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Where You’ll Find Me at HIMSS 2013

Posted on February 28, 2013 I Written By

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

I can’t believe that HIMSS 2013 is finally here. Well, it’s almost here. I fly out on Saturday, and I’m seeing the tweets come in from the various vendors who are arriving in New Orleans to setup their booths. For those that can’t attend, we’ll do our best to give you a peek into the event. For those that can attend, I always love to meet those who read EMR and HIPAA in person. The following is a list of events that I’m hosting, participating in or otherwise engaged. All of these events and more are also listed in the Influential Networks HIMSS 2013 Event Guide.

I look forward to seeing many of you at these great events and in the hallways of HIMSS. It’s always great to see old friends and make new ones.

#SocialMedia and #Influence Tweetup
Monday, March 4, 2013
2:30 PM – 3:30 PM
Description:
Discuss the best approaches to influencing audiences around your ideas, products or services with John Lynn and Shahid Shah, InfluentialNetworks.com. Learn how social media can be used to get your messages out to those who matter. Discover common myths and misconceptions about new media, and learn proven strategies and techniques to get the most out of social media.
Location: Social Media Center

Discussion with Rita Bowen, Chief Privacy Officer at HealthPort, About HIPAA Omnibus Rule
Tuesday, March 5, 2013
12:00 PM – 1:00 PM
Description:
Come learn from one of the leading experts on HIPAA, Rita Bowen, as she discusses the latest details on the new HIPAA Omnibus rule with John Lynn, HealthcareScene.com.  We’ll talk about all the changes with business associates, how to make sure your compliant, and making a smooth transition to the new rule.
Location: HealthPort Booth #6841

New Media Meetup at #HIMSS13 Sponsored by docBeat
Tuesday, March 5, 2013
6:00 PM – 8:00 PM
Description:
Great food, free drinks, and time to mingle with the best and brightest that healthcare social media has to offer.  Come and meet people you’ve only connected with online and find new friends.  The New Media Meetup is where the online world meets offline.
Location: Mulate’s Party Hall – 743 Convention Center Boulegvard, New Orleans, LA
Register to attend: http://tinyurl.com/HIMSS13NMM

Point of Care Video with Metro
Wednesday, March 6, 2013
12:30 PM – 1:00 PM
Description:
Come learn more with John Lynn, HealthcareScene.com, about Metro’s latest point-of-care systems, AccessPoint mobile computing system, and their Metro Access platform.  We’ll be shooting a video of their latest products.  Don’t worry, you don’t have to be in the video unless you want to be.
Location: Metro Booth #6312

An Interview with Mitochon About Their Recently Launched EMO (Electronic Medical Office)

Posted on February 27, 2013 I Written By

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

The following is an interview with Mitochon about their newly launched EMO (Electronic medical Office) and a discussion of some of the various trends happening in healthcare IT like: ACOs, Meaningful Use, and HIEs.

Q: Tell us about your recently launched EMO (Electronic Medical Office) product.

A: Our Electronic Medical Office product is a complete end-to-end solution for the modern day medical practice. Allowing the practice to accomplish all their daily task in one solution. One application, one vendor, one solution….. EMO.

Q: When did you start thinking about a suite of applications beyond just EHR?

A: We have seen for years the issues the practice has had to endure when dealing with multiple vendors, products and interfaces. The finger pointing and passing the buck when many different vendors are involved. Its the old right hand left hand issue. Just over two years ago as a team we knew we had to step forward and develop an end-to-end solution and give the practice the continuity and consistency of dealing with one vendor and one solution to take care of all the practice needs from the Patient accessing their medical records and financial data from their own PC to the tracking of insurance claims and collections.

Q: Will EMO (Electronic Medical Office) be free like your past Free EHR offering?

A: Yes EMO will be a FREE offering. In addition to our FREE EMO we are offering a plus package, with EMO+ you get all the features of EMO and back office Revenue Cycle Management. With EMO plus the practice pays only 2.85% of their monthly collections and we handle all the billing and collections from a back office perspective.

Q: In this world of EHR consolidation, EHR’s closing down, etc, why should a doctor feel comfortable choosing Mitochon?

