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EHR Expert Jobs, Healthcare Social Media, MU Attestation Data

Posted on March 31, 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 guess Cleveland Clinic doesn’t think the government trained EHR workforce. I know a lot of them that can’t get a job in any EHR position.


This story is a crazy one and spiral out of control is the right term. Although, this post by Amanda Blum is the best look at the issues from my point of view. Dr. Nick is right that you do have to be careful. In fact, the case above wasn’t even something that happened on social media. It was something that happened in person at a conference and then social media blew it up. So, I’d actually argue that it’s more important than ever for you to be involved in social media. That way if something does blow up, you see it and can deal with the situation before it spins out of control.

What I do hate most about the story is the lack of civility and not giving people the benefit of the doubt. I hate that part of the way society is heading. Communication can solve a lot of issues if people would just use it. Instead, we assume the worst in people. That’s unfortunate.


Evan’s opening line to the blog post says, “CMS just released the December 2012 attestation data, and one thing is abundantly clear—many EHR vendors will not be around to see Stage 2.” I don’t agree with his conclusion. I expect we’ll have nearly as many in meaningful use stage 2 as we did in stage 1. Meaningful Use stage 3 is likely where we’re going to see fallout. Although, it does beg the question of how many EHR vendors will stay in business without EHR incentive money?

I’ve often said that it’s surprising how good of a business you can run with just a few thousand doctors.

Patients Want to Share Their Medical Data

Posted on March 29, 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.

During the recent Dell Healthcare Think Tank which I took part in, I had an idea that I think is incredibly powerful and not talked about nearly enough. In fact, I think its reasonable to say that if we want to get healthcare costs down, then we have to learn how to do this well.

The idea revolves around how we talk about privacy of health information with patients. Far too often, patients just hear news reports that talk about all of the reasons they should fear their health information getting out in the open. Instead, they almost never hear stories about how having their health information shared with the right people will actually improve their health.

The simple fact is that if you lead with all the bad things that could possibly happen with health information in the wrong hands, then of course no patient is going to want their patient information shared. However, if they know how sharing their health information with the right people will improve their care, then patients are more than willing to share away.

Basically, what I’m saying is that sharing healthcare data has been marketed wrong. The privacy advocates are well organized and have many people fearful for what will happen with their health information. I don’t have any problem with privacy advocates, because they help us to pause to take a reasonable look at the importance of privacy. However, the need for proper privacy controls doesn’t mean that we don’t share healthcare information at all.

The beauty of all of this is that the majority of people think this is how it happens in healthcare today. They don’t realize that quite often their healthcare information isn’t traveling with them to specialists and hospitals. In fact, when patients discover that it doesn’t they’re usually quite surprised and don’t understand why it doesn’t.

I hope we can work on the data sharing message. We can share your data with the people who need it so we can improve your care. If patients hear this message, healthcare data sharing will not be feared but embraced.

Does Patient Interaction Lock a Doctor In to an EHR?

Posted on March 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’ve been thinking a lot lately about EHR vendor lock in. I think this was prompted by some stories I’ve heard of EHR vendors holding clinics EHR data “hostage” when the clinic chooses to switch EHR software. I heard one case recently that was going to cost the clinic a few hundred thousand dollars to get their EHR data out of their old EHR software. It’s a travesty and an issue that I want to help work to solve this year (more on that in the future).

I think it’s such a failed model for an EHR vendor to try to keep you as their EHR customer by holding your EHR data hostage. There are so many other ways for an EHR vendor to keep you as a customer that it’s such a huge mistake to use EHR data liquidity to keep customers. EHR vendors that choose to do this will likely pay the price long term since doctors love to talk about their EHR with other doctors. If a doctor is locked into an EHR they dislike, then you can be sure that their physician colleagues won’t be selecting that EHR.

There are a whole series of better ways to lock an EHR customer in long term. The best way being providing an amazing EHR product.

I recently considered another way that I think most EHR vendors aren’t using to create a strong relationship with their physician customers. Think about the strength of a company’s relationship with a doctor if a doctor’s patients are all familiar with their connection to the EHR. If a physician-patient interaction occurs regularly through the EHR, then it’s very unlikely that a doctor is going to switch EHR software.

