I’ve long been fascinated by NoMoreClipboard ever since I learned at HIMSS a few years back that Jeff Donnell, President of NoMoreClipboard, was the creative genius behind the always entertaining Extormity EHR parody. So, I guess I should have expected Jeff to continue the trend of creativity in where he’d take PHR vendor NoMoreClipboard in the future.

While many are writing off the PHR after Google Health was shut down, NoMoreClipboard seems to be doubling down (a great reference before HIMSS Las Vegas) on PHR and extending it to capture two healthcare mega trends: patient centered medical homes (PCMH) and accountable care organizations (ACOs).

In an effort to learn more about this move I did the following interview with Jeff Donnell, President of NoMoreClipboard, and Sandra Elliott, Director of Consumer Technology and Service Development at Meridian Health, a not-for-profit health system in New Jersey that helped to create iMPak.

Tell me about what seems to be a shift of NoMoreClipboard from PHR to focus more on the patient centered medical home (PCMH) and facilitating ACOs.

Jeff: Our focus at NoMoreClipboard has always been on providing value to consumers and clinicians – looking for ways to connect patients with providers to facilitate meaningful information exchange, dialog and care coordination. This is not a shift away from PHR. Rather, we are elated that the concept of patient engagement is not only gaining traction, but taking off like a rocket. One of the reasons is the shift toward concepts like PCMH and ACO – where provider organizations have incentives to manage patient populations more carefully. Doing so at scale requires the use of technology to streamline communication, gather and analyze electronic data, and identify those patients who require more aggressive intervention. The PHR can be very valuable as the electronic management and communication tool for patients and their family members. We are adding provider-facing tools to help clinicians manage the patient populations who can benefit most from technology. And the collaboration with iMPak provides patients with easy-to-use, affordable and very powerful medical devices.

ACOs are quite nebulous at this point, so what ACO trends do you think are most promising?

Jeff: While no one is certain what form ACOs will ultimately take, the concept is generating not only interest, but activity. Hospitals, health systems, health plans and employers are making plans, piloting concepts and taking the steps necessary to form or become part of an ACO.

Sandra: The most profound change is the recognition that the care relationship with the patient now extends beyond the hospital doors upon discharge. There is no doubt that more incentives will continue to be placed on reducing readmissions and reducing the overall costs of care no matter what form ACOs will take in the future. The priority of better management of patients once they return home is and will continue to get significant attention.

This new partnership moves NoMoreClipboard into the patient centered medical home.  What do you see as the leading drivers of the medical home?

Jeff: As incentives shift, so must the orientation of the provider community. This is especially true for primary care providers who will assume greater responsibility for managing those with chronic conditions – providing them with a medical home where care plans are developed, deployed and carefully managed. As more hospitals and health systems acquire primary care practices, those practices become more than a source of hospital referrals – they serve as the front line in managing the care of patients who are discharged from the hospital to ensure quality and guideline adherence. This role is not only critical to improving outcomes and reducing cost, it also improves the real and perceived value of PCPs. Technology is no longer a barrier to enabling medical homes at reasonable costs.

You’ve focused on ease of use for patients.  Tell me some ways you’ve made this simple for users.

Jeff: One of the benefits of working with iMPak is their health system connection – Meridian Health in New Jersey is one of the owners. Meridian has experienced how difficult it can be to get certain patient populations to use electronic tools – be it a computer, a smartphone or an electronic medical device. Rather than throw in the towel on collecting electronic data from these patients, iMPak has developed simple devices that require little or no training and are ideal for those patients who say “I will never, ever use a computer.”

Sandra: iMPak health journals are used to collect subjective information using a push button journal – “smart” paper stock with an embedded chip that collects and stores patient responses to condition-specific questions. iMPak is also developing screening devices that are the size of a credit card and collect objective data with minimal patient effort. Both health journals and screening devices use touch and post technology so that when the device is placed on a Near Field Communications (NFC) reader, data is automatically downloaded safely and securely.

There are a lot of different medical home devices on the market.  What differentiates the iMPak product from the competition?

