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Epic EHR Switching Video from Mary Washington Healthcare (MWHC)

Posted on May 26, 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’re back with another Fun Friday video (and a bonus story) to prepare you for the weekend. This week’s Fun Friday video comes from Mary Washington Healthcare (MWHC) doing a parody of a Hamilton song, “Right Hand Man,” as part of their switch to Epic. The production quality is really quite amazing and I love the choice of Hamilton. Check it out:

Now for a fun little story. I showed one of these EHR go-live videos to the Healthcare IT and EHR course I taught in Dubai. The majority of attendees were from Saudia Arabia with a few from Kuwait and UAE.

Well, the attendees loved the video. I asked them how well creating a video like this would go over in their hospitals. They all laughed and shook their heads. Certainly, the cultures are quite different. However, I did find it interesting that just as many people in the middle east were taking selfies as the US. Maybe the human desire isn’t all that different.

I don’t expect any of my students in the workshop to do anything like the above video. However, the concept of bringing your team together in an effort like what it takes to create this video is a powerful idea that could be applied regardless of culture.

2 Core Healthcare IT Principles

Posted on May 10, 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.

One of my favorite bloggers I found when I first starting blogging about Healthcare IT was a hospital CIO named Will Weider who blogged on a site he called Candid CIO. At the time he was CIO of Ministry Health Care and he always offered exceptional insights from his perspective as a hospital CIO. A little over a month ago, Will decided to move on as CIO after 22 years. That was great news for me since it meant he’d probably have more time to blog. The good news is that he has been posting more.

In a recent post, Will offered two guiding principles that I thought were very applicable to any company working to take part in the hospital health IT space:

1. Embed everything in the EHR
2. Don’t hijack the physician workflow

Go and read Will’s post to get his insights, but I agree with both of these principles.

I would add one clarification to his first point. I think there is a space for an outside provider to work outside of the EHR. Think of someone like a care manager. EHR software doesn’t do care management well and so I think there’s a space for a third party care management platform. However, if you want the doctor to access it, then it has to be embedded in the EHR. It’s amazing how much of a barrier a second system is for a doctor.

Ironically, we’ve seen the opposite is also true for people like radiologists. If it’s not in their PACS interface, then it takes a nearly herculean effort for them to leave their PACS system to look something up in the EHR. That’s why I was excited to see some PACS interfaces at RSNA last year which had the EHR data integrated into the radiologists’ interface. The same is true for doctors working in an EHR.

Will’s second point is a really strong one. In his description of this principle, he even suggests that alerts should all but be done away within an EHR except for “the most critical safety situations. He’s right that alert blindness is real and I haven’t seen anyone nail the alerts so well that doctors aren’t happy to see the alerts. That’s the bar we should place on alerts that hijack the physician workflow. Will the doctor be happy you hijacked their workflow and gave them the alert? If the answer is no, then you probably shouldn’t send it.

Welcome back to the blogosphere Will! I look forward to many more posts from you in the future.

What Kind of User Experience Are You Offering Patients?

Posted on May 3, 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.

Centric Digital put out a look at the User Experience Trends we should expect in healthcare in 2017. Check out their findings:

*Click on the image to see the larger version.

The summary on the image offers some great insights for hospitals and healthcare organizations as they consider their patient experience plans:

“In 2017, we’ll likely see increases in mobile-first & user-centered design, deep personalization, and conversational AI elements (e.g., bots) implemented across a range of sites for greater engagement.”

How’s your hospital doing at these items?

My guess is that most hospitals are not on trend. I wonder if hospitals even know what mobile-first is and how many have rolled out a mobile-first experience for their patients. My guess is that most hospitals have looked at their website on mobile and possibly implemented a responsive website.

Going beyond that, how many hospitals have created user-centered design. There’s a simple test to know if you’re focused on the user or not. Go to your hospital website and evaluate whether your website encourages engagement or whether your website discourages engagement by users. The reality is that most hospital websites discourage engagement.

We don’t even need to start down the road of discussing deep personalization and conversational AI elements. Let’s start with a mobile-first user centered design and then we can talk about the deep personalization and conversational AI that could benefit your hospital.

While I find these trends interesting, I don’t think I agree with Brenda who shared the image above that these will be the trends for 2017. This sounds more like where the cutting edge organizations are innovating as opposed to the industry trends.

How’s your organization doing in these areas? Are you offering these kinds of user experience to your patients?

Fear of Failure in Healthcare

Posted on May 1, 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.

Healthcare has a culture where the expectation is that you should never fail. Because of this culture we often take too long to adjust and change. This fear of failing at something new often causes is to keep sub optimal situations that impact our patients in negative ways. Doing nothing can often have worse impacts than doing something that goes wrong.

I love the quote that Jared Johnson shared above “Too often we ask, “What if this goes wrong?” instead of, “What if this goes RIGHT?””

This is a powerful idea that many in healthcare need to learn. We’re too afraid of something going wrong that we don’t even think about all the things that could go right if we changed a process, changed a policy, implemented a new piece of technology, etc. You know you have this problem in your organization if you’ve ever asked why something is done that way and they say “It’s just how we’ve always done it.”

