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How to Introduce Microservices in a Legacy Healthcare Environment

Posted on May 31, 2018 I Written By

The following is a guest blog post by Nick Vennaro, Co-founder of Capto Consulting.

Healthcare as a whole is finding new ways to use technology to improve population health and patient experience. Population health is looking for a spectrum of precision in patient and provider data as well as clinical cost metrics and matching that data to patient communication, metrics and clinical outcomes. Patient experience requires streamlining information that is both timely and personalized, which is hard to accomplish with monolithic systems.

A monolithic system is usually one that has grown over many years and performs numerous functions that are not architecturally separated. These systems tend to be brittle and not easily changed.  The proliferation of mergers and acquisitions in healthcare further exacerbates the complexity of operating multiple monolithic systems within a healthcare network. It is not unheard of to operate 5, 8 or even 12 billing systems in parallel, because combining them would take so much more time, and it is more cost effective to let them operate individually.

An increasingly popular architectural style known as microservices are much better equipped to help healthcare organizations move forward rapidly than are the current monolithic, unstructured and difficult to maintain systems. While currently, no consensus exists on how to define microservices, it’s generally agreed that they are an architectural pattern that is composed of loosely coupled, autonomous, and independently deployable services that communicate using a lightweight mechanism such as HTTP/REST.

Now is the time for healthcare organizations to be investigating how best to introduce microservices in their legacy environments if they expect to realize a digital transformation. This is particularly important to enterprises that need to make frequent changes to their systems and where time-to-market is paramount.

The benefits and potential hurdles associated with adopting microservices are well documented. On the plus side, the modular and independent nature of microservices enables improvements in efficiency, scalability, speed and flexibility—all the features a nimble healthcare enterprise requires.  Detractors, however, frequently point to management and security challenges, especially when they pertain to customer-facing applications and services.   These challenges can be overcome with due diligence and planning.

Like virtually all technology decisions, it’s critical to balance risk with reward and, when it comes to microservices, embracing an evolutionary approach and process. After all, lessons can be learned from both success and failure, and the same is true for implementing microservices that can increase product and service quality, ensure systems are more resilient and secure, and drive revenue growth. This blog post will explain how business and technology leaders can smoothly and successfully introduce microservices in a legacy environment.

It’s all about the monkey

A key requirement of microservices design is to focus service boundaries around application business boundaries. A keen awareness and understanding of service and business boundaries helps right-size services and keeps technology professionals focused on doing one thing and doing it very well.

Astro Teller, the “Captain of Google Moonshots” humorously advocates that companies “tackle the monkey first” meaning they should avoid allocating all of their resources on the easy stuff and instead start by addressing the hard problems. The monkey, when deploying microservices in a large, established environment, is understanding and decomposing the legacy systems.

Decompose the legacy environment by identifying seams

In his book, “Working Effectively with Legacy Code,” Michael Feathers presented the idea of a seam as a way to identify portions of code that can be modified without affecting the rest of the code base. This notion of seams can be extended as a method to divide a monolithic system into bounded contexts from which services can be quickly and seamlessly created.

Uncovering seams in applications and building bounded contexts is an important first step in breaking down the monolith. Here are two steps to identify seams:

  • Interview domain experts. This is a key step to learning where the seams are and identifying bounded contexts. Having domain experts that understand what the business should be doing not just what the system currently does is critically important.
  • Understand the organizational structure – Often, organizational structure will provide clues to where the seams can be found.

Once the boundaries are identified, along with the programming language and environment that support them, creating packages and sub-packages that contain these bounded contexts should closely follow. This approach will afford a careful analysis of package usage and dependencies, which are paramount to fully and quickly understanding and ensuring that testing and instrumenting code is being done properly.

Healthcare is a prime candidate for using microservices to find the seams and decompose the monolithic infrastructure. It allows modernization as well as merging technologies without a complete and disruptive overhaul of the monolith at one time. This will allow the healthcare organization more flexibility and ability to compete on many levels, it’s a relatively fast route to a more agile delivery of population health and patient experience.

