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Top EMR and HIPAA Blog Posts of 2016

Posted on December 30, 2016 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.

At the end of each year, it’s fun to pull up the stats and see which blog posts were the most popular blog posts and pages on EMR and HIPAA. What’s shocking to me is how many older posts on EMR and HIPAA are still generating a ton of traffic. Here’s a look at the top 10 blog posts and a bit of commentary on each.

1. Healthcare IT and EHR Conferences and Events – This page has gotten 10 times more traffic than pretty much all of the other posts on this list.  I’m biased, but it’s a great resource.  It also illustrates to me that I should spend more time creating these types of deep resources that are useful to readers.  It also illustrates that I traveled too much in 2016, but I’ve enjoyed every moment of those trips.

2. 6 Healthcare Incubators Growing the Future of HealthTech – This post probably needs to be updated with which incubators are still around and new healthcare incubators that have launched.  Might also be interesting to look at how well companies from the various incubators have done since being in the incubator.

3. Benefits of EMR or EHR Over Paper Charts – This was one of the first pages I ever created on EMR and HIPAA.  The sad part is that it looks like I still had plenty left to complete on that page.  However, it still highlights many of the benefits of EMR and EHR.  I’m glad it’s still getting visits since far too often we love to complain about EMR and EHR and take for granted all the benefits that an EHR provides.

4. 10 Ways Many Dental Offices Are Breaching HIPAA – This was a great guest post by Trevor James.  It was targeted at Dental Offices, but most of the items apply to any healthcare organization.  It’s amazing how many people still don’t understand HIPAA and what it requires.

5. Meaningful Use Is Going to Be Replaced – #JPM16 – This announcement was a bit of a surprise when it happened and I’m trying to understand why we didn’t know this was coming.  I also find it quite interesting that Andy Slavitt chose to make this announcement at JP Morgan’s annual healthcare conference and not at HIMSS or some other event.  Maybe it was just timing, but I think that says a lot about the JP Morgan event.

6. 2014 EHR Mandate – One of the top searches that refers traffic to EMR and HIPAA are related to the question of whether there’s an EHR mandate.  That’s likely why this post is so popular even though it was written back in 2011.  It’s amazing how well this content still applies almost 6 years later.  There is no EHR mandate and I don’t think there ever will be.  However, there are forces and reasons to use EHR.

7. Crazy and Funny ICD-10 Codes – These are still funny today.  Although, I’m a bit surprised that the post is still so popular.  It would be interesting to see a report from an EHR vendor or someone on how many of these funny codes actually get used in practice.  My guess is not very many times, but I’m open to being surprised.

8. The Impact of the 2016 Election on Healthcare IT – This was a prediction post.  We’ll need another year or two to see if my predictions were accurate.  I’m still pretty confident in them.

9. Examples of HIPAA Privacy Violations – More HIPAA Lawsuits Coming? – This post is amazing since it was written back in 2006.  That makes it almost 10 years old.  What can I say?  Concern over HIPAA lawsuits is a big deal and people can’t help to look when a wreck (ie. HIPAA violation) happens.

10. Has Electronic Health Record Replacement Failed? – Props to Justin Campbell from Galen Healthcare on this great piece.  I think we’re just at the beginning of the EHR replacement market.  So, I have a feeling this piece and others like it are going to continue in popularity.

11. Don’t Yell FHIR in a Hospital … Yet – I’m a little shocked to find this on the list since it was only posted a month ago. I guess the topic of FHIR is a good one and Richard’s post throwing some words of caution on the FHIR train was of interest to many.

12. EMR Templates – I think this was the only post on the list that I didn’t remember without looking.  No surprise, the post was from 2012.  I’m always a little scared to read some of my early blog posts.  However, this one was pretty good.  The challenge of template documentation in EHR software versus other methods is still an important discussion, but one that’s not really happening now.

13. Practice Fusion Violates Some Physicians’ Trust in Sending Millions of Emails to Their Patients – This post kind of needs no explanation.  I worked for probably a month writing it, so I’m glad that it’s still getting read.  It probably got an extra bump this year because the FTC finally closed the case against Practice Fusion that came out of this article.  It’s still an astounding story.

14. EMR Companies Holding Practice Data for “Ransom” – Wow!  Another post from 2011.  This is still a problem today, but the dynamics have changed for most companies.  Although, the challenge is likely to get even harder since many EHR vendors are now SaaS based EHR which make it even harder to get your data and easier for the EHR vendor to hold that data for “ransom.”

15. Securing Your HIPAA Controlled Computer Workstations – This post is from 2006.  My how things have changed in 10 years.  It’s an interesting look into where I started with this blog.  I’ve wondered lately if I should get back into more practical posts like this one.

