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Mandatory Nurse Ratios – Good for Massachusetts?

Posted on October 18, 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.

On November 6th, Massachusetts will vote on mandatory nursing levels. Proponents cite burnout, injuries and patient safety as reasons to vote YES. Opponents claim ERs wait times will rise, small hospitals will close and patient bills will increase.

There is no better way to get a sense of what is on the minds of healthcare leaders than talking with fellow conference attendees. At the recent SHSMD18 event, I had the opportunity to attend a social gathering hosted by the New England Society for Healthcare Communications (NESHCo). There was one topic that dominated the discussion – the upcoming vote on November 6th on mandatory nursing levels in Massachusetts.

Mandatory nurse ration has been a hotly debated issue in the state. Voters will now decide if the state will forge ahead with plans to “limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities.”

The proposed MA law sets specific limits on the patient-nurse ratio. For example:

  • 3 patients per nurse in units with step-down/intermediate care patients
  • 1 patient under anesthesia per nurse in units with post-anesthesia care or operation room patients
  • 5 patients per nurse in units with psychiatric or rehabilitation patients

The vote has pitted the Massachusetts Nurses Association (the nurses union, MNA), which strongly supports mandatory nurse ratios, against the Massachusetts Health and Hospital Association (MHHA).

The MNA cites numerous studies, like this one from 2016, that shows for every patient added to a nurse’s workload, the likelihood of a patient surviving cardiac arrest decreases by 5% per patient. And  this one from 2017, that concluded “Exposing critically ill patients to high workload/staffing ratios is associated with a substantial reduction in the odds of survival.”

The MNA has mounted a sizeable campaign to convince MA voters to vote YES. Their website, https://safepatientlimits.org/ is full of interesting articles, stories from frontline nurses and quotes from physicians that support the measure.

The MHHA, on the other hand, is encouraging a NO vote. They acknowledge that nursing levels need to be monitored but imposing strict limits based solely on the unit or patient type will cost nearly $900 million every year. According to the MHHA, patients would end up footing the bill through higher healthcare costs.

The MHAA also claims that specifying the maximum number of patients for each nurse, effectively puts a cap on the number of patients a hospital can accept in their ERs – resulting in longer wait times.

For an excellent overview of the law and the arguments both for and against Question 1, check out this excellent article by Boston’s local NPR station – WGBH. The article also has information about the impact mandatory nurse ratios has had in California which enacted a similar law back in 1999.

What I found fascinating about the discussions with NESHCo members was how hospitals in neighboring states were also voicing their concerns on Question 1. If MA was to mandate nursing ratios, that state’s hospitals would suddenly need to hire thousands of nurses in order to comply with the new law. Where would these nurses likely come from? You guessed it, neighboring states like New Hampshire, Maine, Vermont and Connecticut. It’s easy to see why hospitals in those states would be worried.

I honestly don’t know which way I would vote.

On one hand the current working condition for nurses is unsustainable. Nurses are often asked to work longer shifts because hospitals can’t fill open nursing positions fast enough and most are expected to work without breaks. Could you imagine working 12hrs or more without being able to eat or go to the restroom? 70% of nurses are already feeling burnt out in their current positions. Clearly the status quo isn’t working.

On the other hand, there is currently no provision in the law to adjust the nursing ratios as technology advances. New York Presbyterian Hospital, for example, has built a remote patient monitoring center that tracks patient vitals in real-time. Using a combination of AI, specialized technicians and remote nurses, this “command center” can alert the local nursing staff when a patient may be experiencing an issue. Armed with this technology, not only are patients safer but on-site nurses can spend more time with each patient in their unit. The MA law would have the unintended consequence of squashing investment in this type of technology since staffing levels could not be significantly adjusted.

For more on this topic, take a look at the transcript for this week’s HCLDR chat. Government regulation is also the topic for this weeks’ #HITsm chat hosted by John Lynn. Join the discussion Friday 10/19 at noon ET.

