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Improving Clinical Workflow Can Boost Health IT Quality

Posted on August 18, 2016 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.

At this point, the great majority of providers have made very substantial investments in EMRs and ancillary systems. Now, many are struggling to squeeze the most value out of those investments, and they’re not sure how to attack the problem.

However, according to at least one piece of research, there’s a couple of approaches that are likely to pan out. According to a new survey by the American Society for Quality, most healthcare quality experts believe that improving clinical workflow and supporting patients online can make a big diference.

As ASQ noted, providers are spending massive amounts of case on IT, with the North American healthcare IT market forecast to hit $31.3 by 2017, up from $21.9 billion in 2012. But healthcare organizations are struggling to realize a return on their spending. The study data, however, suggests that providers may be able to make progress by looking at internal issues.

Researchers who conducted the survey, an online poll of about 170 ASQ members, said that 78% of respondents said improving workflow efficiency is the top way for healthcare organizations to improve the quality of their technology implementations. Meanwhile, 71% said that providers can strengthen their health IT use by nurturing strong leaders who champion new HIT initiatives.

Meanwhile, survey participants listed a handful of evolving health IT options which could have the most impact on patient experience and care coordination, including:

  • Incorporation of wearables, remote patient monitoring and caregiver collaboration tools (71%)
  • Leveraging smartphones, tablets and apps (69%)
  • Putting online tools in place that touch every step of patient processes like registration and payment (69%)

Despite their promise, there are a number of hurdles healthcare organizations must get over to implement new processes (such as better workflows) or new technologies. According to ASQ, these include:

  • Physician and staff resistance to change due to concerns about the impact on time and workflow, or unwillingness to learn new skills (70%)
  • High cost of rolling out IT infrastructure and services, and unproven ROI (64%)
  • Concerns that integrating complex new devices could lead to poor interfaces between multiple technologies, or that haphazard rollouts of new devices could cause patient errors (61%)

But if providers can get past these issues, there are several types of health IT that can boost ROI or cut cost, the ASQ respondents said. According to these participants, the following HIT tools can have the biggest impact:

  • Remote patient monitoring can cut down on the need for office visits, while improving patient outcomes (69%)
  • Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)
  • EMRs/EHRs that eliminate the need to perform some time-consuming tasks (68%)

Perhaps the most interesting part of the survey report outlined specific strategies to strengthen health IT use recommended by respondents, such as:

  • Embedding a quality expert in every department to learn use needs before deciding what IT tools to implement. This gives users a sense of investment in any changes made.
  • Improving available software with easier navigation, better organization of medical record types, more use of FTP servers for convenience, the ability to upload records to requesting facilities and a universal notification system offering updates on medical record status
  • Creating healthcare apps for professional use, such as medication calculators, med reconciliation tools and easy-to-use mobile apps which offer access to clinical pathways

Of course, most readers of this blog already know about these options, and if they’re not currently taking this advice they’re probably thinking about it. Heck, some of this should already be old hat – FTP servers? But it’s still good to be reminded that progress in boosting the value of health IT investments may be with reach. (To get some here-and-now advice on redesigning EMR workflow, check out this excellent piece by Chuck Webster – he gets it!)

Modern Day Healthcare Tools and Solutions Can Enhance Your Brand Integrity and Patient Experience

Posted on August 11, 2016 I Written By

The following is a guest blog post by Chelsea Kimbrough, a copywriter for Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Chelsea Kimbrough
Digitally speaking, the healthcare market is more crowded than ever – and finding the perfect provider, practice, or physician online can quickly become an arduous task for even the most tech-savvy patient. But healthcare organizations that dedicate the time, effort, and resources to create a unique digital presence, enhance their search engine optimization (SEO), and reinforce their brand integrity can cut through oversaturated search results to acquire and retain more patients.

In today’s consumer-driven world, shopping for the ideal healthcare organization is quickly becoming the norm. More and more frequently, patients are turning toward the internet during their hunt. In fact, 50 percent of millennials and Gen-Xers used online reviews while last shopping for a healthcare provider. And with 85 percent of adults using the internet and 67 percent using smartphones, accessing this sort of information is easier than ever before.

