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The TEDMED Experience

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For those who follow Hospital EMR and EHR as well, you might have noticed my first post about The Healthcare Forum at TEDMED. That was a great starter event for my experience at TEDMED. A day and a half into TEDMED and I started to wonder if I could describe TEDMED in a couple words. I can’t, but I’m glad I was invited to attend the event as a guest of Xerox.

Instead of trying to describe the experience of TEDMED, I thought I’d offer some of the insights that the TEDMED speakers shared. Just realize that all of these speakers are surrounded by plenty of breathing room where you’re interacting with other TEDMED “delegates.” I’ve had conversations ranging from cancer treatments to genomics to EHR to public health and everything in between and around. In fact, you’re never quite sure who you might meet next and that’s what makes the experience unique.

As for the speakers – you’ll be able to see them all online eventually – but here are some key quotes, insights, comments, and assertions that were made by various speakers.

Anytime Jonathan Bush speaks is a highlight for me. The man does not know how to mince words and so you’re sure to get his raw, unadulterated feelings on a subject. You may disagree with him on some of the things he says, but he often opens your eyes to new areas of healthcare you hadn’t considered. In this case, Jonathan Bush was taking aim at many of the screwed up features of our healthcare system with healthcare costs clearly in focus.

Jonathan offered the following two insights on some of the current healthcare issues:
“The biggest problem is that our profit motive is trapped in a weak marketplace.”

“The tactics non-profit hospitals use would make John D Rockefeller blush.”

Of course, he also followed that up with a number of suggestions on what we need to do to improve healthcare:
“We need to let go of Precious. It will be OK. It’s a $2 trillion baby.”

“Entrepreneurs need to get out there and start delivering care, never mind corporate medical law..Get a lawyer and figure it out.”

“Why do the best doctors in the world only get to treat people in eastern Massachusetts?”

What might have been my favorite talk (and I think the only standing ovation at TEDMED so far) was Zubin Damania (better known as ZDoggMD). It’s not even fair to try and sum up Zubin’s TEDMED talk. I’m certain that once it’s out and available I’ll be embedding the whole video. However, I will highlight one really powerful point he made. When he became a doctor he realized he was “Doing something TO people, rather than something FOR people.” With Zubin’s move to Las Vegas and participation in the Downtown Project, he’s now excited to finally live the physician dream: “Do something FOR people, rather than TO people.”

Deborah Estrin made a really strong case for “packaging up your small data.” She said, “There’s a lot that I can learn about my personal health from my digital behavior.” For example, the app could create a comparative picture of your daily function this month relative to last month, by automatically analyzing motion, location, and vocabulary data plucked from your digital traces. I love the power of small data, but in this case it’s small data because it’s for an individual.

Gary Slutkin provided one of the most insightful TEDMED presentations at this point. He did an amazing job explaining violence as a disease. Even more powerful was how he then showed how violence can be treated similar to the way we treat diseases. The parallels were stunning and provided a unique insight to a challenging problem.

On the first night of TEDMED, the passionate America Bracho offered the following insight “Awareness increases in the presence of contradiction.” America made a number of other passionate comments about community health, but this comment really stood out to me. She highlighted how many of us ignore the plight of our communities so we don’t become aware of the contradictions around us. However, I think this concept applies in so many other areas of healthcare IT. We often turn a blind eye to a healthcare IT issue so we don’t have to recognize the contradiction. Awareness of issues is the first step to solving the contradictions.

One of the most powerful concepts I’ve heard was from Danny Hillis. He talked about the idea of disease preemption instead of disease prevention. Some might argue that disease preemption is just really early stage disease prevention. However, the concept of trying to preempt a disease that could be developing is incredibly powerful. I’ve talked about this from the perspective of treating healthy patients in the past. In this scenario, we could treat someone who appears healthy in order to preempt future health issues. This is a powerful concept that is also incredibly hard to deliver, but we could get closer to it with the right data and sensors.

Mike Pazin, director of ENCODE, called his genome work “fun.” We need more Mikes in healthcare having fun with the genome and we’ll quickly realize the benefits of genomics.

“What if obesity is a cover mechanism? What if diabetes resistance causes obesity as opposed to obesity causing diabetes resistance?” Peter Attia flipped the idea of obesity and diabetes on the head with this question.

Amy Abernethy and Elizabeth Marincola discussed the idea of healthcare information hoarding. Amy asked the important question, “What should healthcare information donation look like?” Elizabeth offered, “Science, Money, and the Public’s Right to Know are on a collision course.” and then “You can have your cake and eat it too. You can be profitable and still share the scientific research.” I’d have loved to hear more examples of how Elizabeth sees this vision happening, but I’m hopeful she’s right that, “The future of medicine is where every student and researcher can access any research done anywhere in the world.”

