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Meaningful Use Does Not Ensure Solid EHR Company – Meaningful Use Monday

Posted on April 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those of you who don’t follow all the inside EHR “baseball” that’s happening right now with Allscripts, you might want to check it out. If you use one of Allscripts various EHR software (do they have 6 EHR softwares now? I lose count) then you really want to pay attention. Here’s my cliff notes version of what’s happened for those who don’t want to research the details. Half the Allscripts board left and so did the CFO. It appears it was an Eclipsys departure with the previous Allscripts board members and CEO Glen Tullman remaining. After this happened the stock (MDRX) plummeted.

While to those inside the EMR world will realize that this isn’t a death knell for everything Eclipsys related, many who don’t know how important the Eclipsys software is for Allscripts could easily see this a different way. Of course, in the heartless world of publicly traded companies and CEO’s doing what they can to prop up stock price, you never know what action they might take next.

The best evaluation I saw of the Allscripts situation is that it is very likely that Allscripts and Glen Tullman will use this stock drop to start making even more drastic moves. For example, we all know that they don’t need that many EHR software and so none of us should be surprised if they choose to sunset 1 or more of their EHR software. Yes, that’s right. Your EHR software isn’t safe even if you buy it from a large EHR vendor like Allscripts (see also when GE ceased operations of Centricity Advance).

Think about it from Allscripts perspective. It takes A LOT of extra resources to ensure that multiple EHR software products are even just meeting the meaningful use and certified EHR requirements let alone actually creating innovative new EHR software features. Cutting out an EHR software will provide a huge cost savings to Allscripts going forward.

Why is this the topic of Meaningful Use Monday? I think this is an incredibly important topic related to meaningful use, because I can already see the physicians and practice managers hitting my website if Allscripts chose to cease their Allscripts MyWay EHR offering (I have no indication that Myway is gone. I’m just speaking hypothetically). I’m quite certain that many physicians and practice managers will wonder how an EHR vendor could sunset or stop developing an EHR software that is certified for meaningful use.

It’s quite simple: Meaningful Use and EHR Certification are NO guarantee of an EHR software’s long term viability.

I have a section in my EMR selection e-Book about ensuring the viability of your EHR vendor. I’ll admit that it’s not an easy task and is more art than science given our limited information about MANY EHR vendors. However, it’s worth considering the long term plans of an EHR vendor and a particular EHR software in that vendor’s quiver. Although, meaningful use and EHR certification do nothing to help you in that regard.

One final warning: we’re just at the start of EHR vendors going out of business, EHR vendors being bought by larger vendors, EHR software being closed down, EMR software being sunset. I give it another year before the Tsunami of EHR software mergers, acquisitions, bankruptcies, fire sales hit our shore. Although, the early warning signs are there and so we should prepare for the oncoming wave. The challenge is knowing where you can find high ground.

EMR Voice Recognition, EMR As Medical Devices, ACOs and HIEs, Top 100 Hospitals, and MU Stage 1 Money

Posted on April 29, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m traveling in what I consider the heart of healthcare IT: Boston. Everywhere you turn and look there’s healthcare all around. I’ve seen multiple vans with Partners on them. I even had a mobile health story in the Delta magazine I checked out on my flight out. Although, I’m not actually in Boston for work. I’m just here on vacation with my wife. So far I’ve done a pretty good job enjoying the vacation and not working. We’ll see how the last couple days go.

Don’t worry Boston, I’ll be back in two weeks for Health 2.0 Boston and we’ll get all the #HITsm crew together for some healthcare IT fun. Yes, bad planning on my part, but I do have an affinity for visiting Boston.

Ok, enough of the sidebar. Now to the usual round up of Healthcare IT tweets:


Is there an EMR where you can’t use voice recognition? I wrote a post on that a long time ago where the answer was no. They can all use voice recognition. Although, as I’ve written about the deep embedding of voice in some EMRs, it’s also true that not all EMR voice recognition is created equal. So, check it out if you like voice.


My answer is that they’re not medical devices. I think we have more than enough regulation in EMRs and I haven’t seen that regulation actually improve EMR software. So, I’m against more EMR regulation.


It’s true that many EHR vendors hold the blame for not exchanging data even if they put on nice demos at the Interoperability exchange at HIMSS. How about next year the interoperability showcase at HIMSS can only show actual implementations of real exchanges? I wonder how different it would be.


This top lists are always fun to click and rarely have much value. Although, to me it probably mostly shows a correlation by the money made and the IT implemented. The more money they have the more likely they are to implement healthcare IT.


Stage 4? You have to have completed every EMR stage (ie. Full implementation).

