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These 5 Innovative Companies Are Cause for Health IT Hope

Posted on October 1, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

When the topic is health IT, it’s easy to get caught up in discussing the major EMR players.

And because of Meaningful Use, there’s a tendency for everyone to do the same things — even if they go about it in different ways. Whether you’re a giant like Epic, an upstart like Kareo or a specialty firm like the gastroenterology-focused gMed, you’re likely making sure, for example, that your customers will be able to exchange structured care summaries with other providers and with patients.

But there’s still plenty of innovation in health IT, much of it with little or no connection to MU2 or other federal requirements. Startups all over the country are trying to improve lives through more efficient collection and use of data.

Here’s a sampling of startups and specific innovations:

  • HealthLandscape. This Cincinnati-based firm markets a mapping application that lets you input data from a variety of sources. The idea is to better understand health information by visualizing it. The company is a subsidiary of the nonprofit Health Foundation of Greater Cincinnati, which worked with the American Association of Family Physicians and the Robert Graham Center to develop the platform.
  • SwiftPayMD. This iPhone and iPad app from Atlanta-based Iconic Data allows physicians to note diagnostic and billing codes by voice right after seeing a patient. I have to admit, when I stopped to think about it, I was surprised that doctors couldn’t already do this. The major selling point: It helps practices to get paid as much as two weeks sooner.
  • Vivify Health. Based in Plano, Texas, this startup has created a cloud-based platform for monitoring and testing patients remotely. Its system works with just about any consumer mobile device to provide customized care plans, coaching, educational videos and interactive video conferencing. In a press release, Vivify Health said it’s helping hospitals, home health agencies, payers and others to reduce readmissions, manage chronic diseases and improve care transitions. It received funding this year from Ascension Health Ventures and Heritage Group.
  • Drchrono. This Mountain View, Calif.-based company bills its flagship product as “the original mobile EHR built for the iPad.” It was part of the Y Combinator, a Mountain View-based seed accelerator, in 2011. Drchrono in 2012 raised $2.8 million in funding led by venture capitalist Yuri Milner.
  • Doc Halo. This firm, based in Cincinnati, makes possible HIPAA-secure texting. (If this list seems slightly Cincinnati-centric, it’s because I worked in the city for eight years and know the market better than I know others.) Many doctors use regular text messaging to discuss patient information, but they shouldn’t. Doc Halo’s mobile app system uses several levels of encryption.

These are just a few projects that I thought were cool. Based on what they’re doing, there’s plenty to be hopeful about in health IT. There are, of course, many other firms equally worthy of mention. And there are now accelerator programs all over the country specifically for health IT startups.

I often get the feeling that the federal government’s involvement is taking the joy out of health IT. That’s not the case, but amid the push to meet MU2 requirements, you might have to look a little harder to find it.

And with these startups, here it is.

Disclosure: gMed and DrChrono are both advertisers on this site.

Patient Engagement Platforms, iPhones Replace Doctors, and a Wireless Health Research Center – #HITsm Chat Highlights

Posted on August 25, 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.

Every week, HL7 Standards, hosts a #HITsm Tweet Chat and poses four questions “on current topics that are influencing healthcare technology, health IT, and the use of social media in healthcare.” It’s always a great discussion and also a great chance to meet a wide variety of people that are passionate about healthcare IT.

In case you missed it, or are curious about what went on this week, we’ve put together the list of topics with some of the best responses for each topic. There were some interesting topics this week, as well as some great responses. If you have any opinions on any of these topics, feel free to continue the discussion in the comments. This chats take place every Friday at 11AM CST. You’ll find members of Healthcare Scene regularly participating in the chat under some of the following Twitter accounts: @techguy@ehrandhit@hospitalEHR, and @smyrnagirl.

Topic One: Payers are adopting more member/patient engagement platforms. How would you design these systems?

Topic Two: Group Health discussed their “learning health system.” What strategic decisions must a health system make to learn?