This ease of access has led patients to adopt more consumer-like behaviors and expectations, such as valuing quality and convenience. Healthcare organizations that proactively ensure their brand image, digital presence, and patient experience cater to these new expectations could be best positioned to thrive. By providing convenient, patient-centric healthcare tools and services, organizations can help facilitate this effort throughout every step of the patient journey.

One such tool is real-time, online appointment self-scheduling, which 77 percent of patients think is important. In addition to adding a degree of convenience for digitally-inclined patients, online self-scheduling tools can support your healthcare organizations’ key initiatives – including driving new, commercially insured patient growth. By using an intuitive way to quickly schedule an appointment, potential patients’ shopping process can be halted in its tracks, ensuring more patients choose your organization over a competitor’s. And with the right tool, your search rankings and discoverability, or SEO, could be significantly enhanced.

Reaching patients where they are most likely to be reached is another way to improve your brand experience. Like consumers, patients are often connected to their phones – so much so that text messages have a 98 percent open rate. Organizations that leverage automated text, email, and voice reminders can successfully communicate important messages, boost patients’ overall satisfaction and health, and improve appointment and follow-up adherence – ultimately setting themselves apart from competitors.

Other digital tools, technologies, and communication strategies can help fortify your brand’s digital standing and patients’ satisfaction, including social media outreach, useful email campaigns, and more. Whatever method – or methods – best serve your organization, it’s important they help improve your SEO, enhance patients’ overall accessibility and experience, and support your brand values and initiatives.

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

Has Technology Changed The Way We Interact With Each Other, Our Healthcare Providers And Healthcare Organizations?

Posted on July 19, 2016 I Written By

The following is a guest blog post by Brittany Quemby,  Marketing Manager of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle

In this blog series, we have talked a lot about healthcare consumerism, the importance of communication in the patient/provider relationship and how embracing technology can lead to an increased patient experience. Today I want to talk about how technology is changing the way we interact with each other in the healthcare industry.

The other day I tried to book a doctor’s appointment with my family physician.  I looked up my family physician’s phone number online and called in. After about 25 rings, 20 minutes on hold and a cranky voice on the other end, I hung up the phone feeling extremely frustrated and couldn’t event remember the time of my appointment.

This left me thinking. Everyday we rely and crave the use of technology to help us be more efficient and to simplify our lives.  I would argue, even more so, when it comes to our health. Approximately 58% of patients believe that technology leads to better care.  Technology has truly transformed the way patients want to interact with providers.  And to be fair, a lot of healthcare organizations and clinicians have been quick to adopt as they see the efficiency and patient experience benefits – so what was the hold up with my family physician?  I think perhaps they just weren’t aware of the facts.

So let’s take a look at them:

Fact 1 – Mobile Health

The truth hurts.  Many of us are addicted to our phone and are guilty of driving home when we were almost at work to retrieve it. When it comes to mobile health, the addiction is just as strong. Over 50% of smartphone owners, have used their phone to look up health or medical information.  A staggering 80% of patients want the option of using their smartphone to interact with healthcare providers.  Traditional methods of inquiring about our health and interacting with healthcare providers are long gone. Today’s technology makes it much more convenient for both physicians and patients to connect, research and communicate right from their smartphone.

Fact 2 – Online Health

Face it! Most of us have gone down the rabbit hole of searching a particular ailment online.  At least 35% of U.S. adults say they have gone online to try to figure out what medical condition they or someone else might have. Research indicates that 77% of online health seekers began their last session at a search engine such as Google, Bing, or Yahoo.  The presence of the internet has given patients easy access to information and has empowered them to make more informed choices about their health. It has also allowed physicians to easily update new information and build interactive treatment plans that can increase patient adherence and retention.

Fact 3 – Online Scheduling

Truth be told, I did scream when I got off the phone with doctor’s office.  Why was calling in to book my doctor’s appointment the most painful thing I had done all week? I am not alone, 77% of consumers think that the ability to book, change or cancel healthcare appointments online is important. Technology has us conditioned to want the quickest and easiest way of getting things done.  It is much quicker and convenient to go online to book the next available appointment than the 8.1 minutes it takes for a patient to complete a scheduling call.  Online scheduling helps to satisfy a patient’s need for quick gratification and alleviates the significant amount of time staff spend scheduling appointments.

