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!!

The Path to Healthcare Interoperability Standards

Written by:

I’ve been thinking a lot about the issues associated with healthcare interoperability. One of the biggest excuses/problems out there is the idea of interoperability standards. Healthcare certainly has plenty of interoperability standards, but adoption and implementation of the actual standards has been the major issue.

I do think that meaningful use and EHR certification is making some difference in regards to standards. I think that Direct Project is likely going to become a pretty solid standard for exchanging some healthcare documents. However, it’s limited in it’s scope.

Instead, I think we’re going to see a different path to healthcare interoperability. It’s going to be led by a few prominent organizations that start sharing info. Once those organizations start sharing data, whatever standard they use will start to spread and will become the standard for interoperability in healthcare.

Which organization or group of organizations will be the ones that break out and establish the standard? I still think the jury is out on that one, but a couple prime candidates are: CommonWell and Healtheway.

I’d love to hear if you see another path to healthcare interoperability or other initiatives that could break through and be successful.

June 24, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

What Would ONC’s Dr. Doug Fridsma Do? (THIS Geek Girl’s Guide to HIMSS)

Written by:

I know you’ve all been wondering how I’m planning to spend my mad crazy week at HIMSS in New Orleans. Well, maybe not ALL of you, but perhaps at least one – who is most likely my blog boss, the master John Lynn. Given the array of exciting developments in healthcare IT across the spectrum, from mobile and telehealth to wearable vital sign monitoring devices, EMR consolidation to cloud-based analytics platforms, it’s been extraordinarily difficult to keep myself from acting like Dori in “Finding Nemo”: “Oooooh! Shiny!” I’ve had to remind myself daily that I will have an opportunity to play with everything that catches my eye, but that I am only qualified to write and speak intelligently on my particular areas of expertise. And so, I’m proud to say I’ve finally solidified my agenda for the entire week, and I cannot WAIT to go ubergeek fan girl on so many industry luminaries and fascinating up-and-comers making great strides towards interoperability, deriving the “meaning” in “Meaningful Use” from clinical data, and leveraging the power of big data analytics to improve quality of patient experience and outcomes.

On Sunday, I’m setting the stage for the rest of the week with a sit-down with ONC’s Director of Standards and Interoperability and Acting Chief Scientist, Dr. Doug Fridsma. His groundbreaking work in interoperability spans multiple initiatives, including: the Nationwide Health Information Network (NwHIN) and the CONNECT project, as well as the Federal Health Architecture. For insight into his passion for transforming the healthcare system through health IT, check out his blog: From The Desk of the Chief Science Officer.

Through the rest of the week, I aspire to see the world through Dr. Fridsma’s eyes, focusing on how each of the organizations and individuals contribute to the standards-based processes and policies that form the foundation for actionable analytics – and improved health. I’ve selected interviews with key visionaries from companies large and small, who I feel are representative of positive forward movement:

Health Care DataWorks piques my interest as an up-and-comer to watch, empowering healthcare systems to improve outcomes and reduce medical costs by providing accelerated EDW design and implementation, whether on-premise or via SaaS solution. Embedded industry analytics models supporting alternative network models, population-based payment models, and value-based purchasing allow for rapid realization of positive ROI.

Emdeon, is the single largest clinical, financial, and administrative network, connecting over 400,000 providers and executing more than seven billion health exchanges annually. And if that’s not enough to attract keen attention, they recently announced a partnership with Atigeo to provide intelligent analytics solutions with Emdeon’s PETABYTES of data.

Serving an area near and dear to my heart, Clinovations provides healthcare management consulting services to stakeholders at each link in the chain, from providers to payers and supporting trading partners – in areas from EMR implementation (and requisite clinical data standards) to market and vendor assessments, and data management activities throughout. With the dearth in qualified SME resources in the clinical data field, I look forward to learning about how Clinovations plans to manage their growth and retain key talent.

Who doesn’t love a great legacy decommissioning story? Mediquant proports adopting their DataArk product can result in an 80% reduction in legacy system costs through increased interoperability across disparate source systems and consolidated access. The “active archiving” solution allows for a centralized repository and consolidated accounting functions out of legacy data without continuing to operate (and support) the legacy system. Longitudinal clinical records? Yes, please!

