It’s that time again for a quick roundup of some interesting tweets happening out their in the wonderful twittersphere.

(awkward moments on Twitter) RT @techguy: Is that a change? ;-) RT @Doctor_V I’m gonna turn 33 charts into a link-baiting content farm

April 29, 2011 3:49 pm via TweetDeckReplyRetweetFavorite

@Doctor_V

Bryan Vartabedian

This series of responses made me laugh. Mostly because my response was totally facetious (and just like me in real life). I wouldn’t have said it if it were true. 33 Charts is an amazing blog. Especially if you love social media and healthcare.

Agree! RT @RichmondDoc: T2 Even if not used 2 practice medicine, SocMed can allow providers 2 support & provide resources 2 each other #hcsm

May 1, 2011 5:33 pm via TweetDeckReplyRetweetFavorite

@Colin_Hung

Colin Hung

Since we’re talking social media and healthcare, this tweet seemed appropriate. I love when people say that they don’t like Twitter because they don’t care what someone ate today. My do people that say such things not understand the real power of social media. I sum it up by saying that Twitter is amazing at connecting people.

Must read and must bookmark! RT @ahier: In case you missed it ~ a #DirectProject must read: http://bit.ly/k0A2bw

May 1, 2011 7:30 am via TweetDeckReplyRetweetFavorite

@janicemccallum

Janice McCallum

Fine, if @ahier and @janicemccallum say I must read it I will. Although, I’ll actually book mark and and post about it later.

Where health care dollars go http://j.mp/m1MnQ5

April 30, 2011 12:54 pm via ReederReplyRetweetFavorite

@erikpupo

Erik Pupo

I’m a sucker for charts. These are quite interesting. At least if you care about the costs of healthcare and where the money is spent.

Can the use of Digital Pen and Paper Technology Shorten the Path to Meaningful Use? http://su.pr/6SmKWv

April 30, 2011 11:44 am via Su.prReplyRetweetFavorite

@EMRDailyNews

EMR Daily News

I’m not sure if I’m ready to usher in the digital pen and paper technology as the path to meaningful use. Although, many of you will likely remember how much I enjoyed Shareable Ink when I first saw it.

RT @kevinmd: Our health is worsening at time when medicine has never been better http://is.gd/4Yi7SD|comments help balance biased post. #hcr

April 30, 2011 4:35 am via Seesmic for AndroidReplyRetweetFavorite

@janicemccallum

Janice McCallum

I’m not sure about the article, but I love the commentary on blogging. I love the comments on the blog. They definitely do a great job of balancing out and mistakes in my posts. Not that I’ve ever created a “biased post.” Not me;-)

Nothing like enjoying the end of the weekend by going over some tweets from interesting people in the healthcare IT and EMR world.

The first one hit me the strongest since I think I sometimes get so wrapped up in the details of EMR and healthcare IT that I forget to stop and remember really why we’re doing all of this. Thanks Diane for reminding us.

What are the ends of medicine? To cure sometimes, relieve often, comfort always. Regardless of wealth or lack thereof.

April 3, 2011 8:22 am via ÜberSocialReplyRetweetFavorite

@DianeEMeier

Diane E. Meier

After John Chilmark from Chilmark Research skipped doing his taxes (thankfully mine are done) to read about ACO’s he provided this perspective:

Reviewing #ACO rules won out, quite amazed at level of focus on pt-centered care, MU a cakewalk in comparison

April 3, 2011 5:03 pm via FlipboardReplyRetweetFavorite

@john_chilmark

John Moore

John also offered this tweet to a Kaiser resource on ACO’s:

Best source of #ACO mat’l I’ve found so far http://bit.ly/i7eqs4

April 1, 2011 3:52 pm via TweetDeckReplyRetweetFavorite

@john_chilmark

John Moore

ACO’s are a hot topic and I have a guest post coming which will hopefully shed even more light on what’s happening in Washington around ACO’s and the new legislation.

