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CXO Scene Episode 3: EHR Cloud Hosting, the EMR Market, and Health IT Staffing Challenges

Posted on August 28, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed the live taping of the third CXO Scene podcast with David Chou, Vice President and Chief Information and Digital Officer at Children’s Mercy Kansas City and John Lynn, Founder of HealthcareScene.com, the video recording is now available below.

Here were the 3 topics we discussed on the 2nd CXO Scene podcast along with some reference links for the topics:
* Cloud hosting
http://www.fiercehealthcare.com/ehr/uc-san-diego-health-pushes-ehrs-to-cloud-uc-irvine-slated-for-november

* Future of the EMR market with McKesson acquisition
http://www.mckesson.com/about-mckesson/newsroom/press-releases/2017/allscripts-to-acquire-mckessons-enterprise-information-solutions-business/
http://www.hospitalemrandehr.com/2017/08/18/is-allscripts-an-also-ran-in-the-hospital-emr-business/

* IT staffing challenges

You can watch the full CXO Scene video podcast on the Healthcare Scene YouTube Channel or in the video embed below:

Note: We’re still working on distributing CXO Scene on your favorite podcasting platform. We’ll update this post once we finally have those podcast options in place.

Take a look back at past CXO Scene podcasts and posts and join us for the live recording of future CXO Scene podcasts.

CXO Scene Episode 2: EMR As a Commodity, Shadow IT, Health IT Training, and Printer Security

Posted on July 28, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed the live taping of the second CXO Scene podcast with David Chou, Vice President and Chief Information and Digital Officer at Children’s Mercy Kansas City and John Lynn, Founder of HealthcareScene.com, the video recording is now available below.

Here were the 4 topics we discussed on the 2nd CXO Scene podcast:
* Did Meaningful Use Turn EMRs Into a Commodity?

* Shadow IT – How should healthcare leaders deal with Shadow IT?

* The EHR Dress Rehearsal – Should this be a best practice for every health IT implementation?

* Printer Security – Where do printers and print devices rank on security risks for an organization?

You can watch the full CXO Scene video podcast on the Healthcare Scene YouTube Channel already:

Note: We’re still working on distributing CXO Scene on your favorite podcasting platform. We’ll update this post once we finally have those podcast options in place.

Take a look back at past CXO Scene podcasts and posts and join us for the live recording of future CXO Scene podcasts.

WannaCry Will Make a CIO Cry

Posted on July 3, 2017 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

If you like CXO scene, you can subscribe to future Health Care CXO Scene posts here or read through the CXO Scene archive. Also, join us for the live recording of our first ever CXO Scene podcast on Thursday, 7/6/17 at 1 PM ET (10 AM PT) where we’ll be talking Petya, MACRA, and Organizational Blindness.

As continuous research is done to create better defenses against malicious computer attacks, cybercriminals have also come up with more ways to get cash into their pockets as quickly as possible.  In the past years, a new breed of computer virus has started infecting computers and mobile devices. These viruses are unlike the previous malware as they lock down the computer including the precious files in it and only unlocks it when the user has paid the demanded amount. WananCry, Cryptolocker, Cryptowall, and TeslaCrypt are the new computer viruses that belong to a family of infections known as ransomware.

Cryptolocker is the earliest version of ransomware that started infecting computers in 2013. It easily infects computers through phishing links usually found in email attachments and through computer downloads.  Once a computer has been infected with ransomware, all the computer files are held as ‘hostage’ of the cybercriminals. In some cases, ads of pornographic websites appear on the screen each time a user clicks. These cybercriminals demand payment in order to unlock the files and restore the computer to its previous state.  As an added pressure, these criminals threaten users to delete all files if certain demands are not met within a specified period (usually within 24 hours). The desperate user usually doesn’t have any choice but to give in.

Ransomware Threat in Hospitals

Threats from ransomware has been widespread and it has affected computers of hospitals. In a Reuters report, it stated that a study from Health Information Trust Alliance on 30 mid-sized U.S. hospitals revealed that over half of these establishments (52%) were infected with the malicious software.  Recently we are starting to see countries get shutdown due these attacks while a global voice dictation vendor was shut down and this interfered with the doctor’s ability to voice dictate their notes.

