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Privacy and Nudity

Posted on October 2, 2015 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

MedX Privacy Panel - photo by Amy Berman

Last week I had the opportunity to attend the Stanford Medicine X conference – commonly referred to as #MedX. This was my first time attending #MedX in-person. In the prior two years I watched the conference via live-stream.

If you’ve never been to #MedX I would highly encourage you to go. It is one of the only conferences where physicians, administrators, policy makers, med students, healthIT people and patients rub shoulders. The break-time conversations alone are worth the price of admission.

There were many interesting sessions at #MedX and many speakers had tweetable quotes, but there was one statement that was by far the most memorable. On Day 2, there was a panel discussion on the nature of privacy in healthcare (whether it prevented harm or innovation). The all-star panel included: Colleen Young, Pam Ressler, Jodi Sperber, Wendy Sue Swanson MD and Susannah Fox. During the closing remarks, Wendy Sue Swanson made THE BEST statement:

“People’s attitudes towards privacy in healthcare is like our attitudes towards nudity. Some people are completely comfortable exposing everything. They aren’t concerned with letting it all hang out. Some are comfortable with a bikini, which still shows a lot, but not everything. Some prefer to be completely covered up.”

Comedic gold.

Wendy’s comment is spot on. Privacy and nudity have a lot in common. Both are topics that are rarely discussed openly (in some circles the topic is completely taboo) and in both cases being exposed unexpectedly is something no one wants. The attitude towards nudity is deeply personal and no amount of words or persuasive argument is likely to change it. Just imagine a nudist trying to convince an ultra-conservative to shed their clothes.

However, personal experience CAN change how we feel about nudity…I mean privacy. Consider this example. Say I became ill and was unable to obtain a diagnosis. In this situation I would openly share my symptoms and health data with a wide audience – family, friends, other health professionals and even my social network. At this point privacy would not be a primary concern for me. However, once I begin treatment, privacy would suddenly become more important. I wouldn’t want the world to know everything and I would want my data protected but shared with those that were involved with my recovery. After successful treatment, my attitude would likely change again. I would want a high degree of privacy so that my health issue was not easily accessible to insurance companies or my employer (thought admittedly it’s probably easy for them to find out).

Kudos to this panel for a thought-provoking look at privacy and thanks to Wendy Sue Swanson for making an analogy that I’ll not soon forget.

Thoughts on Leveraging EMRs Effectively

Posted on September 28, 2015 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 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

Whenever I scan Twitter for #HIT ideas, I find something neat. For example, consider this intriguing tweet:

I say intriguing not because the formula outlined will surprise anyone, but rather, because it captures some very difficult problems in a concise and impactful manner.

Here’s some thoughts on the issues Portnoy raises:

* Optimization:  Of course, every healthcare IT organization works to optimize every technology it deploys. But doing so with EMRs is one of the most difficult problems it is likely to encounter. Not only do IT leaders need to optimize the EMR platform technically, they may also face external demands placed by ACOs, HIE partners and affiliated providers. And it’s also important to optimize for Meaningful Use functions.

* Workflows:  Building workflows that address the needs of various stakeholders is critical, as pre-designed vendor workflow options may be far from adequate. While implementing an EMR may be an opportunity for a hospital to redesign workflows, or to enshrine existing workflows in the EMR interface and logic, hospital leaders need to take charge of the workflow implementation process. Inefficiencies at this level can be costly and will erode the confidence of clinical teams.

* Revenue capture:  When properly implemented, EMRs can help providers generate more complete documentation for claims reimbursement, which leads to higher collections volume. As time has shown, difficult-to-use EMRs can lead to physician frustration, and in turn, cut-and-paste re-use of existing documentation — which is why carefully-designed workflow is so important. But if they are used appropriately, EMRs can boost revenue painlessly.

* Patient and provider engagement: True, IT needs to take the lead on getting the EMR in place, and must make some important deployment decisions on its own. Still, hospitals will have trouble meeting their goals if patients and providers aren’t invested in its success, and without patient interest in their data I’d argue that meeting long-term population health goals is unlikely. On the flip side, if clinicians and patients are engaged, the feedback they offer can help hospitals shape not only the future of their EMR, but also the rest of their clinical data infrastructure.

