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Security and Privacy Are Pushing Archiving of Legacy EHR Systems

Posted on September 21, 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 a recent McAfee Labs Threats Report, they said that “On average, a company detects 17 data loss incidents per day.” That stat is almost too hard to comprehend. No doubt it makes HIPAA compliance officers’ heads spin.

What’s even more disturbing from a healthcare perspective is that the report identifies hospitals as the easy targets for ransomware and that the attacks are relatively unsophisticated. Plus, one of the biggest healthcare security vulnerabilities is legacy systems. This is no surprise to me since I know so many healthcare organizations that set aside, forget about, or de-prioritize security when it comes to legacy systems. Legacy system security is the ticking time bomb of HIPAA compliance for most healthcare organizations.

In a recent EHR archiving infographic and archival whitepaper, Galen Healthcare Solutions highlighted that “50% of health systems are projected to be on second-generation technology by 2020.” From a technology perspective, we’re all saying that it’s about time we shift to next generation technology in healthcare. However, from a security and privacy perspective, this move is really scary. This means that 50% of health systems are going to have to secure legacy healthcare technology. If you take into account smaller IT systems, 100% of health systems have to manage (and secure) legacy technology.

Unlike other industries where you can decommission legacy systems, the same is not true in healthcare where Federal and State laws require retention of health data for lengthy periods of time. Galen Healthcare Solutions’ infographic offered this great chart to illustrate the legacy healthcare system retention requirements across the country:
healthcare-legacy-system-retention-requirements

Every healthcare CIO better have a solid strategy for how they’re going to deal with legacy EHR and other health IT systems. This includes ensuring easy access to legacy data along with ensuring that the legacy system is secure.

While many health systems use to leave their legacy systems running off in the corner of their data center or a random desk in their hospital, I’m seeing more and more healthcare organizations consolidating their EHR and health IT systems into some sort of healthcare data archive. Galen Healthcare Solution has put together this really impressive whitepaper that dives into all the details associated with healthcare data archives.

There are a lot of advantages to healthcare data archives. It retains the data to meet record retention laws, provides easy access to the data by end users, and simplifies the security process since you then only have to secure one health data archive instead of multiple legacy systems. While some think that EHR data archiving is expensive, it turns out that the ROI is much better than you’d expect when you factor in the maintenance costs associated with legacy systems together with the security risks associated with these outdated systems and other compliance and access issues that come with legacy systems.

I have no doubt that as EHR vendors and health IT systems continue consolidating, we’re going to have an explosion of legacy EHR systems that need to be managed and dealt with by every healthcare organization. Those organizations that treat this lightly will likely pay the price when their legacy systems are breached and their organization is stuck in the news for all the wrong reasons.

Galen Healthcare Solutions is a sponsor of the Tackling EHR & EMR Transition Series of blog posts on Hospital EMR and EHR.

Switching EHRs, The Trends And What To Consider

Posted on September 8, 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.

The following is a guest blog post by Winyen Wu, Technology and Health Trend Blogger and Enthusiast at Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Winyen Wu - Stericycle
In recent years, there has been a trend in providers switching Electronic Health Record (EHR) systems: according to Software Advice, the number of buyers replacing EHR software has increased 59% since 2014. In a survey by KLAS, 27% of medical practices are looking to replace their EHR while another 12% would like to but cannot due to financial or organizational constraints. By 2016, almost 50% of large hospitals will replace their current EHR. This indicates that the current EHR products on the market are not meeting the needs of physicians.

What are the reasons for switching EHRs?

  • Complexity and poor usability: Many physicians find that it takes too many clicks to find the screen that they need, or that it is too time consuming to fill out all the checkboxes and forms required
  • Poor technical support: Some physicians may be experiencing unresponsive or low quality support from their EHR vendor
  • Consolidation of multiple EHRs: After consolidating practices, an organization will choose to use only one EHR as opposed to having multiple systems in place
  • Outgrowing functionality or inadequate systems: Some current EHRs may meet stage 1 criteria for meaningful use, but will not meet stage 2 criteria, which demand more from an EHR system.

Which companies are gaining and losing customers?

  • Epic and Cerner are the top programs in terms of functionality according to a survey by KLAS; cloud-based programs Athenahealth and eClinicalWorks are also popular
  • Companies that are getting replaced include GE Healthcare, Allscripts, NextGen Healthcare, and McKesson; 40-50% of their customers reported potential plans to move

What are providers looking for in choosing an EHR?

