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Providers Tell KLAS That Existing EMRs Can’t Handle Genomic Medicine

Posted on November 26, 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.

Providers are still in the early stages of applying genomics to patient care. However, at least among providers that can afford the investment, clinical genomics programs are beginning to become far more common, and as a result, we’re beginning to get a sense of what’s involved.

Apparently, one of those things might be creating a new IT infrastructure which bypasses the provider’s existing EMR to support genomics data management.

KLAS recently spoke with a number of providers about the vendors and technologies they were using to implement precision medicine. Along the way, they were able to gather some information on the best practices of the providers which can be used to roll out their own programs.

In its report, “Precision Medicine Provider Validations 2018,”  KLAS researchers assert that while precision medicine tools have become increasingly common in oncology settings, they can be useful in many other settings.

Which vendors they should consider depends on what their organization’s precision medicine objectives are, according to one VP interviewed by the research firm. “Organizations need to consider whether they want to target a specific area or expand the solutions holistically,” the VP said. “They [also] need to consider whether they will have transactional relationships with vendors or strategic partnerships.”

Another provider executive suggests that investing in specialty technology might be a good idea. “Precision medicine should really exist outside of EMRs,” one provider president/CEO told KLAS. “We should just use software that comes organically with precision medicine and then integrated with an EMR later.”

At the same time, however, don’t expect any vendor to offer you everything you need for precision medicine, a CMO advised. “We can’t build a one-size-fits-all solution because it becomes reduced to meaninglessness,” the CMO told KLAS. “A hospital CEO thinks about different things than an oncologist.”

Be prepared for a complicated data sharing and standardization process. “We are trying to standardize the genomics data on many different people in our organization so that we can speak a common language and archive data in a common system,” another CMO noted.

At the same time, though, make sure you gather plenty of clinical data with an eye to the future, suggests one clinical researcher. “There are always new drugs and new targets, and if we can’t test patients for them now, we won’t catch things later,” the researcher said.

Finally, and this will be a big surprise, brace yourself for massive data storage demands. “Every year, I have to go back to our IT group and tell them that I need another 400 terabytes,” one LIS manager told the research firm.” When we are starting to deal with 400 terabytes here and 400 terabytes there, we’re looking at potentially petabytes of storage after a very short period of time.”

If you’re like me, the suggestion that providers need to build a separate infrastructure outside the EMR to create precision medicine program is pretty surprising, but it seems to be the consensus that this is the case. Almost three-quarters of providers interviewed by KLAS said they don’t believe that their EMR will have a primary role in the future of precision medicine, with many suggesting that the EMR vendor won’t be viable going forward as a result.

I doubt that this will be an issue in the near term, as the barriers to creating a genomics program are high, especially the capital requirements. However, if I were Epic or Cerner, I’d take this warning seriously. While I doubt that every provider will manage their own genomics program directly, precision medicine will be part of all care at some point and is already having an influence on how a growing number of conditions are treated.

A Hospital CIO Perspective on Precision Medicine

Posted on July 31, 2017 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.

#Paid content sponsored by Intel.

In this video interview, I talk with David Chou, Vice President, Chief Information and Digital Officer with Kansas City, Missouri-based Children’s Mercy Hospital. In addition to his work at Children’s Mercy, he helps healthcare organizations transform themselves into digital enterprises.

Chou previously served as a healthcare technology advisor with law firm Balch & Bingham and Chief Information Officer with the University of Mississippi Medical Center. He also worked with the Cleveland Clinic to build a flagship hospital in Abu Dhabi, as well as working in for-profit healthcare organizations in California.

Precision Medicine and Genomic Medicine are important topics for every hospital CIO to understand. In my interview with David Chou, he provides the hospital CIO perspective on these topics and offers insights into what a hospital organization should be doing to take part in and be prepared for precision medicine and genomic medicine.

Here are the questions I asked him, if you’d like to skip to a specific topic in the video or check out the full video interview embedded below:

What are you doing in your organization when it comes to precision medicine and genomic medicine?

