I’ve generally been writing more about the EMR side of EMR and HIPAA lately. For the most part, it seems readers are more interested in EMR and EHR than they are in the details of HIPAA. Although, one of my top posts ever is from back in 2006 about HIPAA Privacy Examples and HIPAA Lawsuits. It seems that people are most interested in HIPAA when it has something to do with a HIPAA violation or lawsuit.

Today’s HIPAA violation could very likely become a HIPAA lawsuit. Plus, it is a word of caution to those about training your staff on HIPAA requirements and also on proper use of social media in healthcare.

Anne Steciw posted about the violation on Search Health IT. Here’s an excerpt from her post:

Details of the health data breach provided by the Los Angeles Daily News indicate that the employee, who was provided by a staffing agency, shared a photo on his Facebook page of a medical record displaying a patient’s full name and date of admission. The employee appeared to be completely ignorant of HIPAA laws.

I’m sure every hospital and healthcare administrator is cringing at this. I’m sure many could share stories of HIPAA issues related with staffing agencies as well. Although, it’s really hard for me to understand how someone even from a staffing agency could be so ignorant to the HIPAA laws. I’m not overstating how ignorant this person was in this situation. The above article explains something even more outrageous and unbelievable:

Even after being told by other posters that he was violating the patient’s privacy, the employee argued: “People, it’s just Facebook…Not reality. Hello? Again…It’s just a name out of millions and millions of names. If some people can’t appreciate my humor than tough. And if you don’t like it too bad because it’s my wall and I’ll post what I want to. Cheers!”

To me this is totally mind boggling. I’m sure many will argue that this person was exhibiting many of the characteristics of the Facebook generation of users. That’s a cop out and an excuse, but does make a larger point that many of the next generation have these outlandish views of what’s theirs and what’s ok and reasonable. Sadly, far too many people think when it’s humor it’s ok to do anything. It’s not and I’m sure those dealing with HIPAA violations won’t find it a reasonable excuse either.

One thing I really hate about stories like this is that they give a bad name to use of social media in healthcare. Social media is like most things which can be used for good or bad. It’s a shame if incidents like this discourage people from accessing the benefits of social media.

This is another good example of how our biggest HIPAA privacy vulnerability is people.

As most of you probably know, I’m a huge fan of technology and it’s also fair to say that I’m a pretty early adopter of social media. In fact, I’m sure that some of you think that I live on social media. I prefer to just say that I’m active in social media. Despite my love and participation in social media, I must admit that I’ve never really been able to get into the love of Foursquare.

For those that don’t know much about Foursquare, it’s an app on your phone where you can check in to specific locations and you can see which locations your friends, family and colleagues have checked into as well. As you check in, you get rewards for checking in and virtual awards such as badges. Plus, if you check in to a certain location enough times, then you become Mayor of that location. Foursquare is far from the only one in this space, but it is definitely the leader and the originator of the space. Although, don’t be surprised if Facebook Places doesn’t give them a good run for their money.

My personal problems with Foursquare is that at least on my cell phone it’s clunky to use, hard to understand and the data gets outdated so quickly that I don’t find it that useful. I’m sure that part of my problem with Foursquare is that I don’t have enough real friends and colleagues on there to really get the benefit of knowing what everyone’s doing and where they’re at. Yes, the idea of sharing and other people knowing this information is scary, but it turns out to be a really cool thing if done right. I know since I often learn where someone is at during a conference by seeing tweets from them.

Considering my lack of adoption of Foursquare, I was of course intrigued by this article talking about why medical practices should be on Foursquare. Here are the main reasons they offer:
1. It’s easy to use.
2. It’s big, and getting bigger.
3. It’s a search engine and a way of being found when people are looking for a doctor.
4. If you don’t claim your place, someone else is likely to do it for you.
5. It says your medical practice is social and tech savvy.

Obviously I disagree with the first one, but that might be my bias. Maybe it’s so easy to use that it’s useless to me. My bias aside, I actually agree with this article that a medical practice should take the 5 minutes it takes to get their practice listed on Foursquare. I’m not suggesting that a doctor or medical practice should become really active on Foursquare. Instead, I’m just saying they should sign up and claim their spot on Foursquare. Then, you get to control your listing as opposed to one of your patients which adds your office for you.

