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The Rise Of mHealth And EHR Use, And The World Of Telehealth – Around Healthcare Scene

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mHealth is on the rise, and it looks like usage of smart phones among physicians is following that same trend. A recent study shows that usage rose about nine percent in 2012, which shows that it is becoming more accepted in the medical world. It will be interesting to see if it increases even more this year (I have a feeling it might.)

Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

Even though 90 percent of doctors are using an EMR at one point or another, only about 55 percent have actually adopted an EHR into their practice. It can be nerve-racking trying to find the perfect EHR. If you are finding yourself at that crossroad, be sure to read these five tips from ADP AdvancedMD on how to have a successful EHR implementation.

Still, some of you may be hesitant to implement an EHR. You may ask, is it worth it? Does it takeaway from healthcare? There is debate from both sides, each with compelling arguments. John believes that technology is overall positive in any industry, and discusses his thoughts, and some of the challenges that faces the industry.

Telehealth and medicine is so huge, it can be hard to digest. Neil Versel recently attended the American Telemedicine Association’s annual conference in Austin, Texas, and saw just how huge this market was. Be sure to check out this video he created from his experience, and to perhaps get a better idea about the many types of telehealth. Similar to the increase in doctors using smartphones, there has been a jump in EMR and HIE use as well. A survey from Accenture found that over 90 percent of doctors are using an EMR in either their practice or at a hospital, and over 50 percent are using an HIE. This increase was highest among doctors in the United States. Be sure to read more of the interesting facts this survey found about EMR and HIE use in the U.S., and around the world.

With summer quickly approaching, it’s more important than ever to stay hydrated. But if you need a little reminder, be sure to look into the Jomi Band.  It gives you warnings when you might be on the brink of dehydration, and makes it easy to keep track of how much water you’ve consumed in a day’s time.

May 12, 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.

What’s Next TEDMED?

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One of the beauties of TEDMED is that they do a really professional job recording the event and sharing the recorded video with the world. For those who missed it or want to re-watch certain sessions, you can find the full TEDMED session recordings available online. Thanks to Xerox, I was able to cover the event in person. If you’re looking for a cliff notes version of TEDMED, check out my previous posts covering the event:

As I think back on TEDMED, I’m stuck wondering about a major healthcare group I would have loved to see on the TEDMED stage: hospital and healthcare administrators. No doubt they’re doing some really innovative things in healthcare, but yet we didn’t see any of them on stage talking about how to innovate the nuts and bolts of healthcare.

It’s not that many of these hospital and healthcare administrators weren’t at TEDMED, because they were there in force. I met with many of them and saw many of them tweeting about TEDMED like this tweet from New York Presbyterian CIO, Aurelia Boyer:

I hope that many more hospital and healthcare administrators will “Step Out” and speak at TEDMED like Hospital CIO Bill Reiger did at The Breakaway Group’s Healthcare Forum at TEDMED. It’s great that hospital and healthcare administrators are listening and learning at TEDMED, but they also have a voice that needs to be heard.

Looking forward to the next year in healthcare let me suggest three topics I hope we’ll find at TEDMED 2014:

Accountable Care Organizations (ACOs) – ACOs represent the core of a rapidly changing healthcare reimbursement environment. This change will fundamentally alter healthcare as we know it. ACOs are a hard topic to package into a slick presentation, but there are stories to be told about the impact for good and bad of ACOs. We often hear: “If you’ve seen one ACO, you’ve seen…one ACO.” How about we start with one ACO TEDMED talk and expand from there?

Interoperability – Almost nothing could provide more value to healthcare than true data interoperability. There are literally hundreds and possibly thousands of people affected every day by the lack of healthcare interoperability. The challenges to interoperability are real and powerful, but I see a shifting tide where organizations are finally looking to embrace interoperability and its inherent benefits. TEDMED would be the perfect place to highlight the interoperability success stories that will inspire others to follow.

Patient Engagement – A number of sessions at TEDMED 2013 began the discussion of the shifting role of patients in healthcare. I won’t be surprised if 2014 becomes the Year of the Patient. Like a slow moving ship that’s impossible to stop, the patient is finally becoming the center of healthcare. ZDoggMD’s comment at TEDMED highlights this shift from the physician perspective, “I went in to medicine to do things for patients, not to patients.” Patients at the center of healthcare is a message that needs to be shared.