The Problem I See with Home Health Monitoring

Posted on April 27, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When I was writing my post about this mHealth infographic, the thought came to me about why I’ve never felt truly comfortable with the idea of Home Health Monitoring (some might call it the Patient Centered Medical Home). I think the problem I see lies in our ambitious goals of what we monitor at home.

As I said a bit in the linked posts, many doctors love the idea of a patient tracking their health information, but their also extremely scared about how they’re going to deal with all of the data coming at them. There are exceptions to this rule, but most doctors don’t usually get a whole bunch of data a patients collected that they have to incorporate into the visit. Sure, a physician treating diabetes will often get a stack of food journals and blood sugar levels. However, most doctors are trained to get the data they need on their own.

I believe this is the real challenge with home health monitoring. In far too many cases I’ve seen mHealth apps that are trying to monitor too much data. Sure, I think it’s great to be ambitious and I think it’s even better to collect as much data as we can. Long term I think that patient collected healthcare data is going to be essential to providing great healthcare. Although, in the short term if we want to break most physicians into Home Health Monitoring, then I think we need to be a little less ambitious and more targeted.

The post mentioned above highlights some things that I don’t think any doctors would be overwhelmed with if they received this information: weight, blood sugar, and vital signs. I’m sure we could add to this list, but a lot can be learned from just these elements. Sure, bringing in full on food journals, sleep data, walking data, exercise data, EKG data, etc etc etc could be useful to a doctor. However, in our current state if you bring all of that data to the doctor you’re likely going to overwhelm them and they won’t know what to do.

I can’t wait for the day we have Smart EMR software that can take the volume of patient collected data and make it actionable for the doctor. Unfortunately, we’re not there yet. Until then, maybe we need to focus our Home Health Monitoring into bit size chunks that doctors can easily digest and actually use.

iMPak Health with NoMoreClipboard – Healthcare Gadget Friday

Posted on 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.

Our next entry in Healthcare Gadget Friday is the iMPak Health Journals from Meridian Health and NoMoreClipboard. You may remember that I called the iMPak Health Journals the most creative technology I found at HIMSS 12. As such I wanted to write more about how they worked.

Here’s a picture I took of the iMPak Health Journal:

It certainly looks pretty simple and it is. That’s done by design. You basically use the iMPak health journal by pressing down on the blue and red circles. Pressing these “buttons” kind of reminds me of the musical greeting cards you get. When you’d press it down the music would start playing. This works very similar. Although, you push the red button to start and then each of the blue buttons represent a response to a healthcare question. It’s as simple as that. You hold down the buttons and it records your answers.

Then, the next time you go for an appointment or through an NFC (near field communication) connection to your cell phone (almost all new cell phones will have this technology) the data is uploaded electronically to the NoMoreClipboard website. From there all of the data can be processed and seen by yourself and your doctor.

I’d hoped to have a video where you could see the use of the iMPak journal, but I wasn’t able to get one that did a nice demo. What I found so creative was how simple it was to collect data from a patient. They didn’t need to download an app. They didn’t need to buy an expensive device that they’re only going to use for a limited time.

Turns out that there are a lot of potential uses for these journals. Some areas that might find them useful are: Insurance Companies, Hospitals / Health Systems, Pharmacy Benefit Management, Pharmaceutical Companies, Employer Benefits Management, and Retail Pharmacies. Here’s a video which shows how it can be used:

One challenge that still exists with this device is getting patients to remember to use the device. A built in alarm that would go off to remind them to answer the questions could help to solve that problem. Although, the journal is so portable, I’d hate to have the alarm go off as you carry it around in your purse or something.

I’ll also be interested to see how many patients lose their iMPak journal or just forget to bring it to the office for their appointment. This isn’t an issue if they’ve been uploading their data using their own cell phone, but would be an issue in those cases where they’re uploading the data in the office.

The biggest competitor to this product is the various mobile health apps that are cropping up. One day I can see the mobile health apps really taking over this space. However, there are still many patients who don’t carry a smart phone or that can’t/won’t go to the hassle of downloading an app to track this stuff. In those cases, I find the iMPak Health Journal a really creative solution to getting the data to be able to provide better patient care.


Full Disclosure: NoMoreClipboard is an advertiser on this site.

Despite Focus On Security Compliance, Provider Data Still Isn’t Secure

Posted on April 26, 2012 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.

It looks like we’ve got a billion-dollar mismatch between rules and reality here. An established security research firm has released a study suggesting that while providers are working hard on meeting HIPAA and other security regs, their data isn’t any more secure than when it was before

Kroll’s 2012 HIMSS Analytyics Report: Security of Patient Data, concludes that the rate of  provider data breaches has been rising over the past six years, despite pressure on providers to conduct more security audits and otherwise tighten up their data ship.