Nurses need help. Mandatory nursing ratios is one possible solution. However, I’m not sure legislation is the best way to improve the nursing situation.

Government Regulations for Healthcare – Where Are We At and Where Are We Headed? – #HITsm Chat Topic

Posted on October 17, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 10/19 at Noon ET (9 AM PT). This week’s chat will be hosted by John Lynn (@techguy) on the topic of “Government Regulations for Healthcare – Where Are We At and Where Are We Headed?”.

The one constant in healthcare is regulation. Healthcare is a highly regulated environment. There’s no way to get away from it. The best we can do is understand what regulations are coming, influence the rule making process so that good regulations are put in place, and learn to deal with the regulations as best you can.

Join us for this week’s #HITsm chat where we talk about some of the latest healthcare regulations. We’ll dive into regulation details and where those regulations could be headed. We’ll also discuss what other regulations might be coming that we should know about. Come and share your perspectives and insights on the important regulations in government.

Topics for this week’s #HITsm Chat:
T1: What government regulations take up the majority of a healthcare organization’s time? What has you concerned about those regulations? #HITsm

T2: How are MACRA and MIPS impacting your organization? What are you doing to make sure you’re compliant? #HITsm

T3: What regulations do you think will be changed soon or which regulations would you like to see changed/updated? #HITsm

T4: What’s happening with value based care and the shift from fee for service? What are you doing to make sure you’re ready for it? #HITsm

T5: What insurance regulations are hitting your organization? How are they impacting you? What other regulation changes should you be watching? #HITsm

Bonus: If you could make any healthcare regulation and have it instantly put in place, what would it be? #HITsm

Upcoming #HITsm Chat Schedule
10/26 – The Health IT Education Landscape
Hosted by @bigdatadavid13

11/2 – TBD
Hosted by TBD

11/9 – TBD
Hosted by @technursejon

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 Importance of Nurses in Healthcare – #HITsm Chat Topic

Posted on October 9, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 10/12 at Noon ET (9 AM PT). This week’s chat will be hosted by Janet Kennedy (@getsocialhealth) and Carol Bush (@TheSocialNurse) from the Healthcare Marketing Network (@HMNwriters) on the topic of “The Importance of Nurses in Healthcare”.

It’s time for #NursingNow. Nurses need to have a solid place at the table – from the C-Suite to Management, Entrepreneurs to Digital Health Innovators.  In collaboration with the World Health Organization and the International Council of Nurses, Nursing Now aims to raise the status and profile of nursing globally.  Nursing Now works to empower nurses to take their place at the heart of tackling 21st Century health challenges.

In this #HITMC chat, Carol Bush (@TheSocialNurse) and Janet Kennedy (@GetSocialHealth) will lead a discussion on Nurse Leadership and how every part of healthcare needs nurses to be present and actively involved.

Resources:

Topics for this week’s #HITsm Chat:
T1: Nurses have always been the backbone of healthcare. Do you think they have a large enough role in healthcare leadership? Why or why not? #HITsm

T2: Should the push to get more nurses in leadership come from nurses or other members of the healthcare team? Why do you think so? #HITsm

T3: Traditional concepts of a nurse’s role have changed over the past decade. What new career paths have you seen nurses take? #HITsm

T4: In a health system or practice setting, in what ways have nurses expanded their roles? #HITsm

T5: Nurses have been embracing entrepreneurship, both inside and outside of healthcare. What characteristics of nursing lend themselves to entrepreneurship? #HITsm

Bonus: Share your favorite nurse story. #HITsm

Upcoming #HITsm Chat Schedule
10/19 – Government Regulations for Healthcare – Where Are We At and Where Are We Headed?
Hosted by John Lynn (@techguy)

10/26 – TBD
Hosted by @bigdatadavid13

11/2 – TBD
Hosted by TBD

11/9 – TBD
Hosted by @technursejon

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.