  • Ability to meet Meaningful Use standards/criteria: In September 2013, 861 EHR vendors met stage 1 requirements of meaningful use while only 512 met stage 2 criteria for certification, according to the US Department of Health and Human Services. Because stage 2 criteria for meaningful is more demanding, EHRs systems are required to have more sophisticated analytics, standardization, and linkages with patient portals.
  • Interoperability: able to integrate workflows and exchange information with other products
  • Company reliability: Physicians are looking for vendors who are likely to be around in 20 years. Potential buyers may be deterred from switching to a company if there are factors like an impending merger/acquisition, senior management issues, declining market share, or internal staff system training issues.

Is it worth it?
In a survey conducted by Family Practice Management of physicians who switched EHRs since 2010, 59% said their new EHRs had added functionality, and 57% said that their new system allowed them to meet meaningful use criteria, but 43% said they were glad they switched systems and only 39% were happy with their new EHR.

5 Things to consider when planning to switch EHRs

  1. Certifications and Compliance: Do your research. Does your new vendor have customers who have achieved the level of certification your organization hopes to achieve? Does this new vendor continually invest in the system to make updates with changing regulations?
  2. Customer Service: Don’t be shy. Ask to speak to at least 3 current customers in your specialty and around your size. Ask the tough questions regarding level of service the vendor provides.
  3. Interoperability: Don’t be left unconnected. Ensure your new vendor is committed to interoperability and has concreate examples of integration with other EHR vendors and lab services.
  4. Reliability and Longevity: Don’t be left out to dry. Do digging into the vendor’s financials, leadership changes and staffing updates. If they appear to be slimming down and not growing this is a sign that this product is not a main focus of the company and could be phased out or sold.
  5. Integration with Current Services: Don’t wait until it’s too late. Reach out to your current providers (like appointment reminders) and ensure they integrate with your new system and set up a plan for integrating the two well in advance.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. 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

Happy Labor Day!

Posted on September 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.

Labor Day in Healthcare

A big shout out to all those who labor hard and do amazing things in healthcare. Particularly those who are stuck working on Labor Day to make sure patients get the care they need. Happy Labor Day!

Are You Wasting your EHR Investment? – Breakaway Thinking

Posted on August 31, 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.

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
Healthcare leaders and clinicians continue to be disappointed with the value Electronic Health Record (EHR) technology provides in their organizations today. The challenges are real, and it will take some time and effort to improve. The technology will continue to evolve at the pace we set as leaders, vendors and healthcare professionals.

When Free Is Expensive
Several years ago, a reputable IT vendor offered us free use of their software, which provided monitoring of equipment that would be valuable to us. Initially, we were excited; the functionality perfectly aligned with our needs, and the application was robust enough to grow with us. We had a need and the software fulfilled the need. We couldn’t wait to have access to the dashboard of data promised by the vendor.

Months after the implementation, we were still waiting. The “free” price tag was alluring, but we quickly recognized the actual maintenance costs and labor required to make the application truly valuable to our organization were far from free. This story drives home a concept that we all understand, but often overlook. Underestimating the “care and feeding” required to maintain a valuable investment puts the entire project at risk. We all need to remember the importance of sustainability even when we are initially excited about a new investment.

EHR systems are expensive and require tremendous resource investment, but the effort is ongoing and we need to plan accordingly.

The Key to Long Term Behavior Change
The difficulty of moving from implementing an EHR to maintaining high levels of adoption over the life of the application is strikingly similar to weight loss and weight management efforts. The percentage of overweight adults in the U.S. is staggering and continues to rise. Today, over 66 percent of adults in the United States are overweight and 59 percent of Americans are actively trying to lose weight. But the problem isn’t weight loss – it’s weight maintenance. Many of us have successfully lost weight, but can’t keep the weight off. As a matter of fact, we regain all the weight (and often more) within 3-5 years.

This isn’t a complex concept: dieting doesn’t incent long-term lifestyle change, thus we re-gain weight after we settle back into old habits. To be successful in the long-term, we need to practice weight management behaviors actively – for years, not months.

We’ve taken the dieting approach to implementing new software solutions in healthcare for too long. We prepare for a go-live event, but fall back into our comfortable old habits afterwards – resulting in work-arounds, regression to ineffective workflows, insufficient training for new users, poor communication and errors. The process of adoption requires a radically different discipline, and the real work begins at go-live.

Instead of checking the project off your to-do list after a successful implementation, you need to create a plan to sustain the changes. A sustainment plan addresses two critical areas:

  • It establishes how your organization will support the ongoing needs of the end users for the life of the application. This includes communication, education and maintenance of materials and resources.
  • It establishes how and when your organization will collect metrics to assess end user adoption and performance.

