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One Hospital Faces Rebuild After Brutal Cyberattack

Posted on July 20, 2017 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.

Countless businesses were hit hard by the recent Petya ransomware attack, but few as hard as Princeton, West Virginia-based Princeton Community Hospital. After struggling with the aftermath of the Petya attack, the hospital had to rebuild its entire network and reinstall its core systems.

The Petya assault, which hit in late June, pounded large firms across the globe, including Nuance, Merck, advertiser WPP, Danish shipping and transport firm Maersk and legal firm DLA Piper.  The list of Petya victims also includes PCH, a 267-bed facility based in the southern part of the state.

After the attack, IT staffers first concluded that the hospital had emerged from the attack relatively unscathed. Hospital leaders noted that they are continuing to provide all inpatient care and services, as well as all other patient care services such as surgeries, therapeutics, diagnostics, lab and radiology, but was experiencing some delays in processing radiology information for non-emergent patients. Also, for a while the hospital diverted all non-emergency ambulance visits away from its emergency department.

However, within a few days executives found that its IT troubles weren’t over. “Our data appears secure, intact, and not hacked into; yet we are unable to access the data from the old devices in the network,” said the hospital in a post on Facebook.

To recover from the Petya attack, PCH decided that it had to install 53 new computers throughout the hospital offering clean access to its Meditech EMR system, as well as installing new hard drives on all devices throughout the system and building out an entirely new network.

When you consider how much time its IT staff must’ve logged bringing basic systems online, rebuilding computers and network infrastructure, it seems clear that the hospital took a major financial blow when Petya hit.

Not only that, I have little doubt that PCH faces doubts in the community about its security.  Few patients understand much, if anything, about cyberattacks, but they do want to feel that their hospital has things under control. Having to admit that your network has been compromised isn’t good for business, even if much bigger companies in and outside the healthcare business were brought to the knees by the same attack. It may not be fair, but that’s the way it is.

That being said, PCH seems to have done a good job keeping the community it serves aware what was going on after the Petya dust settled. It also made the almost certainly painful decision to rebuild key IT assets relatively quickly, which might not have been feasible for a bigger organization.

All told, it seems that PCH survived Petya successfully as any other business might have, and better than some. Let’s hope the pace of global cyberattacks doesn’t speed up further. While PCH might have rebounded successfully after Petya, there’s only so much any hospital can take.

Simulation-Based Education: The New Paradigm in Healthcare Technology – Breakaway Thinking

Posted on July 19, 2017 I Written By

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Conduent Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
Imagine a warehouse filled with classroom training sessions running simultaneously, hotel lobbies packed with consultants checking in and out at the same time, overrun parking lots, buses shuttling employees off campus, and more. These are the harsh, yet common challenges healthcare organizations face with classroom training – a predicament explored in the second edition of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology. As the book explores the real-life headaches of classroom training, it calls on healthcare leaders and organizations to embrace a new education paradigm.

Today the healthcare industry has made considerable advances in technology. Enterprise applications now offer more features and functionality than ever before. Analytics programs, telehealth platforms, mobile health applications – each represents one of the many innovations changing the face of our industry. Yet despite these advances, classroom training remains one feature that has yet to change, a feature deeply-engrained in the habits, mental models, and beliefs of the industry. Healthcare executives already face significant pressure from making multi-million-dollar investments in clinical information systems. Changing how users are educated disrupts another component of healthcare for which executives become solely responsible, and must address and manage.

Despite the strength of the status quo, Beyond Implementation calls for healthcare’s departure from the classroom training model, as research highlights its ineffectiveness for teaching learners how to use new technology – a reason why most industries have abandoned or redesigned the model. Instead of face-to-face instruction, the book recommends healthcare organizations take a simulation-based approach to education, which provides learners with hands-on experience completing their workflows in a simulated EHR. The value of simulation-based education was first proven in the commercial airline industry. Like healthcare today, the airline industry experienced significant disruption through technology as the industry transitioned from analog to flight control systems. Unable to educate pilots quickly enough, the industry developed flight simulators that provided hands-on training that was relevant, accessible, repeatable, and sustainable. The new education model produced impressive learning outcomes, which is why the book argues for a similar model to be applied to healthcare.

