Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

In 2014, Health IT Priorities are Changing

Written by:

The following is a guest blog post by Cliff McClintick, chief operating officer of Doc Halo. Cincinnati-based Doc Halo sets the professional standard for health care communication offering secure messaging for physicians, medical practices, hospitals and healthcare organizations. The Doc Halo secure texting solution is designed to streamline HIPAA-compliant physician and medical clinician sharing of critical patient information within a secure environment.

2014 is a major year for health care, and for more reasons than one.

Of course, some of the most significant reforms of the Affordable Care Act take effect this year, affecting the lives of both patients and providers.

But it’s also a year in which health care institutions will come to grips with IT issues they might have been putting off. Now that many organizations have completed the electronic health record implementations that were consuming their attention and resources, they’re ready to tackle other priorities.

Expect to see issues related to communications, security and the flow of patient information play big in coming months. At Doc Halo, we’re already seeing high interest in these areas.

Here are my predictions for the top health IT trends of 2014:

  • Patient portal adoption. Web-based portals let patients access their health data, such as discharge summaries and lab results, and often allow for communication with the care team. Federal requirements around Meaningful Use Stage 2 are behind this trend, but the opportunity to empower patients is the exciting part. The market for portals will likely approach $900 million by 2017, up from $280 million in 2012, research firm Frost & Sullivan has predicted.
  • Secure text messaging. Doctors often tell us that they send patient information to their colleagues by text message. Unfortunately, this type of data transmission is not HIPAA-compliant, and it can bring large fines. Demand for secure texting solutions will be high in 2014 as health care providers seek communication methods that are quick, convenient and HIPAA-compliant. Doc Halo provides encrypted, HIPAA-compliant secure text messaging that works on iPhone, Android and your desktop computer.
  • Telehealth growth. The use of technology to support long-distance care will increasingly help to compensate for physician shortages in rural and remote areas. The world telehealth market, estimated at just more than $14 billion in 2012, is likely to see 18.5 percent annual growth through 2018, according to research and consultancy firm RNCOS. Technological advances, growing prevalence of chronic diseases and the need to control health care costs are the main drivers.
  • A move to the cloud. The need to share large amounts of data quickly across numerous locations will push more organizations to the cloud. Frost & Sullivan listed growth of cloud computing, used as an enabler of enterprise-wide health care informatics, as one of its top predictions for health care in 2014. The trend could result in more efficient operations and lower costs.
  • Data breaches. Health care is the industry most apt to suffer costly and embarrassing data breaches in 2014. The sector is at risk because of its size — and it’s growing even larger with the influx of patients under the Affordable Care Act — and the introduction of new federal data breach and privacy requirements, according to Experian. This is one prediction that we can all hope doesn’t come true.

To succeed in 2014, health care providers and administrators will need to skillfully evaluate changing conditions, spot opportunities and manage risks. Effective health IT frameworks will include secure communication solutions that suit the way physicians and other clinicians interact today.

Doc Halo, a leading secure physician communication application, is a proud sponsor of the Healthcare Scene Blog Network.

January 30, 2014 I Written By

Connecting Smart Mobile Devices to the EHR

Written by:

My colleague, John Lynn, posted a hilarious CES marketing video advertising a new product it calls the iOximeter.  The iOximeter, which operates on both the iOS and Android platforms, is an independent device which attaches to smart phones, turning the phone into a pulse oximeter.

I strongly suspect that an i-glucose meter, i-scale and i-blood pressure cuff designed for the mass consumer market are starting to make major headway.

Not to be Scrooge at the Christmas party — I think such devices are a very positive development — but I’m left wondering what the purpose of getting the data onto the phone really is.  After all, unless the data gets to a physician conveniently, and ideally comes to live in their EMR, just how much good does it do?

On the consumer side, it does little but add bells and whistles to products consumers are increasingly used to using anyway, given that the price point for these devices is low enough that they’re sold in consumer pharmacies.

