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Monday Health IT Potpurri


This is a little bit self serving since Dan’s tweet includes a link to my article on EMR and EHR called, “If You Were an EHR, Which Would You Be?” Although, that post was 19 days ago, so it’s fantastic that Dan loved it enough to tweet it again. Plus, I’m sure that hospital readers will love that article. Side Note: Be sure to subscribe to all the other Healthcare Scene blogs here.


This shouldn’t be surprising. ACOs only require basics. Once they start requiring advanced capabilities, then they’ll built them.


Good advice from Cassie on LinkedIn. Good advice for anyone looking for a healthcare IT job is to get brushed up on LinkedIn. Not to mention uploading your health IT resume to Healthcare IT Central.

August 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

What Should You Do About HIPAA Today?

Mac McMillan, CEO of Cynergistek, offers some great insight into why organizations should make sure they’re on top of HIPAA today and where they can start.

The above video is just a portion of the full HIPAA Privacy and Security interview I did with Mac. He has a lot of great insight into what’s happening with HIPAA and HIPAA audits.

I also love his comment to encrypt your devices. How is it possible that hospital organizations haven’t heard this and dealt with it already? The other no brainer is to do a proper HIPAA risk assessment. Meaningful Use has pushed this forward in many organizations. Although, I think it’s fair to say that many haven’t done a “proper” risk assessment.

August 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Other Forms of Overcharging in Hospitals

In response to my previous post talking about hospital overcharging being overstated, I got an interesting reply from someone about other ways that “overcharging” is happening in hospitals.

Some are overcharging according EMR upgrade coding errors. How about $720 for ONE nitro tablet. Insurance company did not catch it either. About 9 months after an EPIC implementation so how many people/Insurance were overcharged and never knew?

In the meantime a gastric band operation in the UK is $7500 average. In the US it is between $15k and $30k depending on State. Is that not overcharging?

The first one is really interesting. You can see how after implementation of an EHR in a hospital it would be easy to charge extra for something (even accidentally). There are so many details to look at during an EHR implementation that it’s easy to see how something could be overcharged. Plus, it’s probably not a surprise to many that the insurance company doesn’t catch many overcharges.

The second point they made isn’t an over charge as we were describing it. Although, the price disparity question is a really important one and could be considered over charging in healthcare. Just a different form.

I’ve long said that I think the biggest key to fixing the healthcare pricing problem is to infuse more transparency into the system. Once transparency gets applied to pricing, it usually gets resolved pretty quickly. The second piece to transparency is shifting the cost responsibility to patients. In the past, patients didn’t care since they just paid their co-pay. However, this is quickly changing with more high deductible plans. This shift will require price transparency and then healthcare will be held accountable for what they’re charging for their services.

August 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

The Place of EHR in the Hospital IT Ecosystem

I’ve been thinking a lot about EHR software and the part it plays in the hospital IT ecosystem. The $36 billion of EHR stimulus money has shined a big light on EHR software. No doubt the EHR incentive money has increased EHR adoption, but at what cost. I wonder if the EHR incentive money has caused many hospital IT teams to place undue emphasis on the EHR software.

The reality of a hospital IT ecosystem is that they usually have hundreds of healthcare IT systems in their organization. The EHR is just one of those systems. In fact, it might not even be the largest system. Their ERP system (usually Peoplesoft or SAP in large hospitals) could be larger. However, try being system #90 at a hospital. Do you think the IT people at a large hospital system are paying much attention to what’s happening to that system? Not only are they distracted chasing the EHR incentive money, but even without that incentive there are 89 other systems in front of it.

I’m reminded of this Healthcare CIO Mindmap that I posted previously. It’s a great image of the amazing complexity that a healthcare CIO is facing. Each of the branches on that mindmap represent one or more IT systems that have to be managed by an organization. That’s a complex and challenging task.

I guess my message here is that while the EHR is extremely important to an organization, don’t lose track of all the other healthcare IT systems you support. They won’t likely be noticed in the short term, but transgressing these smaller health IT systems will create organizational debt that will be hard to overcome in the future.

August 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Patients Are Only People in Healthcare System Not Paid to Be There

I was absolutely intrigued by this tweet that was shared at last week’s #HITsm chat.

I’m still chewing on this idea and not sure if this matters and how it matters. I look forward to hearing your thoughts too. Here are a couple things I’m thinking about related to this.

First, the consumerization of healthcare. There really has been a weird dynamic in healthcare where consumers of healthcare (patients) really weren’t the people who were paying for the healthcare. Their employers generally were footing the bill and so patients were mostly interested in their co-payment and not much else since insurance was covering the rest. This has led to some really messed up dynamics when it comes to the cost of healthcare.