I know that’s a lot to chew on. Now sprinkle the above knowledge together with the entertainment – the raw dance motions of David Odde & Black Label Movement, the unique one man band of Kishi Bashi, the all star entertainer Richard Simmons, and many other fine artists – and you’ll have a small window into the TEDMED experience.

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

April 18, 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.

This Week in Health Innovation and The Coming Mobile Health Startup Revolution

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After the great experience many of us had at the Dell Healthcare Think Tank event, Gregg Masters asked if Shahid Shah (my partner in Influential Networks) and I would take part in an online interview he does called This Week in Health Innovation. This is one element of the Health Innovation Broadcast Consortium that Gregg and a few others have put together. We had a great 30 minute conversation about some of the major trends we saw happening in healthcare IT and then we even went into an overtime discussion for another 10 minutes. The time flew by in our discussion, but I think there were some really good nuggets shared in the interview. You can listen to the full interview in the embed below.

Listen to This Week in Health Innovation on Blog Talk Radio

I was also recently asked to do a guest blog post for the NYEC (New York eHealth Collaborative) blog. First, I have to say that I love that their blogging. Second, as many of you know, I’ve been participating in the Digital Health Conference in NYC that the NYEC puts on every year. It is a really great event.

With that background, I think that many of my readers will enjoy my guest post titled “The Coming Mobile Health Startup Revolution.” This is really coming, but I don’t think it’s going to come as most current mobile health people expect. A long series of incremental technology advancements have us prepped for an explosion of innovation in healthcare. I just hope that the healthcare structure doesn’t slow it down.

April 5, 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.

Will the CommonWell Health Alliance Change Interoperability? — #HITsm Discussion

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Today’s #HITsm Chat was a little bit different than usual. Instead of the typical four or five questions, because of the #HITsm HIMSS chat on Tuesday there was only one question:

Will the CommonWell Health Alliance change interoperability?

The CommonWell Health Alliance launched a website, and this is their mission:

The CommonWell Health Alliance will be designed to be an independent not-for-profit trade association organization open to all health information technology vendors devoted to the simple vision that a patient’s data should be available to patients and providers regardless of where care occurs. Additionally, provider access to this data must be built-in to EHR technologies at a reasonable cost for use by a broad range of healthcare providers and the patients they serve.

Overall, the response to this during the #HITsm chat was positive. The chat started out with OchoTex, who said:

— Chad Johnson (@OchoTex) March 8, 2013

T1: Sure it will! Probably mostly in terms of creating awareness that cooperation needs to occur, and will need to happen soon. #HITsm

Hi all. IMO the missing ingredient in achieving interop is network effects; Commonwell brings critical mass to reach tipping pt. #HITsm

— Vince Kuraitis (@VinceKuraitis) March 8, 2013

I think what happens within the next 3 months will determine if CommonWell is real or just a HIMSS PR opp. #HITsm

March 9, 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.

One-Fifth Of Physician Practices Might Switch EMRs

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Here’s yet more evidence that this is the year of the “big switch” in EMRs, at least among physicians. A new survey by Black Book Market Research has concluded that about 23 percent of practices with currently implemented EMRs are unhappy enough with their current system to consider switching to a different vendor.

According to a piece in Medical Economics, doctors’ concerns include a lack of interoperability, excessively complicated connectivity and networking and problems with mobile device integration.

The survey, which reached out to 17,000 doctors, found that internal medicine docs had the highest rates of satisfaction (89 percent), followed  by family practice (85 percent), general practice (82 percent) and pediatrics.

The unhappiest specialists were nephrologists (88 percent), followed closely by urologists (85 percent) and ophthalmologists (80 percent).

So if a practice is going to switch vendors, what are they looking for? The Medical Economics piece listed five “must-have” features doctors voted for in the Black Book survey:

* vendor viability

* data integration and network sharing

* adoption of mobile devices

* health information exchange support and connectivity

* perfected interfaces with lab, pharmacy, radiology, medical billing partners, and others

Unfortunately, they won’t find it easy to find all of these features in a single EMR.  Of course, you faithful editor isn’t the be-all and end-all when it comes to EMR products (who could be?) but it seems to me that if even pricier enterprise products seldom offer all of these options, it’s decidedly unlikely that ambulatory products will. (OK, vendor viability is a judgment call, but in a world where so many practices don’t like their EMR, it’s hard to imagine that vendors are at their strongest.)

Folks, the truth is that it looks like we’re coming to a market crash of some kind. Physicians aren’t getting what they need from EMRs, but vendors aren’t keeping up, especially in the realm of specialty EMRs.

As if that wasn’t enough, the threat of fines looms for practices that don’t get their Meaningful Use act together, something they may have trouble doing if they’re in the midst of EMR shopping, installation and adoption.

Time is getting tight, and customers aren’t happy. Ambulatory vendors, what’s your next move?