A: We started Mitochon with the belief that Health IT services are too expensive and too complex! We wanted to take away the cost barrier that many independent physicians couldn’t previously overcome, enabling them to provide better patient care while qualifying for Meaningful Use incentives. Our advertising business model is proven, sustainable and successful and is a similar model that works for TV, radio, newspaper and the web. We’re here to stay!

The Mitochon application is used in other markets on a paid basis. We are saddened by the fact that companies still pay to use systems that were closed down such as Kareo and Epocrates recent announcement, they are late and trying to resurrect a system that was closed down. We understand other free vendors have over spent on promotion and the day of reckoning is coming closer, we gain 30% of our new users from other free systems that offer poor support, when the investors get sick of running a business with scant regard to profits they will go the way of MySpace, remember them?

Q: Do you think that most of the doctors using your EHR will becoming “meaningful users”?

A: The question should really be if the physicians believe the meaningful useage criteria, as defined, really add to their patient care or do they see it more of a hassle or prying eyes of payers. The vast majority of our users have achieved Meaningful Use. We are a conservative company owned by physicians, we build a real base of users, no hype. We believe we likely have the highest percentage of users achieve MU versus any other EHR.

Q: The claims clearinghouse is a new Mitochon feature. Tell us more about that part of the product.

A: EMO would not be an end-to-end solution if we did not include medical claims clearing. There are no gimmicks or gotchya’s with our clearinghouse. The sending of medical claims as well as status updates of those claims is FREE as well! We are redefining the end the end solution

Q: What other applications aren’t part of EMO (Electronic Medical Office) that you’ll look at incorporating in the future?

A: We have appointment reminders, Statement printing, fully integrated credit card processing that is linked to a users account. We have the in built HIE that allows Physician to Physician referral as well as the soon to be launched Patient Health Record. As the market demands we will continue to add features and functionality. In office dispensing solutions can bring Physicians significant revenue, up to $7,000 per month profit depending on sub-speciality. We are also working to bring an integrated sample closet so physicians can add further value to their patient interaction. Also remember we also have free mobile access to our EHR.

Q: How do you think what you’re doing fits in with other trends like ACOs (Accountable Care Organizations)?

A: In an ACO the goal is population management, better outcomes with lower cost. As such you have to manage the 30% of chronically ill patients who are utilizing 60-70% of the health care dollars. To do so, every provider needs to be engaged, integrated and connected. So our free solution has a role to complement the other solutions so that an ACO can gather information from all their providers. The risk is very high for an ACO that has a leaky infrastructure because the management of risk will be exposed and the cost curve will not be bending, hence no savings will be generated. Our EMO solution is created for instant collaboration and coordination because of the built in HIE function. In our network physicians who care for the same patients instantly are connected and can share medication list, problem list, labs, radiology and progress notes without the additional cost of integrating. We have contracts with 3 ACO’s.

Q: What’s your take on mobile adoption by doctors, particularly when it comes to products like EHR?

A: Mobile phones are ubiquitous in the medical community. We see Physicians and Nurse Practitioners adopting our mobile solution. It is unlikely they will undertake a full clinical interaction on an iPhone but they do use our native iPad App. The key here is it is a tool for the Doc on the run. The office based PC will always be the tool of choice in the foreseeable future, many have just purchased them recently!

Q: What’s something that doctors aren’t paying enough attention to right now?

A: Connectivity. They have just paid for a stand alone EHR, now they need to coordinate care with other providers/hospitals/labs etc. These other entities are cherry picking and paying certain providers who have enough volume or contribution to the hospital or system. It is a cost that may be just as expensive as the EHR in the long term for the physician. This is a crucial part of the solution and why we have an inbuilt HIE functionality allowing physicians to immediately refer patients across our system. This is particularly attractive to the ACO market.

Also, the meaningful use subsidy will end in a few years, if a provider is using an expensive system, how will that affect the ability for the provider to sell their practice to a new physician who is already in debt from med school. We have many fat cat EHR vendors just milking the Physician who they see as an equal opportunity victim. How many EHR’s are showing 60% revenue growth since 2009? This will come to a end soon and the physician will be leveraged again unless they are using a system with an alternate revenue model. Thats where our Mitochon Patent comes in, introducing contextual clinical content into the workflow and subsidize the Physician’s cost.

