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Can We Learn Collecting System Data from How We Collect Medical Device Data?

We’ve been aggregating and sharing medical device data for a really long time in healthcare. Entire corporations are built around collecting and sharing medical device data with another healthcare IT system. If we’ve been able to share this data for so long, could we possibly learn from that experience and apply it to data collection and sharing in other health IT systems?

This is an open question which I hope you’ll join in answering in the comments of the blog. Many readers of this blog are more expert on this topic than I am. So, please chime in and add your thoughts. I think there is a real opportunity for us to learn from the past.

Here are a few of my thoughts:

Motivation – This is the biggest reason that medical device data collection and sharing happened. Organizations saw the value in having this data. I think we’re starting to see a shift in motivation when it comes to collecting system data in a healthcare organization as well. As I wrote about previously, we need data sharing as part of the Health IT procurement process. This will be a slow but important shift for many healthcare organizations. Otherwise you have lethal contracts that put huge financial barriers in the way of sharing data. ACOs and value based reimbursement will continue to motivate organizations to finally want to collect and share system data.

Standards – One of the benefits that device integration had was that there was more of a standard format for sharing the data. This is a lesson for other data system collection. We need a standard. Not a bunch of different flavors of standards, but a standard.

Multiple Standards – Some in the device space might argue that they had their own issues with standards. Every device company had their own standard and you had to integrate with each different device company. This depends on the device, but let’s just assume for a minute that this is indeed the case. How then were these organizations able to collect the medical device data? They just built up interfaces that understood each device’s standard. The key is that each company established a standard for their clinical device and stuck to that standard.

The challenge with other healthcare systems like EHR is that we have so many systems. Plus, even instances of the same EHR don’t follow the same standard. I’m not sure how to remedy this in the current EHR market, but it might be the key to us ever really collecting EHR data. I guess some would argue that market consolidation will help as well.

Connected Tech – One of the biggest challenges in the medical device space was having the technology in the medical device that allowed outside connectivity. Most new medical devices come with connectivity, but in the past you’d have to buy the connectivity separately and store it in a black box under the bed. This is a huge advantage for other healthcare IT software. The data is already connected to the internet.

Those are a few of my thoughts on what we can learn. I’d love to hear your thoughts.

April 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Data Liberation Is The First Step Towards True Collaboration

I generally agree with this idea. It’s really hard to collaborate with someone if you’re not sharing the data about a patient. So, data liberation can be a true enabler for collaboration.

While I think most hospital CIOs will agree with this, I wonder how many act like data liberation is an important strategy for them. Is data liberation really a core value of their hospital organization? My guess is that for most of them it is not.

One major place they can start to make this part of the culture is in the procurement and contracting process. Software vendors are going to happily keep the data as closed as possible unless you require it of them in the contract stage. Once hospital systems make data liberation part of the IT systems procurement process, then we’ll finally be able to see the benefits of data liberation.

The problem we have today is that data liberation and sharing wasn’t part of the previous procurement and contracting process. My guess is that most assumed that being able to share data would be allowed, but few people looked at the fine print and realized what it would mean to them when it came to data sharing. Thus, we’re in a situation where many organizations have contractual issues which make data sharing expensive.

It will take a cycle of new contracts for this to be fixed, but even then it won’t be fixed if you’re organization doesn’t add this to their agenda. Software vendors happily provide the customer what they demand. We need more hospital organizations demanding data liberation.

April 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

ED Alerts Help Health Plans Cut Costs

As readers of this publication know, many hospitals are interested in participating in HIEs, but are buried in projects already and not so sure the investment will pay off.  But here’s an instance where a very modest HIE application helped a health plan save real money in just six months without having to do an expensive buildout.

According to iHealthBeat, a new study by the Agency for Healthcare Research and Quality has found that simply sending near real-time alerts to health plans when a member is admitted to the hospital ED could help the health plan save money and get patients into primary care.

To do the study, Indiana Health Information Exchange programmers developed an application which sent daily alerts about health plan members who visited EDs at nine Central Indiana hospitals. As part of the pilot, the alerts were sent to the participating health plan within 24 hours. The health plan then used this data to replace non-urgent ED visits with primary care visits, iHealthBeat reports.

During the six-month pilot, the health plan was able to reduce nonemergency ED visits at participating hospitals by 53 percent; the same time primary care visits among plan members jumped to 68 percent during the pilot period.

The bottom line in all of this was that after using the daily updates to guide patient behavior, the health plan was able to save $2 million to $4 million over six months. While I could be wrong, I don’t believe there are many test cases out there that can demonstrate the effectiveness of hospital to plan communication and brag of this much success.  While this isn’t exactly an argument for all hospitals to have HIEs, this does suggest that shared, timely information on important patient behaviors can be extremely valuable.

February 4, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

NYC Health Systems Get $7M To Share Data

Seven New York City health systems have gotten a delayed Christmas present — a $7 million grant designed to encourage data sharing initiatives and improve patient recruitment for clinical trials. The primary goal of the project is to use evidence-based research to help patients make good decisions about their healthcare.