On the provider side meanwhile, you’re left with data that, while it might be arranged in pretty charts, doesn’t integrate itself easily into clinicians’ work flow.  And with EMRs already dumping huge volumes of data into their laps, some physicians are actively resisting integrating such data into the records.

No, the existing arrangement simply doesn’t do anything for clinicians, it seems.  Yes, consumers who are into the whole Quantified Self movement might find collecting such data to be satisfying, but the truth is that at this point many doctors just don’t want a ton of consumer-driven data added to the mix.

To make such phone-based devices useful to clinicians, someone will probably have to create a form of middleware, more or less, which accepts, parses, and organizes the data coming in from mobile health app/device combos like these.  When such a middleware layer goes into wide use, then you’ll see hospitals and doctors actively promote the use of these apps and devices.  Until then, devices like the iOximeter aren’t exactly toys, but they’re not going to change healthcare either.

January 9, 2014 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.

A CIO Guide to Electronic Mobile Device Policy and Secure Texting

Written by:

The following is a guest blog post by Cliff McClintick, chief operating officer of Doc Halo. Doc Halo provides secure, HIPAA-compliant secure-texting and messaging solutions to the healthcare industry. He is a former chief information officer of an inpatient hospital and has expertise in HIPAA compliance and security, clinical informatics and Meaningful Use. He has more than 20 years of information technology design, management and implementation experience. He has successfully implemented large systems and applications for companies such as Procter and Gamble, Fidelity, General Motors, Duke Energy, Heinz and IAMS.
Reach Cliff at cmcclintick@dochalo.com.

One of the many responsibilities of a health care chief information officer is making sure that protected health information stays secure.

The task includes setting policies in areas such as access to the EMR, laptop hard drive encryption,  virtual private networks, secure texting and emailing and, of course, mobile electronic devices.

Five years ago, mobile devices hadn’t caught many health care CIOs’ attention. Today, if smartphones and tablets aren’t top of mind, they should be. The Joint Commission, the Centers for Medicare and Medicaid Services and state agencies are scrutinizing how mobile fits into organizations’ security and compliance policies.

Be assured that nearly every clinician in your organization uses a smartphone, and in nearly every case the device contains PHI in the form of email or text messages. That’s not entirely a bad thing: The fact is, smartphones make clinicians more productive and lead to better patient care. Healthcare providers depend on texts to discuss admissions, emergencies, transfers, diagnoses and other patient information with colleagues and staff. But unless proper security steps are being taken, the technology poses serious risks to patient privacy.

For creating a policy on mobile electronic devices, CIOs can choose from three broad approaches:

  • Forbid the use of smartphones in the organization for work purposes. This route includes forbidding email use on the devices. Many companies have tried this approach, but in the end, it’s not a realistic way to do business. You may forbid the use of the technology and even have members of your organization sign “contracts” to that effect. But even for the people who do comply out of fear, the organization sends the message that it’s OK to violate policy as long as no one finds out.
  • Allow smartphones in the organization but not for transmitting PHI. This approach acknowledges the benefits of the technology and provides guidelines and provisions around its use. This type of policy is better than the first option, as the CIO is taking responsibility for the use of the devices and providing some direction. In most cases there will be guidelines regarding message life, password format, password timeout, remote erase for email and other specifics. And while the sending of PHI would not be allowed, protocol and etiquette would be in place for when the issue comes up. Ultimately, though, this approach can be hard to enforce, and the possibility remains that PHI will be sent to a vendor or out-of-IT-network affiliate.
  • Create a mobile device strategy. This option embraces the technology and acknowledges that real-time communication is paramount to the success of the organization. In healthcare, real-time communication can mean the difference between life and death. With this approach the technology is fully secured and can be used efficiently and effectively.

Recent studies have shown that more than 90 percent of physicians own a smartphone. Texting PHI is common and helps clinicians to make better decisions more quickly. But allowing PHI to be transmitted without adequate security can compromise patient trust and lead to government penalties.

