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The Challenge of Managing So Many Vendors

Posted on March 8, 2017 I Written By

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

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

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

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

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

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

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

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

Do Hospital CIOs Have the IT They Need?

Posted on February 27, 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.

While at a CIO reception at the HIMSS-CHIME Forum, I took part in an interesting conversation with a group of CIOs. They were talking about the number of phone calls they get from vendors. They had some unique insights and approaches into how they handled all the incoming messaging from vendors. I’ll save most of those insights for the Healthcare IT Marketing and PR conference that I host, but he also offered this interesting nugget when he said the following:

Our organization more or less has what we need to be successful. We aren’t looking to add more.

He did later acknowledge that if that wasn’t true, that they would go out and search for the vendors as opposed to an incoming call from a sales person.

This CIO’s comment struck me. I don’t think he was being so arrogant as to say that they weren’t going to purchase any more IT solutions. However, I think he was saying that he didn’t see any major enterprise purchases on his horizon.

On the one hand, I think that’s a sign of a maturing of the industry. His hospital organization finally had the IT tools they needed to be successful. That’s a good thing since I think if we’d had the conversation 3-5 years ago it would have been very different.

On the other hand, it’s kind of scary to think that this hospital CIO isn’t really looking at the IT environment around him and looking for new tools and solutions that could make his organization even better. This is a simple illustration of how every IT organization can get in a rut and stop innovating if we’re not careful.

At some point in any IT implementation, you have to step back and double down on the investments you’ve already made. There are huge opportunities in every healthcare organization I’ve seen to maximize the benefits they’re receiving from the IT they’ve already implemented. It’s fair to say that this CIO was at that stage of the game. It was time to stop searching and implementing other systems and time to optimize what’s already in place. That’s a good thing as long as it’s not taken too far.

I think the hospital health IT industry is largely in the same place as this CIO. Most aren’t looking to make new purchases. Instead, they want to extract value out of their previous purchases. What do you think? Have you seen this same sort of market maturity? Any idea on what will be next that will change this CIO and the industry’s thinking?

Are Security Certifications Needed to Simplify the Acquisition Process?

Posted on January 20, 2017 I Written By

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

I’m generally someone who hates certifications. However, I hate them because they’re often implemented poorly and easily gamed. When they’re implemented effectively, they can be extremely helpful. Think about all the safety certifications that electronics have you go through. I’m sure they’ve saved our lives and saved our houses getting burnt down many times over.

I’ve wondered if a security certification would be useful for healthcare IT applications. Certainly it wouldn’t be perfect (security never is), but it could serve as a baseline security check that would help healthcare organizations with their acquisition process.

The reality is that many organizations don’t properly vet the healthcare IT applications they purchase for security. They aren’t consistent and they have limited resources. A security certification in theory would spread the costs of certifying a healthcare application’s security across a large number of organizations and thus save everyone money.

The key to this certification is not to have it as a kind of pass/fail certification. Sure, you want to say that it meets a certain standard of security, but more importantly it would also create a report on what type of security was implemented for that software.

Take encryption for example. Every healthcare organization looks for encryption. A security certification could ensure that the software system has implemented certification appropriately and also describe how the encryption was implemented. Is it end to end security encryption. Do they encrypt the data at rest? What about encryption of the data being stored on the customer’s device? etc etc etc

One challenge with this idea is that CIOs, health IT companies, and other technology professionals can become over reliant on certifications. It would have to be clear that the security certification was just a baseline and not a 100% foolproof way to secure your IT software. This is a challenge since health IT sales reps are going to position a security certification as such. It would take some effective marketing for people to know that the security certification could save them time in their security analysis of a new health IT software purchase, but wasn’t the end all be all.

I imagine some people would argue that this type of certification and details about how an organization or software company implements their security would be a treasure trove for hackers. Certainly you’d have to be careful with what you share and how you share it. However, most of the details are things that a good hacker could figure out anyway.

As it is today, health IT companies just say they’re HIPAA compliant (whatever that means) and many healthcare CIOs are floundering with limited resources for evaluating the security of the applications they buy. A security certification could help them make some headway on this I think.

Done the right way, a security certification could help set a new bar for how vendors approach security. That could be a very good thing. Of course, if not updated regularly and effectively, it could also require a bunch of hoop jumping that doesn’t provide real value. It’s a tricky challenge.

Are CIOs Now Vendor Management Organizations?

Posted on October 21, 2016 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.

Over my past 11 years blogging on healthcare IT, I’ve seen a dramatic shift in the role a CIO plays in healthcare organizations. This was highlighted really well to me in a recent interview I did with Steve Prather, CEO of Dizzion. He commented that hospital CIOs are now mostly vendor management organizations.

I thought this was the perfect way to describe the shift. One challenge with this shift is that many hospital CEOs haven’t realized that this is what’s happening. In many hospital executives minds, the CIO is still generating code, implementing servers, network switches, rolling out desktops, and cabling. In most cases, this couldn’t be further from the truth. Yes, the CIO still has to make sure there’s a high quality network, servers, and desktops, but that does little to describe the work a CIO actually does.

Instead of getting into the nitty gritty, most CIOs have become professional vendor managers. This has become the reality as most of what people think of IT (servers, desktop, networks, email, etc) have become commodity services. There’s very little strategic advantage to do these things in-house. They’ve become such commodity services that it costs much less to outsource many of these services to an outside vendor.

What does this mean for the CIO? Instead of being Microsoft or Cisco certified, they need to be well versed in relationship management. That’s a big shift in philosophy and a very different skill set. In fact, most people who have those type of tech skills and certification are people that can struggle with relationships. There are exceptions, but that’s generally the case. CIOs that can’t handle relationships are going to suffer going forward.

Lest we think that this is a change that’s specific to healthcare, it’s not. This shifting CIO role is happening across every industry. In fact, it highlights why it’s not a bad idea to consider CIOs from outside of healthcare. If you can’t find a CIO who has healthcare experience, you could still find a great CIO from outside healthcare as long as they have the right relationship management skills.

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.

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The Power of “Report Shaming”

Posted on November 13, 2015 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.


This tweet was inspired by a hospital CIO who was talking about the power of reports to shame providers into doing what’s right. I was a little shocked myself when the CIO called it report shaming. No one likes the word shaming, but that’s really what’s happening. Sure, you could be more politically correct and call it holding doctors accountable or creating transparency in your organization, but you can’t argue that fear of being shamed isn’t a powerful form of motivation.

The nice thing in health care is that there’s usually a really powerful mission behind the reports. The report usually represents something that’s best for the patients and every doctor I know cares about improving the care they provide. Sometimes they just need a report to motivate them to do it. Shouldn’t any healthcare provider be ashamed if reports show that they’re not providing the best care possible?

Many could argue that these reports aren’t providing better care. If that’s the case, then you need to rethink the reports. Plus, there shouldn’t be shame in not complying with reports that don’t actually improve care and improve the organization’s ability to take care of patients. Providers should kick back against reports that don’t make health care better. However, I’ve found that it’s usually not the case.

Feel free to call it something other than report shaming if you wish, but there’s a real power in showing healthcare providers how well they’re performing. That becomes even more powerful when you share it across the organization. Technology has made this so simple to do. Our medical education system has created a highly competitive culture between doctors. So, it’s no surprise that performance transparency across providers really works to motivate them to do more and better.

5 Pieces of Advice When Checking Out Epic or Cerner

Posted on September 29, 2015 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.

Elise Ames and Vince Ciotti has an interesting follow up post on Health System CIO that looks at Epic versus Cerner in the hospital EHR (or HIS if you prefer) market. The reality is pretty simple. Epic or Cerner are both going to be around for a long time to come. Although, I really enjoyed the 5 pieces of advice they offer at the end of the post for those buying a new car EHR (LIS):

  1. Owner’s manual —it’s sitting right there in the glove box. For an HIS, check out the user manuals – they’re all on-line today. And unlike RFP feature checklist responses, they contain the truth…
  2. Chat with the mechanics — they know what works well, and what breaks the most. For an HIS, ask to meet your implementation project manager before signing, and ask about their staff and (non?) experience…
  3. Take a test drive in the model you’re buying, and on the roads you’ll be travelling. For an HIS, make unchaperoned site visits and phone calls to client hospitals of your size and using your apps…
  4. Check out the warranty — what’s covered versus what’s not? With an HIS, ask for a boilerplate contract and request changes while you still have some competitive pressure…
  5. Negotiate price — don’t tell the Chevy dealer he won, then ask for a discount. Tell him you may buy a Ford unless he gives you a deal… After all, no one pays list price for a mega-buck HIS, do they?