Medication Compliance & Drug Monitoring – #HITsm Chat Topic

Posted on October 3, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 10/5 at Noon ET (9 AM PT). This week’s chat will be hosted by Joy Rios (@askjoyrios) and Robin Roberts (@rrobertsehealth) on the topic of “Medication Compliance & Drug Monitoring”.

One of the most effective medical interventions to significantly improve the health of patients doesn’t require the latest technology or expensive medication but simply involves helping them take their existing medication as prescribed.

It’s not a light topic, but we believe that people can benefit from more awareness about their actual risks, as opposed to sensationalized risks that make good stories for the popular media.

  • Between 41% and 59% of mentally ill patients take their medication infrequently or not at all.
  • Examples of common non-adherence behaviors include:
    • 1 in 2 people missed a dose
    • 1 in 3 forgot if they took the med
    • 1 in 4 did not get a refill on time

Medication non-adherence is an enormous problem that is still largely unaddressed by the healthcare system, but it’s not totally out of our control. Join us for this week’s #HITsm chat as we talk about medication compliance and drug monitoring.

Topics for this week’s #HITsm Chat:
T1: In what ways has medication non-compliance affected you or anyone you know? Professional or Personal. Can be acute or episodic… #HITsm

T2: Why didn’t the patient adhere? Was there a social determinant? An issue with side effects, access or money? Possible Rx abuse? #HITsm

T3: We know communication with healthcare professionals is key in patient’s adherence and that Medication Reconciliation is gaining traction with MIPS, etc., but are providers going into this level of detail (see example) to ensure patients truly understand why they need to take the meds they are prescribed? Why or why not? #HITsm

T4: Beyond condition management, what impact do you think medication non-compliance has on society as a whole? #HITsm

T5: What ideas & thoughts do you have around strategies for improving medication compliance? Have you come across any impactful strategies or workflows? #HITsm

Bonus: What technology do you think could help with these challenges? #HITsm

Upcoming #HITsm Chat Schedule
10/12 – The Importance of Nurses in Healthcare
Hosted by Janet Kennedy (@getsocialhealth) and Carol Bush (@TheSocialNurse) from the Healthcare Marketing Network

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.

2018 Thrival Festival. Are We Asking the Right Questions?

Posted on September 26, 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.

Presentations in a botanical garden. Workshops in an actual work shop. Disco in a museum. The 2018 Thrival Festival eschewed tradition and challenged attendees to ponder: Are we asking the right questions when it comes to humanity + technology + art?

The annual Thrival Festival held in Pittsburgh PA is truly unique. It combines art, technology, philosophy, music, and yes, even healthcare, into an event that is part science fair and part theatre. Instead of holding the event in a traditional auditorium or hotel, the organizers chose the beautiful Phipps Conservatory and Botanical Gardens as the setting for this year’s event.

Rising like a glass armadillo out of lush grass splashed here and there with colorful flowers, the Conservatory welcomed attendees with a warm scent of green leaves and rich earth. It was immediately apparent we were in for something different as we passed through the mammoth glass entryway and wound our way through the maze of monarchs and waterfalls to reach the main session room.

With sunshine and mother nature as a backdrop, Thrival kicked off with a keynote from John Battelle @johnbattelle, CEO and Editor-in-Chief of WIRED. Battelle wasted no time in setting the tone for the day. Early in his presentation he put up the following picture from National Geographic with the caption: What makes us human?

© Martin Schoeller/National Geographic

The image was from National Geographic’s October 125th anniversary issue (2013) where they photographed the new faces of America – a reflection of the blurring of traditional racial and ethnic lines. Battelle used the slide to highlight that society will soon be challenged to define humanity more broadly than before – as we manipulate our genes, embed technology into our bodies and program human-like qualities into robots.

Later in the morning, the issue of do-it-yourself implantable devices and pseudo-scientific injectable cocktails was discussed by a panel of experts. Dr. Rasu Shrestha @RasuShrestha was asked: Is biohacking the future of medicine? With a smile and wink, he deftly answered the question by putting forward the notion that the original healers and physicians were themselves the biohackers of their day. Instead of nanobots they used herbs and crude instruments to try and cure our pre-industrial ancestors.

