Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

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.

Realizing the Value of Health IT

Posted on September 16, 2013 I Written By

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

I’ve been focused on the value of healthcare IT for a long time. Obviously, I’ve been particularly focused on the value of EHR including a whole series of posts on the benefits of EHR (which I need to finish). I’m a huge fan of the value of EHR and healthcare IT, but I also am a realist. I realize that we aren’t getting all of the value out of healthcare IT that we could be getting. I also realize that poor health IT implementations can actually decrease value as opposed to increasing the value of health IT. Plus, I also see a huge disconnect between the value government sees in healthcare IT and what doctors find valuable.

If you don’t believe healthcare is missing out on the value healthcare IT could provide we don’t need to look any further than the fax machine. A recent CovisintPorter Research study found that “76% of respondents stated that they are handling their inflow of information via Fax.” Mr H from HISTalk aptly described this: “Healthcare: the retirement home for 1980s technology.”

I’ve also seen illustrated dozens of times the way a poor implementation can actually cause more problems than it solves. The Sutter EHR implementation is one example to consider. No doubt there is a lot of internal politics involved in the challenges that Sutter is facing with their EHR, but soon I’ll be publishing on Hospital EMR and EHR some first hand experiences with that EHR implementation. It’s a sad thing to see when an EMR implementation is done the wrong way. However, the opposite is also true. I’ve seen hundreds of organizations that love their EHR and can’t imagine how they practiced medicine before EMR.

One thing I’ve never heard a practicing doctor say is that they want to show meaningful use to be able to realize the value of health IT. I’ve certainly heard doctors say they have to show meaningful use to get the government money. I’ve certainly heard doctors say they want to show meaningful use to avoid the EHR penalties. I haven’t heard any doctor say they want to show meaningful use because it provides value to their clinic.

To me this illustrates the wide divide between the value government wants to see from healthcare IT and the value healthcare IT can provide a healthcare organization. Currently the government is riding on the back of incentive money and penalties to motivate healthcare organizations. No doubt this has caused many healthcare organizations to adopt an EHR. However, the incentive money and penalties won’t last forever. Then what?

What’s sad for me is that EHR adoption was starting to gain some momentum pre-HITECH act. There was a definite shift towards EHR adoption as organizations realized they needed to head that direction. Then, once the HITECH act hit it threw every EHR organizations plans out the door and created an irrational hysteria around EHR. This has led to irrational selection of EHR vendors, rushed EHR implementations, and cemented in many Jabba the Hutt EHR vendors that the relatively free EHR market wouldn’t have adopted pre-HITECH. To be honest, I’m ready for a return to a more rational EHR market based on value created. That’s when we’ll truly start realizing the value of health IT.

Beyond EHR, we need more brave leaders in healthcare IT that aren’t afraid to move beyond the fax machine. Leaders who don’t need a business model to realize that we can do better than the fax machine and other 80’s technology. It shouldn’t take five committees, two research studies, a certification, and outside money for an organization to do what’s right for patients. In fact, doing so is the very best business model in the world.

What scares me is that we’re going to miss out on the value of healthcare IT because our healthcare leaders are too busy fighting the proverbial meaningful use, ICD-10, and ACO fires.

Meaningful Use Stage 2 and HIE Transport – Meaningful Use Monday

Posted on March 19, 2012 I Written By

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

I’ll admit that I’m far from an expert on all the various HIE transport standards and movement happening in making health information exchange a reality in healthcare. However, meaningful use stage 2 is a big step towards getting doctors to exchange information. So, I’ll leverage some experts comments on HIE in meaningful use stage 2 to hopefully get the conversation started. Then, I’m sure some other HIE standards geeks will join in the comments to help us all further understand what’s happening.

John Moehrke has some of the best information I’ve seen for those interested in HIE and meaningful use stage 2. In one post he described his initial “fantastic” impressions of meaningful use stage 2 in regards to security privacy and HIE transport. Here’s the section on HIE transport:

HIE Transport:They have given us one or two Push style transports, and recognized that they interoperate by way of a proxy service that can convert forward and backward. There is no real surprises here as ONC has spent much time developing the Direct Project. Healthcare Providers and EHR developers should really be focusing beyond Direct, but supporting minimal Direct is a good thing to do. It allows us as an industry to move away from the FAX, and start universally communicating and manipulating Documents. I will note that these more Exchange like HIE models would still be considered compliant under the optional third transport.

I think he’s dead on that the majority of providers are going to get to know Direct really well in order to meet the meaningful use stage 2 requirements. In another more detailed post on the various HIE transport options including 3 options within the Direct Project: Full Service HISP, email integration, and integrated into the EHR.

John Moehrke has 3 great images I’ve embedded below which illustrate the above 3 models:

In the Full Service HISP, the user uploads the health information to a web portal or possibly emails the information to the HISP. This model reminds me of the various physician portals I’ve seen out there. They’ve worked really well for doctors who do a lot of referrals and need to exchange data. Although, logging into a portal isn’t the most seamless way of sharing data.

The email integration option requires you to have some good IT experience to be able to configure your email properly to support the identity and security configuration that will be required on your email system. Considering the number of doctors I know that still use aol.com, yahoo.com and gmail.com accounts, this won’t be a good solution for them. I bet even Google Apps accounts won’t support this, but it would be really cool if they did. Would be a really smart move by Google to have gmail support it if they could. The nice part is that once it’s configured you can sign and encrypt the email in a pretty seamless fashion.

Integrating the direct project specification directly into the EHR is the best option since it provides the user a seamless experience. The challenge will be on the EHR vendors to be able to integrate it into their EHR software, but I expect many will see this as the best way to service their customers. It will be harder on the EHR vendor, but the EHR vendors that do this extra effort will have much happier users.

Hopefully this gives a decent overview of the Direct Project options. John Moehrke has a lot more technical details on the subject if you want to read more about those. I know he’s pretty active on Twitter, so I’ll ping him now to have him take a look at this post so I can add any clarifications if needed as well.

I’m excited to see the Direct Project in widespread use. I think the Direct Project vision has best been described as replacing the fax machine. The move to exchanging documents using direct will be a good step forward. Sure, it’s just the first step, but it’s an important and useful one.