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Healthcare Interoperability Series Outline

Posted on November 7, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Interoperability is one of the major priorities of ONC. Plus, I hear many doctors complaining that their EHR doesn’t live up to its potential because the EHR is not interoperable. I personally believe that healthcare would benefit immeasurably from interoperable healthcare records. The problem is that healthcare interoperability is a really hard nut to crack

With that in mind, I’ve decided to do a series of blog posts highlighting some of the many challenges and issues with healthcare interoperability. Hopefully this will provide a deeper dive into what’s really happening with healthcare interoperability, what’s holding us back from interoperability and some ideas for how we can finally achieve interoperable healthcare records.

As I started thinking through the subject of Healthcare Interoperability, here are some of the topics, challenges, issues, discussions, that are worth including in the series:

  • Interoperability Benefits
  • Interoperability Risks
  • Unique Identifier (Patient Identification)
  • Data Standards
  • Government vs Vendor vs Healthcare Organization Efforts and Motivations
  • When Should You Share The Data and When Not?
  • Major Complexities (Minors, Mental Health, etc)
  • Business Model

I think this is a good start, but I’m pretty sure this list is not comprehensive. I’d love to hear from readers about other issues, topics, questions, discussion points, barriers, etc to healthcare interoperability that I should include in this discussion. If you have some insights into any of these topics, I’d love to hear it as well. Hopefully we can contribute to a real understanding of healthcare interoperability.

A Meaningful Use Update

Posted on November 6, 2014 I Written By

The following is a guest post by Barry Haitoff, CEO of Medical Management Corporation of America.
Barry Haitoff
We’re deep in the heart of meaningful use. Every organization has likely evaluated their participation in meaningful use and knows their path forward. While the meaningful use program is quite mature, the regulations are still shifting as various organization push forward their agendas. It’s important to keep an eye on these shifts so you can plan appropriately for your organization. Here are three meaningful use items you should keep an eye on since they could have a significant impact on your clinic:

Flex-IT Act – For those not familiar with this act, it would change the attestation period for meaningful use stage 2 from 365 days to only 90 days. This act is being backed by some very strong healthcare organizations including a call from the AMA, CHIME, HIMSS, and MGMA to make this change. As is noted by these organizations, very few hospitals have attested to meaningful use stage 2 and only 2 percent of eligible providers have attested to meaningful use stage 2 so far (they do have until the end of February).

If the meaningful use stage 2 numbers continue on this trend, CMS will need to do something or risk having the program be labeled a failure. It’s hard to predict what will happen (or not happen) in Washington, but the pressure to change the meaningful use stage 2 reporting periods to 90 days is growing. Poor meaningful use stage 2 attestation numbers could very well push this issue over the edge.

EHR Penalty Hardship Exemption – In case you missed it, CMS reopened the meaningful use hardship exception period. Originally you had to file for a meaningful use hardship exception by July 1, 2014, but you now have until November 30, 2014 to apply for an exception. This is a big deal for those who likely didn’t know they’d need an exception for meaningful use.

While this exception is related to the EHR certification flexibility (ie. your EHR vendor software isn’t ready for you to implement and attest), many have wondered if we won’t see more ways for organizations to avoid the coming meaningful use penalties. These prognosticators suggest that if meaningful use stage 2 numbers continue to be as awful as what’s described above, it’s possible that the government will provide some relief from the meaningful use penalties. As of now, the meaningful use penalties are coming, so you better be prepared.

AMA’s Meaningful Use Letter – The AMA has a strong political voice in Washington and they’ve recently decided to tackle meaningful use head on. They’ve put their efforts into a Meaningful Use Blueprint that calls for more flexibility in the meaningful use program. Without going into all the line by line details, the AMA is asking CMS to:

  • Adopt a More Flexible Approach to Meaningful Use and move away from the current All or Nothing approach to Meaningful Use
  • Align the quality measures, reporting burden and overlapping penalties that exist across programs (Meaningful Use, PQRS, Value Based Reimbursement, etc)
  • Focus Meaningful Use and EHR certification on key areas like Interoperability

None of these issues have been put into action by CMS or ONC yet, but I believe this blueprint provides the framework for the AMA’s lobbying efforts. Therefore, it’s a strong indicator of where the meaningful use program might be going. I expect the majority of these suggestions would be welcome by doctors unless they’ve already gone off the meaningful use deep end and given up on meaningful use altogether. However, you don’t want to be caught flat footed if and when changes to the meaningful use program occur.

Security Risk Assessment
This is not really a change to meaningful use, but a reminder that many organizations have not paid appropriate attention to the HIPAA security risk assessment which is required as part of meaningful use. Far too many organizations check this check box during their meaningful use attestation without actually doing a proper security risk assessment. This is coming back to haunt many organizations during their meaningful use audit.