*Yes, Rasu did use “OG” in his answer, to the delight of the audience.

The panel also featured Rich Lee @lovetron9000 the controversial sex technologist who not only installed a vibrating implant in himself but also recently self-injected a gene therapy that he hopes will cure him of his color blindness. Vilified by authorities, Lee was decidedly normal both on and off the stage answering questions about his motivations.

Over lunch I had the opportunity to chat with Laura Montoya, Founder of Accel:AI and Director of Women Who Code. Montoya teaches development teams to consider the ethical issues relating to AI algorithms. She posed the most interesting question of the day: Would you get into a self-driving car if you knew the algorithm governing it would choose to save the life of a pedestrian over you the passenger?

“Think of it this way,” explained Montoya. “When you sign up for a ride-sharing service, you have to agree to the company’s terms of use. Buried in that agreement is a waiver of liability. Essentially you as an individual are opting into the fact that you are okay with being driven around by a computer rather than an actual driver. The liability of the company for you is therefore limited. Now think about the pedestrian. They have not opted into the company’s self-driving car. They have not agreed that a self-driving car should be in their neighborhood. Therefore, the pedestrian represents a potentially high financial liability – being an innocent bystander. So if the car is faced with the choice of crashing into the pedestrian vs crashing into a tree, would the difference in the degree of liability influence it’s decision. And if it did, would you have knowingly gotten into the vehicle in the first place.”

*Note to self, uncheck the self-driving option from my Uber app.

My Thrival afternoon began with a short viewing of GAPPED – a documentary from Molten Media Group. The excerpt contained powerful and moving interviews of Pittsburgh residents who were in danger of being left behind by the innovation boom that the city is currently enjoying. After the screening, the producers of the film shared that they were seeking to answer a single question: Will Pittsburgh and its people have the chance to rise together or will those unwilling to adapt be left behind?

To me the film asks a much broader question: What happens when innovation wealth is unequally distributed within an ecosystem? And I don’t mean the spoils of innovation like money, equity stakes and fancy offices. What happens when public and private programs inadvertently leave out a portion of the local population? Is it fair that 95% of the innovation seed funding goes to middle-class college graduates while innovators living under the poverty line struggle to keep afloat? I can’t wait to see the entire film when it is released later this year.

I decided to end my Thrival day by attending the Moonshot Workshop led by the XPRIZE Foundation – the people behind the space competition that spawned Virgin Galactic and SpaceX. The workshop started with a short presentation by Amir Banifatemi, AI Lead at XPRIZE. Banifatemi explained the process they go through to curate, refine and define the incentive competitions that “entice the world to take action”. It turns out that it takes the team at XPRIZE over nine months to clearly define one of their challenges.

“If we define the challenge too broadly, teams become overwhelmed with where to start.” Said Banifatemi. “Problems need to be specific enough to spark the imagination but not so blue-sky that people get lost in the possibilities. If we make our challenges too difficult, we may discourage people from entering. It turns out that coming up with the right question, the right challenge is almost as hard as solving it. But if you get the question right, magic happens.

Banifatemi’s statement was the perfect bow on my day at Thrival Festival. Before innovation can happen, a problem or challenge must first exist. Once we understand that problem, our collective imaginations can be unleashed. Better definition of the problem leads to better innovation. The question of: “How can we look inside the human body?” begat X-ray machines. The more refined question of: “How can we look inside the human body without causing harm to the person and with sufficient detail to see tissue?” begat MRI machines (okay maybe a bit of a stretch, but you get the idea).

As the high-energy techno anthems from Veserium washed over me at the Thrival evening event, I found myself thinking about all the questions we are asking in healthcare. Perhaps we need to take a moment and ask ourselves if we are really asking the right ones.

