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Nursing Informatics Pros Seeing Growing Salaries, Opportunities

Posted on March 24, 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.

Here’s something I missed in the explosion of news around HIMSS17. According to a recent study released late last month by the organization, nurse informaticists are largely well-paid and satisfied with their jobs.

According to the American Nurses Association, nurse informaticists have broad responsibilities, including integrating data and supporting provider and patient decision-making. The job description continues evolve with health IT trends, and may vary from one institution to the other,but their work usually involves a mix of nursing science, health records management and information technology solutions.

As the job description has solidified, nursing informatics has begun to become a well-liked specialty. Eighty percent of respondents to the HIMSS study, the 2017 Nursing Informatics Workforce Survey, reported being satisfied or highly satisfied with their careers, HIMSS found. This may be in part due to their pay, with almost half respondents telling researchers that they had a base salary of over $100,000. Not only that, 34 percent said they also got a bonus.

Meanwhile, highly-trained nursing informaticists did better still. Those who had gotten a nursing informatics certification or post-graduate degree took home higher salaries than those who hadn’t. With over half of those who had additional education made more than $100,000 a year, as opposed to 37 percent of those who didn’t, the trade group said.

In addition, nurse informaticists are advancing themselves to a striking degree, with over half of respondents having a post-graduate degree, often in informatics or nursing informatics, HIMSS reported. (Of this group, 57 percent had completed post-graduate degrees, and 29 percent had a master’s degree or PhD in informatics.)

Meanwhile, 41 percent of nurses are involved in a formal informatics program, and almost half had a certification. These efforts seem be paying off, with two-fifths of respondents reporting that they moved into a new position with more responsibility after they got certified.

As nurse informaticists grow, they are accumulating deeper levels of experience.  All told, 31 percent of respondents had more than 10 years of informatics experience, 36 percent had five to 10 years of experience – dwarfing the 24 percent that had just one to four years. One-third of respondents said they’d been in their current position for more than five years, and a majority of respondents reported having seven years plus of related experience.

While these nurses seem like they enjoy their careers, they are still facing some bureaucracy-related problems.  For example, when asked about their concerns, they rated a lack of administrative and staffing resources as the top barrier to their success.

Ongoing shifts in their reporting roles may also be leading to some dissatisfaction. While most respondents told HIMSS that they reported to the information systems or tech department of their organization, a growing number report to administrative or corporate headquarters. (On the other hand, one-third said that their organization has a senior nursing informatics executive or CNIO, which one would hope proves to offer extra support.)

Though the HIMSS summary doesn’t say so explicitly, it seems very likely that demand for nurse informaticists is outstripping supply, given the substantial salaries these experts can command. If your organization needs to recruit such a person, be prepared for some tough competition.

How Technology Helps and Hurts Healthy Behavior Change – #HITsm Chat Topic

Posted on March 21, 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, 3/24 at Noon ET (9 AM PT). This week’s chat will be hosted by Melissa McCool from Stellicare (@MelissaxxMcCool and @Stellicare). We’ll be discussing the topic “How Technology Helps and Hurts Healthy Behavior Change.”

Changing patient behavior is the key to achieving better clinical outcome and lowering healthcare costs. Of the $3 trillion spent on healthcare in the US, an analysis by McKinsey Consulting found that “31% of those costs could be directly attributed to behaviorally induced chronic conditions. Fully 69% of total costs were heavily influenced by consumer behaviors.”

Health care systems now must focus on prevention and the ongoing management of chronic conditions. This is driven by the transition to value based care, an aging population and the increasing incidence of behaviorally induced chronic conditions.

Be sure to join the #HITsm chat this Friday, March 24th, 2017 at 12:00pm ET where we’ll dive into the topic of healthy behavior change and how technology hurts and helps that goal.

The Questions
T1: How has technology helped patients make positive behavioral changes? #HITsm

T2: What role has technology had in preventing or inhibiting positive behavioral choices by patients? #HITsm

T3: If you had a magic wand, what tech element would you add so that patients could be helped in changing behaviors? #HITsm

T4: Have you ever changed any of your health behaviors as a result of technology? #HITsm

T5: What is needed to facilitate widespread health tech adoption around behavior change? #HITsm

Bonus: What health app do you use and recommend? Or have seen do good for those around you? #HITsm

Upcoming #HITsm Chat Schedule
3/31 – AI and Machine Learning
Hosted by @HBI_Solutions

4/7 – TBD

4/14 – TBD

4/21 – Innovation vs Incremental
Hosted by @Colin_Hung

We look forward to learning from the #HITsm community! As always let us know if you have ideas for how to make #HITsm better.

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

Study Offers Snapshot Of Provider App Preferences

Posted on March 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.

A recent study backed by HIT industry researchers and an ONC-backed health tech project offers an interesting window into how healthcare organizations see freestanding health apps. The research, by KLAS and the SMART Health IT Project, suggests that providers are developing an increasingly clear of what apps they’d like to see and how they’d use them.

Readers of this blog won’t be surprised to hear that it’s still early in the game for healthcare app use. In fact, the study notes, about half of healthcare organizations don’t formally use apps at the point of care. Also, most existing apps offer basic EMR data access, rather than advanced use cases.

The apps offering EMR data access are typically provided by vendors, and only allow users to view such data (as opposed to documenting care), according to the study report. But providers want to roll out apps which allow inputting of clinical data, as this function would streamline clinicians’ ability to make an initial patient assessment, the report notes.

But there are other important app categories which have gained an audience, including diagnostic apps used to support patient assessment, medical reference apps and patient engagement apps.  Other popular app types include clinical decision support tools, documentation tools and secure messaging apps, according to researchers.

It’s worth noting, though, that there seems to be a gap between what providers are willing to use and what they are willing to buy or develop on their own. For example, the report notes that nearly all respondents would be willing to buy or build a patient engagement app, as well as clinical decision support tools and documentation apps. The patient engagement apps researchers had in would manage chronic conditions like diabetes or heart disease, both very important population health challenges.

Hospital leaders, meanwhile, expressed interest in using sophisticated patient portal apps which go beyond simply allowing patients to view their data. “What I would like a patient app to do for us is to keep patients informed all throughout their two- to four-hours ED stay,” one CMO told researchers. “For instance, the app could inform them that their CBC has come back okay and that their physician is waiting on the read. That way patients would stay updated.”

When it came to selecting apps, respondents placed a top priority on usability, followed by the app’s cost, clinical impact, capacity for integration, functionality, app credibility, peer recommendations and security. (This is interesting, given many providers seem to give usability short shrift when evaluating other health IT platforms, most notably EMRs.)

To determine whether an app will work, respondents placed the most faith in conducting a pilot or other trial. Other popular approaches included vendor demos and peer recommendations. Few favored vendor websites or videos as a means of learning about apps, and even fewer placed working with app endorsement organizations or discovering them at conferences.

But providers still have a few persistent worries about third-party apps, including privacy and security, app credibility, the level of ongoing maintenance needed, the extent of integration and data aggregation required to support apps and issues regarding data ownership. Given that worrisome privacy and security concerns are probably justified, it seems likely that they’ll be a significant drag on app adoption going forward.

E-Patient Update: Naughty, Naughty Telehealth Users

Posted on March 17, 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.

Wow. I mean, wow. I can’t believe the article I just read, in otherwise-savvy Wired magazine yet, arguing that patients who access telemedicine services are self-indulgent and, well, sorta stupid.

Calling it the “Uber-ization” of healthcare, writer Megan Molteni (@MeganMolteni on Twitter) argues that telemedicine will only survive if people use it “responsibly” – apparently because people are currently accessing care via direct-to-consumer services because their favorite online gambling site was offline for system maintenance.

In making this claim, Molteni cites new research from RAND, published in the journal Health Affairs, which looked at the impact direct-to-consumer telemedicine services had on overall healthcare costs. But the piece goes from acknowledging that this model might not reduce costs in all cases to attacking e-patients like myself – and that’s where I got a bit steamed.

In structuring the piece, the writer seems to suggest that if consumer behavior doesn’t save the health insurance industry money, we need to stop being so gosh-darned assertive about getting help with our health. Then it goes further, arguing that we should just for-Pete’s-sake control ourselves (apparently we’re either hypochondriacs, attention-seekers or terminally bored) and just step away from the computer.  Why can’t we just say no?

First, the facts

Before we take this on, let’s take a look at the journal article which the writer drew upon as a primary source and see what assertions it makes. Facts first.

In the abstract, the authors note that demand for direct-to-consumer telehealth services is growing rapidly, and has the potential to save money by replacing physician office and emergency department trips with virtual visits.

To see whether this might be the case, the authors gathered commercial claims data over 300,000 patients covered by CalPERS Blue Shield, which began covering telehealth services in April 2012. During the next 18 months, 2,943 of those 300,000 enrollees came down with a respiratory infection, one third of which sought services from direct-to-consumer telehealth company Teladoc.

