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The 2015 #HIT99 Results Are In

Posted on July 31, 2015 I Written By

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

Thanks to everyone who participated in the #HIT99. The #HIT99 was announced on July 6th and nominations were opened. We saw a wide variety of nominations and a lot of new additions that I’d never seen before. For me the #HIT99 and #HIT100 are all about social discovery and showing gratitude to your social media peers. I know I experienced both of those during the process. I hope you did as well.

A big shout out to Steve Sisko (@shimcode) for aggregating, cleaning, and otherwise analyzing all of the data associated with #HIT99 nominations. I can only imagine the time he spent working on it. It’s hard work, so thank you Steve!

No list like this would be appropriate without recognition of Michael Planchart (@theEHRGuy) who created the first (and many subsequent) #HIT100. Hopefully this list will honor what he started.

Details:
Here are a few quick observations on the rankings and participation:

  • Includes all tweets tagged with #HIT99 and/or #HIT100 from 7/6/15 through 7/27/15
  • 633 accounts made nominations
  • 319 UNIQUE accounts were nominated
  • Total of 1650 valid nominations were made
  • People were allowed to vote for themselves
  • RT’s of a nomination were counted but only once. (meaning if a person RT’d multiple tweets made by different accounts and that RT contained a nomination already contained in a different tweet the person RT’d, then only one instance of the nomination via RT would be counted)

And a few other notes about the #HIT99 and #HIT100 data that was collected and posted below:

  • Steve Sisko is cleaning up the raw data so it can be posted and shared with the community. You can watch for it to be posted on Steve’s blog shortly. Update: You can download the raw #HIT99 data here.
  • Feel free to post the #HIT99 list to your blog, social media site, paper, LinkedIn group, tattooed on your chest, or wherever else you’d like to post it. Share away. No attribution is necessary unless you want to attribute the #HIT99 community on Twitter.

We really hope that those in the community will take the #HIT99 data and do really cool things with it well beyond what I’ve posted below and what Steve will post on his site. If you need some inspiration or want to join forces, you might start by looking at what Don Lee (@dflee30) has started doing.

I personally thought it would be fun to post 3 interesting lists for great healthcare social discovery: the #HIT99, New Additions to the #HIT99, and #HIT99 Nominees with 1 Vote. So, without further ado, here are those lists: Read more..

Cerner, Leidos, and Accenture Win DoD EHR Project – $4.3 Billion

Posted on July 30, 2015 I Written By

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

All the news at the end of the day yesterday was around Cerner (and their major partners Leidos, Accenture) winning the DoD EHR project. We’d been told the decision would come by the end of the month and you knew a decision was close once the major news organizations started writing about what a waste the DoD EHR project will be before they’d even named the winner. That’s called priming the pump. Of course, the critics make some good points about the DoD EHR project dealing with today instead of the future, and they also suggested that “We’re going to make Epic or Cerner the Standard Oil of health IT. It will become a monopoly at a time when we need to be moving to solutions that allow everyone to participate.”

I guess now that we know that Cerner has won the DoD contract, does that make them the Standard Oil of Health IT?

What we do know is that Cerner, Leidos, and Accenture were awarded the $4,336,822,777 (Our government’s so precise they got a 10 year project down to the dollar?) EHR contract with it projected to be around $9 billion over the life of the 10 year contract. That’s massive by any terms. It’s also much less than the projected $11 billion that was previously discussed. I guess competition for the DoD EHR contract brought the price down? Although, how often does the government project the costs for a project and then they balloon over the life of the project. According to Healthcare IT News, they’ll be working on bringing their first sites live in the Pacific Northwest by the end of 2016 and 1000 sites by 2022.

A lot of people have been commenting how this is a big win for Cerner and a big loss for Epic. Of course, I wrote a little over a year ago that the best thing for Epic might be to NOT win the DoD EHR contract. You can be sure that many hospital systems won’t be selecting Cerner now that they’re going to be tied up with the massive DoD EHR contract. Who does that leave? In most cases, that will leave Epic. I can’t help but wonder how many Soarian users will now decide to go to Epic instead of Cerner as well because of the Cerner win. Cerner should start working on this potential perception problem.