Sandra: The biggest differentiator is the form factor. These devices were designed with the technology-averse in mind. There are millions of people who simply will not use a computer, download an app or place an electronic home monitoring center on their kitchen counter. A significant percentage of these individuals have chronic conditions and can really benefit from sharing electronic data with a health coach or care manager. iMPak has cracked the code for these patients with devices that collect electronic data in a way that is simple, elegant and not at all intimidating.

The other major difference is the time and cost required to develop and deploy these solutions. Unlike complex medical devices that usually take years and millions of dollars to develop, iMPak journals and screening tools can be customized rapidly and affordably.

These differentiators are attracting the attention of organizations interested in partnering with us to develop and deploy purpose-built solutions for a wide variety of use cases ranging from chronic disease management to improving medication therapy.

What are the top 3 benefits someone will glean from using iMPak with NoMoreClipboard?

Sandra: Patients who either lack access to information technology or avoid its use now have an easy, anywhere way to share health information with family members and clinicians who are providing them with care.

Jeff: Family members helping take care of loved ones can now access a complete health picture through a PHR – from the latest in subjective and objective data reported by the patient to a comprehensive health record.

Clinicians, health coaches and other care advocates now have a solution designed to manage patient populations that tend to be difficult to manage – those with serious conditions who are technology averse or lack technology access. Clinical staff can now collect electronic data from these patients, and are provided with up-to-date reporting and alerts that identify those patients who require intervention much earlier.

What’s the biggest barrier to adoption of medical devices in the home?

Jeff: That depends on the home and the people using them. We are focused on homes where the adoption of high-tech, complex medical devices is extremely unlikely for any number of reasons. That does not mean these patients are not candidates for using medical devices. It does mean the devices must be carefully selected to fit the technical capabilities of the target population.

Sandra: Many devices in the home are overwhelming for the great majority of people so they were not being used. iMPak Health has designed its devices in an easy-to-use, intuitive form to overcome some of these intimidation factors

In what ways is a doctor involved in this medical home model?

Sandra: iMPak and NoMoreClipboard are collaborating to provide end-to-end solutions that connect physicians, patients and family members – giving each individual in the care equation a valuable tool to communicate and share information.

The iMPak devices are designed to help patients collect and share electronic health information in a user-friendly form factor. Captured data is then available to patients and their family members via NoMoreClipboard.

Jeff: This same data is also directed to a clinical portal that a doctor, case manager or other care advocate can use to manage a patient population. Collected data populates the portal, giving clinicians a dashboard view of patient status. Data is compared against a rules engine, and alerts identify at-risk patients who require more aggressive intervention.

The doctor seems to be an incredibly important part of medical home models.  What has been doctor’s reaction to this product?  How do you plan to get more doctors to accept this new and evolving model of care?

Jeff: Most physicians we talk to support the use of patient-facing technology, but they are quick to point out how many of their patients are not tech-savvy – senior citizens, rural patients, safety net patients, etc. When we put an iMPak device in the hands of these doctors, their reaction is amazing to watch – you can almost see the light bulbs go on.

As physicians learn that we can provide a complete solution that includes an easy-to-use clinical portal with a rules engine, reporting capability and visible identification of those patients who require additional intervention, we expect interest in this new model of care will grow.

Is it essential that the patient have their medical record in NoMoreClipboard?  What value is gleaned from the data the device provides together with the medical record?

Jeff: The iMPak device data alone is incredibly valuable – subjective and objective data collected from a patient as they experience symptoms or engage in therapy. Adding medications, allergies, conditions, medical history and family history to that data paints a more comprehensive picture. If a clinician can easily see in a combined view what medication form and strength a patient is taking along with the patient’s reported response to that medication, it is that much easier to make rapid and informed clinical decisions.

Do you plan to integrate more devices with NoMoreClipboard?  Will they all be from iMPak or will you work with other medical device manufacturers?