The funding comes from a group known as the Patient-Centered Outcomes Research Institute, or PCORI. PCORI, which will create a clinical data research network in NYC, has already created 29 such networks across the nation, according to Healthcare IT News.

These networks, collectively, will form PCORnet, a $93.5 million patient-centered research initiative. The New York City Clinical Data Research Network (NYC-CDRN), a  consortium of 22 regional organizations, will work together to develop systems supporting data networking efforts and advance patient-centered research, Healthcare IT News reports.

NYC-CDRN will kick off their efforts by identifying patients with diabetes, obesity and cystic fibrosis. It will then partner with patients and clinicians by creating disease-specific community groups.

The NYC-CDRN network will connect medical records for 6 million New York City residents, then anonymize the records, and over the next 18 months, will work to standardize the data. Ultimately, the goal is to allow patients and providers to have access to evidence-based information they can use to make smart healthcare choices.

This should be an interesting project to watch over the next year and a half. PCORI is doing a lot of forward-thinking work with its money, including $5 million to the NIH for a tool called PROMIS designed to help with comparative effectiveness research. PROMIS has existed since 2004, but PCORI is now helping it move forward, making the $5 million in funds available  in research grants up to $500,000 for projects up to two years in length.

January 29, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Do Hospitals Care About Blue Button?

Jennifer Dennard has been doing a series of blog posts detailing her “Blue Button Patient Journey.” It’s a really insightful look from the patients viewpoint about how Blue Button and patient engagement with their medical records is doing.

My gut reaction when I read that post by Jennifer was that is all felt way too complex with so little value to the patient. Which of course led me to the conclusion that patients aren’t going to do this.

If patients don’t care about Blue Button, is there any reason we should believe that hospitals are going to care about Blue Button? I think we all know the answer to that question.

It would be interesting to go around the hospital and ask people what they thought of Blue Button. I have a feeling hospital employees answers would be more like a Jay Leno “Jaywalking” video than an deep explanation of Blue Button.

Of course, I’m sure that hospitals will be adopting Blue Button more and more. However, most of the people in the hospital won’t know that it’s happening. They’ll just be Blue Button enabled by default when they implement their EHR’s patient portal. Maybe that’s not such a bad thing.

Think about how beautiful it will be to have all of your healthcare data Blue Button enabled. It could open up some really interesting possibilities. In fact, if those in the hospital knew about the data being available through Blue Button they might try and stop it from happening. Freeing healthcare data is a good thing and Blue Button is one step towards freeing the data.

Once those in the hospital realize the health data has been available to patients through blue button all along, then they’ll realize that giving patients their health data won’t cause the universe to implode. Hopefully by then we’ll have some really great applications doing beautiful things with all that blue button data.

January 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Kaiser Permanente Branch Joins Epic Network

Though it apparently held out for a while, Kaiser Permanente Northern California has signed on to Epic Systems’ Care Everywhere, a network which allows Epic users to share various forms of clinical information, Modern Healthcare reports.

Care Everywhere allows participants to get a wide range of patient data, including real-time access to patient and family medical histories, medications, lab tests, physician notes and previous diagnoses. The Care Everywhere network debuted in California in 2008, and has since grown to a national roster of more than 200 Epic users.

Many of the state’s major healthcare players are involved, including Sutter Health, as well as prominent regional players such as Stanford Hospital and Clinics, USCF Medical Center and UC Davis Health System, according to Modern Healthcare. Kaiser Permanente Southern California also participates in the network.

According to Epic, the Care Everywhere system allows patients to take information with them between institutions whether or not both institutions use the Epic platform. Information can come from another Epic system, a non-Epic EMR that complies with industry standards, or directly from the patient.

But of course, the vendor likes to see Epic-to-Epic transmission best, as it notes on the corporate site: “When an Epic system is on both sides of the exchange, a richer data set is exchanged and additional conductivity options such as cross-organization referral management are available.”

Care Everywhere also comes with Lucy, a freestanding PHR not connected to any facility’s EMR system. According to Epic, Lucy follows patients wherever they receive care, and gathers data into a single source that’s readily accessible to clinicians and patients. Patients can enter health data directly into Lucy or upload Continuity of Care Documents from other facilities.

While connecting 200+ healthcare organizations together is a notable accomplishment, Care Everywhere is not going to end up as the default national HIE matter how hard Epic tries. As long as the vendor behind the HIE (Epic) has a strong incentive to favor one form of data exchange over another, it cuts down the likelihood that you’ll have true interoperability between these players. Still, I’ve got to admit it’s a pretty interesting development. Let’s see what healthcare organizations have to say that try to work with Care Everywhere without owning an Epic system.

P.S. It’ll also be interesting to see whether Epic is actually “best” for ACOs, as a KLAS study of a couple of years ago suggested. More recent data suggests that best-of-breed tools will be necessary to build an ACO, even if your organization has taken the massive Epic plunge.

December 26, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Challenges of Interoperability in Healthcare

At AHIMA’s annual conference, I had a chance to sit down with Steve Bonney, VP of Business Development and Strategy at BayScribe. In this video interview, Steve and I discuss the challenges of getting structured data in healthcare and how you can use good technology to get the healthcare data without disrupting the physician workflow. Steve also discusses some of the benefits of having interoperable data in healthcare. Then, I ask him if Meaningful Use is going to make structured, interoperable data a reality.

If you’re interested in healthcare data exchange or interoperability, then you’ll enjoy this video.

December 5, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Will the Future of Healthcare Be Data Driven?

The past couple days I’ve had a the opportunity to interact with many of the top healthcare professionals in New York City at the Digital Health Conference. As I think back on the many talks I’ve heard at the event or had with attendees I’m struck by the power that data can hold for healthcare.

Whether we’re talking about the SHINY HIE which will exchange the healthcare data across the state of NY or if we’re talking about the multitude of sensors that are collecting more data than we can process, it’s becoming quite clear to me that healthcare is heading towards a very data driven world. Soon the day will come when very little is done in healthcare without consulting the data. Although, most of that “consultation” will just happen seamlessly as part of the process.

Most doctors already do this today, but on a much smaller level. A doctor consulting a paper chart as part of the care is a doctor looking at the data before providing care. Now imagine that times a million. That’s where we’re headed.

This was really driven home after Jim Messina’s keynote today. In his keynote, he talked about the detailed ways he and the Obama campaign used data to target their efforts. I can’t do his talk justice in this post, but the way he was able to use data to look at the population was remarkable. We need to apply that to healthcare as well.

I’m not talking some pie in the sky “big data” project that so many like to espouse. I’m talking about using the data to really change people’s lives.

I think a lesson can be learned from Jim Messina. He said that for the first year or two they really struggled with these efforts. My guess is that they were still gathering the data sources and trying to find the meaning in the data. The point is that it wasn’t an overnight thing. It took them time, effort, and focus to finally get their arms around the data in a way that they could benefit from it.

Although, Jim Messina’s efforts had one thing that seems to really be lacking in healthcare: a clear goal. Jim Messina had a clear goal of getting Obama reelected. Everyone knew and understood that goal. We need a similar clear goal in healthcare. I think that goal should be: better quality care at lower cost. The challenge is that this goal goes against some of the economic realities for many institutions. However, for those organizations looking long term, nothing will benefit them more financially than reaching this goal.

November 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Judy Faulkner Interoperability Chart

Farzad Mostashari shared the following tweet which includes a picture of the growth in standards-based exchange per Judy Faulkner.

Here’s a blown up version of the chart (click on the image for an even larger version):
Epic Data Sharing Chart

As Farzad notes in the tweet, the patient records exchanged per month is now up to 1.25 million. It’s also worth noting that the red bar in the chart is exchange of records from Epic to Epic. The Green bar in the charts is from Epic to Non-Epic. I hope that green bar continues to grow since as the chart displays, that’s a definite shift in strategy for Epic. Let’s hope this shift continues until the data in healthcare is available where it’s needed when it’s needed.

September 18, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Survey: CIO Pay Isn’t Keeping Up With Responsibilities

With EMRs, ICD-10, HIEs and countless additional technical responsibilities being heaped on the head of healthcare CIOs, one would think that they were paid well for their trouble.  And in most cases, they are.  But a new survey suggests that healthcare CIO pay isn’t keeping up as their responsibilities grow, according to Healthcare IT News.

The survey, by retained executive search firm SSI Search, points out that healthcare reform and the HITECH Act of 2009 have but previously unheard-of pressures on CIOs and IT teams to handle major technology changes and new requirements, “arguably some of the greatest changes to impact modern healthcare in America,” SSI said.

According to SSI Search’, which surveyed 178 respondents,, the typical healthcare CIO these days is a well-educated male who has served in the CIO role for 10 years.  Specifically, 82 percent of respondents were male, 97 percent have a college degree and 61 percent have a master’s degree, Healthcare IT News reports.

Total compensation for these CIOs ranged widely, from less than $125,000 to more than $724,000 per year, Healthcare IT News notes.  But that compensation didn’t track closely with the level of responsibility these CIOs are taking on, the study found. Thirty-eight percent of CIOs reported having an increase in compensation of 10 percent or less over the past four years, SSI concluded.

It’s not that we should feel sorry for these CIOs who, after all, make far more  than most average Americans. But it’s worth noting that their already overloaded plate is having even more piled on it these days.  Whether it’s reflected directly in their compensation or not, CIOs deserve acknowledgement that their very tough job is getting tougher.

For what it’s worth, CIOs seem more or less content with their pay, with more than half reporting that their current compensation is “good – in line with expectations.”

September 5, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.