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AMA’s Digital Health ‘Snake Oil’ Claim Creates Needless Conflict

Posted on June 22, 2016 I Written By

Anne Zieger 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.

Earlier this month, the head of the American Medical Association issued a challenge which should resonate for years to come. At this year’s annual meeting, Dr. James Madara argued that many direct-to-consumer digital health products, apps and even EMRs were “the digital snake oil of the early 21st century,” and that doctors will need to serve as gatekeepers to the industry.

His comments, which have been controversial, weren’t quite as immoderate as some critics have suggested. He argued that some digital health tools were “potentially magnificent,” and called on doctors to separate useful products from “so-called advancements that don’t have an appropriate evidence base, or that just don’t work that well – or that actually impede care, confuse patients, and waste our time.”

It certainly makes sense to sort the digital wheat from the chaff. After all, as of late last year there were more than 165,000 mobile health apps on the market, more than double that available in 2013, according to a study by IMS Institute for Healthcare Informatics. And despite the increasing proliferation of wearable health trackers, there is little research available to suggest that they offer concrete health benefits or promote sustainable behavior change.

That being said, the term “snake oil” has a loaded historical meaning, and we should hold Dr. Madara accountable for using it. According to Wikipedia, “snake oil” is an expression associated with products that offer questionable or unverifiable quality or benefits – which may or may not be fair. But let’s take things a bit further. In the same entry, Wikipedia defines a snake oil salesman “is someone who knowingly sells fraudulent goods or who is themselves a fraud, quack or charlatan.” And that’s a pretty harsh way to describe digital health entrepreneurs.

Ultimately, though, the issue isn’t whether Dr. Madara hurt someone’s feelings. What troubles me about his comments is they create conflict where none needs to exist.

Back in the 1850s, when what can charitably be called “entrepreneurs” were selling useless or toxic elixirs, many were doubtless aware that the products they sold had no benefit or might even harm consumers. And if what I’ve read about that era is true, I doubt they cared.

But today’s digital health entrepreneurs, in contrast, desperately want to get it right. These innovators – and digital health product line leaders within firms like Samsung and Apple – are very open to working with clinicians. In fact, most if not all work directly with both staff doctors and clinicians in community practice, and are always open to getting guidance on how to support the practice of medicine.

So while Dr. Madara’s comments aren’t precisely wrong, they suggest a fear and distrust of technology which doesn’t become any 21st century professional organization.

Think I’m wrong? Well, then why didn’t the AMA leader announce the formation of an investment fund to back the “potentially magnificent” advances he admits exist? If the AMA did that, it would demonstrate that even a 169-year-old organization can adapt and grow. But otherwise, his words suggest that the venerable trade group still holds disappointingly Luddite views better suited for the dustbin of history.

Will the Disconnected Find Interoperability at HIMSS 2016? Five Scenarios for Action!

Posted on February 28, 2016 I Written By

The following is a guest blog post by Donald Voltz, MD.
Donald Voltz - Zoeticx

With the yearly bluster and promise of HIMSS, I still find there have been few strides in solving interoperability. Many speakers will extol the next big thing in healthcare system connectivity and large EHR vendors will swear their size fits all and with the wave of video demo, interoperability is declared cured.  Long live proprietary solutions, down with system integration and collaboration. Healthcare IT, reborn into the latest vendor initiative, costing billions of dollars and who knows how many thousands of lives.

Physicians’ satisfaction with electronic health record (EHR) systems has declined by nearly 30 percentage points over the last five years, according to a 2015 survey of 940 physicians conducted by the American Medical Association (AMA) and American EHR Partners. The survey found 34% of respondents said they were satisfied or very satisfied with their EHR systems, compared with 61% of respondents in a similar survey conducted five years ago.

Specifically, the survey found:

  • 42% of respondents described their EHR system’s ability to improve efficiency as difficult or very difficult;
  • 43% of respondents said they were still addressing productivity challenges related to their EHR system;
  • 54% of respondents said their EHR system increased total operating costs; and
  • 72% of respondents described their EHR system’s ability to decrease workload as difficult or very difficult.