Sandra: NoMoreClipboard and iMPak are working on a complete line of devices, with an initial focus on pulmonary and cardiovascular conditions, as well as health and wellness applications. We are also talking with a number of potential partners about developing purpose-built solutions to support specific use cases. iMPak and NoMoreClipboard also have flexibility to work with other organizations as it makes sense. If a NoMoreClipboard client wants us to integrate with other devices, we can certainly do so. If a hospital system wants to integrate iMPak data with existing healthcare IT applications, they have that freedom.

Currently this product seems focused on the senior population. Do you see this or other related products eventually reaching the wider population?

Sandra: While seniors are a natural fit, any patient population on the wrong side of the digital divide is an ideal candidate for iMPak solutions. This includes underserved populations in urban or rural areas without regular access to technology. These devices are affordable, they are portable, and they are easy to use. We believe these devices can help overcome disparities in care.

This seems like the first step in addressing the patient centered medical home and facilitating ACOs.  Where do you see this going in the next couple years?

Jeff: As we talk to patients with chronic conditions, what keeps them up at night is the difficulty of gathering, organizing and managing all their health information, and making sure that all their doctors have the latest information and are talking with one another about what it means and how to proceed. When we talk to physicians, they describe the challenge of managing transitions in care, gaining access to all the information they know is out there somewhere, and working with patients, families and fellow clinicians to develop a coordinated plan of action.

It is pretty clear that incentives will migrate from fee-for-service to paying for a focus on wellness, prevention, and more thoughtful management of chronic conditions. While the care models (and their labels) that support this will evolve, we believe there will be increased effort to connect patients, family members and clinical teams. Electronic tools will play an important role in fostering dialog, facilitating care coordination and keeping everyone up-to-date based on their role in the care continuum. Significant value can be realized by developing “care networking” tools that combine the power of healthcare IT and social networking on an integrated platform.

John’s Note: NoMoreClipboard, in collaboration with iMPak Health, will launch and demo this new comprehensive solution for achieving a successful medical home or accountable care organization at HIMSS Booth #7902.

Full Disclosure: NoMoreClipboard is an advertiser on this site.

I’m sure many of you are recovering from the Super Bowl right now. I got exactly what I wanted from the Super Bowl: a great game. I didn’t care too much either way, but I am glad that I predicted the Giants to be the winners. Too bad I’m not a betting man. Although, I guess that’s the trick with betting….but I digress.

Time for my regular weekend round up of interesting things happening in the healthcare IT and EMR twittersphere. We’ve got some really interesting tweets this week. Here we go.

@NateOsit We also have a webinar of @eCollab12 for those that wont’ be able to make it to #HIMSS12.ecollab12.eventbrite.com #hitsm

— Leonard Kish (@leonardkish) February 3, 2012

When I created and posted my list of HIMSS 12 sessions, they hadn’t created the agenda for the eCollaboration Forum at HIMSS and so I couldn’t add any sessions. However, the eCollaboration Forum at HIMSS 12 agenda is up now, so check it out. I know there are a number of sessions I’m going to add from the forum. I also love that they have the online option linked in this tweet for those not attending HIMSS 2012.

Yes, stage 2 #meaningfuluse NPRM will be out before #HIMSS12. meaningfulhitnews.com/2012/01/30/yes… #healthIT #ONC #CMS #hitpol #EHR #EMR

— Neil Versel (@nversel) January 31, 2012

This is really important news. I think a lot of us are REALLY interested to see the final meaningful use stage 2 details. Good find by Neil Versel.

Speaking doctor-to-doctor(s) using healthcare social media bit.ly/wiqbyu #hcsm #hcsmeu

— H2Online (@H2Ohu) January 30, 2012

I’m sure we’re going to continue seeing the trend of more and more doctors gleaning value from engaging in social media. At a minimum doctors are going to start finding more and more new patients using social media including things like physician blogging. A well done practice website and social media effort is going to be really valuable for the doctor of the future.

3 reasons why you should start a blog for your hospital bit.ly/ypCE78 #hcsm #blogging

— Mark Ragan (@MarkRaganCEO) January 30, 2012

Yes, blogging will also help hospitals in a number of ways too. Social media can benefit hospitals, doctors, practices, etc.