Topic Three: There’s a new noninvasive total cholesterol test using a digital camera. Could an iPhone replace your doctor some day?

Topic Four: NYU Medical Center opened a wireless health research center. What should their first research project be?

Grab Bag

Kaiser’s Mobile Health Approach

Posted on July 10, 2012 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 about laptops and iPads in healthcare, I had the chance to meet with Kaiser at the Health 2.0 conference in Boston. I had a chat with Brian Gardner, head of the Mobile Center of Excellence at Kaiser Permanente and learned a bunch of interesting things about how Kaiser looks at mobile healthcare.

The first most interesting thing to note was that Kaiser currently does not support any sort of BYOD (Bring Your Own Device) at this time. Although, they said that they’ve certainly heard the requests from their doctors to find a way for the doctor to use their own mobile device. Since this means that all the mobile devices in use at Kaiser are issued by them, I was also a little surprised to find that the majority of their users are currently still using Blackberry devices.

Brian did say that the iPhone is now an approved Kaiser device. It will be interesting to check in with Brian and Kaiser a year from now to see how many Blackberry devices have been replaced with iPhones. I’m pretty sure we know exactly what’s going to happen, but I’ll have to follow up to find out. What is worth noting though is the time delay for an enterprise organization like Kaiser to be able to replace their initial investment in Blackberry devices with something like an iPhone or Android device. While I’m sure that many of those doctors have their own personal iPhones, that doesn’t mean they can use it for work.

I also asked Brian about the various ways that he sees the Kaiser physicians using their mobile devices. His first response was that a large part of them were using it as an email device. This would make some sense in the context of most of their devices being Blackberry phones which were designed for email.

He did say that Kaiser had done some video pilots on their mobile devices. I’ll be interested to hear the results of these pilot tests. It’s only a matter of time before we can do a video chat session with a doctor from our mobile device and what better place to start this than at Kaiser?

Of course, the other most popular type of mobile apps used at Kaiser were related to education apps. I wonder how many Epocrates downloads are used by Kaiser doctors every day. I imagine it gets a whole lot of use.

What I found even more intriguing was the way that Kaiser used to discover and implement apps. Brian described that many of their best apps have come from students or doctors who had an idea for an app. They then take that idea and make it a reality with that student or doctor working on the app. It sounded like many of these students or doctors saw a need and created an app. Then, after seeing its success Kaiser would spread it through the rest of the organization.

This final point illustrates so well how powerful mobile health can be now that the costs to developing a mobile health innovation is so low. Once you lower the cost of innovation the way mobile health has done, you open up the doors to a whole group of entrepreneurs to create amazing value.

Broadband Mobile Should Change mHealth Game

Posted on June 22, 2012 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.

You never know what you’re going to learn when you wander into a cell phone store,  other than being hit with some fairly slick marketing slicks and rapid-fire pitched on that sweet, sweet iPhone upgrade. (Sorry, letting my Apple lust get in the way here.)

In all seriousness, this time I learned something which excited the heck out of me. While this is probably old news to some readers, I was surprised to learn that the cellphone industry is now rolling out support for new mobile protocols allowing for dramatic improvements in broadband mobile speeds.

One standard, LTE, can offer peak downlink rates of 300 Mbps and peak uplinks of 75 Mbps.  LTE, which takes advantage of new digital signal processing techniques developed roughly 10 years ago, is being rolled out by more or less every major U.S. carrier. Existing 4G networks are should shoot up in capacity as well. The next revision of the family to which 4G belongs, standards-wise,  should have a throughput capacity of 627 Mbps.

So let’s bring this around to our ongoing EMR discussions.  What are the HIT implications of these mobile nodes having the throughput to process live streaming video, download multiple imaging studies, conference effortlessly with parties across the world and more?

Well, for one thing, it’s pretty clear that our idea of mHealth will have to change. It makes no sense to plan networks around data sipping apps like the current iPhone crop when you’ll soon have iPads, Android devices and even Microsoft’s Surface tablet drinking it in gulps.

