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Healthcare CIO Mindmap

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During HIMSS, Citius Tech put out this great image they called the Healthcare CIO Mindmap. It’s a beautiful display of everything that’s happening in healthcare IT. Although, it’s also an illustration of the challenge we and hospital CIOs face. Is it any wonder that so many hospital CIOs feel overwhelmed?

Enjoy the Healthcare CIO Mindmap in all its glory below (Hint: Click on the image to see the full graphic):
Healthcare CIO Mindmap

I think that image is enough for anyone to chew on for one day. I’d love to hear your thoughts on it.

April 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

O’Reilly Studies Health IT: The Information Technology Fix

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O’Reilly Media specializes in books, courses and online services in technical innovation. This week, it released a new, comprehensive study on IT in Healthcare: The Information Technology Fix for Health (PDF). It’s written by O’Reilly editor Andrew Oram, who frequently writes on healthcare IT’s trends and issues. Oram takes on four basic, health IT areas in this cogent review:

  • Devices, sensors, and patient monitoring
  • Using data: records, public data sets, and research
  • Coordinated care: teams and telehealth
  • Patient empowerment

In doing so, he brings a sound knowledge of health IT current technology and issues. He also brings a rare awareness that health IT often forgets its promise to combine modern tools with an intimate doctor patient relationship:

In earlier ages of medicine, we enjoyed a personal relationship with a doctor who knew everything about us and our families—but who couldn’t actually do much for us for lack of effective treatments. Beginning with the breakthroughs in manufacturing antibiotics and the mass vaccination programs of the mid-twentieth century, medicine has become increasingly effective but increasingly impersonal. Now we have medicines and machinery that would awe earlier generations, but we rarely develop the relationships that can help us overcome chronic conditions.

Health IT can restore the balance, allowing us to make better use of treatments while creating beneficial relationships. Ideally, health IT would bring the collective intelligence of the entire medical industry into the patient/clinician relationship and inform their decisions—but would do so in such a natural way that both patient and clinician would feel like it wasn’t there. P. 4-5.

Recommended reading.

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April 7, 2014 I Written By

When Carl Bergman’s not rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

Hospital Intern Time, Why ICD10?, and EHR Satisfaction Pre-MU

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Everyone that reads this immediately thinks that this is a terrible thing. It seems ghastly that a doctor that’s paid to treat patients would spend so much time with an EMR vs with patients. I agree with everyone that are highest paid resource should be using as much time as possible with and treating patients. However, this study would have a lot more meaning if it was paired with a previous study that showed how much time a hospital intern spent in a paper chart. Maybe they spent 400% more time with a paper chart than direct patient contact. Then, this stat would come off looking very different. You have to always remember that you have to take into account the previous status quo.


This article and the discussion around ICD-10 was phenomenal. Passionate viewpoints on each side. It fleshed out both sides of the arguments for me really well. Too bad no one will care too much for a while.


Oh…the good old days. When everyone love EHR, because they chose to do it and so they made the most of their choice. Ok, I’m being a little facetious, but I seem to remember a study I saw that showed how much more unsatisfied doctors are with EHR today versus pre-MU. I imagine it’s not all MU’s fault, but it certainly hasn’t helped with physician EHR satisfaction.

April 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Will This Happen in Healthcare?

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I’ll admit that I’m a bit of a nerd (maybe even more than a bit) and I really enjoy reading venture capitalist blogs. One of my favorite reads is Fred Wilson. He posts something every day and he provides some amazing perspective on a lot of things. In a blog post a couple months back he posted the following quote, “programming these days is more about searching than anything else.”

For those of you who are not programmers in the room, you might be wondering how this applies to healthcare. Plus, you might be wondering if this statement is true. I assure you that it is true. The reason it’s true is three fold. First, the speed at which programming evolves is so quick that you have to be good at searching for the latest answer to your question. Second, the resources that are available online to answer those questions are phenomenal. You just have to know the right place to look. The amount of information you have to know to program is so great these days that it’s impossible for you to remember everything.

In many ways, all of these evolutions are a really great thing. As one tech friend of mine told me, “I realized pretty quickly that everything my company needs to know is already out there online. The value I bring is finding that information for them.”

I ask you then, “Will this happen in healthcare?”

I’d like to suggest that it’s already started to happen. I’ll never forget the doctor who visited my blog and commented that “the body of medical knowledge is so vast and complex that it’s impossible for the human mind to process it all.” Doesn’t that sound a lot like what I described above. The amount of medical knowledge and the speed at which it changes is impossible for someone to know and connect.

Is it possible that a future doctor will be better at searching for medical knowledge than they are at knowing that information off the top of their head? I think the answer is that they’ll have to be.