A comment in the above article makes a really good point too. If you want to be active in social media and reach the typical visitors to doctors offices that tend to skew female and older, you probably should be on Twitter and Facebook, not Foursquare. Yelp is another good recommendation for many cities. Lots more could be said about those three services. If people are interested, then we’ll cover those in future posts.

Jeremy Bikman from KATALUS Advisors wrote this interesting comment on a LinkedIn discussion I was participating in:

Perhaps there is a place for MUMPS but only if healthcare continues to thumb its nose at the prevailing technology trends. It’s hard for me to envision healthcare to continue to embrace a technology that doesn’t like to play nicely with other non-MUMPS systems. If there were real advantages to it you would see a fair number of high tech firms utilizing it (Facebook, salesforce.com, Twitter, Spotify, etc).

If your goal is to have an enterprise system with a database that has some scale to it and certainly has good speed, and you don’t really care about interoperability with other systems, then MUMPS is certainly a good viable option. But IMO, the days of healthcare IT being insular, and moving out of phase with the rest of the tech world, are numbered.

I found this comment incredibly interesting. Mostly because I’ve never personally believed that the fact that many of the larger healthcare IT and EMR systems are built on MUMPS was any part of the reason why healthcare entities aren’t interoperable. I’m a tech guy by background, but I’ve never worked on a MUMPS software system myself so I don’t have first hand knowledge of MUMPS in particular. However, it seems wrong to “blame” MUMPS on the lack of healthcare data interoperability.

I guess the way I look at it is that no matter which database back end you have, you’re always going to need some front end interface to take care of the transport of the healthcare data to another system. Is this any harder with MUMPS than another SQL or even NOSQL database? From my experience it shouldn’t matter. I’d love to hear if there are reasons why it is harder.

I also don’t want to give the impression that Jeremy is trying to say that MUMPS is the only reason that healthcare IT has been so insular and closed. I’m pretty sure he agrees with me that a lot of other factors that have stopped healthcare from sharing data. I just don’t believe that MUMPS is one of those reasons.

Of course, the question of whether MUMPS should continue in healthcare is a different question. In fact, I wrote about MUMPS in healthcare IT and EMR here.

What are your thoughts? Is MUMPS the problem with healthcare interoperability? What are the other reasons stopping healthcare interoperability?

Update: Jeremy Bikman provided the following clarifying comment in the comments of this post:
Good points John. I really should have clarified. MUMPS is not really the issue (although I still stand by my assertion that if it was such a superior technology you’d see it all over Silicon Valley, RTP, etc). The main issue is really with the walled garden (w/ razor wire and machine guns along the top) approach of the major EMR/HIS vendors that have it as their foundation.

The more control you exert over your clients and the harder you make it to connect with other systems, the more money you can make…at least in the short-term.

John’s thought: I still look forward to the discussion around MUMPS and interoperability and healthcare interoperability in general.

I saw this tweet and decided I couldn’t pass up posting it. When I read it, all I could think was, Yeah……right!! (yes, that last part is in the sarcasm font)

@NewIQ – David Whitaker
The next five years will be pivotal for EHR solutions. The cloud presents a real opportunity for the creation of a truly dynamic system.
Followed by…
I would not be surprised if the folks at Google or Facebook werent already working on a strategy. #EHR #cloud

I think the last thing Facebook is thinking about is anything to do with EHR. They might be interested in healthcare apps for “consumers” managing their health, but they couldn’t give a rip about EHR. They might even consider helping doctors connect with patients on Facebook (although, even that I think is unlikely), but not an EHR.

Google has probably thought of EHR back when Google Health launched. Obviously they chose to go with PHR and we see how that turned out. I don’t think Google could make a worse mistake than to try and create an EHR.

Yeah, Facebook or Google doing EHR…that would be surprising.

I’m not sure how many of you have followed the announcement of the Google 1+ button. If you haven’t seen them yet, you’ll start seeing them sprinkled all over the internet soon. I just added them to a couple of my sites including EMR and HIPAA. You can see it next to the Facebook button on the right side of each post. Feel free to click it if you’re reading a post that you like. It’s a simple action which can tell me a lot about whether people like the post or not.

