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Are ACOs More About Good Accounting and Reporting Than Improving Care?

Posted on August 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.

I was recently reading David Harlow’s analysis of the recently released data from CMS on ACO performance and found a lot to chew on. Most people have found the results underwhelming unless they’re big proponents of ACOs and value based reimbursement and then they’re trying to spin it as “early on” and “this is just the start.” I agree with both perspectives. Everyone is trying to figure out how to reimburse for value based care, and so far we haven’t really figured it out.

These programs aside, after reading David Harlow’s post, I asked the following question:

The thing I can’t figure out with ACOs is if they’re really changing the cost of healthcare or if they’re mostly a game of good accounting and reporting. Basically, do the measures they’re requiring really cause organizations to change how they care for patients or does it just change how organizations document and report what they’re doing?

I think this is a massive challenge with value based reimbursement. We require certain data to “prove” that there’s been a change in how organizations manage patients. However, I can imagine hundreds of scenarios where the organization just spends time managing how they collect the data as opposed to actually changing the way they care for patients in order to improve the data.

Certainly there’s value in organizations getting their heads around their performance data. So, I don’t want to say that collecting the right data won’t be helpful. However, the healthcare system as a whole isn’t going to benefit from lower costs if most ACOs are just about collecting data as opposed to making changes that influence the data in the right way. The problem is that the former is a program you can build. The later is much harder to build and track.

Plus, this doesn’t even take into account that we may be asking them to collect the wrong data. Do we really know which data we need to collect in order to lower the costs of healthcare and improve the health of patients? There is likely some low hanging fruit, but once we get past that low hanging fruit, then what?

In response to my comment, David Harlow brought up a great point about many of the ACO program successes not being reproducible. Why does an ACO in one area improve quality and reduce costs and in another it doesn’t?

All of this reminds me of the question that Steve Sisko posed in yesterday’s #KareoChat:

There are a lot of things that seem to make sense until you dig into what’s really happening. We still have a lot of digging left to do in healthcare. Although, like Steve, I’m optimistic that many of the things we’re doing with ACOs and value based care will provide benefits. How could they not?

The Post SGR Replacement World – An SGR Infographic

Posted on July 13, 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 regularly blogging about the changes from a fee for service world to a new value based reimbursement world and everything that’s involved in that. I think it’s a key change that’s happening in healthcare that’s going to drive everyone to do things differently. This is particularly true as a healthcare IT vendor.

With that in mind, I found this history of Medicare SGR patches quite interesting. Understanding the past is a great way to take a look at where we’re heading in the future.
SGR Timeline and Move to MIPS and MACRA

King v Burwell Decision Teaches Sad Lesson in Law Making

Posted on June 25, 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.

In case you’re living under a hole (in the healthcare world we call that in the middle of an EHR implementation), the Supreme Court ruled on King v Burwell today. You can read the 47 page document here if you’re interested in the details of the decision. If you’ve ever read a Scalia decision or dissent, then you’ll know what to expect in his dissenting comments.

The reality is that the decision essentially made it a non-event. If they’d decided the other direction, then there would be a lot of scrambling to mitigate the damage of having all the federal health exchanges not be subsidized. That didn’t happen and so ACA (Obamacare) will continue on as before.

I won’t dive into the good and bad of ACA or the efforts to keep it around or get rid of it here. However, the one big takeaway I have from reading the SCOTUS decision is that the law making process is really awful. At one point in the decision they even reference a quote that “we need to pass the law to see what’s in it” which I’m told is a common phrase in Washington. The decision also commented on how the law was poorly crafted because it wasn’t put through the regular congressional procedures.

I understand that the US government has hundreds of years of overhead that they’re dealing with when making laws. A lot of the procedures likely play a critical role in the law making process. However, I feel that the law making process has accrued so much complexity that it makes everything a challenge.

In the tech world we call this situation “technical debt.” Over time as you’re programming a piece of software, you accrue so much technical debt that making changes on the existing code base becomes really expensive. The solution in the software world is often to recode the software from scratch. It’s almost like declaring bankruptcy and starting from scratch.

The SCOTUS decision highlights to me how much legislative debt our government has accrued in their processes. Unfortunately, they can’t declare bankruptcy and start over without the debt. That’s just not feasible or reasonable.

