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Healthcare Leadership Learnings from Niagara Falls

Posted on December 31, 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.

Niagara Falls in Winter
As this picture shows, my wife and I recently got to spend some time alone (ie. no kids) at Niagara Falls. My wife comes from upstate NY and I proposed to my wife while at Niagara Falls. So, it’s a special place to us. As such, we’ve visited it many times. Plus, I just adore waterfalls.

As I was watching the waterfalls this time, I was again blown away by the volume of water that pours over the falls consistently, all day, every day and has for years. It’s extraordinary that it’s even possible, but the power of all that water is awe inspiring.

Thinking about this wonder of the world, I started to think about healthcare. At first I thought that those of us in healthcare IT were strapped at the bottom of the falls and couldn’t leave. The regulations kept coming over the falls and hammering us over and over. The regulations were unrelenting and we just had to try and find a way to survive. I imagine that many reading this could relate to that feeling. In fact, I bet many of you are tired of the regulations and ready to give up and float down the river.

As my mind continued to wander, I thought that the same was true when it comes to a team working consistently on a problem. A well organized team that keeps consistently hammering away at something over time is a powerful powerful force for good. Instead of being strapped to the waterfall, our teams could be the waterfall that’s hammering away over and over at the problems of healthcare.

Never underestimate the power of many people all working consistently to solve a problem. I’ve been part of teams like that and the results are amazing! Where do you find yourself? Are you at the bottom of the falls or are you the falls?

The Impact of AI and Robots on Healthcare

Posted on December 30, 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.

As we end 2014, it seemed appropriate to post a little bit of mental floss for those of us who are trying to consider where all of this technology in healthcare is headed. Luckily, Twitter provides a lot of mental floss and these two tweets will give you a lot to consider when it comes to artificial intelligence (AI), robots, and the mixture of related technologies. We can’t see it now, but 10 years from now we’ll be just as disrupted as we were 6 years ago when the iPhone was introduced.

Here are two tweets that will hopefully help you to reframe your thinking:

What do you think all of this means for the future of healthcare?

Hospitals Put Off RCM Upgrades Due To #ICD10, #MU Focus

Posted on December 29, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If you look closely at the financial news coming out of the hospital business lately, you’ll hear the anguished screams of revenue cycle managers whose infrastructure just isn’t up to the task of coping with collections in today’s world. Though members of the RCM department — and outside pundits — have done their best to draw attention to this issue, signs suggest that getting better systems put in has been a surprisingly tough sell. This is true despite a fair amount of evidence from recent hospital financial disasters that focusing on an EMR at the expense of revenue cycle management can be quite destructive.

And a new study underscores the point. According to a recent Black Book survey of chief financial officers, revenue cycle upgrades at U.S. hospitals have taken a backseat to meeting the looming October 2015 ICD-10 deadline, as well as capturing Meaningful Use incentives. Meanwhile, progress on upgrades to revenue cycle management platforms has been agonizingly slow.

According to the Black Book survey, two thirds of hospitals contacted by researchers in 2012 said that they plan to replace their existing revenue cycle management platform with a comprehensive solution. But when contacted this year, two-thirds of those hospitals still hadn’t done the upgrade. (One is forced to wonder whether these hospitals were foolish enough to think the upgrade wasn’t important, or simply too overextended to stick with their plans.)

Sadly, despite the risks associated with ignoring the RCM upgrade issue, a lot of small hospitals seem determined to do so. Fifty-one percent of under 250 bed hospitals are planning to delay RCM system improvements until after the ICD-10 deadline passes in 2015, Black Book found.

The CFOs surveyed by Black Book feel they’re running out of time to make RCM upgrades. In fact, 83% of the CFOs from hospitals with less than 250 beds expect their RCM platforms to become obsolete within two years if not replaced or upgraded, as they’re rightfully convinced that most payers will move to value-based reimbursement. And 95% of those worried about obsolescence said that failing to upgrade or replace the platform might cost them their jobs, reports Healthcare Finance News.

Unfortunately for both the hospitals and the CFOs, firing the messenger won’t solve the problem. By the time laggard hospitals make their RCM upgrades, they’re going to have a hard time catching up with the industry.

If they wait that long, it seems unlikely that these hospitals will have time to choose, test and implement RCM platform upgrades, much less implement new systems, much before early 2017, and even that may be an aggressive prediction. They risk going into a downward spiral in which they can’t afford to buy the RCM platform they really need because, well, the current RCM platform stinks. Not only that, the ones that are still engaged in mega dollar EMR implementations may not be able to afford to support those either.

