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Dating EHR vs Marriage

Posted on November 8, 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 most of you know, I’m very fond of relating EMR to other parts of life (see marriage and divorce, pregnancy, marriage for money, weight loss, and Katherine posted a Lady or the Tiger one that I enjoyed to name a few). I think we can learn a lot from the comparisons. Plus, it makes the lesson memorable when it’s illustrated with a great analogy. Now you’ll know why I loved the following LinkedIn comment from Danny Lieberman. It’s in response to my post titled Hospital EHR Sales Not About Customer Satisfaction.

I remember from my days running a software development house, we had just finished a big installation at Hadassah Hospital in Jerusalem. We had put our hearts into the implementation and post-installation support – the CIO and hospital GM were happy and that is saying a lot because the GM was one of toughest cookies we ever met.

In parallel, we were romancing another client and since were so focused on Hadassah, the attention they got was sub-optimal.

I will never forget the CIO telling me “Danny – if this the kind of attention you give me while we’re dating, what will our relationship look like after we get married?”

This is key. Health IT vendors need to think long term and not just Obama first-term.

Remembering that the pre-sale phase is just a date or 2 or 3. After you make the sale – you have to live together, make ends meet, have a happy, successful and prosperous relationship.

It’s a great concept to think about with an EHR vendor. You may treat me great when we’re “EHR Dating”, but how are you going to treat me once we’re married?

ACO’s Compensate for Something Doctors Influence Not Control

Posted on April 3, 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.

In my previous post about the ACO Risks and Rewards, I suggested that providers do indeed take on a greater portion of risk in an ACO, but that also opens them up to larger reward possibilities as well. I think this is very much the case and will be an important aspect of healthcare going forward. Many are going to do very well with an ACO if they create the right partnerships.

However, that post on ACO risks and rewards didn’t address what could be physician’s biggest concern with ACOs. This concern is that the ACOs will compensate doctors for something that they they only influence as opposed to control.

Jim Brule, a past healthcare CIO, provided a good summary of this challenge on a LinkedIn thread that I started asking if EMRs were harder to use than paper as was asserted by Anne Zieger in the article linked. Here’s Jim’s comments about ACOs:

I think ACOs – in principle – provide the structure necessary for value-based healthcare. However, a lot of work is necessary to ensure that any given ACO is structured to actually reinforce better outcomes.

One of the key components of that is patient engagement, which many providers are nervous about, as it means tying their compensation to something they influence, not control. I understand their concern, but believe that we need to move in that direction.

It’s definitely a challenge to the ACO model, but like Jim Brule I think we need to and will move in that direction anyway. Jim Brule did also offer what might be the key to allaying physician concerns over an ACO:

Ultimately, though, we can’t do this without good, actionable information – and you’re not going to get that from paper – or free-text notes, electronic or otherwise.

One of the biggest trends we’re going to see in healthcare over the next five years is going to be around data with MUCH of that data coming from the EHR. Some will call it business intelligence. Others will call it data mining. Others will call it big data. I think there’s a few other names out there, but at the end of the day it’s all about taking this voluminous amount of healthcare data and making it actionable and produce results.

Nothing will depend on big data in healthcare more than an ACO. Those vendors who are able to make that data actionable are going to do very well and healthcare costs will benefit from the ACO as well.

Is MUMPS the Major Healthcare Interoperability Problem?

Posted on November 11, 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.

Jeremy Bikman from KATALUS Advisors wrote this interesting comment on a LinkedIn discussion I was participating in:

Perhaps there is a place for MUMPS but only if healthcare continues to thumb its nose at the prevailing technology trends. It’s hard for me to envision healthcare to continue to embrace a technology that doesn’t like to play nicely with other non-MUMPS systems. If there were real advantages to it you would see a fair number of high tech firms utilizing it (Facebook, salesforce.com, Twitter, Spotify, etc).

If your goal is to have an enterprise system with a database that has some scale to it and certainly has good speed, and you don’t really care about interoperability with other systems, then MUMPS is certainly a good viable option. But IMO, the days of healthcare IT being insular, and moving out of phase with the rest of the tech world, are numbered.

