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Bringing EHR Data to Radiologists

Posted on December 2, 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.

One of the most interesting things I saw at RSNA 2016 in Chicago this week was Philips’ Illumeo. Beside being a really slick radiology interface that they’ve been doing forever, they created a kind of “war room” like dashboard for the patient that included a bunch of data that is brought in from the EHR using FHIR.

When I talked with Yair Briman, General Manager for Healthcare Informatics Solutions and Services at Philips, he talked about the various algorithms and machine learning that goes into the interface that a radiologist sees in Illumeo. As has become an issue in much of healthcare IT, the amount of health data that’s available for a patient is overwhelming. In Illumeo, Philips is working to only present the information that’s needed for the patient at the time that it’s needed.

For example, if I’m working on a head injury, do I want to see the old X-ray from a knee issue you had 20 years ago? Probably not, so that information can be hidden. I may be interested in the problem list from the EHR, but do I really need to know about a cold that happened 10 years ago? Probably not. Notice the probably. The radiologist can still drill down into that other medical history if they want, but this type of smart interface that understands context and hides irrelevant info is something we’re seeing across all of healthcare IT. It’s great to see Philips working on it for radiologists.

While creating a relevant, adaptive interface for radiologists is great, I was fascinated by Philips work pulling in EHR data for the radiologist to see in their native interface. Far too often we only talk about the exchange happening in the other direction. It’s great to see third party applications utilizing data from the EHR.

In my discussion with Yair Briman, he pointed out some interesting data. He commented that Philips manages 135 billion images. For those keeping track at home, that amounts to more than 25 petabytes of data. I don’t think most reading this understand how large a petabyte of data really is. Check out this article to get an idea. Long story short: that’s a lot of data.

How much data is in every EHR? Maybe one petabyte? This is just a guess, but it’s significantly smaller than imaging since most EHR data is text. Ok, so the EHR data is probably 100 terabytes of text and 900 terabytes of scanned faxes. (Sorry, I couldn’t help but take a swipe at faxes) Regardless, this pales in comparison to the size of radiology data. With this difference in mind, should we stop thinking about trying to pull the radiology data into the EHR and start spending more time on how to pull the EHR data into a PACS viewer?

What was also great about the Philips product I saw was that it had a really slick browser based HTML 5 viewer for radiology images. Certainly this is a great way to send radiology images to a referring physician, but it also pointed to the opportunity to link all of these radiology images from the EHR. The reality is that most doctors don’t need all the radiology images in the EHR. However, if they had an easy link to access the radiology images in a browser when they did need it, that would be a powerful thing. In fact, I think many of the advanced EHR implementations have or are working on this type of integration.

Of course, we shouldn’t just stop with physicians. How about linking all your radiology images from the patient portal as well? It’s nice when they hand you a DVD of your radiology images. It would be much nicer to be able to easily access them anytime and from anywhere through the patient portal. The great part is, the technology to make this happen is there. Now we just need to implement it and open the kimono to patients.

All in all, I love that Philips is bringing the EHR data to the radiologists. That context can really improve healthcare. I also love that they’re working to make the interface smarter by removing data that’s irrelevant to the specific context being worked on. I also can’t wait until they make all of this imaging data available to patients.

HIM’s Role in Healthcare Security and Privacy – HIM Scene

Posted on November 30, 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

One of my go-to experts on healthcare privacy and security is Mac McMillan, CEO and Co-Founder of CynergisTek. He’s built a really great company that focuses on privacy and security in healthcare and he’s a true expert.

While at AHIMA 2016, I talked with Mac about the role that HIM plays in healthcare privacy and security. We also talk about where healthcare privacy is heading and which part of healthcare privacy and security doesn’t get enough attention. I also asked Mac to make a big 20 year prediction on what will happen with privacy and security in healthcare.

Check out our interview with Mac McMillan, CEO and Co-Founder of CynergisTek:

We shot a number of other videos at AHIMA 2016 which we’ll be posting shortly. If you enjoyed this video, be sure to Subscribe to Healthcare Scene on YouTube and watch our full archive of Healthcare Scene interviews.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Thanksgiving Gratitude

Posted on November 24, 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.

In the US, today is Thanksgiving and so I thought it would be fun to show a bit of gratitude to each of my children on each of my blogs. Feel free to skip this post if you’re looking for Healthcare IT content on Thanksgiving. We’ll be back with our regularly scheduled content on Monday.