What’s scary about this trend is that the healthcare institutions surveyed by Kroll don’t seem to be aware of the problem.  Health IT execs rated themselves at 6.4 out of 7 (seven being “extremely prepared’) on their readiness to address data security. That’s up from 6.06 in 2010 and 5.88 in 2008.

But the data Kroll gathered suggests that they’re overconfident at best. It found that 27 percent of respondents had reported a breach during the past twelve months, up from 19 percent in 2010  and 13 percent in 2008. Worse, of those who saw breaches, 69 percent of providers had seen  more than one breach.

Now, it would be easy to say that regs like HIPAA, Meaningful Use standards and the Red Flags rules are malformed, and that this is just another case of government getting it wrong to industry’s detriment. If there’s any truth to this notion, I do hope CMS leaders take notice and adjusts some of its requirements;  Heaven knows they’d get plenty of credible, carefully thought-out feedback if they ask.

Unfortunately, though, I suspect far from being that easy. We’d all love it if we could just follow the rules, get government approval then say “stick a fork in it, security’s done.”  But as readers know,  security is such a complex mix of implementing technologies and changing inappropriate behaviors that it’s hard to tease out just what went wrong sometimes.

Still, it’s good to have an organization like Kroll remind us that meeting HIPAA requirements isn’t the be all and end all.  Unfortunately, it’s really just the beginning.

mHealth App Infographic

Posted on April 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Ozmosis recently posted a pretty interesting mHealth infographic. I’ve never met an infographic that I didn’t enjoy at least glancing over.

The stat that stood out to me the most was probably the one that says, “40% of doctors believe that mobile health technologies can reduce the number of office visits.” Although, this stat is a bit frustrating because it means that there’s potential to save office visits and we’re not doing much to change it so we don’t need an office visit.

The other one that hit me was that “88% of doctors would like their patients to monitor their health at home, particularly their weight, blood sugar, and vital signs.” I wonder a bit if this question was a bit biased since it offered things that doctors would like for patients to monitor at home. Although, that seems like a whole lot of doctors that want the patient home monitoring. A lot of the doctors I’ve spoken to can see benefits to doing so, but they’re also really concerned about how they’d deal with the influx of data.

Much more could be said, but that gets us started. Now for the full mHealth App Infographic.

Patient Recruitment & EHR

Posted on 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.

For some reason I’ve been recently talking and reading more and more about patient recruitment. I’ve been fascinated by the creative ways that those doing the clinical studies use to be able to recruit patients that fit the very specific needs of most clinical studies. Plus, I’ve been amazed at how much money is required to be able to recruit patients for these studies.

There’s so many interesting quirks involved in the whole patient recruitment business. In most cases, it’s very large companies trying to recruit individual patients. Many of the chronic patients want to know about and be involved in the clinical study. In many cases, it can lead to a great mutually beneficial outcome for both the company that’s doing the clinical study and the patient who receives care that they wouldn’t have otherwise received. Of course, there are A LOT more intricacies involved in patient recruitment, but those are a few of them.

The biggest challenge with patient recruitment is usually finding the right patients for the clinical study. I think we’re on the brink of technology largely solving this problem for clinical researchers.

EHR Software for Patient Recruitment
When you think about the volume of data that’s going into an EHR system, you can see how valuable the granular EHR data could be in identifying which patients are eligible for a certain clinical study. Certainly there are plenty of nuances to when and how you can use this information. I won’t get into those in this post, but I think it’s quite clear that EHR software will be essential to patient recruitment in clinical studies.

I’m sure that some won’t like to hear this. My first response is that this doesn’t have to be a bad thing. In fact, if done right it can be a great thing. We just need to be involved in the discussion so that patient recruitment with EHR software is done the right way. My second response is that this is going to happen whether people like it or not. Instead of trying to stop it, we should focus on how to make it work well for everyone.

Mobile Health Reduces Costs

Posted on April 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s a catchy headline that everyone must read. The problem is that the evidence is still not there to prove this type of headline. Sure, we’ve seen a ton of encouraging signs with mobile health. In fact, I’m also quite confident that we’re going to to the day that mobile health will indeed reduce costs. Although, I think we’re still waiting for the hard core data and evidence that such is the case and which mobile health apps actually produce results.

Let me give you an example of the way mobile health is being reported (in many cases). Check out this article by iHealth Beat. Here are just the headlines which tell an interesting story:
Title: Health Care Providers Tapping Mobile Health Tools To Reduce Costs
* Cost-Savings Potential
* Prototype Devices in Testing
* More Incentives Needed?

Does this line of thinking make any sense at all?

If it’s true that mobile health is providing cost savings, then why is there a need for incentives? Trust me, if the cost savings were really apparent, then there wouldn’t need to be any incentives. Plus, incentives can often lead to perverse issues like we’ve seen with the EHR incentive money.

