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13 Insights for Conquering Healthcare Challenges

Posted on April 30, 2015 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 was recently asked to take part in a “From the Experts” series where they asked us to contribute an insight into how you conquer the healthcare challenges of the future. My response was, “The most valuable prep for #valuebasedcare is to create deep patient connections.” I think that’s still really good advice for healthcare organizations.

Check out the other 12 insights from a wide variety of experts in this embedded slideshare below:

Great Meaningful Use and Eligible Providers Chat

Posted on April 29, 2015 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 recently received an email from a regular reader, Dr. Mike, who owns a single specialty ortho group. In the email Dr. Mike talks about the challenges that Eligible Providers (EPs) are facing with meaningful use stage 2. He describes the story as falling on “deaf ears” at CMS and ONC. He also offered these stats on meaningful use to illustrate his case that meaningful use is a failure:

Only 38,472 have attested to Stage 2, My guess is that only about half actually did Stage 2 as there was the Stage 1 reprieve. Even so, that is only 18% of EPs have successfully attested which is an complete failure of MU.

Then, he asked me an important question:

Someone ask CMS and ONC the tough questions please…Now what are they going to do?

In response to him, I told him that I’d been talking about the challenge that meaningful use is for doctors for quite a while. However, I also told him that most hospitals are participating in meaningful use, so “we’ll see how that plays out.” What I meant is that in the meaningful use program we now have one group (EPs) that are not doing so well with meaningful use and their hospital counterparts that are relying on the millions in EHR incentive money (not to mention avoiding the penalties).

Then I answered his important question, “I can tell you what ONC and CMS are going to do. Spin It!”

Of course, Dr. Mike is great at engaging in conversation so he offered this reply:

1. Elizabeth Myers and the rest of CMS and ONC really did try to spin every bad number and “we cannot assess the numbers yet” was a constant theme.
2. I totally agree they will continue to try to spin the numbers or ignore them as long as possible. I’m not sure why they cannot face the truth about MU.
3. The 36K that did MU 2 are the cream of the crop. I would even argue that the other 82% are the cream also as they were the early adopters and gung ho about MU. The fact that 82% of the over achieving EPs have skipped out on MU 2 is a travesty. There is NO chance ONC and CMS is going to pull in the lagging EPs.
4. If you don’t know already, I own a single specialty Ortho group and we skipped MU completely after we saw the MU 2 rules. Proposed MU 3 just help us box it up and bury it.

I have no idea why ONC and CMS cannot let go of the program, let EHR vendors actually work with EPs for all the thing we are missing from our IT (usability, safety, security, efficiency). Right now we cannot do anything to customize our workflow or improve our experience as it will potentially decertify the EHR for MU. MU sucks all the air out of the room. EHRs right now are a billing and click box for MU system with a marginal clinical system slapped on…

Its about time ONC lets the market do its thing, instead of this constant objective, measures, menu, core, numerators, denominators, attesting, auditing disaster they created.

Once EPs leave the program, they are not coming back. So this should be a big deal for ONC and CMS.

I haven’t gone in and fact checked his numbers (I’d love to hear if you have different numbers), but the emotion in his comments is something I’ve heard from many providers. In fact, I’ve heard it from many EHR vendors. They’re tired of coding their EHR software to the test and the government regulations as well. They want to do more innovative things, but the government regulations are stifling their ability to do it. Resources only go so far.

I think we’re in the early days of provider discontent with meaningful use. However, it’s starting to boil. I’ll be interested to see what happens when it boils over. I’m predicting that will happen once many of these doctors start seeing the penalties hit their pocketbooks.

Usability Pyramid – How Does It Apply to EHR and Healthcare IT?

Posted on April 28, 2015 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.

Today I saw this wonderful usability pyramid come across my Twitter feed:

There’s so much we can learn in healthcare from this pyramid. I’m still chewing on whether the pyramid is the right way to display each of these 4 areas, but I love the way that it breaks it out into these 4 categories. Do they build on each other though?