I found this comment incredibly interesting. Mostly because I’ve never personally believed that the fact that many of the larger healthcare IT and EMR systems are built on MUMPS was any part of the reason why healthcare entities aren’t interoperable. I’m a tech guy by background, but I’ve never worked on a MUMPS software system myself so I don’t have first hand knowledge of MUMPS in particular. However, it seems wrong to “blame” MUMPS on the lack of healthcare data interoperability.

I guess the way I look at it is that no matter which database back end you have, you’re always going to need some front end interface to take care of the transport of the healthcare data to another system. Is this any harder with MUMPS than another SQL or even NOSQL database? From my experience it shouldn’t matter. I’d love to hear if there are reasons why it is harder.

I also don’t want to give the impression that Jeremy is trying to say that MUMPS is the only reason that healthcare IT has been so insular and closed. I’m pretty sure he agrees with me that a lot of other factors that have stopped healthcare from sharing data. I just don’t believe that MUMPS is one of those reasons.

Of course, the question of whether MUMPS should continue in healthcare is a different question. In fact, I wrote about MUMPS in healthcare IT and EMR here.

What are your thoughts? Is MUMPS the problem with healthcare interoperability? What are the other reasons stopping healthcare interoperability?

Update: Jeremy Bikman provided the following clarifying comment in the comments of this post:
Good points John. I really should have clarified. MUMPS is not really the issue (although I still stand by my assertion that if it was such a superior technology you’d see it all over Silicon Valley, RTP, etc). The main issue is really with the walled garden (w/ razor wire and machine guns along the top) approach of the major EMR/HIS vendors that have it as their foundation.

The more control you exert over your clients and the harder you make it to connect with other systems, the more money you can make…at least in the short-term.

John’s thought: I still look forward to the discussion around MUMPS and interoperability and healthcare interoperability in general.

The Pains of Healthcare Data Interoperability Described First Hand

Posted on August 12, 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.

I was hit by this comment made by Ciro on a LinkedIn group that I’m apart of (You can find the HealthcareScene.com blog network on LinkedIn if you want to join).

My patients are discharged from hospitals and are seen in different offices. I have no clue what changes have been made when I open the patient’s record in my emr. We have to call to have notes faxed to us all the time. Then we scan the documents into the emr and attach it to the patient record as a tif file. If a patient has a reaction to a medication and is seen at urgent care facility, I will not know about it unless the patient tells me. There is no integrity in my emr data since changes are made all the time. Our hospital recently spent millions on a emr that does not integrate with any outpatient emr. Where is the data exchanger and who deploys it? What button is clicked to make this happen!

My practice is currently changing its emr. We are paying big bucks for partial data migration. All the assurances we had about data portability when we purchased our original emr were exaggerated to make a sale.

Industry should have standards. In construction there are 2×4 ‘s , not 2×3.5 ‘s. Government should not impinge on privacy and free trade but they absolutely have a key role in creating standards that ensure safety and promote growth in industry.

I have 3 takeaways from Ciro’s comments.

1. The Pain of NO Healthcare Data Exchange – I can’t remember ever reading a first hand account that so aptly described the pains a doctor faces in trying to care for a patient and not being able to get the data they need to care for the patient properly. We need more stories like this that describe the pains of getting data exchanged in healthcare. Doctors need to recognize these pains and broadcast it far and wide. Otherwise, we’re not going to see any real significant movement. Patients can join in the chorus as well.

2. Healthcare Data Exchange Is Still Far Away – “Our hospital recently spent millions on a emr that does not integrate with any outpatient emr.” Doesn’t that comment just sting you to the core? If it doesn’t you’re probably the one that collected the million dollar checks from the hospital. I’m not sure what to say about the CIO that purchased a system that wouldn’t integrate with other EHR software.

3. Govenment’s Missed Opportunity – The last paragraph of Ciro’s comments talks about how the US government should have helped create a standard for data exchange. I still believe the EHR incentive money should be spent on establishing this standard and rewarding use of the standard. It’s probably too late now.

Keep the stories of terrible experiences exchanging healthcare data coming. I love to learn from first hand experiences. So, send them over and I’ll be sure to get your stories out and heard. Examples of great electronic healthcare data exchange would be welcome too. Few things motivate and gets things accomplished as much as pain and jealousy.

Social Media EMR Information

Posted on April 15, 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.

I’m interested to hear how others use social media to consume healthcare IT and EMR information. As most of you probably know, I’m a pretty avid user of social media. For me, it’s a combination of marketing my websites, getting new content and information for my websites, connecting with smart people, and just keeping a finger on the pulse of what’s happening in healthcare IT and EMR.

For example, many of you probably know about my two popular twitter accounts @techguy and @ehrandhit. My @techguy account is really my twitter account for everything and anything I feel like using Twitter to accomplish. It’s an interesting (at least to me) mix of healthcare IT/EMR, television, entrepreneurship, technology/social media, ultimate frisbee, and my other adventures in life. I love the freedom of that account since I’ll do and talk about most anything that I care to tweet about or people I care to connect with. @ehrandhit on the other hand is strictly EMR and Healthcare IT focused. I probably should give it a better voice than what it is now including more connecting with people and more thoughtful comments. Although, most of my best thinking becomes blog posts and then gets linked to that Twitter account.

I’ve also started this EMR and HIPAA Facebook page (You should all Like it). It’s seen some growth over time, but nothing like I expected that it might see. I’m not sure what people think of Facebook. Maybe most people go on Facebook to hang out and not necessarily talk shop. I can appreciate that. Although, when I see the number of people that have “Liked” other sites, I wonder if I’m just missing something about how I’m using Facebook.

I’ve become a big fan of LinkedIn. In fact, that’s why I recently started the Healthcare Scene LinkedIn group. I really love how people’s profiles are attached to the comments that they make. There’s something really refreshing about that approach. Plus, I love the conversations that happen after initially connecting in the group in a discussion about a specific topic. LinkedIn makes it really easy to connect with someone who you’ve been chatting with and extend a business relationship with them. It makes sense that the conversation is great on it since it’s such a business focused website.

While I love the above social media for finding and interacting with healthcare information, I’m still a bit surprised by the thousands of people who’ve signed up to receive the EMR and HIPAA email newsletter. Email isn’t technically social media, but it’s quite clear to me that email still plays a major role in our consumption of information and our interaction with others. Email is something we all use pretty much every day. So, I guess that makes sense why so many people want good information sent to their email. It’s convenient.

Then of course, I have a blog or two under the Healthcare Scene brand (check out the new headers I made for each site). Someone recently commented on my blog about the volume of misinformation that is out there. When I look at the list of blogs that I write and that I’m partnered with, I’m really happy to see the quality of independent information that’s being created to guide people in th EMR and healthcare IT industry.

I love how something as simple as blogging software can empower people to share their unique voice. Add in the above social media tools and the power of search on the internet and I think we can have a real impact for good on healthcare IT and EMR.

What tools do you use to consume information online? Are there tools that I haven’t listed that you love? How do you use those tools to make your and other’s lives better?

Social Media Sessions at HIMSS and Other HIMSS Talk

Posted on February 2, 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.

As many of you probably know, I’m a big fan of social media. Certainly it’s been a great way for me to market the content I create on my websites, but it is much more than that for me. Social media (like Twitter, Facebook, LinkedIn, etc) are a great way for me to connect and interact with other people. I’ve heard so many people tell me they don’t understand Twitter. I like to explain that Twitter is about being able to connect with people related to almost any topic imaginable. It gives you a way to follow them and to communicate with them in a passive and interesting way. It’s incredibly powerful.

Plus, Twitter and other social media is fun. You get the chance to learn a lot from those around you. Not to mention those connections can do some powerful things. I’ve gotten everything from free conference attendance to free graphic design to finding my accountant on Twitter. It’s a beautiful thing if you use it right.