This probably says a lot about me, but I decided to put my oldest child on my oldest blog and so forth down the line based on age of the child and blog. With that alignment, HospitalEMRandEHR.com is host to my third child. Most of you don’t know, that my brother and I have casually been writing a daddy blog called Crash Dad where I refer to my kids as Crash Kids. So, on this blog I want to show some gratitude for Crash Kid #3.
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Crash Kid #3 is an incredible child. In some ways, he’s the black sheep of the family since all of the others got the blonde hair and light skin that you’d expect from my children. Instead, Crash Kid #3 got all the Italian blood from my wife. Yes, that means he’s short and has incredible olive skin, dark hair, and a really amazing personality. He’s also well known for having incredible eyelashes. We actually have a contest on airplanes to see how many people will comment on them. They really are that long and dark and the envy of every woman he meets. He of course wants to shave them off since so many people comment on them. He’s an incredible boy that’s thoughtful, smart, and extremely caring.

I’m so grateful for this sweet boy. He comes home from school almost every day and stops by my home office to give me a hug and tell me that he missed me. There really is nothing sweeter than this in my life. It’s often nice to have that perspective during a challenging day.

Happy Thanksgiving! Who are you grateful for this day?

Healthcare Security is Scaring Hospital CIOs

Posted on November 16, 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.

This post is sponsored by Samsung Business. All thoughts and opinions are my own.

Coming out of the CHIME CIO Forum, I had a chance to mix and mingle with hundreds of hospital CIOs. There was one major theme at the conference: security. If you asked these hospital CIOs what was keeping them up at night, I’m sure that almost every one of them would say security. They see it as a major challenge and the job is never done.

I had more than one CIO tell me that breaches of their healthcare system are going to happen. That’s why it’s extremely important to have a 2 prong security strategy in healthcare that includes both creating security barriers and also a mitigation and response strategy.

One of the most challenging pieces of security identified by these healthcare CIOs was the proliferation of endpoints. That includes the proliferation of devices including mobile devices and the increase in the number of users using these technologies. There was far less concern about the mobile devices since there are some really deeply embedded software and hardware security built into mobile devices like Samsung’s Knox which has made mobile device security a lot easier to implement. The same can’t be said for the number of people using these devices. One hospital CIO described it as 21,000 points of vulnerability when he talked about the 21,000 people who worked at his organization. Sadly, there’s no one software solution to prevent human error.

This is why we see so much investment in security awareness programs and breach detection. Your own staff are often your biggest vulnerability. Training them is a good start and can prevent some disasters, but the malware has gotten so sophisticated that it’s really impossible to completely stop. That’s why you need great software that can detect when a breach has occurred so you can deal with it quickly.

On the one hand, it’s one of the most exciting times to be in healthcare IT. We have so much more data available to us that we can use to improve care. However, with all that data and technology comes an increased need to make sure that data and technology is kept secure. The good news is that many hospital boards have woken up to this fact and are finally funding security efforts as a priority for their organization. Is your organization prepared?

For more content like this, follow Samsung on Insights, Twitter, LinkedIn , YouTube and SlideShare.

Physician Transparency List

Posted on November 4, 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 social media initially started to become popular, a man named Ed Bennet did this amazing job creating a list of hospitals that were doing things on social media (ie. Facebook and Twitter). It was a really incredible look into how hospitals were approaching Twitter and Facebook. At the time, no one knew what they were doing. We were all trying to figure out. It was a dynamic and fun time, but also a bit scary since we were all shooting from the hip.

Over time, most hospitals have adopted a full social media strategy and have professionals that are quite familiar with the options available. Certainly, there are some that execute their hospital social media strategy better than others, but very few hospitals aren’t active in some way on social media.

In typical Ed fashion, he’s moved on from social media and has now created a Physician Transparency List which highlights the ways hospitals are displaying various physician ratings on their hospital website. I love that he calls it a transparency list since so many organizations are afraid of these physician ratings. So, it takes a bit of bravery to be willing to post the ratings on your hospital website.

So far Ed has 35 hospitals on that list, but I believe over the next 3-4 years we’ll see most hospitals doing some form of physician transparency on their hospital website. It very much feels like social media where it started with a few hospitals and then spread to many more.

The reality is that these physician ratings are going to be available to the public. So, why not put them on your hospital website? At least then you control the experience the user has and you can give them the opportunity to engage with you and your organization. In fact, I think that’s where so many hospitals have done a poor job. It’s one thing to display a rating. It’s a whole other thing to create easy opportunities for patients viewing your physicians’ ratings to engage with your organization. It’s such a missed opportunity for most hospitals.

I look forward to seeing Ed’s list continue to grow. Plus, it will be great to see how hospitals are taking advantage of this opportunity to be transparent and engage with patients.

Will Medical Coders Be Needed in the Future? – HIM Scene

Posted on October 26, 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

After spending time with so many HIM professionals at the AHIMA Annual conference, I’ve come back thinking about the future of medical coders. No doubt, many HIM professionals are moving well beyond medical coding into other areas such as healthcare analytics, clinical documentation improvement (CDI), EHR optimization, and much more. However, there’s still a massive need for high quality medical coding and the HIM professionals that provide that service.

As we look into the future, the techie in me feels like medical coding should be automated. Why are we paying people to do medical coding? Why can’t that be automated and be done by robots? It’s not like medical coding is a particularly fun job. I’m sure there are some times it’s fun working on unique cases, but it can be quite monotonous and tedious. Why not have a computer do it instead?

What I’ve learned over the years is that medical coding is more art than it is science. Certainly there are some clear cut cases where it’s basically science. However, a large part of what a coder does isn’t set in stone. There’s some artistic licence if you will, or at least some interpretation that has to happen in order to code a visit properly. Computers aren’t good at interpretation, but humans are.

The other reality is that doctors don’t produce perfect documentation. If they did, then we probably could code a robot to code a patient visit. Since there are nuances to every physician’s documentation, we’re going to need humans that interpret those nuances as part of the coding process. I don’t see this changing in our lifetimes.

One word of caution. Many people fall into the trap that we need automated robot coding to be perfect for it to accepted. That’s just not the case, because human coders aren’t perfect either. In fact, there’s some research that human coders aren’t as good as we thought they were at coding, but I digress. The reality is that automated coding just has to be better than humans, it doesn’t have to be perfect. Even with this said, I don’t see it happening for a while.

What we do see happening now is a collaboration between humans and computers: computer assisted coding. While we don’t have to worry about computers replacing humans in medical coding, we do need to focus on ways that technology can make the work humans do better. That’s a powerful concept that we’re starting to see happen already.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Are CIOs Now Vendor Management Organizations?

Posted on October 21, 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.

Over my past 11 years blogging on healthcare IT, I’ve seen a dramatic shift in the role a CIO plays in healthcare organizations. This was highlighted really well to me in a recent interview I did with Steve Prather, CEO of Dizzion. He commented that hospital CIOs are now mostly vendor management organizations.

I thought this was the perfect way to describe the shift. One challenge with this shift is that many hospital CEOs haven’t realized that this is what’s happening. In many hospital executives minds, the CIO is still generating code, implementing servers, network switches, rolling out desktops, and cabling. In most cases, this couldn’t be further from the truth. Yes, the CIO still has to make sure there’s a high quality network, servers, and desktops, but that does little to describe the work a CIO actually does.

Instead of getting into the nitty gritty, most CIOs have become professional vendor managers. This has become the reality as most of what people think of IT (servers, desktop, networks, email, etc) have become commodity services. There’s very little strategic advantage to do these things in-house. They’ve become such commodity services that it costs much less to outsource many of these services to an outside vendor.

What does this mean for the CIO? Instead of being Microsoft or Cisco certified, they need to be well versed in relationship management. That’s a big shift in philosophy and a very different skill set. In fact, most people who have those type of tech skills and certification are people that can struggle with relationships. There are exceptions, but that’s generally the case. CIOs that can’t handle relationships are going to suffer going forward.

Lest we think that this is a change that’s specific to healthcare, it’s not. This shifting CIO role is happening across every industry. In fact, it highlights why it’s not a bad idea to consider CIOs from outside of healthcare. If you can’t find a CIO who has healthcare experience, you could still find a great CIO from outside healthcare as long as they have the right relationship management skills.

Integrating CDI Efforts Across Inpatient and Outpatient – HIM Scene

Posted on October 19, 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

One of the main topics HIM professionals have been discussing for a couple years is around CDI (Clinical Documentation Improvement). These programs have taken all sorts of shapes and sizes. Some are completely human driven. Others are largely tech driven, but most are a mix of the two. In fact, most CDI programs have gotten quite sophisticated and are really impacting the bottom line of healthcare organizations.

While most healthcare organizations realize that there are benefits to CDI, most of them have restricted these programs to the inpatient environment only. This was illustrated to me really well when I ran into a transcription vendor from India. It was his first time attending AHIMA and he was considering new areas of business including CDI. When we talked about CDI, his first comment was that he’d only ever seen CDI in hospitals, not in the ambulatory world.

While this is the case today, one HIM expert at AHIMA told me that one of the next big frontiers for CDI is going to be outpatient CDI. She went on to tell me that it’s fertile ground that could really benefit every healthcare organization. However, she also suggested that there shouldn’t be two CDI programs: 1 for inpatient and 1 for outpatient. Instead, CDI should be an integrated effort across inpatient and outpatient.

Clinical documentation improvement is only going to become more important in healthcare. Certainly, most CDI projects were started as a way to improve reimbursement. That’s a good goal and a benefit of a high quality CDI project. However, over time CDI is going to become even more important to an organization’s value based reimbursement efforts. In fact, if your clinical documentation isn’t accurate your reimbursement will really suffer. How can you keep a patient healthy if you’ve documented the wrong information for a patient?

How is your organization approaching CDI? Are you doing CDI in both inpatient and outpatient?

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Looking Forward to #AHIMACon16 – HIM Scene

Posted on October 12, 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

As we prepare to head to the 2016 AHIMA Annual convention (see our full list of conferences we attend), we’re excited to talk about how we’re planning to expand HIM Scene to include as many HIM voices and perspectives as possible. HIM Scene will still be hosted here on Hospital EMR and EHR and will still have its own email list where HIM professionals can receive great HIM related content from thought leaders across the industry. However, we’ll be using HIM Scene to share a wide variety of people and perspectives.

The HIM industry is an amazing group of devoted people and that really comes through at every AHIMA annual convention I attend. Plus, HIM has a lot more influence than many people realize. So, we’re happy to do what we can to raise the voices and perspectives of HIM professionals here at HIM Scene.

Looking forward to the AHIMA Annual convention next week in Baltimore, we’re excited to learn about a number of important topics. Here are a few we’ll be sure to report on in future HIM Scene posts:

ICD-10 – A year after implementation, I’m really interested to hear the real stories of how ICD-10 has impacted healthcare organizations for good and bad. I bet there will be a lot of stories that haven’t been shared. I’ll also asking the HIM professionals I meet what they think the impact of the end of the ICD-10 grace period will have on healthcare. I wonder how many will have stories of ICD-10 improving care versus stories of ICD-10 for reimbursement.

Information Governance – This is an eternally hot topic in HIM, but it always continues to evolve. This is particularly true as records have gone electronic. This year I wonder how many people have been involved in some sort of health data sharing project. Information governance can get pretty tricky as healthcare organizations start to share data with each other electronically.

HIPAA Privacy and Security – A really hot topic given all the HIPAA breaches and ransomware incidents in healthcare. I’m sure I’ll find a number of HIPAA privacy officers that will share some good insights into how they’re dealing with these security and privacy challenges. I’m afraid many of them will give me exasperated responses about how their leadership isn’t taking it serious enough.

Informatics – I’ve been really intrigued with HIM’s role in healthcare informatics. Once you dive in, it makes since why HIM would be involved, but I don’t think most people saw that at first. What’s also been interesting to watch is many HIM professionals who’ve kind of shunned their involvement in healthcare informatics. We’ll see if many are still in that position or if most HIM professionals are starting to embrace and participate in the informatics efforts of their organizations.

What hot topics will you be looking for at the 2016 AHIMA Annual Convention? The AHIMA 2016 theme is to “Inspire Big Thinking to Launch Our Future.” We’ll be sure to report back any big thinking we hear from people we meet.

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If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

Honoring the Amazing Work of Dirk Stanley on 9/11

Posted on September 12, 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.

I realize this is a day late, but I try not to work on weekends and so I figured a day late was better than never. Many in the health IT community know Dirk Stanley (check out his CMIO blog) very well, but I have a feeling that most people don’t know the amazing work that Dirk did on 9/11 as a 3rd year medical student. Check out this news report where Dirk recounts the experience:

If any of you know Dirk, this story will likely not come as a surprise. My most common memory of Dirk is him introducing me to some CMIO attending HIMSS for the first time and his sincere efforts to make them feel welcome at the conference. This memory is so vivid for me because it’s happened over and over again. It’s one of the reasons I’m always so excited to see Dirk at conferences. I know I’ll not only get to see him, but also his entourage.

It’s hard for me to believe that 15 years has passed since September 11th. It’s true that I’ll #NeverForget even all this time later. I’m reminded of it every time I see an airplane flying above me. I feel lucky to associate with people like Dirk who made a difference that day in so many people’s lives.