Genomics as the Next “Information Technology” Investment Category

Posted on January 4, 2017 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.

Many of you know that I read various venture capital blogs as my hobby. My favorite is Fred Wilson’s blog. I’ve gleaned so much from his blog that’s helped me personally and professionally. When I know I have some blogs from Fred in my feed reader (which I usually do since he blogs every day), it’s like anticipating a delicious dessert since I know reading his blogs will be a fun experience (yes, I’m a nerd like that).

My Fred Wilson fandom aside, I was fascinated by Fred’s 2017 predictions including this one about genomics:

Tech investors will start to adopt genomics as an additional “information technology” investment category, blurring the distinction between life science and tech investors that has existed in the VC sector for the past thirty years. This will lead to a funding frenzy and many investments will go badly. But there will be big winners to be had in this sector and it will be an important category for VCs for the foreseeable future.

The timing for this is interesting since this week is CES. Last year at CES I moderated a panel on genomics. I led off the panel by saying, “Thanks for coming in from looking at all the iPhone cases to talk about something a little more substantial.” Needless to say, I’m quite bullish on what’s going to be possible with genomics. Although, I think Fred might be a little ahead of the curve on when tech and genomics will merge.

What’s interesting is that there should be an overlap in tech and genomics. How is creating some sort of healthcare analytics any different than doing the same with genomic data? Certainly, you could argue that genomic data is much more challenging and complex, but at the end of the day it’s still about culling through and understanding the data. For some reason though when we say genomics we think that it’s a unique class of investment. In most cases, it’s shouldn’t be all that different.

I do think Fred is spot on when he talks about many genomic investments going badly and many of them being big winners. In that way, it kind of feels more like pharma investment than it does technology. Maybe that’s why people feel like genomic medicine investments aren’t technology investments.

It’s going to be fun to see the genomic market play out. I’m also interested in the companies that are going to make our efforts available to a much broader group of people. I imagine that’s the type of investments that Fred Wilson and USV would like to make. They aren’t likely as interested in investing in the genomic findings, but the genomic tools that will empower anyone to make a genomic discovery. Or possibly the platform that will share and commercialize genomic findings. Those are both really interesting areas that I bet hits Fred’s investment themes well.

Will We Be Sequencing Genomes at Home?

Posted on July 27, 2016 I Written By

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

When I look at the digital health market, I see amazing things happening with wearable technology and digital health apps. I’m even enamored by how much impact the right text message at the right time can impact a person’s health. No doubt, I’m impressed by the simple solutions that seem obvious once someone’s actually implemented it.

While these are all impressive, I think nothing will have a bigger impact on our health than what’s happening with genomic medicine. What’s crazy to me is how quickly genomic sequencing has become accessible to everyone. The Medical Futurist, Berci Meskó, MD, PhD, shared this great National HUman Genome Research Institute chart which illustrates how quickly the cost to sequence a genome has dropped.

Cost of Genome Sequencing Over Time

In Berci’s post he suggests that one day soon it will cost more to mail in your sample than it costs to actually sequence your genome. Will we all have genomic sequencers in our homes like we all have thermometers today? Probably not, but given the cost curve we could if we wanted to have it.

This type of inexpensive genomic sequencing is going to change the way we’re treated by doctors. Given the pace of genomic sequencing, we’re certain to have all this genomic data before we really even know what to do with it. That’s normal since most innovations require us to have the data before we realize how that data can be used. In fact, the coolest innovations in the world often combined a whole series of small innovations. The same will be true as we extract value from our genomic data.

Have you sequenced your genome? Did it provide you any insights that were valuable to you?

Genomic Medicine

Posted on February 3, 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.