Since I live in the healthcare IT world, we’ve seen a lot of this “debt” impact legislation like meaningful use. We’re going to see more of it around value based reimbursement and ACOs as the healthcare payment world evolves. Government involvement is a reality in healthcare for many reasons including the government being one of the biggest healthcare “customers.” There can be a lot of benefits that come from government involvement, but there can also be a lot of challenges and loopholes that can snag you. That’s the lesson I’m taking from the King v Burwell decision.

Farzad Mostashari’s Aledade Raises $30 Million on the Back of the Switch to Value Based Care

Posted on June 15, 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.

On Aledade’s 1 year anniversary, they just announced that they’ve raised a $30 million Series B round of funding from new investor ARCH Venture Partners and return investor Venrock. That brings their total funding to $35 million. For those not familiar with Aledade, it was Founded by Farzad Mostashari and Mat Kendall soon after Farzad left ONC. They work with independent, primary care physicians who want to participate in ACOs and value based reimbursement programs.

Farzad’s blog post announcing the funding says that by end of the year Aledade will have 100 physician practices managing 75,000 Medicare Patients. With such small numbers, this should illustrate what a huge opportunity value based reimbursement will be for many companies that get it right.

Aledade has an interesting business model. They take about $500/provider as a membership fee and then they split the value based reimbursement commission with the provider. 60% of the reimbursement goes to the provider and 40% goes to Aledade. I’ll be interested to see how well this commission structure holds up. While certainly not an Apple to Apples comparison, doctors are use to paying 5-10% commission to billing companies. Will they be ok with paying 40% to what will feel like a billing company to many? Is this an opportunity for medical billing companies?

I have no doubt that physicians and hospitals are going to need a great mix of technology and healthcare knowledge to be successful in this new world of value based reimbursement. Aledade is on the cutting edge of this trend. Time will tell if they’re too early or right on time for the change.

In a recent article in the Palm Beach Post, they said the following about Aledade:

Thanks to Aledade’s focus on data analytics and physician reminders, Mostashari’s doctors became five times more likely to give recommended preventative care to their older patients, such as annual wellness visits and vaccinations against pneumonia.

This sounds great on face. It’s great that primary care physicians are interested in the wellness of their patients. I also think it’s great that we have a method for incentivizing these kinds of actions. However, my fear with this trend is that we’ll push out guidelines for “wellness care” without knowing if those guidelines actually improve someone’s health.

One lesson Mostashari should have learned well from meaningful use is that if you regulate something too early, you might freeze something in regulation that adds a lot of burden without actually improving healthcare. I’m glad they’re on the cutting edge of this trend. Let’s just be thoughtful that we don’t give our doctors more hoops to jump through that don’t actually provide value. That’s the massive challenge we face with the shift to value based reimbursement and we’re just getting started.

Aledade and company are explorers of a new land. I think we’ve only found the Bahamas. Most of us believe the Americas are still out there to be discovered, but we haven’t found it yet. So, let’s be careful drawing the final maps.

Incorporating More Social and Behavioral Data Into an EHR

Posted on June 11, 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.

You all have seen the stats about how our social and behavioral data is a much bigger predictor of our health and wellness than the 15 minutes of data that’s collected during a doctors visit. When people talk about the out of control costs of US healthcare, they often point to these stats and talk about how we have to focus on factors outside of our current healthcare system if we really want to bend the cost curve.

If in fact we had a true healthcare system that was trying to treat the health of a patient and not the symptoms, then we’d take a much more serious look at the social and behavioral determinants of health. The shift in healthcare is to try and make this a reality and to shift the current reimbursement model to one that pays our healthcare organizations to keep the patient healthy and not just treat their chief complaint.

With this in mind, I was intrigued by this IOM report on Capturing Social and Behavioral Domains and Measures in Electronic Health Records. In the report (there are actually 2 phases of the report) they identify 17 areas that influence a patient’s health and wellness. Then, they narrowed it down to 11 domains to consider incorporating into all EHRs.

You can take a look at the report to find all the details of their findings. However, I found their list of 17 social and behavioral domains that influence your health and wellness absolutely fascinating. Here’s the list:

Sociodemographic Domains

  • Sexual orientation
  • Race and ethnicity
  • Country of origin/U.S. born or non-U.S. born
  • Education
  • Employment
  • Financial resource strain: Food and housing insecurity

Psychological Domains

  • Health literacy
  • Stress
  • Negative mood and affect: Depression and anxiety
  • Psychological assets: Conscientiousness, patient engagement/activation, optimism, and self-efficacy

Behavioral Domains

  • Dietary patterns
  • Physical activity
  • Tobacco use and exposure
  • Alcohol use

Individual-Level Social Relationships and Living Conditions Domains

  • Social connections and social isolation
  • Exposure to violence

Neighborhoods and Communities

  • Neighborhood and community compositional characteristics

As we start to see EHR vendors move from digital filing cabinets to actually keeping a population healthy, I’m going to be watching how they incorporate all of this social and behavioral health data into the EHR.

