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This Geek Girl’s Singing: HIMSS 14 Social Media Finale

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As one of the inaugural crop of HIMSS Social Media Ambassadors, a second-generation native Floridian, and a former Orlando resident, it is my sworn duty to summarize, recap, and perhaps satirize the last group of Blog Carnival posts, to metaphorically sing the HIMSS opera finale. And you folks submitted some doozies! I’m very grateful to the HIMSS (@HIMSS) and SHIFT Communications (@SHIFTComm) team for providing me with links to all entries. Y’all have been BUSY!

A man after my own heart, and a frequent #HITsm participant who weathers harsh criticism with witty aplomb: Dan Haley’s (from athenahealth, @DanHaley5) piece on 3 Takeaways From HIMSS – Policy And Otherwise caught my attention with the line, “Regulators are from Mars…” He stole my favorite blog entry prize with the line: “Orlando is magical when you are a kid. Kids don’t attend HIMSS.”

First-time attendee Jeffrey Ting (from Systems Made Simple) outlined his experiences with some of my favorite topics in his piece, HIMSS Reflections By A First-Time Attendee: HIEs and interoperability. I agree with him: the Interoperability Showcase’s “Health Story” exhibit was one of the best presentations of the whole conference.

Dr. Geeta Nayyar’s perspective as a board member of HIMSS and CMIO for PatientPoint gave her a unique vantage point for her post, HIMSS 14: A Truly Inspiring Event. Take note, HIMSS conference planners – your monumental efforts were recognized, as was the monumental spirit of the closing keynote speaker, Erik Weihenmayer.

HIMSS Twitter recaps permeated the blogosphere, with my favorite being the inimitable Chuck Webster’s (@wareflo) HIMSS14 Turned It Up To 11 On And Off-Line!. Chuck also periodically provided trend analysis results of year-over-year #HIMSS hashtag traffic for each period of the conference, complete with memes for particular shapes: Loch Ness monster humped-back, familiar faces of frequent tweeters.

Health IT guru Brian Ahier’s (@ahier) wrapped up the “Best In Show” of HIMSS Blog Carnival , complete with Slideshare visuals awarding Ed Parks of Athenahealth “Best Presentation” and providing an excellent summation of must-read posts.

Interoperability was one of the most prevalent themes of HIMSS, and a plethora of posts discussing the healthcare industry’s progress on the path to Dr. Doug Fridsma’s (@Fridsma) High Jump Of Interoperability (Semantic-Level) were submitted to the Blog Carnival. Notable standouts included: Shifting to a Culture of Interoperability by Rick Swanson from Deloitte, and Dr. Summarlan Kahlon’s (of Relay Health), Diagnosis: A Productive HIMSS 2014, which posited that, “this year’s conference was the first one which convinced me that real, seamless patient-level interoperability is beginning to happen at scale.”

And who could forget about patient engagement, the belle of the HIMSS ball? Telehealth encounters, mobile health apps and implications, patient portals, and the Connected Patient Gallery dominated the social media conversation. Carolyn Fishman from DICOM Grid called it, HIMSS 2014: The Year of the Patient, and discussed trepidation patients feel about portal technologies infringing on face-time.

Quantified-self wearable-tech offered engagement opportunities, as well. Having won one such gadget herself, Jennifer Dennard (@SmyrnaGirl) gave props to organizations like Patientco and Nuance for their use (and planned use) of wearable tech in support of employee wellness programs, and posited on the applications of such tech in the monitoring and treatment of chronic disease in her piece, Watching for Wearables at HIMSS14.

Finally, if you’re able to read Lisa Reichard’s (from Billians Health Data) @billians) highlights piece,Top 10 Tales and Takeaways, without busting out into Beatles tunes, you probably wouldn’t have had nearly as much fun as she and I did at HISTalkapalooza, dancing to Ross Martin’s smooth parodies. You also probably don’t have your co-workers frantically purchasing noise-canceling headphones.