Those are just a few on my must-see list, and I think Dr. Doug Fridsma would be proud of their vision, and find alignment to his ONC program goals. But will he be proud of their execution?

Can’t wait to find out, on the exhibit hall floor – and in the hallway conversations, and the client case study sessions, and the general scuttlebutt – at HIMSS!

March 2, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who 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.

Interoperability, Clinical Data, and The Greatest Generation

Written by:

As a healthcare IT zealot and wanna-be policy wonk, I find myself mired in acronyms, and surrounded (and indulged) by those who understand my rapid-fire Klingon-esque rants on BETOS and LOINC and HCPCS. The larger concepts of interoperability and meaningful use lose the forest for the trees of IHE standard definitions and specific quality measures. Have we lost sight of the vast majority of the healthcare consumers, and their level of understanding and awareness of those larger concepts? Could you explain HL7 ORUs or CCDs to your great-grandma?

I recently visited my 90 year-old grandparents, both remarkably healthy multiple cancer survivors who show no signs of slowing down, and have maintained enough mobility to continue bowling 3 times a week. After an evening of pinochle, my grandma asked me to please help her understand what it is that I DO for a living. We’ve had this conversation before.

“I’m a healthcare technology consultant, Grandma. I work with insurance companies and doctors to help them get all your information.”

Puzzled look.

“When you go to the doctor, Grandma, do they write anything down on paper, or are they using a computer when they talk to you?”

“Oh, they’re always on those computers! Tap-tap-tap. Every question I answer and they tap-tap-tap.”

She illustrates by typing on her lap, and I confirm that she’s a hunt-and-peck person. She stops only after I finish asking my next question.

“Do you have private insurance, or do you use the VA?”

“I have Blue Cross. Your grandpa uses the VA.”

“How many doctors did you have to see for your blood infection?”

“FOUR! Sometimes two in one day!”

“Did they all have to ask you for your history?”

“No – they already had it, on their computer. They even knew about my mastectomy, 30 years ago. One corrected me on the date; I’d thought it was only 20 years ago.”

“Well, Grandma, when you booked your appointment with the first doctor, their computer system automatically requested your medical records from your insurance company. And the insurance company automatically sent your records back to the computer. After the first doctor made notes on your visit, just after you walked out the door, the computer sent an updated copy of your medical records back to the insurance company, and it ordered the lab tests you needed before you went to the next doctor. Then, the lab automatically sent your results to the insurance company AND the doctor who ordered the tests.”

“But the other doctors had the test results.”

“Yes, ma’am. Each time you made an appointment with a new doctor, that doctor’s computer requested your medical records from the insurance company, and the insurance company sent out the most recently updated information. It only takes a minute!”

“Goodness. So, do you build the computer programs that make all that work?”

Eyes wide. THIS impresses her.

“No.”

Puzzled look again, so I quickly continue.

“But I make sure those computer programs can talk to each other, and that the insurance company can make sense out of what they’re saying.”

“Because if they couldn’t talk to each other, I’d have to haul a suitcase from doctor to doctor with my chart?”

“Yes, ma’am. That’s called ‘interoperability’. There are new rules for how doctors’ computers should talk to each other, and to the insurance companies. And I get to work with the insurance company to do other really cool stuff. I take a look at LOTS of people’s medical records to find patterns that might help us catch diseases before they happen.”

“And what’s that called?”

“Clinical informatics. It’s my favorite thing to do, because I get to study lots and lots and LOTS of information. That’s called ‘big data’.”

“Sweetheart, you lost me with the computer words. But I’m just so happy you’re happy!”

She hugs me and grins, and I finally feel like I’ve found the right way to talk about my passion: through use cases. Although, Grandma would call them stories.

And there you have it: the importance of interoperability and clinical data, through the eyes of The Greatest Generation. Check in next year for an update on whether my definitions stuck!

February 21, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who 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.

Interoperability Needs Action, Not Talk – #HIMSS13 Blog Carnival

Written by:

When you talk to people outside of healthcare about the value of healthcare IT, you will often get a response that healthcare IT is fantastic because it makes it so easy for medical data to be shared with who needs the data when they need it. Those of us in healthcare IT know that this is far from the reality of what’s possible with healthcare data today. This is really unfortunate, because the promise of technology in healthcare is to make the movement of data possible. We’re currently missing out on the benefits of this promise.

I don’t know about the rest of you, but I’m sick and tired of hearing the excuses for why healthcare data can’t be shared. We’ve heard them all: privacy, security, data governance, payment model, etc etc etc. Yet we go to the HIMSS Interoperability Showcase and see that the technology to start sharing data is there, but what seems to be missing is the willpower to push the data sharing through despite the challenges and naysayers.

Maybe Farzad is on to something when he called for EHR vendors to do what’s “Moral and Right.” There’s no more moral or right thing someone can do in healthcare than to make healthcare data interoperable. It’s not only EHR vendors that need to do this, but hospital institutions and doctors offices as well.

We need some brave leaders in healthcare IT to step up and start sharing data. No, I don’t want an announcement at HIMSS that a healthcare organization has partnered with a vendor to start sharing data. I don’t want a new organization formed to assist with healthcare data sharing initiatives. I don’t need another book on the challenges of HIE. We don’t need a session on HIEs and data sharing standards. No, we need brave organizations that say that sharing healthcare data is the right thing to do and we’re making it happen.

I’m not suggesting an organization should do anything ruthless or reckless. I’m suggesting that healthcare organization start DOing something as opposed to talking about it. The time for talking is over and the time for DOing is here. Healthcare data interoperability won’t happen until we make this choice to DO instead of TALK.

I’m not even asking for a healthcare organization to start sharing all their healthcare data everywhere. In fact, I think that’s another failed interoperability strategy that we seem to keep trying over and over. If you try to solve all of our healthcare interoperability problems in one major project, you’ll end up doing nothing and solve none of the problems.

Instead a successful interoperability strategy will focus on sharing one meaningful piece of healthcare data while still keeping in mind that this is just the start. Connect the healthcare data end points with that one meaningful piece of data. Once you make that connection, others will start to wonder why that same process can’t be used for other important and valuable pieces of healthcare data. This is exactly the push that healthcare interoperability needs. We need departments and providers jealous of other departments and providers that are sharing their data. The same principle of jealousy can apply across institutions as well.

Yes, this will take a forward looking leader that’s willing to take what many in healthcare would consider a risk. Imagine a hospital CIO whose stuck trying to explain why their hospital is sharing data that will help doctors provide better care to their patients. Imagine a hospital CIO explaining why they’re driving healthcare costs down by lowering the number of duplicate tests that are done because they already have the data they need thanks to interoperable healthcare data. I’d hate for a hospital CEO to have to explain why they’ve reduced hospital readmissions because they shared the hospital data with a patient’s primary care doctor.

Maybe implementing interoperability in healthcare isn’t such a brave thing after all. In fact, it’s a brave thing for us not to be sharing data. Why aren’t we holding our healthcare institutions accountable for not sharing data that could save lives, lower costs, and improve healthcare? Why are we ok with non-profit institutions worrying more about profit than the real stakeholders their suppose to be serving? Are we really so far gone that healthcare organizations can’t do something so obvious: sharing healthcare data?

Think of all the other major healthcare initiatives that would benefit from being able to share healthcare data where it’s needed. Meaningful Use, Obamacare (Affordable Care Act if you prefer), Clinical and Business Intelligence, Mobile Health, ACO’s, population health, etc could all benefit from healthcare institutions that embraced interoperable healthcare data.

Who’s going to take the lead and start doing what we all know should be happening? It won’t happen by #HIMSS13, but over cocktails at HIMSS I hope some hospital CIOs, doctor groups, EHR vendors, and other medical providers come together to do what they know is the right thing to do as opposed to just talking about it.

The above blog post is my submission to the #HIMSS13 Blog Carnival.

February 8, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

An EHR “Voice” When You Don’t Have One

Written by:


I was struck by the following tweet by ANdre Picard and the corresponding article that he links to by Heather Thiessen on Qreview. Go ahead and read the article. I’ll be here when you get back.

This is a powerful concept that I don’t think we fully appreciate, because in our current healthcare environment our EHR isn’t a very good voice on our behalf. In most cases our EHR record is muted and stuck in a data silo at our physician’s office. This is sad because of what Heather describes as the possible benefit of interoperable EHR:

In retrospect, having an EHR in place could have made my hospital visit in Ontario much more efficient, considerably less stressful, and perhaps even less dangerous for all involved. Luckily, my husband had considerable knowledge about my specific peculiarities and allergies, as I was not fully able to communicate them myself. Electronic health records could, essentially, become a patient’s voice when the patient doesn’t have one.