In true TEDMED form, it only seems appropriate that I also suggest a collaborative musical act that could perform at a future TEDMED. If you’ve never heard of The Piano Guys, they’re great. Where else have you seen a piano and cello collaboration perform Coldplay, Usher, and Adele? Although, their real genius is when they take two songs and mix them into one beautiful piece like they did with Love Story Meets Viva La Vida. I can think of a few areas of healthcare that could benefit from some unexpected collaboration.

What did you take away from TEDMED 2013? Have you had a change in perspective personally or professionally? What topics should we see at future TEDMED events?

You can hear more reflections from TEDMED and predictions for the future of healthcare during the May 2 at 2 p.m. ET “Xerox ‘Ask the Experts’ Episode: Looking Ahead After TEDMED” Google+ Hangout that I’m hosting and participating in. Click here for more details and to watch.

Read more coverage from TEDMED from Xerox on the Real Business at Xerox Blog and follow @XeroxHealthcare.

April 24, 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.

User-friendly EMRs, Meaningful Use Fraud, and DietBet – Around Healthcare Scene

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Many are concerned with the user experience in Health IT – particularly regarding the user-friendliness of EMRs. While it is easy to be overwhelmed by the negative reports, there are businesses and providers working hard to resolve these issues. McKesson is one of those companies, and they were recently recognized for their work at HIMSS13. Will more companies start making efforts like this? 

One step toward making EMRs more user-friendly is, well, making them accessible to patients. Unfortunately, according to a recent Accenture study, 65 percent of doctors believe patients should only have limited access to their health records, and 4 percent believe records should be totally closed. Reasons range from self-consciousness of what a doctor says in a record, to being uncomfortable with using digital records. Allowing patient-access may very well be a huge cultural shift for doctors everywhere.

In order to pass Meaningful Use stage 1, one must indicate which EMR was adopted. But, according to BuildYourEMR.com’s CEO, Mike Jensen, 74 percent of the providers who stated they were using his EMR…weren’t. If this is similar across the board, around 5.4 billion dollars were paid in error for incentives. While this isn’t likely to be the case, it’s pretty sad the lengths people will go to in order to get some extra money. EMR vendors need to start going over their CMS data in order to help prevent this fraudulent behavior.

If money was at stake for you to lose weight, would that motivate you? For most people, it probably would. DietBet takes the desire people have to lose weight and pairs it with the innate desire to have money, and creates a weight-loss game. If you lose 4 percent of your body weight in four weeks, you get part of the money pot for the group you are in. If you don’t, you lose the amount you paid to participate in the first place.

John recently had the opportunity to go to TEDMED as a guest of the Breakaway Group (A Xerox company)
. It was a great experience for him, and highlights can be found @ehrandhit or searching #simplehealth on Twitter. John recounts some of key takeaways from TEDMED, and suggests some of the major themes that will likely be seen in healthcare.

April 21, 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.

Traditional Marketing, Drug Companies, and Behavioral Scientists – #HITsm Chat Highlights

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Topic One: @bjfogg behavior model has become well known in tech around engagement. How is this or other models applicable to patient care?

Topic Two: Outside #healthcare, “engagement” is largely about marketing. What can traditional marketing teach us about patients?

Topic Three: Engagement is closely tied to influence and by who you are trying to influence. What are biggest drivers of influence in hc?

Topic Four: Drug companies are masters of influence, how can we improve the influence of engagement?

Topic Five: @nationalehealth and @ONC_HIT work with top behavioral scientists. When does a nudge toward behavior change become a shove?

April 20, 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.

EHR Debates and The Growth of mHealth – Around Healthcare Scene

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With the dissatisfaction that many have felt from EMR, providers and patients alike, outside healthcare companies are coming up with new ideas on how to help. Healthpons, a healthcare version of Groupon, recently launched and aims to help people find affordable care, and allow providers to market themselves. Is this “cash for care” model a trickle down effect of EMR Dissatisfaction?

Among the debates related to EHRs, one of the biggest is about purging data. On one side, people believe that all data from a person’s life in order to give the best care possible. Another camp believes that keeping EHR data opens up the door for the institution being held liable. What do you think?

Hospitals are implementing EMRs left and right. However, who is it that pays for it? Some argue that it’s the consumer, others sometimes even say it’s the insurance companies. In the end, it’s the hospitals themselves.