@TheGr8Chaulupa (best twitter name) and @j_schilz reminds us of the crazy channels vendors are using to sell EHR software. Although, Costco’s only a couple years after Walmart and Sam’s Club EMR was offered (4-5 posts I did on it):

I saw that. How cool! RT @j_schilz: Via my Costco Newsletter: A #MU Certified #EHR Platform Offers Costco Members a fully hosted solution.

April 2, 2011 2:42 pm via HootSuiteReplyRetweetFavorite

@TheGr8Chalupa

Erica V. Olenski

Finally, my announcement of a new EMR and HIPAA EMR was an April Fool’s joke in case you didn’t realize it when you read it. Hopefully everyone that read it enjoyed it as much as I enjoyed writing it (with Katherine Rourke’s help).

A comment on my somewhat controversial thought post about imagining an EMR without billing reminded me that I wanted to ask the question of my readers about what could replace E&M coding. Seriously, I can’t think of anyone I know that actually likes E&M coding. I know some people that are good at it and so they like that they have a skill in that area. However, I don’t remember anyone being a proponent of E&M coding because it provides better patient care or makes life easier for doctors. Am I just missing these reports? So, this leads to the important question…

What could replace E&M coding that would improve healthcare and still handle billing?

Plus, after you read the comment below, you’ll understand why improving billing could also improve many of the billing machines EMR software that’s out there as well. Let’s hear your thoughts.

Here’s the comment that prompted this thought:

The broader problem is that the billing aspects have many more insidiously negative effects than simply sending a charge transaction across an interface.

They actually degrade the quality of the documentation by requiring certain elements to support specific levels of billing. The whole issue of needing to have a certain number of elements done and documented to bill a particular E&M code is one example. A particular visit may have extremely complex history/assessment/decision-making but to get “credit” one also has to document a certain number of irrelevant review of systems items.

It is no surprise that the places that have used EHRs most effectively such as Kaiser and the VA are incentivized to give care that will produce better outcomes. They are less beholden to bureaucratic insurer-driven documentation demands that do not aid in patient care or communication.

Eliminating all of these items (and similar demands for information to fulfill PQRI and other measures that are irrelevant to a particular patient or that fragment thought processes) would improve workflow and efficiency in any system, paper or electronic. It would certainly make it easier to develop an EMR that would support patient care needs.

But just having distinct EMR and billing software isn’t going to do the trick in our current dysfunctional health care system. It is only if an EMR can be designed (and insurer/payor/regulatory demands can be synchronized) so that the health care system looks like a single payer system to the EHR user and clinicians can go about the business of treating patients.

It’s a little bit pie in the sky thinking, but sometimes that’s beneficial.

Hardly any of you have probably heard of Massive Health. Almost none of you have probably heard the name Aza Raskin. Few of you probably know that much about Mozilla Firefox beyond some of you using it to browse the internet. Let’s just say that Mozilla Firefox has changed web browsing as we know it and one of the creative people behind its success is named Aza Raskin.

Why does this matter to EMR and HIPAA? Well, Aza Raskin has announced that he’s leaving Mozilla to start a new health care startup company called Massive Health.

Currently, there’s not much information on the health care startup and only one tweet on the official Massive Health twitter account. Although, it already has 1488 followers. Which is pretty amazing for a healthcare twitter account that’s about a day old.

If you read Aza’s post about the move, you can tell that he takes a unique and thoughtful approach to design. Here’s one section that describes his goals in healthcare:

Each of us has a unique ability. I want to use mine—the knowledge to make products which are disruptively easier and more enjoyable to use—to change people’s lives. Life-changing not in the sense of a new social website or better email, but in making people’s lives materially better by helping them get and stay healthy. Anyone that’s been sick, overweight, or had to deal with a doctor knows that health is a field in dire need of humane design.

Humane Design. Sounds like a relative to the usability of EMR that I’ve talked so much about.