Of course, I’ve been using social media indicators like this for a while. For example, I’ve known the number of people who tweeted out my various posts on Twitter. I often can see how many times an article gets published on Facebook. I always love to get feedback like this that tells me that someone liked the article I created. However, often tweeting a link or sharing a link on Facebook is more than someone wants to do. The Google 1+ is an even simpler and more anonymous way of telling a blogger or other website that you like what they’ve created. I’m interested to see how many people are willing to take the simple step of clicking the Google plus 1 button when they like a post.

However, beyond the benefit to a blogger of knowing which content its readers like, Google is no doubt going to use this information as well to create more targeted search results (and likely ads as well). Some people bristle at the idea that Google would have this information. However, I don’t have any problem with it. In fact, I like that Google will be able to provide me a better service. For example, if I search for EMR on Google, they should know I want to know about electronic medical record sites and not the EMR paintball one. I think data like the plus 1 could help Google to improve that experience for me. That’s a good thing.

I’ve been really interested in these social media indicators and the influence that someone can have online. For example, just because someone has a lot of followers, does that make them an authority? What if you find some health information online? How do you know the quality of that information? What if you’re searching for EMR software? How do you evaluate the quality of the information that’s being provided? What about any biases that information might have? Can social indicators help you to improve your understanding of the quality of the information?

I’m not sure the answers to many of these questions, but I do think there’s power in a crowd of people expressing their opinions on a subject. Even something as simple as clicking on a Google plus one benefit. Will it cure Cancer? No. However, it can still have a profound impact on the way we discover information and how we help others understand the quality of that information.

You know on the weekends I love to through in a little round up of some interesting things said about healthcare IT, EMR and other topics on Twitter. Hopefully, they’ll educate, entertain and inform. If not, tomorrow’s another edition of Meaningful Use Monday.

T2: I used to read 4 newsletters, now I don’t. I’ve chg’d to read tweets & blog post – so much more current. #hcsm

April 24, 2011 5:26 pm via TweetDeckReplyRetweetFavorite

@Colin_Hung

Colin Hung

I’ve been talking about this quite a bit lately on this blog (see my post about social media EMR information). However, I love how the described their shift from newsletters to tweets and blog posts since they’re more current. I obviously agree. Although, if you subscribe to the EMR and HIPAA email you can enjoy the convenience of an email newsletter with the current info of a blog.

Rock Health Launches –The First Seed Accelerator to Promote Interactive Health http://dlvr.it/PZc58

April 24, 2011 11:37 am via dlvr.itReplyRetweetFavorite

@ehrandhit

EMR, EHR and HIT

I saw this announcement a while ago. I’m really excited to see what Rock Health is able to do. They definitely have a number of big names. I wish that I was some way involved with them since I love their approach. Plus, I’m really excited to have my brother, David, participating with me on the Smart Phone Healthcare website I recently launched. Mobile healthcare is a really hot area of the market and I think together we’re going to bring some interesting perspectives to the mobile area of healthcare.

E-Prescribing Incentive Program Comparison: http://bit.ly/hAjVe5 #healthit #medicare #meaningfuluse

April 23, 2011 6:22 am via webReplyRetweetFavorite

@richelmore

HealthcareTechNews

I usually hate PDF’s and a tweet in a blog post that leads to a PDF is probably even worse. Although, it has an interesting format for considering the multiple e-Prescribing incentive programs. Of course, if you’re a regular reader of the site, then you already have started ePrescribing right?

LOL! RT @WilIFerrell: Facebook is like jail, you sit around & waste time, you write on walls & you get poked by people you don’t know.

April 23, 2011 5:17 pm via webReplyRetweetFavorite

@Colin_Hung

Colin Hung

This just made me laugh and so I had to share it. Although, if you Like EMR and HIPAA on Facebook, then it will be so much better than prison. Well, maybe not much better, but it will make me smile.

I’m interested to hear how others use social media to consume healthcare IT and EMR information. As most of you probably know, I’m a pretty avid user of social media. For me, it’s a combination of marketing my websites, getting new content and information for my websites, connecting with smart people, and just keeping a finger on the pulse of what’s happening in healthcare IT and EMR.

For example, many of you probably know about my two popular twitter accounts @techguy and @ehrandhit. My @techguy account is really my twitter account for everything and anything I feel like using Twitter to accomplish. It’s an interesting (at least to me) mix of healthcare IT/EMR, television, entrepreneurship, technology/social media, ultimate frisbee, and my other adventures in life. I love the freedom of that account since I’ll do and talk about most anything that I care to tweet about or people I care to connect with. @ehrandhit on the other hand is strictly EMR and Healthcare IT focused. I probably should give it a better voice than what it is now including more connecting with people and more thoughtful comments. Although, most of my best thinking becomes blog posts and then gets linked to that Twitter account.

I’ve also started this EMR and HIPAA Facebook page (You should all Like it). It’s seen some growth over time, but nothing like I expected that it might see. I’m not sure what people think of Facebook. Maybe most people go on Facebook to hang out and not necessarily talk shop. I can appreciate that. Although, when I see the number of people that have “Liked” other sites, I wonder if I’m just missing something about how I’m using Facebook.

I’ve become a big fan of LinkedIn. In fact, that’s why I recently started the Healthcare Scene LinkedIn group. I really love how people’s profiles are attached to the comments that they make. There’s something really refreshing about that approach. Plus, I love the conversations that happen after initially connecting in the group in a discussion about a specific topic. LinkedIn makes it really easy to connect with someone who you’ve been chatting with and extend a business relationship with them. It makes sense that the conversation is great on it since it’s such a business focused website.

While I love the above social media for finding and interacting with healthcare information, I’m still a bit surprised by the thousands of people who’ve signed up to receive the EMR and HIPAA email newsletter. Email isn’t technically social media, but it’s quite clear to me that email still plays a major role in our consumption of information and our interaction with others. Email is something we all use pretty much every day. So, I guess that makes sense why so many people want good information sent to their email. It’s convenient.

Then of course, I have a blog or two under the Healthcare Scene brand (check out the new headers I made for each site). Someone recently commented on my blog about the volume of misinformation that is out there. When I look at the list of blogs that I write and that I’m partnered with, I’m really happy to see the quality of independent information that’s being created to guide people in th EMR and healthcare IT industry.

I love how something as simple as blogging software can empower people to share their unique voice. Add in the above social media tools and the power of search on the internet and I think we can have a real impact for good on healthcare IT and EMR.

What tools do you use to consume information online? Are there tools that I haven’t listed that you love? How do you use those tools to make your and other’s lives better?

As many of you probably know, I’m a big fan of social media. Certainly it’s been a great way for me to market the content I create on my websites, but it is much more than that for me. Social media (like Twitter, Facebook, LinkedIn, etc) are a great way for me to connect and interact with other people. I’ve heard so many people tell me they don’t understand Twitter. I like to explain that Twitter is about being able to connect with people related to almost any topic imaginable. It gives you a way to follow them and to communicate with them in a passive and interesting way. It’s incredibly powerful.

Plus, Twitter and other social media is fun. You get the chance to learn a lot from those around you. Not to mention those connections can do some powerful things. I’ve gotten everything from free conference attendance to free graphic design to finding my accountant on Twitter. It’s a beautiful thing if you use it right.

The problem most people have is that they don’t know how to use it and their afraid to get started. Well, I will tell you it does take some commitment of time to make it effective. However, it’s been well worth it for me.

Back on topic, the HIMSS 11 conference in Orlando is going to be a great event to see some of the power of Twitter. You can do it by following what people are saying about HIMSS (and the hashtag #himss11) or check out some of the various HIMSS Twitter lists. You don’t even have to be on Twitter to consume the content. It’s pretty interesting to follow even now.

HIMSS also has created a social media pavillion on the exhibit floor where they’ll be having a bunch of social media center sessions. Here’s a sample of some of the session titles, “Twitter Created the New Radio Star” (so true), “Physicians and Meaningful Use: What We Are Seeing in Social Media” and “Blogging as a Career: Strategies for Clinicians and Health IT Bloggers” (by Dr. Kim) and lots more. Cesar from HIMSS always puts together a lot of interesting social media content at HIMSS.

Of course, I put together the New Media Meetup at HIMSS to also bring together some of the smartest and most interesting people using New Media in healthcare. The event has nearly reached capacity and I’m also happy to say that we’ve added a new sponsor, Ozmosis, who will be giving away an iPad at the event. Pretty sweet if I do say so myself.

