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 Most Interesting Things in Healthcare Are At the Intersections

Posted on October 31, 2016 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.

Today my mind is reeling from everything I’ve seen and heard over the past couple weeks as I’ve talked to literally hundreds of incredible people. I’m currently at the MGMA Annual conference in San Francisco and tomorrow I’ll head to the CHIME Fall Forum in Phoenix. This is the crazy fall health IT conference where I could go to a conference every day of the week and still not attend them all. They’re invigorating, but also overwhelming at times.

However, as I sit here processing everything I’ve heard, I’m reminded of something I once heard (sorry that I don’t remember who first said it) that seems even truer today:

The most interesting things in healthcare lie at the intersections.

It’s such a simple, but powerful idea. There are so many things happening in healthcare. Some improve the way an organization runs. Some improve the quality of the data we have in healthcare. Some make coders more efficient. Some provide new revenue streams. etc etc etc.

All of these are good things, but the most powerful thing is when technology and behavioral science or technology and new business models or technology and some other aspect of technology cross paths. In fact, some of the best innovations don’t even include technology, but the inclusion of technology in these lists is my own personal bias. The intersection of different fields is where the real magic is going to happen. It won’t be enough to just be technology.

With that in mind, where do you see the greatest intersections happening in healthcare? Where should they be happening more?

Healthcare Has Found the New World But Hasn’t Even Settled the 13 Colonies Yet

Posted on May 23, 2016 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 was having a conversation recently about healthcare analytics. During that discussion I came up with what I think is the perfect analogy for where we are in the development of healthcare analytics solutions. I’d also include things like health sensors and genomics in this broad definition since the data from these efforts are all going to work to inform various healthcare analytics and clinical decision support solutions.

With that in mind, I think when it comes to these solutions for healthcare, it’s almost like Columbus has discovered a new world. A few other explorers have set foot on land in North or South America and so we know there’s a whole other world of discovery out there. However, from an exploration perspective we’ve barely landed. We know there’s a lot of possibility, but we don’t have any idea the full expanse of what’s still out there. Does this sound like healthcare analytics to you?

Continuing the analogy, we haven’t even settled the 13 colonies let alone discovered the midwest or even considered that the entire west is there with all of its unique possibilities. No, we’re just starting our exploration of what’s possible in healthcare now that we have so much more health data. We see a lot of promise and potential, but we still have to discover where there’s a gorgeous paradise and where there’s a worthless desert.

I love the analogy of explorers since there’s so much discovery that’s still possible in healthcare. All these new sensors and technology are like new boats that can take us new places that we would have never thought possible.

That said, this type of exploration is not for the faint of heart. Much like explorers, some are going to die searching for gold in the new world and die without ever finding it. However, those explorers that die trying lay the framework for all the others that come after. Their failures will help future healthcare explorers to avoid the challenges their predecessors faced.

In many ways, this is why I’m so excited about healthcare and the technology that’s going to facilitate all this new exploration. Some of the discoveries we’ll find are going to require as dramatic a culture shift as it was for the old world to believe Christopher Columbus when he said the world wasn’t flat. That’s going to be painful for many, but it’s going to happen.

Time To Leverage EHR Data Analytics

Posted on May 5, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For many healthcare organizations, implementing an EHR has been one of the largest IT projects they’ve ever undertaken. And during that implementation, most have decided to focus on meeting Meaningful Use requirements, while keeping their projects on time and on budget.

But it’s not good to stay in emergency mode forever. So at least for providers that have finished the bulk of their initial implementation, it may be time to pay attention to issues that were left behind in the rush to complete the EHR rollout.

According to a recent report by PricewaterhouseCoopers’ Advanced Risk & Compliance Analytics practice, it’s time for healthcare organizations to focus on a new set of EHR data analytics approaches. PwC argues that there is significant opportunity to boost the value of EHR implementations by using advanced analytics for pre-live testing and post-live monitoring. Steps it suggests include the following:

  • Go beyond sample testing: While typical EHR implementation testing strategies look at the underlying systems build and all records, that may not be enough, as build efforts may remain incomplete. Also, end-user workflow specific testing may be occurring simultaneously. Consider using new data mining, visualization analytics tools to conduct more thorough tests and spot trends.
  • Conduct real-time surveillance: Use data analytics programs to review upstream and downstream EHR workflows to find gaps, inefficiencies and other issues. This allows providers to design analytic programs using existing technology architecture.
  • Find RCM inefficiencies: Rather than relying on static EHR revenue cycle reports, which make it hard to identify root causes of trends and concerns, conduct interactive assessment of RCM issues. By creating dashboards with drill-down capabilities, providers can increase collections by scoring patients invoices, prioritizing patient invoices with the highest scores and calculating the bottom-line impact of missing payments.
  • Build a continuously-monitored compliance program: Use a risk-based approach to data sampling and drill-down testing. Analytics tools can allow providers to review multiple data sources under one dashboard identify high-risk patterns in critical areas such as billing.

