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Predicting Readmissions, Longitudinal Record, and Physicians’ Time

Posted on May 12, 2017 I Written By

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

Here’s a quick look around the Twittersphere and a few topics that stood out to me that I think might be of interest to you.


I’ve been following algorithms like this for a while and they’re really starting to come into their own. This type of predictive technology or predictive analytics if you prefer is going to really change how we manage patients in a hospital. If done right, it can help us become proactive instead of reactive. This will require us to change a lot of processes though.


Is a longitudinal health record possible in any format? I’m beginning to think that it’s a pipe dream that will never happen. At least not with our current documentation requirements.

I find time studies like these very interesting. However, the thing I hate about them is that we don’t have a time study from before implementing EHR software so we could compare how a physician used their time before EHR and after. No doubt over 50% of their time being spent on documentation and not face-to-face with the patient feels bad. However, how far off was this from where we were in the paper world?

Looking at the chart, prescription refills can be faster in an EHR. Secure messages can be faster with an EHR since you’re not playing phone tag which was the process before secure messages. Telephone encounters were likely the same. That leaves just the progress notes as the one thing that could be more time consuming in an EHR than the paper chart. How much more is the real question. Paper chart progress notes weren’t all that fast either. That’s why stacks of paper charts that weren’t completed were always sitting on physicians’ desks.

I guess the core question I would ask is, “Are EHRs the reason doctors hate medicine, or are the ongoing regulations and requirements that have been heaped on doctors the real problem?” My guess is that all this documentation overheard that’s being required of doctors was a problem in the paper world, but has been exacerbated in the EHR world. What do you think?

2 Core Healthcare IT Principles

Posted on May 10, 2017 I Written By

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

One of my favorite bloggers I found when I first starting blogging about Healthcare IT was a hospital CIO named Will Weider who blogged on a site he called Candid CIO. At the time he was CIO of Ministry Health Care and he always offered exceptional insights from his perspective as a hospital CIO. A little over a month ago, Will decided to move on as CIO after 22 years. That was great news for me since it meant he’d probably have more time to blog. The good news is that he has been posting more.

In a recent post, Will offered two guiding principles that I thought were very applicable to any company working to take part in the hospital health IT space:

1. Embed everything in the EHR
2. Don’t hijack the physician workflow

Go and read Will’s post to get his insights, but I agree with both of these principles.

I would add one clarification to his first point. I think there is a space for an outside provider to work outside of the EHR. Think of someone like a care manager. EHR software doesn’t do care management well and so I think there’s a space for a third party care management platform. However, if you want the doctor to access it, then it has to be embedded in the EHR. It’s amazing how much of a barrier a second system is for a doctor.

Ironically, we’ve seen the opposite is also true for people like radiologists. If it’s not in their PACS interface, then it takes a nearly herculean effort for them to leave their PACS system to look something up in the EHR. That’s why I was excited to see some PACS interfaces at RSNA last year which had the EHR data integrated into the radiologists’ interface. The same is true for doctors working in an EHR.

Will’s second point is a really strong one. In his description of this principle, he even suggests that alerts should all but be done away within an EHR except for “the most critical safety situations. He’s right that alert blindness is real and I haven’t seen anyone nail the alerts so well that doctors aren’t happy to see the alerts. That’s the bar we should place on alerts that hijack the physician workflow. Will the doctor be happy you hijacked their workflow and gave them the alert? If the answer is no, then you probably shouldn’t send it.

Welcome back to the blogosphere Will! I look forward to many more posts from you in the future.

Technology and Healthcare Cartoons – Fun Friday

Posted on May 5, 2017 I Written By

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

After Elon Musk’s announcement of NeuraLink Corp which is working to merge the brain with artificial intelligence, this cartoon seemed like the perfect addition to our Fun Friday series of funny blog posts to get you started on your weekend:

Once we’re tapping into the brain, that brings security questions to a whole new level. I agree with The Verge that we’re still probably further away from this than Elon Musk would like to make us think.

Here’s another cartoon that extrapolates the use of technology in healthcare in a funny way:

While this likely feels like quite a stretch, it may not be as far fetched as it may seem. When you combine 3D printing with robotic surgeries, the concept isn’t as crazy as it reads in a cartoon. I always love it when something that seems like a joke becomes a reality.

What Kind of User Experience Are You Offering Patients?

Posted on May 3, 2017 I Written By

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

Centric Digital put out a look at the User Experience Trends we should expect in healthcare in 2017. Check out their findings:

*Click on the image to see the larger version.

The summary on the image offers some great insights for hospitals and healthcare organizations as they consider their patient experience plans:

“In 2017, we’ll likely see increases in mobile-first & user-centered design, deep personalization, and conversational AI elements (e.g., bots) implemented across a range of sites for greater engagement.”

How’s your hospital doing at these items?

My guess is that most hospitals are not on trend. I wonder if hospitals even know what mobile-first is and how many have rolled out a mobile-first experience for their patients. My guess is that most hospitals have looked at their website on mobile and possibly implemented a responsive website.

Going beyond that, how many hospitals have created user-centered design. There’s a simple test to know if you’re focused on the user or not. Go to your hospital website and evaluate whether your website encourages engagement or whether your website discourages engagement by users. The reality is that most hospital websites discourage engagement.

We don’t even need to start down the road of discussing deep personalization and conversational AI elements. Let’s start with a mobile-first user centered design and then we can talk about the deep personalization and conversational AI that could benefit your hospital.

While I find these trends interesting, I don’t think I agree with Brenda who shared the image above that these will be the trends for 2017. This sounds more like where the cutting edge organizations are innovating as opposed to the industry trends.

How’s your organization doing in these areas? Are you offering these kinds of user experience to your patients?

Fear of Failure in Healthcare

Posted on May 1, 2017 I Written By

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

Healthcare has a culture where the expectation is that you should never fail. Because of this culture we often take too long to adjust and change. This fear of failing at something new often causes is to keep sub optimal situations that impact our patients in negative ways. Doing nothing can often have worse impacts than doing something that goes wrong.

I love the quote that Jared Johnson shared above “Too often we ask, “What if this goes wrong?” instead of, “What if this goes RIGHT?””

This is a powerful idea that many in healthcare need to learn. We’re too afraid of something going wrong that we don’t even think about all the things that could go right if we changed a process, changed a policy, implemented a new piece of technology, etc. You know you have this problem in your organization if you’ve ever asked why something is done that way and they say “It’s just how we’ve always done it.”

While it’s easy to blame the culture of healthcare for this problem it is something we can overcome. Or I should say that it is something a courageous healthcare leader can overcome. This culture all comes from the leaders who don’t frown upon employees who make mistakes, but instead reward those who take a risk that could be extremely beneficial to patients and the organization.

Courageous leaders are ones that aren’t afraid to do what’s right for patients even if it puts themselves at risk. This is not an easy thing to do. It’s always easier to go with the safe, reliable, “nobody gets fired for doing…” approach that’s so common in healthcare. It’s much harder to take a patient point of view and say that I’m going to do what’s right for the patient even when it might buck the organizational culture.

It’s time healthcare leaders fearlessly embraced changes that will improve healthcare. Yes, that will mean some risk of things going wrong. However, the best leaders mitigate the risks as much as possible, but focus on the positive benefits that will come when everything goes right.

Diving Into Population Health

Posted on April 21, 2017 I Written By

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

Population Health is a nebulous term that seems to be applied a lot of different directions. To get a better understanding of what’s happening with Population Health, Healthcare Scene sat down with Arthur Kapoor, President and CEO of HealthEC. HealthEC has been working in healthcare and the population health space for more than 24 years, so they have an interesting perspective on how that space has evolved over the years and where we are today.

You can watch the full video embedded below, or skip to any of the following population health topics we discussed with Arthur:

Utilizing data to understand and better serve populations is only going to become more important in healthcare. A big thanks to Arthur for sharing his insights with us.

If you liked this video, be sure to subscribe to Healthcare Scene on YouTube and watch other Healthcare Scene interviews.

The Disconnect Between Patient Experience and Records Requests – HIM Scene

Posted on April 19, 2017 I Written By

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

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.

This week I met with one of the digital marketing team at a children’s hospital. We had a great conversation about the hospital website and the way the hospital’s website represented the organization to the patient. Plus, we talked about how patients choose to interact with the hospital through their website. There are a wide variety of patient requests through the website, but one of those requests was a request for their patient record.

It wasn’t really a surprise that this digital marketer didn’t really know the details of what’s required for a patient to make an appropriate medical record request from his hospital. In his defense, he didn’t usually answer the questions, but just created the website that collected the questions. However, it was quite clear that the workflow for any medical records request was to send it to their HIM department and let them figure it out.

Most organization then have their HIM staff play phone tag with the patient to explain how to make a proper records request which will allow them to release the information to the patient. The progressive organizations might send the patient an email. However, many of them will then ask the patient to mail, drop off or fax in the official records request. If this sounds painful, I can assure you that it’s as painful as it sounds.

This illustrates the massive disconnect between creating a great patient experience and most organization’s current records request process. Please note that I’m not blaming the digital team at hospitals for the issue and I’m not blaming the HIM people for this problem. I’m blaming the disconnect between the two organizations because the only way to solve this problem is to have both organizations involved.

The best patient experience would actually be for the patient to go to their patient portal and download their whole record. Maybe we’ll get their one day, but there are hundreds of systems in a hospital where a patient’s data is stored. So, it’s going to take a while for us to reach the point where a patient can self-service their data requests.

Since I’m not holding my breath on this amount of data sharing happening between disparate systems, I’m more interested in making the current processes so it’s a seamless experience for the patient. If you can model a medical records request on paper, then you can do it digitally. To their credit, I’ve seen a few organizations working on this. In fact, their system is part education about records requests and part getting the information that’s needed to fulfill a records request.

It’s time that HIM and a hospital’s digital and tech teams come together to make the process for requesting records a seamless patient experience. And if you think using a fax machine is a seamless experience for patients, then you’re part of the problem.

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

Is There a Case to Be Made that Interoperability Saves Hospitals Money?

Posted on April 17, 2017 I Written By

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

Back in 2013 I argued that we needed a lot less talk and a lot more action when it came to interoperability in healthcare. It seemed very clear to me then and even now that sharing health data was the right thing to do for the patient. I have yet to meet someone who thinks that sharing a person’s health data with their providers is not the right thing to do for the patient. No doubt we shouldn’t be reckless with how we share the data, but patient care would improve if we shared data more than we do today.

While the case for sharing health data seems clear from the patient perspective, there were obvious business reasons why many organizations didn’t want to share their patients health data. From a business perspective it was often seen as an expense that they’d incur which could actually make them lose money.

These two perspectives is what makes healthcare interoperability so challenging. We all know it’s the right thing to do, but there are business reasons why it doesn’t make sense to invest in it.

While I understand both sides of the argument, I wondered if we could make the financial case for why a hospital or healthcare organization should invest in interoperability.

The easy argument is that value based care is going to require you to share data to be successful. That previous repeat X-ray that was seen as a great revenue source will become a cost center in a value based reimbursement world. At least that’s the idea and healthcare organizations should prepare for this. That’s all well and could, but the value based reimbursement stats show that we’re not there yet.

What are the other cases we can make for interoperability actually saving hospitals money?

I recently saw a stat that 70% of accidental deaths and injuries in hospitals are caused by communication issues. Accidental deaths and injuries are very expensive to a hospital. How many lives could be saved, hospital readmissions avoided, or accidental injuries could be prevented if providers had the right health data at the right place and the right time?

My guess is that not having the right healthcare data to treat a patient correctly is a big problem that causes a lot of patients to suffer needlessly. I wonder how many malpractice lawsuits could be avoided if the providers had the patients full health record available to them. Should malpractice insurance companies start offering healthcare organizations a doctors a discount if they have high quality interoperability solutions in their organization?

Obviously, I’m just exploring this idea. I’d love to hear your thoughts on it. Can interoperability solutions help a hospital save money? Are their financial reasons why interoperability should be implemented now?

While I still think we should make health data interoperability a reality because it’s the right thing to do for the patients, it seems like we need to dive deeper into the financial reasons why we should be sharing patient’s health data. Otherwise, we’ll likely never see the needle move when it comes to health data sharing.

How Much Does Healthcare Consumerism Matter to Hospital CIOs?

Posted on April 14, 2017 I Written By

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

Today I was greeted on Facebook with a quote from an interview the always wonderful Kate Gamble did with Michael Marino, Chief of IS Operations at Providence St. Joseph Health.

Patients don’t just want “the Marcus Welby experience anymore,” says Michael Marino.
“They want care where they want it, when they want it, how they want it.” The challenge? How to enable that without overburdening clinicians.

I found this evaluation to be spot on. It’s great to know that Michael Marino understands what patients want. However, he also understands how challenging it is going to be provide patients what they want.

The reality is that the system wasn’t set up to provide care “where they want it, when they want it, how they want it.” This is going to require a dramatic way in how we think about care and how we provide that care.

However, the 2nd part is the key point. How do we make this change without overburdening physicians. If the solution overburdens physicians, then it’s unlikely to happen. They’ll kick against the change and patients won’t get the change they desire.

There are simple, win-win solutions out there. Take for example a secure text with your patients with a picture attached. This can be a really efficient way for a doctor to interact with the patient. It can save the doctor and the patient time. It can discover issues earlier than if the patient waited for the next office visit. In some cases, it also frees up the doctors time to do a higher paying office visit.

How many hospital CIOs think about this shift in healthcare consumerism? My guess is that many are so overwhelmed by things like EHR complaints and cybersecurity challenges that most aren’t giving much of a 2nd thought to the shifting patient dynamics. Most of them have an idea that things are changing, but I imagine that most haven’t invested time and money in a way that will prepare them for this shift.

What’s your experience? Are hospital CIOs spending time on these changes? Should they be spending time on healthcare consumerism? What are the consequences if they don’t?

EHR Implementation Accomplished – What’s Next?

Posted on April 12, 2017 I Written By

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

When you look at the world of hospital and health system EHR implementations, it’s fair to say that we can say Mission Accomplished. Depending on which numbers you use, they are all in the range of about 90% EHR adoption in hospitals. That’s a big shift from even 5-10 years ago when it comes to EHR adoption in hospitals. It’s amazing how quickly it shifted.

While it’s easy to sit back and think “Mission Accomplished” the reality is that we still have a LONG way to go when it comes to how we use the EHR. Yes, it’s “Mission Accomplished” as far as getting EHRs implemented. However, it’s just the start of the mission to make EHRs useful. I’d suggest that this is the task that will take up CIOs time the most over the next 5 years.

I think that most people looking at their EHR think about next steps in two large baskets:EHR Optimization and Extracting Value from EHR Data.

EHR Optimization
Most EHR software was slammed in so quickly that it left the users’ heads spinning. Hospitals were chasing the government money and so there was no time to think how the EHR was implemented and the best way to implement the EHR. We’re paying the price for these rushed EHR implementations now.

What’s most shocking to me is how many little things can be done for EHR end users to make their lives better. Many EHR users are suffering from poor training, lack of training, or at least an ignorance to what’s possible with the EHR. I’ve seen this first hand in the EHR implementations I’ve done. I know very clearly that a feature of the EHR was introduced and the users were shown how to do it and 6 months later when you show that feature to them they ask “Why didn’t you teach us this earlier?” Although, they then usually sheepishly say, “Did you teach us this before? I don’t remember it.” At this point it’s not about who we blame, but is about ensuring that every user is trained to the highest degree possible.

The other EHR optimization that many need is an evaluation of their EHR workflow. In most EHR implementations the organization replicates the paper processes. This is often not ideal. Now that the EHR is implemented, it’s a great time to think about why a process was done a certain way and see if there is a different workflow that makes more sense in the digital world. It’s amazing the efficiency you will find.

Extracting Value from EHR Data
As I just suggested, most EHR implementations end up being paper processes replicated electronically. This is not a bad thing, but it can often miss out on the potential value an EHR can provide. This is particularly true when it comes to how you use your EHR data. Most hospitals are still using EHR data the way they did in the paper world. We need to change our thinking if we want to extract the value from the EHR data.

I’ve always looked at EHR data like it was discovering a new world. Reports and analysis that were not even possible in the paper world now become so basic and obvious. The challenge often isn’t the reporting, but the realization that these new opportunities exist. In many cases, we haven’t thought this way and a change in thinking is always a challenge.

When thinking about extracting value from the EHR data, I like to think about it from two perspectives. First, can you provide information at the point of care that will make the patient care experience better for the provider and the patient? Second, can you use the EHR data to better understand an address the issues of a patient population? I’m sure there are other frames of reference as well, but these are two great places to start.

EHR Optimization and creating value from EHR data is going to be a great thing for everyone involved in healthcare and we’re just at the beginning of this process. I think it’s a huge part of what’s next for EHR. What’s your take? What are your plans for your EHR?