As I look at these 4 categories of usability, I think that healthcare IT and EHR have done a pretty good job at the functional area. I also think that most of the advanced EHR users are able to work quickly in their EHR. In fact, it’s a complaint I often hear from EHR users that the EHR is so powerful that it takes forever to configure it. The experienced users love these extra configuration options.

I think very few EHR and healthcare IT companies have done a great job on the intuitive and beautiful side of usability. Many doctors think they can just pick up an EHR and start using it just like they did their iPad. This just isn’t the case. It requires a mix of configuration and training to make an EHR work effectively for an organization. Should it? I have yet to find an EHR where this isn’t the case.

I’d love to hear where people think various healthcare IT and EHR applications fit on this pyramid. Let’s hear it in the comments.

When Has Analytics Ever Said – “You’re Awesome”?

Posted on April 27, 2015 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 was just thinking about all of these analytics vendors and healthcare analytics stories that were sent to me during HIMSS. Every story goes a bit like this. We gathered a whole bunch of data. We analyzed the data. We discovered that we sucked and so we were able to save $X million dollars and improve the quality of care we provide. Makes for a great story no?

I was thinking about this and I was trying to figure out why this story never ends differently. Every analytics implementation I’ve ever seen or heard about finds some major problems in ever healthcare organization. How come they don’t sometimes do the analysis and discover: “Wow! You’re organization is awesome. You shouldn’t change anything!”

I have two theories about why this is the case. First, no healthcare system is perfectly optimized. That means that if you look hard enough, you can always find something that can be improved. There certainly are different degrees of improvement that can be provided depending on the health system’s baseline, but there are always ways that it can be improved. I think this logically makes sense. Especially when we’re talking about something as complex as healthcare.

Second, the people doing the analytics get paid to find problems. If they discovered that everything is going better than the norm and that you have a really high functioning health system, then they wouldn’t get paid. We don’t pay people to tell us we’re doing good. We pay them to tell us where we can improve. So, we get what we pay for.

The closest I’ve seen people come to this is every once in a while I hear a story from a vendor who honestly says, “we can’t do much for you.” I’ve done it a few times here at EMR and HIPAA. Sometimes they’re looking for an audience that doesn’t really read this blog. If you want the PACS administrator, then we’re probably not a good fit. We don’t write much PACS content and so I can’t imaging many PACS admins are reading the blog. It’s just easier to be honest about it. Although, not all companies feel that way.

I’d be interested to hear if you know of other examples where this occurs. Have you seen many times when someone has said, “Your doing great. I can’t help you more.”?

Mark Cuban’s Suggestion to Do Regular Blood Tests

Posted on April 24, 2015 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 really intrigued by the tweets from Mark Cuban and the response from many to his tweets from those in the healthcare IT community. Here’s a summary of the 3 tweets which ignited the discussion:

  1. If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health
  2. create your own personal health profile and history. It will help you and create a base of knowledge for your children, their children, etc
  3. a big failing of medicine = we wait till we are sick to have our blood tested and compare the results to “comparable demographics”

My friends Dan Munro and Gregg Masters have both been writing a lot about the subject, but there are many others as well. They’ve been hammering Mark Cuban for “giving medical advice” to people when he’s not a doctor. I find these responses really ironic since many of the people who are railing against Mark Cuban are the same people who are calling for us to take part in the quantified self movement.

What I think these people who rail against Mark Cuban want to say is: Don’t misunderstand what Mark’s saying. More testing doesn’t always improve healthcare. In fact, more testing can often lead to a lot of unneeded healthcare.

This is a noble message that’s worthy of sharing. However, I think Mark Cuban understands this. That’s why one of his next tweets told people to get the tests, but don’t show the results to their doctors until they’re sick. In fact, Mark even suggests in his tweets that the history of all these tests could be beneficial to his children and their children. He also calls it a baseline. Mark’s not suggesting that people get these blood tests as a screening for something, but as a data store of health data that could be beneficial sometime in the future.

How is Mark Cuban storing the results of a bunch of blood tests any different than him storing the results from his fitbit or other health sensor?