It’s worth noting, at this point, that while these goals seem worthy, only a small percentage of providers have the resources to create and manage such programs. Sure, vendors will probably tell you that they can pop a solution in place that will get all the work done, but that’s seldom the case in reality. Not only that, a surprising number of providers are still unhappy with their existing EHR, and are now living in replacing those systems despite the cost. So we’re hardly at the “stop and take a breath” stage in most cases.

That being said, it’s certainly time for providers to get out of whatever defensive crouch they’ve been in and get proactive. For example, it certainly would be great to leverage EHRs as tools for revenue cycle enhancement, rather than the absolute revenue drain they’ve been in the past. PwC’s suggestions certainly offer a useful look on where to go from here. That is, if providers’ efforts don’t get hijacked by MACRA.

The Double Edged Sword of Healthcare Culture

Posted on March 25, 2016 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.

Rasu Shrestha, MD shared the tweet above today which caused me to ponder on the impact of culture on healthcare. This tweet was particularly interesting coming from Rasu who has created a unique culture of innovation within healthcare at UPMC.

While at RSNA, Rasu recounted to me how his UPMC innovation offices shares a building with the Google office. When interviewing candidates, many of those prospects interview at both UPMC and Google. There’s no way that Rasu and his team can compete with Google as far as perks. However, there’s no way that Google (at least the offices in Pittsburgh) can compete with the impact UPMC can have on the lives of individuals.

If it weren’t for the culture and mission of Rasu and UPMC, then they wouldn’t stand a chance recruiting people away from Google. However, that mission makes all the difference for the right person. Plus, if that person doesn’t understand the mission, then UPMC doesn’t likely want them in the first place.

While I believe that Rasu has created a special culture of innovation, the same can’t be said for much of healthcare. In fact, if you read the tweet at the top another way, healthcare culture is holding innovation behind in so many ways.

Said another way, Culture trumps everything and that can be good or bad.

A culture of innovation is great, because it spurs more innovation. A culture of being closed. A culture of fear. A culture of bureaucracy. Those can all be extremely damaging and stifle innovation and change that could improve healthcare.

I want to be careful to say that I’m not advocating a culture of recklessness. Culture can be taken too far either direction. However, I know very few people in healthcare who are reckless and I know a lot of people in healthcare who are paralyzed by a culture of fear.

Take a second to think about your culture and the impact for good and bad it has on your and your organization’s choices.

The Biggest Challenge in Healthcare: Excuses

Posted on January 29, 2016 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.

In one of my many conversations, someone told me the following quote that really stuck with me. I can’t remember who told me it and they didn’t want to be named, but I thought the comment was incredibly insightful.

The problem with healthcare is that it’s all complex. If people want to find an excuse not to do something, they can find one.

I think this quote is spot on. Is there anything in healthcare that isn’t complex? At least in healthcare technology, everything is complex. It’s not enough to just create a solution and roll it out tomorrow. You have to consider HIPAA laws, FDA regulations, reimbursement regulations, Federal laws, state laws, medical licensures, medical liability, etc etc etc.

Doctors principle of “first do no harm” is very real in healthcare and a generally good principle, but it can also be invoked easily to say no to anything you don’t want to do. Even if the thing that could be done doesn’t actually do any harm and could actually be beneficial to patients.

My prediction is the next 10 years, organizations are going to be defined by how an organization approaches this challenge. On the one hand we’ll have organizations that choose to use complexity as an excuse to not innovate. On the other hand we’ll have organizations that embrace hard, challenging, complex problems with solutions instead of excuses. It won’t be easy for these organizations, but it will absolutely differentiate them from their competitors.

I’m not suggesting that we should lower the standards of what’s acceptable to implement in healthcare. Instead, I’m suggesting that we make the effort required to explore new innovations and collaboratively work on solutions that handle the complexity of healthcare while providing incredible value to your organization and patients. After all, the very best things in life are challenging and difficult. Let’s embrace the challenging and difficult instead of using it as an excuse for inaction.

Patient Driven Innovation vs Healthcare Driven Innovation

Posted on December 23, 2015 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 came across this interesting tweet and image from @joyclee:
Healthcare Innovation

I look forward to participating in a discussion around this graphic in the comments. Please be sure to chime in.

My main complaint with the graphic is that the level of healthcare driven innovation should be higher. I’m torn on if it’s higher or lower than patient driven innovation. Either way, I think it deserves to be higher.