Admittedly, it’s not as though hospitals can blithely ignore ICD-10 or Meaningful Use. But letting the revenue cycle management infrastructure go for so long seems like a recipe for disaster.

Another Health System’s Finances Weighed Down By Epic Investment

Posted on December 26, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While Memphis-based Baptist Memorial Health Care Corp. may intend to be “the high-quality and low-cost provider” in its region, spending $200 million on an EMR purchase has got to make that a bit more, shall we say, challenging.

While health systems nationwide are struggling with issues not of their own making, such as some states’ decision not to expand Medicaid, it appears that Baptist Memorial’s financial troubles have at least some relationship to the size of its 2012 investment in an Epic EMR platform.

Baptist, which let 112 workers go in September, has seen Standard & Poor’s lower its long-term rating on the health system’s bond debt twice since mid-2013.  Through June, the system’s losses totaled $124 million, according to S&P.

Baptist employs 15,000 workers at 14 hospitals located across the mid-south of the US, so the staffing cuts clearly don’t constitute a mass layoffs. What’s more, the layoffs are concentrated corporate services, Baptist reports, suggesting that the chain is being careful not to gut its clinical services infrastructure. In other words, I’m not suggesting that Baptist is completely falling apart, Epic investment or no.

But the health system’s financial health has deteriorated significantly over the past few years. After all, back in 2009, S&P gave Baptist Memorial a long-term ‘AA’ rating, based on its strong liquidity and low debt levels; history of positive excess income and good cash flow; and solid and stable market share in his total surface area, with favorable growth in metropolitan Memphis.

However, at this point Baptist is clearly struggling, so much so that is taking the extraordinary step of cutting the salaries of top executives in the system by 22% to 23%. That includes cutting the salary of health system CEO Jason Little. But this is clearly a symbolic gesture, as executive pay cuts can’t dent multimillion dollar operating revenue shortfalls.

So what will help Baptist improve its financial health? In public statements,  Baptist CEO Little has said that the hospitals’ length of stay has been excessive for the compensation that they get from payers, and that fixing this is his key focus. This problem, of course, is only likely to get worse as value-based reimbursement becomes the rule, so that strategy seems to make sense.

But Baptist is also going to have to live with its IT spending decisions, and it seems obvious that they’ve had long-term repercussions. I don’t think any outsider can say whether Baptist should have bought the Epic system, or how much it should have spent, but the investment has clearly been a strain.

Merry Christmas!

Posted on December 25, 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 hope everyone’s enjoying their Christmas. Here’s a look into mine (with my beautiful wife). Merry Christmas!

wpid-20141225_193148.jpg

Tough Ethical Decisions

Posted on December 24, 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.

It’s Christmas Eve, so I thought I’d keep this short and deep. Check out this description of an ethical decision related to driverless cars:

I thought this was apt, because I think we have similarly difficult ethical choices in healthcare as well. The right answer is not always easy.

Should the Sony Hack Have Hospitals Concerned?

Posted on December 23, 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.

If you haven’t heard the details of the Sony hack, then lucky you. It seems that coverage of the hack has been everywhere. Long story short, Sony wasn’t careful and the hackers got a lot of really private information like emails. It was embarrassing to the company in a variety of ways and the effects of it and them eventually pulling The Interview are going to be felt for a long time to come. In fact, some of the hack included Sony’s insurance records which included medical information.

Should hospitals be concerned by the hack of Sony? The hack itself shouldn’t be of particular concern, but it should be a stark reminder that anyone is vulnerable if the hackers want to hack you enough. Unfortunately, the game of privacy and security is a cat and mouse game of trying to make what you have so difficult to access that hackers choose other, simpler targets.

With that said, if Sony, Google, Target, etc can be hacked, then anyone could be hacked. While it’s absolutely critical that you’re doing everything you can to make it hard for hackers to access your systems, it’s also important to make sure that you have proper breach procedures in place as well. How you handle a breach is going to be incredibly important for every organization.

While the Sony hack is going to cost them a lot of money. A breach in healthcare could incur some of the same embarrassment publicly, but there are also stiff HIPAA penalties for a breach. This could get very expensive for organizations that aren’t taking health IT security seriously. If you thought the coming MU penalties are bad, try to calculate in some major HIPAA fines and reduced patient load because patients no longer trust your organization. It will be devastating for organizations.

What is your organization doing to avoid breaches? Are you going beyond the HIPAA risk assessment?

A Turning Point? Wearables Could Save 1.3M Lives by 2020

Posted on December 22, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For years, wearable health bands have been expensive toys useful almost exclusively to fit people who wanted to get fitter. On their own, wearables may be chic, sophisticated and even produce medically relevant information for the user, but they haven’t been integrated into practical care strategies for other populations.

And with good reason. For one thing, doctors don’t need to know whether an otherwise-healthy patient took 10,000 steps during a run, what their heart rate was on Thursdays in June or even what their pulse ox reading was if they’re not wheezy asthmatics. Just as importantly, today’s EMRs don’t allow for importing and analyzing this data even if it is important for that particular patient.

But as the banners at last week’s mHealth Summit pointed out, we’re headed for the era of the mHealth ecosystem, a world were all the various pieces needed to make patient generated data relevant are in place. That means good things for the future health of all patients, not just fitness nuts.  In fact, a Swiss analyst firm is predicting that smart wearable devices will save 1.3 million lives by 2020, largely through reductions in mortality to in-hospital use of such devices, according to mobihealthnews.

New research from Switzerland-based Soreon Research argues that smart wearables, connected directly with smart devices, projects that using wearables for in-hospital monitoring will probably save about 700,000 lives of the 1.3 million it expects to see preserved by 2020. Even better, wearables can then take the modern outside the hospital. “New wearable technology can easily extend monitoring functions beyond the intensive care unit and alert medical professionals to any follow on medical problems a patient may develop,” according to Soreon Research Director Pascal Koenig.

Not surprisingly, given their focus on monitoring aerobic activities, Soreon projects that wearables can be particularly helpful in avoiding cardiovascular disease and obesity. The firm believes that monitoring patients with wearables could prevent 230,000 deaths due to cardiovascular diseases, and reduce obesity related deaths by 150,000.

And that’s just a taste of how omnipresent wearables use may be within a few years. In fact, Soreon believes that patients with chronic conditions will help push up the smart wearables market from $2 billion today to $41 billion, or more than 1000% growth. That’s a pretty staggering growth rate regardless of how you look at it, but particularly given that at the moment, clinical use of smart wearables is largely in the pilot stage.

What few if any pundits are discussing — notably, as I see it — is what software tools hospitals will use to crunch this flood of data that will wash it on top of the astonishing volume of data EMRs are already producing.

True, at the mHealth Summit there were vendors pitching dashboards for just this purpose, who argued that their tools would allow healthcare organizations to manage populations via wearable. And of course tools like Apple HealthKit and Microsoft Health hope to serve as middlemen who can get the job done.

These solutions will definitely offer some value to providers. Still, I’d argue that wearables will not make a huge impact on clinical outcomes until the day what they produce can be managed efficiently within the EMR environment a provider uses, and I don’t see players like Epic and Cerner making big moves in this direction. When the mHealth ecosystem comes together it’s likely to produce everything analysts predict and more, but bringing things together may take much longer than they expect.

Will I See Any Hospital CIO’s at CES?

Posted on December 19, 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.

For those not familiar with the International CES conference, it’s held in Las Vegas every year at the beginning of January. CES stands for consumer electronic show and it is a show that literally takes over the city of Las Vegas. It’s so full of tech and geek that they use the entire Las Vegas Convention Center, the entire Sands Convention Center, and all of the conference area of the Westgate (Previously LVH and the Hilton), and all of the conference area in the Aria, and at least a couple days at Mandalay Bay. Long story short, the event is massive! I bet some of the larger vendors spend upwards of a million dollars or more on their booths.

As part of the growth of the show, there’s been a larger and larger digital health section of the show. Plus, that doesn’t really include the massive companies like Samsung that have gotten into health as well but have an enormous booth in another area of the show.

The largest portion of health at CES carries the banner of the Digital Health Summit and mostly includes wearables (check out my previous post on Hospitals and Wearables) and robotics (often tied to Telemedicine). However, I know many technology people come to see where the tech is headed so they can prepare. That’s why I attend the event every year.

To be honest, I’ll be surprised if I see any hospital CIOs at CES. Possibly a few hospital CTOs who are looking at some technology, but that might even be a stretch. What it makes me wonder is where hospital IT executives search to see what’s happening next for technology. Where do you look for innovation and where technology that can benefit your hospital is heading?

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.