You can imagine the celebrations happening at the companies that won this contract. HIStalk posted a great image that shows all the partners that will be involved in the bid:
DoD EHR Partners

While they may be celebrating the contract now, it reminds me of startup companies who do big celebrations when they raise a round of funding. Those celebrations are premature since it’s really the start of all the hard work to come.

I personally lean more towards G Gordon Liddie’s comment on the HIStalk post on this subject:

Cerner will do as good a job as Epic would have done…which won’t be great. The federal government can’t pull off something like this.

I think this shares many people’s fears of a project this size. Others might suggest, if the government can’t roll out an insurance exchange website without major issues, how are they going to make an EHR roll out which is much more complex a success. I’m sure Cerner, Leidos, and Accenture will be thinking about this every day for the next 5-10 years.

Other DoD EHR Coverage:
Healthcare IT News
nextGov
HIStalk
MedCityNews

How Do We Balance Improved Outcomes with Protecting Personal Information?

Posted on July 29, 2015 I Written By

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

There’s an interesting article by the Pacific Standard (never heard of them before now) about the “hidden market” of medical data that exists. The final paragraph provides a great summary of the challenges we face when it comes to health data:

There is no perfect way to balance the competing priorities of using big data for improved health outcomes and protecting our personal information. Opinions on which interests should come first will differ—and should. But the debate cannot be open, honest, or effective if major companies like Walgreens or Safeway are secretive about what they do. People are often generous when it comes to volunteering personal data for the purpose of advancing medicine. They are less so when it comes to enriching sellers of information. Either way, the proper course of action is disclosure. Simply put, if our medical data is being bought and sold, we deserve to know it—and have a say. Perhaps making our data available to others is as helpful to medicine as IMS claims. But shouldn’t that be up to us?

That’s the best summary of balancing improved outcomes and personal information that I’ve ever read. We all want better outcomes and I think that most of us believe that the right healthcare data will get us to better outcomes. We also all want our data to be protected from people who will use it inappropriately. The balance between the two competing priorities will never be perfect.

The reality is that there’s going to be more and more healthcare data available about all of us. Much of that data is going to be shared with a large number of organizations. Most people are just fine with that sharing assuming they believe the sharing will help them receive better care. However, there does need to be some mechanism of transparency and disclosure about when and how data is used. That doesn’t happen today, but it should happen.

The challenge is that pandora’s already out of the box. The data is already flowing a lot of places and putting in accountability now will be a real challenge. Not that I’m against challenging things, but we’re kidding ourselves if we think that accountability and transparency around where and when are data is shared is going to be easy to accomplish. First, companies are going to be dragged kicking and screaming to make it happen. Some because they know they’re doing some things that are at least in the grey area and some are totally shady. Others aren’t doing anything inappropriate, but they realize the costs to implement transparency and accountability for the health data they share is going to be very high. A high cost project that doesn’t add any more revenue is a hard business proposition.

While I’m not hopeful that we’ll see a widespread transparency about what health data’s being shared where, I do think that some forward thinking healthcare companies could push this agenda forward. It will likely happen with some of the companies who have avoided the grey and shady areas of health data sharing that want to create a competitive advantage over their competitors and build trust with their users. Then, some others will follow along.

What do you think that could be done to make health data sharing that’s happening today more transparent?

9 Sectors of Healthcare IT Investment

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.

Much of what we talk about here is new investments and new companies in healthcare IT. Much of the future of healthcare is built around these investments. SoCal HIMSS recently shared a great image that broke out the healthcare IT investment environment into 9 sectors:

Here are the 9 healthcare IT investment sectors mentioned:

  • ACO Tools
  • ACO-Oriented RCM
  • Employer Wellness
  • Benefits Management
  • Health Consumers
  • Patient Engagement
  • Big Data
  • PM & EMR
  • Remote Care

I always love seeing healthcare IT opportunities broken down into sectors like this. No doubt, we could all think of a company we could start in pretty much every sector. Although, certainly some are more saturated than others (see PM & EMR for example).