Whether in the presidential election campaign or at HIMSS, outside of the convention center hype, our abilities are confined by real world facts.  Widespread implementation of EHRs have been driven by physician and hospital incentives from the HITECH Act with the laudable goals of improving quality, reducing costs, and engaging patients in their healthcare decisions. All of these goals are dependent on readily available access to patient information.

Whether the access is required by a health professional or a computers’ algorithm generating alerts concerning data, potential adverse events, medication interactions or routine health screenings, healthcare systems have been designed to connect various health data stores. The design and connection of various databases can become the limiting factor for patient safety, efficiency and user experiences in EHR systems.

Healthcare Evolving

Healthcare, and the increasing amount of data being collected to manage the individual as well as patient populations, is a complex and evolving specialty of medicine. The health information systems used to manage the flow of patient data adds additional complexity with no one system or implementation being the single best solution for any given physician or hospital. Even within the same EHR, implementation decisions impact how healthcare professional workflow and care delivery are restructured to meet the constraints and demands of these data systems.

Physicians and nurses have long uncovered the limitations and barriers EHR’s have brought to the trenches of clinical care. Cumbersome interfaces, limited choices for data entry and implementation decisions have increased clinical workloads and added numerous additional warnings which can lead to alert fatigue. Concerns have also been raised for patient safety when critical patient information cannot be located in a timely fashion.

Solving these challenges and developing expansive solutions to improve healthcare delivery, quality and efficiency depends on accessing and connecting data that resides in numerous, often disconnected health data systems located within a single office or spanning across geographically distributed care locations including patients’ homes. With changes in reimbursement from a pay for procedure to a pay for performance model, an understanding of technical solutions and their implementation impacts quality, finances, engagement and patient satisfaction.

Moving from a closed and static framework to an open and dynamic one holds great potential while requiring an innovative look at how technology is used as a tool to connect the people, processes and data. Successful application and integration of technology will determine future healthcare success. Although the problems with healthcare data exchange have not been solved, numerous concepts have been proposed on how to solve these challenges.

Connecting the Disconnected

Currently, healthcare data flow is disconnected. Understanding the current and future needs of patients and healthcare professionals along with how we utilize the technology tools available to integrate data into a seamless stream can bring about an enhanced, high-quality, efficient care delivery model.  One successful integration example, middleware, has been used for years to integrate data in financial and retail organizations with its simple open technology.

One of the leaders in middleware integration is Zoeticx, a healthcare IT system integrator who integrates the data traffic and addresses, adding the missing components to connect, direct and act upon the healthcare data flow.  This technology helped one hospital struggling with the typical EHR interoperability plaguing most healthcare facilities connect multiple EHR systems.  In addition, the health-care facility used middleware to identify a new revenue stream from CMS reimbursements for patient wellness visits while also improving patient care.

Accessing patient information from EHR’s and other patient health data repositories is critical for patient care. The development of tools and strategies to enhance the patient experience, improve quality and innovation of the care delivery model requires an understanding of how data is accessed and shared.  Current EHR’s have employed numerous ways to extract patient data, each of which brings opportunities and challenges. Here are a few examples to ask about at HIMSS.

The Critical Care Team – Distributed Care

The critical care environment is a challenging one with numerous healthcare professionals teaming up to manage and care for patients. Delays in addressing critical issues, lab values or other studies can negatively impact these patients or lead to redundancy and inefficiencies which increase costs without impacting outcomes. Coordinating care between the various care team members can be a challenge.

The medical record and the nursing flow sheet had traditionally been the platform for communication and understanding the trajectory of care. With the incorporation of the electronic medical record, things have changed. EHR’s bring along new constraints in caring for critical patients while at the same time bring about potential to enhance care delivery through the improvement in communication and management of these patients.

Chronic Care Management

There is a growing prevalence of US adult patients who are managing two or more chronic medical conditions. Governmental and commercial insurance providers have embraced this trend by introducing chronic care management (CCM) programs in an effort to better manage these patients so as to limit costly hospital admissions and improve quality of life.