@DonRosenthal Tablets are for content consumption. PCs are for content creation. Much more intellectual flexibility w/ PCs. #HITsm

— Erica V. Olenski (@TheGr8Chalupa) February 3, 2012

I was fascinated by this tweet. First because I wonder what changes will make tablets more than just great for content consumption. Second, the idea of PCs being more intellectually flexible.

RT @patientslikeme: “my healthcare data is not nearly as portable/accessible as my financial data.” @jeff_cole #hcsm

— Jacqueline Thong (@jacthong) January 30, 2012

I know there are reasons why financial data is more portable and accessible than healthcare data, but it still irks me that we haven’t overcome those reasons…yet!

I’ve generally been writing more about the EMR side of EMR and HIPAA lately. For the most part, it seems readers are more interested in EMR and EHR than they are in the details of HIPAA. Although, one of my top posts ever is from back in 2006 about HIPAA Privacy Examples and HIPAA Lawsuits. It seems that people are most interested in HIPAA when it has something to do with a HIPAA violation or lawsuit.

Today’s HIPAA violation could very likely become a HIPAA lawsuit. Plus, it is a word of caution to those about training your staff on HIPAA requirements and also on proper use of social media in healthcare.

Anne Steciw posted about the violation on Search Health IT. Here’s an excerpt from her post:

Details of the health data breach provided by the Los Angeles Daily News indicate that the employee, who was provided by a staffing agency, shared a photo on his Facebook page of a medical record displaying a patient’s full name and date of admission. The employee appeared to be completely ignorant of HIPAA laws.

I’m sure every hospital and healthcare administrator is cringing at this. I’m sure many could share stories of HIPAA issues related with staffing agencies as well. Although, it’s really hard for me to understand how someone even from a staffing agency could be so ignorant to the HIPAA laws. I’m not overstating how ignorant this person was in this situation. The above article explains something even more outrageous and unbelievable:

Even after being told by other posters that he was violating the patient’s privacy, the employee argued: “People, it’s just Facebook…Not reality. Hello? Again…It’s just a name out of millions and millions of names. If some people can’t appreciate my humor than tough. And if you don’t like it too bad because it’s my wall and I’ll post what I want to. Cheers!”

To me this is totally mind boggling. I’m sure many will argue that this person was exhibiting many of the characteristics of the Facebook generation of users. That’s a cop out and an excuse, but does make a larger point that many of the next generation have these outlandish views of what’s theirs and what’s ok and reasonable. Sadly, far too many people think when it’s humor it’s ok to do anything. It’s not and I’m sure those dealing with HIPAA violations won’t find it a reasonable excuse either.

One thing I really hate about stories like this is that they give a bad name to use of social media in healthcare. Social media is like most things which can be used for good or bad. It’s a shame if incidents like this discourage people from accessing the benefits of social media.

This is another good example of how our biggest HIPAA privacy vulnerability is people.

While I definitely had quite a bit of excitement over this year’s CES and Digital Health Summit, I have to admit that I ended up leaving CES a bit disappointed. I’m trying to decide if it being the fifth year I’ve attended CES is making me immune to the hype that surrounds the event or if I’ve just been going to too many conferences in general and so I’ve already heard much of the hype. At the end of the day, I describe this year’s CES as incremental versus trans formative.

There were a few exceptions of things that caught my eye while navigating the CES circus that are worth mentioning.

Ion Proton Genetic Sequencer
Probably the most amazing thing I saw for healthcare was the Life Technologies Ion Proton Genetic Sequencer. Plus, I’m not alone with this feeling. Dan Costa of PC Mag called it “The Coolest Thing I Saw at CES 2012.” To be quite frank, it is pretty amazing. It’s part of the amazing movement happening in bringing genomic data to healthcare.

The Ion Proton Genetic Sequencer (they need a better name) is awesome cause you can do a full genome in a day on a machine that costs about the same as an MRI machine. Plus, I personally think they’re just getting started on optimizing the technology. As they continue to improve the technology the cost of the machine and the time and cost to do the analysis will continue to drop. We still don’t know exactly how to use the genomic data in healthcare, but machines like this are going to make it possible for us to find new ways to use this data for good.