I love that idea of an EHR being the patient voice when the patient doesn’t have one. I know there are a lot of companies working on this problem and coming at it from 100 different directions. The day our healthcare data gets its voice can’t come soon enough for me.

September 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Hospital Mergers EHR Data Migration Challenge, Smart Phone HIPAA Security, Healthcare Interoperability and Patch Adams Video

Written by:

Time again to take a look around the EMR and healthcare IT twittersphere at some of the best tweets. We’ve got some really interesting tweets to consider along with a tweet that includes a video of the real Patch Adams (many I love that movie) in his element. If I ever get a chance to meet Patch Adams, I’m going to jump at the chance. I’m certain that he’s endless entertainment.

Also, you can check out the Around Healthcare Scene post on EMR and EHR.

Now on to the EMR and Healthcare IT tweets:


I’ve talked quite a bit about the challenge of EHR mergers. I’ve definitely not talked about the challenge to EHR when hospitals merge. I can see this being a great future topic for Hospital EMR and EHR. There are a lot of intricacies involved in the subject and will be a very important topic as EHR becomes more widely adopted.


This is an interesting tweet. I guess my challenge with the idea is that I bet off-the-shelf laptops and desktop computers meet few HIPAA, meaningful use requirements either. The important difference is that more can be done on a desktop to secure it than most smart phones. Although, I think this will continue to change over time.

On this topic, I’ve seen more and more people making the argument that a virtual environment is the key to good security on a smartphone. This is a good way to secure a smartphone, but it also is a good way to kill the usability of a smartphone. I’m still not sure exactly how we’re going to bridge the divide.


I’d love to see and hear of examples of this happening. I’d be happy to do my part in providing more visibility if I just knew where interoperable health IT was happening.


This video is outrageous, hilarious and fantastic. I’m not sure what the medical world thinks of Patch Adams, but I welcome fresh takes. No doubt Patch Adams is a unique individual that’s not afraid to stretch the cultural norms.

June 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Drivers of Healthcare Interoperability – Meaningful Use and ACOs

Written by:

Seems like this week must be interoperability week on EMR and HIPAA after my post yesterday about HIE transport in meaningful use stage 2 and my post today on drivers of healthcare data interoperability.

I was looking through some past notes from a meeting at AHIMA that I had with Health Language Inc. It was a fascinating conversation with Brian F. McDonald, Executive VP and CFO and Marc A. Horowitz, Senior VP. I remember that these guys eat, drink and sleep medical terminology. One of the really interesting observations I took from talking with them was:

Meaningful use and ACOs are the drivers of interoperability in healthcare.

Months after first hearing this idea, it rings even more true. In meaningful use stage 2, ONC and CMS have made it very clear that they plan to use meaningful use as a motivating force behind the sharing of healthcare data. This includes sharing of healthcare data doctor to doctor and also doctor to patient. I expect meaningful use stage 3 will find these concepts at their core as well.

As we try and evaluate what an ACO would look like, some form of healthcare data exchange has got to be part of the solution. I don’t believe anyone will find a way to really improve health the way an ACO will need to improve care without an exchange of data between EHR systems. Considering the pay for performance days are short at hand, this will be an encouraging factor for EHR systems to start exchanging data.

I’ve often said the big problem with interoperability of data in healthcare is the financial aspects and the governance (ie. when to share data) aspects. I see ACOs and meaningful use pushing healthcare providers to figure out both problems.

If not these drivers, what else will get healthcare to start sharing data?

March 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

My 2012 EMR and Health IT Wish List

Written by:

As I said in my previous EMR and Health IT in 2012 post, I’m going to create some of my own lists for 2012. I decided to tackle the first one on the list: My 2012 EMR and Health IT Wish List. This was kind of fun to think about. I’m also sure that I’ll come up with other ideas once this is posted, so don’t be surprised if I add things to this list in a future post.

I should also note that I’m not sure any of these things are going to happen in 2012. In fact, I bet that many of them aren’t, but this list isn’t about what is going to happen. This list is about what I wish would happen.

