Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Clinical Optimization Effort and ROI Matrix

Posted on September 6, 2017 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.

Over on Hospital EMR and EHR, Galen Healthcare Solutions has been providing some really practical and detailed information on optimizing an EHR as part of their EMR Clinical Optimization Series and they’re just getting started. Along with the EMR Optimization blog posts, they also have published a FREE EMR optimization whitepaper that dives into tips, tricks, and perspectives on how to approach driving a tangible return on your EMR investment.

I love that we are finally moving past the discussion of EMR implementation and moving towards EMR optimization. As David Chou, CIO at Children’s Mercy Kansas City, recently said in the CXO Scene podcast, “Hospitals have invested at minimum $100 million on their EHR and that doesn’t include all the consulting and training services required to implement the EHR on top of it.” Given this massive investment, it is more than time to optimize our EHR implementations and ensure we’re getting a great ROI from the investment.

In Galen’s EMR Optimization Whitepaper, they shared this really impressive matrix that looks at the clinical optimization effort required against the benefits an organization will receive from those efforts:


(Click on the above image to see the large version of the matrix)

There’s a lot to chew on in this matrix, so feel free to spend some time looking over the details. In fact, it would be beneficial to do a deep analysis of this matrix with your organization. No doubt you’ll uncover ways that your organization can benefit from better clinical optimization and it will help you evaluate areas where you should focus your initial attention.

While there’s a lot of detail in this matrix, I was struck by how few levers had an impact on costs. This is a tremendous insight to consider when it comes to EHR and clinical optimization and their impact on healthcare costs. No doubt there are other more important drivers of cost that need to be considered.

On the other hand, I was also struck by how many of the opportunities in the matrix were able to directly maximize revenue while also improving quality. Sometimes I think we look at the care we provide and see our efforts to improve quality as counter to our efforts to maximize revenue. This chart clearly illustrates how you can focus on improving the quality of care your patients receive while still maximizing your organization’s revenue.

I also like to look at the outliers in these matrices. In the matrix above, they’re found in the middle of the matrix. They require less effort, but the monetary ROI is high. I’m talking about “Keeping Patient in Network” and “Driving care delivery and managing acute and chronic diseases by evaluating the patient’s problem list in clinical documentation.” These are both things that can be done much more effectively on the back of the data found in the EHR. Are you maximizing these opportunities? I know many organizations that have barely begun the work of reducing volume leakage and improved clinical decision support. Those might be great places for your organization to start in your EMR optimization efforts.

What stands out to you when you look at the EMR optimization matrix above? Would you change any of the values in the matrix? Are there areas that are missing from the matrix that you would add? How many of these optimization efforts are you working on in your organization? We look forward to hearing your thoughts and perspectives in the comments and on social media.

Note: Galen Healthcare Solutions is a sponsor of Healthcare Scene and the EMR Clinical Optimization Series of blog posts.

Healthcare Blockchain Use Case

Posted on August 3, 2017 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.

There’s been a lot of talk about using blockchain in healthcare. While I don’t think that it’s the end all be all solution that many make it out to be, I do think that healthcare could benefit in a lot of ways from blockchain.

David Chou recently shared this healthcare use case for blockchain which it looks like he got from Deloitte:

I’d be interested to hear blockchain experts thoughts on this use case. Is this reasonable? Could this be reasonably achieved with blockchain? Are there risks to implementing this use case?

We all know about the major challenges associated with interoperability in healthcare. Blockchain itself doesn’t solve a lot of these interoperability problems. It can’t because most of the interoperability problems in healthcare are business problems and not technology problems. However, I wonder if we can make data sharing in healthcare so simple that it would be embarrassing not to do it. Then, we might be on to something.

Other thoughts on blockchain in healthcare? I still have a lot to learn about this new technology.

