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How Do You Improve the Quality of EHR Data for Healthcare Analytics?

Posted on May 8, 2013 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.

A month or so ago I wrote a post comparing healthcare big data with skinny data. I was introduced to the concept of skinny data by Encore Health Resources at HIMSS. I absolutely love the idea of skinny data that provides meaningful results. I wish we could see more of it in healthcare.

However, I was also intrigued by something else that James Kouba, HIT Strategist at Encore Health Resources, told me during our discussion at HIMSS. James has a long background in doing big data in healthcare. He told me about a number of projects he’d worked on including full enterprise data warehouses for hospitals. Then, he described the challenge he’d faced on his previous healthcare data warehouse projects: quality data.

Anyone that’s participated in a healthcare data project won’t find the concept of quality data that intriguing. However, James then proceeded to tell me that he loved doing healthcare data projects with Encore Health Resources (largely a consulting company) because they could help improve the quality of the data.

When you think about the consulting services that Encore Health Resources and other consulting companies provide, they are well positioned to improve data quality. First, they know the data because they usually helped implement the EHR or other system that’s collecting the data. Second, they know how to change the systems that are collecting the data so that they’re collecting the right data. Third, these consultants are often much better at working with the end users to ensure they’re entering the data accurately. Most of the consultants have been end users before and so they know and often have a relationship with the end users. An EHR consultant’s discussion with an end user about data is very different than a big data analyst trying to convince the end user why data matters.

I found this to be a really unique opportunity for companies like Encore Health Resources. They can bridge the gap between medical workflows and data. Plus, if you’re focused on skinny data versus big data, then you know that all of the data you’re collecting is for a meaningful purpose.

I’d love to hear other methods you use to improve the quality of the EHR data. What have you seen work? Is the garbage in leads to garbage out the key to quality data? Many of the future healthcare IT innovations are going to come from the use of healthcare data. What can we do to make sure the healthcare data is worth using?

Rural Hospital EHR

Posted on April 2, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I mentioned in my previous post on EHR Penalties and Meaningful Use Failure, I had a really good discussion with Stoltenberg Consulting about rural hospital EHR at HIMSS this year. While Stoltenberg no doubt works with hospital systems of every size, I could tell that they had a real affection for the rural hospital EHR challenge. Plus, it was great to be educated some more on the challenges rural hospitals face when it comes to meaningful use and EHR since I’ve been doing a lot more writing about it on my Hospital EMR and EHR website.

I collected a few observations from my chat that I think are worth talking about when it comes to the unique rural hospital EHR situation. One of those ideas is the challenge that rural hospitals have in providing EHR help desk support. It’s worth remembering that hospitals are 24/7 institutions that need 24/7 support in many cases. Now imagine trying to staff an EHR help desk for a small rural hospital. From what I’ve seen, most can barely have an IT support help desk available, let alone an EHR help desk. Stoltenberg Consulting wisely sees this as a great opportunity for EHR consults to provide this type of service to rural hospitals. If you spread the cost of a 24/7 EHR help desk across multiple hospitals, the costs start to make sense.

Another interesting observation was that most rural hospitals are mostly Medicare and Medicaid funded. I’m not an expert on the pay scales of rural America, but when you look at the costs of living in the rural areas you realize that they don’t need to make as much money to live. Plus, I imagine in some cases there just aren’t that many jobs available to them. If they aren’t making as much money, then they’re more likely to qualify for Medicare and Medicaid. Why does this matter?

The amount of Medicare a rural hospital has matters a lot since if they don’t show “meaningful use” of a “certified EHR” then they will incur the meaningful use penalties. It’s simple math to see that the more Medicare reimbursement you receive the larger the EHR penalty you’ll incur.

There’s something that doesn’t feel right about the rich hospitals who’ve likely implemented an EHR before the stimulus getting paid the EHR incentive money while rural hospitals who can barely afford to keep their doors open getting not only penalties, but large penalties because of their large Medicare reimbursement. It’s probably water under a bridge now, but I could see why Stoltenberg Consulting suggested that rural and community hospitals should have been given more time to show meaningful use of an EHR.

