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Will How Well You Document Determine Your Quality Ranking?

Posted on March 6, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We all know that the best doctors in the world are determined by how well that doctor documents the visit.
-Said No Doctor Ever!

Seriously, it’s an absurd claim that the quality of a doctor’s documentation would be how we rank the quality of a doctor. I’m sure just reading the headline probably pissed you off. I was upset just typing it. We all know that there are a lot of great doctors who are really awful at documenting. We know there are some awful doctors that’s documentation looks beautiful.

Since we all know this is the case why would I ask the absurd question about a doctor’s documentation determining their quality rating? Because I can see a path where we head this direction.

Yes, it’s scary to consider, but that’s why it’s so important that we consider it. I think this could be the impact of the quality reporting scores that come from MACRA/MIPS/APMs. It seems like it’s only just a matter of time before these scores will hit the Physician Compare website.

Don’t be surprised if they’re also made publicly available so that every health rating site on the internet pulls them down from CMS and uses them as one more factor in how they determine the highest quality doctors. If you don’t believe this will happen, then you haven’t followed what they’ve done with other CMS data.

Remember that these websites don’t have to have actual quality data. They just have to show the perception of quality data. Most consumers aren’t smart enough (or diligent enough) to know the difference. In fact, CMS itself calls it quality data, so they’ll be able to use that word freely. Imagine the doctor who gets ranked lower because their MIPS quality score was lower or non-existent because they have a small Medicare population or because they chose not to participate in the program. This is not a far fetched idea and is a fear I’ve heard from many health systems.

It’s too bad we don’t have a real way to measure quality. Then, we’d all want that data to be shared. However, I’m close to the conclusion that you can’t truly measure clinical quality. At least not in any scalable way. I’m hoping one day we’ll get there, but I don’t see it happening anytime soon. Until then, companies will use whatever perception of quality they can find and many high quality doctors will suffer because of it.

Honoring the Amazing Work of Dirk Stanley on 9/11

Posted on September 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I realize this is a day late, but I try not to work on weekends and so I figured a day late was better than never. Many in the health IT community know Dirk Stanley (check out his CMIO blog) very well, but I have a feeling that most people don’t know the amazing work that Dirk did on 9/11 as a 3rd year medical student. Check out this news report where Dirk recounts the experience:

If any of you know Dirk, this story will likely not come as a surprise. My most common memory of Dirk is him introducing me to some CMIO attending HIMSS for the first time and his sincere efforts to make them feel welcome at the conference. This memory is so vivid for me because it’s happened over and over again. It’s one of the reasons I’m always so excited to see Dirk at conferences. I know I’ll not only get to see him, but also his entourage.

It’s hard for me to believe that 15 years has passed since September 11th. It’s true that I’ll #NeverForget even all this time later. I’m reminded of it every time I see an airplane flying above me. I feel lucky to associate with people like Dirk who made a difference that day in so many people’s lives.

Value Based Reimbursement: Another Challenge for HIM Professionals

Posted on August 3, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

How many times have you heard something along these lines: “HIM professionals must stay relevant and current with the continuous healthcare changes.” I must sound like a broken record to my team but it is absolutely true! HIM professionals provide the bridge between clinical data and reimbursement methodologies through CDI, coding, documentation integrity, and health data analytics to name a few. It has been proven time and time again that these HIM skills are vital to healthcare organizations but these skills must also be adapted and be put to good use each time a new guideline or rule is introduced.

Value-Based Reimbursement is an area that continues to grow with the push for quality patient outcomes and healthcare savings with potential penalties for excessive costs and poor quality of care. Reimbursement incentives that are tied to quality of care make perfect sense and HIM professionals need to take the plunge into these initiatives. By marrying departments and cross-functioning teams, we are able to generate proactive data and improve performance.

At my facility, I oversee the HIM department as well as the Quality department because we work closely together and will continue to have an even closer relationship throughout healthcare reform. This is becoming very common in the industry.

In this roundtable article for the Journal of AHIMA, we each outlined how we are bringing HIM to the table for Value Based Reimbursement initiatives and maximizing the tried and true skills of HIM professionals.

