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!!

Old World & New World Healthcare IT Map from Health 2.0

Posted on August 7, 2014 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 good people at Health 2.0 put together this great digital health map as a way to illustrate the broad landscape of technologies that encompass Health 2.0. I’ve embedded a small version of the map below (click on it to see the full map). What do you think of the map? Is there anything missing from it?

Old World and New World Healthcare IT

Health 2.0 also mentions that this map together with the four main categories: consumer facing, professional facing, patient-provider communication, and data, analytics, and exchange and 19 other subsegments will be how they structure the Health 2.0 conference in San Francisco.

I think one of the messages I get out of all of this is how complex the healthcare industry is right now. Certainly I’ve focused a lot of my posting on the EHR world, but there are a number of other areas not really related to EHR where technology can help. This map is an interesting way to have a more global perspective of healthcare IT. Thanks Health 2.0 for sharing it.

Health Data: Little White Lie Detector

Posted on December 31, 2012 I Written By

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

As we bring 2012 to a close and ponder the new year ahead, many of us make resolutions to change something in our lives, and frequently, that something is our health. According to the University of Scranton Journal of Psychology, 47% of Americans make New Years Resolutions. Of those, the #1 New Years Resolution for 2012 is to lose weight. Staying fit and healthy and quitting smoking also appear in the top 10. Each of these health-related resolutions translates into quantifiable healthcare data that is, or can be, captured and measured to assist the resolution-makers in achieving their goals. Our calorie consumption and burn can be calculated, our blood oxygen level monitored, our ratio of fat:lean muscle mass tracked over time. If only we were all a bit more like George Washington, and couldn’t tell a lie, the success rate for annual resolutions would be higher than 8%.

The inclination to tell little white lies to protect ourselves from inconvenient, uncomfortable truths exists in all of us. “Do these jeans make my butt look fat,” meets, “Of course not,” rather than, “Yes, your butt DOES look fat in those jeans – but it’s not the jeans’ fault.” “Can Timmy come play,” warrants, “We already have plans – let’s rain check,” in lieu of, “Your child is a brat who cannot enter my home because I prefer to keep all my hair rooted in my scalp.”

Many, if not most, of us extend these white lies to ourselves. The dress that fit last month but doesn’t today “shrunk at the dry cleaner”. Cigarettes only smoked during cocktail hour don’t really count as “smoking”. You count the time you spend standing to give office presentations as “exercise”. You “usually” eat healthy, except for the tell-tale McDonald’s bags in your garbage showing a once-a-day burger and fries habit.

What if there were a way to identify and hold you accountable for these self-delusions – a health data lie detector? Would you change your behavior? Could you achieve your healthy resolution? And might it have a quantifiable impact on healthcare cost if you did?

I had a partial thyroidectomy a few years ago. A year after my surgery, I found I had gained 7 pounds in 11 days, was feeling lethargic and was having difficulty sleeping. As a very active adult who meticulously maintained body weight for a decade, I was disturbed, and convinced that my symptoms were a result of my remaining thyroid tissue failing. I went to my primary care physician to request a hormone test.

The nurse and doctor both agreed that, in 90% of cases, the root cause of weight gain is diet, and they asked myriad questions, capturing all my answers in the clinical notes of their EMR: had I been eating differently, had I altered my exercise routine, had I been traveling. I was adamant that nothing had drastically changed. Given my fitness and history, they agreed to order the hormone test, and a blood vitamin test, as well.

All lab work came back normal. BETTER than normal. So I retraced every detail of my routine over those 11 days. And I discovered the culprit: office candy.

A bad meeting one day led to grabbing a handful of chocolates from one co-workers bowl, which became grabbing a handful of chocolates from each bowl I encountered on my department’s floor…several times a day. Did you know there are 35 calories in a single Hershey’s kiss? 220 calories in a handful of peanut M&Ms? 96 calories in a mini-Butterfinger bar? Turns out, I was eating between 500-700 calories a day in office candy. And that wasn’t all.