EHR Companies Would Embrace Interoperability – It’s an incredible shame that in 2012 we still don’t have interoperable health records. EHR companies need to get off the stump and make this a reality. The technology is already there and has been there for a while. EHR companies need to start making this dead simple because it’s the right thing to do. Sometimes doing the right thing is more important than the bottom line. Plus, doing the right thing ends up often being the best long term strategy for your bottom line as well.

Start doing what’s right and making your EHR interoperable!

Meaningful Use Would Go Away – I’m actually certain that this one won’t be happening in 2012, but I wish it would. I guess there’s a small chance that it could go away if Republicans take control of Washington and start slashing everything Obama related. However, I have a feeling that even then meaningful use will find its way back into Washington. There’s too much invested in it.

My reasoning for wanting meaningful use gone is clear. It provides a perverse incentive to providers and often incentivizes them to choose an EHR software that doesn’t work well for their practice. As I’ve mentioned in some recent posts, far too many clinics are so focused on meaningful use and EHR incentive money that they’re ignoring the real and tangible business cases for implementing an EHR in their clinic. I think this is a bad thing for healthcare and EHR software in general. The short term bump in EHR adoption won’t be worth the cost of EHR implementations focused on the wrong criteria.

I also really hate how meaningful use has hijacked the software development cycle of pretty much every EHR vendor out there. This is a real travesty since rather than developing for user/customer requirements EHR vendors are developing for a criteria. Talk about a perfect method for destroying innovation. This is a real travesty in my opinion.

Of course, I’m a realist and realize that meaningful use isn’t going away. We have to make the most with what we’re given and live with the realities that exist. However, in this New Year Wish list, I wish that meaningful use would be a past memory.

New Healthcare Model that Provides Care, Not Reimbursement – I’m sure many of you might be thinking that I’m calling for ACO’s in this wish list item. We’ll see how ACO’s evolve, but my gut tells me that the ACO model still won’t make the fundamental change that I wish would happen in healthcare. There’s far too much focus on reimbursement the way our healthcare is structured today. I’m not arguing that doctors and other healthcare professionals not get paid what they deserve. I’m just wishing that there was more focus on care for patients and less worry on maximizing the reimbursement.

How does this have to do with health IT and EHR? I’ve long argued that the biggest bane to EHR systems is the onerous reimbursement requirements. I can’t imagine how much healthcare could benefit from fabulous EHR systems if the energy spent on maximizing reimbursement were spent on improving patient care.

Diabetes Prevention App – I’ll admit that this is a little personal. I come from a long line of diabetes in the genes and I love sweets far too much. I’m pretty much destine to be a diabetic. I think that mHealth apps can have amazing power if done correctly. My wish is for someone to create a Diabetes app that will help me overcome the seeming destiny I have in this regard. The key will probably be illustrating in a profound way the impact of the choices I’m making.

Of course, you could insert hundreds of other chronic illnesses into this wish list too. I’d love to see mobile health work to solve those as well.

A True Patient Identifier – I realize that America is a large place, but we’re also a really creative country that can figure out creative solutions to problems. The lack of a true patient identifier is a challenge and a problem in healthcare. I’d love to see this problem finally resolved. I think every EHR company would rejoice at this as well.

Real EMR Differentiation – My heart absolutely goes out to doctors, practice managers and others who have the unenviable job of trying to sift through the 300+ EMR companies. I’d love for some EMR companies to really do something so innovative to differentiate themselves from the rest of the pack.

No doubt part of this problem is what I stated above about meaningful use. Hard to create innovation and differentiation in EHR when you have to develop for a government list of requirements.

EHR Data Liberation – I’ve wanted EHR data Liberation for a long time, but I think in 2012 this is one thing on the list that could become a reality. It’s a bit of a long shot, but I think there’s potential for this to happen.

My gut tells me that if we can find a way to liberate the data that’s stored in EHR software, then we’d see a dramatic increase in adoption of EHR. One of the major concerns doctors have with selecting an EHR is that once they select an EHR they know they’re locked in with that EHR for the long run. If a doctor knew that they could switch EHR software if they made a bad choice, then they’d be much more likely to pull the trigger on EHR adoption.