Full Disclosure: Mitochon is an advertiser on EMR and HIPAA.

One-Fifth Of Physician Practices Might Switch EMRs

Posted on February 26, 2013 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.

Here’s yet more evidence that this is the year of the “big switch” in EMRs, at least among physicians. A new survey by Black Book Market Research has concluded that about 23 percent of practices with currently implemented EMRs are unhappy enough with their current system to consider switching to a different vendor.

According to a piece in Medical Economics, doctors’ concerns include a lack of interoperability, excessively complicated connectivity and networking and problems with mobile device integration.

The survey, which reached out to 17,000 doctors, found that internal medicine docs had the highest rates of satisfaction (89 percent), followed  by family practice (85 percent), general practice (82 percent) and pediatrics.

The unhappiest specialists were nephrologists (88 percent), followed closely by urologists (85 percent) and ophthalmologists (80 percent).

So if a practice is going to switch vendors, what are they looking for? The Medical Economics piece listed five “must-have” features doctors voted for in the Black Book survey:

* vendor viability

* data integration and network sharing

* adoption of mobile devices

* health information exchange support and connectivity

* perfected interfaces with lab, pharmacy, radiology, medical billing partners, and others

Unfortunately, they won’t find it easy to find all of these features in a single EMR.  Of course, you faithful editor isn’t the be-all and end-all when it comes to EMR products (who could be?) but it seems to me that if even pricier enterprise products seldom offer all of these options, it’s decidedly unlikely that ambulatory products will. (OK, vendor viability is a judgment call, but in a world where so many practices don’t like their EMR, it’s hard to imagine that vendors are at their strongest.)

Folks, the truth is that it looks like we’re coming to a market crash of some kind. Physicians aren’t getting what they need from EMRs, but vendors aren’t keeping up, especially in the realm of specialty EMRs.

As if that wasn’t enough, the threat of fines looms for practices that don’t get their Meaningful Use act together, something they may have trouble doing if they’re in the midst of EMR shopping, installation and adoption.

Time is getting tight, and customers aren’t happy. Ambulatory vendors, what’s your next move?

The Final HIPAA Omnibus Rule: A Sharing of Accountability

Posted on February 25, 2013 I Written By

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

The following is a guest post by Rita Bowen, MA, RHIA, CHPS, SSGB, SVP of HIM and Chief Privacy Officer, HealthPort. If you’re attending HIMSS, I’ll be doing an interview with Rita at HealthPort’s Booth 6841 at Noon on Tuesday 3/5/13. Come by and learn more about the HIPAA Omnibus Rule and get any questions you have answered.

It seems an eternity ago, four years to be exact, that the HITECH Act introduced changes to HIPAA. After much speculation, rumor, innuendo and anticipation, HHS released the final HIPAA omnibus rule, which significantly amends the original HIPAA Privacy, Security, Breach and Enforcement Rules. HHS Secretary Kathleen Sebelius introduced the new rule by stating:

“The final rule greatly enhances a patient’s privacy protections, provides individuals new rights to their health information, and strengthens the government’s ability to enforce the law.”

Ms. Sebelius conceded that healthcare has changed dramatically since HIPAA was first enacted and that the new rule is necessary to “protect patient privacy and safeguard patients’ health information in an ever expanding digital age.”

The new rule, at 563 pages, is not brief, but covered entities can’t let that inhibit them from becoming intimately acquainted with this document. I’ve made an initial review of the rule and culled what I feel are its key concepts:

  • Business Associates (BAs) of covered entities are now, for the first time, directly liable for compliance with certain requirements of HIPAA Privacy and Security rules, including the cost of remediation of breaches for which they are responsible.
  • The rule goes so far as to revise the definition of a “breach.” This new definition promises to make the occurrence of breaches – and the required notification of breaches — more common.
  • The use and disclosure of protected health information for marketing and fundraising purposes is further limited, as is the sale of protected information without individual authorization.
  • The rule expands patients’ rights to receive electronic copies of their health information and to restrict disclosures to health plans regarding treatment for which they’ve already paid.
  • Covered entities are required to modify and redistribute their notice of privacy practice to reflect the new rule.
  • The new rule modifies Individual authorizations and other requirements to facilitate research, expedite the disclosure of child immunization proof to schools, and enable access to decedent information by family members and others.
  • The additional HITECH Act enhancements to the Enforcement Rule are adopted, including provisions addressing enforcement of noncompliance with HIPAA rules due to willful neglect.