How Companies Can Prevent Ransomware Attacks

Ransomware attacks are serious threats in healthcare. When computers in hospitals stop functioning, there will be delay in information access and flow and may compromise the safety of the patients. When there is ransomware attack, caregivers will have no access to patients’ data which can be crucial for those who are unconscious. It can also result in delayed or undelivered lab requests and prescriptions. And since there are medical devices that rely on computers to be operated, they can be inoperable all throughout the period the computer is held ‘hostage.’

With more medical facilities relying heavily on technology for its operation, it’s crucial to keep the computers malware-free. The following are some tips on how you can prevent these ransomware attacks:

  • Back up your data
    One of the best things companies can do to protect themselves from ransomware is to regularly do backups. Regularly backing up your files can give you a peace of mind even if a malicious attack happens. Since ransomware can also encrypt files on mapped drives, it’s important to have a backup regimen on external drives or backup services that are not assigned a drive letter. The one key element that is missing during the backup process is testing the backup to make sure that it is working. Do not miss the testing step.
  • Make file extensions visible
    In many cases, ransomware arrives as a file with a .PDF.EXE extension. By adjusting the settings to make these file extensions visible, you can easily spot these suspicious files. It also helps to filter email files with .EXE extension. Instead of exchanging executable files, you may opt for zip files instead.
  • Take advantage of a ransomware prevention kit
    The rise of ransomware and its threats have paved way for cybersecurity companies to come up with ransomware prevention kits. These kits protect the computer by disabling files that are run from the App Data, Local App Data folders, and executable files run from Temp directory.
  • Disable the RDP
    The RDP or Remote Desktop Protocol is a Windows utility that enables others to access your desktop remotely. If there is no practical use of RDP in your daily operations, then it’s best to disable it as it’s often used by ransomware to access targeted machines.
  • Update your software regularly
    Running outdated software makes your computer more vulnerable to ransomware attacks. So, make sure to regularly update your software.
  • Install a reliable anti-malware software and firewall
    This is applicable to malware in general. Having both the anti-malware software and firewall creates a double-wall protection against these malicious attacks. If some gets past the software, the firewall serves as the second level of protection from the malware.
  • When ransomware attack is suspected, disconnect immediately from the network
    While this isn’t a foolproof solution, disconnecting immediately from the network or unplugging from the WiFi as soon as ransomware file is suspected can reduce the damage caused by the malware. It may take some time to recover some files but doing this can sometimes cut back the damage.

Ransomware poses a serious threat not just to the security of hospital files but as well to the patients’ safety. Hence, companies, especially healthcare facilities, must not take this malware issue lightly.  Your biggest security risk exposure is internal so make the effort to educate your internal workforce as a priority as well.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Cloud – Biggest Health IT Myths

Posted on June 7, 2017 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

If you like CXO scene, you can subscribe to future Health Care CXO Scene posts here or read through the CXO Scene archive.

So many companies are now embracing the reduced costs and agility that come with moving their data to the cloud. However, there are still so many contradictory opinions regarding which is a safer way of storing company data – on-premise storage or cloud storage? In view of this, we are going to start by dispelling the biggest IT myths that are making their rounds on the internet.

By moving your data to the cloud, you will have zero control over your technology

The fact is that by moving your data to the cloud, you can meaningfully reduce the pains and resources spent to continually upgrade software and maintain hardware. Your IT personnel can now focus on the primary business by improving operations instead of focusing on ‘Mr. Fix it’ services. Instead of a company spending a bigger chunk of its budget on expensive servers for workload and email storage, adopting the cloud can help them focus on their business strategy and support their core business in a more flexible and dynamic fashion that allows for quick responses to situations.

Storing data on premise is way safer than cloud storage

Security is principal for any business. A security breach could not only sell your trading secrets to your competitors, but it could potentially bring down your entire site and cause you to lose a lot of revenue and customer trust. It’s therefore a no brainer that the security of your business is one of the greatest concerns, especially when considering cloud storage.

With technology evolving every passing day, security has transformed into a full-time job that requires a full team of security professionals who often command handsome salaries that many businesses can’t afford. By working with a reputable cloud-based company, you get to gain first class access to one of the best security any money can buy for your business.