The Petya Global Malware Incident Hitting Nuance, Merck, and Many Others

Posted on July 3, 2017 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 Petya Malware (or NotPetya or ExPetya) has really hit healthcare in a big way. The biggest impact on the healthcare IT world was the damage it caused to Nuance, but it also hit Merck and some other healthcare systems. After a shaky start to their communication strategy, Nuance seems to finally at least be updating their customers who saw a lot of downtime from when it first started on June 28 until now. This rogue Nuance employee account has been pretty interesting to watch as well. There’s a lesson there about corporate social media policies during a crisis.

Petya was originally classified as ransomware, but experts are now suggesting that it’s not ransomware since it has no way to recover from the damage it’s doing. It’s amazing to think how pernicious a piece of malware is that just destroys whatever it can access. That’s pretty scary as a CIO and it’s no surprise that Petya, WannaCry, and other malware/ransomware is making CIOs “cry.”

It’s been eye opening to see how many healthcare organizations have depended on Nuance’s services and quite frankly the vast number of services they offer healthcare. It’s been extremely damaging for many healthcare organizations and has them rethinking their cloud strategy and even leaving Nuance for competitors like MModal. I’m surprised MModal’s social team hasn’t at least tweeted something about their services still being available online and not affected by Petya.

I’ll be interested to see how this impacts Nuance’s business. Nuance is giving away free versions of their Dragon Medical voice recognition software to customers who can’t use Nuance’s transcription business. Long term I wonder if this will actually help Nuance convert more customers from transcription to voice recognition. In the past 5 days, Nuance’s stock price has droppped $1.54 per share. Considering the lack of effective alternatives and the near monopoly they have in many areas, I’ll be surprised if their business is severely damaged.

As I do with most ransomware and malware incidents, I try not to be too harsh on those experiencing these incidents. The reality is that it can and will happen to all of us. It’s just a question of when and how hard we’ll be hit. It’s the new reality of this hyper connected world. Adding to the intrigue of Petya is that it seems to have been targeted mostly at the Ukraine and companies like Nuance and Merck were just collateral damage. Yet, what damage it’s done.

Earlier today David Chou offered some suggestions on how to prevent ransomware attacks that are worth considering at every organization. The one that stands out most to me with these most recent attacks is proper backups. Here is my simple 3 keys to effective backups:

Layers – Given all the various forms of ransomware, malware, natural disasters, etc, it’s important that you incorporate layers of backups. A real time backup of your systems is great until it replicates the malware in real time to your backup server. Then you’re up a creek without a paddle. An off site backup is great until your off site location has an issue. You need to have layers of backup that take into account all of the ways your data could go bad, be compromised, etc.

Simple – This may seem like a contradiction to the first point, but it’s not. You can have layers of backups and still keep the approach simple and straightforward. Far too often I see organizations with complex backup schemes which are impossible to monitor and therefore stop working effectively. The KISS principle is a good one with backups. If you make it too complex then you’ll never realize that it’s actually failing on you. There’s nothing worse than a failed backup when you think it’s running fine.

Test – If you’ve never tested your backups by actually restoring them, then you’re playing russian roulette with your data. It’s well known that many backups complete without actually backing up the data properly. The only way to know if your backup really worked is to do a test restore of the data. Make sure you have regularly scheduled tests that actually restore your data to a backup server. Otherwise, don’t be surprised if and when your backup doesn’t restore properly when it’s really needed. Malware events are stressful enough. Knowing you have a good backup that can be restored can soften the blow.

Backups won’t solve all of your problems related to malware, but it’s one extremely important step in the process and a great place to start. Now I’m going to go and run some backups on my own systems and test the restore.

Wide Ranging Impact of A Healthcare Cybersecurity Attack

Posted on March 8, 2017 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 Chou recently shared this amazing graphic of the “above the surface” and “beneath the surface” impacts from cyber attacks. The above the surface attacks are those that are better know costs related to an incident. The beneath the surface attacks are the less visible or hidden costs of a cyber attack.

Which of these impacts concerns you most?

If this list of 14 impacts on your organization isn’t enough to wake you up to the importance of cybersecurity, then there isn’t much hope. However, most of the CIOs I’ve seen are well aware of this and it’s why it keeps them up at night.

Is It Groundhog Day with Population Health? – #HITsm Chat Topic

Posted on February 28, 2017 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 3/3 at Noon ET (9 AM PT). This week’s chat will be hosted by Hosted by David Chou (@dchou1107) and Lisa Esch (@lisaesch). We’ll be discussing the topic “Is It Groundhog Day with Population Health?“.

Population health seems to be a hot topic in every healthcare IT circle. One of the challenges with population health is that everyone is applying the term to everything. It’s hard to know exactly what is happening with population health and what’s all talk. Plus, in many cases it feels like we’ve been down this road before.

With this in mind, join as at this week’s #HITsm Twitter chat to try and cut through the hyperbole and talk about the population health that’s really making a difference. Plus, we’ll look at how to make sure financial incentives are aligned and where population health is going in the future.

The Topics
Here are the topics to help flesh out the theme of ‘Is It Groundhog Day with Population Health?’

T1: What did you see last week at #himss17 that excited you about population health? #HITsm

T2: Why has this taken so long? We have been talking about value based care since 2011, has any progress been made? #HITsm

T3: Are the financial incentives aligned to moved towards a population health approach? #HITsm

T4: Who are the disruptors that you see so far? #HITsm

T5: What’s next and how do you see this play out? #HITsm

Bonus: Do you think population health impacts your personal health? How? #HITsm

Upcoming #HITsm Chat Schedule
3/10 – Digital Transformation in Healthcare
Hosted by Murray Izenwasser (@MurrayIz and @AAJTech)

3/17 – TBD

3/24 – TBD

We look forward to learning from the #HITsm community! As always let us know if you have ideas for how to make #HITsm better.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Virtual Reality in Healthcare

Posted on January 18, 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.

David Chou has an interesting post up over at the Healthcare Standards blog that talks about virtual reality (VR) and where we’ll see it in healthcare. He posits the following 3 areas of healthcare where the healthcare industry can benefit:

  1. Training
  2. Diagnosis
  3. Treatment

I can’t argue with David’s assessment of how virtual reality solutions will be used in healthcare. I think the most promising of these is likely in the medical training area. However, there are no doubt going to be some great treatment options that use VR as well.

The problem with virtual reality in healthcare is that none of the virtual reality companies are going to focus any of their effort on healthcare. Everyone that I talked to at CES (see all our coverage of Digital Health at CES) made it very clear that VR technology was going to start with gaming and video. That opportunity is so large that they don’t have any time or need to go after other markets.

This isn’t to say that virtual reality won’t be used in healthcare. What I’m saying is that virtual reality vendors aren’t going to be doing things to make it easy for healthcare to adopt their technologies. Innovators that want to use virtual reality in healthcare are going to have to take and adapt what’s built for other industries and apply it to healthcare.

Here’s a simple example. I saw an amazing number of 360 degree camera options that are paired with virtual reality. You literally can turn around and see what’s happening all around you as if you were standing in a room. It’s quite amazing technology (although there was some digital stiching that still needs to be improved) and you could see some application of the technology in healthcare. The problem is that it’s unlikely that this video technology is going to be HIPAA compliant by default. Let’s not even talk about these vendors signing a HIPAA business associate agreement.

This example is why I think the medical training aspect of virtual reality is so promising. It’s not governed by HIPAA and so the technology doesn’t have to worry about those requirements and regulations. The same is true for treatment. The problem there is that for it to truly be classified as a treatment, it’s going to have to go through FDA testing and/or clinical trials. The pace of change is moving so fast with virtual reality technology that by the time you finished a clinical trial or became FDA cleared the old virtual reality technology you used will be considered legacy software and hardware.

With all of this said, I had a chance to try out the next generation Oculus Riftat the Dell venue and it was an extraordinary experience. I got lost in the virtual world (I was playing a simple video game) and completely forgot that I was in a noisy bar. I’m excited to see all of the places virtual reality will pop up. That includes in healthcare.