Unlike classroom training, simulation-based education is more personalized and targeted. Education is role-specific and teaches learners how to complete their daily tasks in a simulated EHR environment. Users learn to complete their daily tasks according to best practice workflows guided by real-life clinical scenarios that increase relevancy, retention, and engagement. One significant benefit is users accumulate experience in the application without risks to patient safety. They also access their education at a time most convenient to them, as education is accessible 24/7 anywhere there is an internet connection. The accessibility of simulation-based education eliminates the headaches and costs of renting out warehouses, hiring trainers and consultants, scheduling staff to attend three eight-hour training sessions, and more.  It’s no wonder why simulators are shown to improve confidence and knowledge in the system – which are key indicators of proficiency.

Considering the challenges and opportunities facing healthcare organizations, the need for a better education paradigm is apparent. Now more than ever, our industry is grappling with the challenges of swapping their legacy systems with new enterprise applications, which research has shown brings significantly greater challenges than the switch from paper to electronic. In addition to new strategies around leadership and other areas, organizations must provide education that helps users make the transition from old workflows, keyboard shortcuts, and habits more quickly and seamlessly. Our industry is also beginning to focus on improving outcomes through technology, a trend that requires organizations to create a workforce of proficient users efficiently and effectively.

In every aspect, healthcare stands to benefit by replacing its analog approach to education. Whether reducing costs or improving knowledge and confidence in the system, the argument for classroom training is obsolete. It’s time that our industry embrace a new model that reflects the level of innovation healthcare leaders and professionals are working so hard to adopt.

Conduent is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training. Download their Free Whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

Healthcare Data Integration Cutting Room Floor: Cluttered with Valuable Unused and ‘Laundered’ Data – #HITsm Chat Topic

Posted on July 12, 2017 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 7/14 at Noon ET (9 AM PT). This week’s chat will be hosted by Bill Fox (@FoxBigData) of @MarkLogic on the topic of “Healthcare Data Integration Cutting Room Floor: Cluttered with valuable unused and ‘laundered’ data.”

Improving healthcare data integration, flexibility, agility and time to market for development and implementation starts with ingesting data and ends with analytics and insights-an operationalize before you analyze best practice approach.

How healthcare data is captured, represented, secured and made available to the application services intended to support the value-based models of care everyone expects to improve patient outcomes, while addressing escalating costs, is a fundamental necessity for digitally transforming today’s healthcare organizations.

Thankfully, operational data integration technologies have rapidly emerged that address and support the critical functionality healthcare providers, health plans and ancillary organizations need to support the healthcare consumers and patients, and effect true health care outcome improvement and cost containment challenges.

The intention of this chat is to share ideas, facts, thoughts, and opinions on the theme of whether the legacy technology that still dominates most IT shops in healthcare supports reform and innovation initiatives or not. Quite simply, are we leaving too much valuable, unused and ‘laundered’ healthcare data” on the ‘Cutting Room Floor’ of the very healthcare organizations we’re all counting on to best leverage that data? Our hope is that this chat helps to surface how healthcare organizations – providers, payers, 3rd parties and vendors – can get the most from our respective investment in our healthcare data platforms.