Cloud storage offers security against both digital and physical attacks. Additionally, most of today’s tech providers have moved to the cloud meaning we are going to see more and more innovations happening in the cloud, and you don’t want your business left out.

One thing that most people who are so against the cloud don’t consider is the fact people are the greatest security weakness of all. Every security breach is instigated by a person, and the good thing about the cloud is that it uses the latest technological developments to eliminate the need for people to man the security system.

You won’t be able to monitor your data’s sovereignty once you move to the cloud

Legally speaking, the physical location of your company can command where your business data is going to be held. For example, all public companies in Europe are required by law to store their corporate data in the European Union. This is not something that you need to worry about concerning the cloud. Most cloud providers today offer a vast range of data locations meaning you can always access one no matter where your company is located. Though sovereignty shouldn’t be any problem for you, you need to do your due diligence to ensure you remain on the right side of the law.

Moving to the cloud means you are going to have to move everything which could be very disruptive

When you start seriously considering moving vast amounts of your company’s data to the cloud, it’s easy to see why you could see it as a challenge. However, as with any change you are ever going to make in your company, you should take it slow to ensure you understand how the cloud truly works. Additionally, you and your employees will still feel like you are in control especially if you are so used to network based storage.

Now that we’ve got the myths dispelled, it’s time to seriously consider moving to the cloud. While on-premise storage is still a common phenomenon in most business, it’s not easy to ignore the fact that it is labor intensive, costly, uses a lot of energy and there’ still a chance that an insider can breach your security.

Cloud storage spells out so many more benefits aside from security. Time for you to keep up with the trend and move to the cloud.  I love it when I hear the traditional IT leader defend the position on why they want to build infrastructure and a data center, I guess the key phrase for them is Career Is Over (AKA CIO).

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Great Healthcare IT Leaders

Posted on January 25, 2016 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

As we prepare for the upcoming HIMSS conference on Feb 29 – Mar 4, 2016, I encourage the community to connect with these top thought leaders who will go above and beyond in engaging with the community. Looking forward to catching up in Vegas.
himss16 cio

Aaron Miri CIO at Walnut Hill Medical Center @AaronMiri 
Anna Turman CIO at Chadron Community Hospital and Health Services @iamTurman
Chad Eckes Board Member at NC HIMSS
Chris Belmont CIO at MD Anderson Cancer Center @CBelmont88 
Cletis Earle CIO at St. Luke’s Cornwall Hospital
Cris Ross CIO at Mayo Clinic
Darren Dworkin CIO at Cedar Sinai Medical Center @DworkinDarren
Dave Miller CIO at Optimum Healthcare IT @dlmilleroptimum
Dick Escue CIO at Valley View Hospital
Drex DeFord CIO Advisor @drexdeford 
Edward Marx CIO at The Advisory Board @marxists
Gareth Sherlock CIO at Cleveland Clinic Abu Dhabi
Gene Thomas CIO at Memorial Hospital of Gulfport
James Brady CIO, Kaiser Permanente Orange County
Jay Ferro CIO at American Cancer Center @jayferro 
John Delano CIO at Integris health
John Halamka CIO at Beth Israel Deaconess Medical Center @jhalamka
John Jay Kenagy CIO at Legacy Health
Jon Manis CIO at Sutter Health
Joseph Hobbs Regional CIO at NetApp @JOEtheCIO 
Kristin Darby CIO at Cancer Treatment Centers of America @khdarby
Marc Chasin CIO & CMIO at St. Luke’s Health System @M_Chasin
Marc Probst CIO at Intermountain Health @probst_marc
Michael Archuleta CIO at MT San Rafael Hospital @Michael81082
Mike Reagin CIO at Sentara Healthcare
Patrick Anderson CIO at Hoag Memorial
Pravene Nath CIO at Stanford Health @pravenenath
Robin Sarkar CIO at Lakeland Regional Health System
Sarah Richardson CIO at NCH Healthcare System @conciergeleader 
Scott Maclean Deputy CIO at Partners Health @stmaclean
Shafiq Rab CIO at Hackensack University Medical Center @CIOSHAFIQ
Steve Huffman CIO at Beacon Health System @SteveHuffman_IN
Steve Stanic CIO at Baptist Health (Jackson, MS)
Sue Schade CIO Advisor @sgschade 
Todd Richardson CIO at Aspirus
Will Weider CIO at Ministry Health @CandidCIO 

