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Looking forward to the CHIME Fall Forum

Posted on October 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.

Tomorrow I’ll be heading to the CHIME Fall Forum. It’s the premiere meeting of healthcare CIOs. I love the opportunity to sit down with CIO’s and talk about what’s happening with them. The event is in San Antonio, so let me know if you’ll be there so we can meet and say hi.

I think the topics are going to be pretty predictable at the event. I’m sure there will be plenty of meaningful use and ICD-10 discussions, but I think that analytics and what they’re doing with it will also be extremely popular. I’m also interested to hear what people are doing as far as security and privacy. Things like the Bash vulnerability were a major deal and I’ll be interested to see if people really dealt with it appropriately. I’m afraid I’ll meet some who ask me what vulnerability I’m talking about. That will be sad, very sad.

What do you think are the hot topics in healthcare IT? I’m interested to know if these hospital CIOs can focus on anything but the regulatory related projects. If they are, I’ll be interested to hear what projects they are taking on next. Are they doing secure text messaging? Are they focused on revenue cycle? What about patient engagement?

The battle to stay on top of everything that’s happening in healthcare IT never ends. I’ll be interested to hear where the battle is heading next. If you have thoughts, I’d love to hear them in the comments.

The Changing Health IT Consulting Job Market

Posted on October 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 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.

Cassie Sturdevant has a great post up on Healthcare IT Today titled “The New Health IT Consulting Skill Set.” In the post, she talks about the changing Health IT market for consultants. She’s absolutely right that between 2010-2012 it was a white hot market and that the market has since cooled down. As she mentions, that means that clients can be much more selective in who their hire. Then, she outlines a few ways to differentiate yourself as a consultant:

  1. Operations or Clinical Background
  2. Communication Skills
  3. Multi-Faceted Knowledge

Those are some good suggestions and if you read the full article, you can find more details from Cassie on each suggestion. If I were to summarize Cassie’s suggestions, it would be that healthcare organizations will need someone with a much deeper knowledge of EHR and Healthcare IT than they had to have previously.

As I look at the healthcare consulting market going forward, I see two major areas of opportunities: EHR switching and EHR optimization.

EHR Switching – Since the majority of hospitals have now implemented some form of EHR, the new EHR implementation market is drying up. However, that’s not to say that we won’t see a lot of new EHR purchases. These new EHR Purchases will instead be hospitals that are buying a new EHR. This EHR switching takes a lot of effort and skills to do it properly. Plus, it takes an organization that has a deep understanding of both the legacy and new EHR software. Watch for the EHR switching to really spike post-meaningful use.

EHR Optimization – This is a really broad area of work. However, so many of the EHR implementations were done on shortened timelines that almost no EHR optimization occurred during the implementation. This presents a major opportunity. Every organization is going to be looking for ways that they can extract more value out of their EHR investment. Consultants that have deep knowledge about how to get this value will be in high demand.

It’s still an exciting time to be in healthcare IT with lots of opportunities. It’s not the gold rush that it was, but there is still plenty of opportunity to do amazing things with an organization’s healthcare IT.

If you’re looking for a healthcare IT job, be sure to check out these Health IT company job postings:

If your organization is looking for some healthcare IT talent, check out our Healthcare IT central career website.

Is Healthcare So Distracted by the Trees That We Can’t See the Forest?

Posted on October 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 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 was listening to a healthcare IT professional talk recently about the challenges they face in the trenches. In a somewhat exasperated way they said more or less that “We have to be careful that we don’t get so distracted by the trees that we can’t see what’s happening with the forest.

What an amazing insight! As a healthcare IT professional, it’s really easy to get bogged down in the operational day to day requirements. Whether you’re dealing with meaningful use requirements, prepping for ICD-10, upgrading your EHR software, managing your patient portal, updating your CDS rules, or any of the myriad of regular IT support like desktop replacements, network upgrades, firewall management, etc etc etc, it’s easy to get bogged down in this more operationally focused work. How many healthcare IT professionals keep an eye on what’s happening with healthcare in general?

Unfortunately, I think far too many of them are completely overwhelmed with operations. Most of them don’t realize the movement towards a more engaged patient. A lot of them don’t know about the shifting reimbursement towards a new value based reimbursement model. Most are up to date on the ICD-10 delays, but few understand if the ICD-10 delays are a good or a bad thing for healthcare.

In some ways, that’s not a terrible thing. There’s a real power in being focused on the project at hand and executing it at the highest level possible. Especially if you have a great leadership organization that’s keeping a keen eye on macro healthcare trends that need to be considered by your hospital.

However, even the very best leaders can learn and benefit from a highly involved workforce that understands not only the immediate operational needs of the organization, but that also have a broader understanding of why certain projects matter to an organization in the bigger picture. There’s nothing more challenging to a leader than to push forward a project which isn’t understood as being important by their staff.

Like in most things in life, it takes balance. Finding that balance in your organization can provide some amazing results.

Video Interview with John Halamka, CIO at Beth Israel Deaconess Medical Center

Posted on October 10, 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 happened upon a really laid back interview by CXOTalk with John Halamka, CIO at Beth Israel Deaconess Medical Center and a bunch of other things (see the list at the bottom of this post). John Halamka has been doing this for a long time (20 years at Beth Israel Deaconess Medical Center) and so he has some interesting perspectives. Plus, he’s put himself out there all over the place including participation in the meaningful use committees.

Here are some great lines from the interview:
“There’s no problem that can’t be blamed on IT.”

“You should never go live based on a deadline. You go live when the product is ready or the people are ready to use the product.”

“If you go live too early, no one will ever forget. If you go live too late, no one will ever remember.”

Check out the full video for other interesting insights into healthcare IT and John Halamka:

John D. Halamka, MD, MS is Chief Information Officer of the Beth Israel Deaconess Medical Center, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.

What Can We Expect with Meaningful Use Stage 3?

Posted on October 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 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 incomparable John Halamka, CIO of Beth Israel Deaconess Medical Center and Co-Chair of the HIT Standards Committee, has a good post up on his blog talking about the future of standards, certification and meaningful use stage 3. Here’s one excerpt about MU stage 3 and EHR certificaiton:

Meaningful Use Stage 3 regulations are currently in draft and will be released as NPRM before the end of the year. My hope for these regulations is that they will be less prescriptive than previous stages, reducing the burden of implementation for providers and vendors.

It’s purely my opinion, but I’m optimistic that simplification will happen, given that the 2015 Certification Rule is likely to decouple Meaningful Use and certification. Certification is likely to be incremental year to year without the tidal wave of requirements we’ve seen in the past. Certification of health IT (not just EHRs) will be with us for a long time and may be leveraged by more programs than just the EHR incentive programs. Imagine that modules for patient generated data (such as wearables), health information exchange (HISPs), and analytics services (such as those used for care management by ACOs) could be certified and used in any combination to achieve outcomes.

I’m really hopeful that Halamka is right and that MU stage 3 will be dramatically simpler. However, in government work, I’m rarely confident that something will be simple. In fact, his comments about ongoing certification are sad too. Anyone who’s had to work with supposedly certified CCD documents from multiple EHR vendors that should be “standard” knows what I mean. Because of examples like this, I’m not a fan of government certification setting the standard, but Halamka might be right that they may use EHR certification to try.

What will be interesting to me is what motivation organizations will have to continue on with meaningful use stage 3. The EHR incentive money will be gone. Certainly the EHR penalties are a pretty sizable motivation for many organizations. Although, probably not as sizable as many think when you compare it against even the MU 2 burden (another reason why MU 3 needs to be simpler). Also, I still wouldn’t be surprised if we had an ICD-10 Delay-esque move by the AMA or some other healthcare organization to remove the EHR penalties. It will be a little harder since the penalties are hard revenue that has to be accounted for, but don’t put it past a good lobbyist.

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.