How do you measure the quality of a doctor? In same ways, it’s impossible. Ideally, there would be a way to determine whether the quality of care a doctor provides is worth the cost they charge. However, there are risks involved in this, and really, it’s hard.  Don’t we all want the best doctor possible, for the lowest price? How can we keep doctor’s accountable for the care they provide?

If you have a hard time deciding the quality of a doctor, why not take matters into your own hands? Most people know that Google contains a plethora of health information, and that smartphones have a variety of health-related apps. The digital health market is growing at a fast rate and more technology is being released each day. What do you think the future holds for mHealth?

The past few weeks, some well-known names in health IT have lost dear family members. Remember these people in your thoughts.

April 7, 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.

Communication With Providers, Patient Alert Fatigue, and #HealthIT — #HITsm Chat Highlights

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#HITsm T1: How do you WANT to communicate with your healthcare provider? How does it differ from what’s available?

 

#HITsm T2: How can we avoid patient alert fatigue as we move toward engaged care and #mHealth acceptance?

 

#HITsm T3: Will the shortage of qualified #healthIT professionals to fill openings force a delay in meeting Meaningful Use requirements?

 

#HITsm T4: Open Forum> What #healthIT topic has interested you most this week?

April 6, 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.

Hospitals, Representative Ask For Extension of EMR “Safe Harbor”

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Right now, it’s legal for hospitals to give doctors EMRs under certain circumstances, despite the existence of the Stark law banning payments intended to induce referrals.  Specifically, hospitals won’t face anti-kickback enforcement if doctors pay 15 percent of the cost of EMRs donated by hospitals.

But the Stark law exception established by CMS, plus a “safe harbor” rule established by the HHS Office of the Inspector General, are both due to expire at the end of 2013. This will take place despite the fact that Medicare incentives for EMR adoption will continue through 2016, notes iHealthBeat.

Hoping to address this state of affairs, the Federation of American Hospitals has made the renewal of EMR exceptions to the Stark law its top recommendation in a proposed list of safe harbors, reports Modern Healthcare. More recently, Rep. Jim McDermott (D-Wash.) wrote a letter to the chief counsel to HHS’ OIG to extend those exceptions soon.

Extending these safe harbor provisions at least through the life of the Meaningful Use program seems necessary and wise. After all, it’s hard enough to get smaller practices up on EMRs even with the promise of incentives. Letting hospitals pay for most of the cost of the system would meet the public policy objectives which prompted the creation of HITECH in the first place.

According to Modern Healthcare, the federal Office of Management and Budget is reviewing proposed rules regarding the Stark exception and the anti-kickback safe harbor. Let’s hope they’re finalized in time to solve the problem.

April 3, 2013 I Written By

Katherine Rourke 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.

Analytics-Driven Compassionate Healthcare at El Camino Hospital

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Given its location in the heart of Silicon Valley, it may not be remarkable that El Camino Hospital was the first hospital in the US to implement EMR. What IS remarkable is that El Camino implemented EMR 51 years ago, leveraging an IBM mainframe system that Lockheed Martin refactored for healthcare from its original intended use for the space program.

Take a moment to process that. El Camino didn’t need PPACA, Meaningful Use, HITECH, or HIPAA to tell them health data is critical. El Camino saw the value in investing in healthcare IT for electronic data capture and communication without federal incentive programs or lobbyists. With that kind of track record of visionary leadership, it’s no wonder they became early analytics program adopters, and recently turned to Health Care DataWorks (HCD) as a trusted partner.

When I sat down with executive leadership from El Camino and HCD to discuss the journey up Tom Davenport‘s analytics maturity scale from rudimentary operational reporting to advanced analytics, I expected a familiar story of cost pressure, clinical informatics, quality measure incentives or alternative payment models as the business drivers for new insights development. Instead, I heard the burgeoning plan for a visionary approach to patient engagement and “analytics-driven compassionate care”.

Greg Walton, CIO of El Camino Hospital, admitted that initial efforts to implement an analytics program had resulted in “textbook errors”: “’Competing on Analytics’ was easier to write than execute,” he said. Their early efforts to adopt and conform to a commercially-available data model were hindered by the complexity of the solution and the philosophy of the vendor. “One of the messages I would give to anybody is: do NOT attempt this at home,” Greg laughed, and El Camino decided to change their approach. They sought a “different type of company…a real-life company with applicable lessons learned in this space.”