One problem some people have pointed out is that if you’re doing these blood tests as a baseline, then what if the blood tests weren’t accurate? Then, you’d be making future medical decisions based on a bunch of incorrect data. This is an important point worth considering, but it’s true of any health history. Plus, how are we suppose to make these blood tests more accurate? If the Mark Cuban’s of the world want to be our guinea pigs and do all these blood tests, that’s fine with me. Having them interested in the data could lead to some breakthroughs in blood testing that we wouldn’t have discovered otherwise.

Along with improving the quality of the data the tests produce, it’s possible that having all of this data could help people discover something they wouldn’t have otherwise seen. Certainly any of these possible discoveries should go through the standard clinical trial process before being applied to patients broadly. However, researchers only have so much time and so many resources to commit to clinical trials. Could all the data from a wide swatch of blood tests better help a research identify which research or clinical trials are worth pursuing first? I think so.

For me it all goes back to the wide variety of health sensors that are hitting the market. A blood test is just a much more powerful test than many of the health sensors we see on the market today. So, the warning to be careful about what you read into all these blood tests is an incredibly important message. However, with that fair warning, I don’t see any problem with Mark’s suggestion. In fact, I think all of the extra data could lead to important discoveries that improve the quality of the tests and what measurements really matter.

Neat Telemedicine Peripheral

Posted on April 23, 2015 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’m a techguy by education and background (literally @techguy on Twitter) and so I love cool new tech toys. Plus, I’m a boy and you know boys and their toys. So, I was really excited when leading into HIMSS, Revolve Robotics offered to send me a Kubi which I could test out. I’ve personally found that with devices, the only way I can really effectively write about them is to have one and use it for a while. A 15-30 minute canned test at an exhibit hall just doesn’t work for me. With that in mind, I put the Kubi through its paces while I was away at HIMSS.
kubi-move
For those not famliar with the Kubi, it’s a robotic arm that makes video conferencing much more engaging since the person on the other end of the video conference can control the Kubi and point it in any direction they want. It’s literally as if you were present and turned your head a different direction to see what else was happening in the room.

Here’s some pictures which show the Kubi in an actual patient room (click on the image to see a larger version):

The Kubi works with a variety of iOS and Android devices. I was surprised that even my Samsung S5 smartphone fit into the Kubi. Along with the Kubi itself there are 2 different mobile applications. One you can use to control the Kubi while using Skype, Google Hangouts, etc for the video conferencing. The other app is Kubi video which provides a really seamless integration between controlling the Kubi and streaming video. It’s pretty slick to connect and just click where you want the Kubi to “look”.

One challenge in healthcare is that Kubi video is not HIPAA compliant, but Revolve Robotics recently announced partnerships with swyMed to offer a real telemedicine solution for healthcare on top of the Kubi. They’re also working with partners like swyMed to integrate the Kubi control functions into these third party video conference providers. That will be a great feature since it is a little odd to control the Kubi with one app and have the video conference working in another one.

As I start to think about how a Kubi and video conferencing application could be used in healthcare, I can see a number of opportunities. On the one hand you have the patient focused applications which allow someone who’s “stuck” in a hospital bed to be able to communicate with their caregivers or loved ones. Often, the patient can’t even get out of the bed or isn’t strong enough to hold up a tablet for an extended period of time. The Kubi solves that problem. Plus, it allows the friends and family to look around the hospital room. I can already see someone watching TV with their loved one over the Kubi. Small things like that really change the patient experience.

On the other side of things, I could see a Kubi working really well for doctors or nurses wanting to check in with their patients. If the patient clicks the nurse call button, why does the nurse have to run all the way down to the room? They could just hop on the Kubi, find the patient and see what’s needed. In fact, doing so could save them trips back and forth to the room which wastes time.

I think about when my wife was giving birth. How cool would it have been for the doctor to do a video chat on the Kubi with us as opposed to just talking with the nurse and the nurse relaying the message? It doesn’t need to be every update. Maybe it’s when we first showed up or when something major changes. Of course, this could be done with a lot of telemedicine products, but it’s interesting the way the Kubi makes it more dynamic and friendly.