I did say I’d be singing to bring HIMSS to a virtual close.

Can’t wait to get back to the metaphorical microphone for HIMSS 2015 in Chicago!

March 14, 2014 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

#HIMSS14 Day 1 – Interoperability, HIE and Social Media

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Well, this is technically my second or third day, but this is the first official day of HIMSS. It’s a mad house like you can imagine and the vendor hall is as big as you’d expect. You need about 3 weeks to go through it. I actually decided to do a walking meeting with someone and we basically walked the whole exhibit floor twice. Luckily, the conversation was good and we dove into some interesting topics. I also told them about my future mobile strategy for Healthcare Scene. She liked it. Hopefully I can roll it out in the next few months.

My day happened to start off with a lot of discussion on interoperability and HIE with MAeHC and then Orion Health. I think it’s really interesting to see the progress we’ve made when it comes to interoperability and HIE, but I also found it interesting that Micky Tripathi from MAeHC still described healthcare interoperability as being in its infancy. I largely agree with him and it’s really too bad. Although, it was also interesting to compare that to Orion Health talking about how they’ve proven that HIE can work. Plus, they also noted something I’ve written multiple times: Private HIEs are growing faster than the Public HIEs.

I’m still really torn on the business model for interoperability and HIEs. I don’t see a clear model in most situations. I even saw one tweet yesterday that talked about taxing on a per patient basis to pay for the HIE. I heard that in NY they’re actually literally working on a tax to fund it. However, I really think that calling it a per patient tax is a really bad way to describe the funding. I’ll certainly be covering more of my interoperability and HIE discussions in the future. Watch for those blog posts in the coming weeks.

I also did a lot of social media talk today. Together with Shahid Shah and Cari McLean we had a discussion about Social Media and Influence. It was great to see so many friendly faces in the audience. I feel lucky every chance I get to hear Shahid talk. He’s really good at reframing things in interesting ways. Plus, Cari has a unique perspective to offer from her perch on top of the HIMSS Social Media tower. I previously noted that social media has just become an integral part of HIMSS. What’s interesting is that most of the companies at HIMSS haven’t created it as an integral part of their company. Many are still learning, but it’s great to see them learn. I hope many will attend the Health IT Marketing and PR Conference where we dive in a lot deeper on these topics.

As I said to someone today, social media can provide value to every company, but not every company should do social media. Some companies aren’t ready to commit to doing social media the right way. Other companies aren’t ready to be that open and transparent. Social media is just one tool in the kit. Although, it’s a really powerful one if used properly. I’ve also been touched by the power of social media to help individuals. Social media has connected me to people that would have no doubt been back at their rooms or in the corner of the event wondering why they were there, but instead they’re out having a good time and connecting with other interesting people.

There you go. I talked about a number of other things today, but I’ll cover that over the weeks and months ahead. For now I’m calling my day today HIMSS HIE, Interoperability and Social Media day.

Be sure to also check out my #HIMSS14 Twitter Roundup and my post on Hospital EMR and EHR about the real cause of hospital readmissions. I think the later post will be a post I reference over and over as people continue to talk about solutions that reduce hospital readmissions.

February 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Making the Case for Healthcare Data Interoperability

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My post titled “Patient Controlled Records Could Work Internationally” has driven a lot of interesting conversation in both the comments and my email inbox. I want to highlight some of the responses in a few future posts. The responses do a really good job extending the conversation around a patient controlled health record.

One example of this is from regular reader and commenter R Troy (Ron). As I mention in my post, I think that the patient controlled medical record can work for chronic patients, because they care about their care. R Troy’s comment does a good job explaining a couple examples of why chronic patients can really benefit from having and controlling their patient record:

I am sure that you are quite correct; people in good health have far less interest in maintaining their own health records, except perhaps for those who are fanatics who want to track everything.