If there’s any common theme to all of this, I’d submit, it’s participation. Unlike most efforts corporate IT departments undertake, EMR rollouts are unlikely to work until everyone they touch gets on board. Hospitals can invest in any EMR technology they like, but if providers can’t use the system comfortably to document care, patients don’t log on to access their data, or revenue cycle managers don’t see how it can improve revenue capture, the project is unlikely to offer much ROI.

Digital Health Tech Funding Keeps Growing

Posted on September 25, 2015 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 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

I recently had a chance to look at data from CB Insights on digital health funding, and it turned out to be worth seeing. While anyone in healthcare IT knows that digital health technologies are a Big Deal, I hadn’t pieced together just how much money is pouring into the space.

According to CB Insights, digital health funding hit a robust $3.5B last year, and the space saw several IPOs as well.  A full 30 digital health ventures cashed out in 2014, compared with just eight exits by US-based digital health players in 2011.

One interesting feature of this activity is that three of the four companies that went to IPO last year (, Everyday Health and Castlight Health) support consumers. Honestly, I would have assumed that companies that serve providers would have had a bigger footprint.

Also, while there’s too few too data points to draw broad conclusions, I note that the two biggest deals done in 2014 — the Fitbit IPO and Under Armour’s $475M buyout of MyFitness Pal — were done by companies with a consumer focus as well. And Fitbit stock has gone great guns, with its value soaring from $4.1B at IPO to a market cap of about $8B.

On the other hand, it’s worth noting that the biggest exit listed by CB Insights was that of Veeva Systems, which provides cloud-based services to the life sciences industry. Clearly, there’s still a meaningful place for digital health companies that serve B2B needs.

On top of all of this investment, it’s worth noting that some of the hottest action in digital health isn’t going to make the CB Insights funding list. After all, well-funded giants like Apple, Qualcomm, Microsoft, Google and Samsung are just hitting their stride when it comes to digital health solutions. These behemoths bring their own huge piles of cash to the party, and pump up the opportunities in this space just by being there.

While healthcare probably isn’t mission-critical to any of the companies above, there’s still signs that they intend to invest heavily in digital health — and may yet prove to dominate key verticals. (For example, Apple HealthKit has tremendous potential, and its approach could become the default for integrating consumer health data with EMRs.)

Bottom line, the digital health market is very much in flux, and very hard to call. If I were sitting on a pile of cash, I’d probably invest in personal digital health data integration with providers, but that’s just me. The record so far suggests that investors haven’t given the provider enablement side of digital health, but rather, consumer empowerment.

I do think that the market will eventually swing around to hard-core business services that integrate all of these consumer digital health investments with day-to-day care. But it could take a few years of investors chasing rainbows until they get practical. In the mean time, hospitals would be smart to make their own digital health plays and even do their own startups. While digital health companies are everywhere, providers need to have a say in how this niche plays out.

Antitrust In The Brave New EMR World

Posted on September 18, 2015 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 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

Late last month, former Brigham and Women’s Hospital CEO Paul Levy made waves in the health IT world when he accused Epic of conspiring with Boston healthcare system Partners HealthCare.

In a post on his wryly-named Not Running a Hospital blog, Levy argues that Epic’s relationship with Partners raises antitrust concerns:

Here’s how it works.  Partners enters into a contract with Epic for the construction of an EHR for its facilities.  The two organizations go to the Partners-affiliated, but independent, medical practice groups and tell them that they have to install the Epic EHR–even if the EHR they have had for years is perfectly adequate for their purposes.  If a doctor’s practice asks why they can’t keep their old system, Epic makes clear that interoperability between its system and the practice’s legacy system is not feasible.  Meanwhile, to clinch the conversion, Partners also informs the local practices that failure to install the Epic system will foreclose those practices from participating in the favorable insurance contracting relationships it enjoys.  It is in this manner that the Epic-Partners actions box out the competition in this market.

