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Traditional Marketing, Drug Companies, and Behavioral Scientists – #HITsm Chat Highlights

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Topic One: @bjfogg behavior model has become well known in tech around engagement. How is this or other models applicable to patient care?

Topic Two: Outside #healthcare, “engagement” is largely about marketing. What can traditional marketing teach us about patients?

Topic Three: Engagement is closely tied to influence and by who you are trying to influence. What are biggest drivers of influence in hc?

Topic Four: Drug companies are masters of influence, how can we improve the influence of engagement?

Topic Five: @nationalehealth and @ONC_HIT work with top behavioral scientists. When does a nudge toward behavior change become a shove?

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April 20, 2013 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.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  HealthCare IT  Hospital EHR  Hospitals
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Meaningful Use Stage 3 Priorities

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In my reading, I came across this message of what the priorities for meaningful use stage 3 should be:

To be considered for Stage 3, objectives must support new models of care, address national health priorities, promote advancement, be achievable and widely adopted by 2016, and be reasonable from a products and organizational perspective.

I thought this was a really interesting statement, because there’s always a lot of discussion about what meaningful use should really accomplish. If you ask someone in healthcare IT what meaningful use is suppose to accomplish, I expect you’d get a different answer from every person that you ask. That’s unfortunate, because if we’re going to spend billions of dollars on this you’d think we’d have a clear vision of what we want to accomplish with that money.

At the end of the day, it’s ONC-CMS-HHS that makes the meaningful use rules and so it doesn’t really matter what we think if they don’t think the same way we do. Plus, unfortunately it’s a really sad minority that actually give feedback during the meaningful use process.

I wonder how many doctors actually gave any sort of feedback to ONC during the meaningful use process. I’m not talking doctors who are now working for some company. I’m talking about practicing doctors who took the time to understand the MU regulations and provided comments on it. The same could be said for hospital C-level executives. I heard of some that copied and pasted their response from their EHR vendor, but how many hospital CIO’s really dug into the regulations and provided comment? The answer is not enough (despite significant effort on ONC’s part to hear from them).

The above statement seems to make ONC’s position clear on what they want to accomplish with meaningful use stage 3. In fact, the priorities listed above seem in line with the actions they’ve taken when it comes to meaningful use and other ONC initiatives. Right, wrong, or otherwise, it’s important to understand where ONC is coming from when they make the final meaningful use rules. Everyone else can say what they want, but they’re not making the rules.

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March 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Filed Under: ARRA  EHR  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  HealthCare IT  Meaningful Use
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HIMSS Analytics Clinical & BI Maturity Model

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While the theme of HIMSS 2013 may have been, “How Great Is Interoperability,” the effectiveness of the many facets of interoperability are only as good as the actionable value of the shared data. The clinical insights that should be enabled by Meaningful Use Stage 2+ are expected to drive market trends in myriad areas of the healthcare system: chronic disease management, targeted member interventions, quality measures. In order to assess organizational readiness to capitalize on the promise of Meaningful Use, HIMSS Analytics began measuring the implementation and adoption of EMR and clinical documentation using a maturity model called EMRAM.

EMRAM

But, in analytics terms, EMRAM’s results are simply targeted foundational reporting, answering the question, “WHAT happened with Meaningful Use EMR adoption criteria.” So, you’ve got your clinical data in an EMR. Now what are you able to DO with it?

In 2013, HIMSS Analytics is taking a broader approach with the introduction of a new Clinical Business Intelligence maturity model, creating a framework to benchmark participating providers’ analytics maturity level.

I’ve been fortunate to know James Gaston, Senior Director of HIMSS Analytics Clinical & Business Intelligence, for many years, going back to his days with Arkansas Blue Cross. His appreciation for BI initiatives is matched only by his enthusiasm for the first day of turkey hunting season. When I ran into him at TDWI’s BI World summit in Orlando in November, he acted like a kid on Christmas morning, telling me about the brave new world of clinical data management that he was about to tackle. The excitement continued to build in the months leading up to HIMSS. James was practically glowing when we spoke about the upcoming C&BI Maturity Model release.

“Our customers are interested in not just understanding how to deploy IT applications, but how effectively they’re using those applications to support clinical business intelligence, as well as analytical pursuits,” James said. “So, HIMSS Analytics partnered with IIA to create and present a Clinical & BI Maturity Model that helps healthcare organizations measure that level of effectiveness.”