“The most important thing to remember in this sector: you’re investing in PEOPLE. This is a PEOPLE business,” Greg said. “And that if there’s any aspect of IT that’s the most people-oriented, it’s analytics. You have to triangulate between how much can the organization absorb, and how fast they can absorb it.” In HCD, El Camino found an analytics organization partner whose leadership and resources understand healthcare challenges first, and technology second.

To address El Camino’s need for aggregated data access across multiple operational systems, HCD is implementing their pioneering KnowledgeEdge Enterprise Data Warehouse solution,including its enterprise data model, analytic dashboards, applications and reports. HCD’s technology, implementation process, and culture is rooted in their deep clinical and provider industry expertise.

“The people (at HCD) have all worked in hospitals, and many still work there occasionally. Laypersons do not have the same understanding; HCD’s exposure to the healthcare provider environment and their level of experience provides a differentiator,” Greg explained. HCD impressed with their willingness to roll up their sleeves and work with the hospital stakeholders to address macro and micro program issues, from driving the evaluation and prioritization of analytics projects to identifying the business rules defining discharge destination. And both the programmers and staff are “thrilled,” Greg says: “My programmers are so happy, they think they’ve died and gone to heaven!”

This collaborative approach to adopting analytics as a catalyst for organizational and cultural change has lit a fire to address the plight of the patient using data as a critical tool. Greg expounded upon his vision to achieve what Aggie Haslup, Vice President of Marketing for HCD, termed “analytics-driven compassionate care”:

We need to change the culture about data without losing, and in fact enhancing, our culture around compassion. People get into healthcare because they’re passionate about compassion. Data can help us be more compassionate. US Healthcare Satisfaction scores have been basically flat over the last 10 years. Lots of organizations have tried to adopt other service industry tools: LEAN,6S; none of those address the plight of the patient. We’ve got to learn that we have to go back to our roots of compassion. We need to get back to the patient, which means “one who suffers in pain.” We want (to use data) to help understand more about person who’s suffering. My (recent) revelation: what do you do w/ guests in your house? Clean the house, put away the pets, get food, do everything you can to make guests comfortable. We want to know more about patients’ ethnicity, cultural heritage, the CONTEXT of their lives because when you’re in pain, what do you fall back on? Cultural values. We want a holistic view of the patient, because we can provide better, compassionate care through knowing more about patients. We want to deploy a contextual longitudinal view of the patient…and detect trends in satisfaction with demographics, clinical, medical data.

What a concept. Imagine the possibilities when a progressive healthcare provider teams with an innovative analytics provider to harness the power of data to better serve the patient population. I will definitely keep my eye on this pairing!

March 25, 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.

NetPulse, HIEs, and The Importance of Reliable EMRs — Around Healthcare Scene

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Have you ever wished that all your fitness and food trackers were in one place? Well, look no further. NetPulse is trying to do just that. The new platform is working with some of the hottest apps, as well as fitness equipment makers, to make taking control of your health easier and more convenient.

A group of researchers recently published an opinion in the Journal of the American Medical Association regarding cloud-based health records versus HIEs. The verdict? They feel that the cloud-based health records might be a better way of sharing health records. What they had to say was rather interesting, so don’t miss the recap of it over at EMR and EHR.

Still looking to use HIEs, rather than Cloud-based health records? The ONC has recently released a toolkit to help different healthcare professionals use them more efficiently. This toolkit includes several guides and a spreadsheet to help determine costs and savings that are associated with implementing an EHR.

For those that missed HIMSS, check out the video that John filmed of the Metro point of care solutions. It gives you a first person perspective of what you could have seen demoed at HIMSS if you were able to attend. Plus, it’s pretty cool to see the point of care and BCMA technologies in action.

It’s important for an EMR to be usable. However, this isn’t always the case, and it can be extremely frustrating. Dr. Shirie Leng, an anesthesiologist, is someone who feels that way. In a recent piece over at KevinMD.com, Dr. Leng discusses her EMR usability wish list. Be sure to check it out, and see if you agree. What is your usability wish list?

And, how smart is your current EMR? According to John, it might just be stupid. While they may have value, most EHR software is just full of dumb data repositories. Despite the negativity of this perspective, the future of EHRs does have hope. With the help of entrepreneurs innovators, current EHRs will be turned smart.

Finally, in order for EMRs to make the changes needed, to improve usability and become more “smart,” the vendors need to get it together.  KLAS recently put several popular EMRs head-to-head, reviewing their usability and efficiency. Although names weren’t listed, they found that some EMRs were very difficult to learn, and it’s not necessarily the physician who is using its fault. Perhaps it’s time that physicians and hospitals demand higher quality products.