Once they had their data in hand, the research looked at patterns of care utilization and spending levels for treatment of acute respiratory illnesses.

After completing the analysis, the authors found that 12% of direct-to-consumer telehealth visits replaced visits to other providers, while the remaining 88% represented new care utilization. Net annual spending on acute respiratory illness grew $45 per telehealth users, researchers found.

The researchers concluded that because it offers more convenient access, direct-to-consumer telehealth may increase utilization and healthcare spending.

It should be noted that Molteri’s article doesn’t look at whether increased utilization was excessive or ineffective. It doesn’t ask whether patients who accessed telemedical care had different outcomes than those who didn’t and if those new patients saved the health system money because of the interventions that wouldn’t have happened without telehealth. It doesn’t address whether patients who used telehealth in addition to face-to-face care were actually sicker than those who didn’t, or had other co-existing conditions which affected overall costs. It just notes a pattern for a single group of patients diagnosed with a single condition.

Also, it’s worth pointing out that we don’t know whether Teladoc’s performance is better or worse than that of rivals like HealthTap, MDLive and Doctor on Demand. And if there are meaningful differences, that would be important.  But the piece doesn’t take this on either.

So in summary, all we know is that using one provider for one condition, a health plan paid a little bit more for some patients’ care when they had a telemedicine consult.

Consumer indictment

But in Molteri’s analysis, the study offers nothing less than an indictment of consumers who use these services. “For telehealth to fully deliver on its promise, people have to start treating their health care less like an Uber you summon in a thunderstorm,” she asserts, while citing no evidence that people do in fact access such services too casually.

All told, the piece suggests that the people are accessing telehealth for trivial reasons such as, I don’t know, kicks, or as an easy way to find an online buddy. Really? Give me a break. Even when it’s delivered online, people seek care out because they need it, not because they’re lazy or, as I noted above, stupid.

To be as fair as I can be, the article does note that direct-to-consumer healthcare models have unique flaws, particularly a lack of integration with patients’ ongoing care. It also concedes that some providers (such as the VA, which has slashed costs with its telehealth program) are using the technology effectively.

It also notes that telemedicine can do more to meet its potential if it’s used to manage chronic disease and engage people in preventive care. “Telehealth has to be integrated fully into a total care system,” said Mario Gutierrez, executive director of the Center for Connected Health Policy, who spoke with Molteri. As a patient with multiple chronic conditions, I couldn’t agree more. Anything that makes care access easier on one of my bad days is a winner in my book.

Ultimately, though, the author unfortunately bases her article on the assumption that the real problem here is patients accessing care. Not the gaps in the system that prompt such usage. Not the unavailability of primary care in some settings. Not the 15-minute fly-by medical visits that perforce leave issues unaddressed. Not even the larger issues in controlling healthcare costs. No, it’s e-patients like me who use telehealth to meet unmet needs.

Please. I can’t even.

Epic and other EHR vendors caught in dilemmas by APIs (Part 2 of 2)

Posted on March 16, 2017 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The first section of this article reported some news about Epic’s Orchard, a new attempt to provide an “app store” for health care. In this section we look over the role of APIs as seen by EHR vendors such as Epic.

The Roles of EHRs

Dr. Travis Good, with whom I spoke for this article, pointed out that EHRs glom together two distinct functions: a canonical, trusted store for patient data and an interface that becomes a key part of the clinician workflow. They are being challenged in both these areas, for different reasons.

As a data store, EHRs satisfied user needs for many years. The records organized the data for billing, treatment, and compliance with regulations. If there were problems with the data, they stemmed not from the EHRs but from how they were used. We should not blame the EHR if the doctor upcoded clinical information in order to charge more, or if coding was too primitive to represent the complexity of patient illness. But clinicians and regulators are now demanding functions that EHRs are fumbling at fulfillling:

  • More and more regulatory requirements, which intelligent software would calculate on its own from data already in the record, but which most EHRs require the physician to fill out manually

  • Patient-generated data, which may be entered by the patient manually or taken from devices

  • Data in streamlined formats for large-scale data analysis, for which institutions are licensing new forms of databases

Therefore, while the EHR still stores critical data, it is not the sole source of truth and is having to leave its borders porous in order to work with other data sources.

The EHR’s second function, as an interface that becomes part of the clinicians’ hourly workflow, has never been fulfilled well. EHRs are the most hated software among their users. And that’s why users are calling on them to provide APIs that permit third-party developers to compete at the interface level.

