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EHR Alerts, Top 10 Health IT Topics, Gesture Based EHR, and Adverse Events

Posted on December 18, 2014 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 thought it might be valuable to highlight a few interesting tweets I’ve seen recently. Some of them come from the other Healthcare Scene blogs, but I think you’ll find interesting.


Have alerts helped your organization? Alert fatigue is a very real thing, but when calibrated effectively, I’ve seen them really benefit an organization.


This is a fun list of healthcare topics. Do you see any topics that should be added to the list?


We’ve heard about gesture based EHR many times before. Mostly in the surgery room and mostly as demonstration projects. I don’t think this will really go huge and mainstream in healthcare, but could likely get some pickup for very targeted use cases.


Carl does a really great job in this article talking about Adverse Events and the legislation that’s proposed around EHR adverse events. This is a really important topic that doesn’t get nearly enough attention.

The Value of Goals in Hospital IT

Posted on December 17, 2014 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 someone sends me a press release that says that a hospital has attested to meaningful use or has achieved HIMSS stage 7, I kind of roll my eyes and move on. As a blogger, it really doesn’t tell me much about that organization. It’s one small data point in what I try to look at in the broader health IT ecosystem. Now, if I don’t see these things happening, I’ll start to wonder what’s going on. However, one individual announcement to me isn’t that interesting.

That’s not to say that healthcare organizations shouldn’t participate in programs like meaningful use and the various HIMSS stages. Sure, the incentive money is great and the adoration of your colleagues at HIMSS when you achieve HIMSS stage 7 is great as well, but that’s not why you should do either of these (ok, maybe the money in MU is worth doing it for).

The best reason your organization should look at going after something like HIMSS stage 7 is because there’s a lot of value in an organization working towards a goal. Of course you should look at the goals you’re trying to achieve to make sure your pointed in the right direction, but nothing unifies an organization like trying to achieve a special recognition. It’s hard to underestimate the value that’s created working towards a common goal.

Having an ambitious goal for your organization helps everyone in your organization to perform better and takes your organization to a higher level than you could have ever dreamed. We could argue over the value or lack thereof of meaningful use. What can’t be argued is the way organizations have come together to be meaningful use compliant.

Also, don’t underestimate the power of celebrating these achievements. While it’s one thing to celebrate your achievements internally (and you should), it’s also really valuable for those in your organization to receive accolades and recognition from their peers in other organizations.

Next time you look at some of these recognition, definitely consider if they espouse the values your organization wants to achieve. However, also take into account the powerful force a high goal and recognition for achieving that goal can provide your organization.

Healthcare Interoperability – Learning From Proprietary PC History

Posted on December 16, 2014 I Written By

Interoperability; Some vendors have the unmitigated gall to try and keep their systems proprietary. When they refuse to make code or training available to others, competition will have difficulty achieving interoperability and customers will not be able to move too far from the vendor and their own profitability is secured. Competition is greatly reduced.  Capitalism at its finest.

A long, long time ago in a land far away, 4 vendors in the minicomputer and PC markets attempted to do just about the same thing. Wang, Data General and Digital Equipment were almost totally proprietary. Interoperability was little more than a dream. Proprietary would secure success.  The fourth company was the leader in the PC world. They also were not able to communicate with competitors and vice versa. For years, IBM compatible meant the difference between success and failure. Why? Try profit. If you control a market and can keep others away, profits remain high.   After a time, as with IBM there will come a time that giving up the proprietary nature of the product will cause an increase in sales and profits.

Throughout the 80’s and 90’s IBM’s competitors and some large users complained bitterly about all four company’s proprietary nature. The 3 minicomputer companies “bet the farm” that they could succeed by being proprietary. IBM did the same. The rest is history. One won and three lost.

Epic is in the same boat as those four. Being proprietary is increasing their profitability currently.  As time progresses will Epic decide that the time is right to allow the competition access to their product and code and, like IBM, will they do it at the right time to remain the market leader.  Any bets?

