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Physician Burnout, a Healthcare Issue Unique to Our Healthcare Providers

Posted on May 25, 2018 I Written By

The following is a guest blog post by Justin Campbell, Vice President, Strategy, at Galen Healthcare Solutions.

I Can’t Get No Satisfaction…but I try, and I try, and I try, and I try – Rolling Stones

Justin CampbellIn a 2018 Medscape survey exploring the professional satisfaction of providers, 42 percent of 15,000 survey respondents reported feeling burnt out with their jobs, up from an overall rate of 40 percent in 2017. In recent years, physician burnout has become a serious industry issue, with national policy discussions ensuing on how to best combat the problem. Researchers have drawn correlations between physician burnout and higher medical error rates, lower overall quality of care, and increased clinical staff turnover. Year after year, the underlying drivers of dissatisfaction have remained consistent: overwhelming charting requirement, long work hours, and cumbersome EHRs.

As health IT leaders, one question we should be asking ourselves is how we can best apply our EHR expertise to help reduce physician burnout. To answer this question, let us look to the doctors we aim to help. When physicians are at the bedside, they analyze a patient’s condition and formulate a care plan accordingly. They look to diagnostic test results, review trended vitals, pain scores, and nursing assessments, and consult with specialists in a massive data gathering exercise all aimed at quantifying the problem and crafting a treatment plan.

Providers are telling us there is a problem, and they are consistently identifying the primary underlying causes. IT department leaders have a direct influence over many of the drivers of physician burnout, so it is time for us to dig into the details, measure the problem, and craft a treatment plan. How do we measure and manage physician burnout?

There’s Gold In Those EHR Audit Logs

The Office of the National Coordinator’s EHR Certification Requirements mandate that all certified EHRs be capable of generating an audit log detailing all user activity, stored in a database alongside user credentials and a date and time stamp. At first glance, these unassuming audit logs appear to provide little actionable insight, but buried in the data there is value. When audit logs are compiled across several months, data analysts will quickly see that they have a rich dataset that can be sliced and diced to expose the EHR navigation and module utilization trends of key physician populations.

Analyzing patterns within EHR audit logs will allow savvy data analysts to determine the average length of time providers spend working in the EHR. This information can be calculated at the individual level or aggregated across all providers.

Source: Galen Healthcare Solutions

Knowing how long providers are spending on administrative tasks in the EHR is valuable information for a number of reasons. First and foremost, this information can be used as a benchmark to measure the impact of future software updates or optimization projects. Any significant changes to provider workflow should be retrospectively reviewed to understand how it impacts the average time providers spend in the EHR. First, do no harm.

Analyzing user activity logs at the individual level also helps identify highly efficient EHR users within each specialty. The EHR workflow patterns of these EHR champions can be modeled. Peers can be educated on how to adjust their own workflows to mirror specialty-specific champions, reducing their own daily EHR burden. These “quick win” workflow adjustments are changes that can be adopted by clinical staff immediately, before extensive EHR optimization efforts are undertaken.

Audit log analysis can also highlight which EHR modules providers spend the most time in. In most cases, updating user preferences and optimizing the information displayed on EHR screens can expedite chart navigation. Simplified documentation templates and macros training can expedite the documentation process. A library of evidence-based order sets and targeted clinical decision support algorithms can minimize time spent entering orders.

Analyzing utilization trends at the EHR module level exposes the workflow tasks that are consuming a disproportionate amount of provider time.

Don’t. Stop. There.

EHR audit log analysis can reveal how much time providers are spending in the EHR, and where specifically they are spending that time. It can identify physician champions, and highlight those that are struggling. Audit log analysis can be used to measure EHR-induced physician burnout and support system-wide optimization efforts aimed at improving satisfaction.

Beyond this, EHRs offer a wealth of additional datasets that can help highlight inefficiencies in clinical workflows. Traditional health IT data analytics typically aims to uncover problems in care quality or revenue cycle management, but analysis focused on EHR workflow improvement is just as noble an effort, and one providers have long been seeking.

Gain perspectives from HDO leaders who have successfully navigated EMR clinical optimization and refine your EMR strategy to transform it from a short-term clinical documentation data repository to a long-term asset by downloading our EMR Optimization Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement & data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell and LinkedIn.