I think that some people confuse making noise with true healthcare innovation. It’s one thing to make a bunch of noise. It’s another to really impact health care. I love grass roots efforts to “hack healthcare.” However, I’ve seen a lot of efforts that haven’t really made an impact.

Of course, I guess it’s worth discussing if an innovation needs to have impact to be considered an innovation. I look forward to reading your thoughts in the comments.

Some Inspiring and Thought Provoking Ideas from the HIMSS15 Final Keynote

Posted on April 16, 2015 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 last keynote at HIMSS is always inspiring for me. They’ve almost always ended up being one of the more prominent memories for me from HIMSS. This year was no different. I really need to chew on a bunch of what was said still, but Jeremy Gutsche was throwing out nuggets of wisdom throughout his talk. Here are some tweets that show what I mean:

The Future Of…Patient Engagement

Posted on March 19, 2015 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.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Healthcare has a major challenge when it comes to the term “Patient Engagement.” $36 billion of government money and something called meaningful use has corrupted the word Patient Engagement. While meaningful use requires “5% patient engagement”, that’s a far cry from actually engaging with patients. Anyone that’s attested to meaningful use knows what I mean.

As we move past meaningful use, what then will patient engagement actually look like?

When I start to think about the future of patient engagement, I’m taken back to my experience with a new primary care provider that’s trying to Restore Humanity to Healthcare (see Restore Humanity to Healthcare part 2 as well). In this case, I’m exploring the idea of unlimited primary care along with a primary care team that includes a doctor, but also includes a wellness coordinator that’s interested in my wellness and not just my presenting problem.

Once you take the payment portion out of primary care, it dramatically changes the equation for me. Gone are the fears of going to the doctor because you don’t want to pay the co-pay. Gone are the days where a doctor needs to see you in the office in order to be able to make money from the visit. With unlimited primary care, an email, phone call or text message that solves the problem is a great solution for the doctor and the patient.

Of course, this model of primary care is only one example of the shift that’s going to drive us to patient engagement. ACOs and value based care models are going to require a much deeper relationship between doctors and patients. Trust me that 5% patient engagement through an online portal isn’t going to be enough in these new models.

Plus, these new models are going to really convert our current sick care system into a true healthcare system. I like to call this new model “Treating Healthy Patients.” Quite frankly we’re not ready for this change right now, but in the future we’ll have to adapt. The biggest change is going to be in how we define “patient” and “healthy.”

The wave of connected medical devices and innovation are going to completely reframe how we look at health. Instead of describing ourselves as healthy, the data will tell us that we’re all sick. We’re just at different points in the continuum of sickness.

In the future, patient engagement will be the key to treating each of us individually. The symptoms will change from coughing and vomiting to 85% risk for diabetes and 76% risk for a heart attack. We thought we had patient compliance issues when someone is coughing and vomiting (ie. something they want to fix). Now imagine patient compliance challenges when the patient isn’t feeling any pain, but they need to change something in order to avoid some major health problem.

I think this describes perfectly why we’re entering one of the most challenging times in healthcare. It’s a dramatic shift in how we think about healthcare and has a new set of more challenging problems that we’ve never solved. One of the keys to solving these new challenges is patient engagement.

The Future Of…Healthcare Innovation

Posted on March 17, 2015 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.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Innovation is a fascinating concept. Historians and philosophers have been thinking and investigating the key to innovation forever. I’m not sure anyone has ever found the true secret sauce to innovation. Every innovation I’ve ever seen has been a mix of timing, luck, and hard work.

Some times the timing is not right for a product and therefore it fails. The product might have been great, but the timing wasn’t right for it to be rolled out. Innovation always requires a little luck. Maybe it was the chance meeting with an investor that helps take and idea to the next level. Maybe it’s the luck of getting the right exposure that catapults your idea into a business. Maybe it’s the luck of the right initial end users which shape the direction of the product. Every innovation has also required hard work. In fact, the key to ensuring you’re ready for luck to be heaped upon you or to test if your timing is right is to put in the work.

The great thing is that it’s a brilliant time to be working on innovations in healthcare. We’re currently at the beginning of a confluence of healthcare innovations. Each one on its own might seem like a rather small innovation, but taken together they’re going to provide amazing healthcare innovations that shape the future of healthcare as we know it.

Let me give a few examples of the wave of innovations that are happening. Health sensors are exploding. Are ability to know in real time how well our body is performing is off the charts. There are sensors out there for just about every measurable aspect of the human body. The next innovation will be to take all this sensor data and collapse it down into appropriate communication and actions.

Another example, is the innovations in genomic medicine. The cost and speed required to map your genome is collapsing faster than Moore’s law. All of that genomic data is going to be available to innovators who want to build something on top of it.