There are numerous barriers to engaging physicians and patients in the management of chronic health conditions. One of the findings from a recent survey of chronic care management by health plan was how improvement in coordination of care between multiple physicians and other healthcare professionals can positively impact the care received and improve utilization. With commercial and governmental incentives, development and implementation of CCM management tools that interface with EHR’s and connect patients and professionals can enhance care delivery in this expanding population of patients.

Care Transitions

Patients admitted to the hospital for scheduled procedures or the unexpected management of a medical issue are at risk of being readmitted for preventable issues that develop following discharge.  For aging patients with multiple chronic conditions, enhanced communication to limit misunderstandings, conflicts in disease management and compliance with medications are critical as they move from hospitals to intermediate care settings and ultimately back home. Management of these critical care transitions depend on communication of patient data, the meaning ascribed to this data by the primary care physician along with those who managed these patients in the hospital becomes a critical component in care quality, patient satisfaction and to address preventable readmissions.

Healthcare professionals have emerged to manage many aspects of patient care and are dependent on access to patient data which is often spread between EHR’s and other health data systems. Connecting and sharing this information plays a role in how these patients are managed. Development of clinical pathways that integrate and translate evidenced-based medicine into the care delivery model is a critical component to the management of care across transitions.

Patient data, treatment plans and monitoring approaches to chronic conditions and underlying risks must be integrated and communicated between patients and healthcare professionals. The complexity of healthcare and the distributed care-team model makes this more critical now than ever before. Understanding data flow between all members of the care team, including patients and their family, becomes key in the development of strategies to achieve high quality, cost effective and engaging solutions that ultimately impact outcomes.

The Annual Health Screen

Preventative care is an expanding area of medicine with the goal of trying to control US healthcare costs. In 2011, The Affordable Care Act established the Annual Wellness Visit for Medicare beneficiaries. The purpose of this initiative is to perform an annual health risk assessment and identify all of the healthcare professionals caring for a beneficiary. By identifying risks and care professionals, coordination of care and risk mitigation can be put in place.

The Centers for Medicare & Medicaid Services (CMS) is promoting this service in an effort to enhance patient care, reduce unexpected care and reduce healthcare costs. With an expansive list of healthcare professionals who can perform the Annual Wellness Visit, a critical component in implementing this service hinges on communication and the sharing of the information obtained. Understanding and connecting patients, professionals, and their health data into a unified, accessible system must be managed.

Personalized Health

The landscape of patient health data is expanding. Personalized health and wellness trackers, genetic variants influencing risks for chronic conditions and pharmacogenetics, are all revealing new biologic pathways that will impact how care is delivered in the future. Systematically integrating these disparate pieces of data is becoming critical to translate individual disease risk and treatment recommendations. Emerging uses of personalized data will impact how we store, access and use this data for personalized diagnosis and management of disease.

Solving the technical challenge of accessing the data, development of decision-support tools and visually displaying the results to physicians and patients who will ultimately act upon the findings is being actively developed. How these new technologies are integrating into clinical medicine will impact their use and the engagement of all those involved. Exploring the potential ways to integrate emerging technologies into current EHR’s becomes critical to the future of healthcare delivery.

The process of healthcare delivery, use of data to drive decisions and employing various technological tools have become interdependent components that hold great potential for impacting quality of care. Gaining an understanding of the clinical needs, designing processes that meet these patient needs while incorporating evidence-based decision support has become a critical component of healthcare delivery. Understanding the current thinking, available technology and emerging solutions to the challenges we face with data flow and communication is the first step to developing innovative and impactful solutions.

Step up at HIMSS and ask the presenter how they plan to address these needs. Then reach out to the authors at Donald.voltz@gmail.com or Thanh.tran@zoeticx.com for a reality check.

About Donald Voltz, MD
Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.

Board-certified in anesthesiology and clinical informatics, Dr. Voltz is a researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.