How Does Interoperability Affect Technology Adoption in Healthcare? – #HITsm Chat Topic

Posted on September 25, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 9/28 at Noon ET (9 AM PT). This week’s chat will be hosted by Niko Skievaski @niko_ski from @redox.

In her opening remarks at the 2nd ONC Interoperability Forum, Centers for Medicaid and Medicare (CMS) Administrator Seema Verma set the goal of eliminating the use of fax machines in healthcare by 2020. It’s true – fax is still the most common form of communication among providers for transmission of medical records, test results, instructions, and treatment regimens all thanks to its insusceptibility to hacking. While the rest of the world is embracing digitalization and the benefits it has brought us, healthcare seemed a bit reluctant about moving on. Fax or other paper-based records are largely inconvenient and created barriers to information exchange.

In the era of artificial intelligence and machine learning, we’re generating data in an unbelievable speed – more information to process, exchange and analyze, posing bigger challenges for snail-paced interoperability progress. Tech giants see this lack of interoperability as a perfect opportunity to enter healthcare and disrupt the “broken” industry. Apple Health is promoting open API for iOS users to own their health data; Amazon’s working with multiple healthcare organizations to build its own system; and the recent interoperability pledge by the six big companies is set to transform healthcare data infrastructure.

Coming from an outsider perspective, these companies are familiar with the user authorization approach. When you sign in to an app with your Google account, you’ll be asked to grant the app access to your information through an authentication protocol called OAuth 2.0. Ideally, this is the vision for healthcare data use in the future.

But the existing healthcare data infrastructure, in the meantime, is drastically different from the one these tech giants are familiar with. Perhaps a more realistic, pragmatic approach is to work with the established stakeholders in healthcare, particularly the big EHR vendors, instead of bringing in a whole new system to solve interoperability.

Join us for this week’s #HITsm chat to discuss interoperability’s impact on technology adoption in healthcare and share your opinions on what stakeholders need to do to improve interoperability and accelerate technology adoption.

Topics for this week’s #HITsm Chat:
T1: What are the biggest barriers to technology adoption in healthcare? #HITsm

T2: Is interoperability more challenging now with more data generated by technologies such as AI? #HITsm

T3: Will patient-authorized API access bring fundamental changes to interoperability? #HITsm

T4: How will tech giants’ move into healthcare impact interoperability? #HITsm

T5: What needs to be done by the established stakeholders in healthcare, e.g. EHR vendors, to solve interoperability? #HITsm

Bonus: What do you want as a patient when it comes to interoperability? #HITsm

Upcoming #HITsm Chat Schedule
10/5 – Medication Compliance & Drug Monitoring
Hosted by Joy Rios (@askjoyrios) and Robin Roberts (@rrobertsehealth)

10/12 – TBD
Hosted by Janet Kennedy (@getsocialhealth) and Carol Bush (@TheSocialNurse) from the Healthcare Marketing Network

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.

Will The Fitbit Care Program Break New Ground?

Posted on September 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.

Wearables vendor Fitbit has launched a connected health program designed to help payers, employers and health systems prevent disease, improve wellness and manage diseases. The program is based on the technology Fitbit acquired when it acquired Twine Health.

As you’ll see, the program overview makes it sound as the Fitbit program is the greatest thing since sliced bread for health coaching and care management, I’m not so convinced, but judge for yourself.

Fitbit Care includes a mix of standard wearable features and coaching. Perhaps the most predictable option is built on standard Fitbit functions, which allow users to gather activity, sleep and heart rate data. However, unlike with individual use, users have the option to let the program harvest their health data and share it with care teams, which permits them to make personalized care recommendations.

Another option Fitbit Care offers is health coaching, in which the program offers participants personalized care plans and walks them through health challenges. Coaches communicate with them via in-communications, phone calls, and in-person meetings, targeting concerns like weight management, tobacco cessation, and management of chronic conditions like hypertension, diabetes, and depression. It also supports care for complex conditions such as COPD or congestive heart failure.

In addition, the program uses social tools such as private social groups and guided workouts. The idea here is to help participants make behavioral changes that support their health goals.