Fact 4 – Digital Communication Platforms

The fact that I couldn’t remember the time of my appointment the moment I got off the phone was a bit embarrassing. But let’s face it, we’ve become so reliant on technology telling us where we need to be and what time we need to be there that our brains begin to ignore certain timelines. The truth is, the sticky note no longer holds the top spot in patient’s minds. A whopping 85% of consumers say that they would welcome digital appointment reminders, medication reminders and general health tips.   This type of technology is a win-win for both patients and clinicians.  Patients receive a simple reminder that can be added into their calendar allowing them to show up and be better prepared and clinicians receive appointment confirmations allowing them to increase their operational efficiencies, revenue and better manage their daily schedule.

Fact 5 – Tracking Health

Tracking health is not a new concept, but the exchanges and the method patients are tracking their health has revolutionized with newer technology. When recommended by a doctor, 3 in 4 consumers followed advice to wear technology to track their health. Over 20% of patients track their health indicators with the use of technology.  Technologies that assist in tracking one’s health have allowed for higher patient engagement which can lead to better monitoring and increased outcomes.  Both US consumers (77%) and doctors (85%) agree that using wearables helps a patient engage in their own health.

As technology evolves, so will our interactions as patients, providers and healthcare organizations.   It’s imperative to capitalize on the many benefits healthcare technology has given us to ensure we expand our connectivity, grow our data, increase our health outcomes and continuously improve our communication and collaboration. However, and unfortunately, in the meantime while we wait for everyone to catch up some of us will suffer from the frustration of expecting technology and not getting it. #Siricantyoujustrunmylife

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

Most Popular Healthcare IT Articles of 2015

Posted on December 31, 2015 I Written By

John Lynn is the Founder of the 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 and 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 we come to the end of 2015, I thought I’d take a minute and look back at our top 16 most read Healthcare IT articles in 2015.

6 Healthcare Incubators Growing the Future of HealthTech – Great article. No doubt there are more great healthcare incubators starting all the time. Looks like maybe we should go back and do an update.

Healthcare IT and EHR Conferences and Events – If you’re looking for healthcare IT related conferences and events, this page is a great resource. Along with showing our schedule of conferences and events, we also highlight some of the most popular healthcare IT conferences.

Crazy and Funny ICD-10 Codes – People love a good laugh. Amazing that this post in 2011 was still making people laugh in 2015. It would be interesting to see how many times these funny codes have been used since ICD-10 started on Oct 1, 2015.

Benefits of EMR or EHR Over Paper Charts – I love when people just complain about their EHR software. It’s amazing how quick we forget the benefits of EHR and start to take them for granted.

The 2015 #HIT99 Results Are In – I love this list of people. If you’re looking for an amazing group of healthcare IT people to follow, start with this list.

2014 EHR Mandate – I’m really glad that so many years later this post is still getting traffic. I’m still annoyed by people that say that EHR was mandated. This post outlines why it’s not mandated, but why you should consider EHR anyway (Note: Government money isn’t one of the main reasons)

Mark Cuban’s Suggestion to Do Regular Blood Tests – I was amazed at the brouhaha that Mark’s comments created. This post was my take on it. I side with Mark, but most people I read did not. This topic is going to become more and more important as more tests and sensors enter the market.

Best Scanners for High Volume Scanning in a Doctor’s Office – I need to update this post with the latest version of the various scanners out there. I’ll have to reach out to Fujistu, Ambir, and Canon to get updates on the latest scanners.

HIPAA Security and Compliance Thoughts from the Healthcare Cyber Security Summit – This is a great guest post by Anna Drachenberg. I always love when smart people take time to share their insights on this blog.

Practice Fusion Violates Some Physicians’ Trust in Sending Millions of Emails to Their Patients – This is still the article that took me the longest to write. In fact, it probably took me 10 times as long as any other article I’ve written. I’m glad that people are still reading it. It’s a story that every EHR vendor should learn about so they can avoid the same thing happening to them.

