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Where Do We See the Latest Startup Methodology in Healthcare IT?

Posted on September 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 13 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.

I’ve been spending the day at the Intelligent Insite Build conference in beautiful Fargo, ND. I’ll be on stage later to talk about what’s happening with Healthcare IT. However, the past day at the conference I’ve been really intrigued by the company culture that exists at Intelligent Insites.

While I do almost all of my work in Healthcare IT, I also have a foot in the vegas tech startup world as well. As part of that and my love of tech, I’m always interested in startup culture and the latest trends in startup company creation. What I didn’t expect was to find these startup culture concepts in full bloom in Fargo, ND. I guess I should have known that the Internet and social media were spreading these ideas everywhere. Even in Fargo and even in Healthcare.

Just to share a few examples. It was great to see the whole Intelligent InSites team training on lean startup methodology. The extreme customer service focus is another example. I also loved the way the company has integrated itself into the local startup company ecosystem. I’m sure this is just touching the surface, but is a clear sign of the startup culture they’ve created.

What’s a little surprising to me is that I don’t know of other hospital IT companies that exhibit a similar culture. I’d love to hear if you know of others.

My guess is that we don’t hear about them more in hospital IT because hospitals have a general fear of the “startup” idea. The hospital culture is a no risk culture and the startup culture is seen as one of risks.

What hospitals don’t understand is that a startup is about some business risk, but not patient risk. The former can be a challenge for some organizations, but that’s a risk with organizations of all sizes. A large organization could just as easily cut that department. Plus, a well capitalized startup company is just as stable or more stable than a large company. The patient risk shouldn’t be a concern with a well run startup company.

We need to embrace more of the creativity that startups can bring to an industry. Healthcare can use a bit more creativity.

Where Do You Want to Go?

Posted on September 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 13 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.

Our hospital’s a lot like Alice in Lewis Carroll’s classic Alice’s Adventures in Wonderland? You may remember that Alice comes to a crossroads with two paths before her, each stretching onward but in opposite directions. She is confronted by the Cheshire cat, of whom Alice asks, “Which path shall I follow?”

The cat answers: “That depends where you want to go. If you do not know where you want to go, it doesn’t matter which path you take.

I’m afraid that many hospital IT organizations are very much like Alice. They’re so distracted by the operational challenges they face that they don’t really have a good understanding of where they’re going. This is a tremendous problem because it starts to compound itself.

An organization without a steep sense of direction will waffle and go any direction. This will lead to your best employees leaving for greener pastures. No direction and loss of your best people is a recipe for disaster for any organization.

I recently heard that Marc Andreessen’s (created first widely used web browser) personal mantra is “Often wrong but never in doubt.” I’m still chewing on whether I agree with this approach to leadership, but at least there’s no doubt about where a leader like Marc wants to go. There’s power in all team members rowing in the same direction. Even if you have to change course along the way, you’re still getting somewhere. Everyone rowing in different directions just makes you go in circles.

Does your hospital IT organization have a good vision of where they want to go?

The Forgotten Pieces of Healthcare IT

Posted on August 27, 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 13 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.

I’ve obviously been thinking a lot lately about the rest of the healthcare IT world beyond EHR software. We’ve had such a focus on EHR software, that we’ve forgotten a lot of other IT projects that need attention. I saw a quote recently that a CIO is no longer just managing the IT infrastructure. I believe that’s spot on.

A hospital CIO needs to be an integral part of the business decisions of their organization. You can’t buy a few hundred million (or a few billion) dollar EHR and not think that it won’t have a major economic impact on your organization. However, while a hospital CIO needs to do more than just IT infratructure, they still have to do the IT work as well.

I was thinking about all of the various IT projects that a hospital CIO could still be managing:

  • Internal Network
  • External Internet Connection
  • Firewalls
  • Data Center (this could be a few hundred things in itself)
  • Servers/Virtualization
  • Desktops (virtual or otherwise)
  • Mobile Devices (cell, tablets, etc.)
  • Telephony
  • Identity Management
  • Email
  • Shared Drives
  • Printers
  • Scanners
  • Biometrics

I’m sure I’m leaving some obvious ones off. Please add to the list in the comments. However, even just looking at this is pretty overwhelming. Luckily, most hospital CIOs have a lot of people helping them support all of these efforts. However, each one needs to be considered and managed.

Take a simple example like email. You’d think we’d have it down to a science and we kind of do. However, if you host it in house, you have to constantly stay on top of it, update the software, manage mailbox sizes, spam filters, etc. Whether you outsource your email or keep it in house you also have to manage all the account creation and deletion. You have to provide ongoing help desk support and training.

The point I’m trying to make is that each one of these technologies has its little nuances. It takes time and effort to do them well. Unfortunately, many of them have been transgressed as the all hands on deck EHR efforts have occurred. Now we’re heading back to clean up these messes. Looking at the list above, there are a lot of possible messes waiting for a hospital CIO.

The Place of EHR in the Hospital IT Ecosystem

Posted on August 20, 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 13 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.

I’ve been thinking a lot about EHR software and the part it plays in the hospital IT ecosystem. The $36 billion of EHR stimulus money has shined a big light on EHR software. No doubt the EHR incentive money has increased EHR adoption, but at what cost. I wonder if the EHR incentive money has caused many hospital IT teams to place undue emphasis on the EHR software.

The reality of a hospital IT ecosystem is that they usually have hundreds of healthcare IT systems in their organization. The EHR is just one of those systems. In fact, it might not even be the largest system. Their ERP system (usually Peoplesoft or SAP in large hospitals) could be larger. However, try being system #90 at a hospital. Do you think the IT people at a large hospital system are paying much attention to what’s happening to that system? Not only are they distracted chasing the EHR incentive money, but even without that incentive there are 89 other systems in front of it.

I’m reminded of this Healthcare CIO Mindmap that I posted previously. It’s a great image of the amazing complexity that a healthcare CIO is facing. Each of the branches on that mindmap represent one or more IT systems that have to be managed by an organization. That’s a complex and challenging task.

I guess my message here is that while the EHR is extremely important to an organization, don’t lose track of all the other healthcare IT systems you support. They won’t likely be noticed in the short term, but transgressing these smaller health IT systems will create organizational debt that will be hard to overcome in the future.

Security Issues of Paper Medical Records and Faxes

Posted on 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 13 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.

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.

Do Consulting Firms Increase or Decrease Your Bottom Line?

Posted on 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 13 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.

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.

HIPAA Compliant Texting

Posted on 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 13 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.

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?

Do Hospital Leadership Pay Attention to Healthcare Startups?

Posted on 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 13 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.

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)

Balancing Operations with Strategic Thinking

Posted on 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 13 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.

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.

Hospital CEO Resigns Over Failed EHR Implementation

Posted on 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 13 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.

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.