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Do We Underestimate the Power of Smart Phones in Healthcare? – Fun Friday

Posted on July 29, 2016 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Smart phones have become a serious societal addiction. In some ways that is bad and no doubt there are plenty of studies that will come out about the negative impacts from cell phone addiction. However, the fact that people always have their cell phone is also a tremendous opportunity for healthcare to really engage their patient. This is what came to mind when I saw these funny cartoons about our addiction to our cell phones.

Cell Phone Addiction - Social Science Research Cartoon

Cell Phone Addiction Cartoon

Thanks Eric Topol for sharing these cartoons.

What’s Your Value Based Care Strategy? What Role Does IT Play?

Posted on February 23, 2015 I Written By

John Lynn is the Founder of the 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 and 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 pretty regularly take a look at various healthcare IT whitepapers to glean insights into what’s happening in the industry and what advice vendors are offering healthcare organizations. I’ve been keeping a special eye on the changing reimbursement model and move to value based care and so I was interested in this whitepaper titled “How to Win with Value-based Care: Developing Your Practice’s EHR Strategy.”

The whitepaper starts with a dive into some of the changing care and reimbursement models that are emerging in healthcare. Then they offer this 4 step “Winning Strategy” for being ready for these changes:
Step 1: Assess your current situation
Step 2: Develop a customized VBC Plan that’s right for your practice
Step 3: Determine IT solution needs
Step 4: Implementation

In many ways, this 4 step plan could be applied to any project. Of course, the whitepaper dives into a lot more detail for each step. Although, I was struck by step 3. It takes for granted that value based reimbursement will require an IT solution. This whitepaper comes from a healthcare IT company with some value based IT product offerings so you have to question whether IT will be at the core of a practice’s value based care strategy or not.

As I think about the future of coordinated care and value based reimbursement, I think it’s more than fair to say that technology will be at the center of these initiatives. Value based care requires data to prove the quality of the care you’re providing. Certainly you could try and collect some of this data on paper, but does anyone think this is reasonable?

Try identifying all overweight patients in your patient population using paper chats. I can see in my mind’s eye an army of medical records professionals sifting through stacks of paper charts. It’s not a pretty solution and it’s fraught with error. That’s one query on an EHR system.

One of the biggest elements of value based reimbursement will be communication with patients. Can we build that real time communication on the back of snail mail? It sounds almost silly talking about it. Of course we’re going to use mobile devices, secure messages, and even secure video communication. We still have A LOT of work to do in this regard, but it’s the future.

Of course technology is going to be at the core of value based reimbursement. It’s the only way to accomplish what we’re striving to accomplish. The next question is: will the EHR make this possible or are we going to need something new and more advanced?

The Nurse Will See You Now

Posted on May 13, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at

The Atlantic just wrote a piece highlighting the growing trend of non-physicians (commonly referred to as midlevels) providing healthcare. The reason is simple: supply and demand–more precisely, a fixed supply.

For any location where a patient demands healthcare services, there is only a binary result: either there is a qualified healthcare professional available to deliver care, or not. This slide (from Pristine’s investor presentation) illustrates this:

Screenshot 2014-05-04 21.01.17

The supply and demand problem is further compounded by an archaic regulatory system. The path toward becoming a physician, at least in the US, is so arduous that the decision to pursue becoming an MD must be made by age 18 or 19. Even if a huge cohort of 18 year olds suddenly decided they wanted to be physicians, the artificially capped supply of available residency slots each year stimies traditional supply and demand economics.

Nursing, on the other hand, has a more varied cohort in terms of age of entry. Many nurses don’t enter the profession until well into their late 20s or 30s. The same is true of physician assistants. This has resulted in a more liquid supply of non-physician practitioners, and these non-physician practitioners are available to respond to the influx of new patients resulting from the ACA, and to the growing number of retiring baby boomer population.

Given the fixed supply of physicians, there are two fundamental ways to solve the supply and demand problem: make physicians more efficient, or substitute physicians with others who can do an equally good job for a given patient’s needs.