As I mentioned, I’m still learning about the rural hospital EHR space, but I found these points quite interesting. If you have a different view or have experience that differs, I’d love to hear about it in the comments. No doubt there are thousands of unique rural environments and I’d love to learn more about them and how they’re approaching EHR. Please share your experiences and thoughts in the comments.

HIPAA Omnibus – What Should You Know?

Posted on March 26, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I had the great opportunity to sit down with HIPAA expert, Rita Bowen from HealthPort, at HIMSS 2013 and learn more about the changes that came from the recently released HIPAA Omnibus rule. The timing for this video is great, because today is the day the HIPAA Omnibus rule goes into effect. In the video embedded below, Rita talks about what you should know about the new HIPAA changes, the new business associate requirements, and restricting the flow of sequestered health information.

Analytics-Driven Compassionate Healthcare at El Camino Hospital

Posted on March 25, 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.

Given its location in the heart of Silicon Valley, it may not be remarkable that El Camino Hospital was the first hospital in the US to implement EMR. What IS remarkable is that El Camino implemented EMR 51 years ago, leveraging an IBM mainframe system that Lockheed Martin refactored for healthcare from its original intended use for the space program.

Take a moment to process that. El Camino didn’t need PPACA, Meaningful Use, HITECH, or HIPAA to tell them health data is critical. El Camino saw the value in investing in healthcare IT for electronic data capture and communication without federal incentive programs or lobbyists. With that kind of track record of visionary leadership, it’s no wonder they became early analytics program adopters, and recently turned to Health Care DataWorks (HCD) as a trusted partner.

When I sat down with executive leadership from El Camino and HCD to discuss the journey up Tom Davenport‘s analytics maturity scale from rudimentary operational reporting to advanced analytics, I expected a familiar story of cost pressure, clinical informatics, quality measure incentives or alternative payment models as the business drivers for new insights development. Instead, I heard the burgeoning plan for a visionary approach to patient engagement and “analytics-driven compassionate care”.

Greg Walton, CIO of El Camino Hospital, admitted that initial efforts to implement an analytics program had resulted in “textbook errors”: “’Competing on Analytics’ was easier to write than execute,” he said. Their early efforts to adopt and conform to a commercially-available data model were hindered by the complexity of the solution and the philosophy of the vendor. “One of the messages I would give to anybody is: do NOT attempt this at home,” Greg laughed, and El Camino decided to change their approach. They sought a “different type of company…a real-life company with applicable lessons learned in this space.”

“The most important thing to remember in this sector: you’re investing in PEOPLE. This is a PEOPLE business,” Greg said. “And that if there’s any aspect of IT that’s the most people-oriented, it’s analytics. You have to triangulate between how much can the organization absorb, and how fast they can absorb it.” In HCD, El Camino found an analytics organization partner whose leadership and resources understand healthcare challenges first, and technology second.

To address El Camino’s need for aggregated data access across multiple operational systems, HCD is implementing their pioneering KnowledgeEdge Enterprise Data Warehouse solution,including its enterprise data model, analytic dashboards, applications and reports. HCD’s technology, implementation process, and culture is rooted in their deep clinical and provider industry expertise.

“The people (at HCD) have all worked in hospitals, and many still work there occasionally. Laypersons do not have the same understanding; HCD’s exposure to the healthcare provider environment and their level of experience provides a differentiator,” Greg explained. HCD impressed with their willingness to roll up their sleeves and work with the hospital stakeholders to address macro and micro program issues, from driving the evaluation and prioritization of analytics projects to identifying the business rules defining discharge destination. And both the programmers and staff are “thrilled,” Greg says: “My programmers are so happy, they think they’ve died and gone to heaven!”