16. Best Scanners for High Volume Scanning in a Doctor’s Office – A good scanner is still essential in every healthcare organization even if you have an EHR.  These Fujitsu’s are still good options, but I’ve also seen great success with the Ambir and Canon imageFormula scanners as well.

17. Don’t Blame HIPAA: It Didn’t Require Orlando Regional Medical Center To Call the President – This was a great reality check from Mike Semel on the salacious news that the President had got involved in the HIPAA issues related to the Orlando shootings.  Mike did this a number of times in 2016, so check out all his HIPAA blog posts.

18. HIPAA Cloud Bursts: New Guidance Proves Cloud Services Are Business Associates – Another great example of Mike Semel dropping HIPAA knowledge bombs.  It’s no surprise that his posts are on this list multiple times.

19. Quality Reporting: A Drain on Practice Resources, New Study Shows –  This chart from Steven’s post has really stuck with me.  The administrative bloat in healthcare is brutal.  The challenge is that I’m not sure how we get back to the more reasonable levels of the past.  Every doctor I know feels this and it’s an awful thing for patients.

20. Health Plans Need Your Records: Know What’s Driving Requests and How to Be Prepared – I’d known Craig Mercure for years and across multiple companies.  It was great to meet up with him again in 2016 at his new position at CIOX Health.  He certainly opened my eyes to the new world of health plan records requests.  CIOX has a great business doing this for health plans.

There’s a quick run down of the top blog posts on EMR and HIPAA for 2016.  Seeing all my old posts is fun and sometimes embarrassing.  I guess it does highlight the powerful long tail of great content.

Did you have a favorite EMR and HIPAA post?  We’d love to hear about it.

CVS Launches Analytics-Based Diabetes Mgmt Program For PBMs

Posted on December 29, 2016 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.

CVS Health has launched a new diabetes management program for its pharmacy benefit management customers designed to improve diabetes outcomes through advanced analytics.  The new program will be available in early 2017.

The CVS program, Transform Diabetes Care, is designed to cut pharmacy and medical costs by improving diabetics’ medication adherence, A1C levels and health behaviors.

CVS is so confident that it can improve diabetics’ self-management that it’s guaranteeing that percentage increases in spending for antidiabetic meds will remain in the single digits – and apparently that’s pretty good. Or looked another way, CVS contends that its PBM clients could save anywhere from $3,000 to $5,000 per year for each member that improves their diabetes control.

To achieve these results, CVS is using analytics tools to find specific ways enrolled members can better care for themselves. The pharmacy giant is also using its Health Engagement Engine to find opportunities for personalized counseling with diabetics. The counseling sessions, driven by this technology, will be delivered at no charge to enrolled members, either in person at a CVS pharmacy location or via telephone.

Interestingly, members will also have access to diabetes visit at CVS’s Minute Clinics – at no out-of-pocket cost. I’ve seen few occasions where CVS seems to have really milked the existence of Minute Clinics for a broader purpose, and often wondered where the long-term value was in the commodity care they deliver. But this kind of approach makes sense.

Anyway, not surprisingly the program also includes a connected health component. Diabetics who participate in the program will be offered a connected glucometer, and when they use it, the device will share their blood glucose levels with a pharmacist-led team via a “health cloud.” (It might be good if CVS shared details on this — after all, calling it a health cloud is more than a little vague – but it appears that the idea is to make decentralized patient data sharing easy.) And of course, members have access to tools like medication refill reminders, plus the ability to refill a prescription via two-way texting, via the CVS Pharmacy.

Expect to see a lot more of this approach, which makes too much sense to ignore. In fact, CVS itself plans to launch a suite of “Transform Care” programs focused on managing expensive chronic conditions. I can only assume that its competitors will follow suit.

Meanwhile, I should note that while I expect to see providers launch similar efforts, so far I haven’t seen many attempts. That may be because patient engagement technology is relatively new, and probably pretty expensive too. Still, as value-based care becomes the dominant payment model, providers will need to get better at managing chronic diseases systematically. Perhaps, as the CVS effort unfolds, it can provide useful ideas to consider.

Healthcare Is Going to Benefit from the Confluence of Consumer Technologies

Posted on December 28, 2016 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.

Next week is the annual CES conference in Las Vegas. It’s a unique event that brings together 170,000 people across 4 of the largest conference venues in the world. It’s enormous and a little hard to process.

Having attended for the last ~11 years, it’s been amazing to see the pace of progress with so many technologies. Remember that it’s only been about 9 years since the iPhone was launched. While smartphones and tablets have gotten so much better over this time period a whole slew of other consumer technologies have as well.

