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What the 2014 Election Means for Healthcare

Posted on November 13, 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.

After the landslide victory by republicans in congress, the house and many governor races, I was really interested to think about how this could impact healthcare and healthcare IT. Luckily, the really smart publishing company (ok, they’re not a publisher, but they publish really great content), The Advisory Board Company, has an article that talks about what the election outcome means for healthcare.

Here are their 5 key takeaways:

  1. Republicans face uphill battle to make changes to the ACA
  2. Reconciliation gives Senate opportunity to impact health care spending
  3. Congress will take up important health care policies beyond the ACA
  4. Republican victories in key governor races may slow Medicaid expansion
  5. Health care will remain a focus area at state and federal levels

The first point is the one that many people are talking about. Without the Presidency, I’m not sure that the republicans can do much to change ACA. They might make some of the programs miserable or somehow pull funding from pieces of the ACA, but with the President still in office they won’t be able to do much.

The biggest thing they’ll have to deal with very soon is the next SGR fix (or whatever they do to deal with SGR). The SGR Fix or patch if you prefer expires in March. The battle between Congress and the White House is going to be brutal. I see the same theater that we saw play out last year happening again. They’ll wait until the final hour and then pass a patch that will get us by another year with very little change. I do wonder if they’ll attach another ICD-10 delay to the bill like they did in 2014.

I still think that healthcare IT in general is pretty bipartisan. There are a few in Congress that have made overtures about the HITECH act and meaningful use being a waste of money. I’m sure we’ll see some similar tunes again, but I think it’s unlikely to really change anything when it comes to healthcare IT and EHR.

Those are a few thoughts on how the election results will impact healthcare. What do you think? Will these election results impact anything else in healthcare?

Healthcare IT Content The Way You Like It

Posted on November 12, 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.

As most of you know, I organized my first conference this year focused on Healthcare IT Marketing and PR (HITMC). I’m a few days away from officially announcing the HITMC 2015 event, so more information on that coming soon. One of my big takeaways from the HITMC 2014 event was that people want to consume the content the way they want to consume the content and that it’s powerful to repurpose the same content and display it in a different way.

Many of you have likely been reading Vishal Gandhi’s (@csvishal2222) Cost Effective Healthcare Workflow Series of blog posts that’s sponsored by ClinicSpectrum. I think it’s been a great series focused on many of the needs of practice managers and healthare clinics. However, Vishal and ClinicSpectrum decided to take the series to another level as they’ve repurposed the content in lots of different ways.

For example, they took a blog post on building accountability and consistency into your practice and created this slideshare presentation. They also created this video on the subject. I won’t be surprised to see an infographic on this soon too.

In another example, ClinicSpectrum took this EHR Workflow video interview I did with Vishal and turned it into a 3 part blog post: Part 1, Part 2, Part 3. I loved the approach since many people don’t want to sit down and watch a video which has a specific amount of time required to consume the video. However, they’ll happily read through a blog post on a subject that matters to them. While some do prefer the video format because you can hear the inflection in someone’s voice and the energy behind what they’re saying.

At Healthcare Scene, we’re doing everything we can to provide a wide variety of formats to people to allow them to consume the content we create the way they want to consume it. I’d love to hear what you think of all of these various forms of content. Which content format do you prefer? What could we do better? I look forward to hearing your thoughts on the subject.

Happy Veteran’s Day

Posted on November 11, 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.

Today, I wanted to take a moment to remember the veterans who have sacrificed so much for us. I recently read an article that talked about how we use to celebrate the WWII veteran’s when they would return from war. They talked about the glorious welcome home that each of these veterans would receive. Then, they discussed how our current veterans don’t seem to get the same welcome home as those WWII veterans did. They suggested that it was because our current military is a volunteer force whereas many WWII military were drafted.

I think this is true to some extent and it’s unfortunate. Certainly our current volunteer military deserves as much support and praise as those who were drafted to go to war. Hopefully on this Veteran’s Day we can all take a little time to think about this and support those people who literally risk life and limb to keep our country free. That’s worthy of support and celebration.

I know that so many in healthcare are Veteran’s. At the recent CHIME Fall Forum the big party was a full on rodeo at this amazing ranch in Texas. At one point during the rodeo the announcer honored the military veterans and asked that they all stand up to be recognized. I was impressed by the number of people who stood up. They fought the war for our country and now they’re fighting the war for patients. That’s definitely worthy of our honor and respect.

Veteran's Day

Salesforce Reportedly Working to Create $1 Billion Healthcare Business

Posted on November 10, 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.

That’s the news as reported by Reuters in late October. The article talks about Salesforce’s interest in creating a healthcare business and believe it can reach $1 billion in revenue. The article also highlights how SalesForce has recently hired over a dozen people from the healthcare and medical device sectors.

Plus, they even talk about the roll out of the CareWeb Messenger product that is built on the top of Salesforce’s technology:

The University of California at San Francisco, for instance, rolled out CareWeb Messenger, built on top of Salesforce’s technology, through which doctors, nurses and patients talk online and on mobile devices. UCSF and Salesforce have close ties: in April, CEO Marc Benioff donated $100 million to its children’s hospital.

I’ll be interested to see how this first product plays out. It actually fits into Salesforce’s core competencies quite well. Although, the secure healthcare messaging space is a crowded one. With that said, I was invited to a Salesforce event to talk about healthcare. Unfortunately, the timing was bad so I couldn’t make it, but now I’m particularly interested in what was said at the event.

It seems that sooner or later, all of the big tech companies come after healthcare. We’ve seen the same with Google, Microsoft, Dell, Apple, Samsung, and many more. While it must be incredibly enticing for these companies to come after a trillion dollar market like healthcare, most of these companies come into healthcare with an amazing amount of naivety as to the complexities of healthcare. Once they get in, they find these complexities and change their mind. We’ll see if Salesforce does something similar.

With that said, Salesforce has the money, the platform and the connections to do something in healthcare. Plus, I welcome fresh ideas and perspectives from companies like Salesforce in healthcare. I think that we all agree that there’s a huge opportunity for technology to improve healthcare. I want as many people working on finding those solutions as possible. Doesn’t hurt to have a multi-billion dollar company taking an interest in it as well.

What do you think of Salesforce’s entrance into healthcare? Will they be a major player? Where do you think it makes sense for them to focus their efforts?

Some of the articles on this talk about Salesforce building an EHR or things like that. Given the regulations and the environment, I never see that happening. Although, with the money they have available to them, maybe they’ll surprise us all.

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