Last month I was lucky to lead a panel discussion on the topic of genomics in medicine at CES. I was joined on the panel by Andy De, Global Managing Director and General Manager for Healthcare and Life Sciences at Tableau, and Aaron Black, Director, Informatics, Inova Translational Medicine Institute. There certainly wasn’t enough time in our session to get to everything that was really happening in genomics, but Andy and Aaron do a great job giving you an idea of what’s really happening with genomics and the baseline of genomic data that’s being set for the future. You can see what I mean in the video below:

Be sure to see all of the conferences where you can find Healthcare Scene.

Will Your Healthcare Analytics Solution Scale?

Posted on October 26, 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.

One of the big themes being talked about at the Healthcare IT Transformation Assembly this week and particularly during my Care Performance Transformation roundtable with Midas+ has been around healthcare analytics and the solutions that will help a hospital utilize their data for population health, value based reimbursement, and improved care. This has made for an interesting discussion for me after having attended SAP Teched last week where SAP talked about the need for the right healthcare data solution that can scale to the needs of healthcare.

At both of these events it became very clear that the future of healthcare is being built on the back of healthcare data. The quantity and quality of healthcare data is expanding rapidly. There’s a lot of healthcare data being generated within the 4 walls of every healthcare organization. There’s a lot of healthcare data being generated outside of the healthcare setting. Plus, we’re just barely getting started with all of the data that’s needed for all the -omics (Genomics and Proteomics). Getting a handle on this data and ensuring the data can be trusted is of paramount concern for healthcare leaders.

What seems to be playing out is healthcare organizations are having to choose to invest in both point solutions and larger healthcare analytics solutions. Unfortunately there doesn’t seem to be one catch all solution that will solve all of a healthcare organization’s data transformation needs. None of the current solutions scale across all types of data and solve all of the current healthcare requirements. Although, some could eventually grow into that role.

In today’s discussion in particular, a number of hospital CIOs made clear that they had no choice but to have a variety of care transformation and healthcare analytics solutions. There wasn’t one integrated solution they could purchase and be done. In many ways it reminds me of the early days of PM, HIS, LIS, and EHR purchasing. Most purchased them separately because there wasn’t one integrated solution. However, over time people moved to buying one integrated system across PM, EHR, LIS, etc as the software become integrated and mature. Will we see the same thing happen with our healthcare analytics solutions?

While we’ve seen the move to more integrated healthcare IT solutions, we’re also seeing a move away from that now as well. Every EHR vendor is working on APIs to allow third party companies to integrate new solutions with the EHR. There’s a realization that it would be nice if the EHR could do everything in one nicely integrated solution, but it won’t. It’s a cycle that we see in software. I imagine we’ll see that same cycle with healthcare analytics solutions as well.

Are There Elements of Healthcare IT That Won’t Eventually Be On the Cloud?

Posted on August 19, 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.

I came across this video from Dell that looks at the Future of Healthcare and how cloud computing is working to transform healthcare. It’s a marketing video for Dell, but it brings up some interesting points about where healthcare IT is headed:

After watching the video, I asked myself the question that’s the title of this blog post: Are There Elements of Healthcare IT That Won’t Eventually Be On the Cloud?

I think the answer is no. I think it will also take healthcare a while to actually get fully on the cloud. However, it’s happening across every aspect of healthcare IT. Plus, there are going to be a number of healthcare IT innovations in the future that are only going to be cloud based. I think genomics and personalized medicine is the perfect example. Those innovations are going to both require cloud technology to make it a reality.

Will We Be Maintaining Our Genomic Health Record?

Posted on May 4, 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.

If you’re interested in Genomic Medicine like I am, be sure to check out my article on EMR and EHR called “When Will Genomic Medicine Become As Common As Antibiotics?” That’s a really interesting question that’s worth considering. We’re not there yet and won’t get there for a couple years. However, I think that genomic medicine will become as common as antibiotics and will have a massive impact on healthcare the way antibiotics have as well.

The article mentioned links to a genomics whitepaper that talks about a person’s genomic health record. I’d never heard the term before, but I’m definitely intrigued by the idea of everyone having their own genomic health record.