Digital Signatures in EMR – Signatures are still the biggest source of blame for paper in health care. Well, that doesn’t count printing from EHR software. I’m glad that we now have a number of great digital signature options. Much has changed since this post back in 2007.

EMR Companies Holding Practice Data for “Ransom” – I wish I could say that this isn’t a problem anymore. Unfortunately, I’m sure we’re going to see even more of it as organizations choose to switch EHR.

HIPAA Compliance and Windows Server 2003 – I wonder how many healthcare organizations still have Windows Server 2003 in production. I’m guessing far too much.

Examples of HIPAA Privacy Violations – More HIPAA Lawsuits Coming? In 2006 we knew that more HIPAA violations were coming, but I don’t think then we even dreamed of the size of the breaches that would occur. I think more HIPAA Lawsuits are still coming.

Firewall & Windows XP HIPAA Penalties – Same story with Windows XP as Windows Server 2003. You’re a brave soul to still run Windows XP in a healthcare organization.

The Next Major Healthcare Product – Care Management System – I still reference this article a lot when talking with people about trends in healthcare IT. I got my first PR pitch about a Care Management System. We’ll see if the term catches on. Regardless of whether the term catches on or not, the concept of a patient centered care management system is the next stage of what we need to provide care to patients.

Not a bad list. Looks like a few of the posts need updating. Something to look forward to in 2016. Happy New Year!

CMS Redefines Telemedicine by Bringing Better Care to 15 Million Patients and Huge Profitability to Medical Facilities

Posted on September 17, 2015 I Written By

The following is a guest blog post by Donald Voltz, MD.
Donald Voltz - Zoeticx
Telemedicine is about reaching out to patients in remote locations, but limited to videoconferencing between patients and health providers. It is similar to a face-to-face service with the exception that the patient and primary care provider are not physically together. Such efficiency is limited in term of scope and only addresses the geographical challenge and scarcity of physician availability, a far cry from what CMS wanted for its Chronic Care Management Services (CCM) which would fundamentally change telemedicine as it is practiced.

CCM services bring the telemedicine definition to the next level – a quiet continuous monitoring and collaboration from all care services to the patient, given the ability to anticipate and engage in care issues. Such ability not only curbs care costs, it would also increase care provider bandwidth, giving them the ability to cover more patients with better efficiency. The challenge is not on the requirements part of CCM services, but the lack of an IT solution to really address all CMS guidelines, including its intent to enforce the concepts through the healthcare industry.

The New England Journal of Medicine has covered the major challenges from the new CCM guidelines, touching on all the major shortcomings in today healthcare IT offerings.  Healthcare providers recognized that the fee-for-service system, which restricts payments for primary care to office-based visits, is poorly designed to support the core activities of primary care, which involve substantial time outside office visits for tasks such as care coordination, patient communication, medication refills, and care provided electronically or by telephone.

The time has come for a paradigm shift to reengineer how we deliver care and manage our patients. To arrive at a new plateau requires rethinking the needs of our patients and how to meet these needs in an already resource constrained system. Unless we develop solutions that both integrate with and enhance the technologies currently available and those yet to be realized, we will not realize a return on health IT investment.  This needs to be an area of focus for hospital CEOs, CIOs and CMOs.

Huge Market Opportunity

According to the 2010 Census, the number of people older than 65 years was 40 million with increasing trends to 56 million in 2020 and not reaching a plateau until 2050 at 83.7 million.  With two-thirds of Medicare beneficiaries having two or more chronic conditions while one-third has more than three chronic conditions according to CMS data, putting the number of patients who qualify for CCM services at 15 million. This number is predicted to continue on an upward trend until 2050.

The World Health Organization (WHO) recognized the growing burden this trend in chronic disease places on the healthcare system and addressed the need for innovative solutions in their 2002 report. While the potential market is huge, in the billions of dollars yearly, healthcare organizations have been struggling to address the CMS guidelines with key requirements from CMS. We can no longer afford not to address the needs of patient with chronic medical conditions along with engaging them in their healthcare decisions.

CMS’ CCM guidelines are as follows:

  • 24×7 access to clinical staff
  • Patient care continuum
  • Collaboration, coordination between primary care providers and other care services
  • Electronic management of care transition among care providers
  • Coordination between home and community care services
  • Patient engagement

Here is how these guidelines are now being addressed:

The Patient-Centric Model

While each patient has a primary care provider who is responsible for CCM service, they are not confined to receiving care in a single practice or institution. The primary care provider assumes the role of care coordinator, but care is likely to be distributed between multiple care providers, often across different care locations. In a patient-centric care model, care services can come from any care providers – geographically and organizationally diverse, necessitating an accountable provider to coordinate and orchestrate high-quality care across multiple chronic conditions.

Secure Electronic Care Transition

CMS clearly states these CCM care plans must be electronically available at all times to all care providers who will be delivering care to these patients, not available by faxing, or scanning as patient data is currently shared. The chronic care management plan must be available to all healthcare providers who might take care of these patients 24×7. In addition, the primary care provider who assumes the care coordinator responsibility for a patient is expected to follow-up on the care delivered, additional needs of the patient and changes in chronic condition that may have been addressed by a healthcare professional remote to the patients’ primary practice.

CMS neither authorizes how such a CCM system is designed nor enforces how efficient the implemented care service is. The monthly reimbursement limits the time and additional resources physicians are able to allocate for the development, implementation and daily operations of a CCM program in their practice. The manual implementation of a system that meets all of the requirements defined by the CMS will far exceed the reimbursement recovered. It is also likely to be inferior to one with some degree of automation coupled with messaging when a patient’s condition changes or their chronic care management plan is accessed by other providers. Efficiency along with automated logging of time spent on care coordination are critical requirements for a service to be effective.

A CCM service solution must meet the requirements defined by CMS while integrating into the current operational structure of primary care practice and integrate with current health IT systems and manage the secure documentation flow.  It must also offer a built-in notification system to alert physicians to changes in patient status and/or access to the care plan while maintaining an efficient operation in clinics with a lower overhead and no need for additional infrastructure.

While CMS does not enforce the efficiency of a CCM care service, the monthly payment must represent an increase of revenue to care providers. Care providers cannot implement a new potential code while increasing its cost due to manual labor increase. So, efficiency must be part of the solution requirements.

The answer to CCM service would be a new healthcare application offering secure documentation flow, built-in notification and collaboration services to support a low cost, efficient operation for clinics.

The CCM application must address the following requirements:

  • No disruption of existing services. The application must operate and integrate seamlessly with any existing EHR so to not change provider workflow or disrupt current processes; defining a very stringent requirement to keep the existing EHR systems untouched and unchanged while allowing for this new service to co-exist.
  • Secure electronic care transition with CCM care plan sharing. Patients can engage with this new care service even when the service may not be contained within the same network as the primary care provider. Patients ultimately maintain control of what information and with whom this information is shared. The primary care provider is responsible for maintaining the CCM care plan, as well as the patient, and should expect any information shared will be used for a single care session and not beyond it. Although the CCM care plan is expected to contain the most up-to-date medication information, primary care providers are not interested in opening up their entire system to others, but instead need to maintain control and secure access while allowing for access to these protected documents.
  • Automation, automation and automation. Efficiency of the whole CCM service must be at the core so that primary care providers can enhance patient care without adding expense and resources to implement it. Consider a patient with Congestive Heart Failure (CHF) where continuous monitoring of weight is critical for early intervention and the avoidance of hospitalizations. To engage patient’s in their care, they must be given a mechanism to report daily weight to their primary care provider. The primary care provider must have a solution where attention is given if the patient’s condition so it not has exceeded a certain threshold. Automation is required so that primary care providers can be efficient and only given attention when attention is required. Automation must be in place so that no activities such as follow-up would be omitted.
  • An EHR-agnostics solution. Implementation of a CCM service must address the constraints of a non-homogeneous environment. Healthcare organizations and physician practices are not able to control the EHR environments when patients receive care outside of their primary practice. The requirement for electronic document exchange along with the expectation of the latest patient health data being contained in the CCM care plan goes beyond a static solution offered by a data duplicated HIE (Health Information Exchange) infrastructure.
  • Visible value to a patient. A critical requirement for CMS reimbursement is a patient’s opting into a CCM management program that includes out-of-pocket monthly co-pay for the service of 8 dollars per month. A patient must see the value for CCM services which can be demonstrated through enhanced engagement, access to providers and the assurance that their condition is being overseen each month by their chronic care coordinator. Anticipation of an early intervention for potential problems along with the ability to inquire and receive feedback on their condition(s) brings added value to patients and their loved ones. This value can only be delivered if such a service can be developed in an efficient manner with a low cost of operating and a limited expansion of personal to bring it about.
  • Documentation of discontinuous time spent on care coordination. CMS requires at least 20 minutes are spent on care coordination activities each month in order to bill for this for patients enrolled in the program. Without a seamless component to log such activity, the efficiency of the overall process comes into question. A comprehensive CCM application must address the practice management side to account for and generate monthly reports of the CCM activities completed.