The Ergonomics of EHR – Hospital Liability?

Posted on December 15, 2014 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 often hear about the ways technology causes ergonomic problems for us and our health. Whether it’s wrist pain from all the typing or back pain from the way we sit or eye strain from looking at a screen all day. Technology has a number of really major challenges when it comes to ergonomics.

Unfortunately, I don’t think most hospitals have put much thought into the ergonomic impact of an EHR on their nurses and doctors. Since many of these health issues happen over time, I think we haven’t yet awoken to these problems. This is an issue that’s likely going to impact a lot of hospitals in the next 3-5 years.

Think about the potential liability a hospital could have because of a poorly done EHR implementation which causes back pain, wrist strain and kills people’s eyesight. That’s a really big deal and worth considering.

A while back I actually saw this infographic dedicated to some of the ergonomic challenges that nurses face in a hospital. We need to start talking about these topics a lot more or it’s going to grow into an enormous problem.

Hospital EHR Ergonomics

How Is Your Hospital Approaching ICD-10?

Posted on December 12, 2014 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 writing quite a bit recently about ICD-10. You may enjoy this post I wrote about the real problem of ICD-10 being UNCERTAINTY. I’ve seen a lot of good reasons why we should go forward with ICD-10 and there’s no doubt that the move to ICD-10 does not come without a cost (training, implementation, system testing, etc). Although, not knowing if ICD-10 is coming or not is absolutely killer.

There are a lot of great ICD-10 resources out there to help you with your ICD-10 transition strategies. Although, I think most hospitals are wondering if they should prepare for ICD-10 or not. Those that were getting prepared last year got burned. Now they’re likely wondering if they’re going to get burned again. Those that weren’t prepared for ICD-10 last year were saved and they’re likely hoping to be saved again.

How is your hospital approaching ICD-10? Are you going forward with ICD-10 preparation using projects that are masked as Clinical Documentation Improvement (CDI) programs? Are you in wait and see mode? Are you going full bore in preparing, training, and testing for ICD-10?

I said that last one kind of ironically. I haven’t seen any organization that’s doing that right now which is really amazing. Last year at this time, I knew a bunch of organizations that were fully engage in preparations for ICD-10. This year, no such message. Last year at this time, many were calling for ICD-10 preparation. This year, people are afraid that they’re going to be “the boy who cried wolf.” There’s only so many times you can cry ICD-10 before people stop listening. We might be there already. It’s amazing the power of uncertainty.

As I said in my ICD-10 uncertainty post linked above:

My gut tells me that if ICD-10 isn’t delayed in the SGR Fix bill next year, then ICD-10 will probably go forward. You’ll notice that probably was the best I could say. Can anyone offer more certainty on the future of ICD-10? I don’t think they can and that’s the problem.

How Is Your Hospital Approaching ICD-10?

mHealth and Hospitals

Posted on December 11, 2014 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 week I’ve been doing quite a bit of thinking around the topic of mobile health thanks to all the #mHealth14 tweets I’ve been seeing on Twitter. One of the major takeaways I’ve seen from this year’s mHealth Summit and previous mHealth Summits was the prediction that one day mobile health and connected health and all the other variations will one day just be health.

I think it is true that mobile and connected health will eventually just be standard healthcare. However, it’s not today. In fact, I think that’s why most hospitals haven’t hopped on board mobile health yet. They are waiting for mobile health to be a standard of health. This tweet seems to capture some of this feeling.

Most of the hospitals I know see mobile health as a tool as opposed to a solution. Is it because we’re early in the market? Maybe, but I think there’s a lot more to this discussion.

When I think about hospitals and mHealth, I think there are three ways that they are adopting these mobile health technologies: existing vendors, rogue apps, and research dollars.

Existing Vendors
This is the most common use of mobile health in hospitals. However, most hospital CIOs and other hospital IT professionals wouldn’t even think of it as mobile health. They already think of it as health.