We’ve talked forever about people having a personal health record which they need to collect and maintain. Some people store it in a PHR on the web and others store it on a mobile phone. However, we’ve never really seen the personal health record take off. This is true for a number of reasons. The first is that it’s still quite difficult to aggregate your entire health record across multiple providers. I even read of one PHR that was paying doctors to provide them a patient’s record. The second problem is that patients don’t know what to do with all the records once they have them. Even if they go to their doctor and say they have their full patient record, the doctor hands them a stack of health history forms to fill out. Best case, they file a copy of the patients records in the chart (usually in some sort of PDF or paper copy).

Now let’s think about those challenges from the perspective of a genomic health record. If you’ve paid thousands of dollars for genomic tests and analysis, are you going to want to pay that again to the next doctor you see? No, they’re going to ask you for your copy of their genomic record and use that as part of your care. Patients won’t want to pay for another genomic test and it will be easier to get their record, so they’ll be more motivated to get and maintain it than they were with a simple personal health record. It’s pretty compelling to consider.

Some challenges and questions I have about how this will evolve. Will your PHR start to include your genomic health record or will it be something that’s stored separately? Will their be a standard for the genomic health record so that the doctor can easily use that record in the work they’re doing? Will the genomic health record be so large that it will have to be stored in the cloud?

What do you think of the concept of a genomic health record?

The Future Of…Healthcare Innovation

Posted on March 17, 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 post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Innovation is a fascinating concept. Historians and philosophers have been thinking and investigating the key to innovation forever. I’m not sure anyone has ever found the true secret sauce to innovation. Every innovation I’ve ever seen has been a mix of timing, luck, and hard work.

Some times the timing is not right for a product and therefore it fails. The product might have been great, but the timing wasn’t right for it to be rolled out. Innovation always requires a little luck. Maybe it was the chance meeting with an investor that helps take and idea to the next level. Maybe it’s the luck of getting the right exposure that catapults your idea into a business. Maybe it’s the luck of the right initial end users which shape the direction of the product. Every innovation has also required hard work. In fact, the key to ensuring you’re ready for luck to be heaped upon you or to test if your timing is right is to put in the work.

The great thing is that it’s a brilliant time to be working on innovations in healthcare. We’re currently at the beginning of a confluence of healthcare innovations. Each one on its own might seem like a rather small innovation, but taken together they’re going to provide amazing healthcare innovations that shape the future of healthcare as we know it.

Let me give a few examples of the wave of innovations that are happening. Health sensors are exploding. Are ability to know in real time how well our body is performing is off the charts. There are sensors out there for just about every measurable aspect of the human body. The next innovation will be to take all this sensor data and collapse it down into appropriate communication and actions.

Another example, is the innovations in genomic medicine. The cost and speed required to map your genome is collapsing faster than Moore’s law. All of that genomic data is going to be available to innovators who want to build something on top of it.

3D printing is progressing at light speed. Don’t think this applies to healthcare? Check out this 3D printed prosthetic hand or this 3D printed heart. If you really want your mind blown, check out people’s work to provide blood to 3D printed organs.

If you think we’ve gotten value out of healthcare data, you’re kidding yourself. There are so many innovations in healthcare data that are sitting there waiting in healthcare data hoards. We just need to tap into that data and start sharing those findings with a connected healthcare system.

The mobile device is an incredible innovation just waiting for healthcare. We are all essentially walking around with a computer in our pocket now. We’ve already started to see the innovations this will provide healthcare, but it’s only just the beginning. This computer in our pocket will become the brain and communication hub for our healthcare needs.

I’m sure you can think of other innovations that I haven’t mentioned including robotics, health literacy, healthcare gaming, etc. What’s most exciting to me about the future of healthcare innovation is that each of these innovations will combine into a unforeseen innovation. The most powerful innovations in healthcare will not be a single innovative idea. Instead, it will come from someone who combines multiple innovations into one beautiful package.

The most exciting part of innovation is that it’s usually unexpected and surprising. I love surprises. What do you see as the future building blocks of innovation in healthcare?