As you may have guessed, I have chronic problems – in my case asthma and allergies primarily. And one family member is T1D, and another has a serious auto immune disorder. The latter in particular is part of my passion for EHR’s – I believe that treatment would be far better handled and the results understood with EHR’s with analytical capabilities. Same reason I want a good PHR capability – because that illness plus my issues demand having good data when an emergency occurs, or you move to a new doctor.

A few years ago, the family member with the immune disorder had been scheduled for outpatient treatment at Hospital X. The night before, that person needed to get to an ER ASAP. We wanted the ambulance to go to the ER at X. But there was a bad winter storm, and the ambulance took the person to Hospital Y, in a separate hospital system.

It took Y a few days to get sufficient paper records faxed over from X and from the treating doctor to properly care for the patient, making the situation even worse, and very wasteful cost wise. While HIE would greatly have helped, so would a viable PHR that was well populated and very readily and quickly accessible at Y. BTW, I’m not sure if X and Y are yet able to communicate (the doctor is still not live on an EHR), but I am quite sure that the EHR used in the ER at X (which the patient uses from time to time) has only minimal connections to the EHR used by the rest of hospital X.

One of my HealthIT instructors had orthopedic work done at hospital Z, with lots of imaging. A short time later, he found himself in the ER of hospital X – which could not access any of the imaging from Z, which now had to be completely repeated. Both wasteful and dangerous.

If HIE’s were ‘universal’, at least in the US, the need for a PHR would mainly revolve around the patient’s need to see all their info in one container, plus to get at it from outside the US if the need came up. But it would still exist.

We won’t go into all the challenges of the universal HIE here, but until those challenges are solved. You can see the value of a chronic patient having their universal health record that they can share no matter where they go for healthcare.

November 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Eyes Wide Shut – Managing Multi-EMR Meaningful Use Stage 2 Is Hard

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Most discussions on Meaningful Use (MU) seem to focus on a single healthcare provider organization (acute or ambulatory), with a single EMR, and a single Medical Record Number (MRN) pool generating unique patient identifiers. Even in that context, the complaints of the difficulties of successfully implementing the technology and obtaining the objectives are deafening. How daunting might those challenges seem, multiplied across a large integrated delivery network (IDN), attempting to make enterprise-wide technology and operational process decisions, in alignment with MU incentive objectives?

Imagine you are an IDN with 9 hospital facilities, sharing a single EMR. You also have 67 ambulatory practices, with 7 additional EMRs. You’ve made the progressive choice to implement a private health information exchange (HIE) to make clinical summary data available throughout the IDN, creating a patient-centric environment conducive to improved care coordination. To properly engage patients across the IDN and give them the best user experience possible, you’ve purchased an enterprise portal product that is not tethered to an EMR, and instead sources from the HIE. And because you’ve factored the MU incentive dollars into the budget which enabled these purchasing decisions, there is no choice but to achieve the core and select menu measures for 2014.

It is now October 2013. The first quarter you’ve chosen to gather Stage 2 attestation data starts on April 1, 2014. All your technology and process changes must be ready by the data capture start date, in order to have the best opportunity to achieve the objectives. Once data capture begins, you have 90 days to “check the box” for each MU measure.

Tech check: are all the EMRs in your IDN considered Certified Electronic Health Records Technology (CEHRT) for the 2014 measures?

Your acute EMR is currently 2 versions behind the newly-released MU 2014-certified version; it is scheduled to complete the upgrade in November 2013. Your highest-volume ambulatory EMR is also 2 versions behind the 2014-certified version, and it cannot be upgraded until March 2014 due to vendor resource constraints. Your cardiology EMR cannot be upgraded until June due to significant workflow differences between versions, impacting those providers still completing Stage 1 attestation. One of your EMRs cannot give you a certification date for its 2014 edition, and cannot provide an implementation date for the certified version. The enterprise portal product has been 2014-certified as a modular EMR, but the upgrade to the certified version is not available until February 2014.

