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When Would It Make Sense to Share Your Healthcare Data Findings?

Posted on November 21, 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.

During a recent visit with Stoltenberg Consulting, we had a really interesting discussion about the future of innovation in healthcare. I think we all saw the potential that healthcare data findings can do to improve healthcare. I believe we’re sitting on top of amazing untapped potential in healthcare data that’s going to start being mined over the next few years.

With this in mind, I asked the questions, “Will hospitals and health systems share their data findings? How will we share the data findings?

I think these are extremely important questions as we enter the new world of healthcare discovery and I don’t think the old methods of published journal articles is going to get us to where we want to go. Think about how hard it is to go through the process of getting a journal article published and then the time it takes for the journal article to diffuse through the healthcare system.

Many people fear that health systems won’t want to share their healthcare data findings thanks to competitive concerns. While this may be true in some specific cases, I’ve found the opposite to be the case in healthcare organizations. When they find something that benefits their patients or health system, they are happy to share it with everyone. I think it’s something about the nature of healthcare that makes us want to improve the lives of everyone versus bowing to competitive pressures.

While I think that many want to share their healthcare data findings, the reality is that most of the healthcare data findings aren’t shared. I think that many health systems discover something in their data, but they don’t have an easy way to share it with the broader healthcare community. The choice isn’t to deliberately not share the findings, but they don’t have the time to share it.

We need to find a way to solve this problem. I think social media will play one small part in this type of sharing, but it’s only one element. We need a platform in healthcare that simplifies the sharing of healthcare data discoveries. If it’s not dead simple for a healthcare professional to share their discoveries, it doesn’t make sense for them to do it.

Given the lack of a healthcare discovery platform, this presents a great opportunity for companies like the aforementioned Stoltenberg Consulting to package up these discoveries in easier to consume packages. I’m not sure that this is a terrible model either.

In a simplistic view, one hospital could share their health data discoveries online and another hospital could replicate it. However, the process is rarely that simple and often requires a bit more work to make the results a reality. This is where it makes sense for an outside company to bring the full package of services and software to make the discovery a simple reality for a hospital. The hospitals I know often want to buy the full stack solution. They don’t have the bandwidth to recreate the solution themselves.

Regardless of how it happens, I hope we can find better ways to diffuse healthcare innovations and discoveries across all of healthcare.

Epic Salary Info

Posted on November 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.

Many of you probably remember that we helped promote an Epic Salary Survey. As promised, they’ve published the results of the survey and we thought that many readers would be interested in the Epic Salary survey results.

The survey had 753 responses. Not bad for an online survey that was promoted across various blogs and social media outlets. Although, as you can imagine, some states are better represented than others. It’s the challenge of having 50 states.

This is my favorite chart from the Epic salary survey results (you can download the full survey results and data by states here):
Average Epic Salary by Job Position

As I look at some of these salaries, I’m reminded of the doctor who said that they shouldn’t be spending time learning their EHR. The hospital CFO then told the doctor, “I’m sorry, but that Epic consultant costs a lot more than you.”

Now I’d like to see one from Meditech and Cerner.

John Glaser to Stay on as Senior VP of Cerner Upon Close of Acquisition

Posted on November 19, 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.

In case you’re living under a rock (or more affectionately, you’re too busy working to follow the inside baseball of EHR company acquisition), Cerner is set to acquire Siemens in late winter or early spring pending all the needed approvals for companies this size. Watching the merging of these two companies is going to be very interesting indeed.

Neil Versel just reported that John Glaser, current CEO of Siemens Health Services, has announced that upon close of acquisition he’ll be joining the Cerner team as a Senior VP. I also love that John Glaser made this announcement on the Cerner blog.

I think this is a big deal since I believe John Glaser is at the point in his career that he could do just about anything (or nothing) if that’s what he desired. The few times I’ve interacted with John Glaser, he was sincerely interested in moving healthcare forward through the use of advanced IT. I imagine that’s what’s motivating him to stay with Cerner. No doubt, Cerner is sitting on a huge opportunity.

In John Glaser’s blog post, he provided an interesting insight into Neal Patterson’s comments at the Cerner user conference:

In his CHC keynote address, Cerner CEO Neal Patterson did a masterful job of conveying Cerner’s commitment to patient-centered care. Before he spoke, a patient and her nurse were introduced with explanation that the woman’s life was saved by a Cerner sepsis alerting system. Neal then shared the incredible challenges he and his wife have faced in her battle with cancer because of limited interoperability.

