Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

Security Issues of Paper Medical Records and Faxes

I loved this tweet. It’s a great reminder that far too often when we look at EHR Implementations we compare it against a world that is 100% and 100% efficient. This is an unfair comparison. Instead of comparing EHR against the perfect world, we need to compare EHR to the alternative. In most cases, we should be comparing the EHR world to the paper chart world. Doing so makes all the difference.

I’ve written previously about this concept when I wrote, It’s Not Like Paper Charts Were Fast. In that instance I was comparing the speed of EHR documentation with paper chart documentation. They’re much closer than we like to remember. In fact, in many cases EHR documentation is much faster than paper charts. Although, critics of EHR prefer to compare the speed of EHR to an automatic documentation world. Unfortunately, the automatic documentation world is still a fantasy. Hopefully that dream eventually comes true.

As the tweet above mentions, the same could be applied to security. No doubt there are security challenges in an EHR world. However, there were and are security challenges with paper charts and faxes as well. For example, there was no good way to audit who accessed a paper chart. That’s not an issue in an EHR world. I could go on and on, but you get the idea.

When evaluating EHR, let’s always remember to compare it to the alternative and not the perfect world that really doesn’t exist.

July 28, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Do Consulting Firms Increase or Decrease Your Bottom Line?

I’ve been learning a lot more about the Health IT and EHR consulting industry as I work with many of them who post jobs on our Health IT job board. In fact, I’ve written previously asking the question, “Are Most EHR Consulting Companies Really Staffing Companies?” The reality is that many of the so called consulting companies out there are much more like staffing companies than they are consultants. It’s just a lot more sexy to call someone a consultant than a temporary staff member. Plus, it’s hard to charge the rates they do as a temporary staff member, but a consultant seems to justify the higher rates.

I should make clear that there’s nothing wrong with this approach to business. Many healthcare organizations need the temporary staff that consulting companies provide. However, it has diluted the term consulting quite a bit in the process.

If you’re looking for a good way to know what type of consulting company you’re working with consider this question: Does the Consulting Firm Increase or Decrease Your Bottom Line?

The reality is that consultants are expensive. It costs money to get someone to come in and share their time and expertise with you. Plus, when you look at how many “billable hours” a consultant has available to them with travel, finding business, etc, they have to charge a premium to make up that time. However, just because something costs money doesn’t mean that it’s not worth it.

If I told you that you could spend $50,000 and you would save $200,000, every one of you would do it. If I asked you if you’d spend $100,000 in order to generate $500,000 in increased revenue you’d all be interested. This is the model a great consultant provides. Sure, the numbers are projections of value and that what makes it difficult. Although, many consultants are hired these days to complete specific tasks as opposed to provide ROI. That’s how you can quickly recognize the difference between a true consultant and a temporary staff.

The challenge consulting companies face is that it’s much easier to prove that tasks were complete. It’s much harder to really impact a company’s bottom line.

July 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

HIPAA Compliant Texting

We’re quickly seeing HIPAA compliant texting as a standard in healthcare. Certainly there are some organizations that are resisting, but I fear for those healthcare organizations that are letting SMS run rampant in their organization. SMS is not HIPAA compliant and so that’s a real risk for an organization that allows it to go on. However, I’m seeing organizations across the country adopting a secure text messaging solution.

I’ve often said that the best way to solve a problem is to make doing the right thing easy or better than doing the wrong thing. This can easily be applied to HIPAA compliant texting. I outlined 11 reasons why a secure text message solution was better than SMS before and one of those reasons wasn’t the fear of HIPAA. Can someone really argue that SMS is better or acceptable?

Besides the argument that secure text messaging is dramatically better than SMS, the great part is that a plethora of secure text messaging solutions are available that are just as easy as SMS. I’m personally bias to docBeat since I’m an advisor to them and they’ve created a really great product. However, there are lots of other dedicated secure messaging companies including TigerText, docHalo, qliqSoft, and many more. Plus, that doesn’t even include large companies like Imprivata who offer Cortext and even athenahealth’s Epocrates has secure text messaging built into their product.