The problem most people have is that they don’t know how to use it and their afraid to get started. Well, I will tell you it does take some commitment of time to make it effective. However, it’s been well worth it for me.

Back on topic, the HIMSS 11 conference in Orlando is going to be a great event to see some of the power of Twitter. You can do it by following what people are saying about HIMSS (and the hashtag #himss11) or check out some of the various HIMSS Twitter lists. You don’t even have to be on Twitter to consume the content. It’s pretty interesting to follow even now.

HIMSS also has created a social media pavillion on the exhibit floor where they’ll be having a bunch of social media center sessions. Here’s a sample of some of the session titles, “Twitter Created the New Radio Star” (so true), “Physicians and Meaningful Use: What We Are Seeing in Social Media” and “Blogging as a Career: Strategies for Clinicians and Health IT Bloggers” (by Dr. Kim) and lots more. Cesar from HIMSS always puts together a lot of interesting social media content at HIMSS.

Of course, I put together the New Media Meetup at HIMSS to also bring together some of the smartest and most interesting people using New Media in healthcare. The event has nearly reached capacity and I’m also happy to say that we’ve added a new sponsor, Ozmosis, who will be giving away an iPad at the event. Pretty sweet if I do say so myself.

If you can’t tell, I have HIMSS on the brain right now. Maybe it’s because I’m inundated by all the PR people asking to meet with me at HIMSS. The good thing is that my schedule is nearly full and so it’s easier for me to say sorry when the schedule is full. Although, there’s always more room to add to my list of possible parties to attend. So, if you know of any I should attend, let me know.

I was also amazed by the list of government officials that will be attending HIMSS. That’s pretty much all of the high level health leadership that exists in the US government. The only person that they could add to top what’s on that list is Obama and/or Biden.

I won’t go over all the other HIMSS sessions that look interesting, including some interesting HIMSS 11 keynote speakers. All in all I think it will be a great event where I’m running all over the place. However, I plan to run quickly between places, but to have slow, valuable conversations with those with whom I do meet. I’d rather have 10 valuable conversations with smart people than 100 shallow conversations with random people.

If you’re attending HIMSS, what gets you excited?

P.S. Here are the links to some of my various social media profiles:
@ehrandhit – Twitter feed of EMR and healthcare IT news
@techguy – EMR stuff, but a little bit of everything else that interests me too
EMR and HIPAA on Facebook – Like the EMR and HIPAA fan page and get the latest EMR news on Facebook. Plus, you’ll make me feel good when I see the number of fans go up.

Online EMR Resource – LinkedIn

Posted on October 9, 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.

Update (12/30/13): We’ve come a long way since 2010 when this post was created. Now Healthcare Scene and Healthcare IT Central have LinkedIn groups.

There are a ton of EMR resources online these days. I remember when I started this blog, there really was only a small handful of people talking about EMR. Now, it’s kind of exploded and there’s conversations happening all over the internet about EMR. That’s why I’m particularly grateful for those who read this blog, participate in the comments and find value from it.

One of my more recent finds is the group forums on LinkedIn. They’re definitely not perfect and sometimes get too much spam, but they are an interesting place to discuss EMR. Here’s an example of a group about Small Medical Practice EMR and PM Solutions. Pretty much a perfect match for this blog right?

One of the key things I like about the groups on LinkedIn is that people’s comments are tied to their LinkedIn profile. This is pretty neat since then I can see what’s behind the comment that someone is making. I can better understand the perspective they have on the situation and why they might be commenting a certain way. It’s also cool, because I’ve gotten to meet a bunch of interesting people in the EMR world. Plus, I know quite a few of my readers come from LinkedIn as well.

Of course, you can also catch up with us on Twitter – @ehrandhit (just passed 5000 followers) and Facebook – EMR and HIPAA Fan page.

I also must admit that I’m always astonished and flattered by the people I see sign up for the EMR and HIPAA email list. That list has really grown and it’s pretty amazing to think that someone wants what I’ve written in their email box almost daily. It’s pretty humbling to see the list of doctors, practice managers, EMR vendors, and other healthcare IT people that sign up for it. So, thank you.