I still can’t help but imagine an EHR having all of our genomic data available to it.

Liquipel
Probably the coolest general technology and innovation that I saw at CES was called Liquipel. Liquipel is a technology that makes your device repel water using a nano coating. The best way to understand how it works is to check out some of the Liquipel videos and I’ll embed one below that gives a nice overview.

Of course, they have the disclaimer that it should never be submerged in water, but it was amazing to see it repel the water and still work. Plus, probably the coolest demonstration they did was with a Kleenex. They’d applied the nano-coating to a Kleenex and then they placed it in water. You’d think it would shrivel up and absorb the water. Nothing. I then asked if I could touch the Kleenex to see if I could feel the coating. Nothing. It felt like a Kleenex.

Many health IT people would love this technology. Then, it wouldn’t be such a concern to put your iPad next to the sink in the exam room. I wonder if the nano technology can do anything with infection control with devices. I imagine it doesn’t solve that issue.

I’m sure many are wondering how they can get their device treated with Liquipel. Right now they said you have to drop it by their office in California to get it done over a lunch or something. However, they’re working with phone manufacturers to get their technology in every phone. Pretty amazing stuff.

John Sculley
Another highlight of CES for me was the chance to hear John Sculley talk at the Digital Health Summit. I can’t say he said anything too groundbreaking. Although, he did say that health IT companies should stop focusing their revenue model on corporate health programs. I found that interesting. The most interesting comment came from colleague Dan Munro after John Sculley’s talk. He commented how interesting it was that so many of these older ex-CIO’s of major tech companies are getting into healthcare. I carried the thought through for Dan that as you age, you start to care about healthcare a lot more than you did when you were younger and healthier. I wonder if we’ll see this trend continue as more tech people get older and start to care more about healthcare.

Here is a quick look at some of the other articles recently posted on some of the other HealthcareScene.com websites:

EHR and EMR Videos

David Collins of HIMSS Discusses the Course of Global Health at the 2011 mHealth Summit- David Collins, Senior Director of Professional Development at HIMSS, speaks at the 2011 mHealth Summit about HIMSS’ involvement in this year’s Summit, and about how HIT X.0 is affecting the course of Global Health.

Cerner Smart Room Technology Overview Video- An updated view of Cerner’s Smart Room technology. The Cerner Smart Room incorporates technology and workflow software to improve consumer care and clinician efficiency. The Smart Room is powered by CareAwareTM device connectivity architecture.

EHR and EMR Screenshots

These three posts provide numerous screenshots from the DentiMax Dental Practice Management Software.  Are there special considerations for a dental practice as opposed to a regular medical practice when it comes to EHR/EMR/PM?

Screenshots from the DentiMax Dental Practice Management Software
More Screenshots from the DentiMax Dental Practice Management Software
Appointment Book Pro Screenshots from the DentiMax Dental Practice Management Software

Smart Phone Health Care

How to Get Physicians Onboard with mHealth- No matter how great an app or device may be, it will be difficult for any developer to be successful if they don’t get some level of buy in from physicians in general.  People will always resort back to their physician when it comes to the quality of medical products.

Axial’s Care Transition Suite Wins “Ensuring Safe Transitions from Hospital to Home” Mobile App Challenge- In a recent online discussion I had concerning an article I recently wrote, the point was raised that for an app or device to be successful it must fulfill a need.  While I don’t think that it is absolutely essential to success, it certainly makes the path to success much more realistic.

As most of you probably know, I’m a huge fan of technology and it’s also fair to say that I’m a pretty early adopter of social media. In fact, I’m sure that some of you think that I live on social media. I prefer to just say that I’m active in social media. Despite my love and participation in social media, I must admit that I’ve never really been able to get into the love of Foursquare.