Getting to Compliance

And now comes the challenging part – compliance! The new rule goes into effect on March 26, and covered entities and BAs are expected to comply by September 23, so there is much work to do. Hospitals and clinics need to thoroughly comprehend — and then prepare for — the sweeping changes in BA liability. They’ll need to communicate these changes and new requirements to BAs and update their BA agreements accordingly. And since BAs are now directly liable for breaches, organizations must decide how they’ll enforce their BA agreements with regard to privacy and security. Additionally, comparable agreements must now be shared between BAs and their subcontractors.

What are the keys to successful compliance?  The following tips should ensure your smooth transition into the new rule:

  • Become intimately acquainted with the new rule — and its ramifications for your organization, your BAs, and their subcontractors.
  • Identify a privacy officer within all of your partner organizations.
  • Define a process for the notification of patients in the event of a breach of their protected health information (PHI).
  • Update breach notification materials to reflect the new Rule.
  • Update, repost and redistribute your Notice of Privacy Practices.
  • Document current privacy and security practices, and conduct a risk assessment.
  • Make certain your healthcare security technology solution is flexible, secure, and scalable to handle the growing volume of audit inquiries promised by the RACs.
  • Encrypt all devices that store patient information.
  • Communicate new HIPAA requirements and expectations to BAs.
  • Update business associate agreements (BAAs) to clarify that BAs pay the cost of breach remediation, when the BA is responsible for the breach.
  • Provide a template of a comparable agreement for BAs to use with their subcontractors.
  • Monitor your partners’ efforts to protect patient data.

The new HPAA omnibus rule has arrived and the challenges it presents should not be underestimated. Communication and organization will be your keys to success!

Rita Bowen, MA, RHIA, CHPS, SSGB

Ms. Bowen is a distinguished professional with 20+ years of experience in the health information management industry.  She serves as the Sr. Vice President of HIM and Privacy Officer of HealthPort where she is responsible for acting as an internal customer advocate.  Most recently, Ms. Bowen served as the Enterprise Director of HIM Services for Erlanger Health System for 13 years, where she received commendation from the hospital county authority for outstanding leadership.  Ms. Bowen is the recipient of Mentor FORE Triumph Award and Distinguished Member of AHIMA’s Quality Management Section.  She has served as the AHIMA President and Board Chair in 2010, a member of AHIMA’s Board of Directors (2006-2011), the Council on Certification (2003-2005) and various task groups including CHP exam and AHIMA’s liaison to HIMSS for the CHS exam construction (2002).

Ms. Bowen is an established speaker on diverse HIM topics and an active author on privacy and legal health records.  She served on the CCHIT security and reliability workgroup and as Chair of Regional Committees East-Tennessee HIMSS and co-chair of Tennessee’s e-HIM group.  She is an adjunct faculty member of the Chattanooga State HIM program and UT Memphis HIM Master’s program.  She also serves on the advisory board for Care Communications based in Chicago, Illinois.

EHR and Mobile Health News Around the Country

Posted on February 24, 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.

It may come as a surprise to some, but according to a study by eClinicalWorks, the majority of physicians like EMR-connected apps, and mHealth apps in general. 2,291 healthcare professionals were surveyed, and 649 were physicians. Over 90 percent of physicians feel it’s valuable to have their EMR connected to an app. The study also revealed other interesting things concerning physicians and medical apps.

And EHR vendors may want to consider this when developing and updating their EHR. From the Black Book Rankings, here is a list of top EHR vendors among hospitals. I bet some of these ones definitely have.

On a similar topic, there was a recent study about physican EMR use in the United States. Apparently, they are behind other countries. While usage has definitely increased recently, with 69 percent of doctors using some type of EMR in 2012, it’s still well-below the rates in the Netherlands, Norway, New Zealand, the U.K, Australia, and Sweden, all that have EMR usage rates above 88 percent.

For anyone that is interested, there is quite a bit of legislation on telemedicine this year across the United States. This chart shows all that’s going on in three different categories — legislated mandate for private coverage, legislated medicaid coverage (primarily interactive video,) and other proposed bills affecting medicaid coverage.

There’s always a lot going on in the mHealth world. Have you heard of FilmArray? It’s a device that was developed by a company in Utah. So what does it do? Well, it can detect 20 respiratory diseases in less than an hour. This will definitely make it easier for people to get their illnesses diagnosed quickly. In other news, HealthTap has released a new program called TipTaps. The program sends tips, created by health professionals, and personalized for a person’s lifestyle.

#HIMSS14 Speakers, Healthcare in 2013, and More — #HITsm Chat Highlights

Posted on February 23, 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.

This weeks topics were suggested by Dan Munro, a contributor at Forbes.

Topic One: Head of ONC Farzad Mostashari calls and asks you what his top 2 priorities should be. What do you say? @Farzad_ONC

Topic Two: Biz Stone was HIMSS12 Keynote and Clinton will Keynote #HIMSS13. Who should Keynote HIMSS14?

Topic Three: Fill in the blank> Healthcare’s End-of-Year Headline for 2013 will be _______.

Topic Four: Among early stage healthcare startups – who’s your favorite? #mHealth

Topic Five: Should we skip over #ICD10? #healthIT

Some Inside Baseball for the EHR World

Posted on February 22, 2013 I Written By

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

I thought I’d take this moment to take a quick look at what many might consider inside baseball when it comes to the EHR world. Although, I’ve been intrigued by a couple announcements that were made recently.

The first announcement is Kareo buying the Epocrates EHR which came just in time for HIMSS. You might remember that I covered the Epocrates EHR on a number of occasions. I first saw the Epocrates EHR at HIMSS in 2010, and subsequently wrote about Epocrates “killing” their EHR immediately after launch. When that happened, I think we all wondered what would happen with the Epocrates EHR code base. You don’t just throw a meaningful use certified EHR to the curb do you?

We now know the answer to that question is no. Kareo saw fit to acquire the Epocrates EHR software and Dr. Tom Giannulli, formerly of Epocrates, is now the Kareo CMIO. I can imagine that Dr. Giannulli wanted to stay with his baby (the Epocrates EHR). I’m also quite intrigued that Kareo is offering the EHR for free (at least for now?). The funny thing is that I had written that the Epocrates EHR should be free. I guess I was sort of right, but I definitely didn’t think that the Epocrates EHR would become free since Kareo makes their money from the Practice Management and billing side of the house. We’ll see how that strategy works for Kareo. In some ways it’s taking a page out of the AthenaHealth playbook.

What might be simply an odd coincidence of timing (or not), Practice Fusion just sent out a letter (shown below) to its users from Practice Fusion Founder and CEO, Ryan Howard. In it he acknowledges Practice Fusion’s past challenges with billing, and he outlines their strategy on making the Practice Fusion billing situation better.

Does this relate to Kareo? Maybe, maybe not. What I do know is that many Practice Fusion users are on Kareo as well since it was Practice Fusion’s only major Practice Management software partner when Practice Fusion started. It seemed like a great match since Practice Fusion only had EHR, and Kareo only had Practice Management. Kareo now has an EHR, and Practice Fusion is working on billing and practice management. I guess we should have seen this coming.

Here’s the full email I got from Practice Fusion (Full Disclosure: They said Dr. Lynn, but I’m not a doctor.):

Hi Dr. Lynn,

The Practice Fusion team takes pride and appreciates your role in making us the fastest growing EHR community in the US.

We also recognize that billing has not been our strongest suit. Improved superbills and an updated payer list have been highly requested by our user community.