About Nick Vennaro
Nick Vennaro is cofounder of Capto, a management consulting firm. Nick has more than 25 years of experience leading enterprise-scale technology and business management initiatives for Fortune 500 companies. Nick will be presenting May 31 at the Healthcare IT Expo on “Using Outcomes-based Contracts to Increase Performance and Innovation.”

Bringing Their Valuable Experience to Healthcare Wasn’t Black & White for Zebra Technologies

Posted on May 30, 2018 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.

Earlier this year I wrote about the strong contingent of non-healthcare companies that exhibited at HIMSS18. Ever since then I have been curious to find out more about these companies – especially how they adopted their solutions to healthcare and how as outsiders they view the industry as a whole.

One of the companies that caught my eye was Zebra Technologies, a company that has a long history of providing mobility solutions for retail, manufacturing and government. In retail, for example, Zebra provides devices and software that consolidates inventory data from multiple source systems and delivers that date in real-time to sales associates. Not only does this result in better customer service, it also accelerates revenues for retailers. Zebra’s clients include retail giants Target and Walmart.

I recently sat down with Chris Sullivan, Global Healthcare Practice Lead at Zebra, to get his take on what the impact a company like Zebra could have in healthcare and what challenges there were bringing the company’s solutions into healthcare. Below is an abridged transcript of our conversation.

Is it an advantage or disadvantage being a healthcare “outsider”?

Being a company that has a long history outside of healthcare is both an advantage and a disadvantage.

The advantage is that we have tired and true solutions that work in other industries that in some ways are more demanding than what we see in healthcare. For example in auto manufacturing, tracking assets and inventory in the supply chain is extremely difficult. There aren’t nearly as many moving parts in a healthcare supply chain. Because we have solutions that can handle this type of complexity, it means we have an advantage when we take those solutions to healthcare.

Another advantage is our deep technical knowledge when it comes to mobility. We know what it takes to roll out a truly enterprise-class mobility solution and that gives us an advantage over companies that only have experience in the healthcare field.

The disadvantage is that as an organization it’s taken us time to build up our healthcare acumen and in the past we may have missed some of the nuances of healthcare. Just getting to know the acronyms and the terminology has taken time.

How did you address this gap?

As a company we had become more humble when it came to healthcare. We had to admit to ourselves that we had a lot to learn and that we had acknowledge that the way we need to do things a little differently in healthcare. There’s a very fine line between brining valuable expertise from other industries in a way that doesn’t override healthcare customers when they want to do something differently.

Our CEO and other senior leaders set the example. They recognized the gap and invested in bringing healthcare “insiders” onto the team. That’s why I’m here. They also invested in bringing the voice of healthcare customers into Zebra’s operations and processes. We now have a Customer Advisory Board where we vet product ideas and adjust based on their valuable feedback.

What was the most surprising thing that Zebra learned about Healthcare?

For the non-healthcare folks at Zebra, I think the complexity of healthcare workflows was a really big surprise. It’s a lot more complex than people realize. There are so many nuances and variables that just don’t exist in any other industry.

I think the magnitude of the opportunity in healthcare also took many by surprise. Not only is opportunity within the healthcare supply chain, but there is also plenty of opportunity for Zebra to help with care delivery.

Some were surprised to learn at how many barriers exist between patients and clinicians. There is just so much that gets in the way of caring for patients. There’s all the administration, documentation, collecting data from multiple sources and looking for assets. People became clinicians because they wanted to care for patients and somehow we’ve got them doing admin work.

What opportunities does Zebra see in healthcare?

We see an opportunity to help healthcare organizations improve their workflows. Specifically we see an opportunity for our technologies to eliminate unnecessary administrative and non-value-add steps for caregivers. By streamlining the workflow, quality would improve, the organization would become more efficient and thus require less resources, the patient experience would improve and care would be safer. There’s a lot of wasted time and resources in healthcare. We can help with that.

We also see an opportunity to bring true enterprise-level mobility solutions to healthcare. Up to this point, healthcare has had experience with smartphones and tablets, but those are consumer devices designed for individual consumers. They aren’t enterprise-class devices and they have inherent limitations in a healthcare setting. For example, they can’t be cleaned and disinfected very easily. They are difficult to secure. Managing upgrades is a nightmare. Plus smartphone cameras are not the same as industrial-strength barcode scanners which are common in enterprise devices.