The day will soon come when a hospital gets hit with a HIPAA violation (possibly during a HIPAA audit) and insecure SMS will be the culprit. Considering the advancements in secure text messaging options, hospitals won’t have anywhere to hide. It’s very clear that there are HIPAA compliant options available and so I can’t imagine they’ll be lenient with organizations that aren’t doing something about it.

I’d love to hear your experience with HIPAA compliant text messaging. Do you use it in your hospital? What do you love or hate about it? Are you still using SMS?

July 23, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Do Hospital Leadership Pay Attention to Healthcare Startups?

Today I got the press release announcing the 2014 class of startup companies that will be participating in the New York Digital Health Accelerator (NYDHA) program. I’ll put the list of companies in the 2014 class at the bottom of this post for those that are interested.

While I find all of the various healthcare IT incubator/accelerator programs quite interesting, I wonder how many hospital executives are really paying attention to what’s happening with these companies. My gut feeling tells me that very few of them are watching it at all. The reality is that most of them are so busy with the operational aspects of their business that they don’t have time to look at the latest batch of healthcare IT startup companies. Although, I think this is a mistake since they could learn a lot about trends in the industry by looking at these companies.

However, I think there’s a deeper issue here than them just making the time to look at these companies. The larger issue is that most of these health systems write off the idea of working with these “startup” companies without even taking a look at what they’re doing. I think that this is part of the industrialized thinking that we need to change in healthcare to really improve.

Let’s also not confuse what I’m describing with being wreckless. We have a special duty in healthcare to take care of patients in the best way possible. I think working with healthcare IT startup companies helps us fulfill that duty. Sadly, I think many executives don’t see it that way.

What I think could help these executives is to have a forum where they could easily sort through the latest and greatest of what’s happening. Unfortunately, I don’t think anyone’s created that forum yet.

2014 NYDHA Healthcare Startup Companies
AllazoHealth addresses the problem of medication non-adherence by leveraging existing member data to anticipate which patients will not take their medications to predict how best to effectively influence each patient to take their medication.  (www.allazohealth.com)

Clinigence’s solution—built around clinical data analytics, sematic data aggregation, and predictive modeling—provides real-time clinically-based reports about care gaps which help healthcare providers improve outcomes to proactively address the shift to value-based models and the growing demand for quality patient care. (www.clinigence.com)

Covertix helps healthcare organizations protect and control confidential data shared between patients, healthcare professionals, hospital networks and third party vendors to improve their coordination of care.  (www.covertix.com)

iQuartic’s technology merges, structures and mines EHR, PBM, claims and mHealth data for analytics that inform and benchmark care based on outcomes/best practices and adjusted population.  (www.iquartic.com)

Noom makes software to help people live healthier.  For consumers, the Noom Weight Loss Coach, with over 11 million downloads, coaches users on nutrition and exercise. Noom’s different patient engagement apps are based on its consumer-facing app. (www.noom.com).

Quality Reviews empowers patients through their flagship product, RateMyHospital.com, a real-time, mobile patient feedback tool.  (www.q-reviews.com) 

Sense Health uses mobile technology to build personal connections between providers and high-risk Medicaid patients to improve outcomes and the quality of care.  (www.sensehealth.com)

July 22, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Balancing Operations with Strategic Thinking

One of the biggest challenges I see hospital CIOs facing is trying to balance the operational requirements of their organization with the high level strategic thinking that’s really needed to make an organization effective. I think we all underestimate the operational challenges that most hospital CIOs face. Most health IT organizations are relatively young and were put together at a break neck pace. This provides an exceptional challenge for hospital CIOs.

If all the hospital CIO was tasked with doing was meaningful use of a certified EHR, that could consume all of their time and it would still be a challenge to do it effectively. However, meaningful use is far from the only thing that hospital CIOs are dealing with in their organization.

Meaningful use gets all the press and so we often forget about all of the IT tasks that were originally associated with the office of the CIO. Things like managing the network, the computers, and all the other IT infrastructure has come a long way, but still requires a high quality leader to keep it up to date and working efficiently. A lot of us look at these things as commodities that every organization just has and does. This really discounts the effort and time that’s required to do this effectively.

