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Meaningful Use Reporting Period Changed to 90 Days and Other Proposed Changes

Posted on April 10, 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.

In case you missed the news, CMS posted the proposed rule that modifies meaningful use in 2015-2017 (Here’s the rule on the Federal Register). The 210 page document dropped late on Friday right before HIMSS. If you think we’ve seen CMS do this before, we’ve seen it happen a lot. They love to issue the rules on Friday and often right before HIMSS. At least that’s better than when they released the rule during HIMSS, but not much.

The summary of the changes is pretty straightforward:

  • Streamlining reporting by removing redundant, duplicative, and topped-out measures
  • Modifying patient action measures in Stage 2 objectives related to patient engagement
  • Aligning the EHR reporting period for eligible hospitals and CAHs with the full calendar year
  • Changing the EHR reporting period in 2015 to a 90-day period to accommodate modifications

The patient engagement was changed from 5% to a single download, view, and transmit as it’s been called. I think many will look on this as a very favorable change since you can’t force a patient to do something and so your incentive and penalties shouldn’t depend on their action.

It also makes sense that they change the hospital reporting period to the calendar year like it’s been for EPs. The change probably has some logistical questions for many hospitals, but it will make the process cleaner.

The big one of course is the 90 day attestation period. We knew it was coming and I think everyone’s glad that it’s here. Now it will be interesting to see how many wait until October to start their attestation period. That’s pretty risky if you ask me, but that didn’t stop organizations from waiting just the same.

I don’t think there will be many issues with what’s in this proposed rule. Although, we’ll see over the next week what other things people find as they dig into the rule. I know many were waiting for this to drop and are now breathing a sigh of relief over the 90 day reporting period.

Let us know in the comments if there are other details you find that we didn’t talk about or nuances we might have missed. Enjoy the light reading on the flight to HIMSS.

1/5th of Hospital EHRs are Poor Fits

Posted on April 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.


This is a really fascinating stat from Black Book. I’d like to dig into their methodology for this question. Defining what’s a “poor” fit is really hard when you realize that a poor fit is defined by hundreds and possibly thousands of EHR users in a hospital.

What I’ve found is that it’s really hard to make broad statements about EHR satisfaction at a hospital. The doctors may hate it, but the executives love it. The front desk may be annoyed by it, but the pharmacy is really happy. The nurses may love it…ok…I don’t think I know of any EHR that’s loved by nurses, but that’s a discussion for another blog post. Nurses often get left out in the EHR design and we’ll leave it at that for now.

With that disclaimer, let’s think about what it means that 20% of hospital EHRs are a poor fit. Does that mean that we’re going to see a wave of EHR switching in the hospital EHR world? I don’t think so.

The reason I don’t think so is that the hospital EHR is too expensive. Plus, changing EHR is so disruptive that you have to be really down on your EHR to actually switch. Sure, some of them are that down on their EHR that they’ll switch EHR. However, most of them don’t like it, but they aren’t ready to go through heart replacement surgery and take out their current EHR and replace it with a new one.

Some other factors at play is that they may not like their current EHR, but it’s the devil they know. That’s a powerful reason not to switch. Also, is there really a better alternative? Many who aren’t satisfied with their EHR aren’t convinced that switching to another EHR will be much better. Plus, many of these organizations are in the middle of meaningful use. If you switch EHR vendors in the middle of meaningful use, you might as well announce that you’ll be taking a year off from meaningful use (and all that entails…ask Intermountain).

While I don’t think we’ll see a wave of immediate EHR switching, once the renewal licenses come up, we’ll see more switching of EHR. Plus, if someone can come out with a high quality cloud based EHR for hospitals, then that could help with switching costs as well. However, until then, hospitals have mostly chosen their horse and now they have to ride it out. Of course, this assumes they don’t get acquired by a larger hospital system and are forced to switch EHR. That’s happening in a big way and is likely to continue.

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?