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EHR Vendors Need to Expand Their Definition of Customer Service

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

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

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

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

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

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

July 21, 2014 I Written By

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

Meaningful Use Audits, RAC Audits, and HIPAA Audits

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The following is a guest post by Barry Haitoff, CEO of Medical Management Corporation of America.
Barry Haitoff
Healthcare has always been a deeply regulated industry, so in many ways healthcare organizations are already used to dealing with government scrutiny. However, we’ve recently seen a number of new audit programs hit the healthcare world that didn’t exist even a few years ago. Here’s a look at a few of them you should be prepared for.

Meaningful Use Audits
This is one of the newest audit programs to hit healthcare. Depending on your attestation history, it could have a tremendous impact on your organization’s financial health. These EHR incentive audits have been happening across every size organization and are conducted by the CMS hired auditing firm, Figliozzi and Company of Garden City, N.Y. If you get a letter or email from Figliozzi you’ll know what it is right away. An EHR incentive audit is a big deal since the meaningful use program is all or nothing. If they find even one thing wrong with your meaningful use attestation, you could lose ALL of your EHR incentive money.

CMS recently released an informative guidance document outlining the supporting documentation needed for an EHR incentive audit. Pages 4 and 5 of the document go through the self-attestation objectives and others detailing the audit validation and suggested documentation needed for each. If you’ve attested to meaningful use, then you’ll want to take some time to go through the document to make sure you can provide the necessary documentation if needed. In many cases this simply includes dated screenshots to prove measure completion. While many EHR vendors can be helpful in the meaningful use audit process, you should not totally rely on them.

In a recent blog post, Jim Tate makes a compelling case for why you might want to consider doing a mock EHR incentive audit and how to make sure that the audit is effective. Although smaller organizations won’t likely be able to afford an outside audit, having it done by someone in your organization that wasn’t involved in the attestation is beneficial. The CMS guidance document could be used as a guide. A mock audit could help discover any potential issues and help you put mitigation strategies in place before you have a real audit and your hands are tied.

Recovery Audit Contractor (RAC) Audits
RAC audits are currently on hold as CMS works to improve the program and deal with the enormous audit backlog. We still haven’t heard from CMS about when the RAC audits will resume, but we should hear something later this summer. While no RAC audits are occurring right now, that doesn’t mean that once the RAC audits resume, the claims you’re filing today can’t and won’t be audited.

The best thing you can do to be prepared for RAC audits is to make sure that your documentation and billing ducks are in a row. A great place to start is to look at your most common denials and look at how you can improve your clinical documentation, coding and billing for each of these denials. Also, make sure that your process for responding to audits is standardized and effective. The RAC audit is just one example of an audit performed by payers. Don’t be surprised if you’re subjected to audits from other agencies or commercial payers.

RAC audits recovered billions of dollars in overpayments in recent years. You can be sure that they will continue and that other similar initiatives are coming our way. There’s just too much incentive for the government not to do it.

HIPAA Audits
The US Department of Health and Human Services’ Office for Civil Rights (HHS OCR) first started doing HIPAA audits as part of a 2011 pilot program. It’s fair to say that HHS OCR’s audit program was one of discovery as much as it was of compliance. However, the HITECH Act and Omnibus Rule have started to up the ante when it comes to enforcement of HIPAA. HHS OCR announced that they’d be surveying 800 covered entities and 400 business associations to select the next round of audit subjects. An OCR Spokesperson said, “We hope to audit 350 covered entities and 50 BAs in this first go around.”

Unlike previous audits that were done by KPMG, these HIPAA audits will be done by OCR staff. One area that these audits will likely focus on is the HIPAA Security Risk Assessment. The importance of doing this cannot be understated and is illustrated by the fact that it’s a requirement for meaningful use. I will be surprised if these audits don’t also focus on the new HIPAA Omnibus Rule requirements. I’m sure many of the HIPAA audits will catch organizations that never updated their HIPAA policies to comply with HIPAA Omnibus.

Summary
No one enjoys an audit of any sort. However, being well prepared for an audit will provide some level of comfort to yourself and your organization. Now is your opportunity to make sure you’re well prepared for these audits that could be coming your way. These audit programs likely aren’t going anywhere, so take the time to make sure you’re prepared.

Medical Management Corporation of America, a leading provider of medical billing services, is a proud sponsor of EMR and HIPAA.

July 14, 2014 I Written By

EHR Incentive Market Share Charts Worth A Thousand Words

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One thing I really love about the government lately is their goal to be as transparent as possible. Certainly they still have a ways to go, but I think healthcare has done some significant things when it comes to transparency into the government health programs. A great example of this is the Health IT Dashboard which has all of the data for the various health IT programs.

I don’t want to steal Carl Bergman’s thunder, because he’s already posted some really interesting Hospital EHR market share data and his previous EHR market share data. Plus, he’s planning to dive into the meaningful use market share data next. I love the approach of multiple sources when it comes to evaluating EHR market share and so I look forward to his analysis of EHR incentive market share against the EHR adoption market share from Definitive Healthcare and SK&A.

Until then, I thought I’d give you a taste of the EHR vendor participation in the EHR incentive program. This data comes from the ONC dashboards listed above and are put into some really nice snapshots of the data by ONC.

First up is the data for EHR vendor attestations by eligible professionals (ie. ambulatory doctors):
EHR Incentive Market Share - Eligible Professionals

And the EHR vendor attestations by hospitals:
EHR Incentive Market Share - Hospitals

It’s worth noting that the above data is just the EHR incentive money data. No doubt the actual EHR adoption data would have a few differences and include some companies in specialties that don’t qualify for EHR incentive money. Not to mention specialty specific EHR vendors who likely don’t make the chart even if they dominate their specialty. These charts do serve as an interesting proxy for EHR market share that’s worthy of discussion even if it doesn’t paint the full picture. Plus, even more important will be to watch the change in these numbers over time.

With that disclaimer, we could analyze this data a lot of ways. I’ll just offer a few interesting insights I noticed. First, 711 vendors have been used in the ambulatory EHR incentive program. That’s a lot of vendors. Only 78 of those 711 supply secondary EHRs as opposed to the primary EHR. 452 EHR vendors supply a primary EHR to less than 100 eligible professionals. 200 EHR vendors supply a primary EHR to fewer than 10 eligible professionals. These observations and a comparison of the ambulatory versus hospital EHR incentive charts’ “Other Vendors” shows how fragmented the ambulatory EHR market share is right now.

I was also intrigued that Mitochon Systems, Inc. was on the list even though they shut down their Free EHR software in May 2013. They had white labeled their EHR software to a number of other companies and so it will be interesting to see how that number evolves. I assume they sold the software to those companies, but I hadn’t heard an update.

On the hospital side of things, MEDITECH certainly doesn’t get the credit they deserve for the size of their install base. The same goes for CPSI, MEDHOST and Healthland. I think their problem is that people only want to read about the Mayo, Cleveland Clinic, and Kaiser’s of the world and so the articles about Billings Montana Hospital (I made that hospital up) rarely happen. I should find more ways to solve that since the small hospital market is huge.

I do wish that there was a way to divide the ambulatory chart into hospital owned ambulatory practices and independent ambulatory practices. That would paint an even clearer picture of that market.

What do you think of these charts? What can we learn from them?

July 8, 2014 I Written By

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

Your EHR Vendor Isn’t Certified: Remove Barriers and Conquer Meaningful Use Stage 2

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I wrote previously about the “Triple Aim” of healthcare and even questioned if doctors really cared about the triple aim. For those not familiar with the triple aim, it includes: improving the health of our country, enabling less expensive care, and increasing patient engagement with their healthcare. All of these are noble goals and worthy of effort. Plus, even if providers aren’t moved by this goal, that doesn’t mean that much of the legislation and regulation that hits healthcare won’t be guided by this triple aim.

I was reading through this Allscripts whitepaper titled “Your EHR Vendor Isn’t Certified: Remove Barriers and Conquer Meaningful Use Stage 2” when I thought about how the triple aim is going to impact an organization’s decisions moving forward whether they like it or not.