Clearly, your timeline to successfully test and implement the multitude of EMR upgrades required prior to your attestation date is at risk.

Each EMR might be certified, but will it be able to meet the measures out of the box?

Once upgraded to the 2014 version, your acute EMR must generate Summary of Care C-CDA documents and transmit them to an external provider, via the Direct transfer protocol. Your ambulatory EMRs must generate Transition of Care C-CDA documents and use the same Direct protocol to transmit. But did you purchase the Direct module when you signed your EMR contract, or maintenance agreement?

Did you check to see whether the Direct module that has been certified with the EMR is also an accredited member of DirectTrust?

Did you know that some EMRs have Direct modules that can ONLY transmit data to DirectTrust-accredited modules?

You determine your acute EMR will only send to EMRs with DirectTrust-accredited modules, and that you only have a single ambulatory EMR meeting this criteria. That ambulatory EMR is not the primary target for post-acute care referral.

You have no control over the EMRs of providers outside the IDN, who represent more than 20% of your specialist referrals.

Your 10% electronic submission of Summary of Care C-CDA documents via Direct protocol measure is at risk.

Is your organization prepared to manage the changes required to support the 2014 measures?

This is a triple-legged stool consideration: people, process, and technology must all align for change to be effective. To identify the process changes required, and the people needed to support those processes, you must understand the technology that will be driving this change. Of all the EMRs in your organization, only 2 have provided product specifications, release notes, and user guides for their 2014-certified editions.

Requests for documentation about UI, data, or workflow changes in the 2014 versions are met with vague responses, “We will ask product management and get back to you on that.” Without information on the workflow changes, you cannot identify process changes. Without process change recognition, you cannot properly identify people required to execute the processes. You are left completely in the dark until such time as the vendors see fit to release not only the product, but the documentation supporting the product.

Clearly, your enterprise program for Meaningful Use Stage 2 health IT implementation and adoption is at risk.

What is the likelihood that your Meaningful Use Stage 2 attestation will be a successful endeavor for the enterprise?

As a program manager, I would put this effort in flaming red status, due to the multitude of risks and external dependencies over which the IDN organization has zero control. I’d apply that same stoplight scorecard rating to the MU Stage 2 initiative. There is simply too much risk and too many variables outside the provider’s control to execute this plan effectively, without incurring negative impacts to patient care.

The ONC never said Meaningful Use would be easy, but does it have to be this hard?

October 2, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

A Biometrically Controlled Healthcare System

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I recently had a nice conversation with Brian Dubin, VP at CERTIFY, where we discussed biometrics in healthcare. Brian got me interested when he described CERTIFY as a biometrics based “big data” company. When I first started this blog, I fell completely in love with all the various biometric options. Check out one of my first posts on Facial Recognition back in April 2006. Shortly after that I even made this EMR and biometrics contribution to a healthcare IT wiki as part of a “blogposium”. [Excuse my moment of nostalgia]

While CERTIFY works with all of the major biometric fingerprints: Finger, Palm, Iris, Facial, Voice, and Signature, I was even more intrigued by a discussion we had around a healthcare system that was biometrically controlled (my word not CERTIFY’s). I realize that the word “controlled” might have negative connotations surrounding it, but I think it is fascinating to consider all of the ways that your biometric identity could be incorporated into healthcare.

Here are some examples I’m considering (some are a reality today and others will be in the future):
Arrive at the office – Imagine that when you arrive at the hospital or medical practice and a video camera grabs your image and the front desk already knows who you are and can say, “Hi John, glad to have you hear today.” Yes, this freaks out some people, but many of the front desk people remember the faces of the patients. Now they can know your name and check you in much quicker.

Positive patient identification – If you don’t like the video camera identification of a patient, you can also do positive identification of the patient using biometrics in a less big brother’s watching you way. When they sit down at the desk to check in, the patient can use a biometric device to identify themselves. Technology like the one I talk about in my post Retina Scanning vs. Iris Recongition are what can be used for this approach.