Don’t misunderstand me. Providers will still need an amazing baseline of information to be able to search and filter through the vast amount of data. However, they’ll likely remember where to find the answers versus knowing the answer off hand. Plus, their education and training will give them a baseline for understanding the data that they find. This is much the same as the programmer who know the basics, but learns more by searching and finding more information. The technology in this case doesn’t replace the person, but makes the person better.

I also feel the need to note that this won’t preclude other skills like empathy that are so important to the patient-provider relationship. You can’t use a tech search to help you show empathy to someone who’s just miscarried. Those skills will still be needed as much as ever. However, when it comes to medical knowledge I won’t be surprised if it becomes more about searching than anything else.

April 4, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Live Stream of Health IT Marketing and PR Conference and Free Guitar Giveaway

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Next week (April 7-8) the inaugural Health IT Marketing and PR Conference is happening in Las Vegas. As most of you know, I’ve worked really hard to make this a great event for everyone involved. A look at the final agenda for the conference should give you an idea of how great this event is going to be.

Free Live Stream
For those of you who weren’t able to make it to Las Vegas for the event, we’ve put together a free live stream of the conference. All you need to do is go to that page and register. Then, we’ll email you the details you’ll need to access the live stream. We appreciate Health Innovation Media and Supernap which provided the technology and support needed to make the live stream available for FREE.

Guitar Giveaway
One of the speakers has also put together a great free guitar giveaway for those attending the conference or watching from home. Chris O’Neal from peer60 and formerly of KLAS will be giving a presentation on How to Influence Ratings, Marketing Research, and Analyst Firms from 9:30-10:30 a.m. PT on Monday, April 7 of the conference. To enter, tweet how many minutes and seconds into his speech Chris will repeat the famous Rolling Stones song title, “I can’t get no satisfaction.” Be sure to mention @peer_60 and include the hashtags #HITmc and #guitargiveaway.

Here’s a simple link that will prime your tweet with everything you need to enter except the guess itself. Check out the peer60 blog post which has all the details, rules, and a picture of the guitar they’re giving away.

The official hashtag for the conference is: #HITMC. Following and participating in the conversation is a great way to see what’s happening at the conference and to connect with those interested in this event. We look forward to seeing you online and many of you in Las Vegas.

Don’t forget to register for the live stream.

April 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Why Do People Find ICD-10 So Amusing?

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In case you missed the news, ICD-10 has been delayed a year. It’s likely that we’ll be taking a break from talking about ICD-10 for the next 6-10 months. However, before we put ICD-10 on the shelf, you might want to read two opposing arguments for and against ICD-10: The Forgotten Argument For ICD-10 and Why ICD-10? Plus, below is a guest blog post by Heidi Kollmorgen, Founder of HD Medical Solutions, putting some perspective on where we’re at with coding. She has some good insights I hadn’t heard before. I’ll probably wrap up this series on ICD-10 with a look at what organizations should do now that ICD-10′s been delayed.
Heidi Kollmorgen
Many people who don’t understand the value of ICD-10 go straight to the “humorous codes” as a reason to justify delaying its implementation or even not adopting it at all. Does anyone realize those codes only make up 67 of the 1583 pages of the 2014 Draft Set?

Those seemingly “useless” codes are stated in the ICD-10 Chapter 21 Guidelines as having “no national requirement for mandatory ICD-10-CM external cause code reporting”. External Causes of Morbidity codes “are intended to provide data for injury research and evaluation of injury prevention strategies” only.

The *real* ICD-10 codes are more specific and allow greater accuracy for clinical data purposes. Many would agree that patient safety and effective and timely patient-centered care are the goal of most healthcare providers. Clinical data gathered and analyzed is what allows this to be achieved and ICD-10 codes are critical for more accurate analysis (1).

ICD-9 was adopted and went “live” in 1979 – how many advances has medicine made since that time? The ICD-9 code set does not allow doctors to accurately identify how they are treating patients any longer, nor does it allow accurate reporting of the services they provide to their patients. In 2003 the NCVHS recommended the adoption of ICD-10 and fourteen years later providers still claim they haven’t had time to prepare (2).

Doctors and other healthcare professionals who choose to take advantage of the daily barrage of free ICD-10 training and education from CMS and countless other sources for themselves and their staff will not go out of business. Providers who recognize that hiring an educated and/or certified medical biller/coder is an investment with huge ROI potential.

Those individuals have the training and ability to prevent and decrease denials and rejected claims from the onset when the claims are initially prepared. They also understand the intricacies of carrier guidelines so providers who hire them will never go out of business or suffer from decreased cash flow, rather their reimbursement would improve and they would also be compliant.

The days of hiring your neighbors daughter or friend because they need a job, or because they like working with numbers are over. It shouldn’t be impossible to understand how saving money in overhead and payroll only costs you infinitely more in lost reimbursement. Is the irony lost in correlating the profession of Health Information Management to Nursing? In the history of medicine it was only in the last one hundred or so years that licensing of nurses went into law. http://www.nursingworld.org/history Would any doctor today work with an unlicensed or inexperienced person who claimed to be a nurse? Would any hospital or facility hire someone who applied for a nursing position only because they liked working with people? That’s basically how the profession of nursing began.

In regards to the opinion held by many how ICD-10 codes are outlandish I would agree in some cases. I have a wicked sense of humor and because I know the codes I could create funnier cartoons than any you have come across. The difference is that coders understand how that argument holds no merit and only proves how providers don’t even understand ICD-9-CM. Unfortunately, most are probably using it incorrectly as well and it may be one of the causes of low reimbursement.

Just in case you see a patient today who is a water skier and has an accident while jumping from a burning ship use ICD-9-CM E8304. Have a patient who was knocked down by an animal-drawn vehicle while riding a bike? There’s a code for that too – ICD-9-CM E827.

The good news is how the Guidelines for ICD-9-CM patient encounters are similar to ICD-10-CM for these types of codes. If you don’t typically use them now you won’t when ICD-10 goes into effect either. Providers who document what they did, why they did it and what they plan to do do about it will have no problem switching to ICD-10. Aren’t we lucky nothing has changed about that?

Heidi Kollmorgen is the founder of HD Medical Solutions which offers practice management services for solo and multi-physician groups. She holds AHIMA certifications and is dedicated to optimizing reimbursement by following compliant measures. She can be found at http://hdmedicalcoding.com/ or follow her on Twitter @HDMed4u.

April 2, 2014 I Written By

New Reality TV Show to Follow ONC Leadership

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The past six months have been really amazing here at Healthcare Scene. In October, we acquired Healthcare IT Central and associated health IT career resources and next week we’ll be hosting the first ever Health IT Marketing and PR Conference. While these are two major milestones for Healthcare Scene, we’re not stopping there. We have ambitious plans to really bring healthcare IT to the masses.

What many people who read this site don’t know is that along with my healthcare IT blog network, I also have a reality TV blog network that covers TV shows like Dancing with the Stars, So You Think You Can Dance, and America’s Got Talent to name a few. Considering my passion for both healthcare IT and reality TV, I figured it would only be a matter of time until those two passions would be brought together.

I’m really excited to announce that I’ll be the Executive Producer of a new Health IT reality TV show that covers the inner workings of healthcare IT from the perspective of those working at ONC. Where possible, cameras will be following around the ONC leadership providing people an insight into things like meaningful use, RECs, ACOs, and ICD-10. The working name for the show is, “Under the Covers with ONC.” We start taping next week.

I want to applaud new ONC head, Karen DeSalvo, for really taking health IT to the next level with this show. It’s about time those people working so hard on something as important as health IT finally get some recognition. What better way to do this than to do a reality TV show?

Imagine how exciting it will be to see video of Karen DeSalvo tweeting “Call into the #HIT Standards Committee’s virtual meeting here: 1-877-705-6006.” Imagine how you’d feel watching the TV show if you were on the same call. You could say you were there. I wish we’d been filming when Karen DeSalvo Retweeted, “Hey, Tweeps, thanks for reading our workforce blog post. We have had more than 1090 readers so far!” Can you imagine the excitement of the moment? Now we’ll be able to share those type of moments with everyone.

Doug Fridsma, Chief Science Officer at ONC, commented on the show, “I can’t wait for people to finally see me get down and roll around with those healthcare standards. Who wouldn’t want to watch me work through the S&I framework?”

Some people have expressed concern that we won’t be covering their favorite government health IT project. To those people I say, go and create your own reality TV show. If I can do it, you can too. You may start by reaching out to Kathleen Sebelius who is supportive of this project but noted, “Good things the cameras weren’t rolling when we heard that Congress had slipped another ICD-10 delay into the SGR bill.” I think secretly, Sebelius is just jealous that Obama didn’t invite her to take part in his Between Two Ferns interview.

We reached out to Farzad Mostashari, Former ONC National Coordinator, to get his thoughts on the new ONC reality TV show. He replied, “I’ve been preaching for years that my hard working colleagues at ONC deserved more credit for the work they do. I just hope the show doesn’t get caught up in the petty discussions over whether it should have been blue button or purple button and instead focuses on things of substance like whether ICD-10, MU, etc are the ‘perfect storm’ of regulation or if it was more like a perfect earthquake.” I think we can all agree that it’s unfortunate we didn’t get this in place while Farzad was coordinator. His bow tie would have looked so great on camera.