There’s a KLAS report that does a great job at explaining how the inadequacies of the iPhone in healthcare has given rise to companies like Zebra.

Can you give me an example of enterprise-mobility work you have done in other industries that you are now applying to healthcare?

Sure. We have experience with many other verticals in addition to healthcare. One example would be the work we do for Ford Motor Company. As you know, Ford has a highly automated production line. It’s very expensive to have that line shut down. Zebra helps to tag all the equipment in those facilities so that production managers know exactly where their assets and inventory are located at all times. This is critical to ensuring that there is never a delay in getting the right asset to the right place at the right time.

We’re adopting this same know-how and associated technology to healthcare. It’s really vital to know where all your assets are in a hospital – from IV poles to beds to carts. The same applies to tracking high-dollar consumables like implantable devices. It’s really expensive to have doctors and nurses waiting around for the right equipment or the right medication to arrive – which is analogous to the work we do with Ford.

What advice would you give to other companies looking to enter healthcare?

Be humble. Don’t assume that because your solution worked in another industry that it can be plopped into healthcare as-is.

Play nice with others. There’s a big ecosystem in healthcare and you have to learn how to work together with those other players. Healthcare is a team sport.

What Will 5G Mean for Healthcare?

Posted on May 29, 2018 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The above tweet also included an image, but I decided it was too disturbing to embed on this blog. Yeah, I know that means you all just clicked through to see it. While a bit disturbing, the picture definitely made me stop and ask the question, “What does 5G mean for healthcare?”

I’m not sure how many people have been following 5G, but it’s getting really close to becoming a reality. For those not familiar with the technology, here’s an anecdote that highlights how fast 5G can be “In testing, the transfer speeds for the “5G” network sent data at 1.056 Gbit/s to a distance of up to 2 kilometers.”

1 Gig per second. What would it mean that you could transfer 1 Gig per second wirelessly? Now, I should note that it’s going to take some time for the devices to be able to support these kinds of speeds. Plus, it will also take the applications time to figure out what to do with this type of speed. However, it changes how we think about what we’re streaming completely.

In healthcare, those radiology images that are so big would be nothing to share with anyone anywhere anytime. You could literally have multiple HD cameras filming your healthcare experience live in real time with no issues at that speed. Genomic data is huge, but it could easily be shared with these types of speeds to anyone that needs it anywhere.

This is just the obvious stuff. What’s so incredible about reaching new types of breakthrough speeds like this is that it enables us to discover new opportunities that we couldn’t even think of previously because the speeds made that type of thinking impossible. When you look at the volume of data that sensors will be streaming about our lives, you can see why these speeds could be extremely valuable. Plus, at these speeds, federated data becomes much easier to stomach because you know even large data sources are available with ease.

What do you think of 5G data? How do you think it will impact healthcare? It’s amazing how broadband changed so many things we do online and enabled so many new services. 5G could and likely will do the same.

Memorial Day – #VegasStrong

Posted on May 28, 2018 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This Memorial Day has a little extra meaning for those of us that live in Las Vegas. It’s the first memorial day since the tragedy that happened on the strip in Las Vegas. The above photo is a memorial that’s been set up for the victims of the tragedy about 1/2 a mile from my house. It’s a stark reminder of an enormous tragedy. However, on Memorial Day it’s also a reminder of the thousands who have given their lives for the freedoms we do enjoy. I’m grateful for their sacrifice and appreciate them and all those who have passed on in defending freedom.

I hope everyone has an enjoyable Memorial Day and slows down enough to hug their family and friends and let them know how much you love them.

Physician Burnout, a Healthcare Issue Unique to Our Healthcare Providers

Posted on May 25, 2018 I Written By

The following is a guest blog post by Justin Campbell, Vice President, Strategy, at Galen Healthcare Solutions.