For those that don’t know much about Foursquare, it’s an app on your phone where you can check in to specific locations and you can see which locations your friends, family and colleagues have checked into as well. As you check in, you get rewards for checking in and virtual awards such as badges. Plus, if you check in to a certain location enough times, then you become Mayor of that location. Foursquare is far from the only one in this space, but it is definitely the leader and the originator of the space. Although, don’t be surprised if Facebook Places doesn’t give them a good run for their money.

My personal problems with Foursquare is that at least on my cell phone it’s clunky to use, hard to understand and the data gets outdated so quickly that I don’t find it that useful. I’m sure that part of my problem with Foursquare is that I don’t have enough real friends and colleagues on there to really get the benefit of knowing what everyone’s doing and where they’re at. Yes, the idea of sharing and other people knowing this information is scary, but it turns out to be a really cool thing if done right. I know since I often learn where someone is at during a conference by seeing tweets from them.

Considering my lack of adoption of Foursquare, I was of course intrigued by this article talking about why medical practices should be on Foursquare. Here are the main reasons they offer:
1. It’s easy to use.
2. It’s big, and getting bigger.
3. It’s a search engine and a way of being found when people are looking for a doctor.
4. If you don’t claim your place, someone else is likely to do it for you.
5. It says your medical practice is social and tech savvy.

Obviously I disagree with the first one, but that might be my bias. Maybe it’s so easy to use that it’s useless to me. My bias aside, I actually agree with this article that a medical practice should take the 5 minutes it takes to get their practice listed on Foursquare. I’m not suggesting that a doctor or medical practice should become really active on Foursquare. Instead, I’m just saying they should sign up and claim their spot on Foursquare. Then, you get to control your listing as opposed to one of your patients which adds your office for you.

A comment in the above article makes a really good point too. If you want to be active in social media and reach the typical visitors to doctors offices that tend to skew female and older, you probably should be on Twitter and Facebook, not Foursquare. Yelp is another good recommendation for many cities. Lots more could be said about those three services. If people are interested, then we’ll cover those in future posts.

Here is a quick look at some of the other articles recently posted on some of the other HealthcareScene.com websites:

EHR and EMR Videos
Medical Billing Software & Practice Management Software Demo Video from ADP AdvancedMD – Medical billing software, like AdvancedMD from ADP, will help improve your insurance collections and workflows in your entire medical practice. With cloud software you never have to install software or maintain servers again. Just login from anywhere and you can manage your patients and your entire practice.

Cerner CareAware MDBUS® Demonstration Video – This video is a demonstration of Cerner’s CareAware MDBUS®, a platform which connects medical devices to the electronic medical record using plug-and-play functionality.

EHR and EMR Screenshots
These three posts provide numerous screenshots from the Simple EMR. Check them out and I’d love to read some feedback on what you think about their EMR interface. Is it a Simple EMR?
Screenshots from the Simple EMR
More Screenshots from the Simple EMR
Even More Screenshots from the Simple EMR

Smart Phone Health Care
Future of mHealth Dependent on Interoperability and Use of Available Technology – One of the biggest stumbling blocks with mHealth is there are way too many people developing products rather than businesses.  That is the problem with most of the companies in mHealth at this point.  There are tons of apps and gadgets and other fun things out there, but there is no one company that is trying to bring it all together.  Interoperability is the real basis of success in this industry.

iPads Not Adopted as Quickly by Hospitals as Doctors – iPads are all the rage amongst doctors right now and it is understandable with all they are able to do.  They provide a great amount of convenience for a relatively small financial investment.  For some reason hospitals have not been as quick to adopt this great technology.

I’ve seen this coming over the past couple years of attending CES (Consumer Electronics Show). Yes, one of the real advantages I have of living in Las Vegas is all the amazing conferences that I get to attend. CES is one of those conferences. If you thought HIMSS was big (and it is big), CES blows HIMSS out of the water when it comes to size of conference and particularly absolutely insane over the top booths. Imagine a 50+ foot high video wall with hundreds of TVs bigger than you have in your house and at the center the biggest consumer HD TV on the planet.