I think you could break out every one of these domain areas and create a company around collecting this data which could then be made to be consumable by an EHR vendor. In fact, if you look at the world of healthcare IT startups we already see a lot of companies that are working in these areas. The most obvious is the dietary patterns and physical activity domains. How many hundreds of healthcare IT startup companies are working on quantifying those areas of our lives? A wise entrepreneur might look at this list and find a less obvious area where they could improve people’s health.

My biggest takeaway from this list: Healthcare still has such an amazing opportunity to improve health. We’ve barely just begun to tap into this data.

Knotty Problems Surround Substance Abuse Data Sharing via EMRs

Posted on May 27, 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.

As I see it, rules giving mental health and substance abuse data extra protection are critical. Maybe someday, there will be little enough stigma around these illnesses that special privacy precautions aren’t necessary, but that day is far in the future.

That’s why a new bill filed by Reps. Tim Murphy (R-PA.) and Paul Tonko (D-N.Y.), aimed at simplifying sharing of substance misuse data between EMRs, deserves a close look by those of us who track EMR data privacy. Tonko and Murphy propose to loosen federal rules on such data sharing  such that a single filled-out consent form from a patient would allow data sharing throughout a hospital or health system.

As things currently stand, federal law requires that in the majority of cases, federally-assisted substance abuse programs are barred from sharing personally-identifiable patient information with other entities if the programs don’t have a disclosure consent. What’s more, each other entity must itself obtain another consent from a patient before the data gets shared again.

At a recent hearing on the 21st Century Cures Act, Rep. Tonko argued that the federal requirements, which became law before EMRs were in wide use, were making it more difficult for individuals fighting a substance abuse problem to get the coordinated care that they needed.  While they might have been effective privacy protections at one point, today the need for patients to repeatedly approve data sharing merely interferes with the providers’ ability to offer value-based care, he suggested. (It’s hard to argue that it can’t be too great for ACOs to hit such walls.)

Clearly, Tonko’s goals can be met in some form.  In fact, other areas of the clinical world are making great progress in sharing mental health data while avoiding data privacy entanglements. For example, a couple of months ago the National Institute of Mental Health announced that its NIMH Limited Datasets project, including data from 23 large NIMH-supported clinical trials, just sent out its 300th dataset.

Rather than offer broader access to data and protect individual identifiers stringently, the datasets contain private human study participant information but are shared only with qualified researchers. Those researchers must win approval for a Data Use Certification agreement which specifies how the data may be used, including what data confidentiality and security measures must be taken.

Of course, practicing clinicians don’t have time to get special approval to see the data for every patient they treat, so this NIMH model doesn’t resolve the issues hospitals and providers face in providing coordinated substance abuse care on the fly.

But until a more flexible system is put in place, perhaps some middle ground exists in which clinicians outside of the originating institution can grant temporary, role-based “passes” offering limited use to patient-identifiable substance abuse data. That is something EMRs should be well equipped to support. And if they’re not, this would be a great time to ask why!

HIMSS15: Adoption Still a Problem for Organizations Swapping EHRs – Breakaway Thinking

Posted on May 20, 2015 I Written By

The following is a guest blog post by Todd Stansfield, Instructional Writer from The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Todd Stansfield

Each year the Health Information and Management Systems Society’s (HIMSS) annual conference is the Super Bowl of health IT. No other conference boasts more attendees ranging from health IT innovators and collaborators to pioneers. This year 40,000 plus participants descended on Chicago, all eager to learn about the new direction, trends, and solutions of the industry.

As always, buzzwords were aplenty—interoperability, care coordination, patient experience, and value-based care, to mention a few. During her keynote address on April 16, Karen DeSalvo, National Coordinator for the ONC, called the current state of health IT the “tipping point.” In 2011 the ONC released its four-year strategic plan focused on implementing and adopting electronic health records (EHRs). Now, DeSalvo says the industry is changed and ready to move beyond EHRs to technologies that will create “true interoperability.”