While it’s easy to blame the culture of healthcare for this problem it is something we can overcome. Or I should say that it is something a courageous healthcare leader can overcome. This culture all comes from the leaders who don’t frown upon employees who make mistakes, but instead reward those who take a risk that could be extremely beneficial to patients and the organization.

Courageous leaders are ones that aren’t afraid to do what’s right for patients even if it puts themselves at risk. This is not an easy thing to do. It’s always easier to go with the safe, reliable, “nobody gets fired for doing…” approach that’s so common in healthcare. It’s much harder to take a patient point of view and say that I’m going to do what’s right for the patient even when it might buck the organizational culture.

It’s time healthcare leaders fearlessly embraced changes that will improve healthcare. Yes, that will mean some risk of things going wrong. However, the best leaders mitigate the risks as much as possible, but focus on the positive benefits that will come when everything goes right.

How Much Does Healthcare Consumerism Matter to Hospital CIOs?

Posted on April 14, 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.

Today I was greeted on Facebook with a quote from an interview the always wonderful Kate Gamble did with Michael Marino, Chief of IS Operations at Providence St. Joseph Health.

Patients don’t just want “the Marcus Welby experience anymore,” says Michael Marino.
“They want care where they want it, when they want it, how they want it.” The challenge? How to enable that without overburdening clinicians.

I found this evaluation to be spot on. It’s great to know that Michael Marino understands what patients want. However, he also understands how challenging it is going to be provide patients what they want.

The reality is that the system wasn’t set up to provide care “where they want it, when they want it, how they want it.” This is going to require a dramatic way in how we think about care and how we provide that care.

However, the 2nd part is the key point. How do we make this change without overburdening physicians. If the solution overburdens physicians, then it’s unlikely to happen. They’ll kick against the change and patients won’t get the change they desire.

There are simple, win-win solutions out there. Take for example a secure text with your patients with a picture attached. This can be a really efficient way for a doctor to interact with the patient. It can save the doctor and the patient time. It can discover issues earlier than if the patient waited for the next office visit. In some cases, it also frees up the doctors time to do a higher paying office visit.

How many hospital CIOs think about this shift in healthcare consumerism? My guess is that many are so overwhelmed by things like EHR complaints and cybersecurity challenges that most aren’t giving much of a 2nd thought to the shifting patient dynamics. Most of them have an idea that things are changing, but I imagine that most haven’t invested time and money in a way that will prepare them for this shift.

What’s your experience? Are hospital CIOs spending time on these changes? Should they be spending time on healthcare consumerism? What are the consequences if they don’t?

Survey Data on the Healthcare IT Job Market

Posted on March 24, 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.

I’ve been working for a number of years with Pivot Point Consulting, a Vaco Company (previously known as Greythorn) on their Health IT Market Report that looks at the Healthcare IT career space. This year they decided to do a trends edition that took this year’s survey results and compared it with historical data from the past three years which added a new layer of insight to the report.

While at the HIMSS conference, I had a chance to sit down with Ben Weber, Managing Partner, Pivot Point Consulting, a Vaco Company, to talk about their Health IT Market Report and the insights that were gleaned from their survey.

You can find my full video interview with Ben Weber at the bottom of this post or click on any of the links below to skip to a specific topic we discussed:

Be sure to download the full 2017 Healthcare IT Market Report: Trends Edition to dive into the responses to all the questions on the survey. Let us know in the comments what survey results stand out to you.

If you’re searching for a healthcare IT job, be sure to check out the jobs that Pivot Point Consulting has posted on Healthcare IT Central.

Who’s Over MACRA? CIO? COO?

Posted on March 22, 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.

In no surprising way, MACRA is a major topic in pretty much every hospital and health system in the US. There’s a lot of money to be had or lost with MACRA. This is especially true for health systems with a lot of providers. Plus, it sets the foundation for the future as well. I believe MACRA will be as impactful as meaningful use, but without as many incentive payments (chew on that idea for a minute).

As I’ve talked to hundreds of organizations about MACRA, I’ve seen a whole array of responses for how they’re addressing MACRA and who is in charge. Is this a CIO responsibility since MACRA certainly requires EHR and other technology? Is this a COO job because MACRA is more of an operations problem than it is a technical problem? Some might make the case for the CMO/CMIO to be in charge since MACRA requires so much involvement from your providers.

From my experience, the decision usually comes down to choosing between the CIO and the COO, but with input and buy-in from the CMO/CMIO. How the CIO positions themselves will determine if they are over MACRA or not. Some CIOs see themselves as tech people and so they shy away from touching MACRA. Other CIOs see themselves as integral part of their business success and so they want to have MACRA under their purview. Most progressive CIOs that I talk to want the later.

I’m an advocate for a CIO that’s involved in the business side of things. Those CIOs that don’t want this duty are going to miss out on strategic opportunities for their organization. I heard one CIO describe that they viewed their IT organization as Information As A Service provider. Their job as the IT department was just to provide the information from the IT systems to someone else who would deal with the information, the MACRA regulations, etc.

The Information as a Service provider concept has issues on multiple levels. The most important is that if you’re just an information provider, then you lose out on the opportunity to be a strategic part of your organization. However, from a more practical MACRA level, it’s really challenging to provide the right information for MACRA when you’re just an information provider and know little about the regulation. We all know how quickly communication can break down when the person needing the information is disconnected from the people who provide the information and they’re disconnected from the people entering the information.

No doubt a healthcare CIO has to be careful what projects they add to their plate. However, I don’t think MACRA is one of those projects that should be pushed off to someone else. Certainly there can be specific organization cultures where it makes sense for the COO to run things, but I think that should be pretty rare.

How are you approaching MACRA at your organization? Who’s over it? I look forward to hearing your experiences in the comments.

The Challenge of Managing So Many Vendors

Posted on March 8, 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.

The more I talk to CIOs, the more I realize that CIO at a hospital and health system is as much about vendor management as it is anything else. And quite frankly, those CIOs are tired and overwhelmed by all the vendor management they do. Every CIO I’ve met is looking to decrease the number of vendors they’re working with and not increase it.

In some ways it makes sense. Even if you look at the basic IT commodity items like servers, systems, storage, networking, security, single sign on, etc you’re probably looking at 14-16 vendors for most organizations. This doesn’t include all the higher end clinical systems (including the EHR) and all of the shadow IT systems that have seeped their way into departments thanks to easy to purchase and use cloud solutions.

At the higher end, I’ve heard of some health systems having 300 different systems that they had to manage. It’s a much smaller number at the lower end small, rural hospital, but it’s still a huge task for even them since they outsource almost everything. They usually can’t attract or afford long term staff to the rural hospitals.

Is it any wonder why that hospital CIO told me that “we’ve got what we need”?

I wonder if the real undercurrent of his comment was “I don’t want any more vendors to manage. I have more than enough!”

My guess is that this CIO who has “all the IT he needs” would probably have no problem looking at and implementing new features and functionality from their existing vendor. That’s a huge advantage for existing vendors as they continue to grow a bigger footprint in the hospitals where they have customers. However, are they missing out on a lot of innovations because of this approach?

At the end of the day, a CIO has to be an effective vendor manager. The better they do at this job, the better their organization will perform.

EMR Add-Ons On The Way

Posted on March 3, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study backed by speech recognition software vendor Nuance Communications has concluded that many healthcare leaders are planning to add new technologies to supplement their EMRs, Popular add-ons cited by the study include (naturally) speech recognition, mobility options and computer-assisted physician documentation tools. While the results are partially a pitch for Nuance, of course, they also highlight the tension between spending on clinical improvement and satisfaction and boosting the bottom line with better documentation tech.

The study, which was conducted by HIMSS Analytics, was designed to look at ways to optimize EMRs and opportunities to improve care at hospitals and health systems. Conducted between August 17 and September 6 of last year, it draws on 167 respondents from 142 different healthcare organizations. Forty percent of respondents hold C-suite titles, and an additional 40% were in IT leadership. (It would be interesting to see how the two groups’ perceptions vary, but the study summary doesn’t provide that information.)

According to HIMSS, 83% of respondents reported having confidence that their organization would eventually realize their full potential, particularly improving care coordination and outcomes.

To this end, 75% of respondents said they’d boosted their EMR efforts with training and support resources, while two-thirds have increased staff in at least one IT area since implementing their system. Respondents apparently didn’t say how much they’d increased their budget, if at all, to meet these needs – and you have to wonder how these organizations are paying for these efforts, and how much. But the report didn’t provide such information.

To increase clinician satisfaction with EMR use, 82% of respondents said providing clinician training and education, 75% are enhancing existing technology and tools and 68% adopting new technology and tools. To read between the lines once again, it’s worth noting that hospitals and health systems seem to be putting a stronger emphasis on training than new tech, which somewhat contradicts the study’s conclusions. Still, EMR add-ons clearly matter.

Meanwhile, about one-quarter of survey respondents said that they planned to introduce EMR-enhancing tools at the point of care, primarily to improve documentation and boost physician satisfaction. Those included mobility tools (44%), computer-assisted physician documentation (38%) and speech recognition (25%). These numbers seem a bit lower than I would have expected, particularly the mobile stat. I’m betting that establishing mobile security is still a tough nut to crack for most.

While increasing clinician satisfaction and improving care outcomes is important, boosting financial performance clearly matters too, and respondents said that improving documentation was central to doing so. Fifty-four percent said that better documentation would reduce the number of denied claims they face, 52% expect to improve performance under bundled payments, 38% predicted reduced readmissions and 38% thought documentation improvements would better physician time management and improve patient flow.

Again, I doubt that C-suite execs and IT leaders will pay equal attention to tools which improve their finances and those which meet “softer” goals – and financial goals have to take priority. But these stats do suggest that hospitals and health systems are giving EMR add-ons some attention. It will be interesting to see if they’re willing to invest in EMR enhancements — rather than burrowing deeper into their existing EMR tech — over the next year or two.