Looking forward to CES, it’s amazing to see the development of things like: 3D Printing, Virtual Reality, Augmented reality, IoT (Internet of Things…or as I like to call it Smart Everything), voice recognition, AI, robotics, sensors, etc etc etc. It’s an exciting time to be in an industry where so many things are developing so quickly.

Maybe I’m skewed because I’m a blogger in healthcare, but it’s really amazing how healthcare sits at the confluence of so many of these technologies. The overlap that’s going to happen between augmented reality, 3D printing, AI, sensors and new things we barely understand is going to be extraordinary.

I recently saw a 3D printing conference for healthcare. While 3D printing is very exciting for healthcare, it wouldn’t be nearly as exciting if we didn’t have all of the other innovations in cameras, storage, data sharing, virtual reality, etc. We needed evolutions and innovations in all of these spaces for the other technologies to really work well.

I’ve often said that the most interesting things in healthcare happen at the intersections. I think that’s particularly true in the digital health space. As I head to CES, I’ll be watching for this type of crossover of technologies. I think this year we’re going to see a lot of companies utilizing multiple technologies in ways we’d never seen previously.

Connected Health is Like Going from Printed Maps to Waze

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.

At the Connected Health Summit this year, I had a chance to talk with Chris Nicholson, CEO of mPulse Mobile. I was really impressed with what mPule Mobile was doing and I loved that they were actually doing things and not just talking about things that they could do. Sure was a refreshing experience from many other meetups with startups in this space.

During our discussion, Chris offered an interesting comparison between healthcare before connected health and healthcare after. I wasn’t recording our discussion, but here’s the gist of his comparison.

In the past health tech was kind of like a static map that was outdated as soon as it was printed. New tech is like Waze which is being constantly updated. Waze evolves based on a variety of factors and data to be able to create a custom experience for the user.

For those not familiar with Waze (Now owned by Google), it uses everyone’s driving information in order to make sure you’re taking the fastest route possible. The app has been so successful, it has caused new traffic problems in neighborhoods when Waze would reroute drivers through a neighborhood most people wouldn’t have thought to take to avoid a trouble area. It caused so much traffic in these neighborhoods, a lot of neighbors got really upset.

While there are challenges with any application, I think that Chris’ comparison is a good one. The EHR is essentially a static map of a person’s visit to the doctor. That information is outdated almost immediately after the patient leaves the doctor’s office. It’s great for historical understanding, but certainly isn’t a real time look at what could most benefit a patient’s health.

As I prepare for CES next week, I’m excited to see the slew of health sensors and health applications that will be at the conference. These combinations of technology will get us closer to the Waze of healthcare where our health status and the status of where our health is headed is updated in real time. I haven’t seen the Waze of healthcare yet. Have you?

#WhatTheHealthcare – Brilliant, but Sad

Posted on December 27, 2016 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.

If you’re on social media, you’ve probably seen the #WhatTheHealthcare hashtag that was started by HealthSparq. Along with the social media posts, they’ve also created a #WhatTheHealthcare! site that aggregates the frustrating healthcare stories that are out there.

Here’s a sample of the type of #WhatTheHealthcare stories they’re sharing:

As the title of this post says, it’s brilliant, but also very sad. There are so many #WhatTheHealthcare moments out there and we need to do better.

If you have a #WhatTheHealthcare moment, share it with us in the comments or on Twitter with the #WhatTheHealthcare hashtag. I have a feeling these stories are just getting started. The only way we can fix these problems is if we’re not afraid to share them. The next step that might be interesting is pairing these #WhatTheHealthcare moments with solutions.

So far most of the #WhatTheHealthcare stories have been from the patient perspective. It would be interesting to hear all the #WhatTheHealthcare stories from the doctors, nurse, front desk, HIM, etc perspectives as well.

Connected Wearables Pose Growing Privacy, Security Risks

Posted on December 26, 2016 I Written By

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

In the past, the healthcare industry treated wearables as irrelevant, distracting or worse. But over that last year or two, things have changed, with most health IT leaders concluding that wearables data has a place in their data strategies, at least in the aggregate.

The problem is, we’re making the transition to wearable data collection so quickly that some important privacy and security issues aren’t being addressed, according to a new report by American University and the Center for Digital Democracy. The report, Health Wearable Devices in the Big Data Era: Ensuring Privacy, Security, and Consumer Protection, concludes that the “weak and fragmented” patchwork of state and federal health privacy regulations doesn’t really address the problems created by wearables.

