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The Future of…Healthcare IT

Posted on March 23, 2015 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.

As part of HIMSS 2015, they’re holding a blog carnival where people throughout the healthcare IT community can contribute blog posts covering 5 different topics. Each topic looks at “The Future of…” and then “Connected System, Big Data, Security, Innovation, and Patient Engagement.” I thought the topics were quite interesting, so I created a post for each of the 5 topics. Here’s links to each of them:

I’d love to have you chime in on each of the topics that interest you. Let me know if you agree or disagree with my commentary and prognostication. Even better, feel free to write your own blog post on any or all of these topics. They are important topics that will make up much of what happens in healthcare IT.

Are there any other “Future of…” topics you wish would have been discussed?

Two Hidden Gems at the HIMSS15 Annual Conference

Posted on March 20, 2015 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 deep in my preparations for the HIMSS Annual Conference in Chicago. It’s amazing how quickly the schedule fills up. It has me really excited to meet with so many amazing people. To all the PR people who have sent me pitches, I’ll be getting back to you shortly. Yes, I do respond to each and every one of you. No, sending another request won’t get a response faster. In fact, it will make the response slower.

My own schedule aside, I was thinking today that there are two gems at HIMSS that many people don’t know about. So, I thought I’d share them with you.

The CIO Forum
This event is put together by CHIME and is a shorter version of the CHIME Fall CIO Forum. You can check out the schedule of events here. CHIME always does a great job bringing together some great speakers from the industry and also some to address topics like leadership.

While the content is great, the best part of the event is being surrounded by CIOs. Everywhere you turn is another hospital CIO. It makes for a tremendous opportunity to connect and learn from hospital CIOs. The event does cost extra, so make sure you get the right pass if you want to attend. If you’re there, come say hi.

New Media Meetup
I’m a little bias on this event since it’s the one I host, but it’s always my favorite part of HIMSS. There’s a special energy at the event that comes from all of the amazing people in New Media that are at HIMSS. Everywhere you turn at the event you run into someone else that you’ve likely interacted with on Twitter or some other social media.

The event has evolved over time. Originally it brought together bloggers, but quickly expanded to anyone involved in social media. You can find all the details for the event here. I hope that some readers can make it. If you do, be sure to come take a selfie with me or something.

Those are a few of my favorite events at HIMSS that many people don’t know about. What are your favorite parts of HIMSS?

Another Day…Another Healthcare Breach

Posted on March 19, 2015 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 about the Anthem Healthcare breach of millions of patient records. That’s been followed by an announcement by Premera Blue Cross that they’ve had 11 million records breached as well. Plus, I’m sure we’re just at the start of healthcare data breaches that are going to occur.

What’s astonishing to me is that many seem to be playing this up as a new thing. I remember about 15 years ago when I was in college and a guy I knew told stories about hacking through an entire hospital system. In fact, he casually made the comment, “You don’t want to hack the government cause they’ll come after you, but hospitals and universities you can easily hack and nothing will happen.”

This story illustrates two points. First, breaches of healthcare organizations have been happening for a long time. This isn’t something new. Second, we’re just now starting to put in place the technology that will detect breaches. That’s a good thing. In fact, in some ways we should applaud the fact that we actually know these breaches are happening now. I’m certain that many of these breaches happened before and we just never knew about it because you don’t have to report a breach you don’t know about.

Now that we know about these breaches, will that spur action? I think it will in some organizations. It certainly won’t be a bad thing for security and privacy. Unless we’ve become so callous to the breaches (like the title of this post suggests) that we stop caring about breaches because “they’re bound to happen.”

I hope that this post doesn’t encourage apathy on the part of healthcare organizations security and privacy. I assure you that no hospital wants to go through a breach of healthcare data. While impossible to guarantee it won’t happen, a sincere effort to create a culture of compliance in your hospital can go a long way to preventing many breaches.

As my college hacker friend told me many years ago, “You can never make something 100% secure, but you can make it hard enough for someone to hack that it’s not worth their time.” If it’s not worth their time, they’ll usually move on to someone easier.

Sometimes We Forget the Consequences of Doing Nothing

Posted on March 18, 2015 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.

Healthcare IT publications like to hop all over a story that talks about the negative side effects of EHR or some other technology in healthcare. The train wreck is something that people love to read about and so publications love to lather up the story and report all of the problems and challenges a hospital faces when going electronic.