This collaborative approach to adopting analytics as a catalyst for organizational and cultural change has lit a fire to address the plight of the patient using data as a critical tool. Greg expounded upon his vision to achieve what Aggie Haslup, Vice President of Marketing for HCD, termed “analytics-driven compassionate care”:

We need to change the culture about data without losing, and in fact enhancing, our culture around compassion. People get into healthcare because they’re passionate about compassion. Data can help us be more compassionate. US Healthcare Satisfaction scores have been basically flat over the last 10 years. Lots of organizations have tried to adopt other service industry tools: LEAN,6S; none of those address the plight of the patient. We’ve got to learn that we have to go back to our roots of compassion. We need to get back to the patient, which means “one who suffers in pain.” We want (to use data) to help understand more about person who’s suffering. My (recent) revelation: what do you do w/ guests in your house? Clean the house, put away the pets, get food, do everything you can to make guests comfortable. We want to know more about patients’ ethnicity, cultural heritage, the CONTEXT of their lives because when you’re in pain, what do you fall back on? Cultural values. We want a holistic view of the patient, because we can provide better, compassionate care through knowing more about patients. We want to deploy a contextual longitudinal view of the patient…and detect trends in satisfaction with demographics, clinical, medical data.

What a concept. Imagine the possibilities when a progressive healthcare provider teams with an innovative analytics provider to harness the power of data to better serve the patient population. I will definitely keep my eye on this pairing!

The Health IT Tablet Shift and Some Hope for Windows 8

Posted on March 20, 2013 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.

One of the most amazing shifts that we’ve seen in healthcare is the acceptance of the tablet form factor. I’ve been fascinated with tablets since they first came out. The idea was always great, but in implementation the idea always fell apart. Many a sales rep told me how the tablet was going to be huge for healthcare. Yet, everyone that I know that got one of the really early tablets stopped using it.

Of course, the tablets that I’m referring to our the pre-iPad tablets. As one Hospital CTO told me at HIMSS, “the iPad changed tablets.

It’s so true. Now there isn’t even a discussion of whether the tablet is the right form factor for healthcare. The only question I heard asked at HIMSS was if a vendor had a tablet version of their application. In fact, I’m trying to remember if I saw a demo of any product at HIMSS that wasn’t on a tablet. Certainly all of the EHR Interface Improvements that I saw at HIMSS were all demonstrated on a tablet.

As an extension of the idea of tablets place in healthcare, I was also interested in the healthcare CTO who suggested to me that it’s possible that the Windows 8 tablet could be the platform for their health systems mobile approach. Instead of creating one iPad app that had to integrate all of their health system applications, he saw a possibility that the Windows 8 tablet could be the base for a whole suite of individual applications that were deployed by the health system.

I could tell that this wasn’t a forgone conclusion, but I could see that this was one path that he was considering seriously when it came to how they’d approach mobile. I’m sure that many have counted out Microsoft in the tablet race. However, I think healthcare might be once place where the Windows 8 tablet takes hold.

When you think about the security needs of healthcare, many hospital IT professionals are familiar with windows security and so they’ll likely be more comfortable with Windows 8. Now we’ll just have to see if Windows 8 and the applications on top of it can deliver the iPad experience that changed tablets as we know them.

EHR Penalties after Meaningful Use Failure

Posted on March 15, 2013 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.

While at HIMSS I had a discussion with the consulting firm Stoltenberg Consulting. I was really intrigued by their approach to EHR consulting and will likely write more about it later. Plus, the started what in many ways became a theme of my HIMSS experience around rural healthcare EHR. You can be sure I’ll be writing about rural EHR here on this site and on Hospital EMR and EHR much more in the future.

In our casual introductory conversation we had a good discussion about how many of the smaller hospitals look at meaningful use and the EHR incentive money. Needless to say, many of these smaller institutions are faced with a huge challenge when it comes to adopting an EHR and showing meaningful use. Many of these rural hospitals barely have an IT staff and the CFO usually takes care of the IT environment. I heard one story at HIMSS where the IT person at a rural hospital started out as the janitor and his home IT skill made him the most qualified person to help.

Needless to say, rural and smaller hospitals have some real challenges facing them when it comes to EHR adoption and showing meaningful use of that EHR. Although, an even worse thought struck me in my discussions about these smaller hospitals.