In his article, Levy calls on Massachusetts Attorney General Maura Healey, and attorneys general of other states for that matter, to be on the lookout for similar deals between Epic and health systems elsewhere.

Interestingly, in other cases health systems accused of seeking excessive market power have used their Epic investment as a defense. For example, when its 2012 acquisition of Nampa, ID-based Saltzer Medical Group was challenged by the FTC, Boise health system St. Luke’s cited its $200M Epic system as a mitigating factor. Its lawyers asserted that St. Luke’s investment in effort was proof that the health system would be able to improve the region’s healthcare by better care coordination.

But the argument didn’t fly with the FTC, which didn’t believe that tying employed doctors to an EMR was needed to generate regional healthcare efficiencies. “Shared access to electronic medical records that St. Luke’s cited as a central benefit of the transaction can be achieved without an employment relationship or merger,” said Deborah Feinstein, director of the FTC’s Bureau of Competition at a speech given last year.

In my opinion, both Levy and Feinstein make excellent points. If Levy is right, it can easily be argued that Partners and Epic are engaging in questionable behavior, as it troubles at least this non-lawyer to see doctors strongarmed into using any particular EMR. And given that St. Luke’s was in the process of building a program to coordinate with unaffiliated physicians, it does seem that crying “we have Epic!” doesn’t address the problem.

But these are just bullet points. Overall, my sense is that neither state attorneys general nor the FTC and DoJ are sure how EMRs impact a health system’s market power, nor what constitutes anticompetitive behavior on the part of a vendor. I don’t know whether regulators don’t see EMR issues as a priority or are simply biding their time, but from my standpoint they are more than ripe for attack. What do you think?

Is More Data Driving Less Individualized Healthcare?

Posted on September 16, 2015 I Written By

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

Many would agree that the goal of most healthcare professionals is to promote individualized treatment and care for every person who comes through an organization’s doors. Unfortunately, healthcare professionals and leaders are compulsorily focused on meeting regulatory requirements and capturing tons of data which may lead to less focus on individual patients. Unique personal characteristics can get lost in the big data of healthcare that is focused on producing aggregate trends and scores. 

HIM professionals are getting more and more involved in the collection of data and the use of this data for impacting clinical care decisions. While we are not the providers of clinical care, we still play a big role in the data life-cycle and its affect on population health. The fact that HIM professionals are not involved in direct patient care is beneficial to an organization because we can focus on gathering, measuring, and analyzing raw data that is returned to the clinicians in the form of information. Turning this data into meaningful information allows the clinicians to make positive impacts on individual patient outcomes and control healthcare costs by removing some administrative burdens. 

Key regulatory agencies such as The Joint commission are looking for an individualized plan of care for each patient. Meanwhile, Meaningful Use initiatives are pushing for a more statistical approach to capturing the same data on each patient to drive an aggregate snapshot of a patient population. Objectives for aggregate data and composite scores can overlook some individual nuances and take valuable time away from the patient’s one on one time with a clinician. This can put clinicians in a tough spot balancing between all of the different competing requirements.

HIM professionals are here to help find the balance between these objectives by assisting in the development of documentation templates and automated workflows. Pulling data forward in the EMR and minimizing duplicate entries are ways to successfully achieve this. In a perfect world, clinicians should be able to focus their time on gathering data about each patient’s particular condition and individual socioeconomic factors of health. Required regulatory data fields should be easy to find with prompts and they should make sense for a clinician’s normal workflow. These requirements should not be an excuse for non-individualized healthcare.

The quest for individualized healthcare can be difficult when clinicians are bogged down with checklists and requirements. What I hope to see more of in the future is better utilization of HIM professionals’ skills in support of individualized care and regulatory outcomes measurements. This results in a more streamlined workflow for clinicians, more data and information at their fingertips, and ultimately better outcomes for each individual person.

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

Are We Patients or Healthcare Consumers?

Posted on September 15, 2015 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

Hello My Name is 221-365 - Robert Occhialini

On the weekly #hcldr tweetchat last Tuesday, I posed the question “Are we patients or healthcare consumers?” What resulted was a flurry of comments that made it clear that people are very divided on the issue.

