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Recorded Video from Dell Healthcare Think Tank Event – #DoMoreHIT

Posted on March 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.

I mentioned that I was going to be on the Dell Healthcare Think Tank event again this year. It was my 3rd time participating and it didn’t disappoint. In fact, this one dove into a number of insurance topics which we hadn’t ever covered before. I really learned a lot from the discussions and hopefully others learned from me.

Plus, in the first session I had the privilege to sit next to Dr. Eric Topol. He’s got such great insights into what’s happening in healthcare. Of course, I’m also always amazed by Mandi Bishop, who many of you may know from Twitter or her Eyes Wide Shut series here on EMR and HIPAA.

In case you missed the live stream of the event, you can find each of the three recorded sessions below. I also posted the 3 drawings that were created during the event on EMR and EHR. I look forward to hearing your thoughts on what was shared. Thanks Dell for hosting the conversation that brought together so many perspectives from across healthcare.

Session 1: Consumer Engagement & Social Media

Session 2: Bridging the Gap Between Providers, Payers and Patients

Session 3: Entrepreneurship & Innovation

The Future Of…Patient Engagement

Posted on March 19, 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.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Healthcare has a major challenge when it comes to the term “Patient Engagement.” $36 billion of government money and something called meaningful use has corrupted the word Patient Engagement. While meaningful use requires “5% patient engagement”, that’s a far cry from actually engaging with patients. Anyone that’s attested to meaningful use knows what I mean.

As we move past meaningful use, what then will patient engagement actually look like?

When I start to think about the future of patient engagement, I’m taken back to my experience with a new primary care provider that’s trying to Restore Humanity to Healthcare (see Restore Humanity to Healthcare part 2 as well). In this case, I’m exploring the idea of unlimited primary care along with a primary care team that includes a doctor, but also includes a wellness coordinator that’s interested in my wellness and not just my presenting problem.

Once you take the payment portion out of primary care, it dramatically changes the equation for me. Gone are the fears of going to the doctor because you don’t want to pay the co-pay. Gone are the days where a doctor needs to see you in the office in order to be able to make money from the visit. With unlimited primary care, an email, phone call or text message that solves the problem is a great solution for the doctor and the patient.

Of course, this model of primary care is only one example of the shift that’s going to drive us to patient engagement. ACOs and value based care models are going to require a much deeper relationship between doctors and patients. Trust me that 5% patient engagement through an online portal isn’t going to be enough in these new models.

Plus, these new models are going to really convert our current sick care system into a true healthcare system. I like to call this new model “Treating Healthy Patients.” Quite frankly we’re not ready for this change right now, but in the future we’ll have to adapt. The biggest change is going to be in how we define “patient” and “healthy.”

The wave of connected medical devices and innovation are going to completely reframe how we look at health. Instead of describing ourselves as healthy, the data will tell us that we’re all sick. We’re just at different points in the continuum of sickness.

In the future, patient engagement will be the key to treating each of us individually. The symptoms will change from coughing and vomiting to 85% risk for diabetes and 76% risk for a heart attack. We thought we had patient compliance issues when someone is coughing and vomiting (ie. something they want to fix). Now imagine patient compliance challenges when the patient isn’t feeling any pain, but they need to change something in order to avoid some major health problem.

I think this describes perfectly why we’re entering one of the most challenging times in healthcare. It’s a dramatic shift in how we think about healthcare and has a new set of more challenging problems that we’ve never solved. One of the keys to solving these new challenges is patient engagement.

What’s Your Value Based Care Strategy? What Role Does IT Play?

Posted on February 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 pretty regularly take a look at various healthcare IT whitepapers to glean insights into what’s happening in the industry and what advice vendors are offering healthcare organizations. I’ve been keeping a special eye on the changing reimbursement model and move to value based care and so I was interested in this whitepaper titled “How to Win with Value-based Care: Developing Your Practice’s EHR Strategy.”

The whitepaper starts with a dive into some of the changing care and reimbursement models that are emerging in healthcare. Then they offer this 4 step “Winning Strategy” for being ready for these changes:
Step 1: Assess your current situation
Step 2: Develop a customized VBC Plan that’s right for your practice
Step 3: Determine IT solution needs
Step 4: Implementation

In many ways, this 4 step plan could be applied to any project. Of course, the whitepaper dives into a lot more detail for each step. Although, I was struck by step 3. It takes for granted that value based reimbursement will require an IT solution. This whitepaper comes from a healthcare IT company with some value based IT product offerings so you have to question whether IT will be at the core of a practice’s value based care strategy or not.