Along with the chocolate snacks, I’d fallen into some poor nutrition habits at meals. I started to consume other starchy carbs regularly: the pre-dinner bread basket at restaurants, pizza, pasta, sandwich bread. I didn’t feel I ate to excess, but I also didn’t take into account the difference in nutrient density between the mass quantities of fruits and vegetables I had been eating for years, and the smaller (yet still plentiful) quantities of processed starches I was currently eating.

The changes in diet likely disturbed my sleeping pattern and led to my lethargy, which in turn made my daily workouts less intense and effective at calorie-burning.

In short, my weight gain was legit, and the two doctor visits and the lab tests could have been avoided had I been completely honest with myself. I cost each actor in the healthcare system money with my self-deluding little white lie: the office administrative staff, the LRNP, the doctor, the medical coder, the lab, the insurance company, myself. There is also a per-transaction cost associated with each HIPAA-covered request that the doctors’ office EMR and lab information system generated. Given that I have only been to the doctor three times this year, and twice was for this weight gain concern, one could accurately conclude that 66% of my annual medical costs could have been avoided in 2012.

The health data exists within Meaningful Use-certified EMR systems to capture and communicate both the absolute data (height, weight, lab results, etc.) and the unstructured notes data (patient comments, doctor notes, responses to questionnaires, etc.). The capability to automatically compare the absolute with the unstructured data already exists. It wouldn’t take an inordinate amount of effort to program a lie detector to call out many of the most common little white lies.

What would happen to medical cost if we stopped lying to ourselves, and to our healthcare providers? And how high a percentage of the nation’s total healthcare bill could be avoided by this type of analysis? Better still, how much would the healthcare industry change if patients not only took responsibility for their own action/inaction, but modified their behaviors accordingly?

I’ll tell you what happened to me. I dropped the candy and starchy carbs, and I lost those 7 pounds. Keeping them off will be 2013’s New Years Resolution.

National Patient Identifier, Allscripts Discontinues MyWay, EHR Incentive Payments Stopped, and Remotoscope — Around Healthcare Scene

Posted on October 7, 2012 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.

EMR and EHR

HIMSS Pushes for National Patient Identifier System

An estimated 14 percent of medical records contain incorrect patient information. Because of this, deadly errors can occur. In an effort to cut back on these errors, HIMSS is trying to implement a national patient identifier system. A single identifier isn’t going to solve problems, but it’s a step in the right direction.

Dr. Nick, CMIO of Nuance Talks About Their Acquisition of Quantim and J.A. Thomas & Associates

In this interview, Dr. Nick discusses an important string of acquisitions by Nuance. This is an interesting move by Nuance and Dr. Nick does a good job of describing the vision of Nuance going forward with these acquisitions and their view of how healthcare documentation will happen in the future.

EMR Thoughts

Allscripts May Sell Out To Private Equity Buyer & Allscripts to Discontinue MyWay EHR

It has been a really busy week for Allscripts. First came the news that Allscripts was considering a sell to a Private Equity Buyer. This news is harder to read since it could mean a big sell or it could just be posturing. In what I think is even bigger news is that Allscripts is discontinuing their MyWay EHR. This is a big move on Allscripts part. It’s a necessary decision by Allscripts because they have too many EHR software to manage, but it’s going to leave a lot of doctors and a lot of VARs scrambling.

EMR, EHR and Healthcare IT News

HIMSS Opposes Call for Suspension of EHR Incentive Program

We’ll be writing some more pieces soon on the members of Congress that are calling for a halt on the HITECH Act and payment of EHR incentives. However, this was HIMSS’ response to the request to halt EHR incentive payments. It’s not a surprising response, but I do like the data that HIMSS provides to the conversation. Most people see this move as a political one, and not necessarily one that puts the HITECH EHR incentives at risk.

Hospital EMR and EHR

Smart Bed Technology Interview with Casey Pittock of BAM Labs 

Vice President of Sales and Marketing at Bam Labs was recently interviewed over at Hospital EMR and EHR. BAM Labs created the Smart Bed, a mat that is placed under a person’s mattress that can measure heart rate, breathing rate, and motion. Pittock discusses how it was created, the accuracy of it, and how providers can interact with the data.