We need a wave of EHR vendors that aren’t afraid of liberating their EHR data, because they:
1. Know that their EHR software is so good users won’t leave
2. Know that if someone wants to leave their EHR software it’s better that they find one that’s good for them than the few extra dollars the EHR company will make off an unhappy user.

How’s that for a wish list? I think achieving these things would do an amazing amount of good in healthcare and EHR. Of course, I won’t be holding my breathe on any of them happening any time soon. That doesn’t mean I won’t keep holding out hope.

January 3, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

9 Ways IT is Transforming Healthcare – “Top 10″ Health IT List Series

Written by:

As is often common at the end of the year, a lot of companies have started putting together their “Top 10″ (or some similar number) lists for 2011. In fact, some of them have posted these lists a little bit earlier than usual. This week as people are often off work or on vacation, I thought it might be fun to take one list each day and comment on the various items people have on their lists.

The first list comes from Booz Allen Hamilton and is Booz Allen’s Top 9 ways IT is Transforming healthcare. Here’s their list of 9 items with my own commentary after each item.

Reduces medical errors. I prefer to say that Health IT has the potential to reduce medical errors. I also think long term that health IT and EMR will reduce medical errors. However, in the interim it will depend on how people actually use these systems. Used improperly, it can actually cause more medical errors. There have been studies out that show both an improvement in medical errors and an increase in medical errors.

My take on this is that EMR and health IT improves certain areas and hurts other areas. However, as we improve these systems and use of these systems, then over all medical errors will go down. However, remember that even once these systems are perfect they’re still going to be run be imperfect humans that are just trying to do their best (at least most of them). Even so, long term health IT and EMR software will be something that will benefit healthcare as far as reducing medical errors.

Improves collaboration throughout the health care system. I’m a little torn as we consider whether health IT improves collaboration. The biggest argument you can make for this is that it’s really hard to be truly interoperable in really meaningful and quick ways without technology. Sure, we’ve been able to fax over medical records which no one would doubt has improved health care. However, those faxes often get their too late since they take time to process. Technology will be the solution to solving this problem.

The real conundrum here is the value that could be achieved by sending specific data. A fax is basically a mass of data which can’t be processed by a computer in any meaningful way. How much nicer would it be to have an allergy passed from one system to another. No request for information was made. No waiting for a response from a medical records department. Just a notification on the new doctor’s screen that the patient is allergic to something or is taking a drug that might have contraindications with the one the new doctor is trying to prescribe. This sort of seamless exchange of data is where we should and could be if it weren’t for data silos and economics.

Ensures better patient-care transition. This year there was a whole conference dedicated to this idea. No doubt there is merit in what’s possible. The problems here are similar to those mentioned above in the care collaboration section. Sadly, the technology is there and ready to be deployed. It’s connecting the bureaucratic and financial dots to make it a reality.

Enables faster, better emergency care. I’m not sure why, but the emergency room gets lots of interesting technology that no one else in healthcare gets. I imagine it’s because emergency rooms can easily argue that they’re a little bit “different” from the rest of the hospital and so they are able to often embark on neat technology projects without the weight of the whole hospital around their neck.

One of the technologies I love in emergency care is connecting the emergency rooms with the ambulances. There are so many cool options out there and with 3G finally coming into its own, connectivity isn’t nearly the problem that it use to be. Plus, there are even consumer apps like MyCrisisRecords that are trying to make an in road in emergency care. I’d like to see broader adoption of these apps in emergency rooms, but you can see the promise.

Empowers patients and their families to participate in care decisions. Many might argue that with Google Health Failing and Microsoft HealthVault not making much noise, that the idea of empowering patients might not be as strong. Turns out that the reality is quite the opposite.

Patients and families are participating more and more in care decisions. There just isn’t one dominant market leader that facilitates this interaction. Patients and families are using an amalgamation of technologies and the all powerful Google to participate in their care. This trend will continue to become more popular. We’ll see if any company can really capture the energy of this movement in a way that they become the dominant market leader or whether it will remain a really fluid environment.

Makes care more convenient for patients. I believe we’re starting to see the inklings of this happening. At the core of this for me is patient online scheduling and patient online visits. Maybe it could more simply be identified as: patient communication with providers.

I don’t think 2011 has been the watershed year for convenient access to doctors by patients. However, we’re starting to see inroads made which will open up the doors for the flood of patients that want to have these types of interactions.