I’m hopeful that we’ll see a sea of mobile health applications that really do appreciable and transparently lower the cost of healthcare for providers and patients. I just think we’re still early in the curve of knowing the benefits of deploying technology. Those companies that nail it are going to be extremely successful though. It’s entrepreneurship at its best.

Healthcare IT Companies That Shouldn’t Do Social Media

Posted on I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I posted previously, I’m a very big proponent of healthcare IT companies using social media. Plus, as I mention in the column, I think you have to be careful to ensure that the voice of the company is involved in the social media efforts. Otherwise, you’ll lose your authentic voice and your social media efforts will be a fail. The best way to do this is through good training of your staff with smart outsourcing of certain aspects of your social media.

I believe that every healthcare IT and EHR company could benefit from social media, but I don’t think all healthcare IT and EHR companies should do social media. In fact, the company with the wrong culture will see bad results if they start using social media. Here are some issues a company might have that would make them not want to do social media:

Those Who Can’t Commit – If you can’t commit to social media, then don’t start. It’s better to do nothing then to have something laying their half done. For example, a blog should have at least 1 post a week. Anything less and you lose momentum and lose your audience. Twitter should be updated multiple times a week, but more importantly you need to make sure you respond to any relevant @ replies that you receive on Twitter. Don’t underestimate what I call the content beast. No matter how much you think you’re ahead, you’ll be surprised when it needs to get fed again. Be ready to commit to feed it regularly.

Those Overwhelmed by Their Email – This is partially related to the first point, but I think that your ability to manage your email is a good sign of whether you’ll be able to handle social medial or not. Starting into social media ends up adding more and more channels of information to be processed. If you have trouble managing one channel, email, then you’re likely going to feel extremely overwhelmed adding in multiple social media channels. Plus, most of those social media channels leverage email to some extent as well, so it will just make your email abyss even greater.

Those Who Don’t Care About Their Customers – This is a hard one for someone to understand and realize, but a few are self aware enough to realize it. The point is that if you don’t care about your customers to your very core, it will be seen in your communication on social media. I’m sure that most companies will wonder how this is possible because they’re so focused on the customer, but trust me they exist.

Those Who Suck – Sorry I couldn’t think of a better word, but it’s the only one that I think describes these companies. If your company has bad support, a poor sales process, and other related issues you don’t want to be found on social media. Imagine the questions that you’ll get if this is the case and your inability to properly respond to them. It makes for an ugly situation.

Those Who Can’t Take Heat – Some companies can’t take any sort of criticism. Instead of learning from the comments, they get confrontational. Sure, there will be some in social media who may make outlandish statements. Some people can’t resist the urge to start a confrontation. I’m certainly not perfect in this regard, but the best healthcare IT companies are humble in their approach to it. They correct when needed, but appreciate feedback from those who might see the world different than they do. A lot of good can come out of frank social media discussions. It’s not always about being right.

Those Who Drank the Kool-aid and Are Afraid of Those Who Haven’t – I must admit that these people always give me a good laugh. You might know the type of person I’m talking about. They’ve only worked for one company in healthcare IT (or maybe only one company ever) and they’ve been to one too many Ra Ra company meeting where all that they’ve heard is the good side of the story. I actually think social media is great for these people since it will help them to expand their mind. They just shouldn’t be the face of the company social media. I should probably add the other extreme: the long term jaded healthcare IT professional. I actually love these people on Twitter since they provide incredibly valuable insight. Although, you have to be careful having them as the face of the company.

I’m sure we could look at other characteristics that would prevent a company from deciding to participate in social media. I’d love to hear your thoughts and comments on this subject. Some stories would be quite interesting as well.

How to Avoid Meaningful Use Penalties – Meaningful Use Monday

Posted on April 23, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

When the EHR Incentive Program was first announced, many providers told me that while they might be willing to forego the potential incentive payments for meaningful use, they could never accept the 2015 penalties (AKA “adjustments”) for non-compliance. Back in 2009, 2015 seemed far in the future—but for those motivated by penalty avoidance, it’s time to make sure that meaningful use is within your grasp. 

The Proposed Rule for Meaningful Use Stage 2, (page 13771), defines the timeline for the assessment of penalties. The safest way to avoid the 2015 penalty is to successfully demonstrate meaningful use in 2013. (Yes, 2013—this is not a typo!) Failing that, a provider whose first year of participation is 2014 has until October 1, 2014 to successfully attest, which means that he/she must begin the 90-day reporting period no later than July 3 of that year. For future year penalties—that increase by 1% annually—the pattern would be the same: full calendar year reporting two years prior or 90-day reporting in the year prior to the penalty assessment.

Bottom line: You cannot wait until 2015 to be a meaningful user if you are concerned about the penalties. And if you haven’t embarked on the EHR adoption process yet, 2013 will sneak up on you very quickly!