I Can’t Get No Satisfaction…but I try, and I try, and I try, and I try – Rolling Stones

Justin CampbellIn a 2018 Medscape survey exploring the professional satisfaction of providers, 42 percent of 15,000 survey respondents reported feeling burnt out with their jobs, up from an overall rate of 40 percent in 2017. In recent years, physician burnout has become a serious industry issue, with national policy discussions ensuing on how to best combat the problem. Researchers have drawn correlations between physician burnout and higher medical error rates, lower overall quality of care, and increased clinical staff turnover. Year after year, the underlying drivers of dissatisfaction have remained consistent: overwhelming charting requirement, long work hours, and cumbersome EHRs.

As health IT leaders, one question we should be asking ourselves is how we can best apply our EHR expertise to help reduce physician burnout. To answer this question, let us look to the doctors we aim to help. When physicians are at the bedside, they analyze a patient’s condition and formulate a care plan accordingly. They look to diagnostic test results, review trended vitals, pain scores, and nursing assessments, and consult with specialists in a massive data gathering exercise all aimed at quantifying the problem and crafting a treatment plan.

Providers are telling us there is a problem, and they are consistently identifying the primary underlying causes. IT department leaders have a direct influence over many of the drivers of physician burnout, so it is time for us to dig into the details, measure the problem, and craft a treatment plan. How do we measure and manage physician burnout?

There’s Gold In Those EHR Audit Logs

The Office of the National Coordinator’s EHR Certification Requirements mandate that all certified EHRs be capable of generating an audit log detailing all user activity, stored in a database alongside user credentials and a date and time stamp. At first glance, these unassuming audit logs appear to provide little actionable insight, but buried in the data there is value. When audit logs are compiled across several months, data analysts will quickly see that they have a rich dataset that can be sliced and diced to expose the EHR navigation and module utilization trends of key physician populations.

Analyzing patterns within EHR audit logs will allow savvy data analysts to determine the average length of time providers spend working in the EHR. This information can be calculated at the individual level or aggregated across all providers.

Source: Galen Healthcare Solutions

Knowing how long providers are spending on administrative tasks in the EHR is valuable information for a number of reasons. First and foremost, this information can be used as a benchmark to measure the impact of future software updates or optimization projects. Any significant changes to provider workflow should be retrospectively reviewed to understand how it impacts the average time providers spend in the EHR. First, do no harm.

Analyzing user activity logs at the individual level also helps identify highly efficient EHR users within each specialty. The EHR workflow patterns of these EHR champions can be modeled. Peers can be educated on how to adjust their own workflows to mirror specialty-specific champions, reducing their own daily EHR burden. These “quick win” workflow adjustments are changes that can be adopted by clinical staff immediately, before extensive EHR optimization efforts are undertaken.

Audit log analysis can also highlight which EHR modules providers spend the most time in. In most cases, updating user preferences and optimizing the information displayed on EHR screens can expedite chart navigation. Simplified documentation templates and macros training can expedite the documentation process. A library of evidence-based order sets and targeted clinical decision support algorithms can minimize time spent entering orders.

Analyzing utilization trends at the EHR module level exposes the workflow tasks that are consuming a disproportionate amount of provider time.

Don’t. Stop. There.

EHR audit log analysis can reveal how much time providers are spending in the EHR, and where specifically they are spending that time. It can identify physician champions, and highlight those that are struggling. Audit log analysis can be used to measure EHR-induced physician burnout and support system-wide optimization efforts aimed at improving satisfaction.

Beyond this, EHRs offer a wealth of additional datasets that can help highlight inefficiencies in clinical workflows. Traditional health IT data analytics typically aims to uncover problems in care quality or revenue cycle management, but analysis focused on EHR workflow improvement is just as noble an effort, and one providers have long been seeking.

Gain perspectives from HDO leaders who have successfully navigated EMR clinical optimization and refine your EMR strategy to transform it from a short-term clinical documentation data repository to a long-term asset by downloading our EMR Optimization Whitepaper.