Lack of planning and execution in these two areas will lead to a slow and steady decline in end user adoption over time.

Effective sustainment plans require resources – time and money. Keep in mind that adoption is never static; it is either improving or degrading in the organization. A series of upgrades can quickly lead to decreased proficiency among end users, completely eroding the value of the application over time. Leadership must plan for the investment and fund it to achieve improved performance.

Most organizations only achieve modest adoption after a go-live event, and it takes relentless focus to achieve the levels of adoption needed to improve quality of care, patient safety and financial outcomes. Sustainment plans are most successful when they are part of the initial budgeting and planning stages for EHR.

Metrics Make the Difference
Metrics are the differentiating factor between a highly effective sustainment plan and one that is just mediocre. End user knowledge and confidence metrics serve as a barometer for their level of proficiency, providing the earliest indication of adoption. Ultimately, performance metrics are powerful indicators of whether end users are improving, maintaining or regressing in their adoption of the system. If we get an early warning that proficiency is slipping, we can react quickly to address the problem. These metrics ensure the organization is progressing toward high levels of adoption, overcoming barriers and gaining the efficiencies promised by EHR adoption. Metrics act just as the scale does in long-term weight management; they are the first indicator that we are falling back into old behaviors that are not consistent with sustainable adoption.

Metrics also keep us on track when performance does not meet expectations. Two potential scenarios in which the go-live event is successful but performance metrics fail to reach expectations help illustrate this idea. For instance, performance metrics could not be achieved because the system is not being utilized effectively. This may be due to inadequate training and therefore lower proficiency, or a problem with the actual performance by end users in the system. Measuring end user proficiency allows us to identify “pockets” of low proficiency among certain users or departments and make sure they receive the education needed. Once users are proficient, we can refocus our attention on the performance metrics.

A second scenario is less common but more difficult to diagnose. Users could be proficient, but specific performance metrics are still not meeting expectations. In this case, we need to analyze the specific metric. Are we asking the right question? Are we collecting the right data? Are we examining a very small change in a rare occurrence? There may also be a delay in achieving certain metrics, especially if the measurements are examining small changes. A normal delay can wreak havoc if we start throwing quick fixes at the problem. In this situation, staying the course and having confidence in the metrics will bring desired results.

Like sustained weight loss, EHR adoption is hard work.  Commit to a sustainment plan and a measurement strategy to ensure your EHR continues to provide the long-term value that was promised at go-live.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

Looking at EHR Internationally

Posted on August 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.

Today, I’m sitting in my hotel room in Dubai (Check out my full health IT conference schedule) looking out over this incredible city. This is the 3rd time I’ve come to Dubai to teach an EHR workshop and so I’ve had a chance to fall in love with some many things. Not the least of which is the people that come to participate in the workshop. Each time is a unique perspective with people coming from around the middle east including countries like Saudia Arabia, Oman, Bahrain, Qatar, and of course Abu Dhabi and Dubai in the UAE to name a few.

There’s something incredible about coming to a place that is culturally so different and yet when I talk about EHR software it’s more alike than it is different. A great example of this is the often large divide between doctors and EHR implementers. It seems that everyone struggles to get doctors to take enough time to really learn how to use the EHR effectively. Then, despite not doing the training they complain that the EHR doesn’t work properly. If you’ve ever been part of an EHR implementation you know this cycle well.

What I find interesting in the middle east is that they don’t feel suffocated by regulations like we have in the US. There’s much more freedom available to them to innovate. However, there’s not the same drive to innovate here that exists in most US markets. It’s interesting to sense this disconnect between the opportunity to innovate and the desire to innovate.

I think there’s also a bit of a misconception about the region. From the US perspective, we often see these rich middle eastern countries and think that they just have as much money as they want and they can spend lavishly on anything. When you look at some of the amazing buildings or the indoor ski slopes in Dubai it’s easy to see how this perspective is well deserved. However, that’s not the reality that most of these healthcare organizations face. This seems to be particularly true with gas prices being quite low. In many ways, this is a similar to what many doctors experience. Doctors like to drive the Mercedes, but then complain that they aren’t really paid as much as people think. That creates a disconnect between what’s seen and the reality. I think the middle east suffers from this disconnect as well.