The whitepaper underscores the shift towards more patient engagement, smart EHR tools, and population health. I think that generally summarizes meaningful use and is why it’s going to be really important that everyone in healthcare is involved in it.

Even if you don’t want to participate in the meaningful use program specifically, the overall trends that meaningful use represent are likely going to be with us for the foreseeable future. No doubt the government’s focus will continue this direction and I think payers are heading the same direction as well. They probably won’t adopt meaningful use entirely, but elements from it and other programs will likely be adopted by payers.

Check out the full whitepaper for more details on these trends and making sure your EHR is ready for them.

July 2, 2014 I Written By

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

Eyes Wide Shut – Patient Engagement Pitfalls Prior to Meaningful Use Reporting Period

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July 1, 2015 – the start of the Meaningful Use Stage 1 Year 2 reporting period for the hospital facilities within this provider integrated delivery network (IDN). The day the 50% online access measure gets real. The day the inpatient summary CCDA MUST be made available online within 36 hours of discharge. The day we must overcome a steady 65% patient portal decline rate.

A quick recap for those who haven’t followed this series (and refresher for those who have): this IDN has multiple hospital facilities, primary care, and specialty practices, on disparate EMRs, all connecting to an HIE and one enterprise patient portal. There are 8 primary EMRs and more than 20 distinct patient identification (MRN) pools. And many entities within this IDN are attempting to attest to Meaningful Use Stage 2 this year.

For the purposes of this post, I’m ignoring CMS and the ONC’s new proposed rule that would, if adopted, allow entities to attest to Meaningful Use Stage 1 OR 2 measures, using 2011 OR 2014 CEHRT (or some combination thereof). Even if the proposed rule were sensible, it came too late for the hospitals which must start their reporting period in the third calendar quarter of 2014 in order to complete before the start of the fiscal year on October 1. For this IDN, the proposed rule isn’t changing anything.

Believe me, I would have welcomed change.

The purpose of the so-called “patient engagement” core measures is just that: engage patients in their healthcare, and liberate the data so that patients are empowered to have meaningful conversations with their providers, and to make informed health decisions. The intent is a good one. The result of releasing the EMR’s compilation of chart data to recently-discharged patients may not be.

I answered the phone on a Saturday, while standing in the middle of a shopping mall with my 12 year-old daughter, to discover a distraught man and one of my help desk representatives on the line. The man’s wife had been recently released from the hospital; they had been provided patient portal access to receive and review her records, and they were bewildered by the information given. The medications listed on the document were not the same as those his wife regularly takes, the lab section did not have any context provided for why the tests were ordered or what the results mean, there were a number of lab results missing that he knew had been performed, and the problems list did not seem to have any correlation to the diagnoses provided for the encounter.

Just the kind of call an IT geek wants to receive.

How do you explain to an 84 year-old man that his wife’s inpatient summary record contains only a snapshot of the information that was captured during that specific hospital encounter, by resources at each point in the patient experience, with widely-varied roles and educational backgrounds, with varied attention to detail, and only a vague awareness of how that information would then be pulled together and presented by technology that was built to meet the bare minimum standards for perfect-world test scenarios required by government mandates?

How do you tell him that the lab results are only what was available at time of discharge, not the pathology reports that had to be sent out for analysis and would not come back in time to meet the 36-hour deadline?

How do you tell him that the reasons there are so many discrepancies between what he sees on the document and what is available on the full chart are data entry errors, new workflow processes that have not yet been widely adopted by each member of the care team, and technical differences between EMRs in the interpretation of the IHE’s XML standards for how these CCDA documents were to be created?

EMR vendors have responded to that last question with, “If you use our tethered portal, you won’t have that problem. Our portal can present the data from our CCDA just fine.” But this doesn’t take into account the patient experience. As a consumer, I ask you: would you use online banking if you had to sign on to a different website, with a different username and password, for each account within the same bank? Why should it be acceptable for managing health information online to be less convenient than managing financial information?

