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The Double Edged Sword of Healthcare Culture

Posted on March 25, 2016 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.

Rasu Shrestha, MD shared the tweet above today which caused me to ponder on the impact of culture on healthcare. This tweet was particularly interesting coming from Rasu who has created a unique culture of innovation within healthcare at UPMC.

While at RSNA, Rasu recounted to me how his UPMC innovation offices shares a building with the Google office. When interviewing candidates, many of those prospects interview at both UPMC and Google. There’s no way that Rasu and his team can compete with Google as far as perks. However, there’s no way that Google (at least the offices in Pittsburgh) can compete with the impact UPMC can have on the lives of individuals.

If it weren’t for the culture and mission of Rasu and UPMC, then they wouldn’t stand a chance recruiting people away from Google. However, that mission makes all the difference for the right person. Plus, if that person doesn’t understand the mission, then UPMC doesn’t likely want them in the first place.

While I believe that Rasu has created a special culture of innovation, the same can’t be said for much of healthcare. In fact, if you read the tweet at the top another way, healthcare culture is holding innovation behind in so many ways.

Said another way, Culture trumps everything and that can be good or bad.

A culture of innovation is great, because it spurs more innovation. A culture of being closed. A culture of fear. A culture of bureaucracy. Those can all be extremely damaging and stifle innovation and change that could improve healthcare.

I want to be careful to say that I’m not advocating a culture of recklessness. Culture can be taken too far either direction. However, I know very few people in healthcare who are reckless and I know a lot of people in healthcare who are paralyzed by a culture of fear.

Take a second to think about your culture and the impact for good and bad it has on your and your organization’s choices.

Are CIOs Done with the Plumbing and Ready for the Drywall?

Posted on December 4, 2015 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.

At RSNA 2015 I had a chance to sit down with Evren Eryurek, Software Chief Technology Officer at GE Healthcare. We had a wide ranging conversation about what’s happening across all of healthcare IT and GE’s new healthcare cloud offering. However, the thing that stuck with me the most from our conversation was the comment he used to open our conversation.

Evren told me that as he sits down with health care CIO’s he’s finding that CIO’s are done with the plumbing work and now they’re asking the question, “What’s next?”

This statement really resonated with me. Up until now we’ve been doing a lot of the plumbing work in healthcare. It’s necessary work, but it’s stuck behind the walls and most people take it for granted really quickly. We see that first hand with EHR software and all the interfaces to the EHR software. We absolutely take for granted that charts are instantly at our fingertips with the click of a button. We take for granted that charts are legible. I could go on, but you get the point.

The problem is that even though we have the plumbing work done it’s still pretty ugly. We haven’t put up the drywall (to continue the metaphor) that will add some real form and function to the plumbing and framing work (the EHR) that we’ve been doing the past couple years. I think organizations are ready for this now.

While at RSNA I also spent some time talking with Rasu Shrestha, MD, MBA, and Chief Innovation Officer at UPMC. I asked him what topic was most interesting to him. His answer was “Data Tranformation.” I plan to have a future video interview (see our full history of video interviews) with him on the subject.

His concept of data transformation aligns really well with what other CIOs were telling Evren. They’re ready to figure out what we can do with all of this EHR data to improve care and move health care forward. The plumbing work is done. The foundation is laid. Now let’s look to the future of what we can do.

This same sentiment is reflected in a comment John Halamka, MD, MS, and CIO at Beth Israel Deaconess Medical Center, made in a recent blog post, “our agenda is filled with new ideas and it feels as if the weights around our ankles (ICD10, MU) are finally coming off.”

What Would New Care Delivery Models Look Like If Created Today?

Posted on November 24, 2015 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.


This tweet has been on my mind the last month. I’m sure that many in the trenches probably think that this type of thinking is a pipe dream and not worthy of discussion. While it’s true that we can’t go back and change the past, this type of thinking may predict where we need to go in the future.

I and many others have long talked about the way EHR software was built to maximize billing and then meaningful use. The focus of the EHR was not on how to improve patient care, but was really built around how the organization could manage it’s billing and make more money. So, we shouldn’t be too surprised that the EHR systems we have today aren’t these amazing systems that dramatically improve the care we provide.

With that said, there’s a sea change happening in health care when it comes to how organizations are being reimbursed based on value. Might I suggest that an organization that wants to be ready for this change in reimbursement might want to take the time to think about what care models would look like if they were created from scratch today without the overhead of the past.

I’m not the only one thinking about this. Check out this tweet from Linda Stotsky that quotes Rasu Shrestha, MD, MBA.


In the article that’s linked to in that tweet Rasu describes the real challenge of rethinking our care models:

What does it truly mean to have a patient-centered approach to care? As a clinician, I can tell you confidently that most of my colleagues tend to get defensive amid talk of the need to adopt a patient-centric approach to care. “Of course, we’re focused on the patient!” seems to be the most common reaction. Many simply assume that because care is essentially imparted onto a patient, everything we do, naturally, is patient-centric

Then he offers this frank comment:

But where is the patient in all of this? Is a system designed to help document our attempts to cure the patient, and help bill for the associated services, really the best we can do? Perhaps the problem is bigger than just the EMR. Perhaps our frequently paternalistic, and often heroic, approaches to care have been cherished, celebrated and incentivized for far too long. Perhaps we need to rethink care in a big way.

I agree with Rasu. He also quotes Ellen Stoval, survivor or three bouts of cancer who says, “We have been chasing the cure, rather than the care.” I’m actually optimistic that these changes are happening. We’re going to see a drastically improved health care system. It’s going to take time, but most changes do. What’s most exciting is that if we navigate these shifts properly, then doctors will finally get to practice medicine the way they imagined medicine. Instead of churning patients to meet revenue, they could actually spend more time caring for patients. That’s something worth aspiring towards.