Fortunately, healthcare organizations can take advantage of mobile technology’s capacity to improve care while still keeping PHI safe. In a recent survey of currently activated customers of Doc Halo, a secure texting solution provider, 70 percent of respondents using real-time secure communication reported better patient care. Seamless communication integration and a state-of-the-art user experience ensure that the percentage will only rise.

Doc Halo, a leading secure physician communication application, is a proud sponsor of the Healthcare Scene Blog Network.

January 6, 2014 I Written By

Should Patients Care About Their Doctors’ Text Messages?

Written by:

The following is a guest blog post by Dr. Jose Barreau, CEO of Doc Halo.

For all the money they spend on state-of-the-art EMRs, compliance officers and other measures to ensure they’re protecting their patients’ medical information, many healthcare organizations have a gaping hole in their security.

Physicians and other clinicians are as apt as anyone to send a quick text to a colleague. Maybe an attending physician wants to ask a resident about test results or an office worker needs to pass along a patient’s question.

But standard SMS text messages are not HIPAA compliant. Communicating protected health information in this way could compromise patient privacy and expose your organization to substantial fines.

That’s not to say doctors shouldn’t text. Because of its instantaneous nature, mobile messaging can improve efficiency and quality of care. But healthcare providers should make sure they’re using a secure texting platform.

If you have a non-HIPAA-compliant texting habit, you’re in good company. In research last year, nearly 60 percent of physicians at children’s hospitals said they sent or received text messages for work.

It’s easy to view text messages as “off the record.” Chances are they aren’t going into an EMR, and there’s a sense that no one but the sender and recipient will see them.

But when you fire off a text, you don’t know where it will end up. Some of these text messages contain sensitive details of diagnosis and treatment that have been discussed.  Also it’s hard to say whose servers the messages might be stored on, or for how long.  When patients entrust healthcare providers to care for them, they expect their data to be cared for, too.

The Department of Health and Human Services certainly knows about the problem. Last year the agency told an Arizona physicians practice to address the issue in a risk-management plan. The group “must implement security measures sufficient to reduce risks and vulnerabilities to ePHI to a reasonable and appropriate level for ePHI in text messages that are transmitted to or from or stored on a portable device.”

Healthcare providers can text about their patients without violating HIPAA — but only with secure messaging technology. Here are features to look for in a healthcare texting solution:

  • Encryption at all levels — database, transmission and on the app — with federally validated standards
  • Tracking of whether messages have been delivered, with repeated ping of the user
  • A secure private server that is backed up
  • Remote mobile app wipe option if a phone is lost or stolen
  • Automatic logout with inactivity
  • Ability to work on all spectrums of cell data and Wi-Fi for broad coverage
  • Limited data life — for example, 30 days — for messages

Patients benefit when their healthcare providers have quick and secure ways to stay in touch. A secure text messaging platform can help you to provide better care while avoiding HIPAA violations.

Doc Halo, a leading secure physician communication application, is a proud sponsor of the Healthcare Scene Blog Network.

November 25, 2013 I Written By

Mobile PHRs On The Way — Slowly

Written by:

On-demand mobile PHRs are likely to emerge over time, but not until the healthcare industry does something to mend its interoperability problems, according to a new report from research firm Frost & Sullivan.

As the paper notes, mobile application development is moving at a brisk clip, driven by consumer and governmental demands for better quality care, lower healthcare costs and improved access to information.

The problem is, it’s hard to create mobile products — especially a mobile PHR — when the various sectors of the healthcare industry don’t share data effectively.  According to Frost  & Sullivan, it will be necessary to connect up providers, hospitals, physician specialty groups, imaging centers, laboratories, payers and government entities, each of which have operated within their own informational silos and deployed their own unique infrastructures.

The healthcare industry will also need to resolve still-undecided questions as to who owns patient information, Frost & Sullivan suggests.  As things stand, “the patient does not own his or her health information, as this data is stored within the IT  protocols of the EHR system,  proprietary to providers, hospitals and health systems,” said Frost & Sullivan Connected Health Senior Industry Analyst Patrick Riley in a press statement.