Some like Laurel Ann Whitlock (@twirlandswirl) felt that the consumer moniker is appropriate:

Others like Sarah Greene (@researchmatters) and @EyeSteve felt the opposite:

This line of thought is interesting. There is an underlying assumption that “consumer” implies a commoditized and transparent market – one where the service, outcomes and pricing are all well known to the individual making the purchasing decision. Most of healthcare doesn’t fit into this nice little box – except with routine health/wellness visits. For many this is where the consumer analogy breaks down. People do not feel like consumers not because they don’t want to be, but because healthcare is so confusing and opaque that normal consumer behavior is the exception rather than the rule. There was a little bit of negativity directed at calling patients consumers, a sentiment that was called into question by none other than Dr. Nick van Terheyden (@drnic1):

Steve Sisko (@ShimCode) put forth the notion that this shouldn’t be an either/or discussion:

I agree with both gentlemen. I don’t think there is anything inherently bad about being a healthcare consumer. It would be wonderful to have a system where we were all so healthy that our interaction with healthcare providers was a simple transaction. I believe that for the most part, “patient” is the appropriate name because it speaks to the deeper relationship with healthcare providers. This is especially true for those with chronic conditions and rare diseases.

D’Anna Holmes (@PoPculture_px) summed up the discussion nicely:


Another Giant In Play: 3M Looking At “Strategic Alternatives” For HIS Unit

Posted on September 14, 2015 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 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

Given the staggering number of EMR launches that took place in the wake of the Meaningful Use kickoff, mergers, sell-offs and business failures were quite predictable. Despite the feds’ doling out $30B in incentive dollars, even that wasn’t enough to keep hundreds of EMR entrants afloat.

It hasn’t been as clear what would happen to large vendors with HIT interests, given that they had enough capital to ride more than one wave of provider adoption. The field has just begun to shake out, with only a small handful of major transactions taking place. Recent plays by large tech players include Cerner’s $1.3B acquisition of Siemens Health Services, which included the Soarian EMR. There’s also ADP’s sale of EMR solution AdvancedMD to Marlin Equity Partners after previously acquiring e-MDs. Not to mention Greenway and Vitera Healthcare Solutions joining forces and Pri-Med acquiring Amazing Charts.

Another major move was announced this April at HIMSS 15, when GE Healthcare announced that it was phasing out its Centricity Enterprise product. According to news reports, the Enterprise product only generated 5% of the Healthcare division’s EMR revenue. I could keep going, but you get the point.

Now, 3M has joined the fray, announcing this week that it was “exploring strategic alternatives” for its HIS business, including spinning off or selling the unit.  (It’s also considering keeping its HIS business on board and investing in its future.)  The company, which has signed Goldman, Sachs & Co. as strategic advisor and investment banker, says that it will probably announce what direction it will head in by the end of the first quarter of next year.

On the surface, 3M Health Information Systems looks like a very solid business. The HIS unit, which is focused on computer-assisted coding, clinical documentation improvement, performance monitoring, quality outcomes reporting and terminology management, reportedly works with more than 5,000 hospitals, plus government and commercial payers. According to 3M, the HIS business generated trailing 12-month revenues of about $730M, and has sustained 10%+ compounded annual growth for 10 years.

That being said, it’s hard to say what the fallout from the ICD-10 switchover will be, and it’s not unreasonable for 3M to consider whether it wants to compete in the post-switchover world. After all, while the HIS unit seems to be quite healthy, it’s certainly faces stiff competition from several directions, including EMRs with integrated billing and coding technology. Also, the company may be saddled with outdated legacy infrastructure, which makes it hard to keep up in this new era of revenue cycle management.

By the end of the first quarter of 2016, 3M will have had a chance to see how its customers are faring post-ICD-10, and how its customers needs are shifting. 3M will also find out whether other HIS players with (presumably) newer technology in place are interested in doing a rollup with its business.

Truthfully, if 3M doesn’t think it can benefit from investing in the HIS unit, I’m not sure who else would benefit from doing so. In fact, I’d argue that 3M is undermining its chances at a deal by waffling over whether it plans to invest or divest; as I see it, this implies that the HIS unit will be on life support without a major cash infusion, which is not something I’d find attractive as an investor.  If nothing else I’d want to buy the unit at a firesale price! But I guess we’ll have to wait until March 2016 to see what happens.