One of the trends happening in the industry is the shifting costs from employers to patients. This is largely happening on the backs of high deductible plans. We’re just starting to see the shock that these high deductible plans are having on patients. Once the shock’s been absorbed I think we’ll start seeing a much more proactive patient when it comes to how they choose a doctor and the price they’re willing to pay for medical care.

The second thing that the above tweet brings to mind is the idea of patients not wanting to be in the healthcare system. I’ve written regularly about the need for healthcare to start “Treating Healthy Patients.” That’s a huge shift in mentality from where we are today. Although, I’m hopeful that as ACO’s and value based reimbursement goes into effect, we’ll see a wave of health care that’s focused on outreach to patients who by all accounts are “healthy” or at least feel that way.

What do you think about these two topics? Are there other things we can learn from the perspective provided in the tweet above?

August 19, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Negative Maintenance Leadership

It seems like I have a little trend of leadership posts going on. This one goes along the lines of my previous post where I talked about Surpassing Expectations. The next leadership concept that I want to talk about comes from Brad Feld and he calls it Negative Maintenance.

Here’s how Brad describes it from his perspective:

There are days that I’m high maintenance. Everyone is. But if you subscribe to my “give before you get”, or #givefirst, philosophy, you are constantly contributing more than you are consuming. I’ve talked about this often in the context of Startup Communities, but I haven’t really had the right words for this in the context of leadership, management, and employees in a fast growing company.

I think that this description applies just as well to healthcare organizations. We all know the Hospital CIO who takes more than he gives. The hospital CIO that makes a project 10 times harder than it needs to be with the exact same (or sometimes worse) results. Hopefully you’ve also known leadership that makes your life easier. They remove roadblocks. They clearly articulate the path forward. They make the work easier as opposed to harder.

The same applies to anyone on a project team. There are those people on a team that are high maintenance, no maintenance, and negative maintenance. The highest performing teams are those that have a team full of negative maintenance people.

What kind of team member are you?

August 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

650 Posts, 500,000 Pageviews and Interesting Search Terms

It’s an exciting time for Hospital EMR and EHR. We just passed 650 blog posts since we started this hospital IT focused blog back on May 19, 2011. Hard to believe that this blog is already 3 years old. 215 posts a year is a pretty amazing body of work. Plus, we’re approaching nearly half a million pageviews in that time and have 1,198 email subscribers for just this blog (not including the general Healthcare Scene email subscribers). A big thank you to everyone who reads us regularly.

I thought it would also be fun to take a look at the funny, interesting and insightful things that people are searching on Google (and other search engines) that lead them to the site:

epic certification – With 1,625 searches (and thousands of more searches for variations of this term), there is a lot of interesting in becoming Epic certified. Unfortunately, I think that means there are a lot of really unsatisfied people when they find out that there’s no easy way to get Epic certified. I hope this changes.

epic emr – Obviously we’ve written a lot of content about Epic. Although, overall interest in Epic is always high. So, it’s not surprising that many of our readers are interested in reading about Epic.

soarian & soarian emr – At least for this site, Soarian takes the second spot on searches. I think that’s attributed to some great articles that we’ve written on Soarian over the years.

meditech emr – I’m a little surprised that we still don’t have Cener on the list, but Epic, Soarian, and MEDITECH are attracting more searches to this site than Cerner. I guess that means we need to write more content about Cerner.

meditech vs epic – Looks like many people have been searching to see if they should move from MEDITECH to Epic. At least I assume this is the direction they’re considering. Has anyone heard of someone going from Epic to MEDITECH?

epic certification salary – You can understand the interest in these numbers. Although, I’m surprised that Google didn’t send them to this post on Healthcare IT Today about Epic Salaries and Bonuses. Although, that’s for people working at Epic. Maybe I should do a post on Epic certified consultants salaries.

hospital ehr vendors – This search is not surprising since our Hospital EHR vendor page is one of our most popular pages.

ipad security issues – A great topic of discussion that every hospital is dealing with. Apple has come a long way on this issue, but they could still do better. Although, I’m not convinced they’ll ever fully embrace enterprise IT.

closed loop medication administration – We haven’t dug into this topic as much, but we should. I’ll add it to my list of future topics.

An interesting look at what people are searching on Google (albeit biased by the content of this site). Thanks everyone for reading. I look forward to our next 650 blog posts.

August 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Has Epic Fostered Any Real Healthcare Innovation?

I saw the following tweet and was really struck by the question.

