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Expecting Evolutionary, Not Revolutionary at #HIMSS16

Posted on February 26, 2016 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.

As most of you know, I’m deep in the weeds of planning for the HIMSS 2016 Annual conference. Actually, at this point on the Friday before HIMSS, I’m more or less planned. Now I’m just sitting here and wondering what things I might have missed. With that said, I’ve been preparing for this live video interview with the Samsung CMO which starts in 30 minutes (it’s recorded in case you miss the live discussion) and so I’ve been thinking about what I’m going to see at HIMSS. As someone who follows the changes in healthcare technology every day, I’m expecting lots of evolutionary changes and very little revolutionary.

As I think about it, I’m trying to imagine what someone could announce that would be revolutionary. That includes thinking back to past HIMSS to what announcements really revolutionized the industry. I can only think of two announcements that come close. The first announcement was when the meaningful use regulations were dropped right before the ONC session at HIMSS. Few people would argue that meaningful use has not revolutionized healthcare IT. Certainly many people would argue that it’s been a revolution that’s damaged the industry. Regardless of whether you see meaningful use as positive or negative, it’s changed so many things about healthcare IT.

The second announcement that stands out in my mind was the CommonWell health alliance. I’m a little careful to suggest that it was a revolutionary announcement because years later interoperability is still something that happens for a few days at the HIMSS Interoperability showcase and then a few point implementations, but isn’t really a reality for most. However, CommonWell was a pretty interesting step forward to have so many competing EHR companies on stage together to talk about working together. Of course, it was also notable that Epic wasn’t on stage with them. This year I’ve seen a number of other EHR vendors join CommonWell (still no Epic yet), so we’ll see if years later it finally bears the fruits of what they were talking about when they announced the effort.

The other problem with the idea that we’ll see something revolutionary at HIMSS 2016 is that revolutions take time. Revolutionary technology or approaches don’t just happen based on an announcement at a conference. That’s true even if the conference is the largest healthcare IT conference in the world. Maybe you could see the inkling of the start of the revolution, but then you’re gazing into a crystal ball.

The second problem for me personally is that I see and communicate with so many of these companies throughout the year. In just the last 6 months I’ve seen a lot of the HIMSS 2016 companies at various events like CES, RSNA, MGMA, AHIMA, etc. With that familiarity everything starts to settle into an evolution of visions and not something revolutionary.

Of course, I always love to be surprised. Maybe someone will come out with something revolutionary that changes my perspective. However, given the culture of healthcare and it’s ability to suppress revolutionary ideas, I’ll be happy to see all the amazing evolution in technology at HIMSS. Plus, the very best revolutionary ideas are often just multiple evolutionary ideas combined together in a nice package.

CPOE and MU with Marc Probst and M*Modal

Posted on June 26, 2013 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.

As part of my ongoing series of EHR videos, I had the chance to sit down with Marc Probst, CIO of Intermountain and a member of a number of important healthcare IT committees, Mike Raymer, Senior Vice President of Solutions Management at M*Modal and Dr. Jonathan Handler, CMIO of M*Modal to talk about CPOE and Meaningful Use. It’s another great addition to the Healthcare Scene YouTube channel.

In the interview we have a chance to talk about Intermountain’s move from zero CPOE to mobile, voice recognized CPOE. We talk about the future possibilities of voice in healthcare. I also ask Marc Probst about his views on EHR certification, meaningful use, and CommonWell.


*Note: Marc Probst’s sound was less than ideal. Next time we’ll be sure he has a better microphone.

The Path to Healthcare Interoperability Standards

Posted on June 24, 2013 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’ve been thinking a lot about the issues associated with healthcare interoperability. One of the biggest excuses/problems out there is the idea of interoperability standards. Healthcare certainly has plenty of interoperability standards, but adoption and implementation of the actual standards has been the major issue.

I do think that meaningful use and EHR certification is making some difference in regards to standards. I think that Direct Project is likely going to become a pretty solid standard for exchanging some healthcare documents. However, it’s limited in it’s scope.

Instead, I think we’re going to see a different path to healthcare interoperability. It’s going to be led by a few prominent organizations that start sharing info. Once those organizations start sharing data, whatever standard they use will start to spread and will become the standard for interoperability in healthcare.

Which organization or group of organizations will be the ones that break out and establish the standard? I still think the jury is out on that one, but a couple prime candidates are: CommonWell and Healtheway.

I’d love to hear if you see another path to healthcare interoperability or other initiatives that could break through and be successful.

Open vs Closed EHR Systems with Jonathan Bush

Posted on June 7, 2013 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.

Yesterday I had a video interview scheduled with Jonathan Bush from athenahealth. It was going to be broadcast live on my burgeoning EHR Videos website (Subscibe for EHR Video Email Updates) using the Google Plus Hangout technology. Everything was set until Google Plus HOA (Hangouts On Air as they’re called) wouldn’t load. It was a system wide problem and so we were unable to broadcast the interview. However, Jonathan and I were able to see each other and so we just did a more traditional interview about the subject of open vs closed EHR systems.

As you can imagine Jonathan had plenty to say on the subject of open versus closed EHR systems. We started the discussion discussing the business model of closed EHR systems and how looking at many EHR companies that seemed to be a very good business model. I asked him what was so bad about being closed.

Jonathan then told me that a closed EHR system is a great business model for the software vendor if you can get it. However, he said that as the product category matures the closed systems will get disrupted by more open options. In fact, at one point in our conversation he suggested that once some of the players become truly open, the other EHR vendors will have to follow along.

I was offered one caveat by Jonathan. He was curious if Epic was the exception to this rule. He wondered if Epic had so much money that they could last well beyond most companies. This cash could provide them the runway and opportunity to reinvent themselves along with those companies trying to disrupt them. Although, the most powerful comment made in regards to Epic was when he suggested that Epic has clients that benefit from Epic’s closed nature as well.

Another powerful comment he made was, “Affordable sounds like decline.” The concept is really interesting. Basically, so many EHR vendors have been able to charge an outrageous premium with amazing margins for their EHR software. If they were to choose to lower their price, many could misinterpret that decision as the company cutting prices to increase sales that have dropped off. Certainly the argument can be made that EHR vendors don’t need to charge what they do. However, image is important and could be influenced by a price drop.

While it’s always fun to talk about Epic with Jonathan, I also pressed him on why athenahealth wasn’t more open in the things they do. Couldn’t some of the same arguments made against closed EHR systems be applied just as easily to athenahealth? For example, why isn’t the athenahealth API more open?

In one of his more contemplative responses, Jonathan acknowledged that athenahealth was heading down the path of closed EHR systems. He saw that they were headed in a similar direction with their business model and so they had to decide if that’s the direction they wanted to continue or if they wanted to move towards a more open EHR model. He mentioned their More Disruption Please program and how the number of companies they were working with in that program was a sign of their move to be more open.

Jonathan admitted that the athenahealth API wasn’t where it should be, but that the goal was to have an API for every surface area of athenahealth. I wish we had this comment on video so we could really hold him to it. I love the idea of every surface area of an EHR being available through an API.

I also pressed Jonathan a little bit about CommonWell and whether it would be open to everyone and anyone that wanted to participate. He responded, “We expect every single maker of health information technology to obtain a key for every patient they have and see where that patient has been.” That was a pretty broad statement about openness. He did suggest that CommonWell was the right approach of knowing where the data was stored as opposed to storing every single person’s data in every clinic. It had to be a distributed patient records model.

Jonathan did also tell me that they’d recently got a call from Epic to work with them to build API connections with all the information in Epic. We’ll see if this is a step towards a more open Epic. Although, it still seems to follow the same pattern Judy discussed when she called Epic the most open EHR system she knew. She’s ok opening up with strategic partners.

I ended the conversation with me asking Jonathan what could be done to make the business model of being open work in healthcare. He mentioned two topics that deserve more time and their own dedicated post: a repriced athenaclinicals based on order and anti kick back laws as an obstacle for exchange of information. Both were preventing a market for health information. Our time ran out so I couldn’t dig into these subjects more. I’m going to see if Jonathan or someone from athenahealth would be willing to do a couple future guest blog posts on the subject.

As you can see, I covered a lot of ground with Jonathan in the 10 minutes we had. Imagine if we’d had the full 30 minutes. Plus, you could have heard it straight from him. I’m certain we’ll be inviting Jonathan back for another interview in our series of EHR Videos.

CommonWell Health Alliance – The Healthcare Interoperability Enabler?

Posted on March 4, 2013 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.

The biggest news that will likely come out of HIMSS was the big announcement that was made about the newly formed CommonWell Health Alliance. They’ve also rolled out a website for the new organization.

This was originally billed as a Cerner and McKesson announcement and would be a unique announcement from both the CEO of Cerner and McKesson. Of course, the news of what would be announced was leaked well before the press briefing, so we basically already knew that these two EHR companies were working on interoperability.

In what seemed like some final, last minute deals for some of the companies, 5 different software products were represented on stage at the press event announcement for CommonWell Health Alliance. The press event was quite entertaining as each of the various CEOs took some friendly jabs at each other.

Of course, Jonathan Bush stole the show (which is guaranteed to happen if he’s on stage). I think it was Neal Patterson who called Jonathan Bush the most articulate CEO in healthcare and possibly in any industry. Jonathan does definitely have a way with words.

One of Jonathan’s best quote was in response to a question of whether the CommonWell Health Alliance would just be open to any health IT software system, or whether it was just creating another closed garden. Jonathan replied that “even a vendor of epic proportions” would be welcome in the organization. Don Fluckinger from Search Health IT News, decided to ask directly if Judy from Epic had been asked about the alliance and what she said. They adeptly avoided answering the question specifically and instead said that they’d talked to a lot of EHR vendors and were happy to talk to any and all.

Although, this is still the core question that has yet to be answered by the CommonWell Health Alliance. Will it just be another closed garden (albeit with a few more vendors inside the closed garden)? From what I could gather from the press conference, their intent is to make it available to anyone and everyone. This would even include vendors that don’t do EHR. I think their intent is good.

What I’m not so sure about is whether they’ll put up artificial barriers to entry that stop an innovative startup company from participating. This is what was done with EHR certification when it was started. The price was so high that it made no sense for a small EHR vendor to participate. They could have certified as well, but the cost to become certified was so high that it created an artificial barrier to participation for many EHR vendors. Will similar barriers be put up in the CommonWell Health Alliance? Time will tell.

With this said, I think it is a step forward. The direction of working to share data is the right one. I hope the details don’t ruin the intent and direction they’re heading. Plus, the website even says they’re going to do a pretty lengthy pilot period to implement the interoperability. Let’s hope that pilot period doesn’t keep getting extended and extended.

Finally, I loved when Jonathan Bush explained that there were plenty of other points of competition that he was glad that creating a closed garden won’t be one of them. I hope that vision is really achieved. If so, then it will be a real healthcare interoperability enabler. Although, artificially shutting out innovative healthcare IT companies would make it a healthcare interoperability killer.