Are there any other sectors of healthcare IT investment that you don’t think are included in the sectors listed above?

Ashley Madison Data Breach – A Lesson for Health IT

Posted on July 28, 2015 I Written By

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

The recent hack of the Ashley Madison, Cougar Life and Established Men infidelity/hookup websites has been front page news. Overnight the lives of 50 million site members (pun intended) were potentially stolen by a hacker group calling itself “The Impact Team”. The Washington Post and CNBC have great articles on the details of the hack.

As the story unfolded I became more and more fascinated, not because of the scandalous nature of the data, but because I believe this hack is a lesson for all of us that work in #HealthIT.

The value of the data that is held in EHRs and other health apps is somewhat debatable. There have been claims that a single health record is worth 10-200 times more than credit card data on the black market. The higher value is due to the potential access to prescription medications and/or the potential to use health data to commit Medicare fraud. A recent NPR post indicates that the value of a single patient’s record is approximately $470 but there is not a lot of strong evidence to support this valuation (see John Lynn’s post on this topic here).

While $470 may seem like a lot, I believe that for many patients, the reputational value of their health data is far higher. Suppose, for example you were a patient at a behavioral health clinic. You have kept your treatment secret. No one in your family or your employer know about it. Now suppose that your clinic’s EHR was breached and a hacker asked you for $470 to keep your data from being posted to the Internet. I think many would seriously consider forking over the cash.

To me this hypothetical healthcare situation is analogous to what happened with Ashley Madison. The membership data itself likely has little intrinsic value (even credit card data is only worth a few dollars). HOWEVER, the reputational value of this data is extremely high. The disruption and damage to the lives of Ashley Madison customers is enormous (though some say well deserved).

The fall-out for the company behind Ashley Madison (Avid Life Media – a Canadian company) will also be severe. They have completely lost the trust of their customers and I do not believe that any amount of market spin or heart-felt apology will be enough to save them from financial ruin.

I believe what Avid Life Media is going through is what most small-medium sized clinics and #HealthIT vendors would face if all their patient data was exposed. Patients would utterly lose faith and take their business elsewhere (though admittedly that might be a little harder if other clinic choices were not covered by your insurance). Even if the organization could afford the HHS Office for Civil Rights fines for the data breach, the impact of lost patients and lost trust would be more devastating.

With the number of health data breaches increasing, how long before healthcare has its own version of Ashley Madison? We need to do more to protect patient data, it can no longer be an after-thought. Data security and privacy need to be part of the design process of software and of healthcare organizations.

Life’s short. Secure your data!

Funny Codes Exist in ICD-9 Too…And It Hasn’t Been An Issue

Posted on July 27, 2015 I Written By

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

I was recently thinking about ICD-10 and how in many ways it’s been a punchline of jokes since there are some pretty crazy ICD-10 codes. I’ve enjoyed the crazy and funny ICD-10 codes as much as the next person (we all need a good laugh on occasion), but I think it’s generally been bad for the move of ICD-10. Now that I think ICD-10 will not be delayed again, ICD-10 is no joke.

With that in mind, I wanted to put the funny ICD-10 code discussion to rest. So, I asked on Twitter if there were any “funny” ICD-9 codes (of course if you have any of these things, it wouldn’t be too funny). In response to my tweet, Jennifer Della’Zanna created this great post that puts the “funny” ICD-10 codes in perspective. She also provided me this list of ICD-9 codes that could possibly be considered funny codes as well:

E928.4 External constriction caused by hair
E918 Caught accidentally in or between objects
E005.1 Injury from activities involving yoga
E913.3 Accidental mechanical suffocation by falling earth or other substance
E018.2 Injury from activities involving string instrument playing
E827.4 Animal drawn vehicle accident injuring occupant of streetcar
E845.0 Accident involving spacecraft injuring occupant of spacecraft
E905.4 Centipede and venomous millipede (tropical) bite causing poisoning and toxic reactions
E917.7 Striking against or struck by furniture with subsequent fall
E927.1 Overexertion from prolonged static position
E927.2 Excessive physical exertion
E928.0 Prolonged stay in weightless environment

You could see a nice sticker with a picture for E905.4 as a centipede bite, that’s funnier than the full description. That’s what’s happened with many of the ICD-10 codes that are made into jokes. However, that misses my point. My point is that we’ve had some funny ICD-9 codes for a long time and it’s never been an issue. The ICD-10 codes that have been made into jokes won’t be an issue either. It’s time to move on to the ICD-10 codes that do matter and make sure we’re ready for ICD-10 come October 1st.