The realities of practitioner supply suggest that nurses and other non-physician practitioners will deliver an increasingly large percentage of healthcare services. Physicians will be relegated to the “high end” per Clayton Christensen’s disruption theory. That could manifest itself in a future in which midlevels deliver primary care and triage more acute conditions to “higher end” specialist physicians.

The greatest challenge in the triage-centric model led by midlevels is the (historically quite poor) communication among healthcare providers. We will need a robust technological infrastructure to support the seamless transfer of patient data among providers. Additionally, we’ll need more capable communication tools to empower providers to connect with one another and with patients regardless of location.

Telemedicine seems to be taking hold to power a future in which location is irrelevant. Interoperability is improving within health enterprises, though there are some signs that community health information exchanges (HIEs) are not doing as well as many had hoped.

At some point down the line, we’ll likely look back and wonder why location mattered so much. It shouldn’t, and because of telemedicine, and liquid data connectivity, it won’t.

ACO’s and the Tech Needed to Be Ready

Posted on April 22, 2014 I Written By

The following is a guest post by Barry Haitoff, CEO of Medical Management Corporation of America.
Barry Haitoff
For those not familiar with ACOs (Accountable Care Organizations), I want to provide some insight into ACOs and how a medical practice can better prepare themselves for the coming shift in reimbursement, which is epitomized by the ACO. This is a challenging subject since the ACO is a somewhat nebulous idea that’s rapidly changing, but hopefully I can provide you some strategies that will help you be prepared for the coming changes.

You may remember when we talked in a previous post about the Value Based Payment Modifier and its impact on healthcare reimbursement. As we talked about in that post, healthcare reimbursement is changing and CMS is looking to only pay those providers who are providing quality care. As part of this movement, an ACO is an organization that works on behalf of a community of patients to ensure quality care.

The metrics of how they’ll measure what they reimburse and what they consider quality care are likely to rapidly change over the next few years while CMS figures out how to measure this. However, one key to being ready for this shift is that you’ll need to be part of an organization or group of providers that will take accountability for a patient population.

In some areas of the country, the hospitals are leading these organizations, but in other areas groups of physicians are coming together to form an ACO of just physicians. Either way can work. The key is that the members of these groups are going to each share in the reimbursement the group receives for improving the quality of healthcare patients in the community receive.

Also worth noting is that membership in an ACO isn’t necessarily a prerequisite for value based reimbursement. Whether you choose to be a member of an ACO or not, you’re going to be impacted by value based reimbursement and will need to be ready for the change. Not being ready could lead to lower reimbursement for the services you provide.

While it’s great that organizations of doctors are coming together to meet the need for ACOs, much more is going to be needed to do well in an ACO reimbursement world. The reality is that an ACO can’t exist without technology. Don’t even think about trying to meet the ACO requirements without the use of technology. ACOs will base their reimbursement on trackable data that can be aggregated across a community of providers that are likely on hundreds of different systems. Try doing that on paper. It just won’t happen.

In fact, many people probably think that their EHR software will be enough to meet the needs of the ACO as well. I believe this to be a myth. Without a doubt, the EHR will play a major role in the gathering and distribution of the EHR data. However, unless you’re a homogeneous ACO with providers that are all on the same single instance of an EHR, you’re going to need a whole suite of services that connect, aggregate, and interpret the EHR data for the community of patients. Add on top of that the communication needs of an ACO and the care manager style tracking that will need to occur and it’s unlike your EHR is going to be up to the task of an ACO. They’ll be too busy dealing with meaningful use and EHR certification.

Let me highlight three places where an ACO will need technology:

One of the key needs in an ACO is quality communication. This communication will happen provider to provider, provider to care manager, provider to patient, and care manager to patient and vice versa. You can expect that this communication will be a mix of secure text messaging and secure emails. In some cases it will be facilitated by a patient portal, but most of the secure messaging platforms for healthcare are much slicker and more effective than a patient portal that so far patients have rarely used.

Are you using a next generation secure messaging system to communicate with other providers, your staff, and the patient? You’ll likely need to use one in an ACO.