The Future Of…The Connected Healthcare System

Posted on March 11, 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 post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

As I think about the future of a connected healthcare system, I get very excited. Although, that excitement is partially tamed by the realization that many of these connections could have been happening for a long time. A connected healthcare system is not a technological challenge, but is a major cultural challenge for healthcare.

The Data Connected Healthcare System
Implementation challenges aside, the future of healthcare absolutely revolves around a connected healthcare system. In the short term these connections will focus on sharing the right data with the right person at the right time. Most of that data will be limited to data inside the EHR. What’s shocking is that we’re not doing this already. I guess we are doing this already, but in a really disconnected fashion (see Fax machine). That’s what’s so shocking. We already have the policies in place that allow us to share healthcare data with other providers. We’re sharing that data across fax machines all day every day. Over the next 3-5 years we’ll see a continuous flow of this data across other electronic channels (Direct Project, FHIR, HIEs, etc).

More exciting to consider is the future integration of consumer health device data into the healthcare system. I’m certain I’ll see a number of stories talking about this integration at HIMSS already. These “pilot” integrations will set the groundwork for much wider adoption of external consumer health data. The key tipping point to watch for in this is when EHR vendors start accepting this data and presenting the data to doctors in a really intuitive way. This integration will absolutely change the game when it comes to connecting patient collected data with the healthcare system.

What seems even more clear to me is that we all still have a very myopic view of how much data we’re going to have available to us about a person’s health. In my above two examples I talk about the EHR patient record (basically physician’s charts) and consumer health devices. In the later example I’m pretty sure you’re translating that to the simple examples of health tracking we have today: steps, heart rate, weight, blood pressure, etc. While all of this data is important, I think it’s a short sighted view of the explosion of patient data we’ll have at our fingertips.

I still remember when I first heard the concept of an IP Address on Every Organ in your body reporting back health data that we would have never dreamed imaginable. The creativity in sensors that are detecting anything and everything that’s happening in your blood, sweat and tears is absolutely remarkable. All of that data will need to be connected, processed, and addressed. How amazing will it be for the healthcare system to automatically schedule you for heart surgery that will prevent a heart attack before you even experience any symptoms?

Of course, we haven’t even talked about genomic data which will be infiltrating the healthcare system as well. Genomic data use to take years to process. Now it’s being done in weeks at a price point that’s doable for many. Genomic medicine is going to become a standard for healthcare and in some areas it is already.

The connected healthcare system will have to process more data than we can even imagine today. Good luck processing genomic data, sensor data, device data, and medical chart data using paper.

It’s All About Communication
While I’ve focused on connecting the data in the healthcare system of the future, that doesn’t downplay the need for better communication tools in the future connected healthcare system. Healthcare data can discover engagement points, but communication with patients will cause the change in our healthcare system.

Do you feel connected to your doctor today? My guess is that most of you would be like me and say no (Although, I’m working to change that culture for me and my family). The future connected healthcare system is going to have to change that culture if we want to improve healthcare and lower healthcare costs. Plus, every healthcare reimbursement model of the future focuses on this type of engagement.

The future connected healthcare system actually connects the doctor’s office and the patient to treat even the healthy patient. In fact, I won’t be surprised if we stop talking about going for a doctor’s visit and start talking about a health check up or some health maintenance. Plus, who says the health check up or maintenance has to be in the doctors office. It might very well be over a video chat, email, instant message, social media, or even text.

This might concern many. However, I’d describe this as healthcare integration into your life. We’ll have some stumbles along the way. We’ll have some integrations that dig too deeply into your life. We’ll have some times when we rely too heavily on the system and it fails us. Sometimes we’ll fail to show the right amount of empathy in the communication. Sometimes we’ll fail to give you the needed kick in the pants. Sometimes, we’ll make mistakes. However, over time we’ll calibrate the system to integrate seamlessly into your life and improve your health based on your personalized needs.

The future Connected Healthcare System is a data driven system which facilitates the right communication when and where it’s needed in a seamless fashion.