Healthcare Standard Proliferation Comic

Posted on July 24, 2015 I Written By

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

It’s Friday and I’m in Utah where today is a state holiday (think a second July 4th party). What does all that mean? It’s time for another Fun Friday post. I thought this comic that Dan Munro shared would be perfect:

I think the only modification we need is to have it say “See: Healthcare.” If you want to make this educational, the comic does point out some other places we could look to see where standard proliferation has been a problem. Or you could just enjoy the humor and head for the weekend. Either way, Happy Friday!

Dropout Docs – The Answer for #HealthIT Startups?

Posted on July 23, 2015 I Written By

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

We’d like to welcome a new guest blogger to our ranks. If you’re on social media, you probably know Colin Hung (@Colin_Hung), Co-Host of #hcldr. Colin is also head of Marketing for @PatientPrompt, a product offered by Stericycle Communication Solutions. We look forward to many posts from Colin in the future.

Recently both Nick van Terheyden (@drnic1) and Mandi Bishop (@MandiBPro) shared a link to an interesting article via Facebook. “Dropout Docs: Bay Area Doctors Quit Medicine to Work for Digital Health Startups”.
Dropout Doctors - Bay Area Doctors Leave Medicine for Healthcare Startups
The article highlights a new phenomenon happening In the Bay area – would-be doctors are dropping out of prestigious medical schools to pursue careers in digital health. Even those that complete their schooling are opting to join digital health start-ups/incubators (like Rock Health located in San Francisco, very close to USCF Medical Center) rather than apply for residency.

Being a doctor or a surgeon was once the pinnacle of achievement in American society, but with changes to reimbursements and general healthcare frustration, many are not seeing the practice of medicine as the rosy utopia it used to be (or was it ever?). Now even physicians are succumbing to the siren call of #HealthIT where there is a chance to “do good” and make a difference on a large scale.

I believe this trend could be a good thing for #HealthIT. Having more peers who are enthusiastic and passionate about improving healthcare can lead to more positive innovations. Consider the following quote from a doctor who joined a health care company instead of practicing medicine (from the KQED article):

“I realized that the system isn’t designed for doctors to make the real change you would like to for the patient.”

Having more people who want to put the patient at the center of healthcare makes my #HealthIT heart race. You can’t teach people to have this inner fire. It is something that is intrinsic to the individual…and we need more peers in #HealthIT with this flame.

There is just one line from the article that don’t agree with:

“…dropout doctors are well-positioned for a career in digital health as they have an insider’s view of the industry – and ideas about how to fix it.”

I think it is a bit of a stretch to say that people who went through med-school have a true “insider’s view”. Having not worked in a practice or in a healthcare setting, they would not be familiar with the political, financial or workflow aspects of care on the front lines. I hope these doc-dropouts are humble enough to remain open-minded as they listen to real-life customers provide feedback on the technologies and solutions they are involved with. In fact, dropout docs would be well served by remembering one particular part of their medical training – truly listening to the patient – which in this case may be the entirety of healthcare.

More EHR Consolidation – Modernizing Medicine Acquires gMed

Posted on July 22, 2015 I Written By

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

I’ve been writing and tracking the EHR consolidation world for a long time. It’s always fascinating to me to see how various EHR companies merge, shut down, or build their own little (and sometimes big) empire. Today I was greeted by the announcement that Modernizing Medicine had acquired gMed. I found the announcement pretty ironic since I keynoted both companies EHR user conference last year. So, I know both companies really well.