Under the Hood of Medical Devices

Posted on September 11, 2015 I Written By

The following is a guest blog post by Kevin Phillips, Vice President – Marketing and Product Management at CapsuleTech.
Value of Medical Device Data

When it comes to medical devices, most people think of patient monitoring and physiologic data such as HR, SPO2, respiration rate waveforms and physiologic alarms. But there’s a lot more “under the hood” of a device – a lot more than just physiologic data that, when applied in new ways, can contribute to patient safety efforts and help with operational efficiencies.

Under the hood are three types of data.  The first, and most often understood and used, is patient data that provides information on the physiologic status of the patient; a snapshot, if you will, of a patient’s condition at a given moment in time. The second type of data is treatment details.  These details provide a comprehensive view of treatments being administered to a patient, and include the names of drugs or anesthetic agents, drug concentration, the volume to be infused, or volume of air being delivered via a ventilator.  The third type of data is about the devices themselves. This information includes not only modes of operation, technical alarms, and battery level, but also data, such as firmware versions and unique device identifiers, that is useful to the clinical engineers responsible for maintaining these devices.

Of course, all of this data is meaningless without context.  This “contextual device data” can be added by external systems such as an EMR or by Capsule’s SmartLinx Medical Device Information System®. We define context as key information for each device: how the device is being used; where it is located; to which patient it is connected; and the identity of the primary clinician responsible for this patient. We also want to know information about the device itself including its unique device identifier, synchronized time (e.g. measurement time, device time, and NTP server time). Last, of course, are the clinical observations of the patient.

Today, only a fraction of this data…maybe 10%…is being used by a hospital; what is being used is typically only that data specified by the hospital by its EMR.  And while not all of the remaining 90% of the data is useable in some cases, there is a fair amount of significant value if mined and delivered to the appropriate system or user when it is needed.  Some examples include:

  • Alarm Management Systems – Well-documented patient safety risks posed by the failure to adequately address medical device alarms management by publications such as ECRI has led the Joint Commission to create a National Patient Safety Goal. This goal requires all hospitals to have a policy in place to manage alarms appropriately by 1/01/2016.  This has driven a demand for medical device data like near real-time notification of high priority physiologic and technical alarms from each device.  The art to these data integrations is close collaboration to deliver the proper alarms so not to overwhelm the clinician with nuisances (low priority alarms).
  • Device utilization – While solutions exist to help identify the location of expensive, high-maintenance devices, determining which devices are in use is difficult. Providing timely and appropriate device data to biomedical teams can ensure optimal device management, use and health, easing patient throughput and contributing to patient safety and care.
  • Clinical Decision Support Systems – Whether hospitals have created their own algorithms or purchased a turn-key solution, CDSS’s require high frequency physiologic medical device measurements to properly power their specific algorithms to enable them to identity patients at risk of sepsis or deterioration.
  • Patient Surveillance Applications – Automated patient surveillance helps clinicians to remotely wade through vast information stores to quickly discern data of the greatest value. With the addition of real-time device data, patient surveillance applications can better identify data clusters and trends consistent with patient deterioration and specific disease conditions, prompting clinical intervention.
  • Asset Management – While asset-tracking solutions can help identify the current location of devices, determining which devices are in use or underutilized is difficult. Devices offer a range of built-in operational checks, or support remote monitoring to ensure device readiness and status of any required supplies. The availability of this data to biomedical teams will ensure optimal device management and health, easing patient throughput and boosting patient safety and care.

So what’s under the hood of all of your medical devices?  Probably a whole lot more that you ever imagined that can be of immense value throughout your hospital. Why don’t you take a look today to see what value can be derived.

About Kevin Phillips
Kevin Phillips is the Vice President – Marketing and Product Management at CapsuleTech with over 10 years of experience in various roles within the healthcare, medical device and diagnostic industries. His career has been focused on new product development, product marketing, market analysis, strategic alliances, corporate operations, and sales. Prior to joining Capsule, Mr. Phillips held positions at TransMedics and PathoGenetix (formerly US Genomics). His career has been focused on new product development, product marketing, market analysis, strategic alliances, corporate operations, and sales.