Going back to my personal experience with the product. I was sad that the Kubi video didn’t work with my older iPad. It was one we weren’t using as much anymore and so I could have easily just left it in the Kubi while I was away. Unfortunately, it was too old of a version for that to work. Not a big deal for us though since we have lots of devices in our house.

I still hate the blue tooth pairing of devices (another reason to have a dedicated device that’s paired once and then you forget it), but they have done some unique things to make the pairing recognize the device once it’s put in the Kubi. I wonder if wifi pairing will come soon. I hope so.

It was really fun to use the Kubi while I was at HIMSS to connect with my family back home. In my case, I really could just leave it running and connect to it whenever I wanted. There’s nothing like my 2 year old’s face when he sees me. The nice thing with the Kubi is that talking with a 2 year old is hard. There’s no way he can hold the tablet still and there’s no way he’ll sit still (at least my 2 year old). So, I could follow him around, switch to one of my other kids or my wife and they didn’t have to fight over who was on camera. I could control it myself.


All in all, the Kubi is a pretty creative product. I think it will have a bigger place in healthcare as they start integrating the robotic controls into other applications. The 2 app approach is not going to work out that well for most of healthcare. It needs the integrated experience. I think the Kubi will likely ride the wave of Telemedicine adoption since it makes a nice peripheral to all of those efforts. That’s a good thing for the Kubi since I think Telemedicine is just now starting to come into its own.

Telemedicine Startup Offers Providers A Shot At Equity

Posted on April 22, 2015 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.

Over the last couple of years, the number of telemedicine vendors out there fighting for business has exploded.  These include DoctoronDemand, GoTelecare, HealthTap, MDLIVE, American Well and many, many more.

Health plans are jumping on the bandwagon too. For example, United Healthcare  has been running a popular national television campaign advertising its “virtual clinic” services. UHC is my plan, so I can attest that this service — shown as embedded in its member site — hasn’t been rolled out yet, but that only makes its desire to get out in front of the trend more noteworthy.

Telemedicine models in play include companies that recruit providers and sell them to consumers, vendors who enable telemedicine via proprietary platforms and firms that lead with community building. At present the direct-to-consumer players seem to be somewhat ahead, simply because they’ve already begun developing a national brand, but the story doesn’t end there.

Though consumer-facing telemedicine companies probably have a viable business model, they’ll have to build a memorable consumer brand to make it, something that takes a great deal of  time and money.  On the other hand, vendors that offer white-label telemedicine technology to hospitals and health plans have at least as much to gain, without having to win the loyalty of fickle consumers.

One telemedicine player doing just that is Nashville-based PointNurse, which has developed a distributed collaboration and communications platform providers can use to deliver telemedicine services. I just spoke to CEO Cyrus Maaghul, who gave me a company overview, and was interested to hear that his venture is taking things in some new directions.

PointNurse is different than most companies in the telemedicine space for a few reasons.

For one thing, the platform includes block chain capabilities, which allow providers to accumulate credits for both community participation and actual care delivery. (In case you aren’t familiar with block chain technology, which powers crypto currency Bitcoin, you may want to click here.)

These credits aren’t just for fun. Eventually, when providers accumulate enough credits, they get a pro-rata share of a dedicated pool of equity.

Consumers, for their part, are given a multi-signature wallet which stores both their personal and clinical information, resulting more or less in a PHR with added capabilities. PointNurse hasn’t yet devised a way to share the data with provider EMRs, but that’s a short-term goal.

A wide range of providers can participate in PointNurse, including not only MDs but also nurse practitioners, pharmacists, RNs, LPNs and elder advocates.

A sister venture, HealthCombix, will license the technology underlying PointNurse to hospitals and payers. HealthCombix will provide APIs and tools to build their own distributed applications.

As Maaghul sees it, it’s critical for providers to realize more than a short-term benefit from participating in telemedicine. “I wanted to make providers feel highly motivated — that they can gain from this [arrangement],” Maaghul said. “This creates value for the patient.”

Of course, there’s no proof yet that this or any particular telemedicine business model is going to capture its market niche.  In fact, it’s not even clear what niches will emerge in this space; after all, though it’s moving fast it’s far from mature.