The researchers note that as smart watches, wearable health trackers, sensor-laden clothing and other monitoring technology get connected and sucked into the health data pool, the data is going places the users might not have expected. And they see this as a bit sinister. From the accompanying press release:

Many of these devices are already being integrated into a growing Big Data digital health and marketing ecosystem, which is focused on gathering and monetizing personal and health data in order to influence consumer behavior.”

According to the authors, it’s high time to develop a comprehensive approach to health privacy and consumer protection, given the increasing importance of Big Data and the Internet of Things. If safeguards aren’t put in place, patients could face serious privacy and security risks, including “discrimination and other harms,” according to American University professor Kathryn Montgomery.

If regulators don’t act quickly, they could miss a critical window of opportunity, she suggested. “The connected health system is still in an early, fluid stage of development,” Montgomery said in a prepared statement. “There is an urgent need to build meaningful, effective, and enforceable safeguards into its foundation.”

The researchers also offer guidance for policymakers who are ready to take up this challenge. They include creating clear, enforceable standards for both collection and use of information; formal processes for assessing the benefits and risks of data use; and stronger regulation of direct-to-consumer marketing by pharmas.

Now readers, I imagine some of you are feeling that I’m pointing all of this out to the wrong audience. And yes, there’s little doubt that the researchers are most worried about consumer marketing practices that fall far outside of your scope.

That being said, just because providers have different motives than the pharmas when they collect data – largely to better treat health problems or improve health behavior – doesn’t mean that you aren’t going to make mistakes here. If nothing else, the line between leveraging data to help people and using it to get your way is clearer in theory than in practice.

You may think that you’d never do anything unethical or violate anyone’s privacy, and maybe that’s true, but it doesn’t hurt to consider possible harms that can occur from collecting a massive pool of data. Nobody can afford to get complacent about the downside privacy and security risks involved. Plus, don’t think the nefarious and somewhat nefarious healthcare data aggregators aren’t coming after provider stored health data as well.

Oh How Easily We Forget

Posted on December 23, 2016 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 playing ultimate frisbee and a pharmacist from out of town came to play with us since they were in Las Vegas attending a conference. After a bit of discussion he learned that I was a healthcare IT blogger and so we had a short discussion about the benefits of technology in healthcare. During our discussion he said the following that really hit me:

“Carbon copy… it’s a nightmare.” -Pharmacist

That’s right. One of the hospitals that sends him prescriptions still uses carbon copy to write their prescriptions. The pharmacist then went on to tell me, “If you think reading handwriting is hard to read, try reading it through double carbon copy.”

For many of us, including myself, Christmas is just around the corner. We’ll be spending time with family and friends. We’ll give and get presents. We’ll eat Christmas cookies. We’ll sing Christmas songs. The break can be an extremely enjoyable time for many. However, so many of us (yes, that includes me) just take it for granted.

I think that’s kind of like the benefits technology can and has provided healthcare. How much easier is it to find a chart in an EHR? How much easier is it to read typed out notes versus the hieroglyphics that some doctors called handwriting? How much easier is it to print 2 prescriptions or just ePrescribe a prescription than to use a double carbon copy? I could go on and on, but you get the point.

Both in healthcare IT and in life, we often take so many things for granted once they become a constant in our lives. This holiday weekend I’m planning to slow down, breathe deeply, and appreciate the good things in life. There are many regardless of your situation or circumstances. Taking a little time to remember will help us not forget all the things we have to be grateful for in this world. Let’s put aside our challenges this weekend and pick them back up on Monday.

Happy Holidays to everyone! Thanks for always helping me to remember all the incredible things in my life.

The Case For Accidental Interoperability

Posted on December 22, 2016 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.

Many of us who follow #HITsm on Twitter have encountered the estimable standards guru Keith Boone (known there as @motorcycle_guy). Keith always has something interesting to share, and his recent article, on “accidental” interoperability, is no exception.

In his article, he describes an aha moment: “I had a recent experience where I saw a feature one team was demonstrating in which I could actually integrate one of my interop components to supply additional functionality,” he writes. “When you build interop components right, this kind of accidental interop shows up all the time.”

In his piece, he goes on to argue that this should happen a lot more often, because by doing so, “you can create lot of value through it with very little engineering investment.”

In an ideal world, such unplanned instances of interoperability would happen often, allowing developers and engineers to connect solutions with far less trouble and effort. And the more often that happened, the more resources everyone involved would have to invest in solving other types of problems.

But in his experience, it can be tough to get dev teams into the “component-based” mindset that would allow for accidental interoperability. “All too often I’ve been told those more generalized solutions are ‘scope expansions,’ because they don’t fit the use case,” and any talk of future concerns is dropped, he says.