I’m happy to admit that about half of my attendance is like going to watch the “circus” that is CES. However, last year I was surprised by the healthcare presence at CES (even an EHR vendor was exhibiting). This year it seems that the healthcare IT section of CES will be even bigger and many of my health IT and EMR friends on Twitter are talking about attending CES including Neil Versel who writes on Meaningful Healthcare IT News.

The real key to the healthcare presence at CES has been what I call a “conference within a conference.” In this case the Digital Health Summit takes place as a sub conference to CES. Yes, that includes 2 days of Digital Health speakers and a whole section of the North Hall (right next to all the insane car tech) that’s devoted to Digital Health. I know the people at Zeo have a sleep lab all set up if you get too tired at CES and need a nap. Plus, I think they’ll be live streaming the sleep data online as well.

Assuming I can rip myself away from all the toys and booth babes that are found at CES, I’ll be tweeting and blogging about some of the stuff I see at CES when it comes to healthcare. You can also follow other health people at CES and the Digital Health Summit on Twitter at the hashtag #digitalhealth (If you haven’t figured this out yet, you can click that link and see stuff on Twitter whether you have a Twitter account or not).

If you’re going to be at CES, let me know and maybe we can try and find each other a midst the mayhem. For those not going to CES, hopefully I can provide you some interesting highlights of the event.

As I said in my previous EMR and Health IT in 2012 post, I’m going to create some of my own lists for 2012. I decided to tackle the first one on the list: My 2012 EMR and Health IT Wish List. This was kind of fun to think about. I’m also sure that I’ll come up with other ideas once this is posted, so don’t be surprised if I add things to this list in a future post.

I should also note that I’m not sure any of these things are going to happen in 2012. In fact, I bet that many of them aren’t, but this list isn’t about what is going to happen. This list is about what I wish would happen.

EHR Companies Would Embrace Interoperability – It’s an incredible shame that in 2012 we still don’t have interoperable health records. EHR companies need to get off the stump and make this a reality. The technology is already there and has been there for a while. EHR companies need to start making this dead simple because it’s the right thing to do. Sometimes doing the right thing is more important than the bottom line. Plus, doing the right thing ends up often being the best long term strategy for your bottom line as well.

Start doing what’s right and making your EHR interoperable!

Meaningful Use Would Go Away – I’m actually certain that this one won’t be happening in 2012, but I wish it would. I guess there’s a small chance that it could go away if Republicans take control of Washington and start slashing everything Obama related. However, I have a feeling that even then meaningful use will find its way back into Washington. There’s too much invested in it.

My reasoning for wanting meaningful use gone is clear. It provides a perverse incentive to providers and often incentivizes them to choose an EHR software that doesn’t work well for their practice. As I’ve mentioned in some recent posts, far too many clinics are so focused on meaningful use and EHR incentive money that they’re ignoring the real and tangible business cases for implementing an EHR in their clinic. I think this is a bad thing for healthcare and EHR software in general. The short term bump in EHR adoption won’t be worth the cost of EHR implementations focused on the wrong criteria.

I also really hate how meaningful use has hijacked the software development cycle of pretty much every EHR vendor out there. This is a real travesty since rather than developing for user/customer requirements EHR vendors are developing for a criteria. Talk about a perfect method for destroying innovation. This is a real travesty in my opinion.

Of course, I’m a realist and realize that meaningful use isn’t going away. We have to make the most with what we’re given and live with the realities that exist. However, in this New Year Wish list, I wish that meaningful use would be a past memory.

New Healthcare Model that Provides Care, Not Reimbursement – I’m sure many of you might be thinking that I’m calling for ACO’s in this wish list item. We’ll see how ACO’s evolve, but my gut tells me that the ACO model still won’t make the fundamental change that I wish would happen in healthcare. There’s far too much focus on reimbursement the way our healthcare is structured today. I’m not arguing that doctors and other healthcare professionals not get paid what they deserve. I’m just wishing that there was more focus on care for patients and less worry on maximizing the reimbursement.

How does this have to do with health IT and EHR? I’ve long argued that the biggest bane to EHR systems is the onerous reimbursement requirements. I can’t imagine how much healthcare could benefit from fabulous EHR systems if the energy spent on maximizing reimbursement were spent on improving patient care.