I have said it before and I will continue to say it: Always keep your finger on the pulse of healthcare and stay relevant by taking on these new challenges!

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

Health IT Software Must Be Meaningful and Pleasurable

Posted on April 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the most dynamic healthcare CIO’s is Shafiq Rab, MD, MPH, Vice President and CIO at Hackensack UMC. Healthcare Scene was lucky enough to talk with him at the DataMotion Health booth during HIMSS 2016. Dr. Rab talked with us about Hackensack UMC’s approach to healthcare IT innovation. He offered some great insights into how to approach any healthcare IT project, about Hackensack University Medical Center’s “selfie” app, and their efforts to use Direct and FHIR to empower the patient.

I love that Dr. Rab leads off the discussion with the idea that healthcare IT software that they implement must be meaningful and pleasurable. Far too many health IT software miss these important goals. They aren’t very meaningful and they’re definitely not pleasurable.

Dr. Rab’s focus on the patient is also worth highlighting. Health IT would be in a much better place if there was a great focus on the patient along with making health IT software meaningful and pleasurable. Thanks Dr. Rab and DataMotion Health for doing this interview with us.

The “Feature List” Disconnect from Healthcare Problems

Posted on April 22, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the big takeaways coming out of the Healthcare IT Marketing and PR Conference is that most health IT companies are still spouting out the features they offer and very few actually talk about the problems they solve. This is a huge mistake for a health IT company, but it’s also a big reason why most hospital executives don’t want to hear from you.

As a healthcare executive you’re inundated with marketing and sales pitches and after a while they all start to look the same. Plus, many (some might say most) of those pitches require the hospital executive to try and translate a long list of features into the problems that executive is trying to solve. It’s no wonder that most hospital executives barely look at these pitches and often aren’t aware of the opportunities for innovation that exist for the problems they’re trying to solve.

Think about how many healthcare IT companies could list the following set of features in their sales and marketing:

  • Data Analytics
  • FHIR Enabled
  • HIPAA Compliant
  • EHR Integration
  • Machine Learning
  • Mobile Optimized
  • Real Time Processing
  • etc

I could keep going on, but you get the point. I’m reminded of something Shahid Shah said at our session at HIMSS. No one in healthcare has an interoperability problem. His point isn’t that interoperability isn’t important or valuable. His point was that no one is trying to solve interoperability. They have other problems they are trying to solve and data sharing (ie. interoperability) might be the solution. However, when they think about their problems and challenges interoperability is not on that list.

Hospital systems definitely have plenty of problems they’re trying to solve. Here’s just a few examples to give you a flavor of problems hospital executives are working to solve:

  • Improving HCAPHS Scores
  • Reducing Hospital Readmissions
  • Improving Provider Efficiency
  • Ensuring Accurate Patient Identification
  • Lowering Sepsis Numbers
  • etc

This list never ends. These are problems that hospital executives are working to solve and understanding which problems are vexing a hospital executive is key to getting them interested in the solutions. I think this small change would make it so hospital executives dread the wave of marketing and sales pitches a little less. The reality is that most of these executives are looking for great solutions. It’s just often hard for them to know what problems your company can really solve.

Of course, the next challenge is showing proof of your ability to solve the problem. However, at least that gets a hospital executive one step closer to finding solutions to their problems and challenges.

Future Ready Technology and Data Discussion at the Dell Healthcare Think Tank

Posted on March 11, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m lucky enough to be heading to the SXSW conference again this year. I’m excited to see what interesting things are being said and done at a conference like SXSW. The broad variety of people that attend SXSW provide unique insights and perspectives that you often can’t find at other conferences. I’m sure I’ll be doing a post or two about the things I find at SXSW. Let me know if there’s something I should see while I’m there.

During SXSW I’m also going to slip away from the SXSW activities in order to take part in the Dell Healthcare Think Tank event (not associated with SXSW). I believe this is the 4th year I’ve been able to participate in the event and Dell always does a great job bringing together amazing people to talk about the challenges of healthcare IT. This year I expect no different.