How do hospital clinical and IT staff navigate this increasingly-frequent scenario that is occurring: explaining the data that patients now see?

I’m working hard to establish a clear delineation between answering technical and clinical questions, because I am not – by any stretch of the imagination – a clinician. I can explain deviations in the records presentation, I can explain the data that is and is not available – and why (which is NOT generally well-received), and I can explain the logical processes for patients to get their clinical questions answered.

Solving the other half of this equation – clinicians who understand the technical nuances which have become patient-facing, and who incorporate that knowledge into regular patient engagement to insure patients understand the limitations of their newly-liberated data – proves more challenging. In order to engage patients in the way the CMS Meaningful Use program mandates, have we effectively created a new hybrid role requirement for our healthcare providers?

And what fresh new hell have we created for some patients who seek wisdom from all this information they’ve been given?

Caveat – if you’re reading this, it’s likely you’re not the kind of patient who needs much explaining. You’re likely to do your own research on the data that’s presented on your CCDA outputs, and you have the context of the entire Meaningful Use initiative to understand why information is presented the way it is. But think – can your grandma read it and understand it on HER own?

June 30, 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.

Patient Engagement vs. Patient Education: What’s the Difference?

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The following is a guest blog post by Jamie Verkamp, Chief Speaking Officer at (e)Merge.
Jamie Verkamp
Healthcare organizations often see attesting to the Measures included in Meaningful Use Stage 2 as a burdensome checklist which results in a massive resource drain in exchange for inadequate financial compensation. MU Stage 2 Measure 7 is one such oft-maligned requirement for attestation. This Measure requires that online access to records is provided to 50% of patients and that 5% of patients execute the viewing, download, or transmission of their online health information.  Organizations should not see Measures regarding patient engagement as intimidating or inconvenient. Instead, these Measures seeking to improve patient engagement should be seen as an opportunity to create more loyal, involved, and empowered patients.  The importance of engaging our patients in their own health shows itself in current statistics relating to personal health.  According to a study by TeleVox, roughly 83% of Americans don’t follow treatment plans as prescribed by their physicians.  Adding to that, 42% of Americans feel they would be more likely to follow their care plan if they received some form of motivation to participate.  By giving patients a channel to monitor and participate in their own health, organizations can develop a more educated population capable of producing greater outcomes.

Understanding the reasoning behind the Measures driving patient engagement is the first step; now, we must educate our patient population on the value of logging in and connecting with their information. While the frequency of patients physically visiting their provider’s office is somewhat inconsistent, this is often the most successful way to encourage electronic patient access. Patient facing staff members should be well educated on electronic patient access and be prepared to answer questions as they arise. Physically walking patients through the engagement process of maneuvering their electronic access, or providing video tutorials with simple instructions in the office lobby can increase patient engagement substantially. Consider setting up a station in the waiting room to allow patients to sign up for the service, thus solving the issue of forgotten motivation.

However, organizations must seek to include in their engagement plan the younger and healthier population who may not enter the physical office space outside of unforeseen emergency visits or more often than their annual checkup requires. Looking online to relate with these patients can be beneficial, as this has been found to be where this demographic spends the majority of their time and communication engaging with brands and services.  Providing information and education on an organization’s website, Facebook, Twitter, or even YouTube page through video promotion can assist in sparking an interest with this patient population.  Many times, those likely to engage in a patient engagement offering remain unaware of its availability due to a lack of communication from the healthcare organization.  From the practice standpoint, we must understand our work is not done once the portal is merely completed; rather this is when the real challenge presents itself.

In today’s society, consumers are bombarded with promotional emails and routinely asked for their contact information so further communication can be established.  With this in mind, consumers are more cautious as to what and how much information they provide to companies.  Unfortunately, for the healthcare industry, this includes a cautious nature toward information shared with healthcare organizations.   With this barrier in place, administrators must actively engage with their patients to educate them on the benefits of becoming involved in electronically managing their care.  Before consumers choose to willingly hand over their personal contact information, they will likely need to understand the reasons for doing so and what advantages they will receive.