As I think about the future of coordinated care and value based reimbursement, I think it’s more than fair to say that technology will be at the center of these initiatives. Value based care requires data to prove the quality of the care you’re providing. Certainly you could try and collect some of this data on paper, but does anyone think this is reasonable?

Try identifying all overweight patients in your patient population using paper chats. I can see in my mind’s eye an army of medical records professionals sifting through stacks of paper charts. It’s not a pretty solution and it’s fraught with error. That’s one query on an EHR system.

One of the biggest elements of value based reimbursement will be communication with patients. Can we build that real time communication on the back of snail mail? It sounds almost silly talking about it. Of course we’re going to use mobile devices, secure messages, and even secure video communication. We still have A LOT of work to do in this regard, but it’s the future.

Of course technology is going to be at the core of value based reimbursement. It’s the only way to accomplish what we’re striving to accomplish. The next question is: will the EHR make this possible or are we going to need something new and more advanced?

Mobile Health to Transform Care: The Case for Adoption Now – Breakaway Thinking

Posted on February 18, 2015 I Written By

The following is a guest blog post by Todd Stansfield from The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Todd Stansfield
Mobile health (mHealth) is here to stay, and you don’t have to look far for proof. Patients now use mHealth to comparison shop basic healthcare services and access test results. Providers use it to increase efficiencies and lower costs. And CIOs use it to get more out of an electronic health record (EHR) while juggling new security challenges from the bring your own device (BYOD) movement.

Perhaps one of mHealth’s greatest areas of impact is providers’ bottom line. A new study finds that baby boomers and millennials prefer providers who incorporate mobile technology into their practices. Seven percent of patients responded that they are willing to leave their current provider for one who offers remote care, a move that could have a significant financial impact on independent physician practices. This is especially clear when considering that an overall 20 percent of patients reported seeing the same doctor for less than 2 years and 14 percent reported not having a doctor. Additionally, the Centers for Medicare & Medicaid Services (CMS) is now offering providers roughly $42 a month to manage care for Medicare patients with two or more chronic conditions in its Chronic Care Management program. These patients comprise two-thirds of Medicare beneficiaries. For practices with 20 eligible patients, that figure translates to over $10,000 per provider per year. Providers must use mHealth to meet some requirements of Chronic Care Management, such as offering 24-7 access to consultation, and companies are now creating technologies to help. Just last month, Qualcomm and Walgreens announced a joint venture to pair medical devices with mobile and web apps to provide remote patient monitoring and transitional care support.

And then there’s efficiency. Another study finds that “the average hospital loses $1.7 million per year due to inefficient care coordination,” according to a HealthIT Analytics article. Providers are finding mobile technology valuable for improving health information exchange and communication, areas underserved by current EHR systems. More providers are text messaging care information rather than communicating face-to-face with colleagues, resulting in more informed care teams and fewer avoidable healthcare errors. Providers are also using mobile devices to enhance real-time patient engagement rather than relying on cumbersome computers to document in the EHR. Often the result is improved patient care, shorter appointments, and more time to see more patients. And besides getting in and out of their provider’s office sooner, patients are also welcoming new efficiencies with real-time access to their medical records via smartphone, a selling point among younger generations pursuing an active role in their care. In a recent survey of Americans, millennials indicated a preference for patient portals that they can access via a smartphone or tablet.

Yet providers should plan carefully when implementing mHealth, as there are major costs for failing to set up robust infrastructures that support safe mobile use. Providers should perform security risk analysis to ensure the safety of protected health information (PHI). This includes evaluating the security of all mobile devices—tablets and smartphones—ensuring that each device stores, sends, and receives PHI securely using encryption and other methods. Providers must perform this analysis routinely to receive payments under Meaningful Use (MU) and to prevent the ever-growing number of data breaches. Data security has remained a chief concern for healthcare providers and leaders and has largely stifled the widespread adoption of mHealth. This may change as the Department of Health & Human Services plans to offer more guidance to mHealth developers and users for adhering to HIPAA rules, as it recently announced.

Providers must adopt mHealth to survive in today’s competitive marketplace. Not only will they reap the short-term benefits of higher revenues through Chronic Care Management and attracting new patients, but they will also build the secure infrastructure and tools needed for long-term success. mHealth will be critical to population health and health information exchange, two eventual destinations for the healthcare industry. Providers who adopt mHealth now will be ready for when our industry makes the complete shift toward a population-focused, value-based care model.

In my experience at The Breakaway Group, A Xerox Company, effective adoption begins when leaders engage their workforce in the vision and mission of the project; when education is focused, accessible, and targeted; when performance is measured, collected, and analyzed; and when adoption is sustained amid changing technologies and process improvements. For providers to make the transition successfully healthcare leaders must find and implement technologies that patients and providers want to use. They must provide education that is convenient, focused, and practical for providers, education that spans not only how to optimize the technology but also how to use it safely and in accordance with government regulations. Healthcare leaders must also track performance in quality and efficiency, and highlight areas for improvement. And lastly, they must ensure all efforts are sustained, reinforced, and tailored to changing needs.

mHealth is poised to transform healthcare. It’s no wonder that mHealth raised $1.2 billion in venture capital last year, or more than triple what it raised in 2013. I’d venture to say that a significant share of new patients, new revenues, and new efficiencies will be earned by providers who are going “mobile.”

Xerox is a sponsor of the Breakaway Thinking series of blog posts.

What Is the Future for Rural Physicians? Is There One?

Posted on January 28, 2015 I Written By

Value based payments.  Value based care.  Meaningful  use.  Is there a place for an independent doctor in a suburban location?  This article says that these and all the technology to go with them along with physician acceptance is “Inevitable”.

I have four physicians.  I don’t see a place for them long term.  My first is my Internist.  A few years ago he was given a cell phone as a gift.  It does all he will ever want.  If it rings, he answers it.  If he has to make a call, he dials the number.  He has no computers in his office.  All his files are paper.  As a Doctor he is recognized as one of the best in the state. EHR is not in his future.  Phones, fax, copier suit him just fine.  The article that raised these questions for me was a report from Deloitte.  You might end up with some of the same questions after reading it. 

My second physician has been using EHR for as long as I have known him.  He has 2 offices and four other doctors working for him.  He needs the technology.  He hates it, upgrades only when he has to and would never do it again.  He is also recognizes as one of the best in the state.  His daughter is now in her residency and will join him next year.  My gut feel is that in 3-4 years he turns the business over to her, let’s her worry about it and sails off into the sunset.

My radiation oncologist was great.  He treated me 8 years ago.  My last visit with him was 4 years ago.  The company he worked for terminated him for not generating enough revenue.  His waiting room was always filled but with little to no wait.  His staff was great and could have easily made more money by moving to a large city.  They, like he, enjoyed the suburban life.  All were dumbfounded when he was terminated.  They also learned that for this big city practice, profit was the only incentive.  He’s in FL now, out in the sticks and owns his own practice.

Doctor #4 is a general surgeon.  He is probably the only one that could/would survive in the “inevitable market”.  His office is at the medical arts building at the local hospital.  There are 3 other surgeons in his practice.  He has a fairly up to date computer system,  though not in his location and not compatible with the hospitals new system.  I know that his definition of value based anything and mine differ.  On my last visit he kept me waiting for 45 minutes because lunch went longer than scheduled.  He’s all business.

For 3 of these 4 I see the choice of conforming and or selling out.  They are all rated in the top 25 physicians in the state.  They are not going to increase their patient base to increase revenue.

I am sure that Doctor #4 will succeed. He is all and only business.  He holds the purse strings for his practice and has absolutely no problem in spending whatever it takes for technology to increase profit.  As long as he doesn’t have to use it.

The area that I live in is not unique The hospital‘s area of reach is a bit under 60,000.  As part of that is a resort area, add another 10K for the summer months.  Is there a future for physicians like this?  If so, what will they need to do to stay viable?  Hire a business manager?  More nurse Practitioners?  Sell, retire or join together a form their own physician groups?  Any thoughts?

The Healthcare “Business” and Interoperability

Posted on December 2, 2014 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.

Last month I started what I think is a really important conversation about interoperability. I asked the question, “Do Hospitals Want Interoperability?” Go ahead and read the article. We’ll be here when you get back.

In response to that article and that question, Thomas Lukasik offered the following commentary on a LinkedIn thread:

Imagine one car dealer asking another car dealer to send them all of the information that they have on a customer of theirs so that they can do a better job of selling them a car. Healthcare is a business just like a car dealership, and patients are their customers, so expecting healthcare providers to support a level of health information exchange (a/k/a Interoperability) that would enable another healthcare provider to take business away from them is naive to say the least. Competition is a reality for modern hospitals.. you’ve seen the billboards. They’re more comfortable with the old school business model. Interoperabilty is a double edged sword for them.

I think that most hospitals would agree with this view, but they’ll likely only share it behind closed doors. The hospitals understand the benefits to healthcare of sharing their data with each other, but as a business it doesn’t make sense. As I mention in the article, I’m hopeful that things like value based reimbursement and ACOs can help shift that model where it does make business sense for a hospital to share their data. In fact, I think we’re heading to a day where if you don’t share data you’ll be at a disadvantage.

While we’re heading in that direction, it’s hard to face the stark reality of what Thomas says. Healthcare is still a business and healthcare leaders salaries and bonuses are based on successfully running the business. If we want to have interoperability, we have to change the incentives so that they match that goal.

Scariest Health IT Regulation – Healthcare IT Superlatives

Posted on November 3, 2014 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 thought it would be fun to look at a bunch of Healthcare IT Superlatives (best, scariest, cutest, smartest, funniest, etc etc etc). I imagine this will be a series of blog posts that never stops. If you’d like to see me write about a specific healthcare IT superlative, let me know in the comments or on my Contact Us page. I always like to cater to readers. Then, I at least no one person will find the post useful. Although, if one person finds it useful, it’s very likely that thousands of others are interested as well.

The first Healthcare IT Superlative we’ll consider is: Scariest Health IT Regulation

This is a challenging topic since healthcare is so burdened by regulation. I’m going to use a pretty broad interpretation of what I’d consider a healthcare IT regulation, but I’ll admit that I’m not as familiar with the medical device or pharma industry regulation. If you have experience in either of those, I’d love to hear what regulations in those industries is the scariest regulation.

When I think about all the various healthcare IT regulations, I have to narrow the scope down to the regulations that have the most over arching reach. That basically leaves me with ACO/Value Based Reimbursement, Meaningful Use, and HIPAA. Certainly there are plenty more that could be listed, but it’s not as scary for me if they aren’t large regulations that impact the majority of the healthcare system.

Of all of these, I’m most scared of ACO/Value Based Reimbursement. The worst part of any regulation is ambiguity. ACO and value based reimbursement is so vague right now that I don’t think anyone know where it will really end up going. That’s really scary for me and is likely scary for most healthcare organizations. It’s really hard to plan for something that’s vague and ambiguous.

Furthermore, the move to value based reimbursement and ACOs is likely going to have the biggest economic impact on healthcare. This doesn’t mean that every doctor and healthcare organization is going to lose when it comes to value based reimbursement. Definitely not. There are going to be a bunch of winners and losers. Some will really benefit from ACOs and some will suffer. However, my gut tells me that there’s going to be more losers than winners. That’s pretty scary to consider with all the other challenging dynamics at plat in healthcare today.

There you have it. What healthcare regulations are scaring you the most? Which regulations keep you up at night? I look forward to hearing your thoughts.

What Healthcare Must Plan for in Q4

Posted on September 19, 2014 I Written By

The following is a guest blog post by Ben Quirk, CEO of Quirk Healthcare Solutions.
Ben Quirk
In some ways, 2014 turned out to be not quite as cataclysmic. The early announcement of delaying the adoption of ICD-10 and the more recent announcement to allow hospitals/CAHs and Eligible Professionals participating in CMS’ Meaningful Use programs to attest using their existing Certified Electronic Health Record Technology (CEHRT) took the pressure off healthcare providers scrambling to upgrade their CEHRT to a version that was both ICD-10 and MU-compliant. However, this is only a temporary reprieve through the end of 2014 and there are other priorities that must be addressed before the year ends.

Navigating the ever-evolving healthcare environment will seem much less daunting if you focus on these four areas:

  • Meaningful Use
  • Value-Based Payment Modifiers
  • Transparency
  • Open Enrollment for ACA

Meaningful Use (MU)

If you were not able to upgrade to the 2014 Edition EHR, you will still be able to attest for MU using 2013 criteria. This provides reprieve from the 2014 criteria that requires the implementation of and patient enrollment in a patient portal.

In order to be MU-ready, your organization must proactively:

  • Determine your strategy based on the final rule. Gather data and be prepared to attest for MU by the deadline for the MU program you participate in..
  • Create an audit binder which should include screenshots of required EHR configuration during the reporting period. Should you get an audit 2 years from now, you can refer to this binder for accurate information.
  • Prepare a statement citing why you should be allowed to opt out of those MU measures that you think do not pertain to your practice. Auditors will ask for this on any audit preformed.

All organizations should be prepared to start collecting data for MU 2 by January 1, 2015. This includes having a strategy around the implementation of a patient portal and patient enrollment, sharing data amongst community and other healthcare providers, and radiology interfaces.

Value-Based Payment Modifier

The current Value Based Payment Modifier for providers who serve Medicare beneficiaries is a descendent of the Physician Quality Reporting System (PQRS). It is a way to keep the ACA cost-neutral, but there are some important things you need to know about this newer system. Value-Based Payment Modifier takes claims, Meaningful Use, and physician quality data and rates the quality of care you provide against your peers. Consequently,

  • When you report your Clinical Quality Measures or any clinical data to CMS, make sure your thresholds demonstrate that your practice is providing high quality care.
  • If your practice suffered from vendor problems with data accuracy in the past, this should be fixed.

Transparency

Transparency is something all providers should be aware of. Although available only in a few markets right now, all patients will soon be able to look up information about physicians before deciding where they would like to have their medical procedures done. For instance, if a patient decides to have an ACL repair, s/he can go online to compare exact costs and quality measures (based on the Patient Quality Reporting System) for ACL repair. Practices need to be aware that their prices and quality are being reported publicly. The implications go beyond losing reimbursement. You can actually be delisted from an insurance network. To ensure that your practice remains a viable option for patients:

  • Market your own practice and post your own prices.
  • Make sure you are reporting good quality data.
  • Use sources such as MGMA or OPTUM to see what providers in your area are charging and how you compare.
  • Determine how your reimbursement ranks vs. your competitors on the Medicare website and ensure data accuracy.

Open Enrollment for the ACA

November 15 marks the beginning of the second Open Enrollment period for the Affordable Care Act and there is no indication that this time around will be any easier than the first. Patients will be choosing plans, dealing with things very unfamiliar, and perhaps unaffordable, to them, like deductibles. This directly impacts clinics and the bottom line, especially with those patients who cannot pay their share of the costs. Last year, patients became the number one payor for many practices, even more than insurance companies, because so much revenue came from deductibles. That all resets January 1, but there are things you can do to avoid a possibly painful Q1 of 2015:

  • Check and confirm all patients’ eligibility, what plan they are on, and what their deductible is prior to their scheduled appointment, preferably through an automatic batch eligibility service. Keep this information in the practice management system.
  • Notify patients about their deductibles before they come into the clinic, and make sure to collect payments upfront, or keep a card on file.

The healthcare industry as we knew it for the past many years has ceased to exist. As we move into a new era of integrated delivery systems and a greater emphasis on value-based rather than volume-based reimbursements, the industry is going to remain in a state of flux before it stabilizes once again. The only way organizations are going to survive in this shifting landscape is by anticipating and planning for the next change so that they can stay ahead of the curve. The more an organization knows, the better it can be prepared to confront any potentially negative impact of the ever-evolving nature of the industry.

About Ben Quirk
Ben Quirk is CEO of Quirk Healthcare Solutions, a consulting firm specializing in EHR strategic management, workflow optimization, systems development, and training. The company’s clients have enjoyed remarkable success, including award of the Medicare Advantage 5-star rating. Quirk Healthcare presents a weekly webinar series, Insights, to inform clients and the general public about government programs and industry trends. Mr. Quirk is also Executive Director of the Quirk Healthcare Foundation, a learning institution which fosters innovation in the healthcare industry.

If You Can’t Beat Them, Fund Them!

Posted on September 2, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

In Where Does It Hurt, Athenahealth CEO Jonathan Bush explicitly calls out a number of businesses that are disrupting hospitals. Specifically, these businesses are performing a single function – e.g. labs, imaging, birthing, urgent care – at a much lower cost with higher quality than general-purpose hospitals. These modular businesses are disrupting hospitals by ruthlessly focusing all of their operations around a single service line to optimize quality and reduce costs. This stands in stark contrast to hospitals, which generally try to be all things to all people (the antithesis of entrepreneurship and general business practices).

I’ve previously outlined how healthcare providers are struggling as they shift to risk-bearing reimbursement models. They’re straddling two dramatically different business models as they try to transform their businesses from fee-for-service to risk-bearing. Inverting a business with thousands of employees and billions of dollars worth of assets and processes is nearly impossible. This is even more challenging in a highly uncertain and fast-changing regulatory environment.

But what if there was a better way?

In the Innovator’s Solution, author Clayton Christensen describes how multi-billion dollar companies such as Apple, IBM, Johnson and Johnson, and Intuit have disrupted themselves. When faced with disruptive changes in their respective businesses, these incumbents disrupted themselves by:

  • Funding a separate operating division with its own P&L
  • In physically removed location
  • With dedicated employees who have no responsibilities to the old business model.

This formula by no means guarantees success, but it creates an environment in which the disruptive division can potentially save the business as a whole, so long as the disrupting business has the operating freedom to disrupt the parent. Employees shouldn’t be bound to the processes, assets, and values of the old business model.

How can providers disrupt themselves?

How can providers, in particular large hospitals and health systems, adopt Christensen’s disruption framework? By funding their disruptors! This strategy drives value across a number of dimensions:

1) Hospital management will have the opportunity to learn about the operational expertise necessary to modularize their existing operations at a lower cost

2) Hospital management will have access to insider information about their own disruption that they would otherwise lack. They can in turn use this information to make smarter decisions about their own businesses, and potentially buy out the disruptees if they become too disruptive.

3) Drive inbound referrals from the periphery to the hubs

4) Generate a financial return

A practical example

My company, Pristine, recently spent some time learning about urgent care centers. We wanted to sell urgent care centers a lightweight telehealth platform so they could beam specialists and hospitalists into the urgent care center. This would allow the urgent care center to generate more revenue by avoiding “leakage” while also generating more revenue for the consulting specialist, guaranteeing more referral traffic to the host hospital, and providing the patient a more convenient experience. All parties would win. The idea was perfect in theory, except…

We discovered that non-hospital owned urgent care centers generally dislike hospitals, and are in fact too proud of the quality of care they provide to patients at much lower cost. These urgent care centers know that they’re disrupting hospitals, but are holding that against the hospitals as a reason not to align interests. Similarly, the hospitals view the urgent care centers as a competitive threat and have no desire to do business with them.

The more I think about this situation, the more I’m convinced that hospitals should invest in their disruptors. A financial tie will massage the hard feelings that exist and create an opportunity in which community resources can be most effectively coordinated across the continuum of care. As we move towards risk-based models, hospitals will need to drive patients to the most capitally efficient cost center that can diagnose and treat the patient.

What are your thoughts? Do you know of any major health systems investing in their disruptors? Or of any health systems that are outright trying to disrupt themselves by establishing modular service lines themselves? (Banner Health and University of Arizona are doing this to some extent!)

4 Health IT and EHR Blogs

Posted on August 29, 2014 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, I’ve been regularly trying to feature other Health IT and EHR bloggers out there. A lot of them are creating some really great content and I’m always happy when there are more smart people joining in on the healthcare IT conversation. I hope you enjoy discovering some new blogs that might help you in your work.

Meaningful Health IT News – This is Neil Versel’s healthcare IT blog. Neil is the most prolific healthcare IT journalist out there having written for pretty much every healthcare IT publication over the past couple decades. I’ve mentioned before that Neil’s blog was one of the first ones I looked to when I started writing a blog. I modeled some of the things I do after him. I figured he was a real journalist and I wasn’t, so I should learn from him. I should disclose that Neil’s blog is part of the Healthcare Scene network of blogs. I’m lucky to be able to work with someone like Neil. I only wish he had more time to write on his blog.

Data 4 U – This is a new health IT blog by Lynn Zahner, a former obstetrician/gynecologist, who’s transforming into a health IT professional. Looking at even just the first 3 posts I’m excited to see what Lynn will bring next. It’s always great to have a clinician’s perspective on healthcare IT. I hope Lynn’s able to keep it up.

Kat’s Space – Kat’s blog is a new find for me. She’s a RN and digital marketing interested in tech and social media. It’s too bad I hadn’t found her before now. Sounds like we’d get along really well. She’s also a Google Glass explorer and so she provides some really interesting insights into the Glass and wearable technology space.

Accountable Health – I think we can all use a great accountable health blog. In fact, we can likely use more than one to try and figure out what’s happening with ACOs and other accountable care programs that are in the works. This blog is written by Fred Goldstein. Fred has a unique view of the accountable care world since he’s the Founder of the Population Health Alliance. I think Fred’s blog is one to watch if you care about where healthcare reimbursement is headed.