That’s why, by the end of March, we’re going to deliver you major new enhancements to your billing experience:

• A comprehensive, streamlined superbill, directly integrated with your workflow
• Flexible reports for billing users
• The ability to export billing data to most major billing systems
• New billing software and service partners with more economical pricing

This means you can stick with the exact billing workflow and system you use today in your practice. We’re building the ability to integrate directly by allowing you to export data to your billing system via HL7. If you prefer superbills, you’ll soon have a drastically improved superbill to work with. And if you’re looking for a new billing system altogether, we’ll also have new, low-cost partners coming soon.

We’re excited to be making your EHR faster, more flexible and easier-to-use. Lastly, our commitment to you has not changed since the day you signed on—Practice Fusion will deliver all this for free. Stay tuned for our billing revamp at the end of March!

Best,
Ryan Howard
Founder and CEO
Practice Fusion
ceo@practicefusion.com

Interoperability, Clinical Data, and The Greatest Generation

Posted on February 21, 2013 I Written By

Mandi Bishop is a hardcore health data geek with a Master's in English and a passion for big data analytics, which she brings to her role as Dell Health’s Analytics Solutions Lead. She 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.

As a healthcare IT zealot and wanna-be policy wonk, I find myself mired in acronyms, and surrounded (and indulged) by those who understand my rapid-fire Klingon-esque rants on BETOS and LOINC and HCPCS. The larger concepts of interoperability and meaningful use lose the forest for the trees of IHE standard definitions and specific quality measures. Have we lost sight of the vast majority of the healthcare consumers, and their level of understanding and awareness of those larger concepts? Could you explain HL7 ORUs or CCDs to your great-grandma?

I recently visited my 90 year-old grandparents, both remarkably healthy multiple cancer survivors who show no signs of slowing down, and have maintained enough mobility to continue bowling 3 times a week. After an evening of pinochle, my grandma asked me to please help her understand what it is that I DO for a living. We’ve had this conversation before.

“I’m a healthcare technology consultant, Grandma. I work with insurance companies and doctors to help them get all your information.”

Puzzled look.

“When you go to the doctor, Grandma, do they write anything down on paper, or are they using a computer when they talk to you?”

“Oh, they’re always on those computers! Tap-tap-tap. Every question I answer and they tap-tap-tap.”

She illustrates by typing on her lap, and I confirm that she’s a hunt-and-peck person. She stops only after I finish asking my next question.

“Do you have private insurance, or do you use the VA?”

“I have Blue Cross. Your grandpa uses the VA.”

“How many doctors did you have to see for your blood infection?”

“FOUR! Sometimes two in one day!”

“Did they all have to ask you for your history?”

“No – they already had it, on their computer. They even knew about my mastectomy, 30 years ago. One corrected me on the date; I’d thought it was only 20 years ago.”

“Well, Grandma, when you booked your appointment with the first doctor, their computer system automatically requested your medical records from your insurance company. And the insurance company automatically sent your records back to the computer. After the first doctor made notes on your visit, just after you walked out the door, the computer sent an updated copy of your medical records back to the insurance company, and it ordered the lab tests you needed before you went to the next doctor. Then, the lab automatically sent your results to the insurance company AND the doctor who ordered the tests.”

“But the other doctors had the test results.”

“Yes, ma’am. Each time you made an appointment with a new doctor, that doctor’s computer requested your medical records from the insurance company, and the insurance company sent out the most recently updated information. It only takes a minute!”

“Goodness. So, do you build the computer programs that make all that work?”

Eyes wide. THIS impresses her.

“No.”

Puzzled look again, so I quickly continue.

“But I make sure those computer programs can talk to each other, and that the insurance company can make sense out of what they’re saying.”

“Because if they couldn’t talk to each other, I’d have to haul a suitcase from doctor to doctor with my chart?”

“Yes, ma’am. That’s called ‘interoperability’. There are new rules for how doctors’ computers should talk to each other, and to the insurance companies. And I get to work with the insurance company to do other really cool stuff. I take a look at LOTS of people’s medical records to find patterns that might help us catch diseases before they happen.”

“And what’s that called?”

