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Hospitals Publishing Algorithms and Improving Adherence

Posted on March 2, 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.

Today I wanted to pair two seemingly unrelated tweets to talk about the shift that’s happening in healthcare and also what I hope is happening. Let’s start off with the big announcement that Mayo Clinic is starting to share it’s algorithms that improve patient outcomes on the Apervita platform.

I’ve long wanted some way for algorithms that are discovered to be easily shared. I’ll admit that I haven’t dug into the Apervita platform yet, but I’m interested in seeing how they’re trying to solve the problem of algorithm sharing. I’ll be looking to see what their business model is and if it makes sense from everyone’s perspective. It’s a challenging problem that I’d love for people to solve since it will make our healthcare system better.

This next tweet dives into the question of data versus the actual result of improving health:

I agree with Dr. Morrow that we have a lot of data and we haven’t done much to get all the value we could out of that data. Plus, even if you have great data, there’s a gap between understanding the data and getting the patient or doctor to do something about that data.

I love these two topics paired together, because I think the first step to converting data to adherence is to find the right algorithms that analyze the data. The right algorithms can indicate who to engage with to improve adherence. In many ways, getting people to improve adherence won’t be a tech solution at all. Instead it will be a human interaction that was prompted by great algorithms that poured over all the data we do have. That’s a powerful concept and one that needs to be shared.

Will Cerner Let Mayo Clinic Move to Epic Easily?

Posted on February 9, 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.

As most regular readers know, we don’t try to get into the rat race of breaking news on things like EHR selection, the latest meaningful use, or whatever else might be time sensitive healthcare news. Sure, every once in a while we’ll report something we haven’t seen or heard other places, but we’re more interested in the macro trends and the broader insight of what various announcements mean. We don’t want to report on something happening, but instead want to tell you why something that happened is important.

A great example of this is Mayo Clinic’s decision to go with Epic and leave behind Cerner, GE, and other systems. There’s a good interview with Mayo Clinic CEO, Cris Ross, that talks about Mayo’s decision to go with Epic. As he says in the interview, GE Centricity wasn’t part of their future plans, and so they were really deciding between Epic and Cerner. Sad to see that Vista wasn’t even part of their consideration (at least it seems).

Based on Cris Ross’ comments, he commented that he liked Epic’s revenue cycle management and patient engagement options better than Cerner. Although, my guess is that they liked Epic’s ambulatory better than Cerner as well since they were going away from GE Centricity. Cris Ross’s double speak is interesting though:

As we looked at what met our needs, across all of our practices, around revenue cycle and our interests around patient engagement and so on, although it was a difficult choice, in the end it was a pretty clear choice that Epic was a better fit.

Either it was a difficult choice or it was a pretty clear choice. I think what Cris Ross is really saying is that they’d already decided to go with Epic and so it was a clear choice for them, but I better at least throw a dog bone to Cerner and say it was a hard choice. Reminds me of the judges on the voice that have to choose between two of their artists. You know the producers told them to make it sound like it’s a hard choice even if it’s an easy one.

Turns out in Mayo’s case they probably need to act like it was a really hard choice and be kind to Cerner. Mayo has been a Cerner customer for a long time and the last thing they want to do is to anger Cerner. Cerner still holds a lot of Mayo’s data that Mayo will want to get out of the Cerner system as part of the move to Epic.

I’ll be interested to watch this transition. Will Cerner be nice and let Mayo and their EHR data go easily? Same for GE Centricity. I’ve heard of hundreds of EHR switches and many of them have a really challenging time getting their data from their previous EHR vendor. Some choose to make it expensive. Others choose to not cooperate at all. Given Mayo’s stature and the switch from Pepsi to Coke (Cerner to Epic, but I’m not sure which is Pepsi and which is Coke), I’ll be interested to see if Cerner lets them go without any issues.

I can’t recall many moves between Epic and Cerner and vice versa. Although, we can be sure that this is a preview of coming attractions. It will be interesting to see how each company handles these types of switches. What they do now will likely lay the groundwork for future EHR switching.

Investor Wants to Take Down Epic

Posted on October 13, 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.

I recently came across a really interesting comment from Chamath Palihapitiya, a venture capitalist (made his money working at Facebook), who commented on the healthcare industry and how he wanted to invest in a startup company that would take down Facebook. I embedded the full video below. His comments about EHR and Epic start at about 52:38 or you can click here to see it.

Here’s a great quote for those who can’t watch the video:

“Somebody has to go after the electronic medical record market in a really big way. Let’s go and take down this company call Epic which is this massive, old conglomerate. It’s like the IBM of healthcare.”

After saying this, he talks about how he and other VC investors like John Doerr could call people from Obama (for meaningful use stage 3) to Mayo Clinic to help a startup company try and take down Epic. He even asserts that he’d call Mayo Clinic and suggest that they should rip out Epic and go with this startup company.

Everyone reading this blog know that it won’t be nearly this simple to convince any hospital that’s on Epic to leave it behind. I agree with Chamath that it will happen at some point, but it won’t be nearly as easy as what he describes. Chamath also suggested that it might take $100 million and you might fail, but what a way to fail.

It certainly provides an interesting view into the way these venture capitalists and many startup companies approach a problem. However, I take a more nuance and practical approach of how I think that Epic will be disrupted. I think that it will require a mix of a new technology paired with a dynamic CIO that’s friends with the hospital IT leadership. You need that mix of amazing technology with insider credibility or it won’t be a success. Plus, you’re not going to go straight in and take out Epic. You’re going to start with a hospital department and create something amazing. Then, that will make the rest of the hospital jealous and you’ll expand from there until you can replace Epic. That’s how I see it playing out, but it likely won’t happen until after the MU dollars are spent.

Chamath’s comments were also interesting, because it shows that he doesn’t know the healthcare market very well. First, he said that meaningful use was part of ACA, but meaningful use is part of ARRA (the HITECH Act) and not ACA. This is a common error by many and doesn’t really impact the points he made. Second, he said that Epic is a big conglomerate. Epic is the farthest thing from a conglomerate that you can find. Has Epic ever acquired any company or technology? Cerner, McKesson, GE, etc could be called conglomerates, but Epic is not. Again, a subtle thing, but shows Chamath’s depth of understanding in the industry. It makes sense though. He isn’t an expert in healthcare IT. He’s an expert in seeing market opportunities. No doubt, disrupting Epic and Cerner would make for a massive company.

10 Key Hospital Website Findings

Posted on April 24, 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.

Molly Gamble has a great article on Becker’s Hospital Review website where she takes a look at a report covering top hospital websites. She offers 10 great findings and points of analyses that I thought many would like to read:

1. Even top brands struggle.
2. Key findings:
•    49 percent of hospitals lacked a mobile patient website
•    67 percent failed to offer online rehabilitation and aftercare information
•    Only 1 in 5 had online pre-registration to reduce patient wait time
•    Nearly 1 in 3 failed to facilitate online bill pay
•    At least 18 percent had onsite errors that hindered the patient experience
•    Nearly 1 out of 2 hospitals did not support post-prescription refill requests online
3. Barriers systems face
4. The need for digital governance
5. The top 10 patient-centric hospital websites, according to the report, are:
•    Mayo Clinic (Rochester, Minn.)
•    Cleveland Clinic
•    University of Texas MD Anderson Cancer Center (Houston)
•    Massachusetts General Hospital (Boston)
•    UPMC (Pittsburgh)
•    Duke Medicine (Durham, N.C.)
•    Thomas Jefferson University Hospital (Philadelphia)
•    Massachusetts Eye and Ear (Boston)
•    The Mount Sinai Medical Center (New York City)
•    Florida Hospital (Orlando)
6. Determining patient-friendliness.
7. Google results and brand reach.
8. Mayo Clinic did best in search results.
9. There is a distinction between patient- and brand-centric website content
10. The link between digital presence and spending.

In Molly’s article she covers each of these points in detail. So, if this interests you, check out the full article linked above. What do you think of these findings?

Patient’s Take On Making Hospital IT Patient-Friendly

Posted on September 4, 2013 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.

Today I was talking with my mother about her experiences with hospitals and IT. My mother, you should know, is so computer averse that she won’t send or receive e-mails — she leaves that to Dad.  But despite her fear of home computing, she’s got some interesting opinions about how hospitals should use health IT to involve patients in the care process:

* If possible, she suggests, hospitals should assess a patient’s “electronic IQ” to see how comfortable they are with using technology. I liked this because it could apply not only to in-hospital info sharing but also the patient’s ability to participate in remote monitoring or other mHealth modalities.

*Give patients access to a schedule (via an app on a tablet, perhaps) which tells them when various tests, procedures and clinician visits are likely to happen. This not only calms the patient, it helps keep the family in synch with the patient’s routine, she notes.

* Display results of key tests — or if clinicians are concerned that patients won’t understand them, at least register when the results have been received, so  patients know their care process is progressing. She’d be happy with a note that said: “Dr. X will be in to discuss the results of your CT scan shortly.”

* Allow the patient and their family/caregivers to make notes within the system of what they want to discuss with clinicians.  Otherwise, as she rightly points out, they’re likely to forget what they wanted to say when the nurse or doctor swoops into the room with their own agenda.

Actually, my mother’s vision is already largely in place in at least one facility. As I reported last year, the Mayo Clinic has already begun a program using content- and app-loaded iPads to move the patient through their inpatient stay. Not only does the Mayo implementation do everything on my mother’s wish list, it also allows patients to report on pain levels and exchange messages with doctors.

Let’s hope more hospitals find a way to use IT to make the care process more transparent for patients. While it calls for a not-inconsiderable investment in time and resources, it seems like an excellent way to keep patients engaged in their care.

Leveraging Digital Signage in Hospitals

Posted on December 13, 2012 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.

One thing I love about living in Las Vegas is that we have every conference imaginable in our lovely town. It turns out that most people in healthcare love this as well since it means that they can make a regular trip to Las Vegas for work. My most recent conference find is the Digital Signage Expo, February 26-28 and it has a surprising number of good healthcare focused content at the event.

As I thought about it more, digital signage is popping up everywhere in hospitals. For example, these are some of the areas that digital signage is used in hospitals to engage patients:

  • Digital Signage at Hospital Bedsides
  • Digital Signage in Lobbies
  • Digital Signage in Dining Area
  • Digital Signage in ED

However, the digital signage isn’t just seen by patients, but can also be a great way for hospitals to communicate important messages to clinical staff as well. Here are a few places where digital signage can engage the hospital staff:

  • Digital Signage in Nursing Units
  • Digital Signage in Employee Break Rooms
  • Digital Signage in Physician Lounges

Think about some of the possible benefits of properly implemented digital signage in hospitals:
Reduce Hospital Readmissions – This is a big topic in healthcare right now as hospitals search to lower costs and avoid penalties. Digital Signage can be a great way to properly educate the patients from when they step into your hospital to when they leave.

Increase Patient Compliance – Many hospitals are using their digital signage to educate their patients on discharge instructions, importance of filling and taking medications, and keeping follow up appointments with their primary care doctor.

Educate Caregivers – Many patients are recovering and unable to focus on the messaging provided, but digital signage provides an easy way to educate both the patient and their caregiver at the same time with a consistent, clear message.

Better Outcomes – This can be a particularly powerful outcome when clinical staff regularly see clinical messages. A simple example is using digital messages to improve hand washing in your hospital. An image can be a powerful motivator when it comes to promoting hand washing.

Put Patient at Ease – The right content can do amazing things to put a patient at ease during what can often be a very stressful experience.

Navigate the Facility – We often take for granted how easy it is for us to navigate the hospital. The same can’t be said for patients who visit the hospital irregularly. Digital Signage can’t help to alleviate this issue.

Patient Satisfaction – I have heard people talk about how reimbursement will soon be tied to patient satisfaction. Digital Signage is one major way to change the patient experience in your hospital for good. We will see a dramatic increase in patient satisfaction once we work to make their visit an experience.

Public Safety Alerts – In the wake of Hurricane Sandy and other disasters, I think we all can see the value of having a system available to communicate important safety alerts.

All of the above could lead to the most important result of them all: saving a life.

There’s a lot for a hospital to consider in order to achieve all of the benefits listed above using digital signage. The technology has become much more advanced, the variety of displays available is much broader, and then there’s always the challenge of how to produce and distribute the right content to these displays. Of course, this list doesn’t even include advanced functionality like the convergence of mobile technology with digital signage. That’s right. If you execute your digital signage properly, patients’ mobile devices can be a real asset to your messaging.

It seems like the Digital Signage Expo Healthcare track covers a lot of these challenges and more. Not to mention, it’s always great to hear how things are done in other industries so you can consider how that same thing can be applied to healthcare. Although, probably most interesting is Mayo Clinic’s Sharon Erdman leading a discussion on Patient Experience Design at the event.

I’d love to hear stories of how you’re using digital signage in your hospital or healthcare institution. What benefits and challenges have you seen?

At Mayo Clinic, Patients Getting Loaded iPads That Guide Them Through Stay

Posted on April 5, 2012 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.

Today, we give you a short case study on how the Mayo Clinic is using content- and app-loaded iPads to move the patient smoothly and happily through their experience there.

I don’t know about  you, but these kind of applications really excite me. The patient shown here isn’t just being given an iPad to meander about with, he’s been supplied a tool filled with useful information that better orients him to his process at the hospital.

“The iPad is a nice way to navigate through some of those resources and keep track on a daily basis that you’re doing the things you need to do to make sure you’re doing the things that you should be,” heart patient Randy Sterner tells the interviewer, who seems to find the app easy to use.  (“It made him feel like a part of the process,” notes Sterner’s wife.)

Among the things the iPad app does is allow Sterner to report on, say, levels of pain he feels or exercise he has done. These reports are broadcast instantly to the healthcare team working on his case.

The iPad app in question was created by a team led by Dr. David Cook, who hoped to meet a need that wasn’t being met.  I say, bravo. This seems like a wonderful idea.

Microsoft, GE Creating (Me Too?) Platform For Integrating Clinical Apps

Posted on December 9, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s an fun announcement, a bit light on the details but certainly fascinating enough just by virtues of the companies involved. Microsoft and GE’s healthcare IT business have announced that they’re creating an open platform allowing providers and ISVs to create next-gen clinical apps.

Exactly what apps, the announcement doesn’t say, though it hints at fashionable stuff like population health management. (I think that’s corporate-ese for “we’re not sure what we’ve got yet.”)

Clearly, MS and GE are getting wind of efforts by firms like SAP — which has promised to deliver an abstraction layer which can bring myriad data sources into a single happy EMR database.  With the need for integrated health analytics growing stronger by the minute, health IT middleware has never been sexier.

The MS/GE joint venture brings a number of existing properties to the mix, including:

* Microsoft Amalga, an “enterprise health intelligence platform”

* Single sign-on and context management solution Microsoft Vergence

* GE Healthcare eHealth, an HIE platform

* Microsoft expreSSO, an  enterprise single sign-on solution

Perhaps the most interesting item on the list is GE Healthcare Qualibria. Qualibria is a clinical knowledge app GE is developing in partnership with Intermountain Healthcare and Mayo Clinic, both known for being innovative and forward-looking where quality analytics are concerned.

Not surprisingly, GE Healthcare IT will also be developing its own healthcare apps on the platform, which will be designed to connect with a broad cross-section of existing health IT products.

The stated function of the new platform, as stated in the two companies’ press release,  is “helping healthcare organizations and professionals use real-time, systemwide intelligence to improve healthcare quality and the patient experience.”

The real function, at this point, is “don’t let other enterprise IT companies jump ahead in healthcare IT,” I’d say. But clearly something cool could come out of this at some point, particularly from providers like Intermountain and Mayo. So stay tuned.