All this is supported by the new Fitbit Plus app, which improves patients’ communication capabilities and beefs up the device’s measurement capabilities. The Fitbit app allows users to integrate advanced health metrics such as blood glucose, blood pressure or medication adherence alongside data from Fitbit and other connected health devices.

The first customer to sign up for the program, Fitbit Care, is Humana, which will offer it as a coaching option to its employer group. This puts Fitbit Care at the fingertips of more than 5 million Humana members.

I have no doubt that employers and health systems would join Humana experimenting with wearables-enhanced programs like the one Fitbit is pitching. At least, in theory, the array of services sounds good.

On the other hand, to me, it’s notable that the description of Fitbit Care is light on the details when it comes to leveraging the patient-generated health data it captures. Yes, it’s definitely possible to get something out of continuous health data collection, but at least from the initial program description, the wearables maker isn’t doing anything terribly new.

Oh well. I guess Fitbit doesn’t have to do anything radical to offer something valuable to payers, employers and health plans. They continue to search for behavioral interventions that actually have an impact on disease management and wellness, but to my knowledge, they haven’t found any magic bullet. And while some of this sounds interesting, I see nothing to suggest that the Fitbit Care program can offer dramatic results either.

 

Human Centered Design in Healthcare #askpatients – #HITsm Chat Topic

Posted on September 18, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 9/21 at Noon ET (9 AM PT). This week’s chat will be hosted by Jen Horonjeff (@jhoronjeff) from @Savvy_Coop on the topic of “Human Centered Design in Healthcare #askpatients“.

I, Jen Horonjeff, have a confession – I’m one of the dreaded “non-compliant” patients you hear about. I have been living with juvenile arthritis and other autoimmune diseases for 33 years, so I often have a complex treatment plan. One of my biggest offenses is I don’t get my blood work done every four weeks, which is the regularity for which my doctor has ordered my labs.

I don’t have a fear of needles, it’s also relatively quick to drop into the lab and do, so why don’t I do it?

Because every time I do, the system fails me. The lab inevitably sends me a bill for an exorbitant amount of money claiming my insurance won’t cover it. That’s incorrect, they will, it’s just been billed incorrectly. Yet it’s up to me as a patient to sit on the phone for hours with the lab, the insurance company, my doctor’s office, and probably a friend to vent about it…again.

Healthcare, its systems, products and services, are supposed to improve the lives of patients and families, not create more headaches. But the problem is, until recently, no one really ever asked the patients what they were going through, what mattered to them, or their input how to fix it. Patients have been the recipients of the systems we develop, rather than the co-creators.

This is where human-centered design comes in. Human-centered design is about taking the time to #askpatients and design solutions to fit them, rather than continually have them navigate systems and tools that, at times, feel like a cruel joke. I’m not a bad patient because I don’t get my labs done. I am just exhausted by a system that did not incorporate proper human-centered design.

We all have a role to play to improve this. After a lifetime of stumbling through the healthcare system, I decided to do something about it and started Savvy Cooperative. Savvy is a patient-owned co-op that provides a marketplace for patient insights. Our goal is to make it so easy to connect and work with patients and healthcare consumers there is no excuse not to. I believe the future of healthcare is co-designed with patients.

As you go about your work or interface with the healthcare system, I hope you’ll be on the lookout for all the hoops patients jump through and think, “did anyone #askpatients about this?”

If you need examples where lack of human-centered design affects patients, check out some of our #MessedUpPtExp videos, featuring our friendly Savvy Puppets. Then, join us for this week’s #HITsm chat where we’ll discuss it in further detail.