What’s most heartening about the experience of talking EHR internationally is that there’s one core thing that seems to exist everywhere. That’s a desire to truly make a difference for the patient. That’s the beautiful part of working in healthcare. We all have a desire to make life better for a patient. It’s amazing how this principle is universal. Now, if we could just all execute it better.

Symptoms of the Healthcare Debate

Posted on August 19, 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.

This healthcare cartoon seemed to capture my feelings about much of the healthcare debate that’s happening right now. It’s even worse thanks to the current presidential race.
Healthcare Cartoon - Symptoms of the Healthcare Debate

This cartoon might offer a much simpler explanation for the healthcare cost challenges we face:
Healthcare Costs in the US

A part of me just wants to turn it all off, but it’s a battle that’s too important to ignore. Have a great weekend!

Taking Healthcare Communication to the Next Level

Posted on August 17, 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.

As most of you know, we’ve been doing an ongoing series of Healthcare Scene Interviews where we talk to top leaders in healthcare IT. They’ve been a huge success and we just passed our 50th video interview. If you’ve attended one of our live interviews, you know that we grew quite fond of the Blab platform that we used to host these interviews. Unfortunately, we just got word that Blab has been shutdown. It was a sad day, but we still have options.

While we loved Blab, we use to do our interviews on Google Hangouts and so we’re planning to go back there again to keep bringing you great content and discussion about the challenges that face Healthcare IT. Plus, Google Hangouts has been merged into YouTube Live and that brings some great opportunities for those watching both the live and recorded version at home including being able to Subscribe to Healthcare Scene on YouTube.

With that as background, I’m excited to announce our next Healthcare interview happening Friday August 19, 2016 at 11:30 AM ET (8:30 AM PT) where we’ll be talking about “Taking Healthcare Communication to the Next Level.” This is an extremely important and challenging topic, but we’ve lined up a number of incredible experts to take part in our discussion as you’ll see below:

Taking Healthcare Communication to the Next Level-Headshots

You can watch the interview live and even join in the conversation in the chat on the sidebar by watching on the Healthcare Scene YouTube page or the embedded video below:


(You’ll have to visit the YouTube page to see the live chat since the embed doesn’t include the chat.)

We look forward to learning about healthcare communication from this panel of experts. Please join us and offer your own insights in the chat or ask these amazing panelists your most challenging questions.

Be sure to Subscribe to Healthcare Scene on YouTube to be updated on our future interviews or watch our archive of past Healthcare Scene Interviews.

Major IT Projects and Consulting – Fun Friday

Posted on August 12, 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.

It’s Friday and so time for a little bit of healthcare IT humor. This one probably hits home if you’re working in a major health system and are suffering in a mess of projects. When you think about it, it’s no wonder that so many health systems have gone all in with one death star EHR.

Star Wars Enterprise Health IT Cartoon

This is humorous until you have to pay the consulting bill. This message is an old one and well worth remembering as you work with consultants. Consultants aren’t bad, but be sure you use them effectively.
Consulting Despair Graphic

ZDoggMD Sings 7 Years (A Life In Medicine) – The Path to Health 3.0

Posted on August 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.

Rather than try to explain this ZDoggMD video, I thought this comment from Riley Mcnamara on ZDoggMD’s latest video described it best:

I’m dealing with a lot of crap right now in the clinic, we’re over booked with patients, EHR headaches, and a never ending stream of useless bureaucracy. It’s been one of those weeks that made me question if I can do this. This made me feel better even if it’s just for a little bit! It’s not easy, but I’d never dream of doing anything else! Thanks man!

There truly is a battle going on for the future of healthcare and it’s a battle worth fighting. Thanks for the excellent work ZDoggMD! Shout out to HealthISPrimary.org as well. Check out the video below:

Theranos “Punks” the Scientific Community In First Public Presentation at AACC

Posted on August 2, 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.

Elizabeth Holmes made her first public appearance at #AACC2016 where most thought that she would address the concerns (I’m being nice) around the Theranos products and practices. While most believed that Holmes would not go into much detail, I didn’t see anyone predict that she would not only avoid the controversy, but she also decided to launch a new product. I use the phrase “new product” lightly since it’s similar to lab equipment on the market today, but smaller.

I think this image and tweet describes most people’s reaction to this bait and switch by Theranos and Holmes:
Theranos Punks AACC in First Public Appearance

It’s too bad she chose not to address the controversy before trying to sell another product. Are there any labs out there that will buy this new product until they do address the controversy? I’d hope not. Theranos will have to address it, but for some reason they’re putting it off.

This tweets seems to have captured the sentiment that most will likely feel about any product that Theranos tries to deliver: