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Is Healthcare Missing Out on 21st Century Technology?

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This tweet struck me as I consider some of the technologies at the core of healthcare. As a patient, many of the healthcare technologies in use are extremely disappointing. As an entrepreneur I’m excited by the possibilities that newer technologies can and will provide healthcare.

I understand the history of healthcare technology and so I understand much of why healthcare organizations are using some of the technologies they do. In many cases, there’s just too much embedded knowledge in the older technology. In other cases, many believe that the older technologies are “more reliable” and trusted than newer technologies. They argue that healthcare needs to have extremely reliable technologies. The reality of many of these old technologies is that they don’t stop someone from purchasing the software (yet?). So, why should these organizations change?

I’m excited to see how the next 5-10 years play out. I see an opportunity for a company to leverage newer technologies to disrupt some of the dominant companies we see today. I reminded of this post on my favorite VC blog. The reality is that software is a commodity and so it can be replaced by newer and better technology and displace the incumbent software.

I think we’ve seen this already. Think about MEDITECH’s dominance and how Epic is having its hey day now. It does feel like software displacement in healthcare is a little slower than other industries, but it still happens. I’m interested to see who replaces Epic on the top of the heap.

I do offer one word of caution. As Fred says in the blog post above, one way to create software lock in is to create a network of users that’s hard to replicate. Although, he also suggested that data could be another way to make your software defensible. I’d describe it as data lock-in and not just data. We see this happening all over the EHR industry. Many EHR vendors absolutely lock in the EHR data in a way that makes it really challenging to switch EHR software. If exchange of EHR data becomes wide spread, that’s a real business risk to these EHR software companies.

While it’s sometimes disappointing to look at the old technology that powers healthcare, it also presents a fantastic opportunity to improve our system. It is certainly not easy to sell a new piece of software to healthcare. In fact, you’ll likely see the next disruptive software come from someone with deep connections inside healthcare partnered with a progressive IT expert.

July 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Focused EMR Discussion Boards

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When I was speaking at the gMed user conference, I learned about many of the users who participated on a GI focused online forum for gMed users. Essentially it’s an independent user group for gMed EHR users. Although, with so many GI doctors in one place, you can be sure there are all sorts of focused discussions that would be of interest to gastroenterology doctors.

Of course, there are a lot of other online forums that are similar to the GI forum. For example, Amazing Charts has a really active user forum. The open source EHR, OpenEMR also has a forum. I’m sure there are a lot more. I’d love to hear about other EHR forums you know about in the comments.

Many people probably don’t know that I built up much of my EMR knowledge participating in the now defunct EMR Update. It was a fantastic way for me to learn and share my knowledge. I’m sure that those who participate in the various EMR forums above get the same benefit. Although, it’s probably even more valuable since the forums above are all on the same EHR software.

I can’t tell you how valuable it is for a clinic to be able to turn to other users when they run into trouble. One of the best ways to optimize your EHR is to interact and exchange ideas with other end users. That’s why I’ve started creating a list of EHR user conferences as well. However, for those who can’t take the time off to go to a user conference, an online discussion forum is a great alternative. I’m surprised that more EHR vendors don’t create these types of forums.

July 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

10 Ways Many Dental Offices Are Breaching HIPAA

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The following is a guest blog post by Trevor James.

If you work in the health/dental/medical space, you already know that HIPAA violations are a serious matter. Fines today for not complying with HIPAA laws and regulations are a minimum of $100-$50,000 per violation or record and a maximum of $1.5 million per year for violations of the same provision. Some violations also carry criminal charges with them, resulting in jail time for the violators.

Many dental offices are breaching HIPAA laws without realizing it or have employees doing so without their knowledge.

If you’re a dentist, office manager, or someone who’s been tasked with ensuring HIPAA security within your group, here are the 10 most common ways dental offices are breaching HIPAA regulations so your practice doesn’t make the same mistakes as others.

1. Devices with patient information being stolen

This is a common HIPAA violation for dental offices. It’s important to ensure the devices your dental office uses, like USB flash drives, mobile devices and laptops, are carefully handled and securely stored to prevent them and the patient information on them from being stolen.

2. Losing a device with patient information

Along the same lines as above, it’s also easy (and common) for an employee to lose those kinds of devices. USB flash drives and mobile devices are smaller items, so it’s easy to misplace them. When that happens, it’s easy for sensitive patient information to end up in the wrong hands.

Train your employees on the importance of properly handling these devices and set up some sort of tracking device, like downloading the Find My iPhone app or Where’s My Droid, to help you locate a device if it ends up lost.

3. Improperly disposing of papers and devices with patient information

When it comes time to get rid of papers or devices containing dental records or billing information, be sure you properly dispose of them. Crumpling paper in a ball and throwing it in the trash isn’t the correct way to do things nor is shutting down a device and then tossing it in the garbage. Use a paper shredder and wipe your devices clean of all information before disposing of them.

4. Not restricting access to patient information

Unauthorized access to a patient’s dental information will get you in serious trouble with HIPAA. Patients trust your office with this personal information, so be smart when handling such information so other patients, employees and relatives who aren’t allowed access don’t come across it.

A dental practice breached HIPAA in a case relating to this when they put a red sticker reading “AIDS” on the outside cover of patient folders and those not needing to know said information were able to read it while employees handled the folders. Don’t make simple, costly mistakes like they did.

5. Hacking/IT incidences

Most patient dental information now is stored on computers, laptops, mobile devices, and in the cloud. Today’s technology allows dental practices to more easily communicate, and look up and share patient information or their status on these devices.

The downfall of this technology is the people who are just as smart or smarter than your technology and hack into your devices or systems to get their hands on patient information. Make sure every device has some type of passcode or authentication to get on, install encryptions and enable personal firewalls and security software.

6. Sending sensitive patient information over email

While it’s not a violation to send these kinds of emails, it is a violation if the email is intercepted and/or read by someone without authorized access. Use encryptions and double check that whomever you’re sending the email to is supposed to be receiving the email.

7. Leaving too much patient information over a phone message

A patient may give you the A-Okay to call them, but be sure you don’t leave a message disclosing too much of their information. A friend or family member could check your patient’s message and hear things they shouldn’t, making said patient upset, or equally as bad, you could call the wrong number and say more than you should, which would probably make your patient even more upset with you. Your safest bet when calling a patient and they don’t answer is to leave a message for them to call you back.

8. Not having a “Right to Revoke” clause

When your dental office creates its HIPAA forms, you have to give your patients the right to revoke the permissions they’ve given to disclose their private dental information to certain parties. Not providing this information means your HIPAA forms are invalid and releasing subsequent information to another party puts you in breach of HIPAA.

9. Employees sharing stories about patient cases

People talk. It’s a simple fact. Employees talk with one another and they also talk to patients every workday. Remind them, though, that discussing a patient’s information to an employee lacking authorized access or to other patients is unprofessional and puts your whole practice at risk of being fined by HIPAA.

10. Employees snooping through files

It might seem shocking — or maybe not to some — but employees have been caught snooping through patient and co-worker files before. They do this to find out information for themselves but also because relatives or friends ask them to find things out about a certain person. Snooping is wrong and unprofessional on all levels.

Make sure your employees are clear on this and that they understand how bad the consequences can be for them and your office for doing so.

HIPAA violations in dental offices are all too common. Now that you know the top 10 ways dental offices are breaching HIPAA, you can take every precaution necessary to prevent your practice from violating any HIPAA laws and regulations.

About The Author

Trevor James is the marketing manager for Dentrix Ascend, a cloud based dental practice management software and Viive, a dental practice software for Mac’s.

July 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Value of Data, EMR Jobs, and EMR vs EHR

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I agree with Wen that the EMR and claims data needs to be cleaned up. I think it gives the wrong message to say it’s not meaningful though. Once it’s cleaned up, it has a lot of value.


How many of you have applied for a job because you saw it posted on Twitter? I’m really interested in this since I do a lot of health IT job posts on Twitter. We see quite a bit of traffic from Twitter to our healthcare IT job board, but I haven’t added a good way to track who signs up and applies for jobs. That’s next.


I love how academic Practice Fusion tries to make the discussion. I thought I made the discussion of EMR vs EHR much simpler.

July 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

HIPAA Risk Assessment Infographic

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I’ll admit that I’m a sucker for infographics. I usually post the various EHR infographics I find on EMR Thoughts, but this one seemed more appropriate to post on EMR and HIPAA. You can find all of the various EHR and Health IT infographics I’ve posted on this Healthcare IT Infographic pinterest board as well.

Thanks to Coalfire for putting together this HIPAA Security Risk Analysis Myths infographic.

Update: David Harlow offered this interesting note that might be helpful to some “The infographic suggests that only covered entities need to undergo a security risk assessment. In the EHR context that makes sense, since them with EHRs are CEs, but of course Business Associates need to do this too.”

HIPAA Risk Assessment Infographic

July 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Practical Application of Watson with EHR

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Ever since Watson made its debut on Jeopardy, I haven’t been able to not check out what Watson was doing next. No doubt what Watson did on Jeopardy was impressive. However, it’s one thing to do what it did on Watson. It’s another thing to commercialize the Watson into something useful.

I’d long been hearing that Watson was going to be great for healthcare IT and that healthcare would really benefit from the technology. However, everything I saw felt very conceptual as opposed to practical and implemented. So, I was really interested in talking with Modernizing Medicine about their EHR integration with Watson.

You can find my interview with Daniel Cane and Dr. Michael Sherling, Founders of Modernizing Medicine, talking about Watson and some of the other cool ways they’re trying to help doctors make use of the data in an EHR in the video below. Plus, we even talk ICD-10 and MU 2 delay as well.

Note: Modernizing Medicine is a Healthcare Scene advertiser.

July 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Taking Down Dr. Oz

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I briefly mentioned Dr. Oz in my recent post about NY Med (and the healthcare social media firing). It’s clear to anyone watching the show that Dr. Oz is there for the celebrity factor and not for the actual medical work. He’s always “partnered” with another cardiologist who provides the actual patient care. Of course, I don’t really care too much that he’s on it or not. If it gives them a boost in ratings, good. I like the show.

However, I don’t know a single doctor that likes Dr. Oz and I know many of them who hate Dr. Oz. With this in mind, I found this interview with a medical student whose trying to “take down” Dr. Oz quite interesting. Here’s a short take on what this med student is doing:

Last year, Mazer brought a policy before the Medical Society of the State of New York—where Dr. Oz is licensed—requesting that they consider regulating the advice of famous physicians in the media. His idea: Treat health advice on TV in the same vein as expert testimony, which already has established guidelines for truthfulness.

Although, this quote is really powerful as well, “DR. OZ HAS SOMETHING LIKE 4-MILLION VIEWERS A DAY. THE AVERAGE PHYSICIAN DOESN’T SEE A MILLION PATIENTS IN THEIR LIFETIME.”

This is absolutely one of the problems with social media and other medium like television. The person with the biggest voice doesn’t always have the best information. In fact, sometimes the wrong information is the best way to grow an audience. What’s popular is not always what’s right.

Mazer in his interview highlights the biggest problem with some of the things that Dr. Oz says. The movement in healthcare has largely been towards evidence based medicine. I think that movement will only grow stronger as we can prove the effectiveness of care even better. However, many of the things on Dr. Oz’s show go contrary to evidence based medicine. This leaves the patient-doctor relationship at a cross roads when a patient chooses to follow something they’ve seen on TV versus the advice of the doctor (even if the doctor is on the side of evidence).

Dr. Oz aside, the same principle applies to other information patients might find on the internet. Many doctors would like to just brush this aside and say that patients should “trust” them since there’s bad information on the internet or there’s a bigger picture. That might work in the short term, but won’t last long term.

Long term doctors are going to have to take a collaborative approach with patients. As patients we just have to be careful that we don’t take it too far. Collaboration means that the patient needs to be collaborative as well.

The other way for doctors to battle the misinformation out there is to provide quality sources of trusted information. One way this will happen is on the physician website. Instead of being a glorified yellow page ad, the physician website is going to have to do more to engage and educate patients. That’s part of the opportunity and vision for Physia. It’s an exciting time to be in healthcare…if you like change.

July 23, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Harnessing Open Source Technology to Drive Outcomes in Healthcare

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I’ve long been a fan of open source technologies. My blogs are run and created almost entirely on open source software. In fact, I first wrote about open source EMR on this blog back in January of 2006. We’ve come a long way since then with Vista being the top open source EHR in the hospital world and OpenEMR leading the pack in the ambulatory world.

We’re starting to see more and more application of open source technology in other areas of healthcare IT beyond EMR as well. There are some really amazing advantages to a thriving open source community. I think the key there is to have a thriving open source community behind the project. It’s not enough to just say that your software is open source. If you don’t have a great community behind the project, then the open source piece doesn’t do too much for you.

With that said, I was really intrigued by this whitepaper from Achieve Health that talks about why they are applying the popular open source Drupal framework to healthcare. While I’ve mostly used WordPress for the things I’ve done, I’ve had a chance to use Drupal for a few projects and I’m really intrigued by the idea of applying the Drupal framework to healthcare.

This section of the whitepaper describes their vision really well:

Drupal is not a replacement for legacy IT systems from EMRs, Billing, Practice Management etc., but rather an extension to these systems. Through sophisticated integrations Drupal can enhance the functionality of each system concurrently. While there is no one panacea for the trials ahead, Drupal is highly capable of rising to meet many of the existing and future challenges the industry has to offer.

In the whitepaper they mention open source success stories like Pfizer, Florida Hospitals, Amerigroup Health Services, and Alliance Imaging. I think we’ll continue to hear of more and more open source success stories in healthcare for the reasons outlined in the whitepaper Harnessing Open Source Technology to Drive Outcomes in Healthcare. It takes a bit of a different mentality to go the open source route, but those who do are usually very satisfied. I think healthcare IT could really benefit from this shift in mentality.