When considering all these tasks that require the CIO’s attention, it’s no wonder that many don’t have (or don’t make) the time required to think about their organization in a strategic way. I’d suggest two ways that hospital CIOs can spend more time thinking strategically.

First, learn to delegate and trust the other leaders in your organization. This is much easier said than done. In some cases this means changing the leaders in your organization. However, more often it requires a shift in mentality as a leader. Trusting other people is hard, but absolutely necessary for you to make the most as a leader.

Second, schedule time into your calendar for strategic thinking. I assure you that you’ll feel a little odd doing this. It almost feels like you’re cheating your organization to schedule in time to work on the strategy of your organization. However, there’s definitely truth in scheduling. We do what we schedule. Just don’t cheat yourself during that time. It will be really easy for you to fudge that time and work on other things. Turn off the email. Turn off the cell phone if needed and spend the time focused on where you should take your organization.

Finding time and making an effort to not be overwhelmed by operations and think strategically is the very best thing you can do. Don’t cheat yourself or your organization by focusing on the wrong things.

July 7, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Hospital CEO Resigns Over Failed EHR Implementation

The social media world has grabbed on to a story at Athens Regional where it looks like the poorly done Cerner EHR implementation has “forced” the CEO to resign. Before I talk about the story, I’ve been amazed at how many tweets and retweets there have been for this story. It’s like the proverbial rubber neck we all get when we pass a car accident. I guess reading about a CEO resigning over a failed EHR implementation is must tweet HIT.

Getting back to the story, it seems like the real death nail in this hospital CEO’s coffin was when the doctors started dropping their privileges at the hospital. Here’s a quote from the story linked above:

“The Cerner implementation has driven some physicians to drop their active staff privileges at ARMC,” noted the letter. “This has placed an additional burden on the hospitalists, who are already overwhelmed. Other physicians are directing their patients to St. Mary’s (hospital) for outpatient studies, (emergency room) care, admissions and surgical procedures. … Efforts to rebuild the relationships with patients and physicians (needs) to begin immediately.”

The comments on the article are quite interesting with one doctor talking about how doctors were finally taking control and pointing out the harm these EHR systems are causing. Obviously, I think that’s a huge stretch. Uncooperative doctors can contribute to the harm an EHR can cause as much as the EHR software itself. Although there is a subset of doctors that feel like they need to start a revolution against EHR.

The reality is that the job of hospital CEO isn’t easy. That’s why they get paid millions of dollars (at least a lot of them). In fact, leadership in general is not easy. It’s a hard balance to know when you should trust your team and when you need to dig a little deeper and find out what’s really going on. Either way, this story should be a huge warning to hospital CEOs that they better have a deeper relationship with the hospital CIO.

I’m always surprised when a hospital still doesn’t have the hospital CIO as part of the executive team. Going forward, your EHR and other healthcare IT is going to be one of the biggest factors in the success of your organization. This story illustrates that really well.

I think we’d all agree that the number one thing you can do as a leader is make sure you hire and retain the very best employees. This story is a great example of why your EHR and how you implement it matters when it comes to getting and retaining the very best people. Plus, this is only going to become more important as technology continues to improve.

I obviously don’t know the particulars of this specific story. No doubt there are a few hundred views of what happened. Although considering the stories of what’s coming out, I’m guessing there is plenty of blame to go around. The hospital CEO was just the scapegoat for much larger issues.

Let this be a warning to hospital leadership. Make sure you’re paying enough attention to healthcare IT. It’s now an integral part of what you do.

June 5, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Homegrown versus Vendor Supported Order Set Solutions

I was reading through a whitepaper from Elsevier which asks a good question, “Are Your Order Sets in Order?.” The whitepaper discusses a lot of important issues related to order sets including integration with EHRs, order set workflow, evidence based content, regulatory requirements and next generation order set solutions. These are all really important and interesting, but I was intrigued by the discussion of a homegrown versus vendor-supported order set solution.

I’ll admit up front that I’m a strong proponent for a vendor supported order set solution. In the past this might not have been the case because the technology wasn’t there to integrate a third party vendor’s order set solution into a hospital’s technology stack. However, today that’s just not the case.

What I think is happening is that many organizations started doing their own order sets because that was really the only viable option at the time. Plus, there were probably a few that were arrogant about their order sets being better than what anyone externally could create (although, this is probably a much smaller group). Once the cultural of internally created order sets was created, it’s been really hard for organizations to get out of that cultural rut of homegrown order sets.

I think we’re quickly reaching the point where the home grown order set creators just can’t keep up. Plus, in many cases organizations invested in the creation of the order sets, but didn’t put in the proper maintenance expense to keep them up to date.

The order set whitepaper I mentioned says that their survey found 36% of hospitals used vendor supported order sets while 37% used homegrown ones. That only leaves a quarter of hospitals that aren’t using an order set solution. I think that number will continue to decrease as people realize the value of incorporating standardization into their ordering workflow. Plus, I think we’ll see an increase in hospitals using vendor supported solutions as well.

Do you agree or disagree with this prognostication? Where are order sets heading in the future?

May 29, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Healthcare IT Job Corner

If you’re working in healthcare IT and haven’t checked out Healthcare IT Central, I encourage you to do so now. I acquired the site late last year and we’ve been growing it to be the leading source of health IT jobs and health IT professionals. Plus, if you’re looking for a health IT job or a better health IT job, it’s free for you to register and post your resume. Plus, you don’t even have to register to search through the healthcare IT jobs that companies like Dell and Beacon Partners and First Choice Professionals have posted. In fact, here’s a list of some of our top health IT job searches:

Along with a great health IT and EHR job board, Healthcare IT Central also has a resume database (close to 12,000 active health IT professional resumes) and a great health IT career blog.

On the healthcare IT career blog, we sometimes feature jobs like we did with this Wanted: Healthcare Consulting Senior Principal – Optimization. Plus, I’m sure many of you will love the Dear Cassie series we’re doing. In fact, if you have health IT career questions you’d like answer, let me know and I’ll work with Cassie to get you an answer.

Finding the right health IT professionals to work on your team is still one of the most important thing you can do in any organization. Plus, it’s a real challenge in this highly competitive market. Hopefully the resources above will help those searching for talent and those searching for health IT jobs.

May 14, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.

Reducing Lab Errors

If you love the lab, then you should subscribe to Lab Soft News. Bruce Friedman does a really amazing job covering the LIS environment and often touches on EHR and EHR integrations as well. That’s how I discovered him many years ago (I think we’ve been blogging for about the same number of years).

Bruce’s post about laboratory errors is a good example of the amazing content he shares. He quotes an ECRI Institute report that has some eye opening statistics:

While participating hospitals attributed 25% of the errors to the lab, researchers found that only 4% of potentially harmful errors occurred in the lab. Specifically, researchers determined [that] [n]early 75% of errors occurred in the pre-analytic stage (when tests were selected, ordered, identified, and transported); and about 22% of errors occurred in the post-analytic stage (when tests were interpreted, reported, and stored)

Although, the money quote from his article comes at the end:

The notion of “breaking down silos” in hospitals to reduce preanalytic and postanalytic errors referred to in the excerpt above is easier said than done. I was in charge of the phlebotomy team for a number of years. In one case, I worked with the nursing service to effect a small change in the nursing procedure manual regarding the inspection of a patient ID bracelet prior to the labeling of a blood specimen. Everyone involved agreed that the change was necessary and appropriate but it took about six months to make the change in the nursing procedure manual. Lab test reporting these days has also been made much more complicated with the deployment of EHRs such that some changes require software rather than procedural modifications.

We’ve talked about EHR change and how hard it is to change before. This is another illustration of that challenge.

What I love most about the statistics above is that it reminds me that we are often looking in the wrong place to solve the problem. You’d think to solve lab errors you’d start in the laboratory, but the stats above show how important it is to look outside the lab to solve lab errors.

This reminds me of my article on the real cause of hospital readmissions. It brings me back to the constant need to analyze what’s really causing the problems. It’s really easy to get stuck doing what we’re use to doing. We need to step back and reevaluate our perspective sometimes.

May 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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.