Future of Healthcare Impacted by Integration, Patient Data and New Modes of Delivery

The future of healthcare will be impacted by the integration of technology, patient collected data, and enhancement of healthcare professionals’ ability to deliver care in modes not yet imaged. With respect to management of chronic medical conditions, leveraging technology to coordinate the care delivered so these patients can lead productive lives at a reduced cost with less time in the hospital for exacerbations of their disease is a goal that is now possible.

Development of tools to coordinate care without additional health IT expense, in either time spent learning a new workflow or cost of such an application, is now available. Finding such an innovate model that works for patients, healthcare professionals and health systems for chronic care management will likely spread into other areas of healthcare. CCM services and care coordination allow remote, discontinuous, non-face-to-face management of patients with complex health conditions when it meets stringent requirements – a quiet, continuous monitor of health status and interventions, collaboration of all care delivered to the patient, an ability to anticipate, engage and alert patients and care professionals of impending issues, along with the administrative side of billing and logging such activity.

This ability not only changes the direction of the chronic care cost curve, it also increases care provider bandwidth, giving them the ability to successfully manage more patient, with better efficiency while delivering high quality, valuable care.

About Donald Voltz, MD
Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.

Board-certified in anesthesiology and clinical informatics, Dr. Voltz is a researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.

Thanh Tran, CEO of Zoeticx, also contributed.

Starting with Small and Simple Changes

Posted on June 26, 2015 I Written By

John Lynn is the Founder of the 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 and 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 had the chance to talk with Dr. Adam Sharp, CMO of par8o. While I’d followed at a very high level Dr. Sharp and Dr. Daniel Palestrant’s move from Founding Sermo to the launch of par8o, this was the first time I’d had a chance to really learn what they were doing in their new venture. I’d say that par8o’s core product now is managing the referral process, but they’ve built referral management on a platform that could facilitate all sorts of communication and data sharing across many parts of healthcare.

I love the way they’re approaching healthcare IT because I’ve long believed that many healthcare IT companies are trying to bite off more than they can chew. Many healthcare IT companies have really big visions of how they’re going to solve healthcare’s problems (of which there are many). They raise a bunch of money to go after those problems and then they never really solve anything. In most cases, the healthcare establishment kicks against such massive changes and so it makes it almost impossible for a health IT company to sell such a massive solution.

One reality of life is that we all hate change. This is true even when we know that change is the right thing to do. So, it shouldn’t be any wonder when a healthcare IT company comes in and wants to massively change what we’re doing that they find resistance. I consider that a failed strategy that I’ve seen far too many healthcare IT startup companies employ.

What I heard from par8o is that they’ve taken the opposite approach. They’re focused on a small change that can provide value to a healthcare organization. In this case it’s referral management. When you hear what they’re doing to make the round trip referral and response process electronic, you ask yourself why we haven’t been using technology to do this forever.

I’ve seen over and over again in healthcare IT that these small, simple and almost obvious solutions often make the biggest impact. They make a big impact because healthcare organizations actually adopt them. Dr. Sharp told me that even the small changes they’re introducing often meet resistance from their users. They have to invest a lot of time and effort to overcome that resistance. If even small changes are resisted, you can imagine why massive changes to an organization’s process are flat out refused.