The great part of the Dell Healthcare Think Tank event is that the full event is live streamed for free online so you can watch the discussion no matter where you’re at on Tuesday March 15th from 1-4 PM CT. Plus, the #DoMoreHIT hashtag on Twitter will be extremely alive during the Think Tank event. So you can follow along and even add your own comments and questions on the hashtag as you participate in the event from wherever you might be. Don’t be surprised if we bring up a Twitter comment on the live stream.

This year Dell has done a great job bringing together a diverse panel from many parts of healthcare and I’m especially excited by a number of panelists that represent the patient voice in the discussion. You can see the full list of moderators and panelists below.

Moderators:

  • Mandi Bishop – Healthcare Analytics Innovations & Consulting Practice Lead, Dell, #HIT100 influencer,@MandiBPro
  • Nick van Terheyden, MD – Chief Medical Officer, Dell, @drnic1

Panelists:

Future Ready Technology and Data in Healthcare - #DoMoreHIT

I hope you’ll take the time and join me on the 2016 #DoMoreHIT Healthcare Think Tank live stream and #DoMoreHIT hashgtag on Tuesday March 15th from 1-4 PM CT.

Health IT Workflow Stories at #HIMSS16

Posted on February 26, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

If you’re not familiar with Charles Webster, MD (Better known as @wareflo on Twitter), then you probably don’t know that he has a total and absolute obsession with workflow and specifically workflow technologies. Each year for a number of years, the Workflow King (that’s his other nickname) has gone through the list of HIMSS annual conference exhibitors (~1300 this year) and evaluated how many of them were using workflow engines or workflow automation in their healthcare IT software.

With this background, I thought Chuck would be the perfect guest on a recent Healthcare Scene interview to talk about the evolution of healthcare IT workflow at HIMSS and some of the various companies at HIMSS 2016 that people should visit to see these technologies in action. Along with talking with Chuck, we were joined by a number of healthcare IT vendors that have workflow technologies that will be attending and exhibiting at HIMSS. Enjoy our discussion and a preview of workflow technologies at HIMSS 2016:

The Amazon Echo – Bringing Sci Fi Reality to Healthcare

Posted on February 16, 2016 I Written By

David is a global digital healthcare leader that is focusing on the next era of healthcare IT.  Most recently David served as the CIO at an academic medical center where he was responsible for all technology related to the three missions of education, research and patient care. David has worked for various healthcare providers ranging from academic medical centers, non-profit, and the for-profit sectors. Subscribe to David's latest CXO Scene posts here.

My initial impression of the Amazon Echo was that this is simply a Bluetooth speaker that looks like a portable humidifier with a little bit of artificial intelligence. The next thing I discovered is that the Echo always needs to be plugged in for it to work. But then, after playing around with it, I realized that the Amazon Echo is actually quite impressive.

The Echo introduces the handy Alexa function. The initial conversations with Alexa are very simple. You can ask about the weather, the time, sports results, or the latest news. But with time, I learned that Alexa could even read an audio book; tell me about the local businesses; and where to go for a Thai dinner.

The other benefit of Echo its accessibility and quality. It comes with a remote control or you may control it via your mobile device after downloading the Amazon echo app. The bottom part of the Echo has a 360-degree speaker that surprisingly fills the entire room with sound. Even at a distance of 9-10 feet Alexa can pick up commands.

Because of the sophisticated voice activated system, the Echo has great potential for use by patients in a healthcare setting. The main use case that I see is in the hospital’s patient room. Let’s think of a scenario where we have a 50-year-old patient in the hospital that had just gone through a surgery procedure and is expected to be in the hospital for two days. Echo can be a great device to allow personalization such as: integration to the patient’s Spotify music, control of the room temperature and blinds, the ability to order an Uber for the patient’s family, as well as many other features of a smart home. The goal will be to bring the technology of a smart home into a patient’s room to enhance the patient’s experience away from home.

From a clinical perspective, the Echo can assist the medical provider by reciting the medical education transcribed by the doctor to the patient, such as: the side effects of a prescription drug that the patient should expect for the next month after surgery. If we go back to the example of the patient who is recovering from surgery and has been prescribed drugs, the Echo can either be a replacement or an integrated device for the nurse call system where the patient can ask for pain medication through Echo. In addition, patients can also order their meals through the device if it is integrated with the dietary system in the hospital. As such, the voice-activated system would clearly be a great two-way communication tool for the patient who may not be able to move from their bed with ease.