I’ve heard of many of these suggestions before. However, the first one was one I hadn’t heard before. It’s a great idea and is the beauty of the internet. I’m also surprised by those that don’t do “unchaperoned” visits to current users of an EHR. Yes, it’s one thing to go to a reference site for an EHR. That’s a good thing as well, but you’ll get more value visiting one that isn’t a reference site per se.

Hiring Motivated People and Inspiring Them

Posted on July 8, 2015 I Written By

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

I found this great leadership quote on LinkedIn that was shared by Shanthi Iyer:
Leadership Quote

This is some really great advice to hospital CIOs as they approach hiring at their hospital or health system. Hiring motivated people and inspiring them is a great way to lead an organization. You’d think that inspiring people in healthcare wouldn’t be hard. However, it’s amazing how quickly people can become disillusioned with what’s happening in healthcare IT. Government regulations aren’t usually inspiring.

With that said, all of us in healthcare should be inspired by the possibility that we can save lives. I know that many doctors scoff at the idea that a technology person could have that kind of impact, but we absolutely can. No, we don’t get our hands bloody as we stitch up a patient after surgery. However, we can create systems that make the doctors better and prevent mistakes that would happen otherwise.

Of course, if we’re going to take on the opportunity to save lives we have to also take on the responsibility that if we do our job poorly we can actually damage lives. Both sides of the coin are equally important. Certainly that’s inspiration enough for everyone in healthcare. However, a great leader finds ways to casually remind staff of this vision. That’s the challenge a healthcare CIO faces. Luckily, if you hire motivated people and inspire them, you’ll be amazed by the results.

CIOs Want More Responsibility — And It’s About Time They Get It

Posted on January 19, 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 FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The life of a healthcare CIO is a tough one. More than ever before, healthcare CIOs walk a fine line between producing great technical results and thinking strategically about how technology serves clinicians. As with their more junior peers, many healthcare CIOs only get noticed when something breaks or goes offline. Worse, healthcare CIOs may get the blame dumped on them when a big project — especially a mission-critical one like an EMR implementation — fails due to problems beyond their control.

But despite the political battles they must fight, and the punishing demands they must meet, healthcare CIOs are largely satisfied with their career paths — as long as they have a shot at getting more responsibility that can help them move their organization’s strategy forward. This, at least, is the conclusion of a new survey by SSi-SEARCH.

SSi-SEARCH surveyed 169 CIOs to learn how they felt about key aspects of their job, according to iHealthBeat.  All told, the researchers found that CIOs are most satisfied with the trajectory of their career, compensation and strategic involvement. (This is a significant change from a couple of years ago, when CIOs told SSi-SEARCH that their pay wasn’t keeping up with the growth in their responsibilities.)

On the other hand, healthcare CIOs were markedly dissatisfied with the resources available to them, and almost half (48%) said that there will need to be changes within the next year. That’s certainly no surprise. As we’ve noted in this space before, not only do healthcare CIOs need to implement or further augment EMRs and handle the switch from ICD-9 to ICD-10, many need to make costly upgrades to or replace their revenue cycle management systems.

Even if their institution can’t increase their budget, healtlhcare CIOs would be somewhat mollified if they got some respect for some of the softer skills they bring to the table.

Forty-five percent of those surveyed said they wanted recognition for improving patient safety, 44 percent said they wanted to be recognized for innovation, and 37 percent wanted CEOs to appreciate their skill at “bringing departments together,”  SSi-SEARCH found.

Not surprisingly, they want to be appreciated for their overall contributions to their institutions as well. While 69 percent of CIOs felt that their work was “critically important” to the strategic mission of their organization, and 29 percent felt they had been “very important,” some of their employers don’t seem to see it. In fact, 23 percent of those CIOs surveyed felt that they hadn’t been recognized at all.

Sadly, though the healthcare CIO’s job has evolved far from bits and bytes to projects and strategies that directly impact outcomes, not every institution is ready to give them credit. But if they have CIOs pigeonholed as tech wizards, they’d better change their tune.

Giving CIOs the latitude, responsibility and budget they need to do a great job is enormously important. If healthcare organizations don’t, they’ll never meet the demands they currently face, much less emerging problems like population health management, big data and mobile health. This is a make-or-break moment in the dance between healthcare organizations and IT, and it’s not a good time for a misstep.

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

Posted on October 10, 2014 I Written By

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

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

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

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

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

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

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