What’s most interesting about this approach is that by successfully implementing these small changes, it opens the door for a company to eventually help a healthcare organization make much larger changes. I’ve often asked healthcare IT companies, what’s your gateway drug? (ie. What feature of your product do they really want to buy that gets them started with you?). Once you get them hooked on a specific feature, then you have the relationship and trust built to be able to offer broader changes.

It seems like par8o has taken the right approach to building trust in and providing value to their customers in referral management. I’ll be interested to watch how they leverage that trust and their healthcare communication and data sharing platform (they call it a healthcare operating system) to optimize other healthcare processes. In a fee for service world many healthcare organizations profited from a lack of optimization. In a new value based care world those optimizations are going to become extremely important.

How NOT to Do Population Health

Posted on June 24, 2015 I Written By

John Lynn is the Founder of the 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 and 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 famous world traveler, Dr. Nick (he’s also CMIO for Nuance Healthcare), is attending #AMDIS15 and was kind enough to share out this awesome image:
How to Not Do Population Health

This slide was shared by Coray Tate from KLAS and is a great message to consider.

I also don’t think we should come down too hard on Humana. As healthcare companies start to stretch the normal, stuff like this is going to happen. I think that’s a good thing. At least the diabetic now had a chocolate bar that they could share with someone like me. Then, they’d have a happy friend and making a friend happy is worth so much more than a chocolate bar.

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!

The Next Major Healthcare Product – Care Management System

Posted on May 1, 2015 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While meeting with a lot of people at HIMSS I started to think about what would be the next “must have” IT system that a healthcare organization would look at purchasing. When you look back at the history of IT purchases in healthcare, the Practice Management System (PMS or PM depending on your preference) was one of the first systems that most practices purchased. It was an easy buy for most people. They saw a lot of value to digitize the billing side of their practice. Adoption of practice management systems was widespread. Everyone was and is using one.

After the practice management system came the Electronic Health Record (EHR, but many could argue that EMR came before EHR, but that’s semantics in my books). Over the 10 years that I’ve been blogging about EHR software, we’ve seen the evolution of people asking if they should buy an EHR software to everyone realizing that they needed to go electronic but were trying to figure out which solution was best to $36 billion of government money which basically had the vast majority of doctors choose to hop on board EHR. While we don’t have 100% EHR adoption, we’re getting there. The market for EHR purchases is quite mature now.

With that as background, I’ve been thinking about what system or platform would be purchased next by a practice. I asked a number of people at HIMSS about this. Dr. Tom Giannulli from Kareo suggested that Care Plan Engagement could be an interesting next step. With the coming ACOs and value based reimbursement, you can see where Dr. Tom is coming from in his thinking. Plus, his term mixes the meaningful use term of patient engagement with the care plan approach that’s likely going to be required in future business models.

When I sat down with Carl Ferguson from CTG, he called the next product a Care Management System. When I heard it, I thought that this term could have staying power. The practice management system manages the practice (ie. billing). The electronic health record stores the records electronically. The Care Management System is going to be centered on the patient and the care that a patient receives.

What do you think of the term: Care Management System? There were probably a hundred products at HIMSS that have started to build a product like this. Although, I think a care management system would probably have to be a combination of a number of products out on the market today.

Regardless of what we call it, I think what will set apart the next big healthcare IT product offering is that it will be centered around the patient. A care management system by its very nature would have to be interoperable since the care is being given across multiple organizations. A care plan would make since because the patient’s at the center of the care management system and everyone could be involved in creating the care plan and ensuring that the care plan is being followed. At first take, I really like this terminology and I hope it gains some traction.

One challenge with the term Care Management System is that the abbreviation is CMS. That abbreviation is already quite popular with the government organization (CMS) and also the popular Content Management System (CMS). Although, if that’s the biggest problem with the term, then I feel pretty good about it. Although, this does make me wonder if we’ll go back to the age old integrated PM/EHR debate again when it comes to an integrated EHR/CMS. Will EHR vendors see this opportunity and offer a Care Management System module for their EHR? Some probably think they already are doing that.