February 26, 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.

EHR and Mobile Health News Around the Country

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It may come as a surprise to some, but according to a study by eClinicalWorks, the majority of physicians like EMR-connected apps, and mHealth apps in general. 2,291 healthcare professionals were surveyed, and 649 were physicians. Over 90 percent of physicians feel it’s valuable to have their EMR connected to an app. The study also revealed other interesting things concerning physicians and medical apps.

And EHR vendors may want to consider this when developing and updating their EHR. From the Black Book Rankings, here is a list of top EHR vendors among hospitals. I bet some of these ones definitely have.

On a similar topic, there was a recent study about physican EMR use in the United States. Apparently, they are behind other countries. While usage has definitely increased recently, with 69 percent of doctors using some type of EMR in 2012, it’s still well-below the rates in the Netherlands, Norway, New Zealand, the U.K, Australia, and Sweden, all that have EMR usage rates above 88 percent.

For anyone that is interested, there is quite a bit of legislation on telemedicine this year across the United States. This chart shows all that’s going on in three different categories — legislated mandate for private coverage, legislated medicaid coverage (primarily interactive video,) and other proposed bills affecting medicaid coverage.

There’s always a lot going on in the mHealth world. Have you heard of FilmArray? It’s a device that was developed by a company in Utah. So what does it do? Well, it can detect 20 respiratory diseases in less than an hour. This will definitely make it easier for people to get their illnesses diagnosed quickly. In other news, HealthTap has released a new program called TipTaps. The program sends tips, created by health professionals, and personalized for a person’s lifestyle.

February 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.

EMR Companies, Leveling the Playing Field, and The Eatery: Around Healthcare Scene

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EMR and EHR

What Really Differentiates EHR Companies?

EHR companies are a dime-a-dozen. So what makes them different? While price is sometimes a big deal to some, it isn’t an indicator of success. Marketing and sales can make a difference as well to some. However, there are a few things that should differentiate EHR companies. This includes the importance of efficiency.

Android’s Advantage Over iPhone in Mobile Health Applications

While many in the healthcare world love the iPhone, Android devices may present more options to healthcare professionals. Android offers more customization than the iPhone, and has more flexibility. It may cause developers more headaches, as the iPhone only requires them to only code their application once to work with most iOS devices. But the benefits are countless.

Hospital EMR and EHR

Level the Playing Field with RACs as They Enter Practice Settings

This article is by Lori Brocato, Director of Audit at HealthPort. She lists four ways that hospitals can do to level the playing field with RACs. These reasons are: knowledge is power, it’s a team effort, connect the dots, and learn from mistakes.

How EMR Vendors and Providers Can Partner Effectively

The LinkedIn HIMSS group posed the question — what does a good partnership between an EMR vendor and a provider look like? This post includes a few of Anne Zieger’s thoughts on this question.

Smart Phone Healthcare

The Eatery: A Visual Food Diary

The Eatery puts a twist on the typical food diary — instead of recording food, you take a picture. The user then can rate their food, and others can too.

February 10, 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.

Telemedicine, Accenture, and Influenza App – Around Healthcare Scene

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EMR and EHR

When The EMR *Is* The Problem

Anne Zieger talks about a recent experience at the doctor’s office that took more time than it needed to because of an EMR. While EMRs are meant to increase efficiency and workflow, it isn’t always the case. How can these problems be addressed?

New Telemedicine Starts Bode Well For EMRs

Jennifer Dennard interviewed Sande Olson, a senior health consultant at Olson & Associates about the future of telemedicine technology. She discusses how it has changed recently, a possible trick down effect from the ACA, and integration of telemedicine into EMRs.

Hospital EMR and EHR

What Hospitals Can Learn From Hospitals

Airports are crowded, filled with germs, and just frustrating sometimes. However, there are a few things, technology-wise, that airports do well with, and hospitals should pay attention to. This post talks about three different things hospitals can learn from airports, including having kiosks and big screen displays.

Accenture: Five Questions Hospital Boards Should Ask Before EMR Buys

A study done by Accenture found that about four percent of hospitals will be making an EMR purchase in the next year. Partly because of this, Accenture has compiled a list of questions that should be asked before purchasing an EMR.  They suggest having these questions answered by an independent analysis of EMR vendors.

Smart Phone Healthcare 

CDC Release Influenza App

The CDC has released another app. This time, it focuses on the flu. Because this year’s flu season has run rampant throughout the United States, this app can be very helpful, particularly for physicians. It contains information concerning where outbreaks are happening, the vaccine, and tips on how to stay healthy.

January 27, 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.