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and Gold sponsor of Health IT Expo. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit www.galenhealthcare.com. Connect with us on TwitterFacebook and LinkedIn.

 

Origin Story: Paul M Black, CEO of Allscripts – Deep Roots and Optimism in Healthcare

Posted on May 24, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

This is first in a new series of articles. Over the coming weeks and months I will be publishing the origin stories of interesting, inspiring people in healthcare. These men and women come from all walks of life. Some are titans in the industry, others are leading grass-roots efforts. All are making an impact on healthcare.

As a self-professed comic-book geek, I am fascinated by origin stories – the account or back-story that reveals how someone became who they are today. Origin stories add to the overall narrative and give reasons for a person’s intentions. Knowing someone’s origin stories can give clues to their future actions.

Kicking off this series is the origin story of Allscripts CEO Paul Black. Allscripts, based in Chicago, serves over 45,000 physician practices and 2,500 hospitals around the world with their EHR systems and other Healthcare IT solutions. The company has a rich history of mergers. Early on they merged with Misys and Eclipsys. More recently, the company has acquired McKesson’s Health IT business and Practice Fusion.

It is common knowledge that Mr. Black has a long history in healthcare. Prior to becoming CEO of Allscripts in December 2012, he spent 13 years as Chief Operating Office at Cerner (an Allscripts rival). He has also served as an advisor to healthcare companies through his work at New Mountain Capital and Genstar Capital.

What is not common knowledge is how far back Black’s history with healthcare actually goes. When he was just 5 years old, Black accidentally consumed weed poison that was in an unlabeled vial. Luckily his father, who was the Director of the Pharmacy Department at the local hospital took him to the VA emergency room right away. As a healthcare professional his father knew that the VA had just purchased an artificial kidney machine – the very device needed to treat this type of poisoning. Spoiler Alert: Black made a full recovery thanks to his father’s quick actions and the knowledgeable staff at the VA.

To understand how lucky Paul Black was, you have to remember that back then, there were no toxicologists, no poison control centers, no detailed chemical labels and very little knowledge of poison treatments. In fact, it wasn’t until 1953 that the first poison hotline was established in Chicago by Louis Gdalman R.Ph and Edward Press MD [source: Forging a Poison Prevention and Control System 2004].

Black’s poisoning incident led his father to establish an Iowa poisoning hotline so that people in his home state could find out what to do in a poisoning situation. His work eventually led to the creation of the Iowa Poison Information Control Center – an entity that is still saving lives today.

“My father was always working on ways to improve healthcare,” recalls Black. “He built a machine that would help ensure that the right medication would be administered to the right patient at the right time. It was basically a precursor to a Pyxis machine. He got involved in computers in the early stages and was always looking for ways to use systems (whether physical or software) to solve problems in healthcare.”

Clearly the apple did not fall far from the tree.

Early in his career, Black worked at IBM where he learned “a lot about systems, software and hardware.” But more importantly, it was his time at IBM that ignited his passion for healthcare.

“I just felt good whenever I worked with hospitals and healthcare clients,” explains Black. “It was clear that working with them had a direct impact on care and on individuals in their care.”

Black moved on from IBM and joined Cerner, then an up-and-coming healthcare systems maker. There, he progressed steadily through the ranks until ultimately becoming Chief Operating Officer in 2005. Black retired from Cerner in 2007 and served in a number of advisory/board positions until he was named CEO of Allscripts in 2012.

I asked Black why he chooses to stay in healthcare.

“It’s pretty simple actually. We aren’t done yet,” states Black. “My grandfather was born in 1888 and during his lifetime we went from horse-and-buggy on dirt roads to a full interstate system with fast cars and a railroad system with fast trains. We also went from having to read your news in a newspaper to wireless radio. He even saw us land on the moon. That was an incredible amount of progress for a single lifetime. I would argue that in my lifetime we are going to see a similar leap with just as many innovations, discoveries, and life saving technologies. That’s why I stay. Healthcare is going to be a fascinating industry for the next 20+ years. Plus there aren’t many industries where you get to help the people that save lives.”

Black went on to say that this is a time in healthcare when strong leadership will be required to ensure we make the right decisions for the benefit of the many vs the few. He pointed at genomic testing as an example. Even though the cost of sequencing continues to drop, access to this type of technology and access to clinicians knowledgeable on how to interpret the results is not universal.