Helps care for the warfighter. This is an area where I also don’t have a lot of experience. Although, I do remember one visit with someone from the Army at a conference. In that short chat we had, he talked about all the issues the Army had been dealing with for decades: patient record standards, patient identifiers, multiple locations (see Iraq and Afghanistan), multiple systems, etc. The problem he identified was that much of it was classified and so it couldn’t be shared. I hope health IT does help our warriors. It should!

Enhances ability to respond to public health emergencies and disasters. I’ve been to quite a few presentations where people have talked about the benefits and challenges associated with electronic medical records and natural disasters. They’ve always been really insightful since they almost always have 5-6 “I hadn’t thought of that” moments that make you realize that we’re not as secure and prepared for disasters as we think we are.

It is worth noting that moving 100,000 patient records electronically to an off site location is much easier in the electronic world than it is in paper. With paper charts we can’t even really discuss the idea of remote access to the record in the case of a natural disaster.

Possibly even more interesting is the idea of EMR and health IT supporting public health emergencies. We’re just beginning to aggregate health data from EMR software that could help us identify and mitigate the impact of a public health emergency. Certainly none of these systems are going to be perfect. Many of these systems are going to miss things we wish they’d seen. However, there’s real potential benefit in them helping is identify public health emergencies before they become catastrophes.

Enables discovery in new medical breakthroughs and provides a platform for innovation. Most of the medical breakthroughs we’ve experienced in the last 20 years would likely have been impossible without technology. Plus, I don’t think we’ve even started to tap the power that could be available from the mounds of healthcare data that we have available to us. This is why I’m so excited about the Health.Data.Gov health data sharing program that Priya wrote about on EMR and EHR. There’s so many more medical discoveries that will be facilitated by healthcare data.

There you have it. What do you think of these 9 items? Are there other things that you see happening that will impact the above items? Are there trends that we should be watching in health IT in 2012?

Be sure to read the rest of my Health IT Top 10 as they’re posted.

December 27, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

The Bases of Competition in Healthcare – Open vs Closed

Written by:

I’m sure that many of you have read the always insightful and intriguing Vince Kuraitis and his e-CareManagement blog. If you haven’t you should start doing so now. I just recently came across his post called “Getting an Epic Opinion Off My Chest” about the proprietary solutions and walled gardens that have and are being created in healthcare.

He starts off really strong with the following points:

What are acceptable bases of competition in health care?

My sense is that the distinctions here are not well understood and often go undiscussed, so I’ll quickly get to the point:

It’s OK for care providers to compete on the bases of quality, price, patient satisfaction, and many other factors

It’s NOT OK for care providers to compete on the basis of controlling or limiting access to patient health information. It’s just not right.

He later goes on to assert that in many industries the idea of creating proprietary, non-interoperable technology is an acceptable means of competitive differentiation, but Health Care is different.

Certainly there are people’s lives involved in this and so it’s a different animal all together. If I can’t transfer my music from one MP3 to another it might be unfortunate, but having a loved one die because the right healthcare information was stuck in a closed system is a much more serious issue and one that should require careful consideration.

Outside the ethical reasons to support the benefits of access to patient information, I think there’s a great business case for doing so as well.

One example of the business case I outlined in my post about EMR data liberation. That’s a subtly different situation than what Vince described, but I believe you can make the business case for the benefits of an open system.

For those familiar with SalesForce.com, they could have easily been a few hundred million dollar company on the back of their CRM software. They could have then expanded into other related business verticals as they built off a closed garden. Instead, they opened up their system to allow a lot of other companies to build on their Force platform. As a platform, they’re a multi-billion dollar company.

Why healthcare IT vendors can’t see the value of open is a bit beyond me? I guess some might argue that the GE and Microsoft announcement was a step towards this type of open environment. Based on the analysis I’ve read, I think this is part of their vision for what they’re trying to create.

Whether Microsoft and GE will be able to execute on the vision of the platform is still not clear. However, what I believe is clear is that directionally this is where the market will eventually go. There will be a healthcare platform that does a great job connecting heterogeneous systems.

So, yes, I think that morally the right thing to do is to open your system, but I also think it makes great business sense to do so as well. The closed garden strategy might work well in the short term, but long term open always seems to find a way to win in a much bigger way.

December 15, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.