Sarah Gates, the VP of Research for IIA (the International Institute of Analytics), elaborated. “The HIMSS Analytics C&BI Maturity Model leverages the Competing on Analytics DELTA model, developed by Tom Davenport, which measures not only how well you’re using data and technology, but how well you’re building an analytical organization.” There are 5 core competency measurements in the DELTA model that will inform the HIMSS Analytics C&BI analysis: Data, Enterprise, Leadership, Targets, and Analysts. The methodology is holistic, touching on the cultural aspects of the organization as well as the technical, allowing a longitudinal view of the organization’s analytics program. A yardstick value from 1-5 will be assigned to each respondent based on Davenport’s criteria for each core competency.

Although HIMSS Analytics will eventually offer Level 1-5 certification program for those organizations with observed results for analytics, James and Sarah agreed that it is not appropriate for every provider to reach for the Level 5 gold star. Per Sarah, “Healthcare is an industry just starting to discover analytics. We’re expecting to see lots of practitioners that are emerging in use of analytics, so we believe it (survey results) will be heavy on the lower end of the maturity scale. Data warehouse capabilities and staffing career paths for data analysts will be key differentiators for mature programs.” Not all providers have the resources – financial, human, and/or technical – to attain advanced analytics nirvana, and James wants to insure that these providers don’t feel as if they’ve “failed”; the goal is to baseline against the peer group, identify opportunities for improvement, and focus on what is possible for each individual organization, working within their constraints.

What can we expect to see at next year’s C&BI survey results presentation? James said, “We want to be able to talk about benchmarking the industry as a whole, helping healthcare find its way with clinical business intelligence and begin to understand how important it is, and where opportunities lie Everyone’s talking about clinical and BI – it is the opportunity to realize savings in healthcare, to use information to empower people to make better decisions.”

So, it’s up to you, providers and technology partners. You’ve implemented your EMR, achieved a high adoption rate across your organization’s core clinical processes, attested to Meaningful Use Stage 2, achieved Stage 7 on the HIMSS EMRAM scale, perhaps even participated in multi-HIE CCD medical records sharing with other provider networks. You’ve got the data in-house and availabe. It’s time to see how ready you are to rise to the analytics challenge and maximize your return on those EMR and HIE investments.

Attempt to beat your previous Doug Fridsma long jump.

Note: for the complete HIMSS 2013 Leadership Survey Results, please download PDF here.

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March 14, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Filed Under: Certified EHR  Clinical Decision Support  EHR  EHR Benefits  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR Technology  Healthcare  Healthcare Business Intelligence  Healthcare Interoperability  HealthCare IT  HIE  HITECH  HL7  Hospital EHR  Hospitals  Meaningful Use
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The Marvelous Land of Oz: The HIMSS Interoperability Showcase

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As I walked the floor of the HIMSS Interoperability Showcase, listening to the tour guide’s carnie-esque pitch on the wonders awaiting me with each successive use case encounter, I ALMOST wished I hadn’t worked with so many of the organizations hawking their wares. It’s a bit sad to know the man behind the curtain, to realize that The Great and Powerful Oz is simply a man with a highly mechanized presentation. But that knowledge gives me insight that others attending the Showcase may not have had – and validation that, in the end, Oz IS Great and Powerful, even though he’s just a man.

There were 20 specific interoperability use cases represented at HIMSS this year, collectively, by 101 vendors. In order to qualify to participate, each of the organizations had to successfully demonstrate proficiency with their chosen use case at the Connectathon event in Chicago. In January. In a basement the size of a football field. Packed shoulder-to-shoulder with your closest competitors at high school-cafeteria tables. Talk about a frigid atmosphere!

Perhaps to stay warm, perhaps to pass the time, perhaps in the pursuit of the patient-centric design principles the healthcare industry espouses publicly yet so seldom seems to put into practice, cross-company collaboration occurs. Competitors converge on each others’ laptops, debugging code, refining business rules and algorithms. Functional use cases emerge, success stories are shared, everyone goes home happy with a list of enhancements to incorporate before the main event at HIMSS. The frantic rush to prep for Connectathon is amplified by the urgency and importance of HIMSS. The ONC is watching! Your competitors are watching! The 40K HIMSS attendees will be watching!

Invariably, the use cases are perfected in the weeks leading up to HIMSS, each click carefully orchestrated, each transition scripted, all parties putting forth their best effort to insure success for the spectators – many of whom are clients, prospects, regulatory officials, or journalists seeking The Next Big Healthcare Thing to go viral in the blogosphere. The yellow brick road is constructed, and as one walks its length, the carefully choreographed demonstrations come to life with compelling tales: “Keeping a Newborn Safe,” “Improving Pediatric Care,” “Optimizing Cancer Care,” “Beneficiary Enrollment.” The show goes on, and it’s a good one – albeit with the occasional glimpse of the man behind the curtain.

The perfectly nice gentleman manning the Federal Health Architecture booth seemed eager to demonstrate the capability to request and retrieve a patient’s medical record from multiple HIEs and disparate EMRs. He walked me through the provider portal view, showed me how he could see that there were multiple medical records available for this patient across providers, and talked me through each click up until the print button. Print?

“Aren’t you importing the records into the requesting EMR?” I asked.

“No. Right now, they have to print each set of records.”

“So, each time this scenario presents itself, the provider has to click on each available external record, print multiple pages, compare notes across screen and paper, and later choose whether to manually update his own EMR with the other information?”

The perfectly nice gentleman suddenly seemed uncomfortable. The Great and Powerful Oz, exposed as mere mortal, Oscar Zoroaster Diggs. You’d think I’d know when to quit.

“The standards and technology exist to do CCD discrete data import, and a couple of the large EMR vendors are implementing that capability for high Medicare population IDNs. How does it make the provider more efficient, and give the patient more face-time with his doctor, if we’re still printing and no data consolidation or reconciliation is happening prior to point-of-care? Why didn’t you extend the use case to show end state?”

He assured me that they’re working on it, and we made a deal that NEXT year, I’ll come back and he’ll walk me through their progress towards discrete data import. No printing, he promised. I’m going to hold him to it.

Aside from this specific use case, across the Marvelous Land of Oz, what I’d REALLY love to see next year: the basement Connectathon advancements made to support the use cases for HIMSS actually incorporated into the products. As part of the qualifying criteria for repeat showcase exhibitors, have them demonstrate the capabilities developed in prior years actually functioning in the marketplace under general release. That would be a substantial improvement on this year’s long jump attempt for the Interoperability Showcase.

I want to fall in love with the hard-working man behind the curtain, not the showy pyrotechnics.

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March 11, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Filed Under: CCR  Certified EHR  EHR  EHR Benefits  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR Technology  Healthcare  Healthcare Interoperability  HealthCare IT  HIE  HITECH  HL7  Hospital EHR  Interfaces  Meaningful Use  Personal Musings
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Interoperability: The High Jump and The Long Jump with ONC’s Doug Fridsma

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I’ll admit, I was incredibly nervous about interviewing Dr. Doug Fridsma, the Chief Science Officer for the Office of the National Coordinator and the face of both the Standards and Interoperability (S&I) Framework and the Federal Health Architecture initiative. Not only do I consider him a key luminary, but his overarching responsibility for the future of interoperability and standards-based programs is incredibly alluring. I swoon over those who have the power and desire to effect meaningful, positive change on a grand scale. I wasn’t disappointed.

Doug explained his philosophy towards fulfilling the promise of interoperability with a sports metaphor: the high jump and the long jump.

“I don’t like high jumps,” he said. “High jumps, if you knock down the bar, you’re done and you get no points. Long jumps, you get points for each increment. The high jump for interoperability is ubiquitous data liquidity. The long jump is Meaningful Use.”

The S&I Framework project is tracking progress towards standardization and standards adoption across 5 areas of Meaningful Use and interoperability:

  1. Meaning – shared vocabularies across continuum of care
  2. Structure of messages shared across continuum of care
  3. Transport of messages
  4. Security of transport and messages
  5. Services for accessing messages

All of these categories are exemplified in the flagship project for Meaningful Use and interoperability: the Automate Blue Button Initiative, affectionately known as ABBI. For those not familiar with ABBI, do an experiment: ask your primary care provider whether you can visit a patient portal and download your medical records by clicking the “Blue Button.” If your PCP can provide you the website link to request the download, you should be able to receive your entire medical record (from that provider) in a vaguely huma-readable format (Excel, Word, PDF, etc.). The medical and clinical jargon may not make a lot of sense; however, it’s certainly an incremental hop in the long jump towards interoperability and standards adoption. The standard vocabularies, structure, transport mechanism, security protocol, and web-enabled access are foundational building blocks which enable the Blue Button program’s adoption.

Doug’s goal with the ABBI program was three-fold: get it OUT there, have providers and patients start USING it, and structure it so that it can be repeatable and scalable. Patient engagement advocates across the Twittersphere applaud the sentiment that we, patients, should have ownership of our health data, and many recognize the ONC’s efforts as instrumental in turning the tide for patient access. Several notable bloggers have covered the ABBI project in detail, analyzing its value to healthcare IT development professionals, providers, and patients, including:
Keith Boone @motorcycle_guy – the ABBI Pitch, with a quick overview of the goals for the program, and humorous insight into providers’ qualms about adoption

Greg Meyer @greg_meyer – Scalable Trust and Trust Bundles, with developer-focused details on the structure and transport categories of interoperability

For the next incremental long jump beyond ABBI and Meaningful Use Stage 2, Doug Fridsma and the ONC have several new initiatives tackling the atomic-level data governance and quality of clinical information. In order to communicate between disparate EHR systems, across multiple facilities and potentially multiple payers, it isn’t just the structure of the container and transport of the message that must be consistent: it’s the individual data elements, themselves, which comprise the meat of the message that must be standardized.

The ONC recently announced the Structured Data Capture Initiative with the goal of creating a technical infrastructure to support “structurally sound” standard data elements with support for “unique semantics”, to capture EHR and supplemental clinical data for use across the continuum of care. This effort officially kicked off the week of HIMSS 2013; its progress will be instrumental in broadening the effectiveness of interoperability and Meaningful Use.

So, as I walk the Interoperability Showcase at HIMSS13, watch the use case demonstrations, and ask the participants the tough questions like, “How are you incorporating the use case development you’re exhibiting here into consideration for your next product full release,” I’ll be taking note of those organizations that seem focused on the next incremental jump towards patient-centric, data-driven healthcare systems. And I’ll be wondering what Doug Fridsma and the ONC will do to get to the next incremental jump on the way to the nirvana of ubiquitous data liquidity.

…I’ll also be kicking myself for not taking the opportunity to get a fan photo with Doug while I had the chance.

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March 5, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Filed Under: EHR  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  EMR Implementation  EMR Technology  HealthCare IT  Meaningful Use
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What Would ONC’s Dr. Doug Fridsma Do? (THIS Geek Girl’s Guide to HIMSS)

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I know you’ve all been wondering how I’m planning to spend my mad crazy week at HIMSS in New Orleans. Well, maybe not ALL of you, but perhaps at least one – who is most likely my blog boss, the master John Lynn. Given the array of exciting developments in healthcare IT across the spectrum, from mobile and telehealth to wearable vital sign monitoring devices, EMR consolidation to cloud-based analytics platforms, it’s been extraordinarily difficult to keep myself from acting like Dori in “Finding Nemo”: “Oooooh! Shiny!” I’ve had to remind myself daily that I will have an opportunity to play with everything that catches my eye, but that I am only qualified to write and speak intelligently on my particular areas of expertise. And so, I’m proud to say I’ve finally solidified my agenda for the entire week, and I cannot WAIT to go ubergeek fan girl on so many industry luminaries and fascinating up-and-comers making great strides towards interoperability, deriving the “meaning” in “Meaningful Use” from clinical data, and leveraging the power of big data analytics to improve quality of patient experience and outcomes.

On Sunday, I’m setting the stage for the rest of the week with a sit-down with ONC’s Director of Standards and Interoperability and Acting Chief Scientist, Dr. Doug Fridsma. His groundbreaking work in interoperability spans multiple initiatives, including: the Nationwide Health Information Network (NwHIN) and the CONNECT project, as well as the Federal Health Architecture. For insight into his passion for transforming the healthcare system through health IT, check out his blog: From The Desk of the Chief Science Officer.

Through the rest of the week, I aspire to see the world through Dr. Fridsma’s eyes, focusing on how each of the organizations and individuals contribute to the standards-based processes and policies that form the foundation for actionable analytics – and improved health. I’ve selected interviews with key visionaries from companies large and small, who I feel are representative of positive forward movement:

Health Care DataWorks piques my interest as an up-and-comer to watch, empowering healthcare systems to improve outcomes and reduce medical costs by providing accelerated EDW design and implementation, whether on-premise or via SaaS solution. Embedded industry analytics models supporting alternative network models, population-based payment models, and value-based purchasing allow for rapid realization of positive ROI.

Emdeon, is the single largest clinical, financial, and administrative network, connecting over 400,000 providers and executing more than seven billion health exchanges annually. And if that’s not enough to attract keen attention, they recently announced a partnership with Atigeo to provide intelligent analytics solutions with Emdeon’s PETABYTES of data.

Serving an area near and dear to my heart, Clinovations provides healthcare management consulting services to stakeholders at each link in the chain, from providers to payers and supporting trading partners – in areas from EMR implementation (and requisite clinical data standards) to market and vendor assessments, and data management activities throughout. With the dearth in qualified SME resources in the clinical data field, I look forward to learning about how Clinovations plans to manage their growth and retain key talent.

Who doesn’t love a great legacy decommissioning story? Mediquant proports adopting their DataArk product can result in an 80% reduction in legacy system costs through increased interoperability across disparate source systems and consolidated access. The “active archiving” solution allows for a centralized repository and consolidated accounting functions out of legacy data without continuing to operate (and support) the legacy system. Longitudinal clinical records? Yes, please!

Those are just a few on my must-see list, and I think Dr. Doug Fridsma would be proud of their vision, and find alignment to his ONC program goals. But will he be proud of their execution?

Can’t wait to find out, on the exhibit hall floor – and in the hallway conversations, and the client case study sessions, and the general scuttlebutt – at HIMSS!

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March 2, 2013 I Written By

Mandi Bishop is a healthcare IT consultant and a hardcore data geek with a Master's in English and a passion for big data analytics, who fell in love with her PCjr at 9 when she learned to program in BASIC. Individual accountability zealot, patient engagement advocate, innovation lover and ceaseless dreamer. Relentless in pursuit of answers to the question: "How do we GET there from here?" More byte-sized commentary on Twitter: @MandiBPro.

Filed Under: Certified EHR  Clinical Decision Support  Direct Project  EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare  Healthcare Business Intelligence  Healthcare Interoperability  HealthCare IT  Healthcare Social Media  HIE  HITECH  HL7  Interfaces  Meaningful Use
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Super Bowl Power, Video EMR, EMR Data Standards, and EMR Spend

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In case you missed the Super Bowl, the power went out for a good 30-45 minutes. It’s the EMR’s fault. We could create a whole comedy routine blaming a hospital’s problems on the EMR I think.


I’ve talked about video in EMR for about 7 years. The problem is we don’t have a great way to pull the data out of the video. Plus, I’m sure there will be many that resist the idea of a video recording of their patient visits. I still see it happening one day soon. I wonder if HealthSpot will be doing this in their kiosks.


Who should be creating the structured data standards? I’d like doctors themselves doing it, but they’re too busy (or so most of them say).


I wonder when this spending will stop. At the end of meaningful use?

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February 3, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  HealthCare IT  Meaningful Use
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Redesigning The Patient Medical Record, the Healthcare Challenge’s Results

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The following is a guest post by Carl Bergman from EHR Selector.

The Obama administration’s, Challenge.gov site encourages the public to submit suggestions that solve specific, public policy questions. To do this, it’s set up dozens of contests or challenges. For example, the FTC has a $50,00 challenge for a solution to illegal robo calls that often come from off shore.

In healthcare, the VA and the ONC recently ran a Health Design Challenge for a better patient health record announcing the winners a few days ago.

The challenge asked for a record that:

  • Improves the visual layout and style of the information from the medical record
  • Makes it easier for a patient to manage his/her health
  • Enables a medical professional to digest information more efficiently
  • Aids a caregiver such as a family member or friend in his/her duties and responsibilities with respect to the patient

The entries were judged by a twelve person panel ranging from Wired Magazine’s Executive Editor, Thomas Goetz to Facebook’s Product Designer, Nicholas Felton to Dr. Sophia Chang, the director of the Chronic Disease Care program of the California Health Care Foundation. They looked at several features of a revamped record from overall appeal to how readily it shows important information and how accessible it is for physicians, patients, etc.

The Winners

The judges picked three big winners and three winners in the Problem History, Medication and Lab Summaries areas. Here’s a brief look at the top entries, but the submissions should be looked at more as a resource than a race result, as I’ll discuss.
Nightingale
First place went to Nightingale an anonymous group that won $16,000. Others won smaller amounts. In the next few months, elements of the winning designs will be put together and put up on Github.

Nightingale’s design stressed that health was a continuing concern and that a user should be able to see an improving or declining trend without having to dig for the data. They did this by integrating the often disparate information in visits, exams and lab results. You can see this emphasis in their lipid panel screen. Sliders place each test result for each test’s in a range. Good results slide to green while poorer result move to red.
StudioTACK
Second place StudioTACK took a somewhat similar approach to creating a problem history, which they call a medical strategy rather than a record. They did this by bringing their findings into a body map with references to location and organ.

Matthew Sanders’ CCD scored the best Problem History section award. Sanders rearranged and redesigned the traditional note not by condition nor by past chronology, but into a timeline of past, present and future actions. While he admits that his approach is somewhat redundant for meds, he emphasizes that this arrangement helps all the users maintain a focus on the most important areas for action. Sanders presentation notably describes how he implemented his approach. To do this, he stripped out standard label text, clarified terms and gave the remaining items visual emphasis. This type of analysis makes going through the submissions worth it.
Sanders CCD
This isn’t to say that the way the contest was run and the approach of many submissions  — including some prize winners — were without shortcomings. There were some notable problems.

The Contest’s Problems

The contest’s operators needed to be far more specific about what they wanted and how they judged the results.

The challenge’s purpose was far from clear:

The purpose of this effort is to improve the design of the medical record so it is more usable by and meaningful to patients, their families, and others who take care of them. This is an opportunity to take the plain-text Blue Button file and enrich it with visuals and a better layout. Innovators will be invited to submit their best designs for a medical record that can be printed and viewed digitally.

A medical record is an on going repository of a person’s health context, status, prognosis, plans, etc. It has many contributors and users. The VA’s Blue Button is a snapshot of the person’s status for their use. However, the contest uses these terms interchangeably. Due to this muddle, many of the submissions sent in designs for a medical record, while others, a minority, only redid the Blue Button’s outline. Thus, not all submissions were developed on the same basis. Indeed, the judges seem to acknowledge this since they gave first place to Nightingale, which claims, “to be a new take on health records.” The contest would have done much better if it asked for particular types of screens putting everyone on the same page, as it were.

The contest judging panel while distinguished, had no practicing physicians, nurses or practice managers, a significant failing. While three of the twelve judges are MDs, not one is a practicing physician.

Finally, if you’re going to hand out $50,000 in public funds, you might just want to say why you thought the winners stood out.

The Submissions

The contestants almost universally got one thing right. They designed their entries for desktops/laptops, pads and phones. They showed a great understanding that we don’t work on just one platform, but move from one to the other almost continuously. In this, they deserve much praise. However, all this cross platform awareness is done in by an appalling over, under and misuse of font color, and size. As one post noted about Nightingale:

The text is too small and medium gray on light gray is very hard to see, especially for older people and people on cheap computers with low contrast displays. How can this possibly be the first place winner?

The comment is generous. Nightingale’s gray on gray font is almost unreadable. Granted their submission is a PDF of a prototype, nonetheless the possibility of staring at their screens all day would give me a headache.

They are not alone in color misuse. Second place winner, Studio TACK, goes to excess the other way with a white text on red iPhone screen. It’s more suited to public safety than health.
StudioTack Mobile
Going through the submissions, however, can be most rewarding. I found a gem of a summary page in Uncorkit’s submission. Their infographic approach puts not only labs and weight history on timelines, but also includes BP, conditions and meds. It gives you a great overview and a logical place to drive down for detail information without overwhelming your senses.