Healthspot Kiosk, Hospital Consolidation, and Trustworthy Apps — Around Healthcare Scene

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EMR and EHR

Healthspot Full Patient Visit Kiosk at CES

A full-patient visit can be conducted in a kiosk, thanks to Healthspot. This kiosk, which is being featured at the CES and Digital Health Summit, provides medical tools and an online connection to an actual doctor. There are many possibilities with this, such as being used in an emergency room or pharmacy. While there are still some issues that need to be adjusted and worked out, this won’t be the last we hear from Healthspot.

Apps Will Drive Healthcare Cloud Expansion

While only 4 percent of the healthcare community used cloud technology in 2011, that number is expected to grow in the coming years. What once was something people feared because of security concerns, cloud technology might become more mainstream with the increased expansion of mobile health apps. It may not “explode” in 2013, but it is sure to grow. 

Hospital EMR and EHR

Hospital Consolidation

Perhaps one of the biggest trends in healthcare right now is hospital consolidation. This happens when hospitals join together to buy practices. This can be a good thing, as it can result in savings and getting goods for lower prices. However, there are also many issues associated with it, such as if a doctor is bought out by a hospital that uses an EHR that the doctor dislikes. There are many unanswered questions about hospital consolidation, but it is definitely on the rise.

Using EMRs To Track Providers

Clinicians are often the targets of discussions concerned EMR use. However,  they can also use it to analyze the performance of providers. There are several variables that can be used and measured with an EMR to do this, and Melissa Outlaw from SEERHealth discusses those. Many of them are highlighted in this blog post.

Meaningful Health IT

California HealthCare Foundation CEO Smith stepping down

President and founder of the California Healthcare Foundation is leaving the company this year. Mark D. Smith, who has been an advocate for health IT over the years, has been very influential in his career. He will continue working at the University of California. This post highlights many of his accomplishments and displays how far his influence has spanned over the years.

Smart Phone Healthcare

25 Percent of Americans Trust Apps as Much as Doctors

A study conducted by Royal Philips Electronics revealed some interesting facts. Among the results, the study found that about one-quarter of Americans trust health apps just as much as their doctor. mHealth and mobile apps are getting pretty good, but should they be trusted as much as (or in some cases, more than) a regular physician?

January 13, 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.

Patient Safety, Interoperability, and Resolutions: #HITsm Chat Highlights

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Topic One: The ONC wants public comment on its #healthIT patient safety action plan. What oversight is needed to improve patient safety?

Topic Two: Why don’t we share our clinical info/data? Are you your own #HIE?

Topic Three: What is your definition of healthcare interoperability? How will you know when it becomes reality? 

Topic Four: Resolution check: If you are working at making changes to start 2013, what technology is helping the most?

Topic Five: Free for all: What #healthIT issue captured your interest this week?

January 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.

Telehealth, BYOD Gain Momentum In 2013

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I’ll be honest — I’m always a bit skeptical when I read on health IT trends appearing in a general-interest corporate IT magazine.  Ours is such a tricky business that the nuances often escape my brethren in the journalistic field, unless of course they specialize in the health IT business. But in this case, an eWeek piece has delivered some useful information, and even caught me off guard a bit.

The piece contends that BYOD issues and the use of telehealth are likely to shape the year in health IT:

BYOD:  Bring-your-own-device problems aren’t unique to healthcare by any means, but they’re certainly become a particularly high-profile issue in healthcare.

In the piece, eWeek quotes Dennis Schmuland, chief health strategy  officer for U.S. Health and Life Sciences at Microsoft, who argues that BYOD costs, including privacy, security and licensing for virtualization of software are so high that BYOD may actually be costing organizations big money. Good (and interesting) point.

Certainly, healthcare organizations can’t afford to let that keep happening in 2013, and this year, solutions are likely to emerge, Schmuland told the magazine.

Telehealth:  While they’re in their early stages right now, telehealth services such as American Well’s Online Care are likely to get a stronger footing this year, the eWeek article suggests.

Lynne Dunbrack, program director of connected health IT strategies at IDC Health Insights, notes that consumers are getting used to having videoconferencing at their fingertips, given the extent to which webcams are now embedded in laptops and video chat on mobile phones.

Now that they’re accustomed to videoconferencing, they’ll soon want to use this capability for telehealth visits with doctors, eWeek reports:

Sending a blood pressure reading and seeing a doctor online could be more convenient than taking off from work, Dunbrack noted.

“If you can just go in and have these quick visits, people would be more apt to make these appointments and keep them, and organizations will start to experiment with these services,” said Dunbrack.

In all candor, I think both Schmuland and Dunbrack are a bit ahead of the market. I doubt that we’ll see a huge expansion of telehealth this year, though there may be some additional uptake. And as for BYOD, I’m not expecting to see any comprehensive solution that providers can affordably adopt this year; after all, trends are still shifting and there’s tons of moving parts to consider. But I do think we will see some progress in both areas.  All told, the two have offered some useful fodder for thinking about 2013.

January 4, 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.