“Clinical informatics. It’s my favorite thing to do, because I get to study lots and lots and LOTS of information. That’s called ‘big data’.”

“Sweetheart, you lost me with the computer words. But I’m just so happy you’re happy!”

She hugs me and grins, and I finally feel like I’ve found the right way to talk about my passion: through use cases. Although, Grandma would call them stories.

And there you have it: the importance of interoperability and clinical data, through the eyes of The Greatest Generation. Check in next year for an update on whether my definitions stuck!

What Do I Look for When I Write? I Like Lines Not Dots

Posted on February 20, 2013 I Written By

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

As most of you know, I’m surrounded by planning for the HIMSS Annual Conference that’s happening in about a week and a half. I apologize for those that get tired of all the HIMSS discussion, but it literally overwhelms most things for me. I have about 200 emails in my inbox from PR people asking me if I want to meet with a healthcare IT company while at HIMSS. At this point I’ve mostly gathered those emails to see what companies are offering and starting today I’ll start replying to those emails as I fill out my HIMSS schedule.

I must admit that my initial look at the pitches I’ve received is pretty underwhelming. I think part of this might be that a year is not a lot of time for many things to change. As I said in my 2013 Healthcare IT predictions post, I think that it’s much more valuable to look at a 5 year horizon as opposed to a single year. A year just isn’t enough time for most innovations to really take shape. However, in 5 years you can see some amazing changes.

I was really impressed with Neil Versel’s post about his HIMSS being all about quality and patient safety. If you’re a PR company or someone interested in working with Neil, then you’ll want to take a good look at that post. I hope that Neil is sending a link to that post to all the PR people who email him. I can imagine if I’d lost my father to poor healthcare quality I’d take a similar view. His post started me to think about what interested me most. What did I want to write about at HIMSS.

This is actually a common question that I get from PR people. Many of them ask, “What stories are you looking for at HIMSS?” I’ve always hated that question. I’ve never gone to HIMSS with specific stories in mind. Instead, my goal is to go to HIMSS to discover what stories should be brought to my readers. Sure, I could probably predict some of the stories that will come out of this year’s HIMSS, but my goal is to be open to discover something my readers may not have thought about before.

Plus, I’ve found that it’s pretty rare that I write about something after one meeting. I’m not as interested in a one off experience with a vendor where I write about whatever they’re selling at the moment (a dot on a chart). It does happen on occasion, but I’m more interested in writing about trends I see happening over time (a line). Where were you last year or the year before that or when I last spoke to you at another conference and where are you today? This makes for a much more interesting story.

Another aspect in the line vs dot coverage is that one EMR vendor discussion is a dot, but my discussion with dozens of EMR vendors creates a line that is often much more interesting to my readers.

There you go. A few of my thoughts on what I like to cover. This is true at HIMSS and throughout the year. If you know of lines I should be writing about, I’d love to hear them. Now time to dig through that stack of emails to see what lines I can find.

Meaningful Use Stage 3 Retires Measures that Doctors Don’t Do

Posted on February 19, 2013 I Written By

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

The other day I was spending some time going through the proposed meaningful use stage 3 measures. It’s quite an experience if you haven’t done this already.

As I was going through each of the measures I realized something that could be a little troubling. In a number of cases, they are proposing that certain measures should be retired from the meaningful use attestation process because essentially those measures have reached a percentage in meaningful use stage 2 that they’re fully adopted. I think this is generally a good idea. We don’t need clinics and hospitals reporting information just to report information.

Although, I did find a surprising trend when it came to the measures that were being retired in meaningful use stage 3. Almost all of the measures (possibly all, but I didn’t dig that deep) were measures that were done by someone other than the doctor. A few examples were vitals, smoking status, and demographics. I guess in some cases the doctor might enter these, but you can see how the vitals were likely entered by a nurse or MA and not the doctor.

On the one hand this is a really great thing. That means that in the previous meaningful use stages, the biggest burden was placed on someone other than the doctor while the doctor was only required to have a much smaller percentage. Unfortunately this means that the higher percentages required in meaningful use stage 3 put the burden largely on the backs of physicians.