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EMR vs Tumblr, EMR Issues, and Improving Care

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As we do almost every weekend (every other week on EMR and EHR), we like to take a look at some interesting tweets that we find related to EMR and health IT. We have a bunch of spicy tweets this week that I think each start an important conversation.


My first gut reaction was to laugh. It’s nice that someone is using Tumblr as their therapy for EMR issues. Although, my second reaction is to be a little frustrated that an EMR would be so poorly designed that you could close your EMR in the middle of a report and it wouldn’t be saved. Of course, this isn’t surprising to me since I’ve seen hundreds of EMR, but it is still sad that it’s the state of EMR software today. Imagine if Word was still that way today.


I think this is an important discussion. I think there are workarounds that help this situation. We’ve written about many of them over the years. However, it definitely takes some good design to make the patient the center of the work you do as a doctor and not the EMR.


I love the irony of Farzad’s statement. The real challenge with this idea is that humans can adjust and learn over time much better than computers. At least in the short term. We’ll see how that plays out in the long term as the volume of information that needs to be processed can’t be handled by the human brain.

October 20, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Will The Government Shutdown Lead to the Meaningful Use Stage 2 Delay?

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It seems like every healthcare organization that exists has called for a delay to meaningful use stage 2. I’ve predicted before that I think that meaningful use stage 2 will have some sort of delay. I feel even more confident in that prediction thanks to the government shutdown.

With so many people not working at ONC, I think there’s a practical question of whether they can really be ready for MU stage 2. However, maybe even more powerful is that the government shutdown now gives ONC an excuse for why the delay should happen. They can blame the delay on the government shutdown and not on something else. Let’s call it the straw that broke the camel’s back.

Although, Farzad Mostashari at CHIME 2013 disagreed. Here’s the tweet I sent during his keynote presentation:

It was nice of Farzad to retweet it as well. I think he really believes this statement. I was sad he didn’t reply or retweet my other tweet:

If I were a betting man (which I’m not despite living in Vegas), I’d bet on a MU stage 2 delay. However, Farzad did place that seed of doubt in my prediction. Farzad made a good case for why some parts of meaningful use stage 2 we can’t wait on anymore. However, with him no longer as leader we’ll see if they can hold the course with no delays.

October 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Build Your Own EHR, EMR Patient Satisfaction, and Social Media in EMR

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It looks like Dr. Rob Lamberts is crazy. It’s nice of Farzad to support him. I think Dr. Lamberts response to Farzad was enlightening as well: “Thanks. More endurance than luck, though.” He’s right. None of the individual components of an EHR are technically very hard, but the number of components you have to build is HUGE.


This is a perception thing for sure. We are trained that technology improves whatever it touches. So, when a patient sees a doctor with an EMR, they believe it will mean better quality care. Reminds me of the “Got EMR?” campaign I talked with people about 7 or 8 years ago.


I question the value of having a patient’s social profile in your EMR. However, I think the concept of looking at your EMR as a CRM for patients could become a very important concept over the next 5 years. I think it will take more than just putting in a patient’s social profile though.

August 18, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ONC Cartoon with Homage to Farzad

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Today, someone who calls themselves HIT Sprite sent me a cartoon that looks at ONC dealing with the recently announced departure of Farzad Mostashari. You might not get the cartoon if you don’t know Farzad and ONC well, but for those who live, eat, breathe and sleep health IT, I think you’ll enjoy it.

ONC Cartoon 1
ONC Cartoon 2
ONC Cartoon 3

While not completely accurate, Farzad’s quirks have grown almost as large as his efforts to change healthcare. Will Farzad be better remembered for his bowtie or his work to move healthcare IT forward?

August 9, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Can Healthcare “Step on a Scale” Today?

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At the Healthcare Forum, Dr. Farzad Mostashari posited an important question: Can healthcare step on a scale today?  Embedded in this question is the idea that healthcare should have a simple way to measure the quality of care it provides.  Dr. Mostashari suggested that most practices today can’t step on the proverbial scale.  However, the technology is now available for us to measure and track how well we are doing at providing care.

The problem with stepping on the scale is that the feedback it provides can often be difficult to accept.  Our normal first response to stepping on the scale is to exclaim, “this scale must be broken.”  Dr. Mostashari suggested that “There isn’t a healthcare provider in the world who doesn’t think they’re doing better than they are.”  This isn’t a condemnation of the healthcare providers, but a simple reality of our own self evaluations.  The way to solve this reality distortion is to provide trusted data which illustrates the realities of the situation.

This proverbial “scale” isn’t some high level concept, but is part of a major shift that’s happening in healthcare measurement and payment.  Dr. Mostashari said that “Reimbursement will be tied to how well we manage a population.  People will have to answer, ‘How am I doing?’”  This shift in payment models is happening quickly and healthcare IT will be the tool that measures our progress in key healthcare quality measures.  We must have the courage to step on the scale and face the reality of our baseline metrics.  We must set goals and take action to improve our performance.