Reference & Resources:

This Week’s Topics
T1: What’s your biggest, most expensive health data “hairball” or pain point in combining data across domains or multiple systems? #HITsm

T2: What is the most valuable data that’s not being used today in #healthcare due to cost / complexity of integration? #HITsm

T3: What data impacts #healthcare consumer / member / patient experience and service the most? #HITsm

T4: 80% of all data is unstructured. What types of unstructured data can help improve service, outcomes & lower costs the most? #HITsm

T5: Why should scarce resources be invested in analytics before combining, enriching, harmonizing and operationalizing data first? #HITsm

Bonus: Why do firms continue using legacy ETL & tools vs adopting a “next gen” data integration platform approach? #HITsm

Upcoming #HITsm Chat Schedule
7/21 – Meeting the Patient Where They Are
Hosted by Melody Smith Jones (@MelSmithJones) from HYP3R

7/28 – How Does Age Impact Patient Satisfaction & Provider Switching?
Hosted by Lea Chatham (@leachatham) from @SolutionReach

8/4 – TBD
Hosted by Alan Portela (@AlanWPortela) from Airstrip

8/11 – TBD
Hosted by TBD

8/18 – Diversity in HIT
Hosted by Jeanmarie Loria (@JeanmarieLoria) from @advizehealth

8/25 – TBD
Hosted by TBD

We look forward to learning from the #HITsm community! As always let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

The Fight For Patient Health Data Access Is Just Beginning

Posted on July 11, 2017 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.

When some of us fight to give patients more access to their health records, we pitch everyone on the benefits it can offer — and act as though everyone feels the same way.  But as most of us know, in their heart of hearts, many healthcare industry groups aren’t exactly thrilled about sharing their clinical data.

I’ve seen this first hand, far too many times. As I noted in a previous column, some providers all but refuse to provide me with my health data, and others act like they’re doing me a big favor by deigning to share it. Yet others have put daunting processes in place for collecting your records or make you wait weeks or months for your data. Unfortunately, the truth, however inconvenient it may be, is that they have reasons to act this way.

Sure, in public, hospital execs argue for sharing data with both patients and other institutions. They all know that this can increase patient engagement and boost population health. But in private, they worry that sharing such data will encourage patients to go to other hospitals at will, and possibly arm their competitors in their battle for market share.

Medical groups have their own concerns. Physicians understand that putting data in patient’s hands can lead to better patient self-management, which can tangibly improve outcomes. That’s pretty important in an era when government and commercial payers are demanding measurably improved outcomes.

Still, though they might not admit it, doctors don’t want to deluge patients with a flood of data which could cause them to worry about inconsequential issues, or feel that data-equipped patients will challenge their judgment. And can we please admit that some simply don’t like ceding power over their domain?

Given all of this, I wasn’t surprised to read that several groups are working to improve patients’ access to their health data. Nor was it news to me that such groups are struggling (though it was interesting to hear what they’re doing to help).

MedCity News spoke to the cofounder of one such group, Share for Cures, which works to encourage patients to share their health data for medical research. The group also hopes to foster other forms of patient health data sharing.

Cofounder Jennifer King told MCN that patients face a technology barrier to accessing such records. For example, she notes, existing digital health tools may offer limited interoperability with other data sets, and patients may not be sure how to use portals. Her group is working to remove these obstacles, but “it’s still not easy,” King told a reporter.

Meanwhile, she notes, almost every hospital has implemented a customized medical record, which can often block data sharing even if the hospitals buy EMRs from the same vendor. Meanwhile, if patients have multiple doctors, at least a few will have EMRs that don’t play well with others, so sharing records between them may not be possible, King said.

To address such data sharing issues, King’s nonprofit has created a platform called SHARE, an acronym for System for Health and Research Data Exchange. SHARE lets users collect and aggregate health and wellness data from multiple sources, including physician EMRs, drug stores, mobile health apps and almost half the hospitals in the U.S.

Not only does SHARE make it easy for patients to access their own data, it’s also simple to share that data with medical research teams. This approach offers researchers an important set of benefits, notably the ability to be sure patients have consented to having their data used, King notes. “One of the ways around [HIPAA] is that patient are the true owners,” she said. “With direct patient authorization…it’s not a HIPAA issue because it’s not the doctor sharing it with someone else. It’s the patient sharing it.”