July 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

EHR Vendors Need to Expand Their Definition of Customer Service

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Living in Las Vegas I likely have a skewed idea of what customer service means. In the tech world, we have Zappos headquarters in downtown Las Vegas. Most of you are likely familiar with Zappos unique approach to customer service. They really have taken customer service to the next level and created an entire company culture around the customer service they provide. The same could be said for the experience that the various casinos on the strip offer their customers. They do a really amazing job at most casinos providing an amazing customer service experience.

With this background, I find it really smart of Kareo to open an office in Las Vegas. Although, that’s not really the point of this post. Instead, I want to focus on the idea that most EHR vendors need expand their idea of customer service.

As I look at the world of EHR customer service I see so many organization lacking. Certainly we see examples of terrible EHR customer service that include calling into a call center in another country where the person doesn’t speak English and has no power to actually solve a user’s problems (Disclaimer: I don’t have a problem with call centers in other countries if they are well trained and can actually solve problems). Of course, the same thing can apply to a call center in the US who can’t solve the users’ actual problems. Both are terrible customer service and a problem in the industry. However, there’s a far more painful problem that I don’t think most EHR vendors consider a part of their customer service plan and 99% of EHR vendors have done terrible at this.

Adding new features and accommodating an EHR user’s feature request is just as much a part of the EHR customer service experience as the person who answers the phone. I can assure you that every EHR vendor out there would get rated an F the past few years when it comes to this form of EHR customer service. Why do I know this? I know this because every EHR vendor has been focused on meaningful use that they haven’t had the time to add any meaningful EHR user feature requests and features outside of meaningful use.

This isn’t EHR vendors’ fault. The end users have required it and EHR vendors have had to spend the time doing it. However, EHR customer service has suffered as a consequence. Don’t believe me. Look through all the EHR press releases that have been released over the past couple years. Find me the plethora of press releases that talk about the innovations that EHR vendors have created for their end users that aren’t related to meaningful use. I get the press releases and they’re MIA.

That’s not to say that EHR vendors have done nothing for end users. They’ve made some incremental progress on a few things, but meaningful use has zapped their development time. Stage 2 was even worse. I look forward to the new day where EHR vendors can focus on great customer service and EHR features and not just MU.

July 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

What If Your EHR Only Had 25 Doctors?

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I recently had lunch with an EHR vendor that had an extremely small number of providers. I’ve known this EHR vendor for about 5 years, so this isn’t a new EHR vendor that’s trying to establish themselves in the industry. Instead they’ve focused on having a small, nimble team that’s focused on making the EHR work the right way for the doctors. It’s a novel approach I know, but pretty interesting that his business can survive with so few providers. Also worth noting is that the EHR is certified for meaningful use stage 2 as well.

Now think for a minute how the development process of an EHR vendor would be better if your EHR only had 25 doctors (For the record, the EHR vendor above has a few more than 25 doctors). Would it be much easier to satisfy just 25 physician users? Imagine the personalized service you could provide your users.

One of the real challenges I’ve seen with EHR vendors is that when they’re small, they are extremely responsive to their end users and the end users are very happy. As the EHR vendor grows, they lose that personal touch with the end users and many of those originally happy end users become dissatisfied with their EHR experience.

The problem with scaling an EHR user base is that you can’t make everyone happy. You have to make compromises that will be great in some people’s eyes and terrible in another person’s mind. What large EHR vendors do to try and solve this problem is they create configurable options that allow the end user to customize their system to meet their personal needs. Problem solved, right?

The problem with these configurations is two fold. First, you can’t make everything configurable. Once you go down the path of making everything configurable, it never ends. There’s always something else that could be made more configurable. So, the culture of configurability leads to unsatisfied users who can’t customize everything (even if what they want to customize shouldn’t matter).

Second, if everything is configurable, then it makes the implementation that much more complex. I’ve written before about the need for EHR vendors to have great “out of the box” user experience, but balancing that with allowing the user to configure everything that’s needed. This is a real challenge and most fail. Just look at the number of high priced EHR consulting companies out there. Many of them could better be defined as EHR configuration companies since the configuration needs are so large and complex.

Returning to where we started, when you’re an EHR vendor with 25 doctors you don’t have to build in all the flexibility and configurability. You’re small enough that as an EHR vendor you can do any needed customizations and configurations for the end user. Plus, with this kind of personalized service you can charge a little extra as well.

When you look at EHR development, there’s a spectrum of approaches starting with a fully in house, custom designed EHR through a fully outsourced EHR that can apply to any organization or specialty. In many ways a 25 doctor EHR has a lot of the same benefits of a fully custom EHR software, but spreads the costs of development across more doctors.

As a business, maybe a 25 doctor EHR company won’t dominate the world. Maybe they won’t have a huge exit to some other company or an IPO. However, that doesn’t mean it’s not a great small business if it’s doing something you love. Once you get World Domination out of your sites, it changes a lot of things about how you do business.

July 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.