What if Disney Ran an EHR Support Desk?

Posted on September 8, 2015 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

I am a Disney fan. I love their movies, resorts, service and theme parks. My family just recently returned from a DisneyWorld vacation and during our stay we had an experience that got me thinking about what it would be like if Disney ran the support desk for an EHR vendor (or any HealthIT vendor for that matter).

If that were the case, here is what a client with an EHR problem might experience.

1. A live-operator within 3 rings

On the first night of our stay, we noticed that there was a bit of water on the bathroom floor. It was more than condensation and we suspected that the toilet might be leaking. I picked up the phone and pressed the “At your service” button. Within 3 rings a pleasant lady named Judy answered.

2. A warm greeting by name

“Good evening Hung family, we hope you enjoyed Epcot today. How can I help make your stay more enjoyable?”. Hearing a warm and friendly voice on the phone immediately reduced my irritation at having to call down for service…plus the techie in me was very impressed that their service desk knew which Disney park we had visited that day (presumably through their new MagicBand system).

3. Active listening while the problem is described

I explained the situation to Judy. I told her about the water and how I suspected that our toilet was leaking. It took about a minute to explain everything. Judy did not interrupt me and I could hear her typing notes into her system (I asked).

4. Logical questions based on the described problem

After I finished telling my story, Judy proceeded to ask me several questions. How much was was on the floor? Had it gotten onto the carpet? Could I see anything dripping? Was anything else wet? Etc. What I noticed about her questions was that they were all based on the assumption something was wrong vs that we had done something wrong. For example, she never asked “Did someone just take a shower?” or “Did any of your kids come from the pool to use the washroom”. Using this tact immediately made me fee like Judy was working with me to solve the problem vs just trying to get me off the phone.

5. Offering a realistic solution

After she had asked her questions Judy apologized for the water in our bathroom and then she told me she had asked one of her housekeeping colleagues to come to our room to wipe up the water while we had been talking. Judy then shared with me her assessment of the situation: “Well Mr Hung it certainly may be a leak, but it may also be any number of other things. We really won’t be able to make a determination until we have one of our plumbers come and take a look. Is that something we can do tonight while you are in the room or would you prefer us to look in the morning?” Kudos to Disney – Judy had effectively put the onus on me to determine how critical (or not) the problem was and by asking this question Judy made me feel like a member of the problem solving team.

6. Expressing and demonstrating empathy

What Judy did next was unexpected. “Mr. Hung, I’m going to hang on the phone until Mary arrives. I know that if I was on vacation with my family and there is a problem with the room, I’d want it resolved as quickly as possible. I know how skeptical people are when you hear “someone will be right up”. Sometimes that can mean  5 minutes or 50 minutes. I want to assure you it’s 5 so I’m going to stay on the phone until Mary gets to your room.” Wow. Now I truly felt that Judy was on my side and really looking out for my family.

7. Working together to diagnose the root cause

Mary (name changed) from housekeeping arrived within 5 minutes and she had about 10 towels in her hands. “Mr. Hung, my colleague Judy told me about the water in your bathroom and I’m here to help clean it up. While I’m here I’m going to try and see if I can find the source of the water.” When Judy heard Mary’s greeting she asked if I would like her to stay on the line. I declined since Mary looked more than capable of handling the water.

Mary went to the bathroom and assessed the situation with me. She looked at the water on the floor and started eliminating potential sources out loud so that I could follow along. During this process, I helped Mary by feeling the paper towel she used to test the shower, sink and other fixtures for leaks. Each time my “job” was to verify whether or not Mary correct in saying the towel was dry.

8. Admitting you don’t have an immediate answer

At the end of the process, we arrived back at the toilet as being the most likely source of the water. However, there was nothing visibly wrong with it. There was no obvious sign of water. Mary and I were stumped. She admitted as much and said that she needed to call in an expert because she didn’t have enough knowledge to help me. She radioed for the night plumber and like Judy, offered to stay until he had arrived.

9. Committing to a solution

When the plumber arrived, he spent a few minutes speaking with Mary and then went straight to the toilet. He didn’t recheck anything she had done nor did he ask me any of the same questions that Judy or Mary had. The plumber spent a lot of time inspecting the toilet. In the end he determined that the caulking on the toilet likely needed to be redone and/or the tank had small crack in the back of it that no one could see. Unfortunately if he started working on either of those, it would mean we would not have a working toilet for the rest of the night. Given the little amount of water that was on the floor, I decided to hold off until the morning. The plumber committed to having the toilet fixed tomorrow and then he asked Mary to give us more bath towels to wipe up any excess water during the night.

10. Making it right

When we returned from Magic Kingdom the next day we were sad to see that the toilet had not been fixed. I immediately called downstairs and once again it was Judy who answered. “Mr. Hung, oh my, I can see that we didn’t manage to get your toilet fixed yet. Let me go find out what’s going on and call you right back.” I didn’t even say my name and yet Judy knew what I was going to ask!

About 30 minutes later Patrick, one of the resort managers called our room. Right away he apologized on behalf of Disney for the problems in our room and how they had committed to fixing things today and hadn’t yet done so. He said he had spoken with Judy, Mary and the plumber and they had all agreed that the only way to make it right was to move us to an upgraded room. Patrick then told me he had already asked a bellman to come upstairs to help us pack. Given that it was almost 10pm at night Patrick also let us know that he had added a credit to our account for all the inconvenience this had caused.

The rest of our vacation went without incident and we thoroughly enjoyed our time at Disney, but this support experience stuck with me and as I thought about it I became more and more impressed with all the little things the Disney team had done. What impressed me was:

  • How I never had to repeat myself. Not once was I asked the same the question.
  • How much trust each member of the Disney team had in their colleagues. Mary accepted Judy’s assessment of the situation and the plumber accepted Mary’s. There was no argument or second guessing.
  • How committed each person was to solving the problem. During the time each person spent with us, it felt like we were the only people in the resort with an issue. No one was rushing off to the next problem. They took their time and explained everything to us.

All of us in HealthIT know that support is an important client-facing part of businesses. Yet we often don’t spend enough time or effort to ensure these people get the resources and training they need to be successful. They are often after-thoughts. It shouldn’t be that way. We can and should do better. As Disney demonstrated to me, a pleasant support experience not increases loyalty it also creates fans.

Should Every Patient Have a Number of Health Scores?

Posted on September 4, 2015 I Written By

John Lynn is the Founder of the 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 and 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 today’s #HITsm chat, I saw an interesting tweet from Gus Gilbertson (@gusgilbertson) about incorporating various environmental scores into the healthcare analysis we do:

Which I retweeted with a question:

In another tweet (which I can’t seem to find), someone else suggested that every patient should have a health score as well. I think it’s interesting that Gus compared these scores to the FICO score that we each have. Would it make sense for every patient to have their own FICO like health score?

My question above was sincere: Would a score be enough to do any good?

My feeling is that the answer to that is no. Unless of course we were given a whole range of scores as opposed to one overall health score. For example, maybe we’re given a diabetes score and a cholesterol score and a heart disease score, etc. If we were actually treating a healthy patient and trying to keep them healthy, then having these scores could help a doctor focus on the things that were most at risk for a patient. Plus, the change in score could help the doctor tell a story to the patient which would hopefully encourage the patient to change some behaviors like eating right or exercise.

I’ve seen some related scoring in hospitals already. The Rothman index is one example. As I understand it, that index essentially scores a patient in the hospital on how they’re doing and if that patient’s condition is deteriorating. Could we apply that same principle to a patient’s health status? Even those patients who “feel” healthy?

What’s clear to me is that we have too much data that’s heading doctors way. We need to find some way to present this data and the change in data to the doctor so they can actually use that data for the patient’s benefit. Plus, the data might promote a patient to seek medical care earlier. No doubt all of these changes will transform how we think about medical care. I think that’s a very good thing!