March 24, 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.

HIMSS Analytics Clinical & BI Maturity Model

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While the theme of HIMSS 2013 may have been, “How Great Is Interoperability,” the effectiveness of the many facets of interoperability are only as good as the actionable value of the shared data. The clinical insights that should be enabled by Meaningful Use Stage 2+ are expected to drive market trends in myriad areas of the healthcare system: chronic disease management, targeted member interventions, quality measures. In order to assess organizational readiness to capitalize on the promise of Meaningful Use, HIMSS Analytics began measuring the implementation and adoption of EMR and clinical documentation using a maturity model called EMRAM.

EMRAM

But, in analytics terms, EMRAM’s results are simply targeted foundational reporting, answering the question, “WHAT happened with Meaningful Use EMR adoption criteria.” So, you’ve got your clinical data in an EMR. Now what are you able to DO with it?

In 2013, HIMSS Analytics is taking a broader approach with the introduction of a new Clinical Business Intelligence maturity model, creating a framework to benchmark participating providers’ analytics maturity level.

I’ve been fortunate to know James Gaston, Senior Director of HIMSS Analytics Clinical & Business Intelligence, for many years, going back to his days with Arkansas Blue Cross. His appreciation for BI initiatives is matched only by his enthusiasm for the first day of turkey hunting season. When I ran into him at TDWI’s BI World summit in Orlando in November, he acted like a kid on Christmas morning, telling me about the brave new world of clinical data management that he was about to tackle. The excitement continued to build in the months leading up to HIMSS. James was practically glowing when we spoke about the upcoming C&BI Maturity Model release.

“Our customers are interested in not just understanding how to deploy IT applications, but how effectively they’re using those applications to support clinical business intelligence, as well as analytical pursuits,” James said. “So, HIMSS Analytics partnered with IIA to create and present a Clinical & BI Maturity Model that helps healthcare organizations measure that level of effectiveness.”

Sarah Gates, the VP of Research for IIA (the International Institute of Analytics), elaborated. “The HIMSS Analytics C&BI Maturity Model leverages the Competing on Analytics DELTA model, developed by Tom Davenport, which measures not only how well you’re using data and technology, but how well you’re building an analytical organization.” There are 5 core competency measurements in the DELTA model that will inform the HIMSS Analytics C&BI analysis: Data, Enterprise, Leadership, Targets, and Analysts. The methodology is holistic, touching on the cultural aspects of the organization as well as the technical, allowing a longitudinal view of the organization’s analytics program. A yardstick value from 1-5 will be assigned to each respondent based on Davenport’s criteria for each core competency.

Although HIMSS Analytics will eventually offer Level 1-5 certification program for those organizations with observed results for analytics, James and Sarah agreed that it is not appropriate for every provider to reach for the Level 5 gold star. Per Sarah, “Healthcare is an industry just starting to discover analytics. We’re expecting to see lots of practitioners that are emerging in use of analytics, so we believe it (survey results) will be heavy on the lower end of the maturity scale. Data warehouse capabilities and staffing career paths for data analysts will be key differentiators for mature programs.” Not all providers have the resources – financial, human, and/or technical – to attain advanced analytics nirvana, and James wants to insure that these providers don’t feel as if they’ve “failed”; the goal is to baseline against the peer group, identify opportunities for improvement, and focus on what is possible for each individual organization, working within their constraints.

What can we expect to see at next year’s C&BI survey results presentation? James said, “We want to be able to talk about benchmarking the industry as a whole, helping healthcare find its way with clinical business intelligence and begin to understand how important it is, and where opportunities lie Everyone’s talking about clinical and BI – it is the opportunity to realize savings in healthcare, to use information to empower people to make better decisions.”

So, it’s up to you, providers and technology partners. You’ve implemented your EMR, achieved a high adoption rate across your organization’s core clinical processes, attested to Meaningful Use Stage 2, achieved Stage 7 on the HIMSS EMRAM scale, perhaps even participated in multi-HIE CCD medical records sharing with other provider networks. You’ve got the data in-house and availabe. It’s time to see how ready you are to rise to the analytics challenge and maximize your return on those EMR and HIE investments.

Attempt to beat your previous Doug Fridsma long jump.

Note: for the complete HIMSS 2013 Leadership Survey Results, please download PDF here.

March 14, 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.