The Future is Now – Physician Discontent and Adopting EHRs Today – Breakaway Thinking

Posted on November 18, 2015 I Written By

The following is a guest blog post by Carrie Yasemin Paykoc, Senior Instructional Designer / Research Analyst at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Carrie Yasemin Paykoc

In the movie Back to the Future II, a young man named Marty McFly and his time-traveling companion Doc Brown travel thirty years into the future—October 21 2015—to unite his parents and correct the space-time continuum. Although this “future” date occurred several weeks ago, the technological advancements presented in the movie are not far off from reality.  In the “future” Marty cruises around his home town on a new hoverboard and the sky is filled with mechanical drones. There are a few hologram images and people are dressed in brightly colored, plastic outfits. Aside from the fashion statement, many of these technological advancements are well under way. The future is now!

Not all technology has advanced as rapidly as depicted in the movie, though. From a health information technology (HIT) perspective, it often feels like we are back in 1985 dreaming of better technology.  Electronic health records (EHRs) present one of the biggest opportunities for improvement in healthcare.

A recent study published by the RAND Corporation and sponsored by the American Medical Association (AMA) examined how satisfied physicians are with their EHRs. It found that they approve of the concept of EHRs and are largely satisfied by the ability to remotely access patient information at any time. Most physicians, practice leaders, and staff also agreed that advancements in EHR technology such as improved interoperability and improved interfaces have great potential to improve care as well as physician and patient satisfaction. On the other hand, the current state of EHRs worsened overall professional satisfaction among respondents. Data entry, usability, inefficient workflows, and lack of interoperability were a few of the main pain points mentioned in the study.

A recent parody of Jay Z’s Empire State of Mind articulates many of these same frustrations. “Just a glorified billing system with patient info tacked on,” is one of the poignant lyrics mentioned in the video.  Many physicians are fantasizing about going “back to the future” or using a more sophisticated system.

In order to move forward in advancing EHRs and HIT, clinicians, support staff, and administration need to take responsibility for their organization’s initial technology investment. If data entry, usability, and inefficient workflows are causing pain, it is time to re-revaluate those clinical workflows and escalate system issues and enhancements to their vendors.

Each time I am onsite with a client preparing for go-live I am reminded of all the energy spent on implementing these systems. But it is equally important that clinical leaders re-evaluate their initial workflows and develop a plan for sustained use after the initial excitement has faded. And during this time, leaders must provide feedback and escalate system issues to their vendor.

Engaged clinical leadership is required to not only adopt the current state of EHRs but to transform the future of health information technology. How can clinical leaders do both? First, realize an EHR is not something you can throw-away or easily replace without enormous costs.  In our consumer-based culture, old technologies like cell phones or televisions are often thrown out for the latest advancements. Although EHRs are in many ways less sophisticated than some consumer-based applications, most of those applications (if not all) do not have the ability to improve patient care or patient safety. If using today’s EHR technology saves more lives than using paper alone, it is our collective responsibility to adopt these systems.

Once this paradigm shift has occurred and clinical leaders have made a sustained commitment to using EHRs, progressive and impactful change can occur. Conversations can begin to shift to improving clinical workflows, enhancing interfaces, improving interoperability, and utilizing health information exchanges. But these later conversations will never occur if the focus is on the initial difficulties and stress associated with implementing and using these systems. In order to live up to our vision of the “future,” we must accept the realities of today.

Xerox is a sponsor of the Breakaway Thinking series of blog posts.

Are Changes to Meaningful Use Certification Coming?

Posted on February 10, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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’d been meaning to write about the now infamous letter from the AMA and 20 other associations and organizations to Karen DeSalvo (ONC Chair and Assistant HHS Secretary). I’ve put a list of the organizations and associations that co-signed the letter at the bottom of this post. It’s quite the list.

In the letter they make these recommended changes to the EHR certification program:

1. Decouple EHR certification from the Meaningful Use program;
2. Re-consider alternative software testing methods;
3. Establish greater transparency and uniformity on UCD testing and process results;
4. Incorporate exception handling into EHR certification;
5. Develop C-CDA guidance and tests to support exchange;
6. Seek further stakeholder feedback; and
7. Increase education on EHR implementation.

Unfortunately, I don’t think that many of these suggestions can be done by Karen and ONC. For example, I believe it will take an act of Congress in order to decouple EHR certification from the meaningful use program. I don’t think ONC has the authority to just change that since they’re bound by legislation.

What I do think they could do is dramatically simplify the EHR certification requirements. Some might try to spin it as making the EHR certification irrelevant, but it would actually make the EHR certification more relevant. If it was focused on just a few important things that actually tested the EHR properly for those things, then people would be much more interested in the EHR certification and it’s success. As it is now, most people just see EHR certification as a way to get EHR incentive money.

I’ll be interested to see if we see any changes in EHR certification. Unfortunately, the government rarely does things to decrease regulation. In some ways, if ONC decreases what EHR certification means, then they’re putting their colleagues out of a job. My only glimmer of hope is that meaningful use stage 3 will become much more simpler and because of that, EHR certification that matches MU stage 3 will be simpler as well. Although, I’m not holding my breathe.

What do you think will happen to EHR certification going forward?

Organizations and Associations that Signed the Letter:
American Medical Association
AMDA – The Society for Post-Acute and Long-Term Care Medicine
American Academy of Allergy, Asthma and Immunology
American Academy of Dermatology Association
American Academy of Facial Plastic
American Academy of Family Physicians
American Academy of Home Care Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology—Head and Neck Surgery
American Academy of Physical Medicine and Rehabilitation
American Association of Clinical Endocrinologists
American Association of Neurological Surgeons
American Association of Orthopaedic Surgeons
American College of Allergy, Asthma and Immunology
American College of Emergency Physicians
American College of Osteopathic Surgeons
American College of Physicians
American College of Surgeons
American Congress of Obstetricians and Gynecologists
American Osteopathic Association
American Society for Radiology and Oncology
American Society of Anesthesiologists
American Society of Cataract and Refractive Surgery and Reconstructive Surgery
American Society of Clinical Oncology
American Society of Nephrology
College of Healthcare Information Management Executives
Congress of Neurological Surgeons
Heart Rhythm Society
Joint Council on Allergy, Asthma and Immunology
Medical Group Management Association
National Association of Spine Specialists
Renal Physicians Association
Society for Cardiovascular Angiography and Interventions
Society for Vascular Surgery

Healthcare Groups Want Meaningful Use Evaluated Before Stage 3

Posted on January 16, 2013 I Written By

Anne Zieger 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.

Though the final rules for Meaningful Use Stage 3 aren’t due to take effect until 2016, ONC has already made the draft rules available for public comment.  And comments, to be sure, the agency is getting.

While various groups have chosen their own details to critique, the general consensus seems to be that ONC is getting ahead of itself and ought to give Meaningful Use Stage 1 and 2 a good hard look first.

Accordng to a nice summary from iHealthBeat, here’s where some of the major healthcare groups stand:

* The American Hospital Association is recommending that ONC fund a comprehensive evaluation of MU generally, and while it does, hold off on finalizing Stage 3 recommendations.

*  CHIME, too, is asking ONC to evaluate the existing Meaningful Use program to decide whether achieving stage 3 is realistically possible by 2016.

* The Federation of American Hospitals is also arguing that ONC needs to evaluate current Meaningful Use requirements.  Also, in its letter to ONC, the group argues that the existing structure of two years per stage doesn’t cut it.

* The AMA weighed in with its own recommendation that ONC evaluate Meaningful Use as is before moving ahead. It also suggested changing some thresholds to  make them more reachable; greater flexibility in program requirements; change the certification process to address usability; and improve HIT’s capability to share patient data.

Personally, I think the idea of doing an extensive Meaningful Use evalulation sounds like a good one, and I hope ONC actually does so.  When you’re setting new standards that affect so many providers, why not gather some data on how existing standards work?

Meaningful Use Stage 2 Commentary and Resources – Meaningful Use Monday

Posted on March 5, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

For this week’s Meaningful Use Monday, I decided I’d go through the large list of meaningful use stage 2 commentary that’s been put out over the past week. I’ll do my best to link to some of the most interesting commentary, summaries, etc of meaningful use stage 2 and point out some resources that I’ve found useful.

John Halamka on Meaningful Use Stage 2
First up is the blog post by John Halamka about MU stage 2. I really like his recommendation to read pages 156-163 of the MU rule (PDF here). Sure, the rule is 455 pages, but many of those pages are a recap of things we already know or legalese that is required in a government document. Halamka also created a meaningful use stage 2 powerpoint that people can reuse without attribution. Worth looking at if you’re not familiar with MU stage 2 or if you have to make a presentation on it.

Health Affairs on MU Stage 2
Health Affairs has a nice blog post covering meaningful use stage 2. They offer “3 highlights that seem particularly important:”

  1. The bar for meeting use requirements for computerized provider order entry (CPOE), arguably the most difficult but potentially the most important EHR functionality, has been raised: now a majority of the orders that providers write will have to be done electronically.
  2. There is a major move to tie quality reporting to Meaningful Use. We knew this was coming, but CMS has laid out a host of quality measures that may become requirements for reporting through the EHR.
  3. Health Information Exchange moves from the “can do it” to the “did do it” phase. In Stage 1, providers had to show that they were capable of electronically exchanging clinical data. As expected, in Stage 2, providers have to demonstrate that they have done it.

Health Affairs also talks about the timeline for this rule and the feedback that CMS is likely to get on MU stage 2. I’m sure they’re going to get a lot of feedback and while they suggest that the rule will look quite similar to the proposed rule, I expect CMS will make a couple strong changes to the rule. If nothing else to show that they listened (and I think they really do listen).

Stage 2 Meaningful Use by The Advisory Board Company
The Advisory Board Company has a good blog post listing the 10 key takeaways on stage 2 of meaningful use. Below you’ll find the 10 points, but it’s worth visiting the link to read their descriptions as well.
1. Centers for Medicare & Medicaid Services (CMS) affirms a delay for 2011 attesters.
2. Stage 1 requirements will be updated come 2013.
3. Medicaid definitions are loosened; more providers are eligible.
4. While the total number of objectives does not grow, Stage 2 measure complexity increases significantly.
5. Information exchange will be key, but a health information exchange (HIE) will not be necessary.
6. Patients will need to act for providers to succeed.
7. Sharing of health data will force real-time, high-quality data capture.
8. More quality measures; CMS’ long term goals—electronic reporting and alignment with other reporting programs—remain intact.
9. The Office of the National Coordinator’s (ONC) sister rule proposes a more flexible certification process and greater utilization of standards.
10. Payment adjustments begin in 2015.

AMA MU Stage 2
The American Medical News (done by the AMA) has a blog post up which does a good job doing an overall summary of where meaningful use is at today (post MU stage 2). Meaningful Use experts will be bored, but many doctors will appreciate it.

Justin Barnes on Meaningful Use Stage 2
Justin Barnes provides his view on meaningful use stage 2 in this HealthData Magement article. It seems that Justin (and a few other of his colleagues at other EHR vendors) have made DC their second home as they’ve been intimately involved in everything meaningful use. I found his prediction that the meaningful use stage 2 “thresholds and percentages will remain largely in place come the Final Rule targeted for August, and should not be decreased via the broader public comment phase next underway like we saw with Stage 1.” Plus, he adds that the 10 percent of patients accessing their health information online will be a widely discussed topic. Many don’t feel that a physician’s EHR incentive shouldn’t be tied to patients’ actions. Add this to the electronic exchange of care summaries for more than 10 percent of patients and the healthcare data is slowly starting flow.

Meaningful Use Stage 2 and Release of Information
Steve Emery from HealthPort has a guest post on HIT Consultant that talks about how meaningful use stage 2 affects ROI. This paragraph summarizes the changes really well:

The bottom line for providers is that Stage 2 MU changes with regards to these specific criteria will drive organizations to implement a patient portal or personal health record application; and connect their EHR systems to these systems. Through these efforts it is expected that patient requests to the HIM department for medical records will decrease; as patients will be able to obtain records themselves, online and at any time.

e-Patients and Meaningful Use Stage 2
e-Patient Dave got together with Adrian Gropper MD, to put together a post on meaningful use stage 2 from an e-Patient perspective. This line sums up Adrian Gropper MD’s perspective, “My preliminary conclusion is that Stage 2 is a huge leap toward coordinated, patient-centered care and makes unprecedented efforts toward patient engagement.”

Meaningful Use Stage 2 Standards
Those standards geeks out there will love Keith Boone’s initial review and crosswalks from this rule to the Incentives rule here.

Shahid Shah on Meaningful Use Stage 2
I like Shahid Shah’s (the Healthcare IT Guy) overview and impressions as well. He’s always great at giving a high level view of what’s happening in healthcare IT.

Are there any other meaningful use stage 2 resources out there that you’ve found particularly useful or interesting?

EMR ROI, Steve Jobs EMR, $1 Billion in EHR Stimulus, and EMR Data Security

Posted on December 11, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

Some really interested EMR related tweets in tonight’s round up from around the EMR twittersphere. I’m testing out the new Twitter embed function. We’ll see how it does. It’s a convenient thing, but might need some tweaking.

As always, feel free to follow me on Twitter @techguy and/or @ehrandhit. If you’re on Twitter, let me know so I can make sure I’m following you as well.

Well said! EMR ROI can’t be certified, but it can be measured and planned for.

I wrote a bit about Steve Jobs and EMR before. The icon of Steve Jobs and creating something the way Steve Jobs did is going to be around for a very long time to come.

Over 10k eligible providers and $1 billion in stimulus money. I wonder how many of those 10k providers already had an EMR and how many implemented an EMR to get the stimulus money.

Definitely much higher than I’d have thought as well. Sure, every doctor wants their systems to be secure, but very few make it any sort of priority beyond expecting it to be secure.

Reasons Why EMR Efforts Are Proceeding So Slowly

Posted on May 18, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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.

David Swink wrote an interesting comment on my previous post in which he lists a number of reasons why he thinks the EMR effort is proceeding so slowly. Since many of you don’t read all the comments on this site (I’ll forgive you this time), I thought I’d highlight his comments here to see what people think of his comments and what more they might add to the list.

Thought on why the EMR effort is proceeding so slowly:

1) EMR is much more complex than a simple inventory control system. The “human resources” apps probably come closest to the mark, but there are hundreds of separate HR apps out there, but they don’t have to talk to other HR apps.

2) Government is not good at organizing complex efforts. The government-sponsored HDTV effort took some 30 years to implement, and the results were largely irrelevant in that we’d moved beyond the concept of “broadcast”.

3) The medical community has no “IEEE” standards group to represent their interests and get various vendors to pull together towards a well-defined goal. The AMA could maybe assume this role, except that it is mostly a political organization, with only 17 percent participation by physicians.

4) Large medical groups are not likely to encourage mutual cooperation in EMR development. To them, small physician groups are competition. (Likewise, Sarbanes-Oxley works to the benefit of large corporations who can afford the accounting red tape, to the detriment of Mom-n-Pop organization, where red tape is a meaningful expense.)

I think David missed a number of other important reasons. Like the 300+ EMR and EHR vendors for a start. What else do you think is slowing the EMR effort? And more importantly, what can be done to overcome these challenges?

ePrescribing Through Online AMA Platform

Posted on April 27, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 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 was recently sent a news release about DrFirst offering their ePrescribing services to physicians through a new online American Medical Association (AMA) platform. Here’s a short description of the new AMA platform:

DrFirst is the first company to announce that it is offering its services through the new AMA online platform. The platform, which is currently in beta testing, is aimed at providing physicians access to information, products, services and resources that can facilitate medical practice and ease adoption of evolving health information technologies. The AMA aims to launch its new platform in early 2010.

I find the concept of the AMA offering a platform for doctors interesting. Does anyone else know anything about this platform? On face it just sounds like the AMA trying to get a piece of the revenue that can be generated from adopting these technologies. I’m just not sure why someone would use this new AMA portal instead of just buying the software themselves. What advantages does the AMA portal provide outside of being a recommendation source for various software?