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Hospital to Turn Off EHR Access for Doctors Who Haven’t Finished ICD-10 Training

Posted on July 27, 2015 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 article is pretty shocking. I can imagine how well this would go over at most hospitals. I hope we get to hear how well this strategy works and who will win what appears like a game of chicken between the doctors and hospital. Does the hospital need the doctors more or do the doctors need the hospital more?

Here’s an excerpt from the article linked above that describes what they’re doing:

“There is a ‘go live’ date for these changes that is Oct. 1 for everyone across the country, including us, so we felt it was very important that all medical providers be trained,” Groves said. “We set a date of July 27, which is Monday — if they have not done the training by then, their access to Soarian will be cut off.”

If they don’t have access to the EHR, that’s basically saying that a doctor can’t practice at that hospital, no? It’s interesting that access to the EHR is being used as essentially revoking privileges to be a doctor at a hospital. I can hear many doctors initial reaction being that they didn’t want to access the EHR anyway. Although, it’s a lot more complex than that response would describe. Can you practice medicine at a hospital that has an EHR without having access to the EHR? I believe the answer is no unless the hospital makes some extraordinary concessions to a doctor (not likely to happen in the hospital mentioned above).

What do you think about using EHR access as a way to motivate doctors to do something? Is that a good strategy? Will we see it happen more?

ICD-10 – Is Your Hospital Ready?

Posted on July 22, 2015 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.

There’s been some interesting ICD-10 news coming out lately. It make sense since we’re just over 2 months from the October 1st implementation date. I recently made the case that there will be no more ICD-10 implementation delay now that AMA and CMS have joined together. I think that’s the best assurance we can get that ICD-10 will go forward with no more delay. Although, I’m sure that many hospitals will still play Russian roulette and hope for another delay. I think that’s a dangerous strategy.

For those people that still think ICD-10 is a joke (and there are plenty of funny codes), Jennifer Della’Zanna did a good job looking at the “funny ICD-10 codes” and providing some perspective. My biggest takeaway from her analysis is that there have been funny ICD-9 codes and we didn’t make a big deal out of it. Why are we making a big deal out of the rarely used “funny” codes in ICD-10?

Leave it to Brad Justus to put the funny ICD-10 codes in perspective with a little humor:

What are you doing to get prepared? Have you checked with your software vendors? Do you know that they’re really ready or just gotten lip service? Not all ICD-10 implementations are created equal. Will your payers be ready? Do you have an ICD-10 claim monitoring service so you can know which payers aren’t ready on go live date? How’s your ICD-10 training going for your doctors, billers, etc?

I believe that ICD-10 is on its way. Is your hospital ready? Sadly, I think many hospitals won’t wake up to ICD-10 until October 1st. It’s not going to be pretty at those organizations.

New Merit Based Incentive Payment System (MIPS) Whitepaper

Posted on July 20, 2015 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’m not sure why MIPS (Merit-based Incentive Payment System) doesn’t seem to have gotten more attention, but for those not familiar with MIPS, it’s the law that was put in place as apart of the replacement to SGR. What does that mean? MIPS is going to be the framework that’s used to switch from a fee for service based reimbursement environment to a value based care model. Short Story: MIPS is going to be very important to the future of healthcare!

Jim Tate just put out a whitepaper he recently created that covers the details of the MIPS program. If you’re not familiar with what was signed into law, Jim’s whitepaper will be a good place for you to start. Here’s a small section of the whitepaper which will give you a feel for the MIPS program:

Under MIPS, high-performing providers will be rewarded and low-performing providers will be penalized. It is designed to strengthen, incorporate, as well as consolidate the financial impacts of the MU of CEHRT, PQRS, and VBM programs. The current incentive programs will be combined and a composite threshold performance score (scale 0-100) will be established aimed at informing providers of the levels of reimbursement based on four key performance measures: resource use, MU, quality, and clinical practice improvement activities.

There are four performance categories for deriving a provider’s potential annual score (0-100 points) for MIPS: 25 points for the MU of CHERT, 15 points for clinical practice improvement, up to 30 points for VBM-measured quality and 30 points for the VBM-measured resource use. The details for the MIPS program will be determined by CMS. 2017 will be the first MIPS performance year and those scores will lead to potential payment adjustments in 2019.

Check out Jim’s whitepaper for a lot more details. You can be sure we’ll be talking a lot more about MIPS in the future. Understanding MIPS is going to be extremely important for every healthcare organization. Get ready to put together whole teams of people to make sure you understand MIPS and are able to comply.

Why Should You Invest in Health Information Governance?

Posted on July 14, 2015 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.

Hospitals are becoming large data centers of health information. In some ways, they’ve always been the storage facility of health information, but how we store, transfer, access, and share health information is dramatically changing in our new digital world. Plus, the volume of information we collect and store is expanding dramatically. This is why health information governance is becoming an extremely important topic in every hospital.

In order to better understand what’s happening with health Information Governance, I sat down with Rita Bowen, Senior Vice President of HIM and Privacy Officer at HealthPort, to talk about the topic. We shot these videos as one long video, but then chopped them up into shorter versions so you could more easily watch the ones that interest you most. You can find 2 of the videos below and 3 more over on EMR and HIPAA.

Who Should Manage Information Governance at Healthcare Organizations?

Why Invest in Health Information Governance?

Finding New People on Healthcare Social Media and The Power of Showing Gratitude

Posted on July 13, 2015 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 know that many in healthcare aren’t sure how to get started with social media. The reality is that Twitter is not very fun until you’re following 50-100 smart people that share interesting content, tweets, images, and videos. Once you do that, your entire Twitter experience changes because it’s a great font of learning and connection.

In case you don’t read one of my other blogs, EMR and HIPAA (and if you don’t why don’t you?), we recently announced the #HIT99. For those that don’t want to click into the post, you can basically include the hashtag #HIT99 in a tweet along with someone you want to nominate for the #HIT99 and why you’re nominating them. You can see that a lot of #HIT99 nominations have occurred.

For those of you new to social media, following people nominated to the #HIT99 is a great way for you to discover smart, interesting people in healthcare IT. Follow 50-100 people nominated and you’ll start to love Twitter and all you learn on it. The #HIT99 is a smorgasborg of social media discovery and connection. Finding new, interesting people to follow is always a treat. The #HIT99 provides the perfect opportunity to find and connect with new people you’d have never “met” otherwise.

Of course, if you’re already on social media, there’s a lot more to the #HIT99 if you participate. The #HIT99 asks that you mention why you’re nominating someone. These displays of gratitude are powerful for you and the person receiving it. Even if you don’t want to participate in the #HIT99, think about doing something similar using whatever medium you prefer. It’s a powerful idea that will reap major rewards for everyone involved.

I look forward to many in the Hospital EMR and EHR community participating in the #HIT99. In case you need an example, here’s a nomination that I sent (and is a great person to follow):

Let’s let the social media connection and gratitude flow! We can use more of that in this world.

Hospitals Are Shifting from A Factory Business Model to A Retail Business Model

Posted on July 10, 2015 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 talking with Medhost CEO, Bill Anderson, and he commented to me that hospitals thought they were running a factory, but they’re now running a retail business. When he said it, it really hit me that he’s right. We’re going through this massive change in healthcare that is analogous to us changing from a factory model to a retail business.

I’m sure the comparison isn’t perfect, but from a pricing structure it’s similar for sure. When you look at the fee for service world you can definitely see how healthcare was a factory. Its job was to take in as many patients as possible and spit them out the other end. That’s a bit of a harsh statement for many of the amazing and caring people in healthcare, but from a business perspective that’s pretty close to the reality. In fact, if it weren’t for the thousands and thousands of amazingly thoughtful and caring people in healthcare it would be much worse.

However, with the changes in reimbursement that have started to come and will continue to come, we’re asking healthcare organizations to convert from the factory business model to a more retail approach to medicine. One that focuses on the patient experience as opposed to putting as many patients through as possible. This is a huge shift in mindset.

From a technology perspective, this is going to be a very good thing. The only way to scale up the care provided a population is through technology. A doctor can’t be the end all be all to every patient. However, technology can help them focus on the patients that need them most. Technology can facilitate timely communication with large populations with the single click (or even no clicks).

This transition won’t be easy and it won’t be a simple plug and play technology in most cases. However, it’s going to drastically change the business of healthcare over the next 5-10 years. What are you doing to prepare for this change?

Hiring Motivated People and Inspiring Them

Posted on July 8, 2015 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 found this great leadership quote on LinkedIn that was shared by Shanthi Iyer:
Leadership Quote

This is some really great advice to hospital CIOs as they approach hiring at their hospital or health system. Hiring motivated people and inspiring them is a great way to lead an organization. You’d think that inspiring people in healthcare wouldn’t be hard. However, it’s amazing how quickly people can become disillusioned with what’s happening in healthcare IT. Government regulations aren’t usually inspiring.

With that said, all of us in healthcare should be inspired by the possibility that we can save lives. I know that many doctors scoff at the idea that a technology person could have that kind of impact, but we absolutely can. No, we don’t get our hands bloody as we stitch up a patient after surgery. However, we can create systems that make the doctors better and prevent mistakes that would happen otherwise.

Of course, if we’re going to take on the opportunity to save lives we have to also take on the responsibility that if we do our job poorly we can actually damage lives. Both sides of the coin are equally important. Certainly that’s inspiration enough for everyone in healthcare. However, a great leader finds ways to casually remind staff of this vision. That’s the challenge a healthcare CIO faces. Luckily, if you hire motivated people and inspire them, you’ll be amazed by the results.

RAC Audits Infographic

Posted on July 6, 2015 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.

RAC audits have quickly become a reality in every hospital system. Plus, the costs of managing these audits is increasing for many hospitals. HealthPort has put out this RAC Audits Infographic that highlights some of the trends with RAC audits.

The Year of Audits Infographic.Rev1.6.11.15

Needless to say, managing these RAC audits effectively is going to be extremely important to a health system going forward. From the AHA RACTrac survey which was the source for the infographic it says that “53% of all hospitals reported spending more than $10,000 managing the RAC process during the 4th quarter of 2014, 32% spent more than $25,000 and 8% spent over $100,000.”

What’s even more interesting is that HealthPort notes that many of the other payers are starting to make similar audit requests to measure the acuity of new patients entering the health system thanks to Obamacare (ACA). As this increases, the financial implications continue to increase as well.

What are you doing to make sure your RAC audits and other similar audits are managed effectively?

8 Biggest Epic Price Tags in 2015

Posted on July 3, 2015 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.

Akanksha Jayanthi from Becker’s Hospital Review has aggregated a list of Epic purchases in 2015. The article does make the disclaimer that some hospitals and health systems have not yet disclosed the price of their Epic purchase. So, there are likely more Epic purchases. However, the Becker’s list gives you some insight into how much it costs to purchase Epic.

  • Partners HealthCare: $1.2 billion
  • Lehigh Valley Health Network: $200 million
  • Mayo Clinic: “Hundreds of millions”
  • Lahey Hospital & Medical Center: $160 million
  • Lifespan: $100 million
  • Erlanger Health System: $97 million
  • Wheaton Franciscan Healthcare: $54 million
  • Saint Francis Medical Center: $43 million

This list isn’t surprising for me. In fact, the most surprising part is that Epic would sell a $43 million implementation. That would have previously been unheard of from Epic. However, we’ve seen Epic moving slowly down the chain. I’m not sure if that’s because the top of the chain has dried up or something else, but Epic has definitely been doing smaller implementations which they wouldn’t have considered before.

What should also be noted is that many of these numbers are estimates. With projects of this size, it’s really easy for the cost of the EHR implementation to balloon out of control. In fact, the Partners HealthCare Epic implementation at the top of the list is a great example. It was originally estimated at $600 million and you can see that estimate has doubled.

When you look at these numbers, is it any surprise that investors want to take down Epic? I’d like to see a list of the Epic renewal prices. Can you imagine what the Epic renewal for Kaiser’s $9 billion Epic EHR implementation will be? That’s where the opportunity lies for someone wanting to disrupt Epic.

How Much Time Do You Spend Cleaning Your Data?

Posted on June 29, 2015 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 recently came across this really great blog post talking about data scientists wasting their time. Here’s a quote from the article (which quotes the NYT):

“Data scientists, according to interviews and expert estimates, spend 50 percent to 80 percent of their time mired in [the] mundane labor of collecting and preparing unruly digital data, before it can be explored for useful nuggets.”
– Steve Lohr, NYT

Then, they have this extraordinary quote from Monica Rogati, VP for Data Science at Jawbone:

“Data scientists are forced to act more like data janitors than actual scientists.”

Every data scientist will tell you this is a problem. They spend far too much time cleaning up the data and they all wish they could spend more time actually looking at the data to find insights. I’ve seen this all over health care. In fact, I’d say we have more data janitors than data scientists in healthcare. Sadly, many healthcare data projects clean up the data and then don’t have any budget left to actually do something with the data.

The solution to this problem is easy to write and much harder to do. The solution is to create an expectation and a culture of clean data in your organization.

I predict that over the next 5-10 years, healthcare data is going to become the backbone of healthcare data decision making. Those organizations that houses are a mess are going to be torn down and sold off to the hospital that’s kept a clean house. Is your hospital data clean or dirty?