Topics for this week’s #HITsm Chat:
Ice Breaker: We’ve got a Spotify playlist going of song titles that describe the current state of healthcare – what would you add to our #HealthcareSoundtrack? #HITsm

T1: Everyone has one, what’s one of the messed up patient experiences you’ve personally gone through or heard someone else go through that showed lack of human-centered design? #HITsm

T2: How can technology help to ease these headaches and improve the patient experience, rather than make it worse (feel free to use responses from T1 for inspiration!)? #HITsm

T3: Do you think patients can bring unique and valuable perspectives to the table that can make these technologies even better, and how so? #HITsm

T4: Let’s lay it out there, what are the reasons you have heard for why people or companies don’t work more directly with patients? #HITsm

T5: Some of the big consumer brands have mastered the user experience, but what do they need to do to truly improve the patient experience? #HITsm

Bonus: Who are some of the companies or individuals you feel are winning at human-centered design in healthcare, and what are they doing to show that? #HITsm

Upcoming #HITsm Chat Schedule
9/28 – How Does Interoperability Affect Technology Adoption in Healthcare?
Hosted by Niko Skievaski @niko_ski from @redox

10/5 – Medication Compliance & Drug Monitoring
Hosted by Joy Rios (@askjoyrios) and Robin Roberts (@rrobertsehealth)

10/12 – TBD
Hosted by Janet Kennedy (@getsocialhealth) and Carol Bush (@TheSocialNurse) from the Healthcare Marketing Network

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.

Latest Apple Watch to Cure Heart Disease (Yes, That’s the Sarcasm Font)

Posted on September 13, 2018 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.

By this point, I think that most people have seen the big announcement coming out of the Apple event that the Apple Watch 4 now has ECG and other heart monitoring capabilities built in. The watch will notify you if your heart rate is too low and instances of atrial fibrillation that it detects. Plus, all of this is done as an FDA cleared device (some are reporting that Apple got their FDA clearance in 30 days which is crazy fast for a medical device).

The response to this announcement has been quite interesting. Most aren’t surprised that Apple has been moving more and more into healthcare. Plus, there have been a lot of reports that have mistakenly called this the first consumer ECG which it’s not. AliveCor deserves that credit and I recently wrote about another consumer ECG which is just one of many that are coming. However, many are suggesting that the Apple Watch will be the first time that many younger, healthier people will be regularly using an ECG like this. That’s an interesting idea.

As you might have assumed by the title of this post, I think the Apple Watch announcement isn’t much ado about nothing, but it’s also not the announcement of “sliced bread” being invented either. Let’s dive into what this announcement really means for healthcare.

As I mentioned when I wrote about the other consumer ECG, there’s currently somewhat limited value in what can be done with a single lead ECG. So, it’s important to keep this Apple Watch announcement in the right perspective even though I’m sure most consumers won’t understand these details. One person even commented on how Apple created messaging that calls it an “intelligent health guardian” to confuse people while still avoiding liability:

Perception sells and Apple is as good at creating perception as anyone. Will many more people buy an Apple Watch if they perceive it as something that will help them monitor their health better? Definitely. However, there are some other consequences that many doctors are warning about when it comes to this type of tracking hitting the masses.

First up is Dr. Nick van Terheyden who provides a comparative example of why all this “testing” could lead to a lot of incidentloma’s (Nice word I assume he made up to describe false positives in health tests):

A nephrologist at Cricket Health, Carmen A. Peralta, chimed in with this perspective:

The problem with these devices is that it’s not in Apple’s best interest to truly educate a patient on what the device can and can’t do. If a single lead ECG like this was a reliable arbitrator of when to go to the ED or when to not go, then it would be extremely valuable. However, many doctors I’ve talked to are suggesting that a single lead ECG isn’t sufficient for this type of information. So, a false negative or a false positive from the Apple Watch can provide incorrect reassurance or unfortunate anxiety that is dangerous. Who’s going to communicate this information to the unsuspecting Apple Watch buyer? My guess is relatively no one.

Another doctor made this ironic observation when it comes to the false positives the Apple Watch will produce:

You can just imagine the Apple Watch template in an EHR system. I wonder if it will include an Apple Watch education sheet. Maybe the EHR could send that education sheet to their watch instead of the portal. Wishful thinking…I know.

Another doctor made this poignant observation about the announcement:

We could go on for a while about prevention versus diagnosis. However, I don’t think it’s really an either or proposition. Prevention is great, but detection and diagnosis are as well since we can’t prevent everything.

This MD/PhD student summed up where we’re at with these consumer health devices really well:

I agree completely. The Apple Watch is directionally good, but still far away from really making a significant impact on health and/or our healthcare sysetm.

Video Games and Healthcare IT – #HITsm Chat Topic

Posted on September 11, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 9/14 at Noon ET (9 AM PT). This week’s chat will be hosted by John Lynn (@techguy) from @HealthcareScene on the topic of “Video Games and Healthcare IT“.
I’ve been thinking a lot about the #HITsm chat and it’s evolution since the beginning. As my colleague Colin Hung knows, I’ve long been asking what the future of the chats will be and what’s the value the community can receive from these chats. I’ll admit that I’m still not sure all the answers to those questions, so I’d love to hear your thoughts.

With that said, I do think Twitter chats have been great for two things: connections and learning.

I think the #HITsm chat has served me and many in the community well on both accounts. In the beginning, Twitter chats were an excellent way for us to discover and connect with new and interesting people who were working in the field of healthcare IT. No doubt many of us found hundreds of new friends who were as passionate about the user of technology in healthcare as us. It was an amazing thing and provided so much value to everyone involved. This led to in person meetups that took all of those connections to new levels.

While this still happens today, there is a bit of a diminishing returns that happens now that so many of us know each other so well both online and in person. I’ll be interested to see how this evolves since we still do get new people who join these chats, but even then I wonder how they feel entering a community that kind of already knows each other.

The other clear goal from Twitter chats is learning. It’s always great to take part in a topic where so many experts come together and share knowledge. However, is this the best way to learn? Is there a way we could leverage the community more for learning? Is there a way we could involve more experts to increase the learning and sharing even more? These are all open questions that I’m trying to figure out and would love your thoughts.

As I thought about these things, one thing I realized is that some of the best parts of Twitter chats is connecting around common pieces of humanity. Things like travel, music, geek stuff, and food were always tangential topics that often revealed a different side of people in the community. I loved these tangents (as many people likely realized) because it created a new type of connection with someone in the community. Long story short, I wondered if we could create more of this type of interaction to strengthen bonds in the community in ways we couldn’t plan.

That’s the genesis of this week’s #HITsm chat. Let’s talk about a topic that no doubt many in the community know and love: video games. Most of us have gone through multiple generations of video games. Let’s spend some time sharing some nostalgic moments from video games to connect with others in the community. Then, we’ll also look at how our experience with video games could inform our work in healthcare IT.

We hope you’ll join us for this week’s #HITsm chat on video games. I’m sure we have some passionate memories that will be shared and possibly some new ideas and perspectives on how we can make healthcare better.

Topics for this week’s #HITsm Chat:
T1: What was your first video game system? How’d you get it? What games did you have? #HITsm

T2: Name your top 5 video games and why you loved them. Any memories or special moments with those video games are welcome too. #HITsm

T3: What did video games teach you (good or bad)? #HITsm

T4: Where would you like to see video game principles included in healthcare IT? Share some examples of how healthcare would benefit if it was more like video games. #HITsm

T5: Analogies are fun. What parallels can you draw between video game experiences and healthcare IT? #HITsm

Bonus: If you could create a special power (like they do in video games) what would it be? #HITsm

Upcoming #HITsm Chat Schedule
9/21 – Human Centered Design in Healthcare #askpatients
Hosted by Jen Horonjeff (@jhoronjeff) from @Savvy_Coop

9/28 – How Does Interoperability Affect Technology Adoption in Healthcare?
Hosted by Niko Skievaski @niko_ski from @redox

10/5 – Medication Compliance & Drug Monitoring
Hosted by Joy Rios (@askjoyrios) and Robin Roberts (@rrobertsehealth)

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.