I’m intrigued by what Massive Health might do for healthcare. It seems like a consumer health startup more than one for doctors. I guess he has to start somewhere. I’ll be interested to see what type of creativity he brings to healthcare. A look at the Massive Health website (basically a landing page) looks like they’re going to have a lot of fun doing it too.

Today I have a lot of mixed emotions going on. Although, the one that overwhelms all of the other emotions is excitement. Yesterday was the last day of my day job and so today is my first official day as a full time entrepreneur.

It’s a big step for myself and my family, but I can’t wait to see what I’m going to be able to do online working on it full time. I’ll be continuing my work on this site and EMR and EHR. I also have a number of TV related blogs and so I’ll continue my work on those. Then, I’ll be doing a few little side consulting gigs and speaking events (like this one) to kind of bridge the gap in income.

Then, I’ll also be working to create a new website to help amateur sports teams and other organizations to fund raise (currently called Sportsriffic). I’ll be leveraging the low cost web to give as much back to the organizations as possible. Almost a “Facebook for fundraising.”

In some respects fundraising by these organizations is similar to healthcare. Fundraising hasn’t benefited from technology the way it could, similar to healthcare. I’ve also wondered how this idea might apply to non-profit hospitals, so if you’re part of that I’d love to chat with you. It’s been amazing to see how many people are affected by fundraising and how many different types of organizations could use what I’m building.

This is going to be quite the adventure. I don’t think it will change too much about what I do here. So far, people seem pretty happy with the content I’m creating. However, I’m certainly open to hear feedback on what I could do better, topics I could focus on more, etc. This is going to be an exciting year!

On the weekend I try and go a little big lighter since not as many people read on the weekend. This weekend I decided to go really light and post a couple video clips of Kathleen Sebelius’ appearance on The Daily Show with Jon Stewart.

Thanks to Neil Versel for pointing out this videos. Have a great weekend.

I came across this article that identified the top 5 wirless challenges in healthcare. They go into more detail of the challenges, but here’s their list:

1. Physical connectivity (especially in old hospitals)
2. Technology connectivity issues
3. Meeting user demand
4. Security considerations (high risk of stolen laptops)
5. Network management issues

So these challenges are really mostly focused on hospital situations or at least larger group practices. The exception is the security considerations. However, I think most people are far past the idea of wireless being any less secure than a wired connection. In fact, one could argue that wireless is actually more secure than the wired connection if it’s set up properly.

The biggest issue on this list that I see with wireless is the first one. Some of these old buildings just kill a wireless signal. Add in asbestos and the difficulty to run wire for a wireless access point and you have a real challenge getting a good wireless signal in these old buildings.

One thing I think this list and article are missing is that I think we’re going to see an ever growing trend of people using wireless broadband cards instead of the traditional wireless. Sure, in a small fixed setting, they’ll still use the traditional wireless. However, the mobile doctors doing visits to the hospitals or other locations are going to be using the wireless broadband cards more and more.

I’ve been writing quite a bit lately about Obama’s investment in EMR and healthcare IT. I find the topic completely fascinating and so I expect I’ll be writing a lot more about Obama and EMR/EHR. Hopefully I can not just talk about it, but add something to the conversation.

Related to all of this is a headline I recently read from The American Spectator that said “Obamacare Could Kill You.” While the headline is meant to attract attention, the first paragraph in the article made a lot of sense. Here’s a small portion of it:

It is probable, therefore, that many people who believe they voted merely for what the Obama-Biden campaign site calls “affordable and accessible” health care will be unpleasantly surprised by the “reform” they are about to get.

It is pretty amazing that Obama could put forth such an ideal with so little detail work on how he was going to make healthcare affordable and accessible. If like the article implies that Tom Daschle is looking at adding in more government bureaucracy to healthcare, then our healthcare system is in real trouble. It reminds me a lot of another headline I read that basically said “To see Government run health care, then Just Take a Look at Medicare.” Can you imagine?