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Email vs Text for Healthcare Communication

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The idea of improving communication in healthcare is always a hot one. For fear of HIPAA and other factors, healthcare seems to lag behind when adopting the latest communication technologies. The most simple examples are email and text message. Both are simple and widely adopted communication technologies and most in healthcare are afraid to use them.

At the core of why people are afraid is because native email is not HIPAA secure and native SMS is not HIPAA secure either. Although, there are a whole suite of communication products that are working to solve the healthcare communication security challenges while still keeping the simplicity of an email or text message. In fact, both of the other companies I’ve started or advise, Physia and docBeat, are focused on the problems of secure email and secure text. Plus, there are dozens of other companies working to improve healthcare communication and hundreds of EMR, PHR, and HIE applications that are integrating these forms of communication into their systems.

As we enter this brave new world of healthcare communication, it’s worth considering some of the intricacies of email vs text. The following tweet is a good place to start.

This is really interesting to note and I can confirm those are the general statistics for most email campaigns out there today. I’m not sure of the number of texts that are open, but it’s clear that the number of text messages that are opened is very high.

The reason this is the case is because of the expectation of what’s inside a text message vs an email. When you receive a text, you can be sure that it won’t take up more than a moment of your time. You can consume it quickly and move on with your life. The same is usually not the case with email (especially email lists). Most of the emails that are sent are lengthy because they can be. We try and pack every option imaginable into an email and so people have an expectation that if they start with the email they’re going to need time. I know this is the case because my email subscribers often thank me for my emails because they know they can get something of value quickly.

I think it was Dan Munro that pointed out an exception to the email open rate. His idea was that if the email contains an action item, then open rates are much higher. This was a good insight. There’s little doubt that if an email contains something that you have to do, then more people will open it and do the action. I don’t get a bill in my email and then don’t open it. I have to open it so I can pay the bill. I’m sure this principle can be applied in a number of ways to healthcare.

As we finally bring these common communication technologies to healthcare we need to be thoughtful about which ones we use and when we use them.

April 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.

Patients Want to Share Their Medical Data

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During the recent Dell Healthcare Think Tank which I took part in, I had an idea that I think is incredibly powerful and not talked about nearly enough. In fact, I think its reasonable to say that if we want to get healthcare costs down, then we have to learn how to do this well.

The idea revolves around how we talk about privacy of health information with patients. Far too often, patients just hear news reports that talk about all of the reasons they should fear their health information getting out in the open. Instead, they almost never hear stories about how having their health information shared with the right people will actually improve their health.

The simple fact is that if you lead with all the bad things that could possibly happen with health information in the wrong hands, then of course no patient is going to want their patient information shared. However, if they know how sharing their health information with the right people will improve their care, then patients are more than willing to share away.

Basically, what I’m saying is that sharing healthcare data has been marketed wrong. The privacy advocates are well organized and have many people fearful for what will happen with their health information. I don’t have any problem with privacy advocates, because they help us to pause to take a reasonable look at the importance of privacy. However, the need for proper privacy controls doesn’t mean that we don’t share healthcare information at all.

The beauty of all of this is that the majority of people think this is how it happens in healthcare today. They don’t realize that quite often their healthcare information isn’t traveling with them to specialists and hospitals. In fact, when patients discover that it doesn’t they’re usually quite surprised and don’t understand why it doesn’t.

I hope we can work on the data sharing message. We can share your data with the people who need it so we can improve your care. If patients hear this message, healthcare data sharing will not be feared but embraced.

March 29, 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.

Does Healthcare IT Need Stability?

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Last night during one of my favorite TV shows, Charlie Rose, he interviewed a guy about the economy. One of the discussion points that came out of this interview and that I’ve heard a lot in all the discussions about the economy is having some stability to the economy. Many argue that one of the biggest things holding our economy back is all the unknowns. When there are unknowns companies get paralyzed and hold back doing things they’d do if the economy felt stable.

I wonder if we’re experiencing the same thing in healthcare IT? Could we use some stability in healthcare IT?

Think about all the various unknowns that exist in healthcare IT. Let’s start with ICD-10. The pending ICD-10 implementation date is looming, but that date has been pushed back so many times it’s still unknown if it’s really going to happen this time. That’s the opposite of stability.

I’m sure that many also wonder if the same will be the case with EHR penalties. Will the EHR penalties go into effect? What exceptions will be made for the EHR penalties? I could easily see the EHR penalties being delayed, but then again what if they’re not?

Is it hard for anyone else to keep up with what’s happening with meaningful use? I do this every day and so I have a pretty good idea, but even I’m getting confused as it gets more complex. Imagine being a doctor who rarely looks at meaningful use. So, we’re in meaningful use stage 1, but meaningful use stage 2 is coming, unless you didn’t start meaningful use stage 1 and then meaningful use stage 2 won’t come until later. Oh, and they’re making changes to meaningful use stage 2. That’s right and they’re also coming out with meaningful use stage 3. However, don’t worry too much about meaningful use stage 3 because a lot of people are calling for it to be slowed down. So, does that mean that meaningful use will be delayed? Now how does the meaningful use stages match with the EHR certifications? Which version of my EHR software does which stage of meaningful use?

I think you get the picture.

Of course, I haven’t even mentioned things like ACO’s, HIE’s, 5010, HIPAA, RAC Audits, Medicare/Medicaid cuts, or healthcare reform (ACA) to name a few others.

It’s a messy healthcare IT environment right now. We could definitely use some stability in healthcare.

February 12, 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.

Telemedicine Panel at CES Hosted by HealthSpot

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I had the chance to attend a Telemedicine panel today at CES that was put together by HealthSpot (see my previous post about HealthSpot at CES). They put together a good panel that included:
Peter Tippett, MD, PHD – Vice President, Connected Healthcare Solutions, Verizon
John F. Jesser – Vice President, Health Care Management, WellPoint
William Wulf, M.D. — Central Ohio Primary Care
Leslie Kelly Hall — Healthwise

The panel was an interesting discussion, but I think the underlying discussion really centered around how screwed up many parts of healthcare are right now. This showed itself in two different ways. One was that telemedicine could possibly fix some of those screwed up parts of healthcare. Second, telemedicine is actually hard to execute because of some of the screwed up parts of healthcare. It’s kind of odd to look at it that way.

I tweeted a number of the comments that struck me and so I thought I’d share them here for those who weren’t following along on Twitter.


This was a fitting comment at a “consumer” electronics show.


I think there are still some wackos;-), but I think the message they send is clear.


This would be a monumental achievement if we can embrace HIPAA and make the technology happen. I think the key message is: HIPAA should not be used as an excuse.


Such a no brainer question with an easy answer. Why is it so hard to do?


Will telemedicine become the “standard of care” so that this becomes a big issue? I hope we don’t reach the point that this is the reason we implement telemedicine, but it might take something like it to get people off the proverbial couch.

January 9, 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.

Hospitals Use EMR Data To Target Marketing Campaigns

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When we talk about the benefits we can derive from compiling and analyzing EMR data, most of us focus on care and efficiency improvements, and to some extent population health.  But what if hospitals used EMRs to find appropriate targets for marketing efforts?  Is that kosher?

I don’t know, but it’s clear some hospitals have decided that it is. For example, a recent article in the Columbus Dispatch tells the tale of two health systems which have been data-mining their EMRs to target mailings on health issues to patients in the community.

According to the piece, regional health system OhioHealth has been using this approach for six years, and Mount Carmel Health System has for two years. Both are non-profit systems with large presences in the areas they serve.

It seems that these health systems are largely using these mailings to address patients’ specific health concerns. For example, OhioHealth has sent messages to diabetic patients and others with heart disease. Mount Carmel, for its part, has sent out mammograms and colorectal screenings, as well as to invite patients to seminars on joint replacement and health fairs.

But OhioHealth goes a step further and targets households with higher incomes.

Of course, both parties swear on a stack that none of this violates HIPAA, because marketers never see an individual’s health information.  And maybe they’re right.

As for me, I could go either way as to whether this is an ethical use of medical data. While it may indeed be legal, it’s discomfiting to know that hospitals might be using my clinical data for non-clinical purposes.

That being said, if health education and marketing efforts are done in a tasteful way which doesn’t invade my privacy — or expose my medical situation to the mailman — I can see the benefits.  Sometimes the right reminder or piece of  education can change a patient’s behavior in a timely manner.

And the truth is, if hospitals are going to spend millions and millions on EMRs, maybe this is a way to squeeze those extra bucks out of the system that will help pay for the investment.

I don’t know. I guess it’s something of a tossup. Readers, how do you feel about this issue? Is your hospital mining EMRs for marketing purposes?

November 14, 2012 I Written By

Katherine Rourke 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.

Hospital Forced To Provide EMR Data Access By Court

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A New Hampshire hospital has been forced by the state’s Superior Court to provide public health officials with access to its EMR so they can further investigate a major hepatitis C outbreak.

Exeter Hospital had been ordered by the state’s Division of Public Health Services to release patient records, but had  challenged the order, arguing that it would be violating state and federal law if it provided free access to EMR records.

The issue dates back to July, when a lab technician formerly employed by the hospital was arrested in connection of a hep C outbreak affecting more than 30 patients. The lab tech, who has hep C, allegedly stole fentanyl-filled syringes from the hospital, injected the fentanyl, then refilled the dirty syringes with another substance.

The hospital sought guidance from the courts in an effort to learn just how much access it would have to provide without running afoul of HIPAA and state privacy laws.  (If I were running Exeter Hospital I certainly would have done the same thing; otherwise, one would think  it’d be wide-open liable to suits by patients who objected to the data sharing.)

Now, it seems, the hospital is satisfied that patients involved in the outbreak are adequately protected. From its official statement on the matter:

The Court pointed out that the State needs to follow very specific, CDC-sanctioned protocols in collecting data from Exeter Hospital’s electronic medical record system and can only obtain the minimum amount of information necessary to complete its investigation. The Court has also emphasized that the information collected by the State cannot be re-published which helps to protect the privacy of patients.

For both the patients’ and Exeter’s sake, let’s hope that the public health authorities involved handle such explosive data with extreme care.  A data breach at this point would not only have devastating consequences — particularly if the hepatitis C sufferers’ names were made public — it would also plunge all involved into a legal nightmare. For their sake, I’m hoping for the best.

November 13, 2012 I Written By

Katherine Rourke 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.

Access To Clinical Data Too Easy Via Phone

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Lately, I’ve had reason to be in touch with my health insurance company, my primary care doctor and multiple specialists.  In speaking with each, what I’ve noticed is that the data they collect to “protect my privacy” isn’t likely to do a good job. And I’ve been wondering whether an EMR can actually help tighten up access.

When I called to discuss clinical matters, both the payer and providers asked for the same information: My date of birth, my street address and my name. As far as I know, folks, you can get all of that information on a single card, a driver’s license.  So, anyone how finds or steals or has access to my wallet has all the info they need to crawl through my PHI.

So, OK, let’s say providers and payers add a requirement that you name the last four digits of your social security card.

There’s a few problems with that approach. First, anyone who has your wallet may well have your Social Security Card.  Second, storing patients’ SSNs in the clear in an EMR is an invitation to be hacked, as the SSN is the gold standard for identity theft. Third, if you want to store them in a form that only allows the last four digits to be read, that’s another function you need to add to your system.

So, what’s the solution? Would it work to have patients identify which doctor they see (something a thief wouldn’t know) or a recent treatment or procedure they’d had?  Probably, although some patients — forgetful elderly, or the chronically ill with multiple providers — might not remember the answers.

Seems to me that when there’s universal use of patient portals by both providers and payers, this problem will largely go away, as patients will be able to be looking at their own records when talking to providers. This will make a more sophisticated security screening possible.

But in the mean time, I’m troubled to know that my payer and several of my doctors use a security method which can be so easily compromised.  Do any of you have suggestions as to what those offices might do in the interim between now and when they have a useful portal to offer?

October 26, 2012 I Written By

Katherine Rourke 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.

Verizon Launches HIPAA-Compliant Cloud Services

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Last month, I shared some of Verizon’s big plans for the medical space with you, including their desire to become the industry’s default carrier of secure healthcare data.  This week, Verizon has launched its cloud service line, and I wanted to share some of the details on how it’s set up with you.

Verizon’s Enterprise Solutions division is offering five “healthcare-enabled” services, including colocation, managed hosting, enterprise cloud, an “enterprise cloud express edition” and enterprise cloud private edition. In addition to the services, Verizon provides a HIPAA Business Associate Agreement which, one would assume, is particularly stringent in how it safeguards data storage and tranmission between parties.

The new Verizon services will be offered through cloud-enabled data centers in Miami and Culpeper, Va. run by Terremark, which Verizon acquired some time ago. Security standards include PCI-DSS Level 1 compliance, ITIL v3-based best practices and facility clearances up to the Department of Defense, Verizon reports.

In addition to meeting physical standards for HIPAA compliance, Verizon has trained workers at the former Terremark facilities on the specifics of handling ePHI, Verizon exec Dr. Peter Tippett told Computerworld magazine.

You won’t be surprised to learn that Verizon is also pitching its (doubtless very expensive) health IT consulting services as well to help clients take advantage of all of this cloud wonderfulness.

Not surprisingly, Verizon notes in its press release that “each client remains responsible for ensuring that it complies with  HIPAA and all other applicable laws and applications.”  If I were Verizon, I’d be saying that too, and doubtless states the obvious. That being said, it does make me wonder just how much they manage to opt out of in their business associate agreement.  Call me crazy, but I think they’d want to leave as much wiggle room as humanly possible.

The bigger question, as I see it, is how big the market for these services really is at present. According to the Computerworld story, only 16.5 percent of healthcare providers use public or private clouds right now. Verizon may be able to turn things around on the strength of its brand alone, but there’s no g uarantees. I guess we’ll have to wait and see.

October 4, 2012 I Written By

Katherine Rourke 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.

Verizon Hopes To Be Secure Healthcare Network For All

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If you’re like me, you might be wondering how carriers are  looking at their role in the healthcare business — and whether some of their talk about mHealth is just noise.  (I’ve always seen mHealth as a space ripe to be be dominated by applications developers and device manufacturers, not carriers.)

To get my head straight, I recently had a conversation with Dr. Peter Tippett, chief medical officer and vice president of Verizon Connected Health Care. In it, he changed my view of what Verizon is doing in mHealth, and moreover,  what ground Verizon specifically hopes to own in healthcare over the next several years.

When I think Verizon I think switches and routers and cables, not consumer-facing applications and medical devices. And before I talked to Dr. Tippett, I assumed that Verizon’s main healthcare efforts likely involved going head to head with other wireless/wireline connectivity players for connectivity business in some form.

Well, think again.  Verizon’s Connected Health Division, says Tippett, is aiming to set the bar much higher.

“The question is, ‘what happens after wireless data?’,” Dr. Tippett said. “This isn’t a two month plan, this is a strategic extension of Verizon to transform the healthcare industry using our huge capability around the world.”

On the more immediate front, Verizon has mHealth technology under development which, to my mind, would solve a difficult problem.  For five years, he says, Verizon has been developing a new mHealtlh platform which will tie together data from testing devices like blood pressure cuffs, weight scales and EKGs into an analytics engine that makes sense of it all.

“No doctor wants four glucoses a day from 1,000 patients,” Dr. Tippett says. “Just mobilizing the data isn’t enough. You’ve got to create a cloud service that can do big data analytics on it and normalize the data, then trigger the alerts to the right people — including patients.”

I’m going to keep my eye on the mHealth platform, which definitely intrigues me.

But the really big play for Verizon in this space seems to be in HIPAA-secure data hosting and exchange.  Verizon already has a massive presence around hosting, app management, security, identity management and the cloud, having added Cybertrust and Terramark (enterprise hosting) to build up its lineup.

Verizon now offers secure data sharing on multiple levels:

*  A “medical data exchange” — not unlike the exchange banks use to pass transactions back and forth — allowing any member to share information using Verizon’s security services.

* An exchange “identity layer” which is secure enough to allow Schedule 2 drugs to be prescribed. According to Dr. Tippett, 40 percent of doctors in the U.S. are already using it.

* A global network of highly-secured data centers.

Members of the medical ecosystem who use secure Verizon services can consider their HIPAA compliance and security matters handled, then focus on their core business, Dr. Tippett says. And that can scale to hundreds of millions of users on the network, he notes.

Clearly, this doesn’t sound like the broadband carrier talking — these folks are out to take business from players as diverse as Verisign, IBM and the database giants.  It makes sense to me, on the surface, but in any grand vision there are holes to be picked.

You tell me:  Does Verizon sound like it’s positioned right to become the default secure healthcare backbone?

September 11, 2012 I Written By

Katherine Rourke 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.

The Immortal Life of Healthcare IT, Secure Texting Scam, and iPhone Heart Rate — Around Health Care Scene

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EMR and EHR

The Immortal Life of Healthcare IT

Patient engagement has evolved in many ways in the past century. While patients used to rely on doctors for any information regarding health care, it’s now common for patients to “diagnose” themselves, before even stepping foot into a doctor’s office. “The Immortal Life” by Henrietta Lacks, and the authors thoughts, are compared and contrasted to life nowadays.

Interview with Verizon Wireless’ Arthur Lane

A leader for mobile health solution development for Verizon’s Connected Health, Arthur Lane, was interviewed over at EMR and EHR this past week. He focuses his work on developing solutions that help with Verizon’s wireless, cloud, and security. The interview focuses on Health IT and mHealth, and what is in the works at Verizon. He discussed the benefits of mHealth, and what is to come in the future.

Hospital EMR and EHR
What Won’t Happen in #HIT By September 2013

There’s a lot going on with Health Care IT, and it seems as if we’re always hearing about the latest and greatest innovation. However, despite the leaps and bounds that are being made, we can’t expect everything in the EMR industry to be perfect by next year. Anne Zeigler talks about things that won’t be happening in #HIT over the next year, including lack of major growth in remote monitoring and no high penetration HIE.

Meaningful Healthcare It News With Neil Versel

Sampling of opinions on meaningful use Stage 2

The meaningful use Stage 2 final rules have caused quite a bit of discussion across the web since they were announced. Some good, some bad. Neil Versel compiled some of the opinions and thoughts he has discovered over the past few weeks, and created this post with some of them.

Wired EMR and EHR Doctor

The Secure Texting Scam

Medical practices may be getting offers from companies that offer “secure texting,” that won’t violated HIPAA standards. However, how secure can texting be? Dr. Michael Koriwchak talks about the “secure texting scam,” and talks about the reasons why secure texting can fail. Don’t get caught in this trap, and end up paying a large amount for a product that might not deliver what you think.

Smart Phone Health Care

Detect Heart Rate With iPhone Camera – #HITsm Chat Discovery

Finding out your heart rate is now easier than ever — simply by using the camera on your iPhone. This new way to detect heart rate requires no special equipment, beyond an iPhone 4. The app tracks the information and allows the user to view changes over time, among other features.

September 9, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.