This isn’t an awful thing. We should be aware of the challenges related to implementing technology in healthcare. Hopefully that extra exposure will help us to improve the technology so it’s no longer an issue. However, we have to be careful to not skew our view of technology based on what’s being reported by the healthcare IT publications we read.

The problem with basing our assessment of something on the media is that it’s not exciting for them to report on benefits that have become part of the status quo. No one’s going to read the article that says lives are saved because a doctor can read the chart since it was typed as opposed to illegibly written on paper. Being able to actually read the chart has become so common place, that we’ve started to take it for granted. Medical students today might never have the opportunity to read paper medical hieroglyphics. That’s a fantastic thing, but it doesn’t make for a good story.

It’s almost like we ignore the benefits once they become part of the fabric of how we practice medicine. Plus, we don’t even think about the negative consequences we’ve avoided. As someone told me recently, “No one gets paid for the crisis they averted.”

As part of our analysis, we have to remember to compare the status quo to the alternative and not to the ideal. That’s not to say that we don’t continue to strive for the ideal. We absolutely should push towards it. However, it does mean that we keep a proper perspective on reality and don’t forget the past.

Exploring Non-EHR Technologies – What’s Next?

Posted on March 17, 2015 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.

While this site is named Hospital EMR and EHR, you may have noticed that we’ve been covering more and more non-EHR related technologies. I’m certain that this trend will continue as EHR software becomes mature and most hospitals have implemented an EHR. Although, I’m sure we’ll still cover some EHR switching and related topics as well.

While it’s safe to say that many of these non-EHR technologies still have some tie to the EHR, there are some that can really benefit a hospital and may have nothing to do with the EHR. Think about your HR system for example. Almost nothing to do with your EHR (unless you want to talk about EHR user provisioning). However, a well implemented HR system can dramatically improve a hospital’s human resource function.

This idea is actually a theme for my coverage of the upcoming HIMSS 2015 annual conference in Chicago. In the past I’ve always done a bunch of meetings with EHR vendors and sprinkled in a few other non-EHR meetings. This year I’m pretty sure I’ll be doing a bunch of non-EHR meetings with a few EHR meetings sprinkled in. I’m looking for the answer to: What’s Next?

I think this is on trend with what most hospital IT leadership are thinking. EHR’s are mostly installed and they have a handle on meaningful use along with a group of resources that understand the challenge deeply. Now I think they’re starting to look at what’s next.

When I think about what’s next after an EHR is implemented, I think about it in two ways:

  • How Can I Get the Most Out of My EHR?
  • What Other Non-EHR Technologies Could Benefit My Organization?

I’d love to get your thoughts on both of these questions. Hopefully my posts in 2015 we’ll help to answer these questions. It’s certainly what I’ll be looking for at HIMSS 2015 and of course I’ll share what I find.

Is Your Hospital Embracing or Ignoring Social Media?

Posted on March 16, 2015 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.


At this point, I don’t think there’s any argument that social media influencers our health choices. In the above mentioned survey, 40% of them realize that it’s impacting them. Trying to say that social media doesn’t influence health decisions is like trying to say that your friends and family don’t influence your health decisions. Social media is the new way we communicate with friends and family. They influenced our health before social media and are still doing it, but in the new social media medium.

We know that social media is influencing health decisions, but is your hospital embracing the power of social media or trying to ignore it? I bet most hospital CIOs have no idea. I bet most hospital CMO (Chief Medical Officers) don’t know much better either.

There’s a simple way for you to know how well your hospital is embracing social media. Just ask yourself the question, “Is social media in my hospital considered a marketing and PR task?”

If the answer to that question is yes, then you have not embraced social media in your hospital. Certainly there is a lot of opportunity for a hospital marketing and PR department to use social media and they should (Side Note: I have a conference focused on hospital social media, so I intimately know the power of it in marketing and PR). However, if social media is only considered a marketing and PR task, then your hospital is missing out on so many benefits that can come from a hospital using social media.

The first step to embracing this culture is involving your hospital CIO and hospital CMO (Chief Medical Officer) in social media. They’ll have ideas and insights into how to use social media that go well beyond marketing a hospital’s services. In the new value based reimbursement world, this new form of outreach and connection to patients is going to be critical.

The second step to embracing hospital social media is to put budget and resources (ie. people) behind the initiatives that are created by your marketing/PR team, IT team, and medical team. There’s very little value that’s created from a meeting of these people without the ability to follow through on the ideas and suggestions they create.

Sadly, most hospitals have never even had this meeting (possibly because they don’t want to commit the resources). Those few hospitals who have had this meeting haven’t committed the resources needed to turn their ideas into reality. I think these are both failed strategies for hospitals that will catch up to them in a big way. I think a hospital’s approach to social media will soon tell us a lot about a hospital’s approach to patient care.

Health System Investment in Single EHR Platform

Posted on March 6, 2015 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 heard about this investment at an ACO conferences in Las Vegas. It had been a while since I’d written about the hospital subsidizing the cost of an EHR for their affiliate providers. We all know they’ve been implementing an EHR with their owned practices. However, in a lot of areas the hospital is also spending a bunch of money subsidizing the cost of EHR for their affiliated providers as well.

The above comment is even more interesting in the context of an ACO. Basically, this health system’s progress towards an ACO gave them a really great reason why they should spend money on an EHR for even their affiliate providers. They obviously saw a lot of value in having all the providers and hospitals on a single EHR. Otherwise they wouldn’t have made an investment like this.

This also seems to highlight their bleak outlook on healthcare interoperability. If interoperability was a reality, would they really care that much about having everyone on a single EHR platform?

What is absolutely clear to me is that an ACO needs technology to connect all of the entities in the organization. The single EHR approach is one way. However, there’s a really strong argument to be made that most ACOs are going to be a heterogeneous environment. Where does that leave the ACO?

BIDMC’s Internal EHR and A Possible Epic Future

Posted on February 11, 2015 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 surprising reactions for me in the announcement of Athenahealth’s acquisition of Beth Israel Deaconess Medical Center’s (BIDMC) in house webOMR platform was by John Halamka. As I mention in the linked article, it really isn’t a pure software acquisition as much as it is Athenahealth going to school to learn about the inpatient EHR space. However, John Halamka’s reaction to this announcement is really interesting.

As I read through all of the coverage of the announcement, John Halamka seems to have shifted gears from their current in house EHR approach to now considering a switch to some other external EHR vendor. This is very interesting given this blog post by John Halamka back in 2013. Here’s an excerpt from it:

Beth Israel Deaconess builds and buys systems. I continue to believe that clinicians building core components of EHRs for clinicians using a cloud-hosted, thin client, mobile friendly, highly interoperable approach offers lower cost, faster innovation, and strategic advantage to BIDMC. We may be the last shop in healthcare building our own software and it’s one of those unique aspects of our culture that makes BIDMC so appealing.

The next few years will be interesting to watch. Will a competitor to Epic emerge with agile, cloud hosted, thin client features such as Athenahealth? Will Epic’s total cost of ownership become an issue for struggling hospitals? Will the fact that Epic uses Visual Basic and has been slow to adopt mobile and web-based approaches provide to be a liability?

Or alternatively, will BIDMC and Children’s hospital be the last academic medical centers in Eastern Massachusetts that have not replaced their entire application suite with Epic?

Based on John Halamka’s comments it seems that his belief might have changed or at least he’s considering the option that an in house system is not the right approach moving forward. No doubt Athenahealth is hoping that they’ll delay the decision a few years so they have a chance to compete for BIDMC’s business.

If you look at the rest of the blog post linked above, Halamka was making the case for Epic back in 2013. I think that clearly makes Epic the front runner for the BIDMC business at least from Halamka’s perspective. We’ll see how that plays out over time.

It seems like we’re nearing the end of the in house EHR hospital. Are there any others that still remain?

Will Cerner Let Mayo Clinic Move to Epic Easily?

Posted on February 9, 2015 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.

As most regular readers know, we don’t try to get into the rat race of breaking news on things like EHR selection, the latest meaningful use, or whatever else might be time sensitive healthcare news. Sure, every once in a while we’ll report something we haven’t seen or heard other places, but we’re more interested in the macro trends and the broader insight of what various announcements mean. We don’t want to report on something happening, but instead want to tell you why something that happened is important.

A great example of this is Mayo Clinic’s decision to go with Epic and leave behind Cerner, GE, and other systems. There’s a good interview with Mayo Clinic CEO, Cris Ross, that talks about Mayo’s decision to go with Epic. As he says in the interview, GE Centricity wasn’t part of their future plans, and so they were really deciding between Epic and Cerner. Sad to see that Vista wasn’t even part of their consideration (at least it seems).

Based on Cris Ross’ comments, he commented that he liked Epic’s revenue cycle management and patient engagement options better than Cerner. Although, my guess is that they liked Epic’s ambulatory better than Cerner as well since they were going away from GE Centricity. Cris Ross’s double speak is interesting though:

As we looked at what met our needs, across all of our practices, around revenue cycle and our interests around patient engagement and so on, although it was a difficult choice, in the end it was a pretty clear choice that Epic was a better fit.

Either it was a difficult choice or it was a pretty clear choice. I think what Cris Ross is really saying is that they’d already decided to go with Epic and so it was a clear choice for them, but I better at least throw a dog bone to Cerner and say it was a hard choice. Reminds me of the judges on the voice that have to choose between two of their artists. You know the producers told them to make it sound like it’s a hard choice even if it’s an easy one.

Turns out in Mayo’s case they probably need to act like it was a really hard choice and be kind to Cerner. Mayo has been a Cerner customer for a long time and the last thing they want to do is to anger Cerner. Cerner still holds a lot of Mayo’s data that Mayo will want to get out of the Cerner system as part of the move to Epic.

I’ll be interested to watch this transition. Will Cerner be nice and let Mayo and their EHR data go easily? Same for GE Centricity. I’ve heard of hundreds of EHR switches and many of them have a really challenging time getting their data from their previous EHR vendor. Some choose to make it expensive. Others choose to not cooperate at all. Given Mayo’s stature and the switch from Pepsi to Coke (Cerner to Epic, but I’m not sure which is Pepsi and which is Coke), I’ll be interested to see if Cerner lets them go without any issues.

I can’t recall many moves between Epic and Cerner and vice versa. Although, we can be sure that this is a preview of coming attractions. It will be interesting to see how each company handles these types of switches. What they do now will likely lay the groundwork for future EHR switching.

Getting More Out of the EHR Than What You Put In

Posted on January 21, 2015 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.

When I first met with Stoltenberg Consulting a few years back at CHIME, they said something really interesting that I’m still thinking about today. In fact, I might be thinking about this more today than I was doing before.

Per my notes (so I won’t make it a direct quote), they commented that doctors were putting a lot into the EHR, but they don’t feel like they’re getting a lot out of the EHR.

It’s a powerful idea that is really important for any hospital executive to understand.

I recently wrote about the choice between the Best-of-Breed EHR and the All-In-One EHR approaches on EMR and HIPAA. Here’s the money section:

The real decision these organizations are making is whether they want to put the burden on the IT staff (ie. supporting multiple EHRs) or whether they want to put the burden on the doctors (ie. using an EHR that doesn’t meet their needs). In large organizations, it seems that they’re making the decision to put the burden on the doctors as opposed to the IT staff. Although, I don’t think many organizations realize that this is the choice they’re making.

Choice of EHR is only one of the main reasons why doctors likely feel that they’re getting less out of the EHR than they’re putting into it. Certainly reimbursement requirements and meaningful use should still take a lot of the blame as well. Regardless of how we got here, it’s a very precarious position when the doctors feel like they’re getting less out of the EHR than they are putting into it.

There is a solution to this problem. First, you must work to maximize the physician workflow. Sometimes this means involving the nursing staff more. Sometimes this involves a scribe. Other times it requires a change to your EHR. Other times it means building out high quality templates that make the doctor more efficient.

Second, we must all focus on more ways doctors can get more value out of their EHR. The buzzword analytics has potential, but has been a little too much buzz word and not enough practical improvement for the doctor and patient. We need more advanced tools that leverage all the data a doctor’s putting in the EHR. Clinical Decision Support, Drug to Drug and Drug to Allergy checking are just the first steps. We can do so much more, but unfortunately we’ve been too distracted by government regulation to deal with them. Plus, let’s not kid around. These aren’t easy problems to solve. They take time and effort. Plus, we need a better way for doctors and hospitals to be able to diffuse their discoveries across the entire healthcare community. Sharing these discoveries is just too hard and too slow right now.
EHR Scale
At the end of the day, it’s a simple scale. On the one side you have the time and effort a doctor puts into the EHR. On the other side is the value the doctor gets from the EHR. You can solve this by making the doctor’s EHR work more efficient or by finding more ways the EHR can provide value to the doctor. Much easier said than done. However, if this stays out of balance too long, you can count on a big EHR backlash from doctors.