So if I were to write a section titled “The Future of Current EHRs” it could conceivably be followed by a blank page. But EHRs do move forward, albeit slowly. They must learn to be open systems.

With this perspective, Orchard looks like doubling down on an obsolete strategy. The limitations and terms of service give the impression that Epic wants to remain a one-stop shopping service for customers. But if Epic adopted the SMART approach, with more tolerance for failure and options for customers, it would start to reap the benefits promised by FHIR and foster health care innovation.

Epic and Other EHR Vendors Caught in Dilemmas by APIs (Part 1 of 2)

Posted on March 15, 2017 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The HITECH act of 2009 (part of the American Recovery and Reinvestment Act) gave an unprecedented boost to an obscure corner of the IT industry that produced electronic health records. For the next eight years they were given the opportunity to bring health care into the 21st century and implement common-sense reforms in data sharing and analytics. They largely squandered this opportunity, amassing hundreds of millions of dollars while watching health care costs ascend into the stratosphere, and preening themselves over modest improvements in their poorly functioning systems.

This was not solely a failure of EHR vendors, of course. Hospitals and clinicians also needed to adopt agile methods of collaborating and using data to reduce costs, and failed to do so. They’re sweating profusely now, as shown in protests by the American Medical Association and major health care providers over legislative changes that will drastically reduce their revenue through cuts to insurance coverage and Medicaid. EHR vendors will feel the pain of a thousand cuts as well.

I recently talked to Dr. Travis Good, CEO of Datica that provides data integration and storage to health care providers. We discussed the state of EHR interoperability, the roles of third-party software vendors, and in particular the new “app store” offered by Epic under the name Orchard. Although Datica supports integration with a dozen EHRs, 70% of their business involves Epic. So we’ll start with the new Orchard initiative.

The Epic App Store

Epic, like most vendors, has offered an API over the past few years that gives programmers at hospitals access to patient data in the EHR. This API now complies with the promising new standard for health data, FHIR, and uses the resources developed by the Argonaut Project. So far, this is all salutary and positive. Dr. Good points out, however, that EHR vendors such as Epic offer the API mostly to extract data. They are reluctant to allow data to be inserted programmatically, claiming it could allow errors into the database. The only change one can make, usually, is to add an annotation.

This seriously hampers the ability of hospitals or third-party vendors to add new value to the clinical experience. Analytics benefit from a read-only data store, but to reach in and improve the doctor’s workflow, an application must be able to write new data into the database.

More risk springs from controls that Epic is putting on the apps uploaded to Orchard. Like the Apple Computer store that inspired Orchard, Epic’s app store vets every app and allows in only the apps that it finds useful. For a while, the terms of service allowed Epic access to the data structures of the app. What this would mean in practice is hard to guess, but it suggests a prurient interest on the part of Epic in what its competitors are doing. We can’t tell where Epic’s thinking is headed, though, because the public link to the terms of service was recently removed, leaving a 404 message.

Good explained that Epic potentially could track all the transactions between the apps and their users, and in particular will know which ones are popular. This raises fears among third-party developers that Epic will adopt their best ideas and crowd them out of the market by adding the features to its own core system, as Microsoft notoriously did during the 1980s when it dominated the consumer software market.

Epic’s obsession with control can be contrasted with the SMART project, an open platform for health data developed by researchers at Harvard Medical School. They too offer an app gallery (not a store), but their goal is to open the repository to as wide a collection of contributors as possible. This maximizes the chances for innovation. As described at one of their conferences, control over quality and fitness for use would be exerted by the administrator of each hospital or other institution using the gallery. This administrator would choose which apps to make available for clinical staff to download.

Of course, SMART apps also work seamlessly cross-platform, which distinguishes them from the apps provided by individual vendors. Eventually–ideally–FHIR support will allow the apps in Orchard and from other vendors to work on all EHRs that support FHIR. But the standard is not firm enough to allow this–there are too many possible variations. People who have followed the course of HITECH implementation know the history of interoperability, and how years of interoperability showcases at HIMSS have been mocked by the real incompatibilities between EHRs out in the field.

To understand how EHRs are making use of APIs, we should look more broadly at their role in health care. That will be the topic of the next section of this article.

How Do We Include Every Generation in our HIT? – #HITsm Chat Topic

Posted on March 14, 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, 3/17 at Noon ET (9 AM PT). This week’s chat will be hosted by Erica Johansen with Splash Media (@thegr8chalupa and @SplashMedia). We’ll be discussing the topic “How Do We Include Every Generation in our HIT?”

Commentary on generational nuances have made their way into previous #HITsm chats and those comments usually sparked quite a discussion. So, we couldn’t think of a better way to give the people what they want!

This week, our chat will spark conversations on how generational perspectives are influencing healthcare technology, and additionally, how can we (as health IT leaders) can strive to incorporate and include diverse generational needs into the industry roadmap.

Be sure to join the #HITsm chat this Friday, March 17th, 2017 at 12:00pm ET.

The Topics
T1: What generation do you identify with & are there any stereotypes that you feel are inaccurate? #HITsm

T2: What #healthIT initiatives are setting up future generations for success? What initiatives are setting up for failure? #HITsm

T3: Is there a health concern might you share with someone in another generation? If so, how could #healthIT anticipate that concern? #HITsm

T4: If you could advise #healthIT leadership on behalf of your generation, what would you tell them? #HITsm

T5: In what ways can #healthIT cultivate meaningful engagement from every generation? #HITsm

Bonus: What healthcare technology that exists today holds untapped potential? #HITsm

Upcoming #HITsm Chat Schedule
3/24 – How Technology Helps and Hurts Healthy Behavior Change
Hosted by @MelissaxxMcCool

3/31 – AI and Cognitive Science
Hosted by @HBI_Solutions

4/7 – TBD

4/14 – TBD

4/21 – Innovation vs Incremental
Hosted by @Colin_Hung

We look forward to learning from the #HITsm community! As always let us know if you have ideas for how to make #HITsm better.

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

Are Healthcare Integration Engines Needed?

Posted on March 13, 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.

In a perfect world, we might ask why health systems need to purchase an integration engine. The standards used by integration engines are pretty widespread and every EHR and Healthcare IT vendor uses that standard. Why then do we need an integration engine in the middle?

I’m sure there are a lot of reasons, but two reasons stand out the most to me are: integration costs and flavors of standards.

Integration Costs
It’s amazing how expensive it is to build integrations with EHR and other healthcare IT software. I still look back on the first lab interface integration I did. I couldn’t believe how expensive it was to do the integration and how the vendors were happy to nickle and dime you all along the way. Many of them look at it as a secondary business model.

While an integration engine can’t solve all these costs, if you have a large number of integrations, the integration engine can save you a lot of money. This includes the integration engine’s experience integrating with multiple vendors, but it also means you can often only pay your EHR vendor one time instead of getting charged for every integration.

Flavors of Standards
If you’ve ever managed an integration, you know how miserable it can be. Each side of the integration implements their own “flavor” of the standard (which makes no sense, but is reality) and that flavor can often change as the various software gets updated. It’s no fun to manage and often leads to interface downtime. You know the impact interface downtime can have on your providers who don’t understand the intricacies of an interface. No one likes something that previously just worked to stop working.

This is where integrations engines definitely shine. Their whole job is to manage these types of changes and ensure that they’re prepared for the change. If they can’t do this right, then you should search for a new integration engine. Plus, integration engines usually have tools to help you manage this and to update this as vendors change (and they will change).

Will Integration Engines Survive?
In the perfect world, we wouldn’t need an integration engine. Healthcare is not a perfect world. In fact, it’s far from it, so I see integration engines sticking around for a long while to come. They’re quite entrenched in the business processes of most large healthcare organizations.

While at the HIMSS Conference, I was talking with Summit Healthcare and they noted that they have 1 client that’s sending 5 million messages per day (Yes, I said per day!). That’s a lot of messages and that’s only one client from one integration engine. Hearing that number illustrated how valuable these integration engines are to an organization. It also flew in the face of healthcare not being interoperable. However, it illustrates how much data needs to be shared if we had true interoperability since those 5 million messages only includes a small portion of health data that could be shared.

We’ll look at diving into integration engines in more detail in future posts. I think they’re an important backbone of what’s happening in healthcare IT and many don’t realize it.

E-Patient Update: Patients Need Better Care Management Workflows

Posted on March 10, 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.

Now and then, I get a little discouraged by the state of my health data. Like providers, I’m frustrated as heck by the number of independent data sources I must access to get a full picture of my medications, care and health status. These include:

* The medication tracker on my retail pharmacy’s site
* My primary care group’s portal
* My hospital’s Epic MyChart portal
* A medication management app to track my compliance with my regimen
* A health tracker app in which I track my blood pressure
* My Google calendar, to keep up with my health appointments
* Email clients to exchange messages with some providers

That’s not all – I’m sure I could think of other tools, interfaces and apps – but it offers a good idea of what I face. And I’m pretty sure I’m not unusual in this regard, so we’re talking about a big issue here.

