactics to help you increase your practice’s efficiencies while continuing to engage with patients outside of the office:

  • Send appointment reminders: Send automated appointment reminders to ensure patients show up to their appointment both on time and prepared.
  • Follow-up communication: Patients only retain 20 to 60 percent of information that is shared with them during the appointment. Send a text or email with pertinent follow-up information to increase patient satisfaction and decrease readmissions.
  • Program promotion: Connect with patients to encourage them to come in for important initiatives your practice is holding like your flu-shot clinic.
  • Message broadcast: Communicate important information like an office closure or rescheduling due to severe weather.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

tranSMART and i2b2 Show that Open Source Software Can Fuel Precision Medicine

Posted on April 19, 2017 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Medical reformers have said for years that the clinic and the research center have to start working closely together. The reformists’ ideal–rarely approached by any current institution–is for doctors to stream data about treatments and outcomes to the researchers, who in turn inject the insights that their analytics find back into the clinic to make a learning institution. But the clinicians and researchers have trouble getting on the same page culturally, and difficulties in data exchange exacerbate the problem.

On the data exchange front, software developers have long seen open source software as the solution. Proprietary companies are stingy in their willingness to connect. They parcel out gateways to other providers as expensive favors, and the formats often fail to mesh anyway (as we’ve always seen in electronic health records) because they are kept secret. In contrast, open source formats are out for everyone to peruse, and they tend to be simpler and more intuitive. As open source, the software can be enhanced by anyone with programming skill in order to work with other open source software.

Both of these principles are on display in the recent merger announced by two open source projects, the tranSMART Foundation and i2b2. As an organizational matter, this is perhaps a minor historical note–a long-awaited rectification of some organizational problems that have kept apart two groups of programmers who should always have been working together. But as a harbinger of progress in medicine, the announcement is very significant.

tranSMART logo

Here’s a bit about what these two projects do, to catch up readers who haven’t been following their achievements.

  • i2b2 allows doctors to transform clinical data into a common format suitable for research. The project started in 2004 in response to an NIH Roadmap initiative. It was the brainchild of medical researchers trying to overcome the frustrating barriers to extracting and sharing patient data from EHRs. The nugget from which i2b2 came was a project of the major Boston hospital consortium, Partners Healthcare. As described in another article, the project was housed at the Harvard Medical School and mostly funded by NIH.

  • The “trans” in tranSMART stands for translational research, the scientific effort that turns chemistry and biology into useful cures. It was a visionary impulse among several pharma companies that led them to create the tranSMART Foundation in 2013 from a Johnson & Johnson project, as I have documented elsewhere, and then to keep it open source and turn it into a model of successful collaboration. Their software helps researchers represent clinical and research data in ways that facilitate analytics and visualizations. In an inspired moment, the founders of the tranSMART project chose the i2b2 data format as the basis for their project. So the tranSMART and i2b2 foundations have always worked on joint projects and coordinated their progress, working also with the SMART open source API.

Why, then, have tranSMART and i2b2 remained separate organizations for the past three or four years? I talked recently with Keith Elliston, CEO of the tranSMART, who pointed to cultural differences as the factor that kept them apart. A physician culture drove i2b2, whereas a pharma and biochemistry research culture drove tranSMART. In addition, as development shops, they evolved in very different ways from the start.

tranSMART, as I said, adopted a robust open source strategy early on. They recognized the importance of developing a community, and the whole point of developing a foundation–just like other stalwarts of the free software community, such as the Apache Foundation, OpenStack Foundation, and Linux Foundation–was to provide a nurturing but neutral watering hole from which many different companies and contributors could draw what they need. Now the tranSMART code base benefits from 125 different individual contributors.

In contrast, i2b2 started and remained a small, closely-knit team. Although the software was under an open source license, the project operated in a more conservative model, although accepting external contributions.

Elliston says the two projects have been talking for the last two and a half years about improving integration and more recently merging, and that each has learned the best of what the other has to offer in order to meet in the middle. tranSMART is adopting some of i2b2’s planning, while i2b2 is learning how to organize a community around its work.

Together they believe their projects can improve more quickly. Ultimately, they’ll contribute to the movement to target cures to patients, proceeding now under the name Precision Medicine. Fund-raising and partnerships will be easier.

I have written repeatedly about these organizations to show the power that free and open source software brings to medicine. Their timely merger shows that open source overcomes cultural and institutional barriers. What it did for these two organizations it can do for the fractured landscape of hospitals, clinics, long-term care facilities, behavioral health centers, and other medical institutions struggling to work together. My hope is that the new foundation’s model for collaboration, as well as the results of its research, can slay the growing monster of health care costs and make us all healthier.

Disruptive Innovation vs Incremental Improvement – #HITsm Chat Topic

Posted on April 18, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 4/21 at Noon ET (9 AM PT). This week’s chat will be hosted by Colin Hung (@Colin_Hung) on the topic of “Disruptive Innovation vs Incremental Improvement”.

The term “disruptive innovation” has been driven into our minds by technology and business media. It is the goal of many #HealthIT startups as well as innovation teams at healthcare organizations. Everyone is hoping that their technology or service will be labeled as the next disruptive innovation. I dare say that we are in danger of becoming so obsessed with being disruptive that we are ignoring the here-and-now.

When Clayton Christensen coined the term “disruptive innovation” back in the 90s, he used a very strict definition:

A process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.

In a more recent 2015 HBR article Christensen warns about labeling every improvement as disruptive:

Many researchers, writers, and consultants use “disruptive innovation” to describe any situation in which an industry is shaken up and previously successful incumbents stumble. But that’s much too broad a usage.

If we get sloppy with our labels or fail to integrate insights from subsequent research and experience into the original theory, then managers may end up using the wrong tools for their context, reducing their chances of success. Over time, the theory’s usefulness will be undermined.

Using Christensen’s definition, a disruptive innovation in healthcare would be something that starts off in the underserved part of the market (ex: people who don’t seek care or can’t afford it) and would be seen by incumbents (healthcare providers) as an inferior solution. Slowly that new product/service would go up-market until it replaces the incumbents. Using this lens, many of today’s supposed disruptive #HealthIT innovations fall short. There aren’t many that are aimed at the underserved healthcare markets.

When you use the more common definition, a disruptive innovation is anything that shakes up an incumbent’s market. In a perverse way, this common understanding leads to fear and self-preserving actions. By labeling something as disruptive, you immediately put incumbents on notice – and in response they raise barriers to protect themselves. In a risk-adverse environment like healthcare, convincing someone to adopt a new technology or process is difficult enough but when you label a technology as disruptive, additional barriers get raised: How will it affect privacy? How will clinicians react to it? Will it impact billing? Very few healthcare organizations want to be first to adopt an unproven technology/process.

So the question is, do we even need to proactively seek disruptive innovation in healthcare? Can we not just focus on rapid incremental improvements instead? Let’s fix EHRs so that they aren’t administrative burdens on physicians. Let’s redesign patient portals to be easier to use and let’s fill them with the content patients actually want. Let’s figure out ways to make healthcare payments more transparent. Are we so desperate for a label that we’ve lost sight of making an everyday difference?

Join me on Friday April 21st at 12:00pm ET as we discuss the following questions on #HITsm:

The Questions
T1: Is healthcare too biased against adopting disruptive innovations? Can this bias ever be overcome? #HITsm

T2: Are #HealthIT companies too focused on finding/funding TOMORROW’s disruptive innovation (aka moonshot) vs improvements TODAY? #HITsm

T3: Is the problem just one of labeling? Does it matter in #HealthIT that something is disruptive vs incremental? #HITsm

T4: What do you believe will be the next disruptive innovation in healthcare?  #HITsm

T5: What can be done in healthcare to create an environment where innovation AND improvements are welcomed & encouraged? #HITsm

Bonus: If you had unlimited resources and budget, how would you use them to disrupt healthcare? #HITsm

Be sure to also join tonight’s #hcldr chat where Colin is starting the conversation around disruptive innovation vs incremental improvement.

Upcoming #HITsm Chat Schedule
4/28 – Where Did You Start and How Did You Get Here? The Story of Your Healthcare Career Path
Hosted by Lizzie Barrett (@eliztbarrett)

5/5 – Precision Health 101: Understanding the Keys to Value
Hosted by Bob Rogers (@ScientistBob) from @IntelHealth

5/12 – TBD
TBD

5/19 – Patient Education Using Healthcare Social Media
Hosted by Anne Zieger (@annezieger)

5/26 – TBD
Hosted by Chad Johnson (@OchoTex)

We look forward to learning from the #HITsm community! As always let us know if you have ideas for how to make #HITsm better.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

AMIA Shares Recommendations On Health IT-Friendly Policymaking

Posted on April 17, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The American Medical Informatics Association has released the findings from a new paper addressing health IT policy, including recommendation on how policymakers can support patient access to health data, interoperability for clinicians and patient care-related research and innovation.

As the group accurately notes, the US healthcare system has transformed itself into a digital industry at astonishing speed, largely during the past five years. Nonetheless, many healthcare organizations haven’t unlocked the value of these new tools, in part because their technical infrastructure is largely a collection of disparate systems which don’t work together well.

The paper, which is published in the Journal of the American Medical Informatics Association, offers several policy recommendations intended to help health IT better support value-based health, care and research. The paper argues that governments should implement specific policy to:

  • Enable patients to have better access to clinical data by standardizing data flow
  • Improve access to patient-generated data compiled by mHealth apps and related technologies
  • Engage patients in research by improving ways to alert clinicians and patients about research opportunities, while seeing to it that researchers manage consent effectively
  • Enable patient participation in and contribution to care delivery and health management by harmonizing standards for various classes of patient-generated data
  • Improve interoperability using APIs, which may demand that policymakers require adherence to chosen data standards
  • Develop and implement a documentation-simplification framework to fuel an overhaul of quality measurement, ensure availability of coded EHRs clinical data and support reimbursement requirements redesign
  • Develop and implement an app-vetting process emphasizing safety and effectiveness, to include creating a knowledgebase of trusted sources, possibly as part of clinical practice improvement under MIPS
  • Create a policy framework for research and innovation, to include policies to aid data access for research conducted by HIPAA-covered entities and increase needed data standardization
  • Foster an ecosystem connecting safe, effective and secure health applications

To meet these goals, AMIA issued a set of “Policy Action Items” which address immediate, near-term and future policy initiatives. They include:

  • Clarifying a patient’s HIPAA “right to access” to include a right to all data maintained by a covered entity’s designated record set;
  • Encourage continued adoption of 2015 Edition Certified Health IT, which will allow standards-based APIs published in the public domain to be composed of standard features which can continue to be deployed by providers; and
  • Make effective Common Rule revisions as finalized in the January 19, 2017 issue of the Federal Register

In looking at this material, I noted with interest AMIA’s thinking on the appropriate premises for current health IT policy. The group offered some worthwhile suggestions on how health IT leaders can leverage health data effectively, such as giving patients easy access to their mHealth data and engaging them in the research process.

Given that they overlap with suggestions I’ve seen elsewhere, we may be getting somewhere as an industry. In fact, it seems to me that we’re approaching industry consensus on some issues which, despite seeming relatively straightforward have been the subject of professional disputes.

As I see it, AMIA stands as good a chance as any other healthcare entity at getting these policies implemented. I look forward to seeing how much progress it makes in drawing attention to these issues.

DNA Tests and Meaningful Use Humor – Fun Friday

Posted on April 14, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s Friday, so time for a little humor to start your weekend. First up is one that regular readers of this site will appreciate when it comes to the now tainted phrase: meaningful use:

This Dilbert comic seemed particularly relevant given that 23andMe just got FDA authorization for their consumer genetic health risk reports.

Have a great weekend!