3D printing is progressing at light speed. Don’t think this applies to healthcare? Check out this 3D printed prosthetic hand or this 3D printed heart. If you really want your mind blown, check out people’s work to provide blood to 3D printed organs.

If you think we’ve gotten value out of healthcare data, you’re kidding yourself. There are so many innovations in healthcare data that are sitting there waiting in healthcare data hoards. We just need to tap into that data and start sharing those findings with a connected healthcare system.

The mobile device is an incredible innovation just waiting for healthcare. We are all essentially walking around with a computer in our pocket now. We’ve already started to see the innovations this will provide healthcare, but it’s only just the beginning. This computer in our pocket will become the brain and communication hub for our healthcare needs.

I’m sure you can think of other innovations that I haven’t mentioned including robotics, health literacy, healthcare gaming, etc. What’s most exciting to me about the future of healthcare innovation is that each of these innovations will combine into a unforeseen innovation. The most powerful innovations in healthcare will not be a single innovative idea. Instead, it will come from someone who combines multiple innovations into one beautiful package.

The most exciting part of innovation is that it’s usually unexpected and surprising. I love surprises. What do you see as the future building blocks of innovation in healthcare?

The Fundamental Challenge of Building a Healthcare-Provider Focused Startup

Posted on March 6, 2015 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 kylesamani.com.

Over the past few years, the government imposed copious regulations on healthcare providers, most of which are supposed to reduce costs, improve access to care, and consumerize the patient experience. Prior to 2009, the federal government was far less involved in driving the national healthcare agenda, and thus provider IT budgets, innovation, and research and development agendas among healthcare IT vendors.

This is, in theory (and according to the government), a good idea. Prior to the introduction of the HITECH act in 2009, IT adoption in healthcare was abysmal. The government has most certainly succeeded in driving IT adoption in the name of the triple aim. But this has two key side effects that directly impact the rate at which innovation can be introduced into the healthcare provider community.

The first side effect of government-driven innovation is that all of the vendors are building the exact same features and functions to adhere to the government requirements. This is the exact antithesis of capitalism, which is designed to allow companies to innovate on their own terms; right now, every healthcare IT vendor is innovating on the government’s terms. This is massively inefficient at a macroeconomic level, and stifles experimentation and innovation, which is ultimately bad for providers and patients.

But the second side effect is actually much more nuanced and profound. Because the federal government is driving an aggressive health IT adoption schedule, healthcare providers aren’t experimenting as much as they otherwise would. Today, the greatest bottleneck to providers embarking on a new project is not money, brain power, or infrastructure. Rather, providers are limited in their ability to adopt new technologies by their bandwidth to absorb change. It is simply not possible to undertake more than a handful of initiatives at one time; management can’t coordinate the projects, IT can’t prepare the infrastructure, and the staff can’t adjust workflows or attend training rapidly enough while caring for patients.

As the government drives change, they are literally eating up providers’ ability to innovate on any terms other than the government’s. Prominent CIOs like John Halamka from BIDMC have articulated the challenge of keeping up with government mandates, and the need to actually set aside resources to innovate outside of government mandates.

Thus is the problem with health IT entrepreneurship today. Solving painful economic or patient-safety problems is simply not top of mind for CIOs, even if these initiatives broadly align with accountable care models. They are focused on what the government has told them to focus on, and not much else. Obviously, existing healthcare IT vendors are tackling the government mandates; it’s unlikely an under-capitalized startup without brand recognition can beat the legacy vendors when the basis of competition is so clear: do what the government tells you. Startups thrive when they can asymmetrically compete with legacy incumbents.

Google beat Microsoft by recognizing search was more important than the operating system; Apple beat Microsoft by recognizing mobile was more important than the desktop; SalesForce beat Oracle and SAP because they recognized the benefits of the cloud over on-premise deployments; Voalte is challenging Vocera because they recognized the power of the smartphone long before Vocera did. There are countless examples in and out of healthcare. Startups win when they compete on new, asymmetric terms. Startups never win by going head to head with the incumbent.

We are in an era of change in healthcare. It’s obvious that risk based models will become the dominant care delivery model, and this is creating enormous opportunity for startups to enter the space. Unfortunately, the government is largely dictating the scope and themes of risk-based care delivery, which is many ways actually stifling innovation.

Thus is the problem for health IT entrepreneurship today. Despite all of the ongoing change in healthcare, it’s actually harder than ever before to change healthcare delivery things as a startup. There is simply not enough attention of bandwidth to go around. When CIOs have strict project schedules that stretch out 18 months, how can startups break in? Startups can’t survive 18 month cycles.

Thus the is paradox of innovation: the more of it you’re told to innovate, the less you can actually innovate.