As healthcare is moving towards the goal of creating the best patient experience possible, we have to start integrating consumer products with the strategy of providing a hotel-like experience in an inpatient room. The integration of smart room technology and voice activation communication has become an invaluable part of luxury hotels, and likewise, we must attempt to replicate that same kind of technology and convenience in hospitals.   I have personally witnessed a lot of success by international hospitals incorporating the hotel experience into their culture to improve patient experience. Similarly, I believe that hospitals in the US must start to adjust our strategy in order to meet the expectation of today’s consumer-patients.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Revival of the Physician-Patient Relationships via Electronic Technology

Posted on February 9, 2016 I Written By

David is a global digital healthcare leader that is focusing on the next era of healthcare IT.  Most recently David served as the CIO at an academic medical center where he was responsible for all technology related to the three missions of education, research and patient care. David has worked for various healthcare providers ranging from academic medical centers, non-profit, and the for-profit sectors. Subscribe to David's latest CXO Scene posts here.

One of the latest fads in healthcare is patient-engagement. This is not a new concept at all, but has been practiced in some form for decades. However, with the availability of electronic technology, physicians and healthcare institutions have now embarked on new ways to engage patients. For many years now, there has been a discord in patient-physician relationships. Patients have often felt that healthcare workers never spend adequate time on their cases, rarely allowing them to participate in any decisions and almost never explaining the details about their medical disorders. This bitterness has led many patients to seek alternative healthcare options.

There is now preliminary evidence that use of electronic technology can help improve patient-doctor relationships and also lead to effective treatments and better outcomes.  Patient engagement using electronic technology is also not a new concept. It was first attempted when the Internet was developed in the mid 90s, but failed to gather storm because the technology was relatively new and there was no such thing as androids. The available mobile phones of that time were largely redundant devices that were only used for communication.

Today, almost every healthcare institution and many healthcare workers have web pages that provide educational information to patients. This was the first step in engaging patients. However, with the present availability of mobile devices, the healthcare industry has been able to leap forward. Many clinics now have Apps that give patients access to information, such as: when the doctor will be in the office; how long the wait will be in the ER; possible diagnoses of medical disorders; billing information; and future appointments. Some healthcare practitioners have gone one step further and even offer teleconferencing for patients who are not able to make it to their appointments.

The current strengthening of the patient-physician relationship is further evidenced by the fact that doctors are now encouraging patients to play a greater role in their healthcare and make informed decisions. Shared decision making is now a universal theme in many healthcare institutions. Patient portals can help patients better manage their chronic disorders like diabetes, arthritis, asthma or hypertension. More importantly, this method of engaging patients allows for faster responses from healthcare workers, who now have dedicated staff to answer mobiles phone queries from patients. For example, pharmacists are now able to use mobile technology to help patients better manage their medications, by recording their intake and advising the patients on how to avoid drug interactions.

With the rise of electronic technology, many patients now have most of their medical information, such as medical history and list of medication, stored on their mobile devices which makes it easier to share with healthcare workers when necessary. This dynamic flow of information not only streamlines care, but also fosters continuous and consistent care between the patient and physician. An example of this continuous care may be found in software programs that identify patients in need of particular services, such as annual mammograms, pap smears and chest x-rays. Once these patients are identified, the healthcare workers are able to contact them right away to advise the patient of their specific required medical service, while the software system assists in preventing missed appointments by sending reminders.

Notwithstanding the above, however, patient engagement via use of electronic technology is not without problems. The first and foremost problem is security. Mobile phones routinely get misplaced or stolen and the medical data could easily fall into wrong hands. Secondly, the elderly who make up for the majority of patients in the USA are not usually tech savvy, with very few of them using such mobile devices. Even those who do have a mobile phone are not well versed with Apps or retrieving medical information online.

Additionally, in order for mobile devices to be effective for patient engagement, the healthcare workers need to be efficient in supporting the technology to capitalize on its potential benefits. Even today, one of the most common complaints made by patients is that healthcare providers often times do not return phone calls in a timely manner or even at all. So in order to engage patients, healthcare workers also need to be play an active role. Just sending medical information to a mobile device is not what patients want.

No matter how advanced technology has become, patient engagement via electronic means will never replace the soothing voice or touch of a healthcare provider in the office. It is clear that patient engagement is vital for a successful physician-patient relationship. In fact, there is strong evidence that patients who participate actively in their own care have better medical outcomes and fruitful relationships with their healthcare provider. However, it is important to remember that patient engagement is a two way street. Electronic technology can do wonders for healthcare providers and healthcare institutions, but make no mistake, it can also become a detriment very quickly if not applied and supported adequately. In essence, healthcare providers must remember that current electronic technology can only serve as an assisting tool in managing patients – it cannot act as the healthcare provider itself.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Social Media 101 For Healthcare CXOs – Part 2

Posted on January 14, 2016 I Written By

David is a global digital healthcare leader that is focusing on the next era of healthcare IT.  Most recently David served as the CIO at an academic medical center where he was responsible for all technology related to the three missions of education, research and patient care. David has worked for various healthcare providers ranging from academic medical centers, non-profit, and the for-profit sectors. Subscribe to David's latest CXO Scene posts here.

This is a follow up to my last blog post regarding social media for CXOs.   I increased my action on social networking sites around four years ago when another new employment in Abu Dhabi forced a vast physical separation between me, my colleagues and critical emerging trends in healthcare IT back in the United States. I’ve been a daily Twitter and LinkedIn client from that point forward.

Social media provided the platform to build up solid associations and relationships with different influencers and pioneers in the industry. I also utilize social media to recruit talent, promote the organization’s achievements, speak internally with staff, and update everyone on rising trends.

Leaders who have a big department may not have the capacity to converse with each individual worker. I attempt to use social as one of the communication tool in addition to face-to-face time in order to share my thoughts about where we’re going from a strategy initiatives perspective. I also use the channel to share articles related to industry trends so people can keep up with what’s going on in the market.

My day by day online networking routine starts in the early mornings, before work, and after that continue in full drive following my workday. Social networking is not something you can simply say, ‘I’m going to go through an hour with it”,  You truly live it in small increments throughout your day.

Twitter as dynamic news feed
Twitter is currently my go-to news feed in the morning, and I utilize it to locate the most recent updates, news articles and critique on the healthcare business. Twitter is a decent place for individuals to share thoughts, or what’s at the forefront from the various industry thought leaders.  The majority of the Fortune 500 companies’ CEOs or executive groups are on Twitter sharing what’s happening to their businesses, and what’s happening with their organizations. This forum is a great place where you can get a genuine glimpse from the thought leader’s perspectives.  

I consider social important, however I don’t feel the need to post, or check in consistently.  On the off chance that I have a five-minute or 10-minute gap, I will examine what’s going on. I’ll check my notifications. However, I’m not always on my telephone checking the social stream.

LinkedIn for networking and career success
During the previous year, I began blogging, and I tried to routinely share thoughts on LinkedIn’s publishing platform. I appreciate the feedback I get on industry-specific topics and leadership. LinkedIn likewise allows me make and reinforce proficient connections for networking opportunities and professional success.

My Tips
Let me offer a few tips for CXOs who need to hone their social media methodologies from my experience.  First, CXOs ought to do all that they can to cooperate with their social connections. Use social to drive engagement, whether it’s with your associates, your staff or even your bosses. Listening is also key, and CXOs ought to grasp at the chance to act as a sounding boards for others. You truly need to listen and see what’s out there since many have alternate points of view that can expand your thinking on a topic.  

Lastly, CXOs have to invest the time to decide how social tools function best for them.   As I mentioned earlier, social can be an incredible tool for recruiting, department branding and personal branding. However, it takes exertion and work. It’s not something you can benefit from simply because you made a Twitter account and sat back waiting for people to follow you.

For me, social media is mostly a conduit for learning and a springboard to test ideas. Plus, it’s a platform to connect and engage with new thought leaders. If you are looking to jump start your learning and engagement, I definitely encourage everyone to get on a social media platform and start connecting and having discussions. Take the initial step to connect with others. You can start your initial discussion with me on the various social platforms I am using: Twitter, LinkedIn, and Facebook.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.