Convenience has become one of the most desired aspects of communication and buying behaviors in consumers today.  As a society, we have adopted a “need it now” expectation.  With the ease portable technology has brought to our information search, patients and consumers count on service when they desire it.   This is especially true when it comes to customer service; consumers are becoming less patient and beginning to expect service when they desire.  In a recent study, it was found businesses offering a “Live Chat” option online saw a 15% increase in conversions. Explaining to patients the ease of communication with physicians and key staff members through the portal can be a helpful start in creating buy in.  Communication via the portal includes direct messaging, appointment reminders, and more. Informing patients of potential time saving factors in appointments down the road and quicker access to lab results can also establish and pique interest.  In many instances, finding the optimal moment to address the patient portal can create successful outcomes.  Patients burdened by numerous prescription refill requirements or those frustrated with waiting in line to pay a bill can be directed back to the convenience of a patient portal to handle all of these items at their own computer at home.

As a whole, those looking to meet this Stage 2 requirement must focus their attention on creating personalized communication with patients.  Standardized information will not entice patients and may easily be looked over.  Begin to examine which staff members may be the best fit for providing patient education and focus on educating patients on what they will get out of participating, not just simply meeting your Measure 7 requirements.   Potential touch points can be found within your signage, billing communications, appointment reminders and especially on your practice website and social sites.

According to HealthIT.gov, Meaningful Use Stage 3 will continue with the goal of driving patient engagement and improving outcomes.  This will include, “patient access to self-management tools”. The options for healthcare organizations are clear:

1. An organization can meet the bare minimum for the Stage 2 requirements using a patchwork of initiatives which produce minimally satisfying results while have no significant effect on the patient experience. Then repeat the entire process for the applicable Measures in Stage 3.

2. An organization can have a well-articulated and executable plan. In doing so, the practice, hospital or healthcare organization can commit to utilizing technology for the optimization of patient care, get a full return on investment from the Patient Portal, and simultaneously grow their business through the competitive advantage of a successful online presence. Initiating this push now will further develop readiness for Stage 3 as the implementation date approaches and with productive workflows in place, administrators can free themselves to focus on other Measures for attestation.

So which option will your organization choose? It’s not going to be easy, but change seldom is. Every industry experiences social and digital evolution, now it is healthcare’s turn.

About Jamie Verkamp
This article is a result of a partnership between (e)Merge, a medical growth consulting firm and DataFile Technologies, an outsourced medical records management and compliance company. Jamie Verkamp leads (e)Merge as Managing Partner and Chief Speaking Officer, she works shoulder to shoulder with medical professionals the healthcare industry to improve the patient experience and see measurable growth in clients‘ customer service efforts, referral volumes and bottom lines. DataFile Technologies is led by Janine Akers, CEO. DataFile’s passion for compliance allows them to be thought leaders in HIPAA interpretation while executing innovative medical records workflow solutions on behalf of their clients. Our companies produce white papers, speaking engagements, and videos to keep health professionals up to date on the latest industry topics.

June 3, 2014 I Written By

Meaningful Use As a Requirement for Medical Licensure

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About a year ago, you might remember the article I wrote about the Massachusetts law that would require doctors to be meaningful EHR users to have a medical license. The law was shocking then and the idea is shocking to consider even now.

The good news is that it looks like the law is going to be modified so that physicians don’t have to demonstrated EHR proficiency as part of their medical license. As you can imagine the Massachusetts Medical Society has been working hard to advocate for this change. They say that the modification was “designed to prevent disenfranchising more than 10,000 physicians who, by law or other circumstance, cannot achieve meaningful use certification.” Probably took a rocket scientist to figure that one out.

I think it’s more than heavy handed to tie EHR proficiency to a medical license. The reality is that EHR’s will become mandated thanks to things like reimbursement and medical malpractice insurance. There’s not going to need to be a law that says you have to be proficient in an EHR to hold a license.

Is it any wonder why many doctors are revolting against EHR?

One of the worst thing you can do to get someone to do something is to force them to do it. Instead of these heavy handed approaches, there should be a focus on the value an EHR provides. I don’t know any provider that doesn’t want to do something that provides value to their clinic and their patients. Forcing someone to do something is the lazy approach.