Provider Data Aggregation
Much like paper charts won’t be enough in an ACO world, faxed documents won’t be enough either. Providers in an ACO will need to have patient data from across the entire community of ACO providers. At a minimum providers in an ACO will need to have their EHRs connected with Direct, but most will need to have some sort of outside HIE that helps transfer, aggregate and track all the data that’s available for a patient in the ACO.

The ACO and doctor will really benefit from all the patient data being available at the click of the button. Without it, I’m not sure that ACOs will be able to meet the required quality measures.

Patient Data Aggregation
While all of the providers will need to be sharing their patient data, I think most ACOs will benefit from aggregating patient data as well. At first the ACO won’t be aggregating all of the patient generated data that’s available. Instead, they’ll find a slice of their patient community where they can have the most impact. Then, they’ll work with those patients to improve the care they receive. This is going to require ACOs to receive and track patient generated data. Without it, the ACO won’t have any idea how it’s doing. With so many patients on mobile devices or with access to the internet, what an amazing opportunity we have to really engage with patients.

Those are just a few of the ways technology is going to be needed for the coming changes in healthcare reimbursement and the shift towards value based care in things we call ACOs. Far too many providers are sitting on the sidelines while they let ACOs settle into place. What a missed opportunity. The fact that the ACOs are rapidly changing means that if you participate and make your voice heard, you can help to shape the direction of them going forward. We definitely need more doctors involved in these conversations.

Medical Management Corporation of America, a leading provider of medical billing services, is a proud sponsor of EMR and HIPAA.

Accountable Care Organizations and SCOTUS

Posted on June 19, 2012 I Written By

John Lynn is the Founder of the 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 and 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 Supreme Court ruling on SCOTUS is likely to come sometime this month. There are all sorts of opinions out there about what’s going to happen to the ruling, but a recent tweet caused me to stop and think about the real impact of SCOTUS. The tweet (which sadly I can’t find again) said something about the Supreme Court’s ruling on Obamacare and SCOTUS really doesn’t matter to healthcare since the change in care model has already been started.

I take one slight exception to this comment. I agree that the ACO (Accountable Care Organization) movement and all that it embodies is already upon us and won’t be affected by the Supreme Court’s decision on SCOTUS. However, I think the SCOTUS legal decision does matter and will still have an impact on healthcare. Not to mention the politics related to the decision. Although, I’ll leave both of those topics for a different blog.

I do think it’s worth exploring ACOs and why SCOTUS or NO-SCOTUS, ACOs are here to stay in healthcare.

Dave Chase recently said in a Forbes article that “More than 80% of the newly formed ACOs are driven solely by private sector efforts.

I believe that Dave Chase got these numbers from an ACO Watch article about a Leavitt Partners study on ACO growth and dispersion. It’s a powerful number to consider that despite all the efforts by government to move to accountable care organizations that only 20% of the newly formed ACOs came from the government. What a healthy thing and a great illustration of why SCOTUS won’t impact ACOs in any major way.

Dave Chase in the above linked article adds this additional quote from Philip Betbeze:

As Philip Betbeze stated, “In their day-to-day-lives, it [the SCOTUS decision] largely won’t affect the 180-degree shift they’re making in reimbursement philosophy. For most systems, those changes are taking place largely at the behest of commercial plans and local employers.” The fee-for-value train has left the station. Woe is the health system that hasn’t made aggressive moves to reinvent themselves.

We’re still early in the reimbursement philosophy switch, but the winds of change are upon us. Personally I’m excited to see how health systems reinvent themselves. I think this reinvention will be around these key pillars:

*Communication – ACO’s will drive better communication. This will include patient to doctor, doctor to doctor, and even patient to patient. The beauty is that in an ACO, the goal will be for the patient not to come to the office instead of the de facto, come to the office answer most practices give today.

*Data – Practices better be preparing for the tsunami of healthcare data on the horizon. How an ACO takes that data and uses it to improve patient care is going to be key.

If you look at these pillars of an ACO, are they even possible to deal with without technology?