In case you missed it, you might want to start with the Security Risk Analysis Myths and Facts that EMR and HIPAA posted previously. It covers such topics as security risk analysis’ being optional (they’re not) and your installed certified EHR takes care of your risk analysis (more is required). This CMS FAQ offers more details on what needs to be done to meet this meaningful use requirement. For example, you need to do a security risk analysis ever year you attest to meaningful use. Make sure you take the time to do an appropriate risk assessment of your organization.

What other meaningful use trends and changes do you see on the horizon? What other things should we be considering as we plan our meaningful use future?

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

The Tyranny of “Time” – EHR Efficiency Has a Lifecycle

Posted on November 5, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I love when you can find a picture, chart or graph that describes an important concept. I saw that during a CHIME Fall Forum focus group that was led by Heather Haugen from The Breakaway Group. During the focus group, Heather put up the following slide to describe the level of optimization a hospital experiences during the lifecycle of an EHR.

EHR Adoption Optimization Lifecycle

The key element in the above graph is the trough that happens after the initial adoption. I think the slide into that trough of EHR inefficiency is as steep as what’s shown on the graph, but the dip in efficiency definitely occurs. In fact, I think that the path to inefficient EHR use is slow and that’s why many healthcare leaders don’t notice when it happens.

The solution to this problem is to create a program in your organization that manages upgrades, provides ongoing training, and regular workflow assessment and optimization. I imagine most organizations weren’t worried about this when they slapped in their EHR to meet meaningful use. However, now they’re all going to have to take a deep look into solving this long term problem.

Full Disclosure: The Breakaway Group is a sponsor of the Breakaway Thinking series of blog posts on EMR and HIPAA.

HIPAA Privacy Infographic

Posted on November 4, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Caradigm, a population health company, recently sent me this HIPAA Privacy infographic. As a sucker for infographics, I had to share. While related to HIPAA, the BYOD data at the top of the infographic certainly paints an important picture for healthcare IT administrators. What data stands out to you?

Privacy Breaches

Data Sources:

http://www.arubanetworks.com/pdf/solutions/HIMSSSurvey_2012.pdf

http://www.pcworld.com/article/250642/85_of_hospitals_embrace_byod_survey_shows.html

http://apps.himss.org/content/files/FINALThirdAnnualMobileTechnologySurvey.pdf

“Fourth Annual Benchmark Study on Patient Privacy and Data Security.” Ponemon Institute. 12 March 2014.

http://www.redspin.com/docs/Redspin-2013-Breach-Report-Protected-Health-Information-PHI.pdf

http://www.fiercehealthit.com/story/ocr-levies-2-million-hipaa-fines-stolen-laptops/2014-04-23

http://www.fiercehealthit.com/story/boston-teaching-hospital-fined-15m-ephi-data-breach/2012-09-18

http://blogs.wsj.com/cio/2014/05/09/patient-data-leak-leads-to-largest-health-privacy-law-settlement/

http://www.nytimes.com/2011/09/09/us/09breach.html?pagewanted=all&_r=0

Scariest Health IT Regulation – Healthcare IT Superlatives

Posted on November 3, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I thought it would be fun to look at a bunch of Healthcare IT Superlatives (best, scariest, cutest, smartest, funniest, etc etc etc). I imagine this will be a series of blog posts that never stops. If you’d like to see me write about a specific healthcare IT superlative, let me know in the comments or on my Contact Us page. I always like to cater to readers. Then, I at least no one person will find the post useful. Although, if one person finds it useful, it’s very likely that thousands of others are interested as well.

The first Healthcare IT Superlative we’ll consider is: Scariest Health IT Regulation

This is a challenging topic since healthcare is so burdened by regulation. I’m going to use a pretty broad interpretation of what I’d consider a healthcare IT regulation, but I’ll admit that I’m not as familiar with the medical device or pharma industry regulation. If you have experience in either of those, I’d love to hear what regulations in those industries is the scariest regulation.

When I think about all the various healthcare IT regulations, I have to narrow the scope down to the regulations that have the most over arching reach. That basically leaves me with ACO/Value Based Reimbursement, Meaningful Use, and HIPAA. Certainly there are plenty more that could be listed, but it’s not as scary for me if they aren’t large regulations that impact the majority of the healthcare system.

Of all of these, I’m most scared of ACO/Value Based Reimbursement. The worst part of any regulation is ambiguity. ACO and value based reimbursement is so vague right now that I don’t think anyone know where it will really end up going. That’s really scary for me and is likely scary for most healthcare organizations. It’s really hard to plan for something that’s vague and ambiguous.

Furthermore, the move to value based reimbursement and ACOs is likely going to have the biggest economic impact on healthcare. This doesn’t mean that every doctor and healthcare organization is going to lose when it comes to value based reimbursement. Definitely not. There are going to be a bunch of winners and losers. Some will really benefit from ACOs and some will suffer. However, my gut tells me that there’s going to be more losers than winners. That’s pretty scary to consider with all the other challenging dynamics at plat in healthcare today.

