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Healthcare: Prescribing a Hot Meal or Heating for Your House

Posted on March 25, 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.

When we think of healthcare, we often think of the doctors office or a hospital. We’ve talked many times before how doctors and hospitals today are really about sick care and not health care. If we were really worried about caring for the health of patients, we’d need to do so much more outside of the 4 walls of a doctor’s office or hospital. In fact, we know that it’s the 99% of time at home, work, etc that most influences our health.

With this as background, I was fascinated by this HP article which talks about a new kind of Big Data for healthcare. The article interviews Rebecca Onie, Co-Founder of Health Leads. This excerpt from the article describes the problem they’re trying to solve:

The work was borne out of conversations with physicians who professed profound frustration with delivering care to vulnerable patients. Patients would come into the clinic on a regular basis, and let’s say a kid has an ear infection. A physician can prescribe antibiotics, but the real issue is that there’s no food at home or they’re living in a car. Ninety percent of health outcomes are actually not dictated by clinical healthcare but by these other factors.

Doctors told me, “We don’t ask about these issues, because there’s nothing we can do. We know [healthful food] will have a more profound impact on our patients than anything we’re going to do in the next 13 minutes inside the four walls of the doctor’s office.”

I had a similar conversation with Mandi Bishop, Health Plan Analytics Innovation & Consulting Solutions Owner at Dell Healthcare and Life Sciences, when we were chatting at the Dell Healthcare Think Tank event. She highlighted to me how payers are now looking at how they can pay for ramps in people’s homes in order to help reduce the number of falls that occur.

I love how these simple ideas are so powerful. Obviously, the doctor who treats a person’s cough and cold isn’t very effective if that person goes back to a house which has no heat. We’re treating the symptom, not the problem. We can take care of the broken bones, bruises and other damage that comes from falls, or we could spend much less money preventing the falls by putting in a ramp at someone’s house.

We all intellectually understand why these changes should happen. However, there’s a massive challenge in being able to actually execute these programs. No payer wants to build out the “ramp building” capabilities that are needed to solve this problem. No doctor wants to be calling the utility companies to make sure that someone’s heat gets turned back on. However, they could partner with organizations like Health Leads to get this accomplished.

I know I’m still chewing on this idea. It’s absolutely expanded my thinking when it comes to healthcare and how we can really improve health. I hope it does the same for you. I also love describing it as a prescription for heat or a prescribing a hot meal. Maybe that’s corruption of the word prescription, but it definitely illustrates the idea so well.

Which EHR vendor is going to build in this new subscription service? Yeah, that’s right. None of them. Thus why the EHR vendor needs to open up the kimono for other people to deliver this type of service on top of the EHR platform.

EHR Is the Database of Healthcare

Posted on March 1, 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.

I’ve been regularly writing and thinking for the past few months about something I’ve branded as the “Smart EMR.” Basically, the EMR of the future won’t be a repository of documents and information like before. Instead, doctors will have an expectation that the EMR is smart and can do something valuable with all the health information that’s stored in the EMR. I love this subject. I should put together a presentation on it and start touring it around the country, but I digress.

While at HIMSS I had the pleasure of talking with Sean Benson, VP of Innovation at Wolters Kluwer Health. In our discussion, he said something that hit me like a ton of bricks. He suggested that EHR software is the database of healthcare. The implication being that EHR software is good at collecting healthcare data and storing that data. What they’re not good at doing is actually providing the smart layer that goes on top of that data.

I’m sure that many who know about Wolters Kluwer Health’s (WKH) software offerings might see Sean’s view as bias since WKH, as best I can tell, wants to be the smart layer that goes on top of EHR software. In fact, they showed me some really interesting technology they have for processing all the medical information out there into a really digestible format, but that’s a post for another day. Their interests and clinical decision support software aside, the idea of the EHR software being the database of healthcare seemed to resonate with me.

I’ve often described EHR software to date as a big billing engine. Some EHR are trying to break that mold, but that’s a hard mold to break since a big billing engine is what the market has asked them to create (for the most part). With that in mind, it’s certainly hard for an EHR software to develop a true Smart EHR platform.

I can see in my mind’s eye a product development team going into the EHR vendor executives office and pitching some amazingly smart and effective EHR software for improving patient care. The cynical me then sees the EHR vendor executive saying, “We can’t monetize that.” or a related “That won’t sell more EHR.” The sad thing is that the executive is probably right…at least today. The market hasn’t started demanding a Smart EHR and improved patient care. I’m hopeful that the new ACO model will help to shift that focus, but it’s still too early to tell if that will provide the impetus for change.