About Justin Campbell
Justin is Vice President, Strategy, at Galen Healthcare Solutions. He is responsible for market intelligence, segmentation, business and market development and competitive strategy. Justin has been consulting in Health IT for over 10 years, guiding clients in the implementation, integration and optimization of clinical systems. He has been on the front lines of system replacement & data migration and is passionate about advancing interoperability in healthcare and harnessing analytical insights to realize improvements in patient care. Justin can be found on Twitter at @TJustinCampbell and LinkedIn.

About Galen Healthcare Solutions
Galen Healthcare Solutions is an award-winning, #1 in KLAS healthcare IT technical & professional services and solutions company providing high-skilled, cross-platform expertise and Gold sponsor of Health IT Expo. For over a decade, Galen has partnered with more than 300 specialty practices, hospitals, health information exchanges, health systems and integrated delivery networks to provide high-quality, expert level IT consulting services including strategy, optimization, data migration, project management, and interoperability. Galen also delivers a suite of fully integrated products that enhance, automate, and simplify the access and use of clinical patient data within those systems to improve cost-efficiency and quality outcomes. For more information, visit Connect with us on TwitterFacebook and LinkedIn.


Origin Story: Paul M Black, CEO of Allscripts – Deep Roots and Optimism in Healthcare

Posted on May 24, 2018 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.

This is first in a new series of articles. Over the coming weeks and months I will be publishing the origin stories of interesting, inspiring people in healthcare. These men and women come from all walks of life. Some are titans in the industry, others are leading grass-roots efforts. All are making an impact on healthcare.

As a self-professed comic-book geek, I am fascinated by origin stories – the account or back-story that reveals how someone became who they are today. Origin stories add to the overall narrative and give reasons for a person’s intentions. Knowing someone’s origin stories can give clues to their future actions.

Kicking off this series is the origin story of Allscripts CEO Paul Black. Allscripts, based in Chicago, serves over 45,000 physician practices and 2,500 hospitals around the world with their EHR systems and other Healthcare IT solutions. The company has a rich history of mergers. Early on they merged with Misys and Eclipsys. More recently, the company has acquired McKesson’s Health IT business and Practice Fusion.

It is common knowledge that Mr. Black has a long history in healthcare. Prior to becoming CEO of Allscripts in December 2012, he spent 13 years as Chief Operating Office at Cerner (an Allscripts rival). He has also served as an advisor to healthcare companies through his work at New Mountain Capital and Genstar Capital.

What is not common knowledge is how far back Black’s history with healthcare actually goes. When he was just 5 years old, Black accidentally consumed weed poison that was in an unlabeled vial. Luckily his father, who was the Director of the Pharmacy Department at the local hospital took him to the VA emergency room right away. As a healthcare professional his father knew that the VA had just purchased an artificial kidney machine – the very device needed to treat this type of poisoning. Spoiler Alert: Black made a full recovery thanks to his father’s quick actions and the knowledgeable staff at the VA.

To understand how lucky Paul Black was, you have to remember that back then, there were no toxicologists, no poison control centers, no detailed chemical labels and very little knowledge of poison treatments. In fact, it wasn’t until 1953 that the first poison hotline was established in Chicago by Louis Gdalman R.Ph and Edward Press MD [source: Forging a Poison Prevention and Control System 2004].

Black’s poisoning incident led his father to establish an Iowa poisoning hotline so that people in his home state could find out what to do in a poisoning situation. His work eventually led to the creation of the Iowa Poison Information Control Center – an entity that is still saving lives today.

“My father was always working on ways to improve healthcare,” recalls Black. “He built a machine that would help ensure that the right medication would be administered to the right patient at the right time. It was basically a precursor to a Pyxis machine. He got involved in computers in the early stages and was always looking for ways to use systems (whether physical or software) to solve problems in healthcare.”

Clearly the apple did not fall far from the tree.

Early in his career, Black worked at IBM where he learned “a lot about systems, software and hardware.” But more importantly, it was his time at IBM that ignited his passion for healthcare.

“I just felt good whenever I worked with hospitals and healthcare clients,” explains Black. “It was clear that working with them had a direct impact on care and on individuals in their care.”