Neal’s keynote was very personal – about how we can make a loved one’s care journey easier by ensuring that all records – every detail – are available electronically and accurately wherever the patient receives care. It was the case for interoperability but also the case for making a patient’s life easier and the care better.

It’s hard for me to say how much of this was theatrics, but I’m glad they are at least talking the right talk. I really do hope that Neal’s personal experience will drive interoperability forward. Neil Versel suggested that interoperability would be John Glaser’s focus at Cerner. I hope he’s successful.

While at CHIME, I talked with Judy Faulkner, CEO of Epic, and we talked briefly about interoperability. At one point in our conversation I asked Judy, “Do you know the opportunity that you have available to you?” She looked at me with a bit of a blank stare (admittedly we were both getting our lunch). I then said, “You are big enough and have enough clout that you (Epic) could set the standard for interoperability and the masses would follow.” I’m not sure she’s processed this opportunity, but it’s a huge one that they have yet to capitalize on for the benefit of healthcare as we know it.

The same opportunity is available for Cerner as well. I really hope that both companies embrace open data, open APIs, and interoperability in a big way. Both have stated their interest in these areas, but I’d like to see a little less talk…a lot more action. They’re both well positioned to be able to make interoperability a reality. They just need to understand what that really means and go to work on it.

I’m hopeful that both companies are making progress on this. Having John Glaser focused on it should help that as well. The key will be that both companies have to realize that interoperability is what’s best for healthcare in general and in the end that will be what’s best for their customers as well.

Do Hospitals Want Interoperability?

Posted on November 17, 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 had this discussion come up over and over again today in a series of discussions that I’ve had at the NYeC’s Digital Health Conference in NYC. Many people are blaming the EHR vendors for not being interoperable. Other people are blaming standards. Some like to blame HIPAA (which is ironic since it was passed to make health data portable). There are many more reasons that people give for why healthcare isn’t exchanging data and that interoperability isn’t a reality.

Although, in all of these discussions, I keep going back to the core question of whether hospitals and healthcare organizations really want that healthcare data to be interoperable. As I look back on the past, I can think of some doctors who’ve wanted it for a while, but I think the healthcare industry as a whole didn’t really want interoperability to happen. They would never admit this in public, because we all know on face that there are benefits to the healthcare system and the patient for interoperability. However, interoperability would have been a bad thing financially for many healthcare organizations.

It’s one of the dirty little secrets of healthcare. Sure, the EHR vendors never provided the interoperability functionality, but that’s largely because the healthcare providers never asked for it and largely didn’t want that functionality. They were all a little complicit in hiding the dirty little secret that healthcare organizations were benefiting from the inefficiency of the system.

I’m extremely hopeful that we’re starting to see a shift away from the above approach. I think the wheels are turning where hospitals are starting to see why their organization is going to need to be interoperable or their reimbursement will be affected. ACOs are leading this charge as the hospitals are going to need the data from other providers in order to improve the care they provide and lower costs.

Now, I think the biggest barrier to interoperability for most hospitals is figuring out the right way to approach it. Will their EHR vendor handle it? Do they need to create their own solution? Are CCD’s enough? Should they use Direct? Should they use a local HIE? Should they do a private HIE? Of course, this doesn’t even talk about the complexities of the hospital system and outside providers. Plus, there’s no one catch all answer.

I hope that we’re entering a new era of healthcare interoperability. I certainly think we’re heading in that direction. What are you seeing in your organizations?

ACA Open Enrollment Period Starts Tomorrow

Posted on November 14, 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 is the first day of the open enrollment period for the ACA health insurance exchanges. We all remember the disaster that was the first roll out of the health insurance exchanges. It will be interesting to see how the health insurance exchanges do a year later. I expect they’ll get overwhelmed again, but will generally be much smoother.

I’m particularly interested in this open enrollment period, because I’ll be participating in the search for health insurance. After jacking up my insurance premium thanks to ACA, my insurance plan is pulling out of my state. Sucks for us, but you’ll benefit since I’ll document my experience on the Healthcare Scene network of blogs.

Probably the best tool I’ve found so far has been this tool that previews the health insurance exchange plans. Ok, so the tool has a lot to be desired (ie. Why can’t I easily compare plans? How about some quality filters? etc). However, at least all of the plans are there so I have a place to start. Personally, I work in healthcare and going through the various plan options is like learning another language. I’m not excited to take part in the search.

I’ll be interested to see how the exchange plans compare to what I could just get on the market. Will they cost the same or more? We’ll see. Of course, the real reason that most people use the health insurance exchanges is because they want to get the government subsidized health insurance. Harry Reid just sent me the following about this topic:

Financial assistance is available during open enrollment to help you afford coverage by lowering your monthly payments. In fact, 82 percent of Nevadans who enrolled through the health insurance marketplace last open enrollment period were eligible for financial help to lower the sticker price of coverage.

Pretty amazing to see how many that used the exchanges got some sort of government subsidy for their insurance. I would have thought there would be more that didn’t qualify for government money that still used the exchange.

The Transamerica Center for Health Studies just sent me some interesting findings from their second annual ACA survey:

  • As of July 2014, the percentage of uninsured Americans had decreased from 22 percent to 15 percent since the previous year.
  • Most of the newly insured population acquired their health insurance through an Exchange (30 percent) or a government-sponsored program (28 percent).
  • More than three-quarters of the newly insured are satisfied or highly satisfied with the quality of the healthcare system they now access.
  • The highest percent (44 percent) of the uninsured are age 18 to 34.
  • Of those who are uninsured, 27 percent say paying their health expenses plus the penalty is less expensive than the options available to them.
  • Twenty-two percent of the uninsured did not obtain health insurance prior to the ACA deadline because they were not aware of the individual mandate.

This second time around, I don’t think it will be quite as eventful as the first time around. Although, you can be sure the media will be looking for that story. Usually when you go looking for something, you’re sure to find it.

Reminds me of meetings I do at conferences. They ask me what type of topic I’m looking for at the event. I never give them an answer, because I’m not at the event to cover a specific topic or to try and tell a specific story. I’m at the event to discover what stories are interesting and worth telling. I wish I could say the same for the rest of the media. You can be sure we’ll have plenty of stories this next week on the ACA open enrollment period.

EHR’s Influence on Practice of Medicine

Posted on November 13, 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 recently met with Ensocare to talk about healthcare and healthcare IT and what they saw happening in the industry. We had a far ranging talk about what was happening. However, one thing they said has really stuck with me and caused me to ponder a lot on where we’re at with EHR, where we’ve come from, and where we’re going. Here’s what they said (per my notes):

EHRs were never designed to influence the practice of Medicine.

Thinking about the history of EHR, I concur with this statement. EHRs were designed to better bill for the care you provide. That was their initial purpose. Many were designed to replace the paper chart. Others were built to meet the government meaningful use guidelines. How many were designed to really influence the practice of medicine? Very few if any.

Before we give EHR vendors a hard time, let’s be really honest about the EHR industry. We as the users wanted the EHR to improve our billing or to help us get meaningful use incentive money. We didn’t hold the EHR to the standard of really influencing the practice of medicine. The EHR market gave us exactly what we asked for. We can’t blame EHR vendors for meeting our market demand.

Why then are we surprised that EHRs don’t improve care, when they were never designed to do so?

With this baseline history, I’m not sure this is going to be enough going forward. Now that EHR software is implemented, many have the hope that the EHR will influence the practice of medicine. I’m interested to know how many EHR vendors will be able to create features, functions, workflows, etc that influence medicine versus something from outside the EHR vendor doing it. My guess is that the majority of EHR innovations will come from outside the EHR software itself. Many will work with the EHR data to achieve the result, but it will be someone from outside the EHR vendor that creates the result.

To me, this is the potential of EHR which has yet to be realized. What do you think? Will EHR be able to influence the practice of medicine? Will organizations, companies and individuals be able to build on the top of the existing EHR to influence medicine? Or will we need a new crop of EHR systems that are designed to influence the practice of Medicine? I look forward to hearing your thoughts in the comments.

The State of Government Healthcare IT Initiatives

Posted on November 12, 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.

Brian Eastwood has created a really great article on CIO.com that looks at why Healthcare IT is under fire. His finally couple paragraphs summarize the current challenge for government healthcare IT initiatives:

ONC – as well as HHS at large – admittedly finds itself between Scylla and Charybdis. Too much regulation (medical devices) can do just as much harm as too little regulation (interoperability). Moving too quickly (meaningful use) can cause as much frustration as moving too slowly (telehealth). Politics can explain some industry challenges (reform’s uncertain future) but not others (public perception of Healthcare.gov).

That said, healthcare wants to change. Healthcare has to change. As healthcare continues its rapid, unprecedented march toward modernity, industry leaders have every right to expect – no, demand – a strong, confident voice in their corner. Right now, ONC can barely muster a whisper when, instead, it should be shouting.