Meaningful Health IT News

Attending Health 2.0? Donate Your Old Smartphone

If you have plans to attend Health 2.0 next week, be sure to bring along any old smartphones. Health eVillages will take the device and load onto it different medical materials and sent to doctors that are in third world countries. There are sites for Health eVillage in the countries of Haiti, China, Kenya, and Uganda, with plans to expand to more.

Wired EMR and EHR

The Naivete of mHealth

There are many mHealth creations coming out at a rapid pace. At first glance, these innovations seem incredible and life-changing. However, without supporting documents and proof of the effectiveness, the money and time that goes into implementing certain technologies might not be worth it. This post talks about a home monitor for CHF, and although it’s a great idea, unless a patient is really dedicated to following all the alerts, it may not be effective. Technology needs to be reliable and proven to work before it should be recommended for use.

Smart Phone Health Care

Remotoscope – Diagnose Ear Infections at Home Using Your iPhone

Many children get ear infections, and it’s no fun taking them to the doctor if the diagnosis of one is uncertain. Luckily, a new tool has been invented to help parents and physicians diagnose from home. The tool is a detachable clip that turns a smart phone into otoscope, and parents can take a picture of their child’s eardrum to send to their physician for further analysis.

Kaiser’s Mobile Health Approach

Posted on July 10, 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.

As I mentioned in my previous post about laptops and iPads in healthcare, I had the chance to meet with Kaiser at the Health 2.0 conference in Boston. I had a chat with Brian Gardner, head of the Mobile Center of Excellence at Kaiser Permanente and learned a bunch of interesting things about how Kaiser looks at mobile healthcare.

The first most interesting thing to note was that Kaiser currently does not support any sort of BYOD (Bring Your Own Device) at this time. Although, they said that they’ve certainly heard the requests from their doctors to find a way for the doctor to use their own mobile device. Since this means that all the mobile devices in use at Kaiser are issued by them, I was also a little surprised to find that the majority of their users are currently still using Blackberry devices.

Brian did say that the iPhone is now an approved Kaiser device. It will be interesting to check in with Brian and Kaiser a year from now to see how many Blackberry devices have been replaced with iPhones. I’m pretty sure we know exactly what’s going to happen, but I’ll have to follow up to find out. What is worth noting though is the time delay for an enterprise organization like Kaiser to be able to replace their initial investment in Blackberry devices with something like an iPhone or Android device. While I’m sure that many of those doctors have their own personal iPhones, that doesn’t mean they can use it for work.

I also asked Brian about the various ways that he sees the Kaiser physicians using their mobile devices. His first response was that a large part of them were using it as an email device. This would make some sense in the context of most of their devices being Blackberry phones which were designed for email.

He did say that Kaiser had done some video pilots on their mobile devices. I’ll be interested to hear the results of these pilot tests. It’s only a matter of time before we can do a video chat session with a doctor from our mobile device and what better place to start this than at Kaiser?

Of course, the other most popular type of mobile apps used at Kaiser were related to education apps. I wonder how many Epocrates downloads are used by Kaiser doctors every day. I imagine it gets a whole lot of use.

What I found even more intriguing was the way that Kaiser used to discover and implement apps. Brian described that many of their best apps have come from students or doctors who had an idea for an app. They then take that idea and make it a reality with that student or doctor working on the app. It sounded like many of these students or doctors saw a need and created an app. Then, after seeing its success Kaiser would spread it through the rest of the organization.

This final point illustrates so well how powerful mobile health can be now that the costs to developing a mobile health innovation is so low. Once you lower the cost of innovation the way mobile health has done, you open up the doors to a whole group of entrepreneurs to create amazing value.

Nuance Interviews Me and Jonathon Dreyer at Health 2.0 Boston

Posted on June 26, 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’m currently enjoying the depths of my first experience at ANI 2012 in Las Vegas. It’s been a really great experience meeting a number of healthcare CFO’s and some new healthcare vendors. If any of my readers are at ANI, I’d love to meet. You know how to find me on Twitter (@ehrandhit).