Unfortunately (and this is me talking again) the platform faces the same challenges as any other data sharing initiative.

In this case, the problem is that like other interoperability solutions, SHARE can only amass data that providers are actually able to share, and that leaves a lot of them out of the picture. In other words, it can’t do much to solve the underlying problem. Another major issue is that if patients are reluctant to use even something as simplified as a portal, they’re not to likely to use SHARE either.

I’m all in favor of pushing for greater patient data access, for personal as well as professional reasons. And I’m glad to hear that there are groups springing up to address the problem, which is obviously pretty substantial. I suspect, though, that this is just the beginning of the fight for patient data access.

Until someone comes up with a solution that makes it easy and comfortable for providers to share data, while diffusing their competitive concerns, it’s just going to be more of the same old, same old. I’m not going to hold my breath waiting for that to happen.

Is Your Revenue Cycle Suffering? – Breakaway Thinking

Posted on July 10, 2017 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 Breakaway Thinking blog post series which is sponsored by Breakaway Learning Solutions, a Conduent Company.

Healthcare and specifically healthcare IT seems to be full of distractions. There has always been a lot of regulations in healthcare, but lately, it seems overwhelming. We’re just coming out of one of the most overwhelming distractions to hit healthcare, meaningful use. However, just behind it is MACRA. If you’re part of any healthcare IT organization, you are certainly all too familiar with the impact these regulations have had on your organization.

While each of these regulations is important to your organization, it is worth taking the time to step back and evaluate what areas of your organization might be suffering because you were distracted by meaningful use and now MACRA. One area that’s suffered from these distractions is revenue cycle management. The harsh reality is that when we lose focus on revenue cycle management, it suffers.

Along with losing focus on revenue cycle management, other things are causing organizations’ revenue cycle efforts to underperform. One example of this is the impact switching to an all-in-one EHR system has had on revenue. Many organizations understand that there are benefits to a tightly integrated all-in-one system, but in many cases, these organizations have found that the revenue cycle management in these all-in-one systems is inferior to what they were using previously.

In some cases, the new system is the problem and is causing revenue shortfall. In other situations, when the organization switched to the new revenue cycle management system they didn’t train the users effectively on the new system. So much focus is paid on training the doctors and nurses, it’s easy to see how your revenue cycle professionals don’t get the training they need. Properly training these people on the new system can pay big dividends on the revenue side of things.

Related to training, many healthcare organizations are finding it a challenge to retain their high-quality revenue cycle staff. When a new staff joins the organization, they also will often suffer from poor quality training which directly impacts the bottom line as revenue cycle suffers. Creating a consistent and structured program for training new staff on your revenue cycle management software is a great investment for every organization. Plus, it will help retain those new employees who want to stay with an organization who cares about making sure they’re well trained to perform their job.

No doubt revenue cycle management is only one area that’s suffering amidst all of the regulations and distractions we experience in healthcare IT. Take the time now to sit down and understand what areas of your organization could benefit from some added attention, focus, and training. You’ll be surprised at the opportunities available to improve your organization similar to what’s described above for revenue cycle management.

Learn more about the Breakaway Thinking blog series sponsor, Breakaway Learning Solutions, and download their FREE whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

Tips on Implementing Text Analytics in Healthcare

Posted on July 6, 2017 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.

Most of us would agree that extracting clinical data from unstructured physician notes would be great. At present, few organizations have deployed such tools, nor have EMR vendors come to the rescue en masse, and the conventional wisdom holds that text analytics would be crazy expensive. I’ve always suspected that digging out and analyzing this data may be worth the trouble, however.

That’s why I really dug a recent article from HealthCatalyst’s Eric Just, which seemed to offer some worthwhile ideas on how to use text analytics effectively. Just, who is senior vice president of product development, made a good case for giving this approach a try. (Note: HealthCatalyst and partner Regenstrief Institute offer solutions in this area.)

The article includes an interesting case study explaining how healthcare text analytics performed head-to-head against traditional research methods.

