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Marc Probst Takes Aim at Meaningful Use in Interview at CHIME

Posted on November 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

One of the must read interviews coming out of the CHIME Fall Forum is Mark Hagland’s interview with Marc Probst. We know that Marc Probst had a growing dissatisfaction with meaningful use after he said he would love to kill meaningful use during National Health IT Week. He keeps on that same trajectory during this great interview by Mark. Although, I think Marc is just representing the feelings of many hospital CIOs.

Here are a few excerpts of the interview for those who don’t want to read the whole thing:

So what is meaningful use for you, as an IT pioneer?

Well, it’s a pain in the neck! We believe we were already some of the most meaningful users, in the broader sense of the term, in healthcare IT, prior to the meaningful use program. But meaningful use has imposed rigid functions that you have to do, and I don’t think it’s added any additional value to what our clinicians do, but only to add tasks. So it hasn’t been all that helpful. I sit on the [federal] IT Policy Committee, so I have a little to do with meaningful use, but nonetheless, it hasn’t been [satisfying].

Nice to see that Marc Probst is taking a little bit of accountability for meaningful use. Although, if you’ve ever sat on a committee you know that you can only do so much if the committee is against you. I think the thoughts above are the opinions of many in healthcare. Although, this simple quote from Marc Probst sums up what many would like to see done:

“I honestly think we should now declare victory and move on.”

Although, Marc Probst also offers this sobering reality that many healthcare CIOs will face:

But I think that a fair number are going to say, look, if I haven’t done it this year, I’ll get the penalties anyway if I haven’t yet attested to Stage 2. I think many will focus instead on ICD-10 and data security, because meaningful use is so frustrating and they don’t control the variables; and security, they can control some of the variables. And the penalties are much harsher for breaches than for meaningful use failure.

I’ve never seen someone compare the meaningful use penalties with the penalties for breaches. It’s a very interesting comparison. However, they are hard to compare since the meaningful use penalties are guaranteed to happen if you don’t attest to MU. The breach penalties only happen if you have a breach occur…or I should say if you have a breach occur and you realize it happened (or get caught). That’s likely why more people are concerned with the meaningful use penalties than security and privacy in their organization.

I think this type of sentiment about meaningful use will grow stronger and be heard from more areas of the country. Marc Probst and Intermountain are really powerful figures in the healthcare community. No doubt, Marc’s decision to speak out on this subject will embolden many others to do the same.

Go and read the rest of Mark Hagland’s interview with Marc Probst. Many more good perspectives in the full interview. I’m glad that people like Marc agree with me that we should Blow Up Meaningful Use and focus on interoperability.

Looking forward to the CHIME Fall Forum

Posted on October 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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

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

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

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

The Changing Health IT Consulting Job Market

Posted on October 15, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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

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

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

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

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

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

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

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

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

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

Posted on October 10, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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

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

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

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

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

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

Where Do You Want to Go?

Posted on September 5, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Our hospital’s a lot like Alice in Lewis Carroll’s classic Alice’s Adventures in Wonderland? You may remember that Alice comes to a crossroads with two paths before her, each stretching onward but in opposite directions. She is confronted by the Cheshire cat, of whom Alice asks, “Which path shall I follow?”

The cat answers: “That depends where you want to go. If you do not know where you want to go, it doesn’t matter which path you take.

I’m afraid that many hospital IT organizations are very much like Alice. They’re so distracted by the operational challenges they face that they don’t really have a good understanding of where they’re going. This is a tremendous problem because it starts to compound itself.

An organization without a steep sense of direction will waffle and go any direction. This will lead to your best employees leaving for greener pastures. No direction and loss of your best people is a recipe for disaster for any organization.

I recently heard that Marc Andreessen’s (created first widely used web browser) personal mantra is “Often wrong but never in doubt.” I’m still chewing on whether I agree with this approach to leadership, but at least there’s no doubt about where a leader like Marc wants to go. There’s power in all team members rowing in the same direction. Even if you have to change course along the way, you’re still getting somewhere. Everyone rowing in different directions just makes you go in circles.

Does your hospital IT organization have a good vision of where they want to go?

The Forgotten Pieces of Healthcare IT

Posted on August 27, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I’ve obviously been thinking a lot lately about the rest of the healthcare IT world beyond EHR software. We’ve had such a focus on EHR software, that we’ve forgotten a lot of other IT projects that need attention. I saw a quote recently that a CIO is no longer just managing the IT infrastructure. I believe that’s spot on.