Black moved on from IBM and joined Cerner, then an up-and-coming healthcare systems maker. There, he progressed steadily through the ranks until ultimately becoming Chief Operating Officer in 2005. Black retired from Cerner in 2007 and served in a number of advisory/board positions until he was named CEO of Allscripts in 2012.

I asked Black why he chooses to stay in healthcare.

“It’s pretty simple actually. We aren’t done yet,” states Black. “My grandfather was born in 1888 and during his lifetime we went from horse-and-buggy on dirt roads to a full interstate system with fast cars and a railroad system with fast trains. We also went from having to read your news in a newspaper to wireless radio. He even saw us land on the moon. That was an incredible amount of progress for a single lifetime. I would argue that in my lifetime we are going to see a similar leap with just as many innovations, discoveries, and life saving technologies. That’s why I stay. Healthcare is going to be a fascinating industry for the next 20+ years. Plus there aren’t many industries where you get to help the people that save lives.”

Black went on to say that this is a time in healthcare when strong leadership will be required to ensure we make the right decisions for the benefit of the many vs the few. He pointed at genomic testing as an example. Even though the cost of sequencing continues to drop, access to this type of technology and access to clinicians knowledgeable on how to interpret the results is not universal.

Access to care is a cornerstone of Black’s vision of a perfect healthcare system, something I asked him to describe during our conversation: “My perfect healthcare future is one where everyone has access to healthcare, not just people of means. It’s one where a payment mechanism has been figured out whereby a certain level of access is guaranteed as is a certain level of prevention.”

Black went on to say that this vision is not as far fetched as it may first sound: “My view is that there is enough money already in the healthcare system today to make this happen. If you add the dollars spent by every single player in the healthcare industry – governments, employers, patients, etc – it’s more than enough. We are at 18% GDP. It’s just not being spent efficiently.”

To reach his vision, Black feels we need to build a healthcare system where: “We get the diagnosis right the first time, there is no delay in treatment and there is active involvement from patients in their health.” The latter being the toughest challenge – motivating the average person to exercise more, eat better and make healthier lifestyle choices.

“We have to make it cool to be healthy,” says Black. “In fact we need the healthy equivalent of the Marlboro Man, which I know is an ironic and strange thing to say. But back in the day, EVERYONE wanted to be the Marlboro Man. He was what young men aspired to be like. We need the healthy equivalent to help motivate people to be more engaged in health.”

It is not surprising that Black sees Allscripts playing a significant role in making healthcare more efficient and effective. “Allscripts definitely has a role to play,” explained Black. “We will play that role by staying relevant in the healthcare industry. We have our core EHR products, but we also have four other product lines that are actually EHR-agnostic. We have our population health platform, dbMotion. We have our post-acute system, Netsmart. We have our precision medicine platform, 2bPrecise. And finally we have our consumer platform, FollowMyHealth. We will continue to push aggressively in these markets through innovation and acquisition to provide our clients with the solutions THEY NEED to deliver better care to patients.”

Allscript’s latest acquisition certainly fits with this acquire-functionality-that-clients-want strategy. On May 18th, the company acquired HealthGrid – a communication platform that delivers reminders, alerts and educational materials to patients via phone, text, and other electronic means. This functionality will be rolled into Allscript’s FollowMyHealth product line.

“I feel it’s our duty and obligation to automate the healthcare ‘shop floor’,” declares Black. “The groundwork had been laid with EHRs, but now it’s time to streamline workflows and leverage the data within these systems. We need to reduce the ‘shouting’ in healthcare (too many alarms). We need to improve User Interfaces so systems are easier to use. We need to reduce the documentation requirements on clinicians so they can go back to taking care of patients vs being data entry clerks. Computers should work for us, not the other way around.”

Reflecting on Black’s origin story you can see the thread of hope and optimism woven throughout. From his first (and positive) encounter with the healthcare system when he was 5 years old to watching his father use computers/machinery to try and improve patient care to the positive feelings he had while working with hospital clients at IBM – every experience brought him closer and closer to healthcare until he became part of the industry through his position at Cerner.

It gives me hope that an industry leader like Paul Black is optimistic about the future of healthcare. It’s exciting to learn that he is not just saying the right words, he is putting energy and investment behind them. It will be interesting to see how Allscripts will continue to “remain relevant” and be agile in the years ahead.

How Health IT Helps and Hurts Patients – #HITsm Chat Topic

Posted on May 23, 2018 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/25 at Noon ET (9 AM PT). This week’s chat will be hosted by Amanda (@LALupusLady) on the topic of “How Health IT Helps and Hurts Patients (Especially Those with Chronic Conditions).”

Health IT is a powerful tool. It has changed the way patients, especially people with chronic illnesses live with and manage their care. As a woman living with multiple autoimmune illnesses for over three decades, my perspective is unique as I have seen the shift and how providers have been eager to adopt technology into their practice and recently experienced a doctor’s office where the fax machine is still the primary means of communication.

In my patient experience, I have chosen to adopt and use Health IT to assist me in managing my chronic care. Whether I am tracking my symptoms, keeping a food diary, or putting on a VR headset to help me relieve my pain, Health IT has improved my patient experience. While at the same time, the fact that with all the advances in Health IT that not every advance is a step forward for healthcare. There is frustration by patients that (in 2018) EHR developers have not yet developed a way for various platforms and institutions to connect to create one complete healthcare record for one patient.

Next week, I am proud that I will be at #HITExpo to share my patient experience at Healthcare Scene’s inaugural event in New Orleans. Understanding the value and insight that patients have can build an empathy, which I feel will directly improve the way Health IT collaborations work together.

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1: How is Health IT (Apps, Devices and New Technology) helping streamline the patient experience (especially for people living with chronic conditions)? #HITsm

T2: How is Health IT hindering (hurting) the patient experience (especially for people living with chronic conditions)? #HITsm

T3: What Health IT companies/developers have made a positive impact on your life? How? If you are a patient, what Health IT has directly improved your patient experience? #HITsm

T4: How can Health IT work together with patient communities to improve outcomes and engagement? #HITsm

T5: What can you do to support Health IT “collaborations that work” with patients, especially those living with chronic conditions? #HITsm

Bonus: What are you most looking forward to at #HITExpo? #HITsm

Wishing you a Healthy and Happy Lupus Awareness Month. Can’t wait to chat together.

Upcoming #HITsm Chat Schedule
6/1 – #HITExpo Hiatus
The #HITsm chat will be on hiatus this week with the Health IT Expo happening in New Orleans. Please join in on the conversation happening on the #HITExpo conference hashtag.

6/8 – How Technology and Healthcare Should Gracefully Collide to Provide the Best Patient Experience
Hosted by Jeanne Bliss (@jeannebliss) and Michelle Chaffee (@mdchaffee)

6/15 – TBD
Hosted by Janice McCallum (@janicemccallum)

6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – TBD
Hosted by Cathy Turner (@MEDITECH_Nurses) from @MEDITECH

7/6 – TBD
Hosted by Lea Chatham (@LeaChatham)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

The State Of Healthcare Cybersecurity (Part 2)

Posted on May 22, 2018 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 Part 1 of this series, which drew data from a study by Black Book Market Research, I described how insecure healthcare leaders felt their cybersecurity protections to be. I also noted that a large number of providers are struggling to recruit senior health IT experts, and as a result are basically winging it when it comes to breach protection.

Healthcare organizations’ data security problems run deeper than that, however, the study suggests. Not only are C-level execs finding security investments to be troublesome, IT managers responding to the survey admit that they, too, feel that they are not fully prepared to defend their institution’s data.

To begin with, 74% of surveyed CIOs admitted that they failed to evaluate the total cost of ownership before signing a deal with a cybersecurity solution or service provider, and 89% said they bought their cybersecurity solution to be compliant with security regs, and often, not necessarily to reduce security risks.

And the failure to protect critical information doesn’t stop there.  For example, 57% of IT managers said that they hadn’t taken stock of the full variety of cybersecurity solutions that currently exist, notably mobile security environments, intrusion detection, attack prevention, forensics and testing.

Also, many healthcare institutions seem to react only after they’ve been invaded. According to Black Book, 58% of hospitals didn’t select their current security vendor until after a data security incident, and 32% of healthcare organizations hadn’t scanned for vulnerabilities before an attack.

What’s more, 83% of healthcare organizations haven’t staged a cybersecurity drill which included an incident response process, which arguably leaves them particularly unprepared. Not only that, when an attack comes, some won’t catch it right away, as 29% said they don’t have an adequate solution to instantly detect and respond to cyberattacks.

Meanwhile, 16% of respondents reported being uncomfortable working with vendors that do a hard sell when they find security flaws and vulnerabilities. These insecurities aren’t surprising given that 60% of healthcare enterprises haven’t formally identified specific security objectives and requirements and integrated them into a strategic and tactical plan for breach prevention.

Given how unfocused many security plans are, it’s not surprising that 22% of provider organizations believe their cybersecurity position will worsen between now and the second quarter of 2019. Only 12% of hospitals and 9% of physician organizations reported that they expected to see cybersecurity improvements.

The bottom line here is that if the Black Book research is correct, many healthcare organizations are frighteningly unprepared to protect their data, much less survive a serious attack relatively unscathed. For everyone’s sake, let’s hope that providers wise up to the need for strategic, substantial investments in security technology and staff.

The State Of Healthcare Cybersecurity (Part 1)

Posted on May 21, 2018 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.

Healthcare data has never been under more outside threats than it is today. For a number of reasons, this data has become more attractive to cybercriminals and can be sold on the dark web for a pretty penny. Not only that, emerging threats like ransomware attacks are hitting home and wreaking havoc with the institutions they target.

Unfortunately, according to a new study by Black Book Market Research, healthcare organizations don’t seem to be adequately prepared for this onslaught.

The survey, which collected responses from more than 2,464 security pros working at 680 provider organizations, found that health IT leaders aren’t confident they can defend themselves against cyberattacks. In fact, 96% of IT professionals who responded said that the attackers are significantly ahead of them and could probably cut through the protection their organizations have in place.

Given that stat, it’s not surprising that over 90% of healthcare organizations have seen a data breach since Q3 2016. Worse, almost 50% reported that they had more than five data breaches during this period. Not only that, more than 180 million records have been stolen since 2015, a staggering haul which affects roughly one in every 12 healthcare consumers.

On the surface, it might seem surprising that healthcare organizations haven’t toughened their defenses given the number of threats they face. Actually, they are, but they’re being outgunned. It’s not that they’re not making cybersecurity investments, but both the level of investment and their strategy for deployment may be inadequate.

In a surprisingly frank set of disclosures, one-third of hospital executives that bought cybersecurity solutions between 2016 and 2018 said they did so blindly without much vision or understanding of what they were getting for their money. Respondents said that 92% of data security product and services buying decisions were made at the C-level, and the process didn’t include any users or affected department managers.

One reason that C-level executives with little relevant knowledge are making security investment decisions because they don’t have anyone senior to consult – and the problem is extremely common.

The survey found that 84% of hospitals responding had no dedicated security executive in place. Most say that it’s difficult to recruit a qualified chief security officer, which is why they’re going bare on data security and stumbling through the buying process as best they can.

Some organizations are responding to the shortage of C-level tech talent by outsourcing the function. Twenty-one percent said they outsource security to partners, consultants or selected security-as-a-service options as a placeholder.

Given this interest in outsourcing, healthcare organizations are signing deals with security services and outsourcing companies five times more often than they’re buying cybersecurity products and software. Vendors, in turn, are responding by diversifying the portfolio of services they offer. Still, that’s unlikely to be enough over the long term.

All of this suggests that the healthcare industry is in a security crisis. I’ll offer more details on the situation in part two of this series.

Coworker Humor – Fun Friday

Posted on May 18, 2018 I Written By

John Lynn is the Founder of the 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 and 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! Time to get ready for the weekend with a little co-worker humor:

Good teammates definitely feel like a mythical creature. They’re really really hard to find. So, once you find them, be extremely grateful. It’s amazing how much your teammates impact you. I love that this tweet was about gamers, but it’s true in work and life as well.