It tells the story of a team of analysts in Indiana that set out to identify peripheral artery disease (PAD) patients across two health systems. At first gasp, things weren’t going well. When researchers looked at EMR and claims data, they found that failed to identify over 75% of patients with this condition, but text analytics improved their results dramatically.

Using ICD and CPT codes for PAD, and standard EMR data searches, team members had identified less than 10,000 patients with the disorder. However, once they developed a natural language processing tool designed to sift through text-based data, they discovered that there were at least 41,000 PAD patients in the population they were studying.

To get this kind of results, Just says, there are three key features a medical text analytics tool should have:

  • The medical text analytics software should tailor results to a given user’s needs. For example, he notes that if the user doesn’t have permission to view PHI, the analytics tool should display only nonprivate data.
  • Medical text analytics tools should integrate medical terminology to improve the scope of searches. For example, when a user does a search on the term “diabetes” the search tool should automatically be capable of displaying results for “NIDDM,” as this broadens the search to include more relevant content.
  • Text analytics algorithms should do more than just find relevant terms — they should provide context as well as content. For example, a search for patients with “pneumonia,” done with considering context, would also bring up phrases like “no history of pneumonia.” A better tool would be able to rule out phrases like “no history of pneumonia,” or “family history of pneumonia” from a search for patients who have been treated for this illness.

The piece goes into far more detail than I can summarize here, so I recommend you read it in full if you’re interested in leveraging text analytics for your organization.

But for what it’s worth, I came away from the piece with the sense that analyzing your clinical textual information is well worth the trouble — particularly if EMR vendors being to add such tools to their systems. After all, when it comes to improving outcomes, we need all the help we can get.

International EHR Adoption: Challenges and Solutions – #HITsm Chat Topic

Posted on July 5, 2017 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 7/7 at Noon ET (9 AM PT). This week’s chat will be hosted by Stefan Buttigieg, MD (@stefanbuttigieg) on the topic of “International EHR Adoption: Challenges and Solutions.”

EHR Adoption around the world is still a contentious issue which a large number of healthcare providers still struggle with, especially in continents like Europe. Healthcare I.T Professionals, many time struggle to convince senior management amidst spiralling costs, significant changes in Healthcare System Legislations and Cybersecurity challenges. 59% of 27 EU Member States have an implemented electronic health record whilst the US has a 67% Adoption rate, what can we do better?

Please join us for this week’s #HITsm chat focused on International EHR Adoption. We’ll use the following 6 questions as the framework for the discussion:

This Week’s Topics
T1: What are your EHR Adoption Success Stories? #HITsm

T2: What lessons have you learnt from your EHR Adoption? #HITsm

T3: What challenges are you facing within your country for EHR Adoption? #HITsm

T4: How has legislation supported EHR Adoption in your country? #HITsm

T5: Open-Source, Off-the-Shelf or Custom? #HITsm

Bonus: Economic Incentives or not? Do they work? #HITsm

Upcoming #HITsm Chat Schedule
7/14 – Healthcare Integration Cutting Room Floor: Cluttered with valuable unused and ‘laundered’ data
Hosted by Bill Fox (@FoxBigData) of @MarkLogic

7/21 – Meeting the Patient Where They Are
Hosted by Melody Smith Jones (@MelSmithJones) from HYP3R

7/28 – How Does Age Impact Patient Satisfaction & Provider Switching?
Hosted by Lea Chatham (@leachatham) from @SolutionReach

8/4 – TBD
Hosted by Alan Portela (@AlanWPortela) from Airstrip

We look forward to learning from the #HITsm community! As always let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Providers Work To Increase Patient Payments By Improving RCM Operations

Posted on June 29, 2017 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.

A growing body of research on healthcare payment trends is underscoring a painful fact: that consumers are footing a steadily growing share of their medical bills, and sometimes failing to pay. In response, providers are upgrading their revenue cycle management systems and tightening up their collections processes.