The best example of this is with the EHR vendors. Many of them are rolling out mobile interefaces for their EHR. Is that mobile health? Absolutely. However, the hospital didn’t really think about it as mobile health. They thought of it as implementing their EHR software. It just turns out that the mobile health implementation of EHR software made sense in that situation.

We see this happening across a wide variety of hospital apps. You can be sure that this will continue and only accelerate as these enterprise software vendors finally get their mobile health development complete.

Rogue Apps
Every hospital I know has made a lot of effort to manage mobile devices. Search for BYOD and surrounding topics and you’ll find a ton of conversation about this topic. One major part of this discussions is around rogue apps. Even if the hospital doesn’t allow the rogue mHealth app on the hospital devices, that’s not going to stop a doctor from downloading it on their personal smart phone. Sure, some hospitals have policies against some of this stuff, but rogue apps are alive and well in hospitals all over the country.

Rogue apps reminds me of shadow IT. I guess that rogue apps are a form of shadow IT. So, the concept isn’t new. What’s the lesson? Find a way to empower your users to be able to bring in outside apps that can be used in the hospital. Just because you play ignorant doesn’t mean your hospital’s not responsible for them just the same.

Research Dollars
This is where I see most of the mHealth efforts by hospitals. If it’s not coming from a current vendor, then they usually use some sort of research dollars to “experiment” with mobile health. For some reason it feels better for a hospital to hide behind a “research project” or a “pilot implementation.” Some of it has to do with the procurement and approval process. Other times, they’re just afraid to commit to something that’s not fully tested.

I don’t think mHealth being a pilot project or research project is a bad thing. In fact, I think this is the major reason why mobile health and connected health are still separate from health. Until we have enough time to prove out these ideas, the healthcare establishment won’t be ready to accept them. Once they’ve proven themselves, they’ll just become a standard part of healthcare.

Is mobile going to play an important part of the future of healthcare? Absolutely. Will it take some time to prove out the various methodologies in order for the healthcare establishment to adopt these mHealth technologies? Yes. This is how I see the evolution of mHealth in hospitals. What have you seen?

Should Hospitals Be Engines of Economic Development?

Posted on December 10, 2014 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 was absolutely intrigued by this Wired article by Mark E. Coticchia, Vice President and Chief Innovation Officer of the Henry Ford Health System, titled Hospitals as Engines of Economic Development. In the article, Mark makes the case for the value that a hospital provides its community and the added value they could create as an economic engine by leveraging the know-how and knowledge of its clinicians. Here’s a small quote from the article about how he thinks this should happen:

Medical and administrative know-how and inventions are positively impacting patient care, patient costs and hospital revenue. Yet almost all of the formalized programs to transfer technology to patient bedsides are within major academic medical centers not at the thousands of community hospitals nationwide, many of which have become or are looking to become part of a larger health care system through acquisitions, mergers and affiliation arrangements.

We need to have technology commercialization expertise available to more hospitals. This includes health care systems expanding their technology commercialization functions to their affiliated community hospitals. Alternatively, I anticipate that certain hospitals with substantial technology commercialization capabilities will offer their services to other hospitals with which they aren’t affiliated.

Obviously, Mark is a bit biased since he comes from a large health system. However, he is right that these smaller community hospitals are a place of untapped potential. In many ways it makes sense for these untapped community hospitals to leverage the technology commercialization expertise of these larger hospital systems. Those are things that the community hospital could likely never afford to create. Sounds like a great win win to me.

The real challenge I have with this idea is that it will take more than a partnership to extract value from these community hospitals. The problem with many of the community hospitals is that they haven’t ever had a culture of commercialization. Many of the doctors at these community hospitals will have to have a shift in mentality for this type of partnership to really work. Commercializing an idea isn’t something that most community hospital doctors have thought about doing. This mentality would need to be changed for a partnership like this to be a success.

What do you think of this idea? Is it a good one? Are hospitals an engine of economic development for their communities? Could they be if they’re not today? Should hospitals be pursuing these commercialization efforts?

7 Revenue Cycle Management Tips

Posted on December 9, 2014 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.

Healthcare is getting squeezed from every direction. The discussion around the cost of healthcare has exploded and everyone is looking at ways to lower the cost of healthcare. Unfortunately, for a hospital or healthcare organization, lower cost healthcare means getting paid less for the same things. We’re going to need a major shift in our thinking to be able to handle this shift in cost.

While we figure out these major changes, one thing I see happening across all of healthcare is managing an organization’s revenue cycle. NextGen recently put out this whitepaper titled 7 tips to go from “Getting By” to “Thriving” where they talk about a number of ways you can improve your revenue cycle management. Here’s a look at the 7 tips they offer:

1. Self-pay Collections
2. Measuring Performance
3. Claims Scrubbing
4. Track and Prevent Denials
5. Create and Enforce Write-off Policy
6. Remind Patients of Appointments
7. Maximize Electronic Remittance Advice

You can download the full whitepaper for free if you want to see a much deeper dive into all 7 of these tips.

What I’ve found as I’ve worked with hundreds of healthcare organizations is that most of these things aren’t rocket science. In fact, deep down these organizations know how to manage their revenue cycle. However, many of them aren’t doing it. Sometimes it’s a lack of resources available. In other cases, the organization just needs a reminder.

Unfortunately, revenue cycle management isn’t always the most fun thing you can do in an organization. It’s not a really sexy job that you can go home and tell your friends about. However, from a financial perspective it’s one of the best investments a healthcare organization can make.

New Federal Health IT Strategic Plan for 2015-2020

Posted on December 8, 2014 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.

The big news came out today that HHS had released its Health IT Strategic Plan for 2015-2020. You can find more details about the plan and also read the 28 page Federal Health IT Strategic plan online. Unlike many of the regulations, this strategic plan is very readable and gives a pretty good idea of where ONC wants to take healthcare IT (hint: interoperability). Although, the document is available for comment, so your comments could help to improve the proposed plan.

I think this image from the document really does a nice job summarizing the plan’s goals:
Federal Health IT Strategic Plan Summary

When I see a plan like this, the goals are noble and appropriate. No doubt we could argue about some of the details, but I think this is directionally good. What I’m not so sure about is how this plan will really help healthcare reach the specified goals. I need to dive into the specific strategies offered in the document to know if they really have the ability to reach these goals. I might have to take each goal and strategy and make a series out of it.

What do you think of this new health IT strategic plan?

More CDI and EHR Optimization Discussion

Posted on December 5, 2014 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.

In response to the question I posted in yesterday’s blog post, “What’s the Difference Between CDI Programs and EHR Optimization?“, Richard Tomlinson, Founder and CEO of Nuclei Health Consultancy offered this response that I thought would help continue the discussion and be interesting for readers:

In answer to your excellent question, no. CDI and EHR optimization are not the same; in fact the two models are significantly different, as are their goals.

Without deep dives here, the root decision tree to choose CDI over optimization should be based upon analysis results to the issues and goals identified. What are the identified issues? And what are the identified and measurable goals.

I will share that workflow analysis is one significant differentiator between CDI and Optimization. If one of the goals mentioned above for example is to reduce time documenting , or, a shift of role assignment in portions of workflows to reduce cost or improve provider thruput, then optimization here may include the addition of technology. Sounds counterintuitive, nevertheless the business model of optimization is indeed different.

Reducing clicks in clin doc has been cited as optimization, but I am here to tell you that alone is not the case. I would tend to take that stand alone as CDI, although one can argue reducing clicks does not “improve” clinical documentation.

As an overall, I would tend to say optimization is holistic in its foundation to include analysis of workflows, content build specifications, ROI of additional technology/tools, education, with the cumulative impact compared to a set of defined clinical and business goals. CDI by contrast may support only a goal as simplistic as rearrangement or placement of data to achieve a specific benefit.

I look forward to hearing other people’s thoughts on this subject.