Access to care is a cornerstone of Black’s vision of a perfect healthcare system, something I asked him to describe during our conversation: “My perfect healthcare future is one where everyone has access to healthcare, not just people of means. It’s one where a payment mechanism has been figured out whereby a certain level of access is guaranteed as is a certain level of prevention.”

Black went on to say that this vision is not as far fetched as it may first sound: “My view is that there is enough money already in the healthcare system today to make this happen. If you add the dollars spent by every single player in the healthcare industry – governments, employers, patients, etc – it’s more than enough. We are at 18% GDP. It’s just not being spent efficiently.”

To reach his vision, Black feels we need to build a healthcare system where: “We get the diagnosis right the first time, there is no delay in treatment and there is active involvement from patients in their health.” The latter being the toughest challenge – motivating the average person to exercise more, eat better and make healthier lifestyle choices.

“We have to make it cool to be healthy,” says Black. “In fact we need the healthy equivalent of the Marlboro Man, which I know is an ironic and strange thing to say. But back in the day, EVERYONE wanted to be the Marlboro Man. He was what young men aspired to be like. We need the healthy equivalent to help motivate people to be more engaged in health.”

It is not surprising that Black sees Allscripts playing a significant role in making healthcare more efficient and effective. “Allscripts definitely has a role to play,” explained Black. “We will play that role by staying relevant in the healthcare industry. We have our core EHR products, but we also have four other product lines that are actually EHR-agnostic. We have our population health platform, dbMotion. We have our post-acute system, Netsmart. We have our precision medicine platform, 2bPrecise. And finally we have our consumer platform, FollowMyHealth. We will continue to push aggressively in these markets through innovation and acquisition to provide our clients with the solutions THEY NEED to deliver better care to patients.”

Allscript’s latest acquisition certainly fits with this acquire-functionality-that-clients-want strategy. On May 18th, the company acquired HealthGrid – a communication platform that delivers reminders, alerts and educational materials to patients via phone, text, and other electronic means. This functionality will be rolled into Allscript’s FollowMyHealth product line.

“I feel it’s our duty and obligation to automate the healthcare ‘shop floor’,” declares Black. “The groundwork had been laid with EHRs, but now it’s time to streamline workflows and leverage the data within these systems. We need to reduce the ‘shouting’ in healthcare (too many alarms). We need to improve User Interfaces so systems are easier to use. We need to reduce the documentation requirements on clinicians so they can go back to taking care of patients vs being data entry clerks. Computers should work for us, not the other way around.”

Reflecting on Black’s origin story you can see the thread of hope and optimism woven throughout. From his first (and positive) encounter with the healthcare system when he was 5 years old to watching his father use computers/machinery to try and improve patient care to the positive feelings he had while working with hospital clients at IBM – every experience brought him closer and closer to healthcare until he became part of the industry through his position at Cerner.

It gives me hope that an industry leader like Paul Black is optimistic about the future of healthcare. It’s exciting to learn that he is not just saying the right words, he is putting energy and investment behind them. It will be interesting to see how Allscripts will continue to “remain relevant” and be agile in the years ahead.

How Health IT Helps and Hurts Patients – #HITsm Chat Topic

Posted on May 23, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/25 at Noon ET (9 AM PT). This week’s chat will be hosted by Amanda (@LALupusLady) on the topic of “How Health IT Helps and Hurts Patients (Especially Those with Chronic Conditions).”

Health IT is a powerful tool. It has changed the way patients, especially people with chronic illnesses live with and manage their care. As a woman living with multiple autoimmune illnesses for over three decades, my perspective is unique as I have seen the shift and how providers have been eager to adopt technology into their practice and recently experienced a doctor’s office where the fax machine is still the primary means of communication.

In my patient experience, I have chosen to adopt and use Health IT to assist me in managing my chronic care. Whether I am tracking my symptoms, keeping a food diary, or putting on a VR headset to help me relieve my pain, Health IT has improved my patient experience. While at the same time, the fact that with all the advances in Health IT that not every advance is a step forward for healthcare. There is frustration by patients that (in 2018) EHR developers have not yet developed a way for various platforms and institutions to connect to create one complete healthcare record for one patient.

Next week, I am proud that I will be at #HITExpo to share my patient experience at Healthcare Scene’s inaugural event in New Orleans. Understanding the value and insight that patients have can build an empathy, which I feel will directly improve the way Health IT collaborations work together.

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1: How is Health IT (Apps, Devices and New Technology) helping streamline the patient experience (especially for people living with chronic conditions)? #HITsm

T2: How is Health IT hindering (hurting) the patient experience (especially for people living with chronic conditions)? #HITsm

T3: What Health IT companies/developers have made a positive impact on your life? How? If you are a patient, what Health IT has directly improved your patient experience? #HITsm

T4: How can Health IT work together with patient communities to improve outcomes and engagement? #HITsm

T5: What can you do to support Health IT “collaborations that work” with patients, especially those living with chronic conditions? #HITsm

Bonus: What are you most looking forward to at #HITExpo? #HITsm

Wishing you a Healthy and Happy Lupus Awareness Month. Can’t wait to chat together.

Upcoming #HITsm Chat Schedule
6/1 – #HITExpo Hiatus
The #HITsm chat will be on hiatus this week with the Health IT Expo happening in New Orleans. Please join in on the conversation happening on the #HITExpo conference hashtag.

6/8 – How Technology and Healthcare Should Gracefully Collide to Provide the Best Patient Experience
Hosted by Jeanne Bliss (@jeannebliss) and Michelle Chaffee (@mdchaffee)

6/15 – TBD
Hosted by Janice McCallum (@janicemccallum)

6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – TBD
Hosted by Cathy Turner (@MEDITECH_Nurses) from @MEDITECH

7/6 – TBD
Hosted by Lea Chatham (@LeaChatham)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

The State Of Healthcare Cybersecurity (Part 2)

Posted on May 22, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In Part 1 of this series, which drew data from a study by Black Book Market Research, I described how insecure healthcare leaders felt their cybersecurity protections to be. I also noted that a large number of providers are struggling to recruit senior health IT experts, and as a result are basically winging it when it comes to breach protection.

Healthcare organizations’ data security problems run deeper than that, however, the study suggests. Not only are C-level execs finding security investments to be troublesome, IT managers responding to the survey admit that they, too, feel that they are not fully prepared to defend their institution’s data.

To begin with, 74% of surveyed CIOs admitted that they failed to evaluate the total cost of ownership before signing a deal with a cybersecurity solution or service provider, and 89% said they bought their cybersecurity solution to be compliant with security regs, and often, not necessarily to reduce security risks.

And the failure to protect critical information doesn’t stop there.  For example, 57% of IT managers said that they hadn’t taken stock of the full variety of cybersecurity solutions that currently exist, notably mobile security environments, intrusion detection, attack prevention, forensics and testing.

Also, many healthcare institutions seem to react only after they’ve been invaded. According to Black Book, 58% of hospitals didn’t select their current security vendor until after a data security incident, and 32% of healthcare organizations hadn’t scanned for vulnerabilities before an attack.

What’s more, 83% of healthcare organizations haven’t staged a cybersecurity drill which included an incident response process, which arguably leaves them particularly unprepared. Not only that, when an attack comes, some won’t catch it right away, as 29% said they don’t have an adequate solution to instantly detect and respond to cyberattacks.

Meanwhile, 16% of respondents reported being uncomfortable working with vendors that do a hard sell when they find security flaws and vulnerabilities. These insecurities aren’t surprising given that 60% of healthcare enterprises haven’t formally identified specific security objectives and requirements and integrated them into a strategic and tactical plan for breach prevention.

Given how unfocused many security plans are, it’s not surprising that 22% of provider organizations believe their cybersecurity position will worsen between now and the second quarter of 2019. Only 12% of hospitals and 9% of physician organizations reported that they expected to see cybersecurity improvements.

The bottom line here is that if the Black Book research is correct, many healthcare organizations are frighteningly unprepared to protect their data, much less survive a serious attack relatively unscathed. For everyone’s sake, let’s hope that providers wise up to the need for strategic, substantial investments in security technology and staff.

The State Of Healthcare Cybersecurity (Part 1)

Posted on May 21, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Healthcare data has never been under more outside threats than it is today. For a number of reasons, this data has become more attractive to cybercriminals and can be sold on the dark web for a pretty penny. Not only that, emerging threats like ransomware attacks are hitting home and wreaking havoc with the institutions they target.

Unfortunately, according to a new study by Black Book Market Research, healthcare organizations don’t seem to be adequately prepared for this onslaught.

The survey, which collected responses from more than 2,464 security pros working at 680 provider organizations, found that health IT leaders aren’t confident they can defend themselves against cyberattacks. In fact, 96% of IT professionals who responded said that the attackers are significantly ahead of them and could probably cut through the protection their organizations have in place.

Given that stat, it’s not surprising that over 90% of healthcare organizations have seen a data breach since Q3 2016. Worse, almost 50% reported that they had more than five data breaches during this period. Not only that, more than 180 million records have been stolen since 2015, a staggering haul which affects roughly one in every 12 healthcare consumers.

On the surface, it might seem surprising that healthcare organizations haven’t toughened their defenses given the number of threats they face. Actually, they are, but they’re being outgunned. It’s not that they’re not making cybersecurity investments, but both the level of investment and their strategy for deployment may be inadequate.

In a surprisingly frank set of disclosures, one-third of hospital executives that bought cybersecurity solutions between 2016 and 2018 said they did so blindly without much vision or understanding of what they were getting for their money. Respondents said that 92% of data security product and services buying decisions were made at the C-level, and the process didn’t include any users or affected department managers.

One reason that C-level executives with little relevant knowledge are making security investment decisions because they don’t have anyone senior to consult – and the problem is extremely common.

The survey found that 84% of hospitals responding had no dedicated security executive in place. Most say that it’s difficult to recruit a qualified chief security officer, which is why they’re going bare on data security and stumbling through the buying process as best they can.

Some organizations are responding to the shortage of C-level tech talent by outsourcing the function. Twenty-one percent said they outsource security to partners, consultants or selected security-as-a-service options as a placeholder.

Given this interest in outsourcing, healthcare organizations are signing deals with security services and outsourcing companies five times more often than they’re buying cybersecurity products and software. Vendors, in turn, are responding by diversifying the portfolio of services they offer. Still, that’s unlikely to be enough over the long term.

All of this suggests that the healthcare industry is in a security crisis. I’ll offer more details on the situation in part two of this series.

Coworker Humor – Fun Friday

Posted on May 18, 2018 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.

It’s Friday! Time to get ready for the weekend with a little co-worker humor:

Good teammates definitely feel like a mythical creature. They’re really really hard to find. So, once you find them, be extremely grateful. It’s amazing how much your teammates impact you. I love that this tweet was about gamers, but it’s true in work and life as well.

Healthcare AI Needs a Breadth and Depth of Data

Posted on May 17, 2018 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 I’m enjoying the New England HIMSS Spring Conference including an amazing keynote session by Dale Sanders from Health Catalyst. Next week I’ll be following up this blog post with some other insights that Dale shared at the New England HIMSS event, but today I just wanted to highlight one powerful concept that he shared:

Healthcare AI Needs a Breadth and Depth of Data

As part of this idea, Dale shared the following image to illustrate how much data is really needed for AI to effectively assess our health:

Dale pointed out that in healthcare today we really only have access to the data in the bottom right corner. That’s not enough data for AI to be able to properly assess someone’s health. Dale also suggested the following about EHR data:

Long story short, the EHR data is not going to be enough to truly assess someone’s health. As Google recently proved, a simple algorithm with more data is much more powerful than a sophisticated algorithm with less data. While we think we have a lot of data in healthcare, we really don’t have that much data. Dale Sanders made a great case for why we need more data if we want AI to be effective in healthcare.

What are you doing in your organization to collect data? What are you doing to get access to this data? Does collection of all of this data scare anyone? How far away are we from this data driven, AI future? Let us know your thoughts in the comments.

Strong Statements from Vinod Khosla at HLTH

Posted on May 16, 2018 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.

Last week I had the opportunity to attend a small piece of the new HLTH conference in Las Vegas. My time at the event was cut extremely short as I had to head to Science Camp with 80 5th graders (including my daughter), but I was able to hear the opening keynotes on Sunday. I was most interested in hearing from Vinod Khosla who I don’t always agree with, but he often causes me to look at something a little different or to see the future in a new way. As usual, that’s what he delivered on stage (Between pitches for his companies of course). Here’s a look at some of the pictures and tweets I shared from Vinod’s talk at HLTH.