That being said, this approach has some intriguing aspects. I’ll be interested to see whether its business model and and unusual underlying technology work out.

The Power of Twitter Chats – Community

Posted on April 21, 2015 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 long been a fan of Twitter chats. There’s something great about a group of people coming together regularly to discuss a certain topic. The discussion can be really interesting and insightful. Many people will follow a Twitter chat and learn about a topic they are learning about, but not participate. However, the biggest value for me from participating in Twitter chats is the relationships that are built during the chat.

Mandi Bishop tweeted something at said at HIMSS15:

Considering it’s been retweeted and favorited like crazy, the message has really resonated on social media. Twitter chats are the perfect opportunity to interact with other humans. It’s the quintessential act of being human. Yes, that means that some people will fight over a topic, some people will have good behavior, some people will have bad behavior, some people will go off topic and start talking about hoping on a boat for a vacation, etc. While not all of these things are favorable, it gives a great glimpse into the humanity of a Twitter account. That bonds people in some of the same ways that bonding with someone in person can do.

What comes from all of these human connections is the growth of a community of people interested in a similar topic area. Notice that I said they were interested in a certain topic area and not necessarily that it was a monolithic group of people with the same interests. In fact, every Twitter chat I’ve been in has an amazingly diverse group of participants. No one really knows if you have 10 followers or 33,000 followers. They judge you on the content of your tweet and not your follower count in a Twitter chat.

I’ve seen this first hand as I’ve put together the #HITMC (Healthcare IT Marketing Community) chats. The community that’s come together around these chats has been phenomenal. I think we might have gone a little fast for the community hosting the chat every other week, but we’ll remedy that soon when we move to a monthly #HITMC chat. Regardless, it’s been a fantastic way to bring together the healthcare IT marketing and PR community. It’s become sort of a rallying space for people to share their ideas, learn from their colleagues, and meet new and interesting people. That’s powerful.

I’ve seen the same thing happen in participation in the #KareoChat and #InfoTalk Twitter chats. A community really comes together in a well hosted Twitter chat. One part education and one part meeting really smart people.

I’m not suggesting that Twitter chats are the solution to all your marketing challenges. In fact, in some places, it might not be the answer. However, I’m always amazed at the power of a great Twitter chat to bring together a community of people around an important topic.

Of course, if you don’t have the energy or reach to start your own Twitter chat, you can always piggy back other popular Twitter chats: #HITsm, #hcsm, or #hcldr to name a few.

Some High Level Perspectives on FHIR

Posted on April 20, 2015 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.

Before HIMSS, I posted about my work to understand FHIR. There’s some great information in that post as I progress in my understanding of FHIR, how it’s different than other standards, where it’s at in its evolution, and whether FHIR is going to really change healthcare or not. What’s clear to me is that many are on board with FHIR and we’ll hear a lot more about it in the future. Many at HIMSS were trying to figure it out like me.

What isn’t as clear to me is whether FHIR is really all that better. Based on many of my discussions, FHIR really feels like the next iteration of what we’ve been doing forever. Sure, the foundation is more flexible and is a better standard than what we’ve had with CCDA and any version of HL7. However, I feel like it’s still just an evolution of the same.

I’m working on a future post that will look at the data for each of the healthcare standards and how they’ve evolved. I’m hopeful that it will illustrate well how the data has (or has not) evolved over time. More on that to come in the future.

One vendor even touted how their FHIR expert has been working on these standards for decades (I can’t remember the exact number of years). While I think there’s tremendous value that comes from experience with past standards, it also has me asking the question of why we think we’ll get different results when we have more or less the same people working on these new standards.

My guess is that they’d argue that they’ve learned a lot from the past standards that they can incorporate or avoid in the new standards. I don’t think these experienced people should be left out of the process because their background and knowledge of history can really help. However, if there isn’t some added outside perspective, then how can we expect to get anything more than what we’ve been getting forever (and we all know what we’ve gotten to date has been disappointing).