The Health Challenge submissions have much to recommend them. Just remember how they came about and what they may or may not include.
Uncorkit

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January 28, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  HealthCare IT
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Healthcare Groups Want Meaningful Use Evaluated Before Stage 3

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Though the final rules for Meaningful Use Stage 3 aren’t due to take effect until 2016, ONC has already made the draft rules available for public comment.  And comments, to be sure, the agency is getting.

While various groups have chosen their own details to critique, the general consensus seems to be that ONC is getting ahead of itself and ought to give Meaningful Use Stage 1 and 2 a good hard look first.

Accordng to a nice summary from iHealthBeat, here’s where some of the major healthcare groups stand:

* The American Hospital Association is recommending that ONC fund a comprehensive evaluation of MU generally, and while it does, hold off on finalizing Stage 3 recommendations.

*  CHIME, too, is asking ONC to evaluate the existing Meaningful Use program to decide whether achieving stage 3 is realistically possible by 2016.

* The Federation of American Hospitals is also arguing that ONC needs to evaluate current Meaningful Use requirements.  Also, in its letter to ONC, the group argues that the existing structure of two years per stage doesn’t cut it.

* The AMA weighed in with its own recommendation that ONC evaluate Meaningful Use as is before moving ahead. It also suggested changing some thresholds to  make them more reachable; greater flexibility in program requirements; change the certification process to address usability; and improve HIT’s capability to share patient data.

Personally, I think the idea of doing an extensive Meaningful Use evalulation sounds like a good one, and I hope ONC actually does so.  When you’re setting new standards that affect so many providers, why not gather some data on how existing standards work?

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January 16, 2013 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.

Filed Under: CCHIT Certification  Certified EHR  EHR  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  HITECH  Hospital EHR  Hospitals  Meaningful Use
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Meaningful Use Potpourri – Meaningful Use Monday

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We’ve been publishing Meaningful Use Monday for exactly two years today. Most of the posts have been written by the wonderful Lynn Scheps from SRSsoft and I think they represent a wonderful asset to those interested in meaningful use. That’s close to hundred posts on the subject of meaningful use and EHR incentive money. Hopefully readers have found it as useful as I have in understanding the complexities of meaningful use.

Considering how much we’ve posted about meaningful use, I think it’s time to move meaningful use out of a featured space on the site. Don’t get me wrong, I’m sure there are many more meaningful use posts to come. In fact, it’s likely a post a week will still be about meaningful use and the EHR incentive money in one way or another. However, I hope that we can also help many doctors move past meaningful use to actually meaningfully using EHR and other healthcare technology. For example, I’m planning a series of posts on the benefits of EHR in the current environment. I expect it to drive some really interesting conversation.

Before I end the Meaningful Use Monday series to a more random assortment of meaningful use posts, I thought I’d provide a potpourri of meaningful use thoughts. I think you’ll find them interesting.


This is an interesting title since the article says that most won’t be able to show meaningful use and then goes on to list the statistics for how many doctors are using EHR. So, they’re using EHR, but they don’t have the capability to show meaningful use? To me EHR adoption is the more important number. I also like that EHR vendors have all applied the same CCD standard for data portability. I’m ok if many doctors forgo meaningful use. Although, we’ll see how that plays out if the penalties indeed go into effect.


This is music to my ears. I’ve been preaching this message for a long time. The odd part is that this article references the same studies and data as the first. What is clear from the numbers is that EHR adoption is up. That’s a good thing for healthcare since we need widespread EHR adoption to take the next step to technology adoption in healthcare.


I don’t think this is true, depending on how you define “apply.” I know very few doctors who have applied to meaningful use and not gotten paid. If you know of stories that say otherwise, I’d love to hear them. This is particularly true in meaningful use stage 1. We might see more meaningful use payment rejections in stage 2 and 3, but so far the money has basically flowed out. I think this is by design. The worst thing for ONC would be many doctors working towards meaningful use and then not getting paid.


Yep, meaningful use stage 2 is still getting tweaked. It’s hard to keep up.


Almost a third of the way there. I love this “shovel ready” part of the ARRA economic stimulus package. Makes me laugh to think about it.

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December 10, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Filed Under: ARRA  EHR  EHR Stimulus  Electronic Health Record  Electronic Medical Record  EMR  HealthCare IT  HITECH  Meaningful Use
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