Voice recognition for a call center – Imagine when you call into a call center they used voice recognition to identify you. This could be used to access your information more quickly. Although, it could also be used to make sure that whoever the person in the call center pulled up matches the voice on the phone. This could solve them pulling up the wrong “John Smith.”

Single sign on – If your biometric identity is stored in the cloud, then that should make that identity available on any system. Plus, I’ve always been fond of single sign on with Facial recognition. The camera is always watching if you’re there or not and so if you open a new application it can immediately authenticate you since it’s constantly authenticating your biometric identity.

I’m really intrigued by the idea of using biometric identities across multiple systems. I’ve heard many hospital CIOs talk about the hundreds of IT systems they have to support. I’ve also heard doctors and nurses complain about the number of logins and passwords they have to remember. Could biometrics be the solution to this problem? Could a biometric identity be shared between systems or would each system need to do more of the traditional single sign on integration?

Unattended computer – Related to the single sign on, facial recognition can also identify when you’re no longer at a computer. If you leave the computer it can automatically lock the computer to ensure that the health data is kept private. You have to balance how quickly the device locks, but this can be great for security.

Location access – A lot of places already do this with fingerprint or palm scans to access private areas. Plus, this prevents the sharing of keys. You can’t really share your fingerprint very well.

Signatures – There’s certainly an art and identity in someone’s signature. However, why don’t we incorporate even more biometrics into someone’s signature? The combination of a signature plus some other biometric identity would be even more powerful. Plus, when I sign to pick up a prescription, if the pharmacy knew my fingerprint, they could indeed verify that I was the right patient.

HIE identification – I don’t know anyone that’s doing this, but I wonder if instead of trying to make a unique patient identifier, using social security numbers, or some other convoluted method of identity management, could we just use someone’s biometric identity? If we aren’t there today, I think we’ll get there eventually. I’m sure there could be mismatches when it comes to matching two biometric identities that were captured by two separate systems. However, we have plenty of mismatches using ssn, name, birthdate, etc. Maybe the real answer is a combination of biometrics and name, birthdate, etc.

A Biometric Healthcare Experience
Those are some general examples. Now let’s imagine a patient visit where they walk into the hospital and are immediately recognized as a patient seeing Dr. Jones for a surgery. The front desk knows who you and has you sign any forms using your biometrics and then directs you to room 315. When you arrive at room 315 you gain access to the room using your biometric identity. The nurse arrives to prep you for surgery and knows she’s working on the right patient because of your biometric identity.

The nurse signs into the EMR using facial recognition and that biometric identity is captured so the EMR knows exactly who is entering the data into the system. The lab arrives and attached your biometric identity to the blood draws and the results will automatically be sent to the EHR matching on your biometrics.

Your doctor writes a prescription for you which gets sent to the pharmacy. The pharmacy knows that he is indeed a doctor based on the biometric identity of the doctor. Once you go to pickup the prescription they verify your biometric identity to ensure you’re in fact the right patient for that prescription. You later go to your family doctor who’s received all of the information and reports from your surgery which were easily matched to you thanks to your biometric identity.

I could keep going, but I think you get the idea. I’m sure there are major holes in the above example, but I think it’s interesting to consider what a biometrically controlled healthcare experience would look like. Plus, to take a line from Google’s Founder, maybe I’m still thinking too small. It’s possible that biometrics will be able to do so much more. It’s not going to happen tomorrow or all at once, but I’m certain that biometrics will play a big part in the future of healthcare.

I’d love to hear your thoughts on this. Are we on the path to a biometric controlled healthcare system?

September 6, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Bring Your Own EHR (BYOEHR)

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Nerd Doc recently offered a new term I’d never heard called Bring Your Own EHR (BYOEHR). Here’s the explanation:

As a tech nerd doc, the best advice I can give to CIOs/CMIOs is to find a framework for ambulatory practices that embraces a BYOEHR (Bring your own EHR) in the same vein of BYOD (Bring your own device). What I mean by that is allow providor choice in purchasing and implementing their own EHR while insuring that a framework is set up for cross communication to interlink records.