A new analysis by payment services vendor InstaMed has concluded that consumer spending on healthcare services should grow to $608 billion by 2019. This is a fairly substantial number even given the high volume of U.S. healthcare spending, which hit $3.4 trillion in 2016.

The growth in patient spending has been fueled by the emergence of high-deductible health plans, which are saddling consumers with increasingly large financial obligations. According to CMS figures cited in the report, the average deductible for covered workers with single coverage has doubled over the past several years, from $735 in 2010 to $1.487 in 2016.

But despite the increasing importance of consumers as healthcare payers, providers don’t seem to be doing enough to inform them about costs. More than 90% of consumers would like to know what the payment responsibility is prior to a provider visit, but they often don’t find out what they owe until they get a bill. What makes things worse is that very few consumers (7%) even know what a deductible, co-insurance and out-of-pocket maximum are, so they’re ill-prepared to understand bills when they receive them, studies have found.

Providers are waiting longer to collect what they are owed by patients, with three-quarters waiting a month or longer to collect outstanding balances from patients. And problems with collecting patient accounts are getting worse over time.  In fact, a new study from TransUnion Healthcare found that about 68% of patients with bills of $500 or less didn’t pay off the full balance during 2016, up from 49% in 2014.

Meanwhile, patient financial responsibility for care has risen from 10% to 30% of costs over the last few years, with more increases likely. This has led to expanding levels of consumer bad debt for medical expenses.

In attempt to cope with these issues, providers are buying new revenue cycle management systems. A survey released last year by Black Book Research, which included 5,000 management and user-level RCM clients, found that many healthcare organizations are rethinking RCM technology and demanding better performance.

Forty-eight percent of responding CFOs told Black Book that they weren’t sure they had the budget they needed to upgrade to an end-to-end RCM system this year.  Nonetheless, 93% of CFOs said they planned to eliminate RCM vendors, financial and coding technology firms, that are not producing a return on investment, up from 79% with similar plans in Q4 2015.

In addition to investing in newer RCM technology, providers are making it easier for patients to pay via whatever medium they choose. Not only are providers issuing bill reminders via text, and accepting payments online and by phone, they’re also adding new channels like PayPal payments, bank transfers and mobile payments.

The New Leadership Agenda: 6 Effective Strategies for Driving the Adoption of Healthcare Technology – Breakaway Thinking

Posted on June 28, 2017 I Written By

The following is a guest blog post by Heather Haugen, PhD, Managing Director and CEO at The Breakaway Group (A Conduent Company). Check out all of the blog posts in the Breakaway Thinking series.
Heather Haugen
In executive conference rooms around the country, a common dialogue is emerging. In the wake of multi-million-dollar investments in electronic health record (EHR) systems, healthcare leaders are admitting that they underestimate the “care and feeding” of adopting these new applications. Whether this realization occurs from implementing a new system for the first time, or replacing an existing legacy application, the challenges are largely the same. Change fatigue, resource shortages, user resistance, workarounds, patient safety concerns – all reflect barriers healthcare leaders face adopting new healthcare technology.

But there is good news for healthcare leaders. This month marks the release of the new edition of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology. The book offers healthcare leaders a playbook for approaching and leading the effort to adopt clinical information systems.

The book explores several important leadership strategies that have proven invaluable to healthcare executives around the country.

Strategy #1: Establish a New Leadership Agenda

Leadership is the most fundamental driver of EHR adoption. Because of its importance to the success of the initiative, leaders must relentlessly commit to making EHR adoption a daily priority for executive teams. This includes focusing on the factors that drive optimal use of clinical information systems long after the implementation.