May 23, 2014 I Written By

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

Lack of Rec Support Cause of Meaningful Use Stage 2 Slowdown?

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By now, I imagine that most of you have read about the meaningful use stage 2 delay and EHR certification flexibility. The details and interpretation are still going on, but it’s a big change to the current meaningful use program. Although, the biggest question I hear asked is if the change leaves enough time for organizations to change course. I think the rule has to be open for 60 days of comment before it becomes final. We’ll see if that leaves people enough time.

We’ll see if this change will provide some relief to a meaningful use program that I described as on the ropes. In response to that post, Deborah Sherl, BSN, RN, CHTS, CHPS, made an interesting comment on a possible cause of the meaningful use stage 2

@ John Lynn…. of course I am slightly biased on the topic of the rapid response & deployment of Stage 1 vs Stage 2. A great amount of Stage 1 success was ushered in with the amazing assistance of professional consultants across the country for those EPs & EHs that were willing to use us…. and we were called the Regional Extension Centers Health IT workforce.

Now that the federal grant is done (Feb.2014) Stage 2 implementations are possibly stalled not only by overburdened EMR vendors, but lack of project management forces that were provided by the RECS. Many RECs have built sustainable business models but are no longer “free” services as was perceived while under the HITECH grant.

I find this a very interesting hypothesis. I’m not sure that it accurately reflects why many organizations chose not to attest to MU stage 2, but it certainly didn’t help things. In fact, it adds one more log to the already burning fire. Think about what happens with MU stage 2. We’re going to pay them less incentive money, require them to do substantially more, and oh yeah…those “free” REC support resources are now gone too. Plus, your EHR vendor may or may not be ready either.

I think the changes to the EHR Certification requirements and delay of meaningful use stage 2 are good. Although, I’m hoping this is just the start of HHS blowing up meaningful use and making it dramatically simpler and more meaningful.

May 21, 2014 I Written By

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

Healthcare Risks, Privacy Risks, and Blowing Up MU

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All of healthcare has risks. The key is getting a good grasp of all the risks. Are we doing that really well in healthcare IT and EHR?


I repeatedly find that most people are happy to give up some privacy risk for the potential for better health. This increases even more when someone is seriously sick. Privacy becomes even less important to them.


I always love to see tweets from someone I’ve never met or heard of tweeting out my articles. Tim did a good job summarizing my post about blowing up meaningful use. The post has gotten some good traction and a great discussion. I’m sure that they won’t take my exact approach, but I hope that it will help push ONC to move MU in a direction of extreme simplification.

May 18, 2014 I Written By

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

Will Meaningful Use Be Used by Payers?

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I was on a call recently with someone who started to state that it was inevitable that the payers would start requiring doctors be meaningful users of a certified EHR. I wouldn’t say that it’s 100% sure that payers won’t adopt meaningful use, but I think it’s far from a forgone conclusion that they’ll jump on the meaningful use bandwagon as well.

Before I get into some of the various rationale for why they will or won’t, I’d love to see what you think in the poll embedded beloww:

Those who think that payers will start requiring meaningful use if you want the highest reimbursement rate usually point to the fact that the payers have often followed whatever Medicare is doing. This is true and so it is possible that they’ll piggyback the meaningful use train.

Those who say they won’t do it will say that meaningful use doesn’t really align with what the payers want to accomplish. There are elements that interest them, but it goes too far in many areas.

I’d say that most payers will probably not hop on the meaningful use bandwagon. However, I’m sure that they’ll let Medicare take the lumps while they sit back and watch how doctors react to meaningful use. If a large portion of doctors opt out of meaningful use, then I can’t imagine payers hopping on that train and making all of those doctors angry. I see payers just sitting back and watching how MU plays out before making any firm decisions.

In the end, I think payers will adopt something that may include some elements of MU that align with their business interests. I’ll just be very surprised if they just take MU on in its current state.

What do you think?

May 15, 2014 I Written By

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