Let us know if you think there’s someone else you think we should add to the list. We always love to learn about new people that are worth following.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Hospital CIO David Chou’s Top 3 Focuses for 2016

Posted on December 28, 2015 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

As we wrap up 2015, here are three main focus areas that IT leaders must be prepared for in 2016

Mega Mergers / Affiliations are going to continue across the nation. Healthcare institutions realize that it pays to be big and it will be important to have the organizational size in order to be a player in the market. Almost every type of conceivable partnership is on track for the upcoming year. We have seen partnership between competitors (Kaiser and Dignity Health) that were unthinkable a few years ago. These types of creative partnership and affiliation will enable healthcare providers to regain the advantage against insurers when negotiating reimbursements and also gain best practices from each other to improve quality of care. We will also continue to see community hospitals collaborate with top tier healthcare systems and academic medical centers to generate more consumer options. To control costs, tertiary hospitals are rapidly moving care with lower acuity levels to the community hospitals.

Emerging Technologies such as smart-phones and patient tracking devices are catching on in healthcare and they will become the standard. Besides telling patients about the wait times in the emergency rooms, these devices are now also being used for telemedicine to make home visits and perform diagnosis of non-emergent medical disorders. Consumers are now storing their health information, list of medications and even the costs of treatment on smart-phones. With the smart-phones, consumers will be able to access their health records anywhere anytime. Smart-phones will also allow the ability to speak to a doctor and/or let the doctor see the patient remotely to deliver care from the doctor’s office to the patient’s location. Surveys indicate that the use of mobile devices for maintenance of medical health have doubled in just the past 2 years and many consumers will prefer to use their smart phones to connect to their healthcare provider in the coming year. The biggest question that remains to be seen is how patients and hospitals will manage security on these devices!

Data Security and patient privacy issues are always a concern. Because of the threat from hackers, almost every major medical device will need to have security features to prevent breaches that could cripple the industry. Consumers have already started to become weary of buying any new medical devices and hesitant to use what is available in hospitals because of recent hacking reports. Physician’s office and hospitals will have to step up and ensure there are no breaches in security. Otherwise, the penalties will be severe. More important, it can ruin the reputation of a hospital and lead to a decline in patients.

What are your top 3 focuses in 2016?

Let’s Connect On Facebook and Twitter @dchou1107.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Pros and Cons of Healthcare IT Outsourcing

Posted on December 4, 2015 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

Recently Black Book issued a report stating that CFOs, CIOs both favor outsourcing for technology. Outsourcing is not new to healthcare information technology and it has been practiced for decades. However, with the healthcare scenery changing rapidly, outsourcing of IT has again gained prominence. Introducing technology to a healthcare organization can be an expensive undertaking and thus, outsourcing may be the way to go. One of the main reasons why outsourcing is attractive is because it helps put together resources quickly and reduces the time to market when implementing technology.

Besides cost, other reasons for outsourcing include increased flexibility, organization inability to further develop staff quickly and there may be a cash flow problem in keeping an employee long term. Building a trusted relationship with a vendor is key and someone must monitor their performance to hold the vendor accountable. One needs to weigh the pros and cons before proceeding to outsourcing because it is not without risks.

Outsourcing Tips:

  1. Lower cost is often the single most influential factor when deciding on offshore outsourcing. Some of the world’s largest organization use contract employees or foreign labor to perform the commodity work. This also reduces the need for full time employees.
  2. Outsourcing is ideal when you need a 24×7 workforce. Outsourcing is an easier method to augment your existing staff in order to manage the 24 hour operation we require in healthcare.
  3. With outsourcing, it is usually easier to transition and move temporary staff because they do not have permanent ties with your organization
  4. In certain countries, there are rules and regulations that govern privacy and intellectual property; when you outsource outside of geographical boundaries, you will need to pay closer attention to data export regulations.
  5. You must manage the internal staff culture and feelings about outsourcing. Most personnel will view outsourcing as a threat to their job, so leaders must be transparent when they are outsourcing projects or tasks.
  6. The outsource contract must be clear and concise as to the roles and responsibilities of each party. The arrangement will fail quickly if both parties are not clear on this.