The unique promise of technology is that it can make things better.  One of the core beliefs of Dr. Mostashari and his predecessor, Dr. Blumenthal, is the equation:  man + computer > man

Dr. Mostashari offered some high level ways that technology can help to improve healthcare.  He said, “What we need isn’t necessarily big data in the sky.  We need small data in every interaction we have.  We need to learn from the healthcare interactions and learn from what we’re doing.”  What a drastically different view of health data than what we often see in the market today.  We are collecting a lot of data, but are we using that data in ways that will improve care?  This is the promise of technology in healthcare.

Another way technology could be used to improve healthcare was described as learning as we deliver care.  Think about putting together an A/B trial for emails or letters sent to patients who need to return back to the office.  We can take these care experiences and learn from them.  Our hospital CEOs know what our length of stay is to multiple decimal points, but does our CEO really know what population health management will do for our workflows?

Healthcare is no longer an individual sport.   Healthcare is now a team sport that will require interoperability of healthcare data.  The purpose of clinical notes are no longer short notes for myself or long notes for the CMS auditors, but are data to be used to improve care.

Healthcare improvement needs to happen across the spectrum.  This includes improvement at the community, practice and personal level.  The shared values of health IT are that healthcare can be better, data is the key to making it better, and an optimism that the future will be better than today.  As Dr. Mostashari concluded, “We can use information and tomorrow will be better, faster, and cheaper than today.”

Check out the full Healthcare Forum presentation by Dr. Farzad Mostashari embedded below:

The Breakaway Group, A Xerox Company, sponsored this coverage of the Healthcare Forum in order to share the messages from the forum with a wider audience.  You can view all of the Healthcare Forum videos on The Healthcare Forum website.

August 1, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Farzad Mostashari Tweets #HDPalooza

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Health data geeks from across the US have descended on Washington DC this week for what’s called Health Datapalooza. It’s a sort of Mecca for healthcare data sharing where health data geeks virtually hold hands and sing koombaya as they circle around blue buttons and hard drives full of granular health data. As someone who believes that health data liberacion is the right direction for healthcare, this is a great event and this year it seems to have really hit its stride.

One of the biggest advocates of using healthcare data for good is ONC’s own Farzad Mostashari. Never someone afraid to tweet or Retweet health data related topics, Farzad’s twitter account has been incredibly active during Health Datapalooza. So, I thought I’d use it to illustrate some of the messages Farzad found important enough to share from the event. Plus, I’ll throw in my commentary after each tweet as appropriate. (Note: when the tweet is from someone else it’s because Farzad retweeted it.)


If you want to stop reading here you could, because it’s the core of Farzad’s message. Although, if you want to go into depth on the topic, keep reading. At least Farzad has made clear that he’s going to use whatever methods he has available to make patients’ health data available.


I’ve said this a few times recently as well. I have an extreme belief in the creativity and drive of entrepreneurs. We just need more of them to be able to do their work in healthcare.


Amen! The challenge is getting this message to consumers. If you tell them that their data will be kept private, but will be shared where appropriate to provide better care, every patient wants this to happen. In fact, most already assume this is what’s happening.


Healthcare problems are still a HUGE challenge. We don’t need any more barriers than we already have to overcome.


I wish the $36 billion in EHR incentive money would have been spent on standardization. We’d have had better results. I’m still not sure how we’re going to get to future payment models. Govt could play a role in it.


Speaking of changing payment models. Seems like government doesn’t know how to get their either. A fundamental delivery system transformation could be translated as impossible.


The ladies will love Farzad in his bowtie. I love people who aren’t afraid of trying what seems impossible. Who in health IT is doing that today? I guess looking at the last tweet CMS and ONC are trying.


I’m not sure if we should be proud or sad at the 8% number. Granted, it’s a lot of people that have to learn about it. Although, since many don’t care about their health data, 8% is pretty good.


I’ll be interested to see this number post-meaningful use stage 2. Doctors will be really encouraging their patients to get their health data so they can meet MU stage 2.


This isn’t actually from Health Datapalooza, but Farzad did just retweet it. I haven’t dug into Obama’s plan to deal with patent trolls, but I’m really glad more of a spotlight is being put on this challenging problem. In the case of software, I’m really against patents because as the tweet says they do stifle innovation. It’s ironic because they’re suppose to encourage innovation, but it’s just not the reality of how they’re being used.

June 4, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Meaningful Use and Sequestration

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I’m a little surprised that I didn’t hear more discussion of sequestration and it’s possible impact on meaningful use and other EHR and healthcare IT related programs. Maybe I was just in the wrong circles for this discussion, but I didn’t hear about sequestration until the final day of HIMSS.

I think the effects of sequestration on meaningful use, EHR and other Health IT aren’t exactly known right now. Although some hints at the potential effects of sequestration were given at HIMSS 2013.

Jessica Kahn sent out the following tweet about the topic:

Of course, it’s hard to read into exactly how the EHR incentive payments could be effected by sequestration. I can’t imagine the cuts will allow them to pay a lower incentive amount since that’s been legislated. I could see it slowing payments down. I guess we’ll have to see what Jessica means by her tweet.

Farzad Mostashari also commented on the effect to ONC of sequestration in this PhysBizTech article Q&A:
Q: By how much will sequestration reduce your budget and what has to give?

A: It’s 5 percent: A $3 million cut for an office whose budget has been $60 million since the day it was founded by President George W. Bush. This is going to hurt. We are not furloughing people, which is the bulk of the budget. So our contracts are going to take a big hit.

What do you think will be the impact on EHR and healthcare IT because of sequestration?

March 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

#HIMSS14 Speakers, Healthcare in 2013, and More — #HITsm Chat Highlights

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This weeks topics were suggested by Dan Munro, a contributor at Forbes.

Topic One: Head of ONC Farzad Mostashari calls and asks you what his top 2 priorities should be. What do you say? @Farzad_ONC

Topic Two: Biz Stone was HIMSS12 Keynote and Clinton will Keynote #HIMSS13. Who should Keynote HIMSS14?

Topic Three: Fill in the blank> Healthcare’s End-of-Year Headline for 2013 will be _______.

Topic Four: Among early stage healthcare startups – who’s your favorite? #mHealth

Topic Five: Should we skip over #ICD10? #healthIT

February 23, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

HIMSS Stage 7 Hospitals, HIE Decreases Lab Orders, EHR Implementation Depends on Teamwork

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Happy Easter to everyone reading this and to those who celebrate it. To those who don’t celebrate it, I’d suggest you go and buy the delicious Cadberry chocolate eggs. Not the ones with the creme filling, but the ones in the purple bag. They’re stunningly delicious and should be on sell tomorrow. Unless you live in Las Vegas, and then please leave them so I can buy them. Thanks! While these delicious chocolate eggs have little to do with the true meaning of Easter, they do provide a lot of joy and that’s core to Easter for me.

Easter aside, let’s take a look at some of the various EMR and Healthcare IT related tweets that have come out recently.

This is interesting when you add it to all the reports that say that the US healthcare system is so much worse than the rest of the world. Of course, the US health system is much larger than most other health systems. It also might point to the HIMSS stage 7 status having little real meaningful as far as health IT adoption. It could also point that HIMSS hospital stages aren’t looked at internationally so no one takes the time to meet them. Basically, I wouldn’t read too much into these numbers.

This tweet goes in nice contrast to the report that circled around recently that doctors were more likely to order tests using an EHR than pre-EHR. Mostashari and others took exception to the study and wrote lengthy responses to the study. Of course, the more I read these studies the more disappointed in how most media reports the studies. They make for good headlines, but when you dig deep into the studies you realize that they often have a much more limited scope than what the headline suggests.

I have no idea who “Mike on Healthcare” is (Looks like he’s @MichaelCrosnick on Twitter), but looking at the blog post that Lucia links to I’d like to meet Mike. In that post, he highlights the importance of getting staff buy-in during an EHR implementation and the idea of physician champions. Those are two of my core elements when talking about an EHR implementation. Great to have Mike adding to the collecting EHR knowledge in the healthcare IT blogosphere.

April 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Examples of Health Startup Opportunity

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Anyone that is part of the healthcare IT and EMR world has to realize that we’re in a really incredible time for healthcare IT and EMR. There’s has never been more energy, excitement and actual investment in the Healthcare IT world than there is now. If you don’t believe me, buy your ticket to Las Vegas and attend HIMSS 2012 and I’m sure you’ll see what I mean. I have a feeling that HIMSS Las Vegas is going to be bigger than ever with more money flowing as well.

Just to provide a few examples of what’s happening, the prominent IT investor Esther Dyson has invested in 20 Health IT investments. That’s a whole lot of investment in healthcare IT. She obviously sees some real opportunities available at this time in health IT.

Another recent announcement was the recent batch of 15 Rock Health Startup companies. This is just one of at least 3 or 4 health focused incubators out there. Plus, the latest batch of health IT startup companies from Rock Health even has Neil Versel singing their praises after a previous not so glowing review of the health startup incubator (or health accelerator if you prefer).

One other thing that is easy to underestimate is the value that the US government is putting on supporting healthcare innovation through entrepreneurship. Normally I’m as skeptical as anyone in putting any sort of faith in government to produce results. I still think they have their hands tied in a lot of things, but I give a lot of credit to Aneesh Chopra, Todd Park and Farzad Mostashari for doing their very best to kick against the challenges of big government while enabling health entrepreneurs to be successful.

Priya Ramachandran wrote about an example of one initiative the government is putting forward to help entrepreneurs: Access to Public Health Data. Every time I hear someone talk about the data that’s available from these public repositories of health data, the entrepreneur inside of me kicks in with ideas on how to use that data for good.

It is a really tremendous time to be an entrepreneur in healthcare. I do think we still need a better platform for health IT startups to launch their products and get funding. I have a few ideas I’m working on in this regard. More on this in the future.

December 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.