A hospital CIO needs to be an integral part of the business decisions of their organization. You can’t buy a few hundred million (or a few billion) dollar EHR and not think that it won’t have a major economic impact on your organization. However, while a hospital CIO needs to do more than just IT infratructure, they still have to do the IT work as well.

I was thinking about all of the various IT projects that a hospital CIO could still be managing:

  • Internal Network
  • External Internet Connection
  • Firewalls
  • Data Center (this could be a few hundred things in itself)
  • Servers/Virtualization
  • Desktops (virtual or otherwise)
  • Mobile Devices (cell, tablets, etc.)
  • Telephony
  • Identity Management
  • Email
  • Shared Drives
  • Printers
  • Scanners
  • Biometrics

I’m sure I’m leaving some obvious ones off. Please add to the list in the comments. However, even just looking at this is pretty overwhelming. Luckily, most hospital CIOs have a lot of people helping them support all of these efforts. However, each one needs to be considered and managed.

Take a simple example like email. You’d think we’d have it down to a science and we kind of do. However, if you host it in house, you have to constantly stay on top of it, update the software, manage mailbox sizes, spam filters, etc. Whether you outsource your email or keep it in house you also have to manage all the account creation and deletion. You have to provide ongoing help desk support and training.

The point I’m trying to make is that each one of these technologies has its little nuances. It takes time and effort to do them well. Unfortunately, many of them have been transgressed as the all hands on deck EHR efforts have occurred. Now we’re heading back to clean up these messes. Looking at the list above, there are a lot of possible messes waiting for a hospital CIO.

The Place of EHR in the Hospital IT Ecosystem

Posted on August 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I’ve been thinking a lot about EHR software and the part it plays in the hospital IT ecosystem. The $36 billion of EHR stimulus money has shined a big light on EHR software. No doubt the EHR incentive money has increased EHR adoption, but at what cost. I wonder if the EHR incentive money has caused many hospital IT teams to place undue emphasis on the EHR software.

The reality of a hospital IT ecosystem is that they usually have hundreds of healthcare IT systems in their organization. The EHR is just one of those systems. In fact, it might not even be the largest system. Their ERP system (usually Peoplesoft or SAP in large hospitals) could be larger. However, try being system #90 at a hospital. Do you think the IT people at a large hospital system are paying much attention to what’s happening to that system? Not only are they distracted chasing the EHR incentive money, but even without that incentive there are 89 other systems in front of it.

I’m reminded of this Healthcare CIO Mindmap that I posted previously. It’s a great image of the amazing complexity that a healthcare CIO is facing. Each of the branches on that mindmap represent one or more IT systems that have to be managed by an organization. That’s a complex and challenging task.

I guess my message here is that while the EHR is extremely important to an organization, don’t lose track of all the other healthcare IT systems you support. They won’t likely be noticed in the short term, but transgressing these smaller health IT systems will create organizational debt that will be hard to overcome in the future.

Negative Maintenance Leadership

Posted on August 18, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

It seems like I have a little trend of leadership posts going on. This one goes along the lines of my previous post where I talked about Surpassing Expectations. The next leadership concept that I want to talk about comes from Brad Feld and he calls it Negative Maintenance.

Here’s how Brad describes it from his perspective:

There are days that I’m high maintenance. Everyone is. But if you subscribe to my “give before you get”, or #givefirst, philosophy, you are constantly contributing more than you are consuming. I’ve talked about this often in the context of Startup Communities, but I haven’t really had the right words for this in the context of leadership, management, and employees in a fast growing company.

I think that this description applies just as well to healthcare organizations. We all know the Hospital CIO who takes more than he gives. The hospital CIO that makes a project 10 times harder than it needs to be with the exact same (or sometimes worse) results. Hopefully you’ve also known leadership that makes your life easier. They remove roadblocks. They clearly articulate the path forward. They make the work easier as opposed to harder.

The same applies to anyone on a project team. There are those people on a team that are high maintenance, no maintenance, and negative maintenance. The highest performing teams are those that have a team full of negative maintenance people.

What kind of team member are you?