While I’m busy at the conference I thought I’d post some videos that Nuance did with me at Health 2.0 Boston. It was kind of fun for them to turn the tables and put me on camera with Jonathon Dreyer, Sr. Manager, Mobile Solutions Marketing, at Nuance Healthcare. The videos were broken into 3 parts: health IT trends, mobile adoption in health IT, and social media in healthcare. I hope you enjoy!

Health IT Trends

Mobile Adoption in Health IT

Social Media in Healthcare

Laptops End Up With Kids, iPads Don’t

Posted on June 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.

As I mentioned previously, I had the great opportunity to talk with Kaiser recently about their mobile initiatives at Health 2.0 Boston. It was a great chat with Brian Gardner, head of the Mobile Center of Excellence at Kaiser Permanente.

At one point in the conversation I asked Brian about Kaiser’s approach to devices. Did they allow physicians to bring their own device? Were they deploying their own devices and which devices did they use. Brian made a couple of comments that I found really intriguing.

First, he stated clearly that Kaiser issued all of their devices. They were looking at the BYOD (Bring Your Own Device) idea, but currently they didn’t support any BYOD options. Based on his response to this question I could tell that there were a lot of conversations about this topic happening at Kaiser. I got the feeling that they were likely getting quite a bit of pressure from their doctors to do something along these lines.

Brian then also provided what I find to be a really compelling observation. He commented that from their experience the laptops they issued to doctors always seemed to end up with their physician’s kids using them. I assume they could see this based upon the software the physician’s children installed on the laptop. Then, Brian observed that they hadn’t seen the same thing happening with the iPads they’d given out. He surmised that this was possibly because many of the doctors that got iPads saw it as a privilege and those doctors didn’t want to lose that privilege?

How intriguing no? Why is it that a laptop feels like a commodity and an iPad feels like a luxury item? One you don’t mind your children touching and the other is a luxury that your child shouldn’t touch.

I’d also extend this observation to say that working on a laptop feels like work. Using an iPad feels more like play. At least that’s the feeling I get. I imagine many doctors feel the same way. I wonder if that will change as the iPad starts to get more applications that really help you do work on it.

Mobile Health App Ratings by Kaiser

Posted on May 29, 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 recently had the chance to sit down with Kaiser’s mobile group at the Health 2.0 conference in Boston. We had a really interesting discussion where I was able to learn a number of interesting things about Kaiser’s approach to mobile healthcare. As everyone knows they have a really unique environment with a number of incredible opportunities, but also with their own unique challenges. I’ll be discussing a number of these items in future posts.

Although one opportunity came to my mind in my discussion with Kaiser: A Mobile Health App Rating service by Kaiser.

Many people might remember my previous post about the atrocious idea of an mHealth App Certification. I think this is a really terrible idea and will do nothing to help physicians and patients be able to weed through the overwhelming number of mobile health apps.

With that side comment, I love the idea of Kaiser using its vast network of doctors and patients to rate various mobile health apps. Sure, there are some issues with this model as well, but the benefits of having so many valid doctors rate mobile health apps could be tremendous.

The challenge with most rating services is that you have no way of knowing if the person rating the service is actually who they say they are. For example, Sermo is supposedly a physician only forum. However, I know a lot of non-physicians that are on the forum. One advantage Kaiser has is that they could know if the person in their network is a Kaiser physician or not.

One key question is whether Kaiser would be open to making their physician mobile health app ratings available to the public. I’m sure this will be a tricky question for them to answer. No doubt they already kind of do some of this already in their internal network. Maybe it’s not totally codified into a website with a formal process, but it could be. Plus, the benefits to healthcare in general could be great.

What do you think of Kaiser physicians rating mobile health apps? Are there other better ways to filter through the volume of mobile health apps that exist out there?