The most obvious patient interaction that occurs is through a patient portal that’s connected to a provider’s EHR. Once a clinic has gotten a large portion of their patients connected to an EHR patient portal, then it makes it really hard for a doctor to consider switching from that EHR. It’s one thing for a doctor to change their workflow because they dislike their EHR. Add in the cost of getting patients to switch from a portal they have been using and I can see many doctors sticking with an EHR because of their patients.

Of course, from a doctor perspective, there’s some value in selecting an EHR that uses a 3rd party patient portal. That way if you choose to switch EHR software, then you can still consider keeping your interaction with patients the same through the same third party patient portal. Although, there’s some advantage to using the patient portal from the EHR vendor as well. It’s not an easy decision.

Kaiser Permanente Accused Of Using EMR As Smokescreen

Posted on March 27, 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.

Kaiser Permanente, California’s largest healthcare provider, has been cited by state officials for using its EMR to work its way around requirements to see mental health patients promptly, reports EHR Intelligence.

Potentially risking their own jobs, Kaiser’s own mental health team brought the discrepancies to the attention of the state.  Their complaint not only slams Kaiser’s practices regarding wait times, but also its overall clinical approach to treating mental health patients, going so far as to accuse the giant HMO of defrauding Medicare by upcoding cursory visits as complete.

According to the California Department of Managed Healthcare, Kaiser has been keeping two sets of records, one in its official EMR and another on paper that hid violations of the state’s law mandating short wait times for mental healthcare. The EMR also fails to retain a record of booking dates, so if an appointment date is changed, the wait time is being calculated from the most recent booking date, not the original date, the state charges.

The dual record keeping procedure allowed Kaiser to hide the fact that mental health patients may have waited weeks longer than the state’s “timely access” law requires, for illnesses such as schizophrenia, depression and suicidal ideation, as well as other serious conditions.

In defiance of the state-required two days between contacting an enrollee and booking an appointment, Kaiser had been recording initial contacts on paper, then asking patients to call back during the next window for appointments, up to four weeks later.  The EMR would then record the initial contact as taking place during the later booking windows, leaving out completely the weeks of waiting mentally-ill patients endured.

Kaiser has said that it addressed the discrepancies noted by the government, which were first brought to its attention last August, but the Department of Managed Healthcare has concluded that the changes needed have not yet been made.

HIPAA Omnibus – What Should You Know?

Posted on March 26, 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 had the great opportunity to sit down with HIPAA expert, Rita Bowen from HealthPort, at HIMSS 2013 and learn more about the changes that came from the recently released HIPAA Omnibus rule. The timing for this video is great, because today is the day the HIPAA Omnibus rule goes into effect. In the video embedded below, Rita talks about what you should know about the new HIPAA changes, the new business associate requirements, and restricting the flow of sequestered health information.

Analytics-Driven Compassionate Healthcare at El Camino Hospital

Posted on March 25, 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.

Given its location in the heart of Silicon Valley, it may not be remarkable that El Camino Hospital was the first hospital in the US to implement EMR. What IS remarkable is that El Camino implemented EMR 51 years ago, leveraging an IBM mainframe system that Lockheed Martin refactored for healthcare from its original intended use for the space program.

Take a moment to process that. El Camino didn’t need PPACA, Meaningful Use, HITECH, or HIPAA to tell them health data is critical. El Camino saw the value in investing in healthcare IT for electronic data capture and communication without federal incentive programs or lobbyists. With that kind of track record of visionary leadership, it’s no wonder they became early analytics program adopters, and recently turned to Health Care DataWorks (HCD) as a trusted partner.

When I sat down with executive leadership from El Camino and HCD to discuss the journey up Tom Davenport‘s analytics maturity scale from rudimentary operational reporting to advanced analytics, I expected a familiar story of cost pressure, clinical informatics, quality measure incentives or alternative payment models as the business drivers for new insights development. Instead, I heard the burgeoning plan for a visionary approach to patient engagement and “analytics-driven compassionate care”.

Greg Walton, CIO of El Camino Hospital, admitted that initial efforts to implement an analytics program had resulted in “textbook errors”: “’Competing on Analytics’ was easier to write than execute,” he said. Their early efforts to adopt and conform to a commercially-available data model were hindered by the complexity of the solution and the philosophy of the vendor. “One of the messages I would give to anybody is: do NOT attempt this at home,” Greg laughed, and El Camino decided to change their approach. They sought a “different type of company…a real-life company with applicable lessons learned in this space.”