We’ll be holding a special screening of the TV show at Health Datapalooza in June. I can already feel the energy and excitement of that screening with so many HIT Nerds present to see health IT reality TV. We’ll have a special area at the event where you can take a selfie with all your favorite ONC health IT heroes. Just get in line early. I’m pretty sure the Farzad line is going to be long. Can you imagine how many retweets you’d get if you got a selfie with two ONC Coordinators at once? I can’t wait to see you there.

UPDATE: For those who didn’t notice, this was an April Fool’s joke. I hope you enjoyed it as much as I did.

April 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

The Fundamental Challenge of ACOs

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I’ve been openly bullish on ACOs and capitated payment models. The only way to achieve the triple aim – quality, cost and access – is to create a system that is structurally incentivized towards those ends. The fee-for-service model will never be structured in a way that incentivizes the triple aim. On the other hand, ACOs do.

Early ACO data is mixed. Although some organizations succeeded in lowering costs and improving outcomes, about 1/3 dropped out of the ACO program entirely, and another 1/3 reported no significant cost or quality changes. Only 1/3 were “successful.”

Why? Why did some organizations succeed where others failed? What did each organization do differently? It’s been proven that some organizations can succeed under this model. But not everyone.

ACOs are disruptive to fee-for-service payment models. ACOs invert incentives. They invert how every employee should think about their job in the context of the larger care delivery system. In ACOs, healthcare professionals are implicitly asked to think about preventative care, which tends to lead towards both cost and quality improvements. On the other hands, in a fee-for-service model, healthcare professionals are only incentivized to simply treat the patient in front of them with no regard for prevention or cost.

When the board of directors of a given organization recognizes the need to change the course of a business, the board usually replaces the CEO. After a new strategy is devised, the new CEO typically replaces most of the executives and lays off a significant number of the existing staff. This accomplishes a few things:

1) reduces the burn, making the organization leaner and more capable of pivoting
2) replaces lots of senior and middle management, who were trained and wired around the old business model, and who may conspire against the new model if they don’t believe in it
3) sends a signal to the remaining staff that management is serious about change

Although this plan doesn’t guarantee success, it’s fairly common in large organizations because it can create impetus to break from the inertia of the status quo. The only thing worse than going after the wrong business model is maintaining one that’s failing.

This of course begs the question, how are providers adopting ACOs? Management at provider organizations that have adopted the ACOs are early adopters. They are pioneers. They are leaders. They can see a new, better, ACO-based future. The last thing management at these organizations is going to do is fire themselves after deciding to transition to an ACO.

In light of the above, I am particularly impressed by the early success of the ACO program. Only 1/3 dropped out. Given the fundamental change at hand, I would consider the early data a harbinger of better changes to come. I suspect that almost all of the remaining ACOs will see more significant improvements in years 2 and 3 as they mature and refine processes around value.

March 31, 2014 I Written By

Kyle is Founder and CEO of Pristine, a company in Austin, TX that develops telehealth communication tools optimized for Google Glass in healthcare environments. Prior to founding Pristine, Kyle spent years developing, selling, and implementing electronic medical records (EMRs) into hospitals. He also writes for EMR and HIPAA, TechZulu, and Svbtle about the intersections of healthcare, technology, and business. All of his writing is reproduced at kylesamani.com

You might be an #HITNerd If…

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You might be an #HITNerd If…

you know that blue button is not a funny ICD-10 code.

Find all our #HITNerd references on: EMR and EHR & EMR and HIPAA.

NEW: Check out the #HITNerd store to purchase an #HITNerd t-shirt of cell phone case.

Note: Much like Jeff Foxworthy is a redneck. I’m well aware that I’m an #HITNerd.

March 30, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

My Optimism for Healthcare IT – #DoMoreHIT

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As I posted about previously, I took part in the Dell Healthcare Think Tank event last week. This was my second year participating in the event, and I thoroughly enjoyed the stimulating discussion. In many ways it makes me wish that there was a health IT conference that was 2 days of stimulating discussion like we had, but with a larger mix of people. Would be a great experience.

At the end of the event, we were asked to summarize our thoughts about the event and where we were headed with healthcare IT. Here’s the video of my response:

Sometimes it’s easy to get bogged down in the meaningful use or ICD-10 mire (especially given all the ICD-10 delay talk). That’s natural since they are important issues. However, as I say in the video, I think we’re just getting started when it comes to the impact for good that IT will have on healthcare. Sure we have challenges, but the opportunities and potential is much greater than the challenges.

If you missed the live stream of the event, you can watch the recording here. Also, they had an artist capturing the event as we talked. Check them out below (click on the image to see the larger size):

March 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.