There you have it. What healthcare regulations are scaring you the most? Which regulations keep you up at night? I look forward to hearing your thoughts.

Happy Halloween!

Posted on October 31, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m just getting back from a week full of MGMA and CHIME. I’m in full recovery mode as I head off to trick or treating with my children. Looks like many others in healthcare IT are doing the same:


I wish this included a picture.


CMS loves to do this on holidays.

And this is what I have to look forward to tonight (Aren’t they cute?):
Healthcare Scene Kids

6 Healthcare Incubators Growing the Future of HealthTech

Posted on October 30, 2014 I Written By

With the rapidly-growing demand for technologies that solve challenges for healthcare patients, professionals and institutions, many of the most innovative and disruptive solutions are coming not from large corporations, but small, scrappy startup companies.

With this trend has risen a group of startup “incubators” and “accelerators” specifically focused on healthcare technology entrepreneurs. These organizations serve as a launching pad for healthtech startups by facilitating high-value mentoring, collaboration and investor connections, plus basic needs like office infrastructure and seed funding.

For the startups, this gives them the time and resources to refine their technologies and services while finding investors and customers. Meanwhile the accelerators benefit by building local economies, solving healthcare challenges, and opening up highly-profitable opportunities for their backing investors

Below, we’ll introduce you to some of the leading incubators in the healthcare industry. These incubators have a proven track record in helping innovative young companies bring new ideas and services to consumers and businesses.

The Top-Six Healthcare Incubators and Accellerators

rockhealth

Rock Health – Rock Health invites early stage companies to work within the incubator and receive funding and mentorship from a variety of companies and health organizations. Rock Health notes that 18% of our economy is healthcare-based, but it’s one of the last industries to receive a tech makeover.  With more than 50 active startups in its portfolio, Rock Health is one of the most experienced healthcare incubators, especially for startups that focus on providing web services, mobile applications and SaaS solutions for healthcare providers and companies.

health-wildcatters-e1403108162461

Health Wildcatters – Health Wildcatters is a mentorship-driven healthcare seed accelerator in Dallas; slightly different than an incubator. Though similar to incubators in their goals, accelerators typically acquire a small amount of equity in a startup, then work quickly to help a company achieve a short-term goal like raising money or launching a product. While incubators house companies for months or years, accelerators like Health Wildcatters work in weeks. Health Wildcatters focuses mainly on early-stage healthcare technology startups, including IT, SaaS, digital health and mobile health companies. Companies receive an initial seed investment and a 12-week program in which Health Wildcatters works quickly to help the company build value and refine its product. The name “wildcatter” hearkens back to independent oil entrepreneurs who were willing to take risks in where they drilled. Health Wildcatters takes the same approach to finding companies. This entrepreneurial approach allows it to help more startups reach their goals.

startup-health

StartUp Health –Chaired by TimeWarner CEO Jerry Levin, this incubator aims to fund 1,000 healthcare companies within the next decade to help transform the face of the healthcare industry. StartUp Health works to build sustainable growth in its companies over a three-year period. During the incubation period, StartUp Health matches companies with a network of more than 10,000 health professionals and business people focused on improving digital health and wellness.

The-Iron-Yard-logo-150x150

The Iron Yard – With its first location in Asheville, NC, the Iron Yard is growing a network of incubators focused on growing new areas of technology like digital health, green tech and emerging technologies. Its digital health accelerator, located in Spartanburg, SC, is working to turn one of the nation’s oldest railroad junctions into a hub for digital health innovation. The Iron Yard offers startups $20,000 in seed capital and three months of mentorship and workshops from experts in design, development and financing. The Iron Yard also offers training in web development and programming to place graduates with the startup companies it supports.

blueprint-health

Blueprint Health – Blueprint Health, located in New York City, is one of the largest incubators in any niche and offers an expansive network of healthcare mentors to assist healthcare entrepreneurs launch new ventures. Blueprint Health focuses on companies developing tech projects directly for hospitals, physicians and health plans rather than consumer-facing applications, which means deeper access to established customers. In 2013, Blueprint Health focused its efforts on mature startups companies. While many incubators assist early-stage companies, more than half of Blueprint’s mentees already had paying customers. With more than 12,000 sq. ft. of space and two classes per year, Blueprint Health is able to help more than 100 healthcare companies each year.

healthbox

Healthbox –  Healthbox offers accelerator programs in Boston, Chicago, Tampa, London, Nashville and Salt Lake City that provide  digital health entrepreneurs with funding and access to a global network of healthcare investors and providers. Healthbox launched its first accelerator program in Chicago in 2012 and quickly grew to other states and the UK. It recently expanded its business programs with $7 million in funding and started a program that helps hospitals create their own in-house Healthbox accelerator programs that, in turn, help companies gain traction within their own medical communities. So far, Healthbox has invested in 56 active startups, supported by a network of more than 350 expert mentors.