This is to fend off the trend to a one size (Epic) fits all approach in which no one is happy. C-level management needs to realize that if users (providers) are not happy, the promises of savings via efficiency simply will not happen.

I think we’re starting to hear more and more examples like this. We saw evidence of this in my previous post called “CIO Reveals Secrets to HIE.” That hospital organization had created an HIE that connected with 36 different EMRs. Think about the effort that was required there. However, that CIO realized that there was a benefit to creating all of those connections. The results have paid off with a highly used HIE.

I’m sure we’ll still see hospitals acquiring practices and forcing an enterprise EHR down their throats for a while. However, don’t be surprised if the cycle goes back to doctors providing independent healthcare on whatever EHR they see fits them best. Those hospitals that have embraced a BYOEHR approach will be well positioned when this cycle occurs.

July 23, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

CIO Reveals Secrets to HIE

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Inspira Health Network is a community health system comprising three hospitals in southern New Jersey, with more than 5,000 employees and 800 affiliated physicians. It is an early adopter of health information exchange technology. In this Q&A-style paper their CIO and Director of Ambulatory Informatics share secrets to their successful Health Information Exchange implementation.

One of the most impressive numbers from their HIE implementation is that they were able to get 600 providers using the portal and 36 EMRs connected. Plus, they were able to get their HIE up and running in 4 months while many of the public HIEs were still working on their implementations. As I’ve written about previously, I see a lot of potential in the Private HIE. So, it’s great to see a first hand account from a CIO about their private HIE implementation.

Here are some of the other benefits the CIO identifies in the paper:

  • Ties the Physician Community to the Organization
  • Helps Meet the Meaningful Use Patient Engagement Requirements
  • Helps Address Care Coordination Requirements
  • Paper, Postage, and Staff Resource Savings
  • Improve Patient Length of Stay

Check out the full Q&A for a lot of other insights including rolling out the HIE to doctors who have an EMR and those who don’t. I also love that the CIO confirmed that the biggest technical challenge is that every EHR vendor has interpreted the HL7 standard differently based on the technical limitations of the application. This is why I’m so impressed that they were able to get 36 EMRs connected.

I hope more CIOs will share their stories of success. We’ve heard enough bad news in healthcare IT. I want to cover more health IT success stories.

July 3, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

High Costs of Health IT, ePrescribing, and HIE — #HITsm Chat Highlights

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The following is our regularly scheduled roundup of tweets from yesterday’s #HITsm chat. You can also check out John’s blog post on yesterdays #HITsm topics.

Topic One: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?

 

Topic Two: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?

 

Topic Three: #HIE as a noun or a verb? Does negative press for HIE organization$ hinder health data exchange as a whole?

#HITsm T4: Is #CommonWell just a bully in a fairy godmother costume?

 

Topic Five: Open forum: What #HealthIT topic had your attention this week?

June 29, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

HIEs and Patient Engagement – Why and Why Now?

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The following is a guest post by Jeff Donnell, President of NoMoreClipboard.
Jeff Donnell - NoMoreClipboard PHR
Health information exchanges have become quite adept at moving medical data from provider to provider on behalf of patients, but making that data available to those same patients has rarely been attempted – until recently.

Not including patients at the HIE exchange table is understandable, but ironic. Understandable for reasons ranging from policy challenges to a lack of standards to technical limitations. Ironic because HIEs are ideally positioned to aggregate data from multiple providers – leveraging the interfaces already in place with provider applications – and deliver that data to consumers, overcoming several of the major barriers to patient adoption and use of tools like PHRs and patient portals.