“The most important thing to remember in this sector: you’re investing in PEOPLE. This is a PEOPLE business,” Greg said. “And that if there’s any aspect of IT that’s the most people-oriented, it’s analytics. You have to triangulate between how much can the organization absorb, and how fast they can absorb it.” In HCD, El Camino found an analytics organization partner whose leadership and resources understand healthcare challenges first, and technology second.

To address El Camino’s need for aggregated data access across multiple operational systems, HCD is implementing their pioneering KnowledgeEdge Enterprise Data Warehouse solution,including its enterprise data model, analytic dashboards, applications and reports. HCD’s technology, implementation process, and culture is rooted in their deep clinical and provider industry expertise.

“The people (at HCD) have all worked in hospitals, and many still work there occasionally. Laypersons do not have the same understanding; HCD’s exposure to the healthcare provider environment and their level of experience provides a differentiator,” Greg explained. HCD impressed with their willingness to roll up their sleeves and work with the hospital stakeholders to address macro and micro program issues, from driving the evaluation and prioritization of analytics projects to identifying the business rules defining discharge destination. And both the programmers and staff are “thrilled,” Greg says: “My programmers are so happy, they think they’ve died and gone to heaven!”

This collaborative approach to adopting analytics as a catalyst for organizational and cultural change has lit a fire to address the plight of the patient using data as a critical tool. Greg expounded upon his vision to achieve what Aggie Haslup, Vice President of Marketing for HCD, termed “analytics-driven compassionate care”:

We need to change the culture about data without losing, and in fact enhancing, our culture around compassion. People get into healthcare because they’re passionate about compassion. Data can help us be more compassionate. US Healthcare Satisfaction scores have been basically flat over the last 10 years. Lots of organizations have tried to adopt other service industry tools: LEAN,6S; none of those address the plight of the patient. We’ve got to learn that we have to go back to our roots of compassion. We need to get back to the patient, which means “one who suffers in pain.” We want (to use data) to help understand more about person who’s suffering. My (recent) revelation: what do you do w/ guests in your house? Clean the house, put away the pets, get food, do everything you can to make guests comfortable. We want to know more about patients’ ethnicity, cultural heritage, the CONTEXT of their lives because when you’re in pain, what do you fall back on? Cultural values. We want a holistic view of the patient, because we can provide better, compassionate care through knowing more about patients. We want to deploy a contextual longitudinal view of the patient…and detect trends in satisfaction with demographics, clinical, medical data.

What a concept. Imagine the possibilities when a progressive healthcare provider teams with an innovative analytics provider to harness the power of data to better serve the patient population. I will definitely keep my eye on this pairing!

NetPulse, HIEs, and The Importance of Reliable EMRs — Around Healthcare Scene

Posted on March 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.

Have you ever wished that all your fitness and food trackers were in one place? Well, look no further. NetPulse is trying to do just that. The new platform is working with some of the hottest apps, as well as fitness equipment makers, to make taking control of your health easier and more convenient.

A group of researchers recently published an opinion in the Journal of the American Medical Association regarding cloud-based health records versus HIEs. The verdict? They feel that the cloud-based health records might be a better way of sharing health records. What they had to say was rather interesting, so don’t miss the recap of it over at EMR and EHR.

Still looking to use HIEs, rather than Cloud-based health records? The ONC has recently released a toolkit to help different healthcare professionals use them more efficiently. This toolkit includes several guides and a spreadsheet to help determine costs and savings that are associated with implementing an EHR.

For those that missed HIMSS, check out the video that John filmed of the Metro point of care solutions. It gives you a first person perspective of what you could have seen demoed at HIMSS if you were able to attend. Plus, it’s pretty cool to see the point of care and BCMA technologies in action.

It’s important for an EMR to be usable. However, this isn’t always the case, and it can be extremely frustrating. Dr. Shirie Leng, an anesthesiologist, is someone who feels that way. In a recent piece over at KevinMD.com, Dr. Leng discusses her EMR usability wish list. Be sure to check it out, and see if you agree. What is your usability wish list?

And, how smart is your current EMR? According to John, it might just be stupid. While they may have value, most EHR software is just full of dumb data repositories. Despite the negativity of this perspective, the future of EHRs does have hope. With the help of entrepreneurs innovators, current EHRs will be turned smart.