I think we could broaden the question even more and ask if any EHR vendor has really fostered healthcare innovation. I’m sorry to say that I can’t think of any real major innovation from any of the top hospital EHR companies. They all seem very incremental in their process and focused on replicating previous processes in the digital world.

Considering the balance sheets of these companies, that seems to have been a really smart business decision. However, I think it’s missing out on the real opportunity of what technology can do to help healthcare.

I’ve said before that I think that the current EHR crop was possibly the baseline that would be needed to really innovate healthcare. I hope that’s right. Although, I’m scared that these closed EHR systems are going to try and lock in the status quo as opposed to enabling the future healthcare innovation.

Of course, I’ll also round out this conversation with a mention of meaningful use. The past 3-5 years meaningful use has defined the development roadmap for EHR companies. Show me the last press release from an EHR company about some innovation they achieved. Unfortunately, I haven’t found any and that’s because all of the press releases have been about EHR certification and meaningful use. Meaningful use has sucked the innovation opportunity out of EHR software. We’ll see if that changes in a post-meaningful use era.

August 13, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Pay at Epic – Did You Know There’s an Epic Reddit?

HIStalk recently pointed to a reddit post about the Salary, Raise and bonus structure at Epic. It’s a fascinating look at what you get paid to work at Epic. I’ll be covering that topic in detail on our Healthcare IT Today career blog. However, did you know that there’s a subreddit on Epic?

In some ways, I think this says a lot about how far reddit has come, but it also says something about the size of Epic and the type of employee they attract. The younger reddit generation is their hiring strategy.

The subreddit is quite interesting. They talk about things like lunch at Epic (cheap and good), what it’s like to be a mom at Epic, and even topics like whether you can have a tattoo at Epic. Although, this one talking about the creepy customer announcements made me laugh:

The customer announcements over the loud speaker are so bizarre. It makes me feel like I’m in a1984-esque reality with an unsilenceable propaganda machine.
I doubt they intend it to be this way, but it is all I ever feel when it occurs.
Does anyone not find them creepy?

Looks like they even preach the Epic culture over the loud speaker. I do like that their celebrating each customer win since an Epic customer win is a really big deal. Although, the description makes me wish I could hear one of these announcements.

The Epic subreditt isn’t super active, but I’ll have to keep an eye on it to see any other interesting topics that are started. Maybe start a few of my own.

August 11, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Bitcoin at Hospitals

I wonder how many in the hospital IT community and hospital executive community are following what’s happening with Bitcoin. For those not familiar with Bitcoin, here’s a short description of it from wikipedia:

Bitcoin is a software-based online payment system described by Satoshi Nakamoto in 2008 and introduced as open-source software in 2009. Payments are recorded in a public ledger using its own unit of account, which is also called bitcoin. Payments work peer-to-peer without a central repository or single administrator, which has led the US Treasury to call bitcoin a decentralized virtual currency. Although its status as a currency is disputed, media reports often refer to bitcoin as a cryptocurrency or digital currency.

On a simpler level, bitcoin is an electronic method for paying for something. However, bitcoin acts a lot more like cash than credit cards. Bitcoin is not traceable to an individual similar to how cash is not traceable. It can be given to someone else similar to cash. You have bitcoin wallets on phones where you can store bitcoin and then use it to pay for stuff. Bitcoin is also great since you can pay with bitcoin anywhere in the world and you don’t have to worry about things like exchange rates or credit card transasction fees.

One challenge with bitcoin is that only a few places accept bitcoin. However, that’s changing. A few months ago, the first hotel and casino in Las Vegas started accepting bitcoin. I’ve seen restaurants accepting bitcoin. Conferences have started accepting bitcoin. There are even bitcoin ATMs that are being put up.

Don’t get me wrong, bitcoin still has a long ways to go before you can ubiquitously pay for something with bitcoin the way you can now with cash or credit. However, it’s making good progress and has a lot of potential. With that in mind, I wonder when the first hospital will jump on board the bitcoin wagon. I imagine there are quite a few people who would like to pay their hospital bill with bitcoin which is untraceable. Sometimes people don’t want to share some of the things they get done at hospitals.

I’m certainly not an expert on bitcoin, but I’m interested. So, I thought I’d start the discussion and see what those in the hospital IT community thought of it. Probably the biggest challenge to using bitcoin in hospitals isn’t convincing the IT people that it’s a good idea. It’s convincing the hospital CFO. Until a bunch of patients start requesting bitcoin at their hospital, I don’t imagine many will jump on board. Although, maybe one or two will start as a way to get some PR buzz for their hospital.

What do you think of bitcoin? Should hospitals start accepting bitcoin payments?

August 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.