Enlightening conversations were happening among the crowded booths, hallways, and meeting rooms between organizations looking to ‘rip and replace’ their current EHR for a new one. While some organizations are struggling to unlock data across disparate systems, others are looking to upgrade their current system for one compatible with ICD-10, Meaningful Use, analytics solutions, or a combination of these. Still others are looking to replace systems they dislike for lack of functionality, vendor relationships, etc. In many cases, replacing an EHR is needed to ensure interoperability is at the very least viable. This buzz at HIMSS is a strong indicator that EHRs are still an important and essential part of health IT, and perhaps some organizations have not reached the tipping point.

In addition to the many challenges these organizations are facing—from data portability, an issue John Lynn wrote about in August 2012, to the cost of replacing the system—leaders are agonizing over the resistance they are facing from clinician end users. How can these organizations force clinicians to give up systems they once resisted, then embraced and worked so hard to adopt? How can leadership inspire the same level of engagement needed for adoption? The challenge is similar to transitioning from paper to an EHR, only more significant. Whereas the reasons for switching from paper were straightforward—patient safety, efficiency, interoperability, etc.—they are not so clear when switching applications.

Clinicians are also making harsher comparisons between applications—from every drop-down list, to icon, to keyboard shortcut. These comparisons are occurring at drastically different phases in the adoption lifecycle. Consider the example of an end user needing to document a progress note. In the old EHR, this user knew how to copy forward previous documentation, but in the new system she doesn’t know if this functionality even exists. Already the end user is viewing the new system as cumbersome and inefficient compared to the old application. Multiply this comparison by each of the various tasks she completes throughout her day, and the end user is strongly questioning her organization’s decision to make the change.

This highlights an important point: Swapping one EHR for another will take more planning, effort, and strategy than a first-ever implementation. The methods for achieving adoption are the same, but the degree to which they are employed is not. Leadership will not only have to re-engage end users and facilitate buy-in, they will have to address the loss of efficiency and optimization by replacing the old application.

Leadership should start by clearly outlining the reasons for change, a long-term strategy, as well frustrations end users can expect. They should establish a strong governance and support structure to ensure end users adhere to policies, procedures, and best practices for using the application. The organizations that will succeed will provide end users with role-based education complete with hands-on experience completing best practice workflows in the application. Education should include competency tests that assess end users’ ability to complete key components of their workflow. Additionally, organizations must capture and track performance measurements to ensure optimized use of the system and identify areas of need. And because adoption recedes after application upgrades and workflow enhancements, all efforts should be sustained and modified as needed.

While HIMSS15 brought to the stage a wealth of new ideas, solutions, and visions for the future of health IT, the struggle to adopt an EHR has not completely gone away. Many organizations are grappling with their current EHR and choosing to replace it in hopes of meeting the triple aim of improving care, costs, and population health. For these organizations to be prepared for true interoperability, they must overcome challenges unseen in paper to electronic implementations. And if done successfully, only then will our industry uniformly reach the tipping point, a point where we can begin to put buzzwords into practice.

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

Three Key Capabilities to Manage Population Health

Posted on April 7, 2015 I Written By

The following is a guest blog post by Marc Willard, President of Transcend Insights.
Marc Willard - Trascend Insights
The health care industry’s transition from fee-for-service to value-based reimbursement models demands a dramatic shift in how medical information is used and shared. The ability to generate a single, comprehensive patient view from an individual’s acute care, ambulatory care and wellness data is vital to support this transition. Ten years ago, the technology to move data out of silos to create real-time, physician-friendly, patient-centered population health management (PHM) systems was simply not available.

Fast-forward to 2015, where recent technological breakthroughs are fueling a new era in PHM that promises to help patients achieve their best health while allowing health care systems to create population health platforms that reward value, improve outcomes and reduce costs. For PHM vendors to successfully navigate this profound shift in the health care industry and provide actionable insights on an individual’s complete health care and health status, they need to deliver three key technologies:

  • Community-wide interoperability;
  • Real-time health care analytics; and
  • Intuitive care tools.

Community-Wide Interoperability

In developing a successful PHM system, one of the greatest challenges is working with disparate electronic health record systems that are not designed to communicate with each other, consequently keeping patient data entrenched in silos. Nothing is more frustrating for health care systems, physicians and care teams than dealing with multiple views and logins that impede the flow of information.

For PHM vendors to be successful, they must offer sophisticated health information exchange technology that integrates both clinical and claims data from diverse sources into a single, comprehensive patient view. Recent advances in cloud-based interoperability technology allow health care systems, physicians and care teams to literally get on the “same (electronic) page” with their patients’ complete health care history and real-time treatment strategies.

Interestingly, for health information exchange technology to successfully meet the needs of PHM, we must think beyond traditional electronic health record system interoperability. In addition to integrating data from health information generated outside the four walls of the hospital in ambulatory settings, successful PHM companies will be able to incorporate the valuable insights generated from the latest wearable health technologies that track activity levels, heart rate and other health information into a single, comprehensive patient view. This patient engagement is crucial in the new value-based reimbursement environment, with its focus on wellness and preventive medicine. PHM companies must know how to capture it and deliver meaningful insights to physicians and care teams without overwhelming them.

Several capabilities are required to ensure successful PHM, including bi-directional semantic interoperability, master patient indexing, both clinical and claims data capture and integration, real-time information sharing, results distribution and order processing, care and consent management tools, and of course privacy and security.

Another aspect that is crucial for interoperability is unobstructed access to patient information within traditional silos, so that data can truly be shared. Allowing data to flow requires open systems and interoperability standards that are clean, and widely and easily adopted.

Real-Time Health Care Analytics

A strong PHM tool combines community-wide interoperability with real-time health care analytics capabilities. Effective health care analytics should be able to identify evidence-based gaps in care, drug safety concerns and other opportunities for health improvement while ensuring compliance with the latest clinical guidelines and national quality measures to maximize reimbursement.

Yet the true value in health care analytics is the ability to deliver these insights quickly and simply at the point of care. Every minute counts in health care delivery, and even a five-minute delay in processing information is unacceptable during an office visit, as the physician needs to move on to his or her next patient in a timely manner.

Rather than processing health care data in batch mode, over hours or days, a real-time analysis engine should process data in milliseconds. This enables more informed decisions at the point of care to further ensure that every individual can achieve his or her best health. Physicians now have the ability to take a longitudinal view of how these analytic insights contribute to their patients’ past, present and future health.

Effective real-time health care analytics also allows physicians and care teams to compare an individual’s health status against population benchmarks. By doing so, they can track clinical trends such as readmission rates to further support intervention strategies, reduce risk and decrease costs.

Intuitive Care Tools

Physicians and care teams are more willing to utilize real-time insights generated by sophisticated analytics if they can be easily accessed in a matter of seconds, with just one or two clicks. Even more useful is mobile technology that provides a single, comprehensive view at the physician’s fingertips.

When developing intuitive care tools, PHM vendors should consult directly with physicians to better match and accommodate their unique information needs. For example, offering physicians access to comprehensive clinical trends across a population provides vital insights. When equipped with this information, physicians can improve care delivery through proactive interventions that create meaningful change.

Getting patients involved in the health care equation is equally important when developing intuitive care tools. For example, real-time insights available via mobile point of care solutions allow physicians to maintain eye contact with their patients, have a more meaningful discussion and improve the overall patient experience. As a result, mobile point of care solutions can help physicians encourage their patients to become active participants in their own health, for example, increasing a patient’s medication adherence to help with reducing readmissions.

In addition, once we understand a patient’s total health status and health care needs, physicians and care teams can recommend customized wellness programs that directly address current or future health care concerns. Patient engagement tools as well as a single, comprehensive consumer view can help empower individuals to take control of their own lifestyle choices. For example, smoking cessation classes, nutrition counseling or exercise programs, can help keep individuals healthy and minimize the need for medical interventions.

Keep the Focus on the Patient

With the movement from fee-for-service to value-based reimbursement models, the demand has never been greater for population health management systems that accomplish the industry’s triple aim: improving population health, enhancing the patient experience and reducing costs.

PHM vendors can simplify this transition by developing platforms that offer community-wide interoperability, real-time health care analytics and intuitive care tools. The health IT industry’s transformation must continue to be centered on the patient, whose health and well-being remain the focus of today’s population health management initiatives.

About Marc Willard
Marc Willard is the president of Transcend Insights, a wholly owned subsidiary of Humana Inc., dedicated to simplifying population health. The company, which launched in March 2015, represents the merging of three leading health care information technology businesses: Certify Data Systems, Anvita Health and nliven systems. For more information about Transcend Insights, visit: www.transcendinsights.com.

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.