Imagine many of these smaller hospitals making a good faith effort to adopt EHR and show meaningful use. It’s not that hard to see many of these hospitals falling short of the meaningful use standard. What will this mean to that organization? They’ve spent millions on an EHR. They won’t get the EHR incentive money they likely used as a justification for the EHR spending. To add insult to injury, now they’re going to get penalized for not being meaningful users of an EHR.

This scenario honestly makes me sick to even consider. Something similar could easily happen in small ambulatory practices as well. The scale of the damage will just be different. I expect in meaningful use stage 1 this won’t likely be a problem since it’s self attestation. However, this could become a much bigger issue in meaningful use stage 2.

Although, consider an organization who fails a meaningful use stage 1 audit. In most cases you can’t go back and fix whatever you failed in the audit. You’d be in a very similar situation where you have to return the EHR incentive money and would be open to the meaningful use penalties. At least that’s my understanding of how the EHR penalties will be implemented. If you know otherwise, I’d love to hear it.

While I think the above scenarios are brutal, hopefully this will also serve as a warning for those hospitals pursuing EHR and the EHR incentive money. Be sure you are able to show meaningful use or you’ll not only lose out on the incentive money, but you’ll also be open to the EHR penalties. Not to mention, are you ready for a meaningful use audit?

Meaningful Use and Sequestration

Posted on March 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m a little surprised that I didn’t hear more discussion of sequestration and it’s possible impact on meaningful use and other EHR and healthcare IT related programs. Maybe I was just in the wrong circles for this discussion, but I didn’t hear about sequestration until the final day of HIMSS.

I think the effects of sequestration on meaningful use, EHR and other Health IT aren’t exactly known right now. Although some hints at the potential effects of sequestration were given at HIMSS 2013.

Jessica Kahn sent out the following tweet about the topic:

Of course, it’s hard to read into exactly how the EHR incentive payments could be effected by sequestration. I can’t imagine the cuts will allow them to pay a lower incentive amount since that’s been legislated. I could see it slowing payments down. I guess we’ll have to see what Jessica means by her tweet.

Farzad Mostashari also commented on the effect to ONC of sequestration in this PhysBizTech article Q&A:
Q: By how much will sequestration reduce your budget and what has to give?

A: It’s 5 percent: A $3 million cut for an office whose budget has been $60 million since the day it was founded by President George W. Bush. This is going to hurt. We are not furloughing people, which is the bulk of the budget. So our contracts are going to take a big hit.

What do you think will be the impact on EHR and healthcare IT because of sequestration?

A Little Fun at #HIMSS13 – The Harlem Shake Meme

Posted on March 6, 2013 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.

A lot of business gets done at HIMSS. Although, I think that most would agree that one of the biggest values of going to HIMSS is the relationships you build which lead to business in the future. HIMSS often just lays the groundwork of relationships that can make future things happen.

With that in mind, it’s not surprising that there’s a lot of craziness that happens at HIMSS as well. Turns out a lot of people agreed that doing the Harlem Shake would be a great way to bond with people at HIMSS. Plus, I have to admit that I enjoy the break from the sometimes straight laced HIMSS event.

With that in mind, I’ve aggregated the Harlem Shake videos that were done at HIMSS 2013. They are all pretty entertaining to watch.

First up is a Harlem Shake at the Metro booth. This might be my favorite, because it includes a robot, a couple Healthcare Scene bloggers, and a number of #HITsm friends. I think you’ll enjoy it too. (Watch for the behind the scenes footage to be posted later).

Next up is the Emdeon Harlem Shake video. I love the girl in the chair that’s shaking while spinning. Too funny.

Finally, check out the CDW Harlem Shake. Nice job on the costumes for this one.

Nice work by all involved. I love seeing stuff like this since I think many take things a little bit too seriously. Nothing wrong with having a little fun in the process.

Where You’ll Find Me at HIMSS 2013

Posted on February 28, 2013 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 can’t believe that HIMSS 2013 is finally here. Well, it’s almost here. I fly out on Saturday, and I’m seeing the tweets come in from the various vendors who are arriving in New Orleans to setup their booths. For those that can’t attend, we’ll do our best to give you a peek into the event. For those that can attend, I always love to meet those who read EMR and HIPAA in person. The following is a list of events that I’m hosting, participating in or otherwise engaged. All of these events and more are also listed in the Influential Networks HIMSS 2013 Event Guide.

I look forward to seeing many of you at these great events and in the hallways of HIMSS. It’s always great to see old friends and make new ones.

#SocialMedia and #Influence Tweetup
Monday, March 4, 2013
2:30 PM – 3:30 PM
Description:
Discuss the best approaches to influencing audiences around your ideas, products or services with John Lynn and Shahid Shah, InfluentialNetworks.com. Learn how social media can be used to get your messages out to those who matter. Discover common myths and misconceptions about new media, and learn proven strategies and techniques to get the most out of social media.
Location: Social Media Center

Discussion with Rita Bowen, Chief Privacy Officer at HealthPort, About HIPAA Omnibus Rule
Tuesday, March 5, 2013
12:00 PM – 1:00 PM
Description:
Come learn from one of the leading experts on HIPAA, Rita Bowen, as she discusses the latest details on the new HIPAA Omnibus rule with John Lynn, HealthcareScene.com.  We’ll talk about all the changes with business associates, how to make sure your compliant, and making a smooth transition to the new rule.
Location: HealthPort Booth #6841

New Media Meetup at #HIMSS13 Sponsored by docBeat
Tuesday, March 5, 2013
6:00 PM – 8:00 PM
Description:
Great food, free drinks, and time to mingle with the best and brightest that healthcare social media has to offer.  Come and meet people you’ve only connected with online and find new friends.  The New Media Meetup is where the online world meets offline.
Location: Mulate’s Party Hall – 743 Convention Center Boulegvard, New Orleans, LA
Register to attend: http://tinyurl.com/HIMSS13NMM

Point of Care Video with Metro
Wednesday, March 6, 2013
12:30 PM – 1:00 PM
Description:
Come learn more with John Lynn, HealthcareScene.com, about Metro’s latest point-of-care systems, AccessPoint mobile computing system, and their Metro Access platform.  We’ll be shooting a video of their latest products.  Don’t worry, you don’t have to be in the video unless you want to be.
Location: Metro Booth #6312

4th Annual New Media Meetup at HIMSS 2013 Sponsored by docBeat

Posted on February 14, 2013 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.

For those of you planning to attend the annual HIMSS Conference in New Orleans, I’m pleased to announce the details for the 4th Annual New Media Meetup at HIMSS 2013.

It’s amazing to think that 4 years have already past since that first event, but I’m really excited by what we’ve put together for all those planning to be in New Orleans for HIMSS. The New Media Meetup is one of the highlights of HIMSS for me each year and I expect this year to be no exception.

A big thanks to docBeat for sponsoring the event and making is possible for those of us in New Media to get together over food and drinks at HIMSS. I hope everyone will check out docBeat and thank them for sponsoring the event.

Now for the details of the event…

Register Here!

When: Tuesday 3/5 6:00-8:00 PM
Where: Mulate’s Party Hall – 743 Convention Center Boulevard, New Orleans, LA MAP
Who: Anyone who uses or is interested in New Media (Blogs, Twitter, Social Media, etc)
What: Food, Drinks, and Amazing People

About Our Sponsor
docBeat Secure Text Messaging Logo
docBeat® allows physicians and other healthcare professionals to seamlessly communicate with one another using their mobile phone or web browser while ensuring HIPAA compliance and avoiding liability issues. Plus, there’s no more dealing with the hassle of being on hold to find out who is on call or busy. docBeat® allows physicians to provide a docBeat phone number to be reached at while keeping their actual phone number private. For more information visit www.docbeat.co.

A big thanks also goes out to Erin and Beth from The Friedman Marketing Group for helping us locate a great venue in New Orleans and helping us plan the event. They are class acts and I always love working with them and their PR company.

Finally, thanks as always to all the members of Influential Networks and Healthcare Scene that help us promote the New Media Meetup. It’s beautiful to use the power of social media to put on such a great social media event at HIMSS.

Let me know if you have any questions and I look forward to seeing many of you in New Orleans very soon!