About the Author: David Vogel is a blogger for Datapipe, a leading provider of HIPAA-compliant hosting and managed cloud hosting. Connect with David on Twitter (@DavidVogelDotCo) and Google+ (+David Vogel).

RIP CCHIT

Posted on October 29, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CCHIT announced that it was ending 10 years of service.

Today, the Certification Commission for Health Information Technology (CCHIT) announced that it is winding down all operations beginning immediately. All customers and business colleagues have been notified, CCHIT staff is assisting in transitions, and all work will be ended by November 14, 2014.

Alisa Ray made these comments in the announcement:

“We are concluding our operations with pride in what has been accomplished”, said Alisa Ray, CCHIT executive director. “For the past decade CCHIT has been the leader in certification services, supported by our loyal volunteers, the contribution of our boards of trustees and commissioners, and our dedicated staff. We have worked effectively in the private and public sectors to advance our mission of accelerating the adoption of robust, interoperable health information technology. We have served hundreds of health IT developers and provided valuable education to our healthcare provider stakeholders.”

“Though CCHIT attained self-sustainability as a private independent certification body and continued to thrive as an authorized ONC testing and certification body, the slowing of the pace of ONC 2014 Edition certification and the unreliable timing of future federal health IT program requirements made program and business planning for new services uncertain. CCHIT’s trustees decided that, in the current environment, operations should be carefully brought to a close”, said Ray.

The announcement also said that CCHIT would be donating its remaining assets to the HIMSS Foundation. Makes sense since HIMSS kind of gave them a partial home the past few months as they tried to save the jobs of the many who worked at CCHIT. Credit should go to Alisa Ray for all she did to try and give those who worked at CCHIT a soft landing.

Long, long time readers of this blog will remember my long blog posts talking about CCHIT and the lack of value that they provided the EHR industry. I believed then and even now that EHR certification was more of a tax on the industry than it was something that provided value to the market. They told me it provided some assurance to the purchaser of the EHR, but I never saw such assurances.

Once EHR certification was made part of meaningful use and the HITECH act, it basically made CCHIT irrelevant. Although, I still think that EHR certification in its current state doesn’t provide value to organizations and I’d love to see it go away. Sadly, there’s some legislation which is pushing the opposite direction.

While I disagreed with CCHIT’s approach to EHR certification and the value they provided, I do think there were good people who worked there that had good intentions even if we disagreed on the approach. I hope they all land somewhere great.

What Were The Best Practices and Benefits of Implementing a CDI Program at Baystate?

Posted on October 28, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently sat down with Walter Houlihan, Director of Health and Information Management and Clinical Documentation at Baystate Health, and Steve Bonney, EVP of Business Development and Strategy at RecordsOne to talk about the CDI (Clinical Documentation Improvement) program at Baystate Health. In the video below Walter and Steve talk about the savings that Baystate Health has received from their CDI program including how Walter has used dashboards, metrics and quality to convince senior management to increase Walter’s CDI staff from 4 FTEs to 10 FTEs so that they can review 100% of patients.

Steve and Walter also talk about how they use technology to make those 10 employees more efficient and make it possible for their CDI employees to work remotely.

How is your CDI program working? What technology are you using to make your CDI efforts more efficient? Have you had the success that Walter has had getting buy in from senior management?

The Shifting Focus to Patients, Really?

Posted on October 27, 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 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Everywhere I turn I’m reading articles and tweets that talk about the shift of healthcare towards the patient. All the EHR vendors are touting various patient focused features. Supposedly, a new engaged patient is getting involved in their healthcare and doctors are having to focus much more on the patient that they’ve ever done before. The drum beat of patient focus is being beat in so many places.

Is this really happening or is this just the topic du jour?

Some might argue that things like meaningful use’s patient engagement requirements are pushing this movement forward. However, those who have worked to meet those requirements know very well that meeting the meaningful use patient engagement measures doesn’t look very much like true patient engagement. The concept was interesting, but the actual implementation leaves a lot to be desired.

I have recently seen some patients start to care a little bit more about their health than they did before. This is driven largely by the high deductible plans. It’s amazing how getting people to pay for their care will change their attitude. Although, even then it hasn’t made people want to care about their healthcare. It’s just made them more informed on the price of the healthcare they receive.

Has the healthcare system really turned towards the patient? Are we any more focused on the patient now than we’ve ever been before? I don’t think we are. For all the talk, I haven’t seen much action and I can’t think of something that’s really going to dramatically change things.

I’d love to hear if people disagree. Do you see a shift of focus towards the patient? Have we always been focused on the patient, and so it’s not really a shift at all? Are there things we should be doing to encourage a shift to the patient?