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CPOE and MU with Marc Probst and M*Modal

Posted on June 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.

As part of my ongoing series of EHR videos, I had the chance to sit down with Marc Probst, CIO of Intermountain and a member of a number of important healthcare IT committees, Mike Raymer, Senior Vice President of Solutions Management at M*Modal and Dr. Jonathan Handler, CMIO of M*Modal to talk about CPOE and Meaningful Use. It’s another great addition to the Healthcare Scene YouTube channel.

In the interview we have a chance to talk about Intermountain’s move from zero CPOE to mobile, voice recognized CPOE. We talk about the future possibilities of voice in healthcare. I also ask Marc Probst about his views on EHR certification, meaningful use, and CommonWell.


*Note: Marc Probst’s sound was less than ideal. Next time we’ll be sure he has a better microphone.

Starting the Health IT Ball Rolling

Posted on April 4, 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.

Early on in my EHR implementation experience I had an enlightening moment. In the clinic I was working at, we decided to just do a partial implementation of the EHR software in order for us to replace the scheduling and billing side of our current processes. The clinic was using some old scantron like billing technology that needed to be replaced quickly. So, instead of leaving behind the paper charts, we decided to start by just implementing part of the EHR to start.

As part of this partial EHR implementation we had the clinicians entering the diagnosis and charge capture into a note in the EHR. After a couple weeks of doing this, I was sitting with one of the providers and she said, “John, why can’t I just enter my note right here where it says subjective and objective instead of in the paper chart?” After hearing this, I went to the director’s office and told her what I’d heard. We realized it was a tremendous opportunity for us to finish the full EHR implementation.

It was quite an interesting realization to have them driving us to implement more of the features. I think we see this phenomenon in other areas as well.

I was talking with the hospital CTO of Intermountain, Fred Holston, about their new mobile CPOE app they built together with MModal. I asked if he was concerned about adoption of the CPOE app. It seemed that it was possible that they built an app that doctors would just choose not to use. Fred made some suggestions about why he thought this wouldn’t be an issue, but then he offered an even more valuable insight. Fred suggested that their bigger concern wasn’t whether doctors would use the CPOE mobile app. Instead, they were more concerned that once they rolled out the CPOE mobile app that doctors would start asking for a whole laundry list of other features and applications that were similar to it. Were they ready for that onslaught of requests?

Yesterday, I got a demo of the latest version of the Sfax secure faxing software (Full Disclosure: Sfax is an advertiser on this site.). During the demo, I asked about another possible feature and a really good comment was made, “Once you roll out new features, people start asking for even more features.” We then had a nice discussion about how the product development process is never done.

In some cases, the desire for more features can lead to really unhappy users. If we’d not finished the full EHR implementation quickly, no doubt those providers would have hated the product. If Intermountain doesn’t add more of the requested capabilities to their CPOE mobile app, then their users will be unhappy that the app can’t do more. If Sfax doesn’t continue to add features to their product their users will grow unhappy with the service.

However, the opposite is also true. This desire to use technology in new ways can be a real driver of adoption. We didn’t have to sale the providers on the finishing the full EHR implementation. They’d already sold themselves. Sometimes you just have to get the ball rolling when it comes to health IT. Once the ball is rolling, just be ready to keep up with with the new ideas that start coming as people see new possibilities.

Nuance and MModal – Natural Language Processing Expertise

Posted on July 23, 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.

Many of you might remember that one of the most interesting things I saw at HIMSS this year was the natural language processing that was being done by MModal. In case you don’t know what I’m talking about, check out this video interview of MModal that I did at HIMSS. I still think there really could be something to the idea of retaining the narrative that dictation provides while also pulling out the granular data elements in that narrative.

With that background, I found it really interesting when I was on LinkedIn the other day and saw Dr. Nick van Terheyden,the same guy I interviewed in the video linked above had switched companies. Nick’s profile on LinkedIn had him listed as working for Nuance instead of MModal. I guess this shouldn’t have been a surprise. Nuance has a lot of skin in the natural language processing game and it seemed to me that MModal had the technology that would make it a reality. So, now Dr. Nick van Terheyden is the Chief of Medical Information Officer for Nuance.

I’d say this is a really good move by Nuance and I’m sure Nick is being richly rewarded as well. Nick was one of the most interesting people that I met at HIMSS this year. I’ll be certain to search him out at next year’s event to hear the whole story. Luckily, I also found out that Nick is blogging about voice recognition in healthcare on his blog Voice of the Doctor. I always love it when smart people like Nick start blogging.

“Practical Use” of an EHR Using Transcription

Posted on May 12, 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.

In a post on EMR and EHR about Transcriptionists Partnering with an EMR Vendor, I got an interesting comment by George Catuogno from StenTel about the various technologies that the Medical Transcription (MT) industry are using alongside EMR software. George called the use of transcription with an EHR “practical use” while still showing “meaningful use.” I think it’s a mistake for any EMR company to ignore the transcription industry.

Here’s George’s description of the medical transcription technologies which I think people will find interesting:

The Medical Transcription (MT) industry actually has done a lot to advance itself amidst HIT, particularly EHR technologies, while supporting narrative dictation, which for many physicians is still the preferred method of information capture because it’s fast and easy (efficient) and it tends to more comprehensively captures the patient “story”. DRT, BESR and NLP are three examples of this. I’ll save the best for last.

1. Discrete Reportable Transcription (DRT) is the process of converting narrative dictation into text documents with discrete data elements than can be easily imported into the appropriate placeholders inside an EMR.

2. Backend Speech Recognition (BESR) has been in play for years which allows physicans to dictate without engaging the computer for realtime correction. The correction is instead done retrospectively by a medical transcriptionist. Some speech rec technologies (like M*Modal) support data structuring. The gap remains, however, in getting applications written that readily move that strucutred infomration into EHRs like DRT can.

3. Natural Language Processing (NLP) trumps both of these solutions because it takes a narrative report, regardless of how it was created, and codifies it (SNOMED) for a number of extraction, analytics and reporting applications: Patient Summary, DRT feed into an EMR, Core Measures and PQRI, coding automation, interoperability, and support for the majority of Meaningful Use requirements. Secondary use opens up to clinical trials and other applications as well.

Overall, if the transcription industry can market itself and get its messaging out through the right channels regaridng these innovations that augment transcription and keep physicians dictating, then transcription is a terrific EHR adoption facilitator, enables “practical use” along with Meaningful Use, and will remain relevant for the foreseeable future.

Doctors and Patients and Paperwork

Posted on April 23, 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 was reading through a thread over on EMR Update which talks about this New York Times article. Here’s some really interesting quotes from both sources that are worth considering:

In “The Hostile Hospital,” from the Lemony Snicket “Series of Unfortunate Events” books, the three young orphans at the center of the story visit the fictitious Heimlich Hospital, where Babs, the head of human resources, asks them if they know what the most important work done in a hospital is.

“Healing sick people?” one of the children asks innocently.

“You’re wrong,” Babs growls, silencing the children. “The most important thing we do at the hospital,” she continues without flinching, “is paperwork.”

Humor is the most funny when it stabs so close to the truth.

Currently, most systems have been designed not with clinical needs in mind but to meet the demands of the fee-for-service payment system. The software rapidly codifies diagnoses and symptoms, thus facilitating billing.

No worries though. The EMR billing machines that we have now will soon be replaced with EMR meaningful use machines. {a little satire of my own}

While EMR can capture certain information like medication lists and test results with mind-boggling accuracy and efficiency, it often fails to relay the nuances of a patient’s illness course. “Physicians think in stories,” said Dr. C. T. Lin, a practicing internist and chief medical information officer for the University of Colorado Hospital in Denver, which has used electronic records since 1994. “How can you possibly point and click your way through a patient’s 10-year history?”

This reminds me of the rather compelling video I did with Mmodal where they talk about the need to have both the narrative and granular data in the EMR. I’m always amazed at a physicians ability to look at a narrative section and get the story of what’s happened. Something that lists and results just can’t do justice. As valuable as those lists and results can be in other ways.

Video of MModal at HIMSS

Posted on March 10, 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.

On more than one occasion I’ve talked with people about the work the people at MModal are doing in the healthcare IT space. I think they’re a really interesting technology that could save all those doctors that want to still dictate their notes. MModal offers an interesting solution for preserving the valuable story that a narrative tells while also pulling out the key data elements into granular, reportable pieces.

I don’t think I need to say much more about MModal. Just watch this video interview I did with them at HIMSS 10:

This video coverage of HIMSS 10 sponsored by Practice Fusion and their Free EMR.

HIMSS 10 Day 3

Posted on March 2, 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.

Today was a much more laid back day at HIMSS. I still had pretty much back to back meetings, but I’m learning little by little to manage the day at HIMSS. It’s still a work in progress, but I’m getting closer to managing this HUGE event.

In kind of a surprise meeting, I had a chance to sit down and talk with Shahid from The Healthcare IT Guy. We had a really good chat and I can see us working on a number of projects together. It’s been really interesting to meet people in person that you’ve only ever known online. A few times I’ve come away disappointed, but the opposite was true with Shahid. I couldn’t be more impressed with Shahid.

I had a number of really interesting interviews today and a meeting with the CMO of Verizon to talk about an interesting medical data exchange that they’re working on. It was really interesting to hear the vision of what Verizon and the group behind it are doing to make healthcare data exchangeable. I’ll be posting a lot more on this in the future, but you can see my original post about this consortium for some initial information. I have a video talking about the consortium and another video talking about the really neat technology behind MModal.

I also had a nice media lunch from HP. The food was great. The content was a little weak, but their talk of the thin clients was pretty useful for me in my day job. Little by little I’ve been getting more and more convinced that thin clients will be the future of desktop management. At least in any reasonably sized implementation.

Oh yes, and I have to mention the most incredibly tacky part of the lunch. While they were speaking, one of the media people’s phone rang. Not only did they not turn off the ringer, but he then proceeded to answer the phone in the middle of the meeting and was talking on the phone while the person was presenting. Then, after the call he got up and left. I was totally shocked that he really did that. Unbelievable!!

However, the event of the day without a doubt was the ONC town hall. It started off with David Blumenthal announcing that the details of accrediting the EHR certifying bodies (officially the NPRM on certification) were just released. You can find the details posted on the HHS website. I’ll be posting a lot more about this soon. ONC did a pretty lengthy question and answer and even a powerpoint on the new accreditation for EHR certifications. I’ll cover those details very soon.

I also met one of the people behind Fierce Health IT and talked about possibly working together on something. They really went all out to kind of make a splash at HIMSS and I must admit that they’ve come along way since they first started.

Lots of other things, but I better get to bed so I can make the Blumenthal keynote tomorrow.