While patient ownership of medical data sounds like a problem worth addressing, the industry hasn’t shown the will to address it.  To date, efforts to address the issue of who owns digital files has been met with a “tepid” response, the release notes.

However, it’s clear that outside vendors can solve the problem if they see a need. For example, consider the recent deal in which Allscripts agreed to supply clinical data to health plans.  Allscripts plans to funnel data from participating users of its ambulatory EMR to vendor Inovalon, which aggregates claims, lab, pharmacy, durable medical equipment, functional status and patient demographics for payers. Providers are getting patient-level analyses of the data in return for their participation.

Deals like this one suggest that rather than wait for interoperability, bringing together the data for a robust mobile PHR should be done by a third  party. Which party, what it will it cost to work with them and how the data collection would work are the least of the big problems that would have to be solved — but might be that or nothing for the foreseeable future.

October 24, 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.

Parents Using PHRs More Likely To Get In All Well-Child Visits

Written by:

Parents using an integrated PHR were more likely to take their young children to all recommended well-child visits, according to a Kaiser Permanente study reported in iHealthBeat.

More than 4.3 million members are registered to use Kaiser’s PHR, My Health Manager, on kp.org. During the first half of this year, patients have viewed 17.5 million lab test results, sent 7.4 million secure e-mails to their care providers, refilled 7.1 million prescriptions and scheduled 1.8 million appointments, reports News-Medical.

The study, which was published in The Journal of Pediatrics, analyzed data on more than 7,000 children ages zero to two living in the Northwest U.S. and Hawaii.  The children were enrolled in KP health plans between January 2007 and July 2011.  To determine the appropriate number of well-child visits, researchers  used performance measures listed in the 2010 Healthcare Effectiveness Data and Information Set that state that children aged 0 to 15 months should attend at least six well-care visits, News-Medical says.

The study found that in the Northwest region, children whose parents used the Kaiser PHR during the study period were 2.5 times more likely to bring their child to the recommended number of well-child visits. These children were also 1.2 times more likely to get all of their immunizations.

In Hawaii, meanwhile, children in this group were two times more likely to get all well-child visits, but results related to immunizations were statistically insignficant, iHealthBeat notes.

While it may be too soon to call it a trend, this is one of a growing number of projects which use the PHR concept to help patients engage and take responsibility for their health behaviors.

For example, this summer Howard University Hospital rolled out a mobile PHR for pre-diabetic young adults designed to help them take control of their health.  Howard has given the young adults in the program — aged 18 to 24 and diagnosed with pre-diabetes — access to a mobile version of the NoMoreClipboard PHR for their smartphones.

The program sends a variety of text messages to the young adults targeted by this intervention, which include reminders to interact with the PHR. The program participants are also given a FitBit Zip wireless activity tracker which keeps track of steps taken, distance covered and calories burned per user.

Projects like these, which help patients make the PHR the fulcrum point for better health, are a smart way of using the technology. I expect to see a great deal more of this “PHR=patient engagement=better health” model going forward.

October 18, 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.

mHealth Notification Averts Hospitalization

Written by:

I usually save most of my mHealth specific blogging for my Smart Phone Healthcare blog (subscribe to it if you haven’t already), but this story was too interesting to not share with a larger audience. This story comes from Gerald Theis of MCR Global. Gerald is one of the most patient people you’ll meet in the mhealth space. He’s working across international lines, but this story is where I love seeing Gerald’s work the most. It’s also a great illustration of the power of mHealth.

Last week a patient started to self mutilate (multiple cuts to legs). Her daily severity scores were consistently high (3 = severe). The MCR SMS message Alert was sent to her primary caregiver who made a health check home visit followed by a psychotherapy visit within 24 hours.

This mobile health program helped to engage the primary caregiver and may have averted a hospitalization. The patient was able to use her support system and crisis management psychotherapy session to utilize coping strategies to deal with her internal conflicts and has not harmed herself since the session.

This testimonial demonstrates how we can achieve patient and caregiver engagement via mobile health technology and avoid unnecessary hospitalization.