Needless to say, HLTH was a big event. When you pour $5 million into an event, it better be big. Not to mention the marketing they did for the event. I’m glad to not see HLTH ads on every website I visit now. The turnout for the event seemed good. I saw a lot of social media people there that I know. I was surprised by how many young people were at the conference. Maybe the CEOs they reference in their marketing were a lot of startup CEOs.


This was an extremely powerful and thought provoking statement for me. His assertion is that instead of treating people based on their symptoms, the devices and sensors we use to monitor and measure our health will be so good that these health measurements will drive medicine and not the symptoms we experience. Chew on that concept for a while and you’ll see how it’s not that far fetched even if it is still a ways away.


I’m no expert on medical education, but this does bring up some challenging questions for medical schools. In many ways, it’s similar to what I feel about elementary school for my kids. Sure, there’s a baseline of knowledge that is helpful to understand. However, when it comes to diagnosis, treatment, etc, we’re going to have to seriously consider how we train future doctors. New skills are going to be required to effectively treat a patient. I can’t imagine most medical schools are going to be ready to adapt to this change.


I tweeted this after Vinod talked about all the various tests, labs, etc he’s getting. He sees it as research and suggests that it’s not something that other people should be doing. Vinod seems to have a similar view of health testing as Mark Cuban. Mark Cuban controversial suggested that those who can afford it should do regular blood tests. Opponents argue that it drives unnecessary procedures, unnecessary health fears, and plenty of other issues from over testing. I’ve always felt like there was a balance and it was important for Vinod and Mark to understand these possibilities as they test regularly. However, having this baseline of information could be extremely valuable in discovering what really influences our health.

Some pretty interesting things to think about. Is it very practical for a health IT professional? Probably not and that’s probably why I didn’t see any health IT professionals, CIOs, or other people like that at the HLTH conference. That’s not the goal of the conference really. It seems like there will be another HLTH in 2019. Will be interesting to see what vendors return and who doesn’t.

Of course, some people got distracted at HLTH by the wedding chapel:


Then again, maybe a HLTH Wedding might be a great outcome for some people.

Practical Applications of EMR Optimization Through Clinical Decision Support – #HITsm Chat Topic

Posted on May 15, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/18 at Noon ET (9 AM PT). This week’s chat will be hosted by Justin Campbell (@tjustincampbell) from @GalenHealthcare on the topic of “Practical Applications of EMR Optimization Through Clinical Decision Support”


As a primer for the upcoming Health IT Expo, we will be discussing practical applications of EMR optimization through clinical decision support. Optimization dominates Health IT leaders’ list of priorities as they seek to rationalize EMR investment and harness its capabilities for improving efficiency, care and outcomes. However, boil-the-ocean approaches to EMR optimization can be counterproductive and stifle progress. Instead, Health IT leaders would be best served to focus on practical applications of optimization – specifically through clinical decision support, which serves as a lynchpin to clinical quality improvement initiatives.

Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care.

CDS has a number of important benefits, including:

  • Increased quality of care and enhanced health outcomes
  • Avoidance of errors and adverse events
  • Improved efficiency, cost-benefit, and provider and patient satisfaction

CDS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include:

  • Computerized alerts and reminders to care providers and patients
  • Clinical guidelines
  • Condition-specific order sets
  • Focused patient data reports and summaries
  • Documentation templates
  • Diagnostic support, and contextually relevant reference information

The majority of CDS applications operate as components of comprehensive EHR systems, although stand-alone CDS systems are also used. Many modern EMRs contain CDS capabilities such as rule engines, predictive modeling languages, and alert and order set authoring. However, the development and use of effective CDS within the EMR requires significant clinical, IT, and knowledge management resources that many organizations do not possess. This has led an increasing number of organizations to use compartmentalized decision support platforms other than EMR to drive portions of their CDS programs.

Ideally, CDS tools will be readily accessible to a wide array of caregivers where and when they need them, irrespective of what electronic health record they’re using. One such initiative emerging to share CDS resources is the AHRQ-funded CDS Consortium Project, which has demonstrated successfully that CDS from Partners Healthcare could be delivered to disparate EMRs across the country.

In an age of overwhelming data access and rapid technological development, ensuring clinicians have the clinical decision support tools to sift through a sea of information to find what is most relevant to their patient’s needs is vital to optimizing health outcomes.

In this tweetchat, we will discuss types of CDS (including sepsis surveillance, risk calculators, drug interaction, among others), mechanisms to deliver CDS to the point of care, workflow and alert fatigue implications, and methods for sharing proven CDS libraries.

Resources and Other EMR Optimization & CDS Reading:

  1. EMR Optimization Whitepaper
  2. EMR Optimization Infographic
  3. HealthIT.gov Clinical Decision Support
  4. CDS in the Cloud: Deploying a CDC Guideline for National Use
  5. Almost 20 Percent of CDS Alert Dismissals May Be Inappropriate
  6. EHR vendors, AHIMA push use of clinical decision support to prevent patient falls
  7. EMR Sepsis Surveillance – Achieving Optimal Sepsis Sensitivity & Specificity
  8. Integrated Health Calculators Whitepaper

Join us for this week’s #HITsm chat where we’ll discuss the following:

T1: What experiences do you have with CDS implementation? What impacts (positive and negative) did it have? #HITsm

T2: How can CDS best be deployed to the point of care without exacerbating alert fatigue? #HITsm

T3: How are different types of CDS initiatives (VTE, sepsis detection & prevention; clinical pathways implementation; risk calculation) prioritized? #HITsm

T4: Is CDS best suited to be managed by EMR vendors or can CDS be shared across vendors? How? #HITsm

T5: What are strategies to manage to CDS code and clinical peer review and rating? #HITsm

Bonus: What are mechanisms for making knowledge artifacts for CDS shareable? #HITsm

Upcoming #HITsm Chat Schedule
5/25 – TBD
Hosted by Amanda (@LALupusLady)

6/1 – #HITExpo Hiatus
The #HITsm chat will be on hiatus this week with the Health IT Expo happening in New Orleans. Please join in on the conversation happening on the #HITExpo conference hashtag.

6/8 – TBD
Hosted by Jeanne Bliss (@jeannebliss)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

More Than 1.1 Million Patient Records Breached During Q1 of 2018

Posted on May 14, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Well, this isn’t a pretty picture. According to research by Protenus, roughly 1.3 million patient records were breached between January and March of this year. (The actual number is 1,129,744 records, for those who like to be precise.)

During that quarter, the healthcare industry saw an average of at least one data breach per day, racking up 110 health data breaches during this period, according to the Protenus Breach Barometer.

The researchers found that the single largest breach taking place during Q1 2018 was an intrusion involving an Oklahoma-based healthcare organization. The breach, which exposed patient billing information for 279,856 patients, resulted from an unauthorized third-party gaining access to the health system’s network.

If you assume that the other breaches were also executed by external cyberattackers, think again. According to the data, healthcare staffers represented a far bigger risk of being involved with security violations.

The data suggests that such insiders were most likely to illegally access data on the family members, a problem which accounted for 77.1% of privacy violations in the first quarter of this year. Accessing records on coworkers was the second most common insider-related violation, followed by accessing neighbor and VIP records.

Not only that, Protenus researchers found that if a healthcare employee breaches patient privacy once, there’s a greater than 20% chance they will breach privacy again in three months’ time. Worse, there’s a greater than 54% chance they will do so again in a years’ time. That’s a pretty nasty form of compounding risk.

Not only that, do healthcare institutions catch breaches right away? According to Protenus research, it takes healthcare organizations an average of 244 days to detect breaches once they take place. As readers know, some of these events involve information being exposed to the Internet, offering private information to the public via an unprotected interface. Also pretty ugly, and also a source of lousy PR for the organization.

This research is a sobering follow-up to the company’s year-end report for 2017. Last year, according to Protenus research, there was an average of one health data breach per year in 2017. The 407 incidents it identified affected 5,579,438 patient records.

The largest breach taking place in last year involved a rogue insider, a hospital employee, who inappropriately accessed billing information on 697,800 patients. The rest of the top 10 largest data breaches largely sprang from insider errors.

Wow. If it wasn’t evident already, it’s pretty clear now that healthcare organizations need to tighten up their internal data security measures and training substantially.

While there will always be some folks who want to snoop on celebrity records to find imaging medical information on their ex, and some who plan to sell the information outright, a greater number simply need to be reminded what the rules are. (Or so I assume and fervently hope.)