Strategy #2: Stop Doing List

Time is a scarce and vital asset for every executive team, which faces a host of competing priorities and time-sensitive initiatives. The most successful leadership teams prioritize the right projects that add the most value to the organization. One strategy is to develop a Stop Doing List, a concept popularized by renowned author Jim Collins. The Stop Doing List is the process of choosing which initiatives to stop in order to focus on the most crucial activities. For healthcare leaders, this means eliminating or reprioritizing enough projects to make EHR adoption among the top three priorities for the organization. To develop a Stop Doing List, Beyond Implementation recommends prioritizing initiatives per these criteria:

  • Projects/meetings that do not directly affect quality of care or safety
  • Projects/meetings that are not related to compliance or legal risk
  • Projects that can be delayed with little overall impact
  • Meetings that can be eliminated or consolidated

Strategy #3: Engage Clinical Leadership

Providers carry a powerful voice in a healthcare setting. Leaders must actively engage providers and promote their buy-in through several strategies. One strategy includes developing a provider council. Including representation from across the organization, endorsement from top leadership, and a formal charter and vision for the body, this council should oversee and govern EHR use.  Another strategy is to engage members of the council to serve as champions of the effort by helping their departmental colleagues and serving as an extension of leadership.

Strategy #4: Create a Tone at the Top

Crucial to engaging users in the effort is establishing a tone that emphasizes EHR adoption. Leadership must promote awareness of the initiative by creating a value proposition and brand that connects the EHR system with the organizational vision and mission. Leadership must also establish a rhythm with their messaging and ensure it remains authentic when interacting with users. Leadership should make it a focus to answer key questions about the transition, such as how EHR adoption improves clinical and financial outcomes and how the change will affect users individually. Establishing the importance of the effort, as well as being open and transparent, helps users navigate and accept the transition more easily.

Strategy #5: Governance

Governance is also another key ingredient of effective leadership. Competing interests, differing opinions, and varying experiences all pose barriers to EHR adoption. Leadership must develop a well-defined governance process, which overcomes these barriers by creating policies and procedures that hold users accountable and define expectations and best practices around use of the system. The governance process should evolve over time to address the evolving needs of users as they adopt the application. After developing the governance process, leadership must measure its effectiveness to enforce accountability and make continuous improvements.

Strategy #6: Track Performance Metrics to Drive Continuous Improvements

To improve outcomes, leadership must track the clinical and financial results of EHR adoption. Leadership should identify, select, and empower the right individuals to lead this effort. These individuals should collect, analyze, and report performance metrics that are important to caregivers and will motivate engagement and improvement.

To see improved clinical and financial outcomes, healthcare leaders must ignite and sustain the movement toward the adoption of clinical information systems. It starts with establishing a new leadership agenda that places adoption at the forefront of organizational priorities and continues through strategies that facilitate engagement, communication, governance, and measurement. When leaders engage in these activities, adoption becomes a pervasive mindset across the organization for optimal results.

Conduent is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training. Download their Free Whitepaper “Leadership Insights: Gaining Value from Technology Investments.”

Should We Even Need to Debate EHR Interoperability?

Posted on June 26, 2017 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 saw this tweet from Former AMA president and emergency Physician, Steven J. Stack, and the way he phrased it really struck me:

Do we really need to debate EHR interoperability? A debate would assume that some people think that interoperability is a bad idea. I have yet to meet someone that says that healthcare shouldn’t have EHR data interoperability. Unlike a lot of things happening in healthcare, everyone can see the value of sharing healthcare data.

The only arguments I’ve ever seen against EHR data sharing come from privacy and security advocates that suggest that sharing EHR data can go to far. Reminds me of the cartoon I saw that said something like “How come every hacker can get my health information, but my doctor can’t?” No doubt there are privacy and security concerns related with EHR data sharing, but they can all be solved. Healthcare interoperability is not being impeded by the need for privacy and security.

I’d suggest that the debate on healthcare interoperability is over. We know it’s the right thing to do. The only question is which organization is going to embrace it first and make it a reality. Format, standard, protocols, etc will matter little once we have organizations that have the will to share data.

Let’s stop debating healthcare interoperability and let’s start sharing.