Diabetes Prevention App – I’ll admit that this is a little personal. I come from a long line of diabetes in the genes and I love sweets far too much. I’m pretty much destine to be a diabetic. I think that mHealth apps can have amazing power if done correctly. My wish is for someone to create a Diabetes app that will help me overcome the seeming destiny I have in this regard. The key will probably be illustrating in a profound way the impact of the choices I’m making.

Of course, you could insert hundreds of other chronic illnesses into this wish list too. I’d love to see mobile health work to solve those as well.

A True Patient Identifier – I realize that America is a large place, but we’re also a really creative country that can figure out creative solutions to problems. The lack of a true patient identifier is a challenge and a problem in healthcare. I’d love to see this problem finally resolved. I think every EHR company would rejoice at this as well.

Real EMR Differentiation – My heart absolutely goes out to doctors, practice managers and others who have the unenviable job of trying to sift through the 300+ EMR companies. I’d love for some EMR companies to really do something so innovative to differentiate themselves from the rest of the pack.

No doubt part of this problem is what I stated above about meaningful use. Hard to create innovation and differentiation in EHR when you have to develop for a government list of requirements.

EHR Data Liberation – I’ve wanted EHR data Liberation for a long time, but I think in 2012 this is one thing on the list that could become a reality. It’s a bit of a long shot, but I think there’s potential for this to happen.

My gut tells me that if we can find a way to liberate the data that’s stored in EHR software, then we’d see a dramatic increase in adoption of EHR. One of the major concerns doctors have with selecting an EHR is that once they select an EHR they know they’re locked in with that EHR for the long run. If a doctor knew that they could switch EHR software if they made a bad choice, then they’d be much more likely to pull the trigger on EHR adoption.

We need a wave of EHR vendors that aren’t afraid of liberating their EHR data, because they:
1. Know that their EHR software is so good users won’t leave
2. Know that if someone wants to leave their EHR software it’s better that they find one that’s good for them than the few extra dollars the EHR company will make off an unhappy user.

How’s that for a wish list? I think achieving these things would do an amazing amount of good in healthcare and EHR. Of course, I won’t be holding my breathe on any of them happening any time soon. That doesn’t mean I won’t keep holding out hope.

Today is going to be the last day looking at other people’s “Top Health IT Lists” since tomorrow I think I’ll create my own Top 10 Health IT 2011 List and then for the New Years I’ll see about doing a Top 10 Health IT in 2012 list. However, today let’s look at something that will likely make the Top 10 2012 Health IT issues: ICD-10. Government Health IT recently wrote an article what they call the Top 5 ICD-10 Pitfalls.

1. Reporting: I’m sure that many think that ICD-10 is just going to happen and be fine. They’ll assume that their reports are just going to work with ICD-10 since they worked with ICD-9. Don’t be so sure. Test the reports so you know one way or another. Diving a little deeper beforehand is a lot better than learning about the problems after.

2. Overlooking impacted areas: Much like an EHR implementation, don’t forget the other people that are affected by ICD-10. Involve everyone in the process so that they can share their concerns so they can be addressed. Plus, by having them involved you’ll get much better buy in from the staff.

3. Teaching old dogs new tricks: ICD-10 is a different beast and will require significant training even if you have an expert ICD-9 coder with years of experience. Don’t underestimate the cost to train your coders on ICD-10.

4. Preparing for impact on productivity: The article mentions Canada’s loss of productivity during their implementation of ICD-10. Do we think we’re going to be any different? Remember also that productivity loss can come in a lot of different places (which is kind of a repeat of number 2 above).

5. Communicating with IT vendors: It’s one thing to trust that your EHR and other health IT vendors are prepared to deal with ICD-10. It’s another to blindly follow whatever you’re being told. Remember at the end of the day it’s your organization that will suffer if your health IT vendor is not ready. I like to use the phrase, trust but verify.

Be sure to read the rest of my Health IT Top 10 as they’re posted.