If you can’t tell, I have HIMSS on the brain right now. Maybe it’s because I’m inundated by all the PR people asking to meet with me at HIMSS. The good thing is that my schedule is nearly full and so it’s easier for me to say sorry when the schedule is full. Although, there’s always more room to add to my list of possible parties to attend. So, if you know of any I should attend, let me know.

I was also amazed by the list of government officials that will be attending HIMSS. That’s pretty much all of the high level health leadership that exists in the US government. The only person that they could add to top what’s on that list is Obama and/or Biden.

I won’t go over all the other HIMSS sessions that look interesting, including some interesting HIMSS 11 keynote speakers. All in all I think it will be a great event where I’m running all over the place. However, I plan to run quickly between places, but to have slow, valuable conversations with those with whom I do meet. I’d rather have 10 valuable conversations with smart people than 100 shallow conversations with random people.

If you’re attending HIMSS, what gets you excited?

P.S. Here are the links to some of my various social media profiles:
@ehrandhit – Twitter feed of EMR and healthcare IT news
@techguy – EMR stuff, but a little bit of everything else that interests me too
EMR and HIPAA on Facebook – Like the EMR and HIPAA fan page and get the latest EMR news on Facebook. Plus, you’ll make me feel good when I see the number of fans go up.

This week I finally got my flight and hotel all lined up for my trip to HIMSS. Thanks to Practice Fusion for sponsoring that part of my trip to HIMSS. It’s greatly appreciated. I think Orlando is going to be a great destination for HIMSS and the energy and excitement is going to be something else thanks to the EMR stimulus money. It should be a pretty exciting event with far too many people, sessions and vendors to take in.

I’m still considering throwing together a New Media Meetup at HIMSS like I did last year. It was a lot of fun and worked out well since we just partnered with MEDecision to pull it off. If you’re interested in helping put something like that together or attending an event like that, let me know and I’ll be sure to let you know the details. I personally really like these sorts of intimate meetings with interesting people who understand New Media like blogs, twitter, Facebook, etc.

What other conferences do people attend? I’ve been to a number of different EMR events this last year. The Mobile Health Expo was a fun event and should get better as it grows. I really enjoyed mixing it up with all the doctors at AAFP (even if I did get kicked out of a session since I wasn’t a doctor).

I’d wanted to go to MGMA this year, but couldn’t quite swing it. The good thing is that the 2011 MGMA Annual Conference is in Las Vegas (my backyard) and so I can easily attend while still enjoying my own bed. HIMSS 2012 is also going to be in Las Vegas which is very convenient for me. Obviously, you can see I have a bit of a bias to EMR or healthcare IT related conferences in Las Vegas. It’s just so much nicer and luckily a fair amount of them come to Las Vegas.

I heard there’s going to be a healthcare portion of SXSW in Austin. That’s a conference I’ve always wanted to go to. Health 2.0 could also be interesting, but I find it much more consumer health app focused than EMR and doctor focused.

Are there any other EMR related conferences that I should keep my eye on?

There are a ton of EMR resources online these days. I remember when I started this blog, there really was only a small handful of people talking about EMR. Now, it’s kind of exploded and there’s conversations happening all over the internet about EMR. That’s why I’m particularly grateful for those who read this blog, participate in the comments and find value from it.

One of my more recent finds is the group forums on LinkedIn. They’re definitely not perfect and sometimes get too much spam, but they are an interesting place to discuss EMR. Here’s an example of a group about Small Medical Practice EMR and PM Solutions. Pretty much a perfect match for this blog right?

One of the key things I like about the groups on LinkedIn is that people’s comments are tied to their LinkedIn profile. This is pretty neat since then I can see what’s behind the comment that someone is making. I can better understand the perspective they have on the situation and why they might be commenting a certain way. It’s also cool, because I’ve gotten to meet a bunch of interesting people in the EMR world. Plus, I know quite a few of my readers come from LinkedIn as well.

Of course, you can also catch up with us on Twitter – @ehrandhit (just passed 5000 followers) and Facebook – EMR and HIPAA Fan page.

I also must admit that I’m always astonished and flattered by the people I see sign up for the EMR and HIPAA email list. That list has really grown and it’s pretty amazing to think that someone wants what I’ve written in their email box almost daily. It’s pretty humbling to see the list of doctors, practice managers, EMR vendors, and other healthcare IT people that sign up for it. So, thank you.