HIEs have recently grown interested in supporting electronic patient engagement, in large part based on provider inquiries regarding meaningful use stage two requirements. Many providers are looking for affordable alternatives to the tethered patient portals being offered by their EHR vendors, and they want to provide their patients with a solution that can be used across the care continuum. Increasingly, providers recognize that a patient who visits five different clinicians is not about to create five different patient portal accounts. Savvy providers realize that the HIE is well equipped to provide portable, interoperable solutions.

For HIEs interested in long-term sustainability, patient engagement makes perfect sense. The HIE can leverage its existing interfaces and aggregated data – making existing medical information available to patients from a single pipe, in a standardized format. The HIE can act as a conduit between consumers and clinicians – adding value for all parties. Providers can transmit data to patients, and recent CMS guidance indicates that all providers who contribute data to a shared portal (like that provided by an HIE) can count patients who use that portal toward their 5% patient participation requirement. Patients avoid having to collect data from every provider they see, and can populate a PHR or HIE portal account with existing electronic data. Everybody wins.

The value is evident, but what about those challenges? In the state of Indiana, we received an ONC Challenge Grant to figure out how to get HIE data in the hands of consumers with a PHR. We are fortunate to reside in a state with five well-established HIEs and a provider community eager to innovate, and we have spent the last two years working on those challenges (giving us a real appreciation for why the ONC affixed the challenge label to this grant program). We have addressed issues ranging from patient ID/Auth/Match to minor consent to provider skepticism to amended data use agreements. We have overcome any number of obstacles to get data flowing, and we are seeing increased levels of engagement and enhanced clinical outcomes.

We have learned any number of lessons to help other HIEs, state agencies and healthcare providers avoid pitfalls and make accelerated progress. We are eager to share what we have learned. Perhaps the most important lesson is to get started now – as crafting and implementing a patient engagement strategy takes time. As nobody appears to be manufacturing more time these days, HIEs and other organizations that envision sharing data with patients even a year or two down the road would be well advised to begin working in earnest, with an eye on making incremental progress.

Jeff Donnell is president of NoMoreClipboard, a web-based, Personal Health Record (PHR) management system designed to consolidate medical information in one convenient and secure location for easy retrieval and updates. NMC enables consumers to share personal or family member medical information with medical professionals electronically, reducing the need for repetitive medical paperwork.  Jeff and the company are committed to developing PHR applications that are consumer-friendly, interactive, secure, mobile and interoperable.  For more information, follow us on Twitter @NoMoreClipboard or visit www.NoMoreClipboard.com.

June 20, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Private HIE’s Will Make Nationwide HIE Possible

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We’ve been working for a long time on creating a nationwide HIE. I still remember when I first started blogging about EMR 7.5 years ago we were talking about implementing RHIO’s. I’m sure someone reading this blog can talk about what the exchange of health data was before RHIO’s. The irony is that we keep talking about creating this beautiful exchange of information, but it never really becomes a reality.

As I look at the landscape, there are very few HIEs that are showing a viable business model. The two leaders I think are probably the Indiana HIE and the Maine HIE. They seem to be the two making the most progress. I think there’s also something going on in Massachusetts, but it’s so complicated of a healthcare environment that I’m not sure how much is reality and hyperbole.

With those exceptions, I’m mostly seeing a lot of talk about some sort of community HIE and not very much action. However, I am seeing quite a few organizations starting to take the idea of a private HIE quite seriously. I’m not sure if this is driven by ACOs, by hospital consolidation, or some other force, but the move to implement a private HIE is happening in many health systems.

For a lot of reasons this makes sense. There is a business reason to create a private HIE and you own all the endpoints, so it’s easier to create consensus.

As I look across the landscape, I think these private HIEs could be what makes the nationwide HIE possible. Once a whole series of large private HIEs are in place, then it’s much easier to just connect the private HIEs than it is to try and connect each of the individual healthcare organizations.

Watch for the major hospital CIOs to meet at events like CHIME or HIMSS and discuss connecting their private HIEs. It will create some unlikely relationships, but it could be our greatest hope for a nationwide HIE.

June 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.