The Current Health IT and EHR Bubble

Posted on May 16, 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 had a really great conversation with Shahid Shah, Jenny Laurello and John Moore at Health 2.0 about the bubble that we’re sitting in right now. John Moore’s response to my question, “When do you think the bubble will pop?” was priceless: “Which bubble?” Yes, we might be seeing multiple bubbles in healthcare IT: EHR, HIE, mobile health, etc.

For this blog, I’m most interested in the EHR bubble. Obviously, the bubble in this case is the creation of the $36 billion in EHR stimulus money that’s being handed out thanks to ARRA and the HITECH act. With over 600+ EHR vendors and a limited number of customers (I think there’s about 700,000 physicians in the US), there are going to be quite a few EHR vendors that won’t make it.

With that said, I don’t think the EHR bubble will pop like it has in other industries. In fact, I think the current IT industry bubble is going to be a much bigger problem. What’s amazing to me is how you can make a decent EHR business with only a few hundred doctors. Sure, a few hundred doctors won’t create 10 times return to investors, but those who take a conservative approach to building their EHR company could get by with what I believe is an astoundingly small customer base. Physicians are just that valuable.

Shahid Shah described EHR as a cottage industry and so cottage EHR companies will survive. I’m not exactly sure how he’d described cottage industry, but I think the regional nature of healthcare is definitely an influence on this. I’m sure many could argue that long term this strategy won’t work, but I believe at least for the forseeable future we’re not going to see the EHR bubble pop for a while.

As I think about the EHR companies I know, they all seem to have plenty of cash to make it through meaningful use stage 2 and likely all the way to meaningful use stage 3 at least. We’ll see how the smaller EHR companies do post meaningful use stage 2, but I don’t see any EHR vendors not making it to meaningful use stage 2. They’ll at least make it to MU stage 2. Then, based on their adoption results (or not) we may see a few EHR vendors run out of money.

What do you think? Are we in an EHR bubble? When will the EHR bubble pop? What other healthcare IT bubbles do you see?

EMR Data Inaccuracies, EMR and Labs, and the Database of Healthcare

Posted on May 13, 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.

As you read this post, I’m probably on a red eye flight to attend Health 2.0 Boston. I’m really excited to attend Health 2.0 Boston. I think Matthew Holt is always interesting and so I hope I get a chance to interview him while I’m there. Plus, I think it’s large enough to bring out some important people, but not so large that you’re overwhelmed and can’t connect with those who attend.

Also, even if you’re just in Boston and not planning to attend Health 2.0 Boston, we’re going to be doing a tweetup on Tuesday evening. I call it the after party. I’m not sure where we’ll do it, but watch @ehrandhit on Twitter and I’ll tweet out the exact time and location for the tweetup. I look forward to seeing all my Boston Healthcare IT friends.

Now, without further ado, some interesting EMR tweets:


The interesting part of the story linked above is that all of the inaccuracies could happen on paper as well.


Reminds me of the announcement that said that physicians order more labs with EHR. I know we implemented the lab cost display in our EHR, and I’m sure that the cheaper tests were ordered, but that was certainly due to the type of clinic that I implemented the feature.


The idea of the internet as a database is very interesting. It’s probably too forward thinking to be really practical today, but we’ll definitely get there. It’s just a question of how quickly. We’re already seeing indications of this. It’s amazing what you can build in a weekend using “internet parts” through powerful APIs.

Note: This post has been a meaningful use free post.

The EHR Serenade by Enoch Choi at Doctors 2.0 and Health 2.0

Posted on September 25, 2011 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 must admit that I don’t know the background of this because I wasn’t able to make it to Doctors 2.0 and Health 2.0 this year, but I couldn’t help but laughing at the performance. Not sure why the YouTube video is black. Maybe it was just the audio of the presentation and they made a video out of it. Either way, I think this is an interesting message for doctors about EHR.

Here’s the description from the YouTube video:
“Give doctors a little respect. Make EHRs more usable. I serenade the last decade of developing and using EHR in full time urgent care practice at AHRQ”

And now for the EHR Serenade:

If someone knows of a video of this presentation at Health 2.0, let me know and I’ll update this post.