Obviously, the whole notion of telemedicine will evolve dramatically, with roving doctors and nurses consulting effortlessly over mobile video.  Skype calls will be as easy to conduct as traditional calls. And reviewing charts from the road will make much more sense, including looks at, say, CT scan results.

But all of this wonderfulness will be severely constrained if EMR makers keep forcing clinicians to use their systems via mobile-hostile devices. This is the time — this month, week and even day — to admit that desktop computers aren’t the platform of choice for smart clinicians.Vendors will have to step up with native clients for remote devices, and moreover, clients that take advantage of the emerging high-speed phones and tablets. If they hang back, the whole mobile high-speed revolution won’t be happpening.

Pricing for iPhone EMR App

Posted on September 20, 2011 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 other day I was browsing the EMR Update forum (where I started my EMR education) and found this interesting comment about the e-MDs iphone app.

EMDs is charging $250 to “install” it even though the phone does the installation for you and then they are charging $35 a month per device for “support”. I guess they are trying to lose all of their long term customers to other EMRs that are free like Practice Fusion. I find these charges to be outrageous.

Note: I tried to verify this pricing on the e-MDs website, but it’s conveniently not listed on their mobile page. Although, they do have a “free trial.” Is that a $250 install to get the free trial? I also found their website tagline ironic: “Affordable EHR software”

I find this comment really interesting on a number of levels. First, it comes from someone who has indeed been a long time e-MDs user and long been a fan and vocal spokesperson for the e-MDs EHR software. The above seems like such a small amount of revenue to alienate your happy EHR users over.

Second, $250 to help the user install the EMR iPhone app? Really? That just feels wrong on every level.

Third, $35/month for support? Of course, this is on top of the doctors existing e-MDs support contract. Such a terrible plan by e-MDs. If they felt like they needed to get some money for the support that would be required for their iPhone EMR app, then they should have rolled it into the existing support contracts. Then, no one would complain. At least not as loudly.

Now I’m starting to wonder what other EHR vendors are charging for their apps. Let me know what you’ve been charged for your EHR app. A while back I posted about all the various EMR Android apps. All of them were free.

Healthcare Infrastructure Independence

Posted on November 3, 2010 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 think it was at the Mobile Health Expo that I heard someone talk about the idea of Infrastructure Independence as the new model for healthcare. I thought it was a really interesting idea.

They described the current model of healthcare as follows:
*Low frequency visits
*Acute care focused
*Appointment driven
*Location centric
*High cost

Then they described what the considered to be the future of healthcare:
*High touch
*Right treatment
*When they need it
*Where they are
*Lower cost

Of course, this was all said in the context of infrastructure independence and mobile healthcare. I found the list and concept very thought provoking.

It also prompted a lot of questions like: What will this mean for doctors? What will it take to move to that type of healthcare?

I remember writing about an iPhone EMR back when the iPhone first launched. I had a lady from San Francisco contact me about an iPhone based EMR that she was using to document all of her patients. She had no office and did all home visits. She documented everything in her iPhone. Talk about keeping her fixed costs low. It was fascinating then and still is now.

Although, I think the idea above extends beyond just a doctor making home visits and documenting their visit through some mobile application connected to an EMR. Instead, The above descriptions describe a future where many times the doctor doesn’t need to be with the patient. I think this will involve some combination of streaming hi def video and medical devices in the home. Everyone has a thermometer at home. Why not a blood pressure cuff and other medical devices which stream the information from the device to your doctor?

It’s a very different world for healthcare. Making this change will be hard, but it’s an interesting world to consider. Certainly many doctors will hate the idea and others will embrace it. As a patient I look forward to the day when I don’t have to make the trip to the doctor and enjoy all the quiet time in the waiting room.

EMR Billing Matters

Posted on August 25, 2010 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.

My previous post about imagining an EMR that didn’t include billing certainly has driven a lot of conversation. Actually, that was the purpose of the post. I indulge in great conversation with multiple perspectives. It’s the beauty of blogging and of life.

However, please don’t let that post confuse you. Billing is an absolute essential part of an EMR software. There’s a very good reason why most EMR software out there amounts to little more than a big billing machine. The demand for healthcare software was initially to solve the challenges associated with medical billing. Markets are great at satisfying demands and that’s why the EMR software is the way it is today.

This means that EMR vendors CANNOT ignore billing. Rightfully so, doctors want to get paid for their work.

Of course, the point of the previous post was to try and expand the conversation beyond billing. Basically, the goal was to try and imagine an EMR software world where patient care was the focus instead of billing. What kind of good could we accomplish if this was our goal?

This follow up post was prompted by this somewhat disturbing email I received:
“I have built just such an EMR product for the iPhone and iPad. I am struggling with financing it because everybody wants billing. They really don’t care about the quality of the EMR.”

I’d make one qualification. No one cares about the quality of the EMR, if you don’t satisfy their billing needs too. Reminds me of HIPAA. No one would purchase an EMR that didn’t meet the HIPAA standards. However, once they hear it meets those standards, they move on to other things like the quality of the EMR.

Guest Post: Will Your New Smartphone Ruin Your Practice?

Posted on April 29, 2010 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.

Guest Post: Hayden Hartland works at Spearstone, makers of Spearstone’s DiskAgent offering which provides a multi-platform approach to smartphone security by allowing lock, data-wipe, and GPS-tracking from any web-browser along with online backup for your business.

Breathtaking advances in smartphone capabilities are changing the ways we work and live. In their latest forms, phones such as the iPhone, Android, Blackberry, Windows Phone, Symbian, and Palm are beginning to rival, and in several areas (think GPS, camera and video) exceed the capabilities of laptops and desktops.

Increasingly, we email, keep contacts, track tasks and appointments, browse the internet, capture family moments, connect with friends, shop, and even run powerful business apps from our hand-held do-it-alls. No wonder then that surveys show some people giving up computers altogether for smartphones. Trends indicate smartphone sales and usage will exceed that of laptops in the next five years. Analysts describe a future where Smartphones that dock to keyboards and monitors obsolesce the laptop altogether.

The problem is that while smartphones are leapfrogging laptops and desktops in utility and connectivity, they have introduced security risks that too few take seriously. Unlike desktops and laptops where some of the biggest risks lie in viruses, and the eventual failure of spinning hard drives, the biggest risk with a smartphone is the loss and exposure of the information you store on it.

More than 5,000 smartphones are lost or stolen each day. Most smartphones hold thousands of confidential records – patient lists, emails, documents, medical records, patient payment records, and so on – yet there is little or no ability to prevent their compromise if your phone is lost or stolen. Many were carried by healthcare professionals (doctors, nurses, dentists, office managers, billing providers, support staff, and so on) whose information represents real risk to their practices and patients if compromised.

Next time you notice a staff member, equipment rep, supply rep  or any BAA using a smartphone, consider asking, “Are our emails accessible on that phone?” and “If you lose it, can anyone access them on the phone?” If you are a medical professional carrying a smartphone you need protection because odds are that eventually you will lose your phone. Furthermore, HIPAA, the FTC and state consumer organizations require notification of all patients of a data breach (not exactly good for any practice or healthcare business).

Current phones and typical user practices do a poor job of safeguarding your confidential information. While many smartphones can require a password or PIN number to use them, few of us can tolerate the hassle of actually using one. We simply use our phones too frequently to put up with it. Yet without one, we’re completely exposed. And while a phone password may protect your information in the case of loss, it can’t stop someone with phone hacking skills who wants to access your information.

Here are some practical tips you can employ to reduce your risks:

  1. Create a passcode for your phone. If you (like me) hate being pestered by it, set it to be required after 4 or 8 hours, so that you only need to enter it once or twice a day. If your phone is stolen and locked the thief will either need to hack your phone or reset the phone to factory settings thereby removing all the data in the process.
  2. Create a splash screen when your phone is locked displaying a contact phone number or email address and reward value. Consider etching your name and contact information somewhere on the phone.
  3. Remove sensitive information from your phone as soon as possible.
  4. Write down your IMEI (International Mobile Equipment Identity) number. If your phone is stolen, call your carrier immediately and ask them to deactivate the IMEI number and the phone will be rendered inoperable for calling on all networks. This ensures the phone is unusable although it doesn’t protect any unencrypted information on your phone.

Fortunately, a few larger clinics and hospitals are beginning to address these concerns. If yours is a larger practice with a Blackberry Enterprise server and or Exchange Mail Server and your users exclusively use the corresponding phones (Blackberries, and Windows Mobile devices), you can remotely remove emails and some other sensitive information in the event of a loss or theft. Other alternatives are to deploy encryption software or use the expensive MobileMe services provided by Apple. For other organizations, Spearstone’s DiskAgent offering provides a multi-platform approach to smartphone security by allowing lock, data-wipe, and GPS-tracking from any web-browser.

EMR Platform

Posted on March 26, 2010 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.

After I wrote my post about 50 EMR markets instead of 1 EMR market, I started to wonder what an EMR might look like that was just an EMR platform.

The basic idea would be that some vendor would create a platform where other vendors could build on top of their platform. They’d offer the core elements and foundation needed for an EMR and then companies could build applications on top of those core elements that focus on the 50 different EMR markets (or whatever the number actually is).

The easy part is seeing someone who builds some specialty specific applications like growth charts for pediatrics or a drawing application for dermatology. The hard part is to decide which elements of the EMR are “core elements” that can act as a foundation for every type of specialty, practice, location, etc.

I guess the question of core elements really comes down to whether we can define any part of the EMR to be something that EVERY doctor could use. I think of the iPhone as the example of a platform that people have taken and expanded with applications. The core elements are the phone, the GPS, the accelerometer, etc. Then, various companies have created applications using that platform that can cover a wide range of markets. Making the comparison of EMR features with iPhone features is not an easy one.

I honestly don’t think any EMR vendor has done something like this yet. Sure, some of them have some API’s where some customizations can be done. However, I’m not sure I’ve seen the full embrace of creating an EMR platform. The closest I’ve probably seen is some to the open source EMR software that’s out there. It seems like some of them have done a good job modularizing the software so that many different people can iterate on the software.

What do you think? Is an EMR platform possible and what would it look like?

Body of Medical Knowledge Too Complex for the Human Mind

Posted on May 20, 2009 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 a recent comment, Steven suggested that an EMR and HIT in general might be necessary because the volume of medical knowledge is so large and complex that it’s too complex for the human mind. Here’s a short section of his comment:

Another set of reasons to adopt EMR, and sooner rather than later, are the reasons that are beyond the horizon. With the rate of change continuing to accelerate in the health care industry, along with our body of medical knowledge, I see a day where a person’s care plan is simply going to be too complex for a human brain alone to work out all the contributing factors. Sometimes I think we’ve already reached that point and haven’t quite realized it yet.

I absolutely love this concept of the body of medical knowledge being “too complex” for us to work it all out on our own. The idea that we need good clinical decision support systems, EMR and other technology we might not have even developed is really intriguing to me. Reminds me of my previous post about not knowing the true benefits of EMR.

The basic concept being that we won’t know the real benefits of EHR adoption until we have a platform for smart people to be really creative. Think about the Apple iPhone. If you look at the creativity that’s come out of the iPhone platform, it’s amazing. However, we would have never seen all this creativity until the platform was adopted in a broad way.

I believe that being able to managing and delivering all the medical knowledge out there is going to be one of those long term benefits we can’t realize until we have broad EMR adoption.