By the way, bear in mind I’m not just talking about hyperportalotus – a fun term for the state of having too many portals to manage – but rather, a larger problem of data coordination. Even if all of my providers came together and worked through a shared single portal, I’d still have to juggle many tools for tracking and documenting my care.

The bottom line is that given the obstacles I face, my self-care process is very inefficient. And while we spend a lot of time talking about clinician workflow (which, of course, is quite important) we seldom talk about patient/consumer health workflow. But it’s time that we did.

Building a patient workflow

A good initial step in addressing this problem might be to create a patient self-care workflow builder and make it accessible website. Using such a tool, I could list all of the steps I need to take to manage my conditions, and the tool would help me develop a process for doing so effectively.

For example, I could “tell” the software that I need to check the status of my prescriptions once a week, visit certain doctors once a month, check in about future clinical visits on specific days and enter my data in my medication management app twice a day. As I did this, I would enter links to related sites, which would display in turn as needed.

This tool could also display critical web data, such as the site compiling the blood sugar readings from my husband’s connected blood glucose monitor, giving patients like me the ability to review trends at a glance.

I haven’t invented the wheel here, of course. We’re just talking about an alternate approach to a patient portal. Still, even this relatively crude approach – displaying various web-based sources under one “roof” along with an integrated process – could be quite helpful.

Eventually, health IT wizards could build much more sophisticated tools, complete with APIs to major data sources, which would integrate pretty much everything patients need first-hand. This next-gen data wrangler would be able to create charts and graphs and even issue recommendations if the engine behind it was sophisticated enough.

Just get started

All that being said, I may be overstating how easy it would be to make such a solution work. In particular, I’m aware that integrating a tool with such disparate data sources is far, far easier said than done. But why not get started?

After all, it’s hard to overestimate how much such an approach would help patients, at least those who are comfortable working with digital health solutions. Having a coordinated, integrated tool in place to help me manage my care needs would certainly save me a great deal of time, and probably improve my health as well.

I urge providers to consider this approach, which seems like a crying need to me. The truth is, most of the development money is going towards enabling the professionals to coordinate and manage care. And while that’s not a bad thing, don’t forget us!

Why Provide Consumer-minded Communications? Patients Expect Them

Posted on March 9, 2017 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
With technology advancing rapidly, communication has become both more accessible and more difficult than ever before. Today, Americans nationwide communicate with their smartphones via various social media platforms, mobile calls, text messages, applications, and more. In fact, 80 percent of consumers now own a smartphone for personal use, which could include making purchasing decisions and seeking out support with not only commercial industries, but with healthcare organizations as well.

Patients instinctively utilize the communication methods they are most comfortable with when interacting with healthcare organizations. These often include traditional methods such as live voice appointment scheduling and telephone answering. But as healthcare consumerism has grown more prevalent, these methods also frequently include digital and automated solutions such as online self-scheduling, appointment reminders via text message, and other automated messaging options.

As a self-professed consumer-minded patient, I tend to seek out the latter communication methods when it comes time to contact my healthcare provider. If there is an option to schedule an appointment online from the comfort of my own home, I take it. When asked if I’d like to opt in for email, voice, or text message reminders and messaging, I always indicate ‘yes.’ And if given the opportunity to meet with my physician virtually rather than in the office, I jump at it.

These features and functionalities provide me with the freedom to more proactively manage my healthcare needs without disrupting my day-to-day responsibilities. This freedom is also why I’ve become a loyal patient to my local provider. And I’m not alone.

As reported by the Beryl Institute, 87 of consumers say the patient experience is extremely important overall and 67 percent report that it plays an extremely important role in their decision-making process. Communication plays a major part in what patients view as their patient experience. If my healthcare provider were to only provide traditional live voice services, I may not have been as apt to schedule an appointment. Similarly, if they focused solely on digital solutions, they could miss out on other valuable patients.

So, what’s the answer?

Healthcare organizations should holistically approach communications with a combination of traditional and technology-based communication methods. Patients must be able to communicate however they feel most comfortable, including via a traditional phone call or by receiving important appointment information via automated emails or texts. Healthcare organizations that provide a combination of live voice, digital, and automated communication support tools are more apt to meet the diverse and evolving expectations of their entire patient population. In turn, these same organizations are more likely to successfully foster ongoing patient loyalty and satisfaction.

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