Another part of me hopes that a true entrepreneur will come along and build an EHR that provides such a stark contrast in how it provides patient care that doctors won’t be able to resist using it. Something impactful like the stethoscope, that if a doctor isn’t using it patients won’t go to that doctor. However, this line of thinking seems to push the concept of EHRs being the database of healthcare and not the All in One Smart EHR.

If I’m an entrepreneur with the vision of transforming patient care through smart use of EHR data, why would I want to build an EHR from the ground up when there are a number of very large EHR vendors that have APIs that allow me to build upon their data? If the data’s already been collected, then I’m likely to focus all of my energy creating innovative solutions with that data, not creating the mechanism to collect the data.

What’s a database? Tools to collect data, store data and then retrieve data. What’s an EHR today? Mechanisms to collect health data, store the data and then retrieve the data.

Ok, that’s a bit of an over simplification, but the analogy is there. You can see why so many EHR vendors are trying to become “the platform” of healthcare. Turns out that being the repository of data that everyone else builds cool stuff on top of is very valuable. However, building that platform requires a very different culture and focus than building Smart EHR solutions.

This is why I’m sure many EHR vendors will try to develop some Smart EHR solutions, but in the end EHR will be the Database of Healthcare that other Smart EHR applications connect into. I don’t think that’s a bad thing at all.

DrFirst Shifts to EHR Platform Company

Posted on February 8, 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.

If you haven’t yet seen this video that DrFirst created for HIMSS 2012 and the HIMSS Healthcare Hero, then you need to watch it now. It’s a really beautiful video: http://bit.ly/AnNvzU

After seeing such a well made video, I definitely wondered what was up DrFirst’s sleeve at HIMSS 2012. So, I reached out and today I had the chance to talk with Cam Deemer President of DrFirst about the transition that’s happening at DrFirst.

I think that most of us have known DrFirst as an ePrescribing company. Since about 2004 they have been extremely focused on the ePrescribing area and that shows in the fact that DrFirst is the “ePrescribing Inside” 230 EHR companies. That’s a really impressive number and includes a client list with such names as GE and Greenway.

DrFirst is ready to make a shift which they’ll be talking about at HIMSS in Las Vegas. What I think makes DrFirst’s ePrescribing platform really interesting is that they can provide it using the DrFirst interface or an EHR vendor can customize it to their liking using a series of API calls. It takes a unique company and a unique set of skills to be able to do this effectively. Now imagine they provide these same functions and features across a whole array of EHR related products and services. By doing so, DrFirst becomes a really interesting EHR Platform.

You can find DrFirst at HIMSS to get the entire list of the products and services that they’ll be offering to EHR software vendors beyond just ePrescribing. However, I was really intrigued when they talked about their EHR platform providing compliance programs, patient education, and even co-pay discounts which help with medication compliance. I wouldn’t say that any of these things on their own are all that interesting. They are however things that a small EHR vendor wouldn’t have the time or the resources to be able to execute properly. For those EHR vendors who use the DrFirst interface, they can be turned on with the flip of an online switch.

Now just imagine a whole suite of other EHR services that DrFirst could provide EHR vendors as well. It becomes a really interesting value proposition. Plus, DrFirst also has a number of interesting solutions in the hospital market that also leverages this platform. Things like medication history for hospitals and a lab platform.

At the end of the day, EHR vendors are going to decide if this is a value added service or not. Many larger EHR vendors are going to develop a number of these features themselves and that should be expected. I just see it as a really healthy thing to have these type of EHR platform services available. Many EHR vendors have been so swamped with meaningful use and EHR certification, it’s great that a third party integration could continue to add real value to an EHR software.

The real challenge for DrFirst is going to be around how well they integrate these new EHR service offerings into the various EHR software vendors. If the integration is clean and adds value, they’re going to do very well. If it’s kludgy (a software term for messy) and doesn’t integrate well, then we won’t see much adoption. I think their current 230 EHR integrations are one sign that it will go smooth, but we’ll see.

My next question to consider is how DrFirst could extend their platform next. I can think of a number of mobile health companies that could benefit from the right connection to prescription data or to doctors. I’ll be pressing them at HIMSS to find out what’s next. I hope you will too and come back and share what you find out.

On a side note, I just got the list of things DrFirst is doing at their HIMSS 12 booth. It’s extensive and will be a can’t miss booth. Watch for the details in my upcoming HIMSS 12 exhibitor post.

Full Disclosure: DrFirst is an advertiser on EMRandHIPAA.com.