I don’t think I’ve seen a better concise summary of the challenges that ONC, CMS, FDA, etc face. This shouldn’t be seen as an excuse for these organizations. We all face challenges in our job and we have to learn to balance them all. The same is true for organizations like ONC.

What makes this challenge even harder for ONC is that they’re in the midst of a massive change in leadership. Not to mention a leader, Karen DeSalvo, who at best has her time split between important issues like Ebola and her work as National Coordinator over healthcare IT. Considering DeSalvo’s passion for public health, you can guess where she’s going to spend most of her time.

In some ways it reminds me of when I started my first healthcare IT blog: EMR and HIPAA. As I started blogging, I realized that I had a real passion for writing about EMR. The same could not be said for HIPAA. Despite it’s name, I was spending most of my time writing about EMR and only covering HIPAA when breaches or other major changes happened. I imagine that DeSalvo will take a similar path.

Without a dedicated leader, I don’t see any way that Brian Eastwood’s vision of ONC shouting with confidence becoming a reality. A bifurcated leader won’t likely be able to muster more than the current whisper. It’s no wonder that CHIME, HIMSS and other major organizations are asking for DeSalvo to be full time at ONC or for her to be replaced with someone who can be dedicated full time to ONC.

What should be clear to us all is that healthcare IT isn’t going anywhere. Technology is going to be a major part of healthcare going forward. Why the government wouldn’t want to make a sound investment with strong leadership is beyond me.

Patient Safety Benefits of EHR, EHR Design, and RIP CCHIT

Posted on November 7, 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.

Here’s a quick look at some interesting tweets out their in the healthcare IT and EHR Twitterverse.


I’ve heard this argument from Epic before. There’s certainly an argument to make for improved patient safety on one system. However, that’s likely because our current systems aren’t interoperable. If they were interoperable, then having one massive system wouldn’t be better for patient safety. Considering, the EHR world is going to be a heterogeneous EHR environment, we need to make it so multiple systems isn’t a patient safety issue.


Ouch! I’ve described them as big billing engines, but I think a tool designed for insurance auditors might be more descriptive. Lately there has been a new layer added. EHR is now a tool for meaningful use auditors as well.


CCHIT being gone won’t likely have much impact on healthcare and EHR. They were basically gone for a number of years already. Although, I think their departure is a good thing for healthcare IT and EHR. I’d just still love to see EHR certification disappear as well. EHR certification is not meaningful.

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.

When Did You Last Job Shadow a Doctor?

Posted on November 4, 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.

My brother is a really good programmer and I always gain a lot of insight into the software and tech world from him when we sit down and talk (which isn’t often since our wives don’t appreciate us enjoying ourselves like that, but I digress). One of the things he told me about developing an application or website is that it’s really hard to know the user’s response to the website. What might seem completely obvious to the maker (designer, programmer, etc), might be completely different from how a new user to the website or application sees it.

This makes common sense once you think about it. When you’re creating the application, you spend so many hours working on it that the layout and location of things are embedded into your brain in a way that it just feels natural to know where to go to find something. New users don’t have this same training embedded into their brain and so they look for very different things.

My brother suggested to me that one of the best ways to solve this challenge is to sit back and watch a user use your program or website. The insights you can glean from the experience are amazing. The great part is that it’s not a hard thing to do either. It takes a little self control to sit back and let them “solve” their problem on their own, but it’s well worth it.

I heard something similar from a CIO at the CHIME Fall Forum last week. They said that they regularly had their tech people shadow a doctor. They then recounted how shadowing a doctor was so valuable since their analysts could see first hand how the workflows they’ve embedded into the system aren’t working effectively for the doctor. You can see first hand how the doctor flips and flops between 3 screens over and over again and how the workflow would be so much more effective on one screen.

You can’t expect your users to report the issues above. First, they are able to accomplish the task, so it doesn’t feel like a system deficiency. Second, they’d have to know that a change like that was possible. Third, most of them are too busy to actually report this type of issue to IT so it can be resolved.

This is why shadowing a doctor (and let me add nurse) is so valuable. You get to see first hand what’s happening and find specific ways you can make your users’ lives better. Plus, it has the added value of showing those doctors and nurses that you care. Sitting in the trenches with these doctors and nurses is a powerful indicator that you want to know what’s going on and care enough to be there with them to see it first hand. Although, don’t ruin that benefit by shadowing the doctor and then doing nothing. Make sure you learn from the experience, make the change, and then communicate the change back to the users.