I believe that successful departments and organization can utilize outsourcing as a competitive advantage if it is managed appropriately, but there has to be a dedicated resource managing the vendor relationship. I have managed both an outsourced IT department along with insourced staff. The key is to have transparent leadership which treats every employee (outsource, and insource) the same. Clear communication is definitely required from the leader.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

Thoughts On The Quality Systems Transaction – What Does It Mean for Ambulatory EMR?

Posted on November 9, 2015 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

The top news last week was from Quality Systems Inc., which owns physician software vendor NextGen Healthcare Information Systems. The news was that NextGen will acquire HealthFusion Holdings, another ambulatory vendor, for $165 million (NextGen also sold their hospital division to QuadraMed the week before). As healthcare systems are consolidating, we are also seeing the consolidation happen on the vendor side and the payer side. The shrinking healthcare profit margin has an effect on the entire industry.

What is next for the ambulatory space?

  1. Physician Groups Joining Health Systems

As we move towards creating a clinical integrated network, the number of physician groups and independent physicians will also decrease where the majority will join an ACO or become an employee for the health systems. The decrease in medical groups and the consolidation of the medical groups will have a huge impact on the ambulatory EMR space. The industry will see a shift in the ambulatory EMR systems transition to the same EMR system that is used by the health systems, so I see a big pickup for the Cerner and Epic in the ambulatory world.

  1. Enterprise EMR

The enterprise EMR will have bigger demands from their clients to focus on the ambulatory side. Health systems are utilizing their technology investments as part of the outreach and growth strategy so it is vital that the clinics and medical groups have a system that fits their workflow. Many industry leading healthcare organizations are becoming a software EMR vendor by providing their ambulatory system to smaller hospitals, rural clinics, and physician groups that cannot afford the technology investment of an enterprise system.

This will be a very interesting space to watch in the next year. We’ll see which players will survive and see what their strategies will be moving forward. I have been providing advisory services for many health systems in regards to their strategy for maximizing their technology investment and making it a revenue-generating tool. So I will be keeping a close eye on this space and sharing insights with you on CXO Scene going forward.

If you’d like to receive future health care C-Level executive posts by David in your inbox, you can subscribe to future Health Care CXO Scene posts here.

The Current State Of “Big Data” In Healthcare – Health Care CXO Scene

Posted on November 2, 2015 I Written By

David Chou is the Vice President / Chief Information & Digital Officer for Children’s Mercy Kansas City. Children’s Mercy is the only free-standing children’s hospital between St. Louis and Denver and provide comprehensive care for patients from birth to 21. They are consistently ranked among the leading children’s hospitals in the nation and were the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center

Prior to Children’s Mercy David held the CIO position at University of Mississippi Medical Center, the state’s only academic health science center. David also served as senior director of IT operations at Cleveland Clinic Abu Dhabi and CIO at AHMC Healthcare in California. His work has been recognized by several publications, and he has been interviewed by a number of media outlets. David is also one of the most mentioned CIOs on social media, and is an active member of both CHIME and HIMSS. Subscribe to David’s latest CXO Scene posts here and follow me at Twitter
Facebook.

Editor’s Note: A big welcome to David Chou, the newest member of the Healthcare Scene family of bloggers. David has a great background as a hospital CIO and will bring a wealth of knowledge to Hospital EMR and EHR readers. We’re calling David’s series of blog posts the Healthcare CXO Scene. You can receive the CXO Scene blogs by email as well. Welcome David!

Healthcare is finally evolving towards utilizing data in our decision-making.  The landscape has changed dramatically with the adoption of Electronic Medical Record across the nation. Healthcare use to be a predominately paper based vertical and there are still lots of areas where it is dominated by paper. The fax is also still alive as a communication channel, but the industry has transformed dramatically in the last few years.

According to the Office Of The National Coordinator in 2013, nearly six in ten (59%) hospitals had adopted at least a Basic EHR system. This represents an increase of 34% from 2012 to 2013 and a five-fold increase since 2008. I am sure that percentage is even higher in 2015 in our journey towards an electronic world.

The workflow for the clinician and physician documentation does take a little longer now that they have to type instead of write their notes, but the advantages of having discrete data elements to run analytics will transform the decision making of every organization. If you Google the definition of “big data” the consensus definition is the wealth of structured, semi-structured and unstructured data that has the potential to be mined for information.

Unfortunately the healthcare vertical is still playing catch up and the majority of the organizations still only have Electronic Medical Record (EMR) data being used for decision-making. The healthcare vertical use to be similar to the airline industry where the key to success was keeping the hospital beds occupied similar to how the airline industry wanted to keep every seat on the airplane filled. The new model of care is figuring out a mechanism to keep patients out of the hospital beds and focus on keeping them healthy through preventative measures. We have to do all of this while figuring out the right financial model to be profitable.

As we move down the journey where we transition from a fee for service payment model to a value based payment model it is critical for every organization to transform their business process. Analytics will be key in making that change. Now let’s focus on the 2 key challenges that will force healthcare providers to focus on data to drive their decisions impacting their operations internally and externally.

Challenge #1: Healthcare reimbursements from Medicare and Medicaid have reduced year after year

This has a huge financial impact on health care since the Medicare expenditures have been growing as the baby boomer population ages. There has also been a steady increase of Medicaid expenditures, so the trend of lower reimbursements for taking care of a growing population will be what lies ahead for us in health care. Effective, quality delivery of care while reducing waste will be the main driver of success in the future.

Healthcare providers must understand the cost of delivering care down to the unit level. You will be surprised by the variation of cost for various procedures. The same procedure cost can vary by as much as 15-25% based on the products used. So one of the key elements of cost containment is standardization. As we transition to a value based payment model there will also be value based contracts which will be structured towards a shared savings model. The contractual terms will vary but the general theme will be to incentivize the providers to reduce cost for providing quality care to a population by offering a percentage of the net savings. We are seeing this trend in the Medicare shared saving program and leveraging data analytics will be the key-driving tool for this to be successful.

Challenge #2: The Move Towards Personalized Care

Consumers/patients have different expectations now. We are living in an on-demand personalized world where every industry vertical is moving towards a predictive environment including healthcare. The ideal scenario would be to consume data from the social platforms, wearables/sensors, mobile, public data, and other sources so that we can really understand in real time the current state of the consumer/patient.

Let’s assume the scenario of a digital consumer who is currently a diabetic patient that has been prescribed to be on a low calorie diet. The patient wears a fitbit and also has their smartphone app that tracks her heart rate. The heart rate is a bit higher than normal and the patient feels a little bit off. This wearable and mobile app is integrated with a central monitoring system at the hospital and an alarm triggers a clinician who checks the patient profile and history and takes the proactive measure of making a video call to the patient.

The patient answers the video call with the clinician and they have a video interaction where the clinician can see the facial color of the patient and asks a few questions. Fortunately the patient finished an intense workout about a hour ago so things are fine with the irregular heart rate at the moment and this video interaction also alleviates any anxiety for the patient. It is about 7pm so the patient decides to get something to eat and he is craving a burger so he pulls in to the drive through. The patient has his GPS turned on from his smartphone and also posts on Facebook that he is at a fast food chain’s drive through. This data element is picked up by the hospital’s CRM app and then an automated text is sent to the patient reminding him of the low calorie diet and makes a few recommendation from the menu. The patient can now make an inform decision and instead of ordering a burger he orders a grilled chicken sandwich.

The technology that I have described is already in place and it is similar to the retail sector when you walk in to the store and they already know your behavior. There is a trigger to create an action which hopefully equates to a sale.

Healthcare must move towards this culture of living in an on demand world where we can predict or persuade a behavior by the patient. The challenge that I see is that the majority of healthcare providers are still focused on their internal operations leveraging EMR data and we have not focused on the digital consumer yet. There are a lot of great work being put together by enterprise vendors and healthcare providers, but as we move down the journey of managing population health we can really learn from the other verticals and how they leverage the big data technology to improve consumer/patient engagement. All of this will ultimately lead to a healthier population.

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