Needless to say, while the industry is extremely interested in FHIR, my take coming out of HIMSS is much more skeptical that FHIR will really move the industry forward the way people are describing. Will it be better than what we have today? I think it could be, but that’s not really a high bar. Will FHIR really helps us achieve healthcare interoperability nirvana? It seems to me that it’s really not designed to push that agenda forward.

What do you think of FHIR? Am I missing something important about FHIR and it’s potential to transform healthcare? Do you agree with the assessment that FHIR very well could be more of the same limited thinking on healthcare data exchange? I look forward to continue my learning about FHIR in the comments.

My Overall View of Healthcare IT After HIMSS15

Posted on April 17, 2015 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 I fly home from HIMSS15 (literally), I’ve been thinking how to summarize my annual visit to the mecca of healthcare IT conferences we know as HIMSS. I’ve seen a bunch of numbers around attendance and exhibitors and I believe they’re somewhere around 43,000 attendees and 1300 exhibitors. It definitely felt that massive. The interest in using technology to improve healthcare has never been higher. This shouldn’t be a surprise for anyone. When I look at the path forward for healthcare, every single scenario has technology playing a massive role.

With that in mind, I think that the healthcare IT world is experiencing a massive war between a large number of competing interests. Many of those interests are deeply entrenched in what they’ve been doing for seemingly ever. Some of these companies are really trying to dig in and continue to enjoy the high ground that they’ve enjoyed for many years. This includes vendors at HIMSS, but also many large and small healthcare organizations (the small entrenched healthcare organizations weren’t likely at HIMSS though) who enjoyed the status quo.

The problem with this battlefield is that they’re battling against a massive shift in reimbursement model. They can try and stay entrenched, but the shift in healthcare business model is going to absolutely force them to change. This is not a question of if, but when. This doesn’t keep these organizations from bombing away as they resist the changes.

If you’re a healthcare startup company entering the battlefield (to continue the analogy), you’re out in the open and absolutely vulnerable. You’re very rarely the target of this major entrenched players, but sometimes you get impacted by collateral damage. As the various organizations throw bombs at each other you have to work hard to avoid getting in their way. This is a tricky challenge.

Even more challenging to these startup companies is they don’t have a way to access many of the entrenched companies so they can work together around a common vision. Most of the startups would love to work with the entrenched healthcare companies, but they don’t even have a way to start the conversation.

The mid size healthcare IT companies are even more interesting. They’ve started to carve a space for them in the battle and many of the entrenched healthcare IT vendors are scared at what this means for them. They’re using every means possible to disrupt the competition. At HIMSS I saw the scars from many of these battles.

Certainly this description is true of many industries. Welcome to economic competition and capitalism. Although, this year at HIMSS I found the battle to be much more intense. In the past couple years meaningful use opened up new territories to be “conquered.” There was enough “land” to go around that companies were often working to capture new territories as opposed to battling their competitors for the same opportunities. That’s why I think we’re in a very different market today versus the past couple years.

The great thing is that in periods of turmoil often comes the most amazing innovations. I believe that’s what we’re going to see over the next couple years. Although, I predict that most of these innovations are going to come from places we don’t expect. It’s just too hard for companies to innovate themselves out of business. There are a few exceptions in history and we might see a few exceptions in healthcare. However, my bet is on the most successful companies being those that choose to obliterate as opposed to automate.

What’s most exciting to me is that healthcare organizations and patients seem to be ready for change. There are varying degrees of readiness, but I believe I’ve seen a groundswell of change that’s coming for healthcare. As a blogger this of course has me excited, but as a patient it has me excited as well.

What were your thoughts of HIMSS 2015? What do you think of the analogy?

While the battle is on in healthcare IT, the best part of HIMSS is always the people. Every industry has some bad apples, but for the most part I’m always deeply impacted by the good nature of so many people I meet at HIMSS. They are sincere in their efforts to try and improve healthcare for good. We certainly have our challenges in healthcare, but similar to what George Bush said in his keynote, I’m optimistic that the good people in healthcare will be able to produce amazing results. The best days of healthcare are not behind us, but are ahead of us.