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How Value-Based Reimbursement is Forcing Care Team Collaboration

Posted on December 5, 2016 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.

At the CHIME 2016 Fall Forum, we sat down with Terry Edwards, CEO and President of PerfectServe, to talk about how care team collaboration was becoming essential in the world of value based reimbursement. This major shift in healthcare is becoming an essential piece of every healthcare organization’s strategy.

In our discussion, we talk about the infrastructure needed to handle the shift to value based care. We also dive into the important topic of physician burnout and how to overcome it. We explore what it really takes to create a collaborative team model in healthcare. Finally, we ask Terry Edwards to share some of the stories of this type of collaboration in action.

Learn more about care team collaboration in our interview with Terry Edwards below:

Be sure to also check out all of Healthcare Scene’s interviews with top leaders in healthcare IT.

A New Platform for Women in Healthcare IT – Doyenne Connections

Posted on December 2, 2016 I Written By

The following is a guest blog post by Janae Sharp (@coherencemed).
janae-sharp
Every day, healthcare loses potential profit from a lack of representation of women in technology. Healthcare IT takes a larger hit than some other technology areas. Taking the problems of gender pay disparity and lack of representation for women in healthcare to a dinner party was the beginning of Doyenne Connections. Founded by Max Stroud, a lead consultant at Galen Healthcare, this group of women in leadership roles in Health IT is about creating real life connections for women in technology.

Max had a vision of forward thinking women in health IT meeting together to enhance their careers and develop ideas together. A sort of “un-conference” emerged and the first weekend was a huge success. Organizations that would be an ideal match for Doyenne connections are companies that are concerned about gender equality. Organizations that believe in the value of a human connection can get involved from the corporate level. The founders club invites women leaders in healthcare IT to mentor and meet up with other women.

In healthcare technology there is so much interest in the next innovation and how technology connects us. Employees can telecommute. Patients can see a doctor over the internet. Providers can collaborate about patients and companies to improve systems via video call. While technology and social media connects us in person meetings are still invaluable.

Healthcarescene.com is proud to partner with Doyenne connections to help promote women in Health IT and how companies can increase their profitability through improving the workplace for women. Investing in the individual women and mentorships and meetups will help improve Health IT innovation and profitability. The costs of gender inequality in the workforce are high and the loss of women in technology and healthcare is an economic problem for our companies and a social problem. Women are underrepresented in leadership roles and average 78 cents for every dollar their male counterparts make.

Want to invest in your company’s gender equality? The Founders club is looking for current and future leaders in Healthcare and Doyenne Connections has spots for corporate sponsorships.

Are Providers Using Effective Patient Communication Methods?

Posted on December 1, 2016 I Written By

The following is a guest blog post by Cristina Dafonte, Marketing Associate of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter:@StericycleComms
cristina-dafonte
This year at MGMA 2016, the Stericycle Communication Solutions team had the opportunity to survey over 800 providers about their patient communication strategy. Getting to collect our own data, rather than relying on facts and figures from scholarly articles, was truly invaluable. But what was even more exciting was sitting down and analyzing the results.

Many of the statistics weren’t surprising – nearly 100% of providers are sending appointment reminders, 60% of providers are using technology to send these reminders, and 2/3 of providers surveyed love the idea of online self-scheduling. These statistics all made sense to me… it’s almost 2017, of course providers would prefer to use technology when it comes to their patient communications.

But as I dug more into the numbers, I saw a startling trend:

  • Only 1 out of 3 providers who “love” online self-scheduling offer it to their patients
  • While almost all providers are sending appointment reminders, 1/3 are still manually calling their patients
  • Over 60% of providers are only sending appointment reminders via ONE modality

I started to think about other parts of my life where I booked appointments or used technology to interact with a vendor– did these healthcare numbers match their non-healthcare counterparts?

First I looked to my hair salon. When I go to their website, I have the ability to book an appointment with my current hair dresser directly on their home screen. I get an email reminder the day that I book the appointment with a calendar attachment. The day before the appointment, I get a text reminding me what time my appointment is and whom it is with. Four months after the appointment, I get an email reminding me that it’s time to come in for my next appointment… with a link to book an appointment online. Surprisingly, this didn’t match what I was seeing in my survey data analysis. When I looked at scheduling an appointment to get my car serviced, I saw the same trend – booking was conveniently online, the communications were all automated, and I received more than one reminder.

So why does there seem to be such a difference when it comes to healthcare communication? Our survey shows that providers like the idea of technology, so, I wonder, why are most providers only going halfway? What is it that is holding them back from fully investing in automated patient communications? According to TIME, the average person looks at his or her phone 46 times per day. As we near 2017, shouldn’t we reach and capture patients where they are engaged and spend most of their time – on their mobile devices and computers?

For more MGMA survey results and a sneak peak into how Stericycle Communication Solutions can help you adopt an automated patient communication strategy, download the infographic here.

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

Don’t Yell FHIR in a Hospital … Yet

Posted on November 30, 2016 I Written By

The following is a guest blog post by Richard Bagdonas, CTO and Chief Healthcare Architect at MI7.
richard-bagdonas
The Fast Healthcare Interoperability Resource standard, commonly referred to as FHIR (pronounced “fire”) has a lot of people in the healthcare industry hopeful for interoperability between the electronic health record (EHR) systems and external systems — enabling greater information sharing.

As we move into value-based healthcare and away from fee-for-service healthcare, one thing becomes clear: care is no longer siloed to one doctor and most certainly not to one facility. Think of the numerous locations a patient must visit when getting a knee replaced. They start at their general practitioner’s office, then go to the orthopedic surgeon, followed by the radiology center, then to the hospital, often back to the ortho’s office, and finally to one or more physical therapists.

Currently the doctor’s incentives are not aligned with the patient. If the surgery needs to be repeated, the insurance company and patient pay for it again. In the future the doctor will be judged and rewarded or penalized for their performance in what is called the patient’s “episode of care.” All of this coordination between providers requires the parties involved become intimately aware of everything happening at each step in the process.

This all took off back in 2011 when Medicare began an EHR incentive program providing $27B in incentives to doctors at the 5,700 hospitals and 235,000 medical practices to adopt EHR systems. Hospitals would receive $2M and doctors would receive $63,750 when they put in the EHR system and performed some basic functions proving they were using it under what has been termed “Meaningful Use” or MU.

EHR manufacturers made a lot of money selling systems leveraging the MU incentives. The problem most hospitals ran into is their EHR didn’t come with integrations to external systems. Integration is typically done using a 30 year old standard called Health Level 7 or HL7. The EHR can talk to outside systems using HL7, but only if the interface is turned on and both systems use the same version. EHR vendors typically charge thousands of dollars and sometimes tens of thousands to turn on each interface. This is why interface engines have been all the rage since they turn one interface into multiple.

The great part of HL7 is it is standard. The bad parts of HL7 are a) there are 11 standards, b) not all vendors use all standards, c) most EHRs are still using version 2.3 which was released in 1997, and d) each EHR vendor messes up the HL7 standard in their own unique way, causing untold headaches for integration project managers across the country. The joke in the industry is if you have seen one EHR integration, you’ve seen “just one.”

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HL7 versions over the years

HL7 version 3.0 which was released in 2005 was supposed to clear up a lot of this integration mess. It used the Extensible Markup Language (XML) to make it easier for software developers to parse the healthcare messages from the EHR, and it had places to stick just about all of the data a modern healthcare system needs for care coordination. Unfortunately HL7 3.0 didn’t take off and many EHRs didn’t build support for it.

FHIR is the new instantiation of HL7 3.0 using JavaScript Object Notation (JSON), and optionally XML, to do similar things using more modern technology concepts such as Representation State Transfer (REST) with HTTP requests to GET, PUT, POST, and DELETE these resources. Developers love JSON.

FHIR is not ready for prime time and based on how HL7 versions have been rolled out over the years it will not be used in a very large percentage of the medical facilities for several years. The problem the FHIR standard created is a method by which a medical facility could port EHR data from one manufacturer to another. EHR manufacturers don’t want to let this happen so it is doubtful they will completely implement FHIR — especially since it is not a requirement of MU.

And FHIR is still not hardened. There have been fifteen versions of FHIR released over the last two years with six incompatible with earlier versions. We are a year away at best from the standard going from draft to release, so plan on there being even more changes.

image-2
15 versions of FHIR since 2014 with 6 that are incompatible with earlier versions

Another reason for questioning FHIR’s impact is the standard has several ways to transmit and receive data besides HTTP requests. One EHR may use sockets, while another uses file folder delivery, while another uses HTTP requests. This means the need for integration engines still exists and as such the value from moving to FHIR may be reduced.

Lastly, the implementation of FHIR’s query-able interface means hospitals will have to decide if they must host all of their data in a cloud-based system for outside entities to use or become a massive data center running the numerous servers it will take to allow patients with mobile devices to not take down the EHR when physicians need it for mission-critical use.

While the data geek inside me loves the idea of FHIR, my decades of experience performing healthcare integrations with EHRs tell me there is more smoke than there is FHIR right now.

My best advice when it comes to FHIR is to keep using the technologies you have today and if you are not retired by the time FHIR hits its adoption curve, look at it with fresh eyes at that time. I will be eagerly awaiting its arrival, someday.

About Richard Bagdonas
Richard Bagdonas has over 12 years integrating software with more than 40 electronic health record system brands. He is an expert witness on HL7 and EDI-based medical billing. Richard served as a technical consultant to the US Air Force and Pentagon in the mid-1990’s and authored 4 books on telecom/data network design and engineering. Richard is currently the CTO and Chief Healthcare Architect at MI7, a healthcare integration software company based in Austin, TX.

What’s Next for HITsm? – #HITsm Chat Topics

Posted on November 29, 2016 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 still working to redesign our site as the new home of the #HITsm chat. We hope you’ll forgive the construction as we worked to make a permanent home for the #HITsm chat. I’m sure it will be a process of ongoing improvement. In the meantime, we wanted to announce the topic and questions we’ll be discussing on this week’s #HITsm chat happening Friday, 12/2 at Noon ET (9 AM PT).

This week’s chat will be hosted by John Lynn (@techguy) from Healthcare Scene where we’ll be talking about what’s next for #HITsm. As the new host of the #HITsm chat, we wanted to spend a chat talking about any unique ideas, hosts, topics, you’d like to see as we continue the tradition of the #HITsm community while striving to make it even more valuable to everyone involved. Plus, we want to make sure we preserve the things that the community finds most valuable.

T1: Which features of the #HITsm chat do you think are the most important to preserve?

T2: What things should we avoid in the #HITsm chat?

T3: What topics and which hosts would you like to see in future #HITsm chats? (You can submit ideas here as well.)

T4: Do you have any creative ideas to take #HITsm to the next level of engagement and value?

T5: What keeps you coming back to participate in the #HITsm chats? What prevents you from participating?

Bonus: What’s your funniest, most exciting, most powerful, #HITsm memory?

Here’s a look at the rest of the #HITsm chat schedule through the end of the year:

12/9 – Innovation in Customer Experience and Digital Health
Hosted by Steve Sisko (@ShimCode) from ShimCode.com

12/16 – Reputation Management
Hosted by Erika Johansen (@thegr8chalupa) from Splash Media

12/23 – No Chat – Happy Holidays!

12/30 – No Chat – Happy New Year!

Vendor Study Says Wearables Can Promote Healthy Behavior Change

Posted on November 28, 2016 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 backed by a company that makes an enterprise health benefits platform has concluded that wearables can encourage healthy behavior change, and also, serve as an effective tool to engage employees in their health.

The data from the study, which was sponsored by Mountain View, CA-based Jiff, comes from a two-year research project on employer-sponsored wearables. Rajiv Leventhal, who wrote about the study for Healthcare Informatics, argues that these findings challenge common employer beliefs about these type of programs, including that participation is typically limited to young and healthy employees, and that engagement with these rules can’t be sustained over time.

The data, which was drawn from 14 large employers with 240,000 employees, apparently suggests that wearable adoption and long-term engagement is possible for employees of all ages. The company reported that among the employers offered the wearables program via its enterprise health platform, 53% of employees under 40 years old participated, and 36% of employees over 50 years participated as well.

Jiff researchers also found that employee engagement had not measurably fallen for more than nine months following the program rollout, and that for one employer, levels of engagement have been progressively increasing for more than 18 months, the company reported.

According to Jiff, they have helped sustain employee engagement by employing three tactics:  Using “challenges,” time-bound immersive and social games that encourage healthy actions, “device credits,” subsidies that offset the cost of purchasing wearables and “behavioral incentives,” rewards for taking healthy actions such as walking a minimum number of steps per day.

The thing is, as interesting as these numbers might be — and they do, if nothing else, underscore the role of engaging consumers rather than waiting for them to engage with healthier behaviors on their own — the story doesn’t address one absolutely crucial issue, to wit, what concrete health impact are companies seeing from employee use of these devices.

I don’t think I’m asking for too much here when I demand some quantitative data suggesting that the setup can actually achieve measurable health results. Everything I’ve read about employee wellness initiatives to date suggests that they’ve been a giant bust, with few if any accomplishing anything measurable.

And here we have Jiff, a venture-backed hotshot company, which I’m guessing had the resources to report on results if it found any. After all, if I understand the study right, with their researchers had access to 540,000 employees for significant amount of time.  So where are the health conclusions that can be drawn from this population?

And by the way, no, I don’t accept that patient engagement (no matter how genuine) can be used as a proxy or predictive factor for health improvement. It’s a promising step in the right direction but it isn’t the real thing yet.

So, I shared the study with you because I thought you might find it interesting. I did. But I wouldn’t take it too seriously when it comes to signs of real change — either for wearables used for employee wellness initiatives. At this point both are more smoke than substance.

Thanksgiving Gratitude

Posted on November 24, 2016 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.

In the US, today is Thanksgiving and so I thought it would be fun to show a bit of gratitude to each of my children on each of my blogs. Feel free to skip this post if you’re looking for Healthcare IT content on Thanksgiving. We’ll be back with our regularly scheduled content on Monday.

This probably says a lot about me, but I decided to put my oldest child on my oldest blog and so forth down the line based on age of the child and blog. With that alignment, EMRandHIPAA.com is host to my first child. Most of you don’t know, that my brother and I have casually been writing a daddy blog called Crash Dad where I refer to my kids as Crash Kids. So, on this blog I want to show some gratitude for Crash Kid #1.
crash-kid-1-4
Crash Kid #1 just oozes creativity. His passion for creating and designing is inspiring to me since it’s the opposite of me. Ever since he could talk he’s been surprising us with the way he looks at life. I’m grateful that he always teaches me what’s most important in life and doesn’t let me allow other things to distract. Talking with him before bed is the perfect way for me to end the day and I’m grateful to him for that.

Happy Thanksgiving! Who are you grateful for this day?

Gratitude for the #HITsm Community

Posted on November 23, 2016 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.

When I wrote about the passing of the #HITsm torch to Healthcare Scene, I was so grateful thinking of the hundreds of incredible people in the #HITsm community that have impacted my life for good. There are too many stories to share here.

With that in mind, I knew that one key to my role in taking over the #HITsm Twitter chat was going to be to involve as many members of the #HITsm community as possible. I’ve already reached out and gotten commitments from @CancerGeek, @theGr8Chalupa, @ShimCode, @SarahBennight, and @Colin_Hung to help me curate the #HITsm hosts. I realized that if I did it alone, I would get sub-optimal results. However, by involving multiple people from a wide variety of perspectives we’d get a wide-ranging, diverse set of perspectives hosting the #HITsm chat.

While this is a great first step, I was inspired by @Matt_R_Fisher and @Resultant to open it up even more. Basically, let’s make it so the #HITsm Brain Trust can crowdsource the topics and hosts as much as possible. Matt and Joe also suggested that maybe out of these submissions we could create a set of topics that serve as a framework for discussions throughout the year. We’ll see what gets submitted, but I think it’s an interesting idea to have a number of themes that we cover in #HITsm throughout the year.

With this type of openness in mind, I created this form where anyone and everyone can participate by submitting topics and hosts for the #HITsm chat. Depending on the number of submissions, we may roll this into a survey where people can vote for topics and hosts they’d like to see most. We’ll still sprinkle in unique topics that might not be as popular though. Help us out and submit any ideas you have for #HITsm hosts and topics below:

Assuming the spam bots stay away, we’ve also made the submissions public so you can review what’s already been submitted before submitting your own. If you’d prefer to send us something privately, you can always connect with us on the Healthcare Scene contact us page or on Twitter (@techguy and @healthcarescene).

On this Thanksgiving week in the US, I also just wanted to say Thank You to all of the #HITsm community. The work we’re doing is important. Let’s all help each other to take what we’re doing to the next level. Healthcare needs us.

A Thankful Look at Healthcare Scene

Posted on November 22, 2016 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 recently working on the Healthcare Scene media kit (still being edited as we speak) and a presentation that illustrates the influence of Healthcare Scene. As part of that slide deck I gathered the numbers for this slide:

healthcare-scene-overview

As I look at any of these numbers, I have to admit that it’s really hard for me to comprehend any of them. We’re approaching the 11th anniversary of Healthcare Scene and it’s really hard for me to imagine how far we’ve come since that weekend I got bored and started blogging about EMR.

This week of gratitude, I’m particularly grateful for those people who trust Healthcare Scene for their daily cup of what’s interesting in healthcare IT. Amidst all the noise that exists in this world, it’s quite humbling to think that so many people look to this network of blogs to stay informed.

Just as humbling is the hundreds of companies that have sponsored the work we do at Healthcare Scene. What’s best is that most of our sponsors started out as readers. It’s gratifying to know that they valued the work we do enough to support our sites. A big thanks to our current crop of sponsors: The Breakaway Group, Stericycle Communications Solutions, HIPAA One, Kareo, Iron Mountain, Intel Health, Samsung, HIM on Call, Central Learning, Greythorn, Innovative Consulting Group, Cumberland Consulting Group, EMR Staffing Partners, UCSD Master in Health Informatics (Online)Galen Healthcare Solutions, and 4MedApproved. As sponsors, I’ve gotten to know each of these organizations quite well and they are all working hard to improve healthcare.

This Thanksgiving Week, I just wanted to take a minute to celebrate and show gratitude to all of you. Thanks for reading. Thanks for commenting. Thanks for sponsoring. Thanks for sharing on social media. Thanks for the private messages and responses. Thanks for the likes and hearts and favorites and retweets. I feel blessed to be part of such an amazing community. I can’t wait to see what happens with healthcare IT over the next decade.

Are Healthcare Data Streams Rich Enough To Support AI?

Posted on November 21, 2016 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.

As I’ve noted previously, artificial intelligence and machine learning applications are playing an increasingly important role in healthcare. The two technologies are central to some intriguing new data analytics approaches, many of which are designed to predict which patients will suffer from a particular ailment (or progress in that illness), allowing doctors to intervene.

For example, at New York-based Mount Sinai Hospital, executives are kicking off a predictive analytics project designed to predict which patients might develop congestive heart failure, as well as to care for those who’ve are done so more effectively. The hospital is working with AI vendor CloudMedx to make the predictions, which will generate predictions by mining the organization’s EMR for clinical clues, as well as analyzing data from implantable medical devices, health tracking bands and smartwatches to predict the patient’s future status.

However, I recently read an article questioning whether all health IT infrastructures are capable of handling the influx of data that are part and parcel with using AI and machine learning — and it gave me pause.

Artificial intelligence, the article notes, functions on collected data, and the more data AI solution has access to, the more successful the implementation will be, contends Elizabeth O’Dowd in HIT Infrastructure. And there are some questions as to whether healthcare IT departments can integrate this data, especially Internet of Things datapoints such as wearables and other personal devices.

After all, O’Dowd notes, for the AI solution to crawl data from IoT wearables, mobile apps and other connected devices, the data must be integrated into the patient’s medical record in a format which is compatible with the organization’s EMR technology. Otherwise, the organization’s data analytics solution won’t be able to process the data, and in turn, the AI solution won’t be able to evaluate it, she writes.

Without a doubt, O’Dowd has raised some important issues here. But the real question, as I see it, is whether such data integration is really the biggest bottleneck AI and machine learning must pass through before becoming accessible to a wide range of users. For example, healthcare AI-based Lumiata offers a FHIR-compliant API to help organizations integrate such data, which is certainly relevant to this discussion.

It seems to me that giving the AI every possible scrap of data to feed on isn’t the be all and end all, and may even actually less important than the clinical rationale developers uses to back up its work. In other words, in the case of Lumiata and its competitors, it appears that creating a firm foundation for the predictions is still as much the work of clinicians as much is AI.

I guess what I’m getting to here is that while AI is doubtless more effective at predicting events as it has access to more data, using what data we have with and letting skilled clinicians manage it is still quite valuable. So let’s not back off on harvesting the promise of AI just because we don’t have all the data in hand yet.