On face, they are both companies in southern Florida and so that’s going to make the transition a lot easier. Not to mention the competition for talent in the area as they grow will be a lot easier with the combined company. I talked to Dan Cane, CEO and co-founder of Modernizing Medicine, and Joe Rubinsztain, MD, CEO and founder of gMed, today about the acquisition. They told me that the combined companies will have roughly 10,000 specialty providers and 420 employees. Plus, Dan Cane commented that they expect to add over 50 to that head count over the next little while. Dan also noted that if you use meaningful use attestation data (which is a decent, but faulty proxy for EHR market share) then it puts the combined companies in the top 15 of EHR vendors. That’s pretty interesting considering they only serve a handful of medical specialties.

I’ve recently written about the power of a specialty EHR company and both of these companies had been executing the specialty specific EHR approach with great success. Who doesn’t like a piece of software that’s customized uniquely for their needs?

I asked Dan and Joe about the future plans for the two software platforms. They’re cognizant that gMed has been so successful in the marketplace because of the tight integration between its PM, EHR, and endoscopy report writer. So, I got the feeling that Modernizing Medicine will be very careful to not “disrupt the apple cart.” Although, I think Modernizing Medicine is keenly interested in taking gMed’s 18 years of experience in gastroenterology and incorporating that knowledge and expertise into the Modernizing Medicine technology. So, I think we’ll see this play out slowly and once Modernizing Medicine has caught their product up to gMed, we’ll see them sunset the gMed software. That could be a year or two at least.

There’s one caveat to all of that though. First, gMed has a PM and Modernizing Medicine doesn’t have one. I asked if Modernizing Medicine would start using the gMed PM. They won’t (at least for now) and I think that’s because Modernizing Medicine wants a truly integrated PM if they’re going to roll out their own PM. Plus, gMed’s PM has so many gastro specific features that I’m not sure it would be a good fit for a dermatologist (one of Modernizing Medicine’s best specialties). My guess is that Modernizing Medicine will utilize gMed’s PM experience to finally roll out their own PM, but we’ll see. They certainly have plenty to tackle when it comes to gastro EHR and deciding what they want to do with the endoscopy report writer which is very popular and important part of what set gMed apart from other EHR vendors.

I respect both gMed and Modernizing Medicine. So, I’m really interested to see what’s going to happen with the combined companies.

Twitter Has A Community for Every Chronic Disease

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.

I know that sites like PatientsLikeMe have been a huge success and really brought together similar patients to share in their healthcare journey. It’s an incredibly powerful thing to have a supportive community there to help you. It’s even more powerful if it’s someone who understands specifically what you’re going through.

This was the thought I had today when I tried to show some sympathy to Tiffany (better known as @TiffanyAndLupus):

I don’t really know Tiffany. I’ve just seen her tweets occasionally since I follow her. When I saw the above tweet, I had to respond with my own experience. Hopefully the interaction will help distract her from the pain and trouble. She favorited it, so I’m going to assume it helped…even if just for a second.

While my tweet might not mean much to her, Tiffany is the founder of the #LupusChat and so she’s well connected to a community of people who understand Lupus much better than I do. It’s hard to underestimate the power of community in our lives. We all long for it. We want to belong. Belonging and being loved is a great thing no matter your state, but especially if you have a health problem.

The beauty of Twitter is that you can find just about anyone on there. There may be some edge cases that are hard to find, but even then you can find supportive people who are in similar positions and can’t find anyone with their unique disease. I think that’s powerful. It’s one reason I love Twitter.

While many topics on Twitter get heated and brutal, I haven’t seen the trolls come out nearly as bad in the chronic care communities. Most of them are very supportive of each other and the health challenges people face. For the most part you see compassion in action. It’s beautiful to watch.

As I was writing this post, Tiffany replied to my tweet and I replied back:

I’m not sure the impact of my tweets on Tiffany. She might not notice a difference either. However, she’s brightened my day and made me smile. As is usually the case, those who extend the hand of kindness often receive the most in return. How could you not appreciate health a little bit more when you read tweets like this: