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Key Articles in Health IT from 2017 (Part 2 of 2)

Posted on January 4, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The first part of this article set a general context for health IT in 2017 and started through the year with a review of interesting articles and studies. We’ll finish the review here.

A thoughtful article suggests a positive approach toward health care quality. The author stresses the value of organic change, although using data for accountability has value too.

An article extolling digital payments actually said more about the out-of-control complexity of the US reimbursement system. It may or not be coincidental that her article appeared one day after the CommonWell Health Alliance announced an API whose main purpose seems to be to facilitate payment and other data exchanges related to law and regulation.

A survey by KLAS asked health care providers what they want in connected apps. Most apps currently just display data from a health record.

A controlled study revived the concept of Health Information Exchanges as stand-alone institutions, examining the effects of emergency departments using one HIE in New York State.

In contrast to many leaders in the new Administration, Dr. Donald Rucker received positive comments upon acceding to the position of National Coordinator. More alarm was raised about the appointment of Scott Gottlieb as head of the FDA, but a later assessment gave him high marks for his first few months.

Before Dr. Gottlieb got there, the FDA was already loosening up. The 21st Century Cures Act instructed it to keep its hands off many health-related digital technologies. After kneecapping consumer access to genetic testing and then allowing it back into the ring in 2015, the FDA advanced consumer genetics another step this year with approval for 23andMe tests about risks for seven diseases. A close look at another DNA site’s privacy policy, meanwhile, warns that their use of data exploits loopholes in the laws and could end up hurting consumers. Another critique of the Genetic Information Nondiscrimination Act has been written by Dr. Deborah Peel of Patient Privacy Rights.

Little noticed was a bill authorizing the FDA to be more flexible in its regulation of digital apps. Shortly after, the FDA announced its principles for approving digital apps, stressing good software development practices over clinical trials.

No improvement has been seen in the regard clinicians have for electronic records. Subjective reports condemned the notorious number of clicks required. A study showed they spend as much time on computer work as they do seeing patients. Another study found the ratio to be even worse. Shoving the job onto scribes may introduce inaccuracies.

The time spent might actually pay off if the resulting data could generate new treatments, increase personalized care, and lower costs. But the analytics that are critical to these advances have stumbled in health care institutions, in large part because of the perennial barrier of interoperability. But analytics are showing scattered successes, being used to:

Deloitte published a guide to implementing health care analytics. And finally, a clarion signal that analytics in health care has arrived: WIRED covers it.

A government cybersecurity report warns that health technology will likely soon contribute to the stream of breaches in health care.

Dr. Joseph Kvedar identified fruitful areas for applying digital technology to clinical research.

The Government Accountability Office, terror of many US bureaucracies, cam out with a report criticizing the sloppiness of quality measures at the VA.

A report by leaders of the SMART platform listed barriers to interoperability and the use of analytics to change health care.

To improve the lower outcomes seen by marginalized communities, the NIH is recruiting people from those populations to trust the government with their health data. A policy analyst calls on digital health companies to diversify their staff as well. Google’s parent company, Alphabet, is also getting into the act.

Specific technologies

Digital apps are part of most modern health efforts, of course. A few articles focused on the apps themselves. One study found that digital apps can improve depression. Another found that an app can improve ADHD.

Lots of intriguing devices are being developed:

Remote monitoring and telehealth have also been in the news.

Natural language processing and voice interfaces are becoming a critical part of spreading health care:

Facial recognition is another potentially useful technology. It can replace passwords or devices to enable quick access to medical records.

Virtual reality and augmented reality seem to have some limited applications to health care. They are useful foremost in education, but also for pain management, physical therapy, and relaxation.

A number of articles hold out the tantalizing promise that interoperability headaches can be cured through blockchain, the newest hot application of cryptography. But one analysis warned that blockchain will be difficult and expensive to adopt.

3D printing can be used to produce models for training purposes as well as surgical tools and implants customized to the patient.

A number of other interesting companies in digital health can be found in a Fortune article.

We’ll end the year with a news item similar to one that began the article: serious good news about the ability of Accountable Care Organizations (ACOs) to save money. I would also like to mention three major articles of my own:

I hope this review of the year’s articles and studies in health IT has helped you recall key advances or challenges, and perhaps flagged some valuable topics for you to follow. 2018 will continue to be a year of adjustment to new reimbursement realities touched off by the tax bill, so health IT may once again languish somewhat.

Will ACOs Face Tough Antitrust Scrutiny?

Posted on August 2, 2017 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.

For some reason, I’ve always been interested in antitrust regulation, not just in the healthcare industry but across the board.

To me, there’s something fascinating about how federal agencies define markets, figure out what constitutes an unfair level of market dominance and decide which deals are out of bounds. For someone who’s not a lawyer, perhaps that’s a strange sort of geeking out to do, but there you have it.

Obviously, given how complex industry relationships are, healthcare relationships are fraught with antitrust issues to ponder. Lately, I’ve begun thinking about how antitrust regulators will look at large ACOs. And I’ve concluded that ACOs will be on the radar of the FTC and U.S. Department of Justice very soon, if they aren’t already.

On their face, ACOs try to dominate markets, so there’s plenty of potential for them to tip the scales too far in their favor for regulators to ignore. Their business model involves both vertical and horizontal integration, either of which could be seen as giving participants too much power.

Please take the following as a guide from an amateur who follows antitrust issues. Again, IANAL, but my understanding is as follows:

  • Vertical integration in healthcare glues together related entities that serve each other directly, such as health plans, hospitals, physician groups and skilled nursing facilities.
  • Horizontal integration connects mutually interested service providers, including competitors such as rival hospitals.

Even without being a legal whiz, it’s easy to understand why either of these ACO models might lead to (what the feds would see as) a machine that squeezes out uninvolved parties. The fact that these providers may share a single EMR could makes matters worse, as it makes the case that the parties can hoard data which binds patients to their network.

Regardless, it just makes sense that if a health plan builds an ACO network, cherry picking what it sees as the best providers, it’s unlikely that excluded providers will enjoy the same reimbursement health plan partners get. The excluded parties just won’t have as much clout.

Yes, it’s already the case that bigger providers may get either higher reimbursement or higher patient volume from insurers, but ACO business models could intensify the problem.

Meanwhile, if a bunch of competing hospitals or physician practices in a market decide to work together, it seems pretty unlikely that others could enter the market, expand their business or develop new service lines that compete with the ACO. Eventually, many patients would be forced to work with ACO providers. Their health plan will only pay for this market-dominant conglomerate.

Of course, these issues are probably being kicked around in legal circles. I’m equally confident that the ACOs, which can afford high-ticket legal advice, have looked at these concerns as well. But to my knowledge these questions aren’t popping up in the trade press, which suggests to me that they’re not a hot topic in non-legal circles.

Please note that I’m not taking a position here on whether antitrust regulation is fair or appropriate here. I’m just pointing out that if you’re part of an ACO, you may be more vulnerable to antitrust suits than you thought. Any entity which has the power to crush competition and set prices is a potential target.

Can Interoperability Drive Value-Based Care?

Posted on December 14, 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.

As the drive to interoperability has evolved over the last few decades — and those of you who are HIT veterans know that these concerns go at least that far back — open data sharing has gone from being a “nice to have” to a presumed necessity for providing appropriate care.

And along the way, backers of interoperability efforts have expanded their goals. While the need to support coordinated care has always been a basis for the discussion, today the assumption is that value-based care simply isn’t possible without data interoperability between providers.

I don’t disagree with the premise. However, I believe that many providers, health systems and ACOs have significant work to do before they can truly benefit from interoperability. In fact, we may be putting the cart before the horse in this case.

A fragmented system

At present, our health system is straining to meet the demand for care coordination among the populations it serves. That may be in part because the level of chronic illness in the US is particularly high. According to one Health Affairs study, two out of three Americans will have a chronic condition by the year 2030. Add that to the need to care for patients with episodic care needs and the problem becomes staggering.

While some health organizations, particularly integrated systems like the Cleveland Clinic and staff-model managed care plans like Kaiser Permanente, plan for and execute well on care coordination, most others have too many siloes in place to do the job correctly. Though many health systems have installed enterprise EMRs like Epic and Cerner, and share data effectively while the patient remains down in their system, they may do very little to integrate information from community providers, pharmacies, laboratories or diagnostic imaging centers.

I have no doubt that when needed, individual providers collect records from these community organizations. But collecting records on the fly is no substitute for following patients in a comprehensive way.

New models required

Given this history, I’d argue that many health systems simply aren’t ready to take full advantage of freely shared health data today, much less under value-based care payment models of the future.

Before they can use interoperable data effectively, provider organizations will need to integrate outside data into their workflow. They’ll need to put procedures in place on how care coordination works in their environment. This will include not only deciding who integrates of outside data and how, but also how organizations will respond as a whole.

For example, hospitals and clinics will need to figure out who handles care coordination tasks, how many resources to pour into this effort, how this care coordination effort fits into the larger population health strategy and how to measure whether they are succeeding or failing in their care coordination efforts. None of these are trivial tasks, and the questions they raise won’t be answered overnight.

In other words, even if we achieved full interoperability across our health system tomorrow, providers wouldn’t necessarily be able to leverage it right away. In other words, unfettered health data sharing won’t necessarily help providers win at value-based care, at least not right away. In fact, I’d argue that it’s dangerous to act as though interoperability can magically make this happen. Even if full interoperability is necessary, it’s not sufficient. (And of course, even getting there seems like a quixotic goal to some, including myself.)

Planning ahead

That being said, health organizations probably do have time to get their act together on this front. The move to value-based care is happening quickly, but not at light speed, so they do have time to make plans to leverage interoperable health data.

But unless they acknowledge the weaknesses of their current system, which in many cases is myopic, siloed and rigid, interoperability may do little to advance their long-term goals. They’ll have to admit that their current systems are far too inward-looking, and that the problem will only go away if they take responsibility for fixing it.

Otherwise, even full interoperability may do little to advance value-based care. After all, all the data in the world won’t change anything on its own.

What Would A Community Care Plan Look Like?

Posted on November 16, 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.

Recently, I wrote an article about the benefits of a longitudinal patient record and community care plan to patient care. I picked up the idea from a piece by an Orion Health exec touting the benefits of these models. Interestingly, I couldn’t find a specific definition for a community care plan in the article — nor could I dig anything up after doing a Google search — but I think the idea is worth exploring nonetheless.

Presumably, if we had a community care plan in place for each patient, it would have interlocking patient-specific and population health-level elements to it. (To my knowledge, current population health models don’t do this.) Rather than simply handing patients off from one provider to another, in the hope that the rare patient-centered medical home could manage their care effectively on its own, it might set care goals for each patient as part of the larger community strategy.

With such a community care strategy, groups of providers would have a better idea where to allocate resources. It would simultaneously meet the goals of traditional medical referral patterns, in which clinicians consult with one another on strategy, and help them decide who to hire (such as a nurse-practitioner to serve patient clusters with higher levels of need).

As I envision it, a community care plan would raise the stakes for everyone involved in the care process. Right now, for example, if a primary care doctor refers a patient to a podiatrist, on a practical level the issue of whether the patient can walk pain-free is not the PCP’s problem. But in a community-based care plan, which help all of the individual actors be accountable, that podiatrist couldn’t just examine the patient, do whatever they did and punt. They might even be held to quantitative goals, if the they were appropriate to the situation.

I also envision a community care plan as involving a higher level of direct collaboration between providers. Sure, providers and specialists coordinate care across the community, minimally, but they rarely talk to each other, and unless they work for the same practice or health system virtually never collaborate beyond sharing care documentation. And to be fair, why should they? As the system exists today, they have little practical or even clinical incentive to get in the weeds with complex individual patients and look at their future. But if they had the right kind of community care plan in place for the population, this would become more necessary.

Of course, I’ve left the trickiest part of this for last. This system I’ve outlined, basically a slight twist on existing population health models, won’t work unless we develop new methods for sharing data collaboratively — and for reasons I be glad to go into elsewhere, I’m not bullish about anything I’ve seen. But as our understanding of what we need to get done evolves, perhaps the technology will follow. A girl can hope.

Health Plans Need Big Data Smarts To Prove Their Value

Posted on November 2, 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.

Recently, Aetna cut a deal which suggests a new role for health insurers in big data analytics and population health management. In partnership with Merck, the health insurer is launching a new program using predictive analytics to identify target populations and provide them with health and wellness services. AetnaCare will start by targeting patients with diabetes and hypertension in the mid-Atlantic U.S., but it seems likely to go national soon.

In its press release on the matter, Aetna says the goal of the program is to “proactively curate various health and wellness services… to support treatment adherence, ensure that critical social support needs are met, and reinforce healthy lifestyle behaviors.” That in and of itself isn’t a big deal. We all know that these are goals shared by providers, employers and health plans, and that most of the efforts health plans make on this front are pie in the sky, half-baked initiatives featuring cutesy graphics and little substance.

But then, Aetna’s chief medical officer gives away the real goal here — to power this effort by analyzing patient data being spun out by patients in varied care settings.  In the release, Dr. Harold Paz notes that patients are getting care in a wide variety of settings, including retail clinics, healthcare devices, pharmaceutical services, behavioral health, and social services, and that these services are seldom coordinated well, and implies that this is the real problem Aetna must solve.

If you listen to this with the ears of a health IT chick like myself, you hear Aetna (and Merck, actually) admitting that they must engage in predictive analytics across all of these encounters – and eventually, use these insights to help patients make good healthcare choices. In other words, they have to think like providers and even offer provider-like services fulfill their mission. And that means competing with or even beating providers at the big data game.

The truth is, health plans are in the same boat as providers, in that they’re at the center of a hailstorm of data and struggling with how to make use of it. Also, like providers they’re facing pressure from health purchasers to slow healthcare cost growth and boost patient wellness. But I’d argue that they’re even less prepared, technically and culturally, to improve health or coordinate care. So jumping in now is critically important.

In fact, I’d argue that health insurers are under greater pressure to improve population health than even sophisticated health systems or ACOs. Why? Because while health systems and ACOs can point to what they do – they make people better, for heaven’s sake — insurance companies are the eternal middleman who must continue to prove that they add value to the healthcare equation.

It remains to be seen whether programs like AetnaCare succeed at helping patients find the resources they need to improve and maintain their health. But even if this concept doesn’t work out, others will follow. Health plans need to leverage their unique data set to boost quality and reduce costs. Otherwise, as providers learn to work under value-based payments and accept risk, employers will have increasingly good reasons to contract directly — and leave the insurance industry out of the game entirely.

2 Major Problems with MACRA

Posted on May 4, 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.

Everyone’s started to dive into the 10 million page MACRA (that might be an exaggeration, but it feels about that long) and over the next months we’ll be sure to talk about the details a lot more. However, I know that many healthcare organizations are tired of going through incredibly lengthy regulations before they’re final. Makes sense that people don’t want to go through all the details just for them to change.

As I look at MACRA from a very high level, I see at least two major problems with how MACRA will impact healthcare.

Loss of EHR Innovation
First, much like meaningful use and EHR certification, MACRA is going to suck the life out of EHR development teams. For 2-3 years, EHR roadmaps have been nothing but basically conforming to meaningful use and EHR certification. Throw in ICD-10 development for good measure and EHR development teams have basically had to be coding their application to a government standard instead of customer requests and unique innovations.

Just today I heard the Founder of SOAPware, Randall Oates, MD, say “I’m grieving MACRA to a great degree.” He’s grieving because he knows that for many months his company won’t be able to focus on innovation, but will instead focus on meeting government requirements. In fact, he said as much when he said, “We don’t have the liberty to be innovative and creative.” And no, meeting government regulations in an innovative way doesn’t meet that desire.

I remember going to lunch with a very small EHR vendor a year or so ago. I first met him pre-meaningful use and he loved being able to develop a unique EHR platform that made a doctor more efficient. He kept his customer base small so that he could focus on the needs of a small group of doctors. Fast forward to our lunch a year or so ago. He’d chosen to become a certified EHR and make it so his customers could attest to meaningful use. Meaningful use made it so he hated his EHR development process and he had lost all the fire he’d had to really create something beautiful for doctors.

The MACRA requirements will continue to suck the innovation out of EHR vendors.

New Layers of Work With No Relief
When you look at MACRA, we have all of these new regulations and requirements, but don’t see any real relief from the old models. It’s great to speak hypothetically about the move to value based reimbursement, but we’re only dipping our toe in those waters and so we can’t replace all of the old reimbursement requirements. In some ways it makes sense why CMS would take a cautious approach to entering the value based world. However, MACRA does very little to reduce the burden on the backs of physicians and healthcare organizations. In fact, in many ways it adds to their reporting burden.

Yes, there was some relief offered when it comes to meaningful use moving from the all or nothing approach and a small reduction in the number of measures. However, when it comes to value based reimbursement, MACRA seems to just be adding more reporting burdens on doctors without removing any of the old fashioned fee for service requirements.

MACRA is not like ICD-10. Once ICD-10 was implemented you could see how ICD-9 and the skills required for that coding set will eventually be fully replaced and you won’t need that skill or capability anymore. The same doesn’t seem to be true with value based care. There’s no sign that value based care will be a full replacement of anything. Instead, it just adds another layer of complexity, regulation, and reporting to an already highly regulated healthcare economic system.

This is why it’s no surprise that many are saying that MACRA will be the end of small practices. At scale, they’re onerous. Without scale, these regulations can be the death of a practice. It’s not like you can stop doing something else and learn the new MACRA regulations. No, MACRA is mostly additive without removing a healthcare organization’s previous burdens. Watch for more practices to leave Medicare. Although, even that may not be a long term solution since most commercial payers seem to follow Medicare’s lead.

While I think that CMS and the people that work there have their hearts in the right place, these two problems have me really afraid for what’s to come in health IT. EHR vendors the past few months were finally feeling some freedom to listen to their customers and develop something new and unique. I was excited to see how EHR vendors would make their software more efficient and provide better care. MACRA will likely hijack those efforts.

On the other side of the fence, doctors are getting more and more burnt out. These new MACRA regulations just add one more burden to their backs without removing any of the ones that bothered them before. Both of these problems don’t paint a pretty picture for the future of healthcare.

The great part is that MACRA is currently just a proposed rule. CMS has the opportunity to fix these problems. However, it will require them to take a big picture look at the regulation as opposed to just looking at the impact of an individual piece. If they’re willing to focus MACRA on the big wins and cut out the parts with questionable or limited benefits, then we could get somewhere. I’m just not sure if Andy Slavitt and company are ready to say “Scalpel!” and start cutting.

Breach Affecting 2.2M Patients Highlights New Health Data Threats

Posted on April 4, 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.

A Fort Myers, FL-based cancer care organization is paying a massive price for a health data breach that exposed personal information on 2.2 million patients late last year. This incident is also shedding light on the growing vulnerability of non-hospital healthcare data, as you’ll see below.

Recently, 21st Century Oncology was forced to warn patients that an “unauthorized third party” had broken into one of its databases. Officials said that they had no evidence that medical records were accessed, but conceded that breached information may have included patient names Social Security numbers, insurance information and diagnosis and treatment data.

Notably, the cancer care chain — which operates on hundred and 45 centers in 17 states — didn’t learn about the breach until the FBI informed the company that it had happened.

Since that time, 21st Century has been faced with a broad range of legal consequences. Three lawsuits related to the breach have been filed against the company. All are alleging that the breach exposed them to a great possibility of harm.  Patient indignation seems to have been stoked, in part, because they did not learn about the breach until five months after it happened, allegedly at the request of investigating FBI officials.

“While more than 2.2 million 21st Century Oncology victims have sought out and/or pay for medical care from the company, thieves have been hard at work, stealing and using their hard-to-change Social Security numbers and highly sensitive medical information,” said plaintiff Rona Polovoy in her lawsuit.

Polovoy’s suit also contends that the company should have been better prepared for such breaches, given that it suffered a similar security lapse between October 2011 and August 2012, when an employee used patient names Social Security numbers and dates of birth to file fraudulent tax refund claims. She claims that the current lapse demonstrates that the company did little to clean up its cybersecurity act.

Another plaintiff, John Dickman, says that the breach has filled his life with needless anxiety. In his legal filings he says that he “now must engage in stringent monitoring of, among other things, his financial accounts, tax filings, and health insurance claims.”

All of this may be grimly entertaining if you aren’t the one whose data was exposed, but there’s more to this case than meets the eye. According to a cybersecurity specialist quoted in Infosecurity Magazine, the 21st Century network intrusion highlights how exposed healthcare organizations outside the hospital world are to data breaches.

I can’t help but agree with TrapX Security executive vice president Carl Wright, who told the magazine that skilled nursing facilities, dialysis centers, imaging centers, diagnostic labs, surgical centers and cancer treatment facilities like 21st are all in network intruders’ crosshairs. Not only that, he notes that large extended healthcare networks such as accountable care organizations are vulnerable.

And that’s a really scary thought. While he doesn’t say so specifically, it’s logical to assume that the more unrelated partners you weld together across disparate networks, it multiplies the number of security-related points of failure. Isn’t it lovely how security threats emerge to meet every advance in healthcare?

What Would New Care Delivery Models Look Like If Created Today?

Posted on November 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.


This tweet has been on my mind the last month. I’m sure that many in the trenches probably think that this type of thinking is a pipe dream and not worthy of discussion. While it’s true that we can’t go back and change the past, this type of thinking may predict where we need to go in the future.

I and many others have long talked about the way EHR software was built to maximize billing and then meaningful use. The focus of the EHR was not on how to improve patient care, but was really built around how the organization could manage it’s billing and make more money. So, we shouldn’t be too surprised that the EHR systems we have today aren’t these amazing systems that dramatically improve the care we provide.

With that said, there’s a sea change happening in health care when it comes to how organizations are being reimbursed based on value. Might I suggest that an organization that wants to be ready for this change in reimbursement might want to take the time to think about what care models would look like if they were created from scratch today without the overhead of the past.

I’m not the only one thinking about this. Check out this tweet from Linda Stotsky that quotes Rasu Shrestha, MD, MBA.


In the article that’s linked to in that tweet Rasu describes the real challenge of rethinking our care models:

What does it truly mean to have a patient-centered approach to care? As a clinician, I can tell you confidently that most of my colleagues tend to get defensive amid talk of the need to adopt a patient-centric approach to care. “Of course, we’re focused on the patient!” seems to be the most common reaction. Many simply assume that because care is essentially imparted onto a patient, everything we do, naturally, is patient-centric

Then he offers this frank comment:

But where is the patient in all of this? Is a system designed to help document our attempts to cure the patient, and help bill for the associated services, really the best we can do? Perhaps the problem is bigger than just the EMR. Perhaps our frequently paternalistic, and often heroic, approaches to care have been cherished, celebrated and incentivized for far too long. Perhaps we need to rethink care in a big way.

I agree with Rasu. He also quotes Ellen Stoval, survivor or three bouts of cancer who says, “We have been chasing the cure, rather than the care.” I’m actually optimistic that these changes are happening. We’re going to see a drastically improved health care system. It’s going to take time, but most changes do. What’s most exciting is that if we navigate these shifts properly, then doctors will finally get to practice medicine the way they imagined medicine. Instead of churning patients to meet revenue, they could actually spend more time caring for patients. That’s something worth aspiring towards.

How Will the Coming Election Year Impact Healthcare IT?

Posted on November 10, 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 seems like the Presidential election should be closer since we’ve been hearing about possible Presidential candidates for the past year. However, we still have a whole year before the next Presidential election. Does anyone else think we’re going to be tired of this process a year from now? (But I digress)

In past years, there was certainly a lot to talk about when it comes to the impact a new president would have on healthcare IT. However, I don’t think that this presidential election will be the same. I think that’s true for healthcare in general as well.

On the healthcare IT side, meaningful use has basically run its course. Sure, Jeb Bush has asked to eliminate meaningful use and government mandates and penalties for EHR use. Although, John Halamka and Marc Probst have both recently asked for the same. We’ve written previously about how getting rid of meaningful use wouldn’t do much of anything to alter the current course of EHR and healthcare IT. It just wouldn’t change much of anything.

What could a presidential candidate do to impact healthcare IT? I really don’t see them having an interest in doing much of anything to impact the current course of healthcare IT. If you think otherwise, I’d love to hear why.

On the healthcare side of things we might see more changes. Certainly the topic of healthcare costing the US too much money is a very big an important topic for the president. However, I think Obamacare and those healthcare reform efforts are too far gone to be able to really go back and change them now. Sure, we could see some changes here and there, but I think it’s too late for a new President to really drastically change what’s already been done.

Related to this is the move away from fee for service to a value based reimbursement environment. Would any President condone this direction? Would any President advocate for a return to the old fee for service environment? I don’t see it happening. As many people have told me, the shift to value based care has left the building. There’s no coming back. Could they modify the approach and some of the details. Certainly! However, they’re not likely going to change the trajectory.

Long story short, I’m not sure any Presidential candidate will do anything that will drastically impact healthcare IT and healthcare as we know it. Sure there will be some tweaks that will have some impact, but nothing major like Obamacare or the HITECH Act.

Do you agree or disagree? I always love to hear other perspectives.

Insightful Tweets from Farzad Mostashari’s Session at #MGMA15

Posted on October 13, 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.

Today, Farzad Mostashari took the stage at the MGMA Annual Conference. As a man that I respect and someone that has deep connections and insights into what’s happening in Washington and how that plays out in actual practice (thanks to his ACO company), I was interested in the insights he’d share.

Here’s a quick Twitter roundup of some of the insights he shared: