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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?

A Look at the HIM World with Dr. Jon Elion from ChartWise Medical Systems – HIM Scene

Posted on April 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.

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.

Healthcare Scene had a chance to interview Dr. Jon Elion, founder and president of ChartWise Medical Systems where we asked him about some of the big happenings in Health Information Management (HIM) and how world of HIM is evolving. Dr. Elion offers some really great insights into the HIM profession. You can watch the full video interview embedded at the bottom of this post or click on one of the questions below to hear Dr. Elion’s answer to that question.

Find more great Healthcare Scene Interviews.

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

Survey Data on the Healthcare IT Job Market

Posted on March 24, 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.

I’ve been working for a number of years with Pivot Point Consulting, a Vaco Company (previously known as Greythorn) on their Health IT Market Report that looks at the Healthcare IT career space. This year they decided to do a trends edition that took this year’s survey results and compared it with historical data from the past three years which added a new layer of insight to the report.

While at the HIMSS conference, I had a chance to sit down with Ben Weber, Managing Partner, Pivot Point Consulting, a Vaco Company, to talk about their Health IT Market Report and the insights that were gleaned from their survey.

You can find my full video interview with Ben Weber at the bottom of this post or click on any of the links below to skip to a specific topic we discussed:

Be sure to download the full 2017 Healthcare IT Market Report: Trends Edition to dive into the responses to all the questions on the survey. Let us know in the comments what survey results stand out to you.

If you’re searching for a healthcare IT job, be sure to check out the jobs that Pivot Point Consulting has posted on Healthcare IT Central.

Who’s Over MACRA? CIO? COO?

Posted on March 22, 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.

In no surprising way, MACRA is a major topic in pretty much every hospital and health system in the US. There’s a lot of money to be had or lost with MACRA. This is especially true for health systems with a lot of providers. Plus, it sets the foundation for the future as well. I believe MACRA will be as impactful as meaningful use, but without as many incentive payments (chew on that idea for a minute).

As I’ve talked to hundreds of organizations about MACRA, I’ve seen a whole array of responses for how they’re addressing MACRA and who is in charge. Is this a CIO responsibility since MACRA certainly requires EHR and other technology? Is this a COO job because MACRA is more of an operations problem than it is a technical problem? Some might make the case for the CMO/CMIO to be in charge since MACRA requires so much involvement from your providers.

From my experience, the decision usually comes down to choosing between the CIO and the COO, but with input and buy-in from the CMO/CMIO. How the CIO positions themselves will determine if they are over MACRA or not. Some CIOs see themselves as tech people and so they shy away from touching MACRA. Other CIOs see themselves as integral part of their business success and so they want to have MACRA under their purview. Most progressive CIOs that I talk to want the later.

I’m an advocate for a CIO that’s involved in the business side of things. Those CIOs that don’t want this duty are going to miss out on strategic opportunities for their organization. I heard one CIO describe that they viewed their IT organization as Information As A Service provider. Their job as the IT department was just to provide the information from the IT systems to someone else who would deal with the information, the MACRA regulations, etc.

The Information as a Service provider concept has issues on multiple levels. The most important is that if you’re just an information provider, then you lose out on the opportunity to be a strategic part of your organization. However, from a more practical MACRA level, it’s really challenging to provide the right information for MACRA when you’re just an information provider and know little about the regulation. We all know how quickly communication can break down when the person needing the information is disconnected from the people who provide the information and they’re disconnected from the people entering the information.

No doubt a healthcare CIO has to be careful what projects they add to their plate. However, I don’t think MACRA is one of those projects that should be pushed off to someone else. Certainly there can be specific organization cultures where it makes sense for the COO to run things, but I think that should be pretty rare.

How are you approaching MACRA at your organization? Who’s over it? I look forward to hearing your experiences in the comments.

Against Medical Advice – ZDoggMD’s New Show

Posted on March 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.

For those of you reading this that don’t know ZDoggMD, what’s wrong with you? Seriously though, check out some ZDoggMD’s parody videos to see what I mean. Along with making “dope parody videos”, he has just started live streaming a new show he called Against Medical Advice which he streams live each week on the ZDoggMD Facebook page.

Check out the trailer for Against Medical Advice:

I love the goals that ZDoggMD has for the show and he’s such a unique talent so check it out. Against Medical Advice episode 1 and episode 2 are out if you want to see something you’ve never seen in healthcare.

If you’re not a fan of his new show, you’ll probably enjoy this heartfelt parody of 7 Years (A Life in Medicine). It’s a good reminder of the importance of the work we’re doing in healthcare.