While focusing on a particular use case can save time, as it allows developers to take shortcuts which optimize their work for that use case, this approach also limits the value of their work, he argues. Unfortunately, this intense focus prevents developers from creating more general solutions that might have broader use.

Instead of focusing solely on their short-term goals, he suggests, health IT leaders may want to look at the bigger picture. “My own experience tells me that the value I get out of more general solutions is well worth the additional engineering attention,” he writes. “It may not help THIS use case, but when I can supply the same solution to the next use case that comes along, then I’ve got a clear win.”

Keith’s article points up an obstacle to interoperability that we don’t think much about right now. While most of what I read about interoperability options — including on this blog — focus on creating inter-arching standards that can tie all providers together, we seldom discussed the smaller, day-to-day decisions that stand in the way of health data sharing.

If he’s right (and I have little doubt that he is) health IT interoperability will become a lot more feasible, a lot more quickly, if health organizations take a look at the bigger purposes an individual development project can meet. Otherwise, the next project may just be another silo in the making.

How Many Points of Vulnerability Do You Have in Your Healthcare Organization?

Posted on December 21, 2016 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.

Far too often I hear healthcare CIOs talk about all of the various electronic devices they have in their organization and how this device proliferation has created a really large risk surface that makes their organization vulnerable to breaches and other nefarious actions. This is true to some extent since organizations now have things like:

  • Servers
  • Desktops
  • Mobile Devices
  • Network Devices
  • Internet Access
  • Medical Devices
  • Internet of Thing Devices
  • etc

As tech progresses, the number of devices we have in our healthcare organizations is only going to continue to grow. No doubt this can pose a challenge to any Chief Security Officer (CSO). However, I actually think this is the easiest part of a CSO’s job when it comes to making sure a healthcare organization is secure. I think it’s much harder to make sure the people in your organization are acting in a way that doesn’t compromise your organization’s security.

As one hospital CIO told me, “I’m most concerned with the 21,000 security vulnerabilities that existed in my organization. I’m talking about the 21,000 employees.

Granted, this CIO worked at a very large organization. However, I think he’s right. Creating a security plan for a device is pretty easily accomplished. It will never be perfect, but you can put together a really good, effective plan. People are wild cards. It’s much harder to keep them from doing something that compromises your organization. Especially since the hackers have gotten so pernicious and effective in the tactics they use.

At the end of the day, I look at security as similar to child proofing your house when you have a young child. You’ll never make it 100% completely safe, but you can really mitigate most of the issues that could cause harm to your child. The same is true in your approach to securing your healthcare organization. You can never ensure you won’t have any security incidents, but you can mitigate a lot of the really dangerous things. Then, you just have to deal with the times something surprising happens. Now if we would just care as much about keeping our healthcare organizations secure as we do keeping our children safe, then we’d be in a much better place.

Zero Marginal Cost and Healthcare

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 stumbled upon an old post from the always insightful and interesting 3G Doctor blog about the concept of ‘Zero Marginal Cost.’ Here’s a great quote they use in the post from Albert Wenger, Managing Partner at Union Square Ventures:

“Why is everyone going online? It turns out there’s a simple answer to that: Kittens. Everyone wants to see Kittens. Well there’s actually something more to this, there’s something serious to this because when I downloaded this image from Flickr there was no noticeable cost to anybody. The marginal cost of creating a copy in the digital world is zero and that is driving all the changes that we’re seeing… …and we’re just at the beginning of this change”

I love the concept of zero (or at least near zero) marginal costs. It’s the premise of so many of the amazing things we experience on the internet. What’s troubling is that healthcare hasn’t embraced the idea of zero marginal costs. At least not in the way that it could.

In healthcare, we still like to talk about how much it’s going to cost a patient to get access to their medical records. There are literally state laws which say how much you can charge. Just writing this after writing about the marginal costs of delivering something electronically makes the concept sound silly. Imagine if your bank charged you per sheet to print out your statements each month. That’s basically what we’re asked to do in healthcare.

We’ve started to see some change in this, but there’s still resistance. There’s a real, palpable feel by many in healthcare that giving free access to all of your patient info could lead to really ugly problems. While there might be a few outlier cases people could identify, I’d argue the opposite. Think about the really ugly problems that occur in healthcare because patients don’t have their health information.

It’s time for healthcare to put down their excuses and embrace the benefits that zero marginal costs of sharing health information can provide. I’m not saying we should do it recklessly. We should be thoughtful in how we do it, but we should do it. It’s no longer a technical or security challenge, it’s just a cultural challenge.