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High Costs of Health IT, ePrescribing, and HIE — #HITsm Chat Highlights

Posted on June 29, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

The following is our regularly scheduled roundup of tweets from yesterday’s #HITsm chat. You can also check out John’s blog post on yesterdays #HITsm topics.

Topic One: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?

 

Topic Two: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?

 

Topic Three: #HIE as a noun or a verb? Does negative press for HIE organization$ hinder health data exchange as a whole?

#HITsm T4: Is #CommonWell just a bully in a fairy godmother costume?

 

Topic Five: Open forum: What #HealthIT topic had your attention this week?

Marketing Your Medical Practice in the Digital (Social) Age

Posted on June 28, 2013 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.

On Saturday, June 30, Tweeters, Instagramers, Pinners and the like will gather to celebrate the fourth annual Social Media Day, presented by Mashable, a leading online source for news and information focused on the Connected Generation. And each year, social media plays a greater role in #healthcare and #HealthIT. Here are a few stats from recent months:

  • 51% of those surveyed say that digital health communications would make them feel more valued as a patient
  • 90% of adults 18-24 years of age say they would trust medical information shared by others in their social media networks
  • 41% of people say social media would affect their choice of health care provider

To raise awareness about the social media benefits for health care professionals, I asked Dr. Lawrence Rosen, an athenahealth client, social-savvy clinician, practice owner and influencer, about best practices and tips for marketing a medical practice on social networks.

When did you realize it was time to put your practice on Facebook? When was that ‘a-ha’ moment?

It happened the day I started my practice, The Whole Child Center, in 2008. I recognized that savvy parents were using Facebook to gather and share information about their kids. They not only wanted to post photos of their one-year-old’s birthday party but also wanted to interact with their health care providers. I thought it would be great if we could develop this online community to build on the brick-and-mortar community we developed within the four walls of our practice.

To create an effective Facebook strategy, it’s key to know your audience and what you’d like them to do. Who are your Facebook target audiences? Are you surprised by any groups that you’re reaching?

As a pediatrician, my primary target audience is easy—moms. And for Facebook, that’s a key demographic. Recent insights showed that 80% of our Facebook audience is women with more than 60% ages 25-44.

The most surprising demographic? Other health care practitioners interested in the unique integrative and eco-sustainable approach we take to medicine.

Discuss the types of content you have generated and how you personally grown your Facebook presence and, in essence, your practice.

Initially, our content was mostly health information, current articles and trends in the news. I then realized that photos and videos garnered much more interest, so we developed a space for parents to post photos of their kids having fun in our office. With HIPAA concerns, we are really careful to never post patient information directly, but parents can certainly share information about their own experiences, and they love sharing these pictures. Also, I’ve found videos of my media appearances or webinars, when posted on seasonal or topical issues, always get a lot of likes and shares.

What are examples of online content that have increased visibility or engagement for your practice? 

The most gratifying and widespread content has been related to our response to the 2012 Hurricane Sandy tragedy in New Jersey and New York. We posted a call for new or gently used baby equipment—strollers, car seats, high chairs—for one of our practice’s  moms to deliver to a devastated section of Queens, NY.  In one week, we gathered enough donations to fill a box truck. This mom, who had family in the damaged area, was so thrilled to partner with us, and it really helped raise awareness in our area of the plight of young families.

Are there any rules of the road, things people should remember when marketing their practice on a social network?

Don’t post private information. Don’t pester your audience by posting 40 things a day. Be strategic, know your audience, pay attention to what people like and share, and keep your content relevant to hot topics, and local or regional health issues. In general, stay away from divisive political or religious issues.

What you post is going to be seen as a reflection of your organization’s values and will positively or negatively affect your reputation. Recognize the power of your social network to engage and build your community.

Dr. Rosen is an integrative pediatrician based in Oradell, N.J. and a contributor to the athenahealth blog

Hacking HIPAA – Patient Focused Common Notice of Privacy Practices

Posted on June 27, 2013 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.

How can you not be interested in an article that talks about hacking? Of course, in this case I’m talking about hacking in a much more general since. Most people think of hacking as some nefarious person compromising a system they shouldn’t be accessing. The broader use of the term hack is to create something that fixes a problem. You “hack” something together to make it work.

This is what David Harlow, Ian Eslick, and Fred Trotter had in mind when they got together to hack HIPAA. They wanted to create a HIPAA Notice of Privacy Practices (NPP) that would provide meaningful privacy choices for patients while still enabling the use of the latest technology. Far too often HIPAA as seen as an excuse for why doctors don’t use technology. However, if the NPP is set up correctly, it can enhance patient privacy while allowing use of the latest technologies in your practice.

The Hacking HIPAA team decided to leverage the power of crowdfunding to see if they could collaboratively develop a patient focused Notice of Privacy Practices. I really love the idea of a Common Notice of Privacy Practices. If you like this idea, you can help fund the Hacking HIPAA project on MedStartr.

For those not familiar with crowdfunding, imagine your healthcare organization getting $10,000 worth of legal work from one of the top healthcare lawyers for only $1000. Looked at another way, you get an updated Notice of Privacy Practices with all the latest HIPAA omnibus rules incorporated for only $1000. Call your lawyer and see if they’d be willing to provide an NPP for that price. Plus, your lawyer probably will just provide you some cookie cutter NPP they find as opposed to a well thought out NPP.

This is such a great idea. I hope that a large number of healthcare organizations get behind the project. I’d also love to see some of the HIPAA disclosure companies and EHR companies support the project as well. The NPP will have a creative commons license so those companies could help fund the project, provide feedback in the creation of the NPP and then distribute the NPP to all of their customers. What better way to build the relationship with your customers than to provide them a well thought out NPP?

If you want a little more information on how the Hacking HIPAA project came together, here’s a video of Fred Trotter talking about it. Also, be sure to read the details on the Hacking HIPAA MedStartr page.

CPOE and MU with Marc Probst and M*Modal

Posted on June 26, 2013 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.

As part of my ongoing series of EHR videos, I had the chance to sit down with Marc Probst, CIO of Intermountain and a member of a number of important healthcare IT committees, Mike Raymer, Senior Vice President of Solutions Management at M*Modal and Dr. Jonathan Handler, CMIO of M*Modal to talk about CPOE and Meaningful Use. It’s another great addition to the Healthcare Scene YouTube channel.

In the interview we have a chance to talk about Intermountain’s move from zero CPOE to mobile, voice recognized CPOE. We talk about the future possibilities of voice in healthcare. I also ask Marc Probst about his views on EHR certification, meaningful use, and CommonWell.


*Note: Marc Probst’s sound was less than ideal. Next time we’ll be sure he has a better microphone.

Bill Would Offer More Ways To Avoid Medicare EMR Cut

Posted on June 25, 2013 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.

Federal lawmakers have introduced a bill which would grow the list of exemptions physicians could seek to the Medicare penalties faced by those not meaningfully using an EMR.

The bill, which was filed in the House by Rep. Diane Black (R, Tenn) would add new hardship exemptions to an existing list which would help solo practice physicians and doctors who are approaching retirement, according to American Medical News.

As readers probably know, most doctors who don’t have a meaningfully-used EMR in place by July 2014 — roughly a year from now — face cuts to to Medicare reimbursement starting in 2015.  The penalty cuts would lower Medicare reimbursement by 1 percent in 2015, and would climb to 3 percent by 2017.

Some physicians already enjoy exemptions from the cuts, AMN notes. Doctors who:

  • Have insufficient Internet access or who face insurmountable barriers to obtaining infrastructure, such as high-speed or broadband Internet.
  • Begin practicing in 2015.
  • Encounter unforeseen circumstances, such as a natural disaster or other unforeseeable barrier.
  • Lack face-to-face interaction with patients or follow-up opportunities with patients.
  • Practice in multiple locations and do not control access to EHRs during more than 50% of patient encounters.

Are already eligible for exemptions from the pending Medicare cuts, AMN reports.

The new bill would extend the above list of hardship exemptions to doctors in a solo practice. It would also offer an exemption for physicians who are 62 or older by the last day of 2015, or who will reach age 62 by 2020, according to the magazine.

It seems like the help with the cuts is needed for solo physicians in particular. According to the National Center for Health Statistics at t he CDC, only 29 percent of solo practitioners had adopted EMRs by 2011.  While that number may have climbed since 2011, solo docs are doubtless still way behind in adoption, and slapping them with reimbursement cuts simply may not make sense.

The Path to Healthcare Interoperability Standards

Posted on June 24, 2013 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 a lot about the issues associated with healthcare interoperability. One of the biggest excuses/problems out there is the idea of interoperability standards. Healthcare certainly has plenty of interoperability standards, but adoption and implementation of the actual standards has been the major issue.

I do think that meaningful use and EHR certification is making some difference in regards to standards. I think that Direct Project is likely going to become a pretty solid standard for exchanging some healthcare documents. However, it’s limited in it’s scope.

Instead, I think we’re going to see a different path to healthcare interoperability. It’s going to be led by a few prominent organizations that start sharing info. Once those organizations start sharing data, whatever standard they use will start to spread and will become the standard for interoperability in healthcare.

Which organization or group of organizations will be the ones that break out and establish the standard? I still think the jury is out on that one, but a couple prime candidates are: CommonWell and Healtheway.

I’d love to hear if you see another path to healthcare interoperability or other initiatives that could break through and be successful.

Obsolete Office Visits, Tracking Customer Behavior, and More — #HITsm Chat Highlights

Posted on June 22, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

John did a full writeup on these topics before the #HITsm chat. Be sure to read his thoughts on Healthcare Unbound.

Topic One: So how long will it be before office visits are no longer the norm? (via Mark Blatt, MD, CMIO Intel)

Topic Two: What technologies will lead the way?

Topic Three: How will these at-home and mobile technologies integrate with existing systems?

 

Topic Four: Aetna’s CarePass will track customer behavior. Will this become the norm, is it a good thing?

Healthcare Unbound #HITsm Chat Thoughts

Posted on June 21, 2013 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.

Most of you have seen that we’ve been working on a number of ways to stretch and deepen the amazing #HITsm community. Check out the EMR and HIPAA YouTube channel for some post #HITsm video chats we’ve done. Plus, we do our weekly #HITsm Twitter Roundups (Every other week our #HITsm roundup is on EMR and EHR). At the core of all of this is the weekly #HITsm twitter chat. If you’ve never participated, it’s an incredible community of people.

I’ve always wanted to do a blog post before the regularly scheduled #HITsm chat where I write some thoughts about the planned #HITsm topics. Leonard Kish (@leonardkish) got the topics for this week’s chat up early, so I thought it was the perfect opportunity for me to write a post based on his topics. Hopefully some can read it before the chat and it will enhance their chat experience.

Topic 1: So how long will it be before office visits are no longer the norm? (via Mark Blatt, MD, CMIO Intel)
This is a bit of a hard question because it depends on how you define office visit. Is an e-visit with the doctor considered an office visit. What if the visit is in a HealthSpot like kiosk? Is that an office visit. I’ll assume for the sake of this question that he means any visit where you didn’t have to go into the office. This could be a telemedicine visit or some other electronic method of interacting with a care provider.

My prediction is that it will probably be 3 years before it’s common for the early adopters to do an e-visit of some sort. It will probably be 6 years before someone like mom is doing an e-visit. Although, there’s a subtle caveat to my answer. Many office visit types will be perfect for an e-visit and some office visit types will never be possible in an e-visit. So, I’m mostly making my prediction based on the former visit type.

Topic 2: What technologies will lead the way?
The Google Plus hangout simplicity has made very clear to me that a video connection between two people is easily possible today. Of course, I’m not suggesting Google Plus will be used for a healthcare office visit, but video and audio using the off the shelf and built in cameras and microphones that come on every laptop, smartphone, and tablet is going to be the preferred method.

As for software, the early adoption is going to be based on which companies the insurance companies choose to reimburse. The insurance companies I’ve talked to are more than happy to have doctors reimbursed for an electronic visit. However, they need some way to know if an e-visit was actually done by the doctor. Even a small space for corruption can cost an insurance company billions of dollars because of their scale. Their method to battle this will be to reimburse only a few telemedicine companies for whom they’ve created deep ties.

Let’s also not count out secure text and secure email as a simple method to replace many unneeded visits.

Topic 3: How will these at-home and mobile technologies integrate with existing systems?
As Anne Zieger recently pointed out, Telemedicine is Not Connecting with EHRs. EHR vendors have so many interoperability challenges as is that integrating with Telemedicine is far down their list of priorities. Instead, I think we’ll see the insurance companies take the lead on integrating Telemedicine into their platforms. We may also see some PHR and patient portals work out deals with the companies that are recognized for reimbursement by the insurance companies.

The other beautiful area for this technology is the cash pay patients. I see a whole new group of cash pay patients emerging. Many people and companies will be willing to pay cash for an e-visit versus making the trip to a doctor’s office for a regular visit. The key question is how the company that provides these visits will get enough locally licensed doctors on board to make this happen, but someone will crack the nut.

Topic 4: Aetna’s CarePass will track customer behavior. Will this become the norm, is it a good thing?
I believe that this will be the norm. In fact, they’re already doing some of this customer behavior tracking already, but most people just don’t know about it. Things like CarePass will just be a public way to do it. I think many will hop on board. I think that this will be a good thing for insurance companies, a good thing for healthcare, and a good thing for many patients. However, a few patients will get really hurt by it.

Topic 5: We’ll need culture change to bring this massive about. what will it take to change culture?
1. Reimbursement 2. Medical Licensing Laws 3. Trusted Technology

If we figure out those 3 areas, we’re going to see the culture change that will unbind healthcare. I personally think we’re headed this direction already and I see nothing that will stop it. It’s just a question of how quickly we can get there.