EMPOWERMENT. All 15 patients are very satisfied with this unique program and are tracking their scores consistently. This self report program is helping them identify triggers and early warning signs as they score each symptom for severity – Mild-Moderate or Severe. Each are shown their graph results that provide a visual way to see their pattern of distress. One asked for an appointment sooner than scheduled because her symptoms were escalating. All like the SMS feature that makes them feel secure.

August 2, 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.

Why BIDMC Is Shunning Epic, Developing Its Own EMR

Written by:

Though its price tag be formidable and installation highly complex, the Epic EMR is practically a no-brainer decision for many hospitals.  As Beth Israel Deaconess Medical Center CIO John Halamka notes, things are certainly like that in the Boston metro, where BIDMC’s competitors are largely on Epic or in the process of installing Epic.

Why are Halamka’s competitors all going with Epic?  He proposes the following reasons:

*  Epic installs get clinicians to buy in to a single configuration of a single product. Its project methodology standardizes governance, processes and staffing in a way that hospitals might not be able to do on their own.

* Epic fends off clinicians’ request for new innovations that the hospital staff might not be able to support. IT merely has to tell clinicians that they’ll have to wait until Epic releases its next iteration.

* Epic is a safe investment for meeting Meaningful Use Stage 2, as it has a history of helping hospitals and providers achieve MU compliance.

* CIOs generally don’t get fired for buying Epic, as it’s the popular move to make, despite being reliant on 1990s era client-server technology delivered via terminal services that require signficant staffing to support. (Actually, it does happen but it’s still rare.)

*  These days, hospitals have moved away from “best of breed” EMR implementations to the need for integration across the enterprise.  As Halamka notes, such integration is important in a world where Accountable Care/global capitated risk is becoming a key factor in reimbursement, so having a continuous record across episodes of care is critical. Epic seems to address this issue.

But BIDMC is a holdout. As Dr. Halamka notes in his blog, BIDMC is one of the last hospitals in Eastern Massachusetts continuing to build and buy components to create its own EMR. He’s convinced that going with the in-house development method — creating a cloud-hosted, thin client, mobile friendly and highly interoperable system — is ultimately cheaper and allows for faster innovation.

In closing, Halamka wonders whether his will end up being one of the very last hospitals to continue an ongoing EMR development program.  I think he’s answered his own question: it seems likely that BIDMC’s competitors will keep jumping on the Epic bandwagon for all of the reasons he outlines.

Will they do well with Epic?  Will they find later on that the capital investment and support costs are untenable? I think we’ll have the answers within a scant year or two. Personally, I think BIDMC will have the last laugh, but we’ll just have to see.

July 31, 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.

How #HealthIT Affects Social Media, Communications and Relationships – #HITsm Chat Highlights

Written by:

Topic One: How has #HealthIT utilized research in social networks (e.g., http://t.co/68HIycMwrT) in design of #EHR & #HIT systems? #HITsm


Topic Two: Social Media & Social Networks: How is #HealthIT most impactful with many:many communication/relationships? #HITsm

Topic Three: What can #Healthcare learn from #HealthIT & #IT generally? #HITsm

Topic Four: What #HIT trends will affect decision support for patients/providers? What has not been considered, but should? #HITsm

July 14, 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.

CPOE and MU with Marc Probst and M*Modal

Written by:

As part of my ongoing series of EHR videos, I had the chance to sit down with Marc Probst, CIO of Intermountain and a member of a number of important healthcare IT committees, Mike Raymer, Senior Vice President of Solutions Management at M*Modal and Dr. Jonathan Handler, CMIO of M*Modal to talk about CPOE and Meaningful Use. It’s another great addition to the Healthcare Scene YouTube channel.

In the interview we have a chance to talk about Intermountain’s move from zero CPOE to mobile, voice recognized CPOE. We talk about the future possibilities of voice in healthcare. I also ask Marc Probst about his views on EHR certification, meaningful use, and CommonWell.


*Note: Marc Probst’s sound was less than ideal. Next time we’ll be sure he has a better microphone.

June 26, 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.