Finally, in order for EMRs to make the changes needed, to improve usability and become more “smart,” the vendors need to get it together.  KLAS recently put several popular EMRs head-to-head, reviewing their usability and efficiency. Although names weren’t listed, they found that some EMRs were very difficult to learn, and it’s not necessarily the physician who is using its fault. Perhaps it’s time that physicians and hospitals demand higher quality products.

Patient Education, Cloudalization of Healthcare, and EHR Vendors – #HITsm Chat Highlights

Posted on March 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.

Topic One: How valuable do you see the use of gaming as a vehicle for patient education and engagement? #mHealth

Topic Three: Is healthcare departing from the client/server architecture toward the cloud? AKA, “The cloudalization of healthcare.”

Topic Three: Is HITECH to blame for introducing false demand for #EHRs? What will happen after all the money is flushed out of the system?

Topic Four: If an #EHR vendor fails, how will their customers migrate to another product if their data is locked in a proprietary system?

 

Meaningful Use Stage 3 Priorities

Posted on March 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.

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

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

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

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

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

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

New EHR Selector Website

Posted on March 21, 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 long as I’ve been blogging, I’ve been quite interested in the various EHR selection tools that are available out there. For a while, it seems like there was a new EHR selection tool coming out every week. The frenzy of EHR selection tools has mostly stopped and only a few major ones remain. One of those is EHR consultant (Full Disclosure: Has been an advertiser on EMR and HIPAA for many years) which has been doing this as long as anyone and has one of the most comprehensive EHR databases out there. The other that has lasted all this time is EHR Selector. Then, to round out the various EHR selection websites, there are the websites out there like Medical Software Advice and even the AAFP offers a tool to help in EHR selection (only available for AAFP members).

As I suggest in my e-Book on EMR selection, I think you should take advantage of multiple EHR selection tools. I call it triangulating the data since none of them are comprehensive with the EHR world changing so quickly. So, you take all of the data and triangulate down to the best EHR possible.

Many might wonder why I’m talking about EHR selection anyway. Well, if you’re being generous, we’re somewhere around 50% EHR adoption. That’s still a lot of doctors who haven’t adopted EHR. Add to that the number of clinics that are looking to switch EHR software, and there’s still a big need for great EHR selection tools.

The reason I started this look at EHR selection websites is because EHR Selector has rolled out an Open Beta with new features. The best feature they’ve rolled out is that EHR selector is now free for everyone to use. I was pretty harsh on EHR selector in the past for charging doctors to use their service. That business model just didn’t make sense to me. Ironically, Carl Bergman (one of the people behind EHR Selector), has since become a regular reader of this site and we regularly exchange emails about the EHR world. So, I’m glad that he converted the service to a free service for everyone to use.

I tried out the new release of EHR selector and I have some mixed reviews. It is a beta release so that’s partially to be expected. I was a bit overwhelmed by the number of fields I had to complete to get into the tool. I imagine that could be streamlined some to make it a better experience for the user. Although, I expect the data is part of the reason the service can be made free. Plus, the more data you offer, the better customized experience the EHR selection tool can offer you.

What I do love about EHR Selector is that it’s always had a deep set of data available. I wonder if this will backfire for some users thanks to the paradox of choice. Although, as a data lover I really love all the data. Plus, they could help solve this issue with how they choose to display the various EHR and their data with a beautiful UI. I don’t think the UI is to that point yet, but having the data is the first step in that process.

My favorite feature of EHR Selector is the Compare EHR feature. I love seeing the features of multiple EHR’s compared side by side. This is where all the EHR data points becomes really valuable as well. One thing I do wish is there was more than just a check mark for each EHR data point. I’d love to have some qualitative description or images of each data point so you could really compare the EHR features that matter most to you.

One of the other shortcomings of EHR Selector is they haven’t yet gotten the data for all 300+ EHR vendors. No doubt that’s a daunting task and you have to start somewhere. I expect they’ll work to resolve this over time. Plus, they need the support of the EHR vendors to be able to get the data as well (not always an easy task).

Certainly EHR Selector isn’t perfect yet, but with its new Free feature it’s worth taking a look at if you’re in the market for an EHR. It’s another nice data point in the EHR selection process.