HIEs and Patient Engagement – Why and Why Now?

Posted on June 20, 2013 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.

The following is a guest post by Jeff Donnell, President of NoMoreClipboard.
Jeff Donnell - NoMoreClipboard PHR
Health information exchanges have become quite adept at moving medical data from provider to provider on behalf of patients, but making that data available to those same patients has rarely been attempted – until recently.

Not including patients at the HIE exchange table is understandable, but ironic. Understandable for reasons ranging from policy challenges to a lack of standards to technical limitations. Ironic because HIEs are ideally positioned to aggregate data from multiple providers – leveraging the interfaces already in place with provider applications – and deliver that data to consumers, overcoming several of the major barriers to patient adoption and use of tools like PHRs and patient portals.

HIEs have recently grown interested in supporting electronic patient engagement, in large part based on provider inquiries regarding meaningful use stage two requirements. Many providers are looking for affordable alternatives to the tethered patient portals being offered by their EHR vendors, and they want to provide their patients with a solution that can be used across the care continuum. Increasingly, providers recognize that a patient who visits five different clinicians is not about to create five different patient portal accounts. Savvy providers realize that the HIE is well equipped to provide portable, interoperable solutions.

For HIEs interested in long-term sustainability, patient engagement makes perfect sense. The HIE can leverage its existing interfaces and aggregated data – making existing medical information available to patients from a single pipe, in a standardized format. The HIE can act as a conduit between consumers and clinicians – adding value for all parties. Providers can transmit data to patients, and recent CMS guidance indicates that all providers who contribute data to a shared portal (like that provided by an HIE) can count patients who use that portal toward their 5% patient participation requirement. Patients avoid having to collect data from every provider they see, and can populate a PHR or HIE portal account with existing electronic data. Everybody wins.

The value is evident, but what about those challenges? In the state of Indiana, we received an ONC Challenge Grant to figure out how to get HIE data in the hands of consumers with a PHR. We are fortunate to reside in a state with five well-established HIEs and a provider community eager to innovate, and we have spent the last two years working on those challenges (giving us a real appreciation for why the ONC affixed the challenge label to this grant program). We have addressed issues ranging from patient ID/Auth/Match to minor consent to provider skepticism to amended data use agreements. We have overcome any number of obstacles to get data flowing, and we are seeing increased levels of engagement and enhanced clinical outcomes.

We have learned any number of lessons to help other HIEs, state agencies and healthcare providers avoid pitfalls and make accelerated progress. We are eager to share what we have learned. Perhaps the most important lesson is to get started now – as crafting and implementing a patient engagement strategy takes time. As nobody appears to be manufacturing more time these days, HIEs and other organizations that envision sharing data with patients even a year or two down the road would be well advised to begin working in earnest, with an eye on making incremental progress.

Jeff Donnell is president of NoMoreClipboard, a web-based, Personal Health Record (PHR) management system designed to consolidate medical information in one convenient and secure location for easy retrieval and updates. NMC enables consumers to share personal or family member medical information with medical professionals electronically, reducing the need for repetitive medical paperwork.  Jeff and the company are committed to developing PHR applications that are consumer-friendly, interactive, secure, mobile and interoperable.  For more information, follow us on Twitter @NoMoreClipboard or visit www.NoMoreClipboard.com.

Amazon AWS Will Sign HIPAA Business Associate Agreement

Posted on June 19, 2013 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.


Thanks to Ian Eslick for catching this piece of news. This is really big news, because there were a lot of companies and organizations that were building healthcare applications on the back of Amazon AWS. I’m glad that Amazon has finally put together a policy related to HIPAA.

Here’s their new section describing their compliance with HIPAA:

AWS enables covered entities and their business associates subject to the U.S. Health Insurance Portability and Accountability Act (HIPAA)  to leverage the secure AWS environment to process, maintain, and store protected health information and AWS will be signing business associate agreements with such customers. AWS also offers a HIPAA-focused whitepaper for customers interested in learning more about how they can leverage AWS for the processing and storage of health information. The Creating HIPAA-Compliant Medical Data Applications with AWS whitepaper outlines how companies can use AWS to process systems that facilitate HIPAA and HITECH compliance. For more information on the AWS HIPAA compliance program please contact AWS Sales and Business Development.

Obviously the devil is in the details on this. I’ll reach out to one of my HIPAA lawyer friends to see what they think of this. If you’re a healthcare organization or vendor that’s on Amazon AWS, I’d love to hear your thoughts as well. The fact that Amazon is now willing to sign a BAA is really big news and a great step forward for anyone wanting to develop an application covered by HIPAA on Amazon’s AWS.