EHR Consolidation Continues as Cerner Acquires Siemens Soarian

Posted on August 5, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

The big news that had been rumored for a while was that Cerner was going to acquire the Siemens Health Services product line including Soarian. The rumor became reality as the acquisition was announced today. You can see the investor slide deck they published here. Most notably, Cerner has committed to supporting the Siemens Soarian product line for a decade:

Following the acquisition, support for Siemens Health Services core platforms will remain in place. Current implementations will continue, and Cerner plans to support and advance the Soarian platform for at least the next decade.

Of course, it’s one thing to suggest this in a press release. It’s another thing to actually do it in practice. However, it was smart of them to announce this approach to allay the fears of Soarian customers. If enough Soarian customers move over to Cerner, then you can be sure the announcement to sunset Soarian will happen. That’s a feature of EHR acquisition and consolidation. It’s just too expensive, especially in this regulatory environment, to maintain two code bases which perform the same functions.

These stats about the combined organizations are quite interesting:

  • 20,000 associates in more than 30 countries
  • 18,000 client facilities, including some of the largest health care organizations in their respective countries
  • $4.5 billion of annual revenue
  • $650 million of annual R&D investment

The last one is interesting given yesterday’s post on R&D companies. However, I think one of the key numbers there is the associates in 30 countries. Siemens Health Services has approximately 5,000 client facilities in over 40 countries including a strong presence in Germany, Sweden, Austria, Spain, Norway, and the Netherlands. You can be sure that a large part of this acquisition by Cerner is being able to go after the global market. There’s a huge opportunity in many countries that haven’t had billions of dollars falsely stimulating the market.

What I found particularly interesting on the investor call about the deal was Siemens efforts to take care of their existing customers. I’d describe it as finding a soft landing for their customers. You can understand why this is important. Many of those Soarian customers are still Siemens customers in other parts of the business like radiology. Siemens no doubt didn’t want to kill their other business by selling Siemens Health Services.

We’ll see what comes of the Siemens and Cerner $100 million innovation budget. If you look at the wording it says stuff like up to $100 million budget. Plus, these two companies are going to have to work together on some projects regardless. Cerner needs the data Siemens has and Siemens will need to get the data into Cerner. Will anything beyond that really occur, I’m not as optimistic.

I did find Neil Patterson’s comments on the post-Meaningful Use era interesting. I’d love to explore more of what he sees in that future. One person described it as a move from documenting the care given to a patient to technology that drives the care given a patient.

I’m not sure hospital execs should be that excited about this acquisition. It takes out another competitor from keeping EHR vendors honest. This really is getting down to a two horse race between Cerner and Epic and I think this acquisition will put Cerner just ahead of Epic in market share.

I liked this tweet from Hospital CIO Will Weider about the acquisition:

Do Consulting Firms Increase or Decrease Your Bottom Line?

Posted on July 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

I’ve been learning a lot more about the Health IT and EHR consulting industry as I work with many of them who post jobs on our Health IT job board. In fact, I’ve written previously asking the question, “Are Most EHR Consulting Companies Really Staffing Companies?” The reality is that many of the so called consulting companies out there are much more like staffing companies than they are consultants. It’s just a lot more sexy to call someone a consultant than a temporary staff member. Plus, it’s hard to charge the rates they do as a temporary staff member, but a consultant seems to justify the higher rates.

I should make clear that there’s nothing wrong with this approach to business. Many healthcare organizations need the temporary staff that consulting companies provide. However, it has diluted the term consulting quite a bit in the process.

If you’re looking for a good way to know what type of consulting company you’re working with consider this question: Does the Consulting Firm Increase or Decrease Your Bottom Line?

The reality is that consultants are expensive. It costs money to get someone to come in and share their time and expertise with you. Plus, when you look at how many “billable hours” a consultant has available to them with travel, finding business, etc, they have to charge a premium to make up that time. However, just because something costs money doesn’t mean that it’s not worth it.

If I told you that you could spend $50,000 and you would save $200,000, every one of you would do it. If I asked you if you’d spend $100,000 in order to generate $500,000 in increased revenue you’d all be interested. This is the model a great consultant provides. Sure, the numbers are projections of value and that what makes it difficult. Although, many consultants are hired these days to complete specific tasks as opposed to provide ROI. That’s how you can quickly recognize the difference between a true consultant and a temporary staff.

The challenge consulting companies face is that it’s much easier to prove that tasks were complete. It’s much harder to really impact a company’s bottom line.