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NYC Epic Rollout Faces Patient Safety Questions

Posted on March 30, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

In the summer of last year, we laid out for you the story of how a municipal hospital system’s Epic EMR installation had gone dramatically south since its inception. We told you how the New York City-based Health and Hospitals Corp. was struggling to cope with problems arising from its attempt to implement Epic at its 11 hospitals, four long-term care facilities, six diagnostic treatment centers and more than 70 community-based clinics.

At the time of last writing, the project budget had exploded upward from $302 million to $764 million, and the public chain’s CTO, CIO, CIO interim deputy and project head of training had been given the axe. In the unlikely event that you thought things would settle down at that point, we bring you news of further strife and bloodshed.

Apparently, a senior clinical information officer with the chain’s Elmhurst and Queens Hospital Centers has now made allegations that the way the Epic install was proceeding might pose danger to patients. A New York Post article reports that in a letter to colleagues, outgoing HHC official Charles Perry, M.D. compared the EMR implementation process to the 1986 Challenger space shuttle disaster.

In his letter, Dr. Perry apparently argued that the project must be delayed. According to the Post, he quoted from a presidential panel report on the disaster: “[For] a successful technology, reality must take precedence over public relations, for nature cannot be fooled.” Another Post article cited anonymous “insider” sources claiming that the system will crash, as the implementation is being rushed, and that the situation could lead to patient harm.

For its part, HHC has minimized the issue. A spokesperson told FierceHealthIT that Perry was associate executive director of the Elmhurst hospital and liason to the Queens Epic project, rather than being CMIO as identified by the Post. (Further intrigue?) Also, the spokesperson told FHIT that “if a patient safety issue is identified, the project will stop until it is addressed.”

Of course, the only people who truly know what’s happening with the HHC Epic implementation are not willing to go public with their allegations, so I’d argue that were obligated to take Perry’s statements with at least a grain of salt. In fact, I’d suggest that most large commercial Epic installations (and other large EHR implementations for that matter) got the scrutiny this public hospital system gets, they’d probably look pretty bad too.

On the other hand, it’s fair to say that HHC seems to crammed enough scandal into the first few years of its Epic rollout for the entire 15-year project. For the sake of the millions of people HHC serves, let’s hope that either there is not much to these critiques — or that HHC slows down enough to do the project justice.

Value-Based Lawn Care – Life Imitating Healthcare

Posted on March 28, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Ah, spring. Warmer weather, budding trees and the return of that big ball of light in the sky. The clearest sign of spring? The arrival of lawn-care flyers in my neighborhood. It’s only been a week of spring and already I have received over 15 flyers.

Normally I just throw these flyers out – taking care of my lawn is a responsibility I prefer not to outsource – but this year one company’s flyer caught my eye. Instead of the pay-as-you-mow or weekly visit programs offered by their competitors, this particular company was offering a program that guaranteed a green lawn until the start of fall. For a set price they would aerate, weed, spray, fertilize, cut and trim your lawn as needed.

“Have a healthy, weed-free lawn all summer. Let us do all the preventative and maintenance work. You just enjoy your weekends.”

Here was a company that was eschewing the industry’s volume-based standard practice and opting for a value-based offering instead. This company smartly recognized that homeowners do not want someone to come and care for their lawn on a regular basis but rather a healthy green lawn. The process to get that healthy lawn makes no difference, just the outcome. Funny how no government penalty system or legislation was need to pressure lawn-care providers into adopting a value-based model.

I must admit I never thought that the lawn care industry in my neighborhood would be going through the same volume-vs-value challenge as we are in healthcare.

I wouldn’t have made this connection had it not been for the excellent post by Sarah Bennight, Director of Marketing at eMedApps. She wrote about the four key requirements she believes are necessary for transitioning to value-based care:

  1. Strong quality measures
  2. Comprehensive population health
  3. Predictive analytics and trending in the clinical setting
  4. Breaking down silos

The lawn-care industry doesn’t have any comparable challenges (or consequences) like those mentioned by Bennight. I can’t imagine that competing landscaping companies are all that interested in sharing data or breaking down industry silos. However, I do think that healthcare can look to other industries for inspiration and ideas to address our own transition to a value-based world.

Better go seed my lawn now.

Value Based Care Hurting Most Vulnerable Hospitals

Posted on March 25, 2016 I Written By

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

In an article by the Washington Examiner, they highlight an interesting impact of the shift to value based reimbursement on hospitals:

Safety-net hospitals are getting hit by Obamacare’s push to penalize poor quality, the latest evidence of problems with the law’s effort to improve quality of care.

A new study from Harvard Medical School found that safety-net hospitals that treat many low-income or uninsured individuals are being penalized more for hospital readmission rates than other hospitals.

If a hospital readmits too many patients 30 days after they are discharged after being treated for a certain condition, that hospital gets penalized. A hospital could receive up to a 3 percent reduction in its Medicare annual patient payments.

The policy, which started in 2011, a year after Obamacare was passed, is intended to address a quality issue at hospitals. It is part of a larger shift in Obamacare to transition Medicare payments away from traditional fees for service toward a new model that rewards quality care.

We saw something similar to this happen during meaningful use as well. The most vulnerable hospitals couldn’t get the EHR incentive money because the incentive money wasn’t enough to cover the entire costs of the EHR. So, they just went without. In fact, an argument could be made that a large portion of the meaningful use EHR incentive money was paid to hospitals that were already on the path to EHR, but that’s a topic for another day.

When it comes to value based reimbursement it takes the right investment in technology and processes to be successful. I know a lot of hospitals that are just trying to keep their doors open. Where does that leave them time to think about these new complex government regulations? No doubt this shift to value based reimbursement is going to cause a lot of them to close their doors or be merged into the larger hospital systems. In fact, the later has been happening for a while and will continue to accelerate.

The article above does suggest a possible solution:

One alternative would have a hospital be measured by how its readmission rate improves rather than whether it meets a national average.

“Hospitals could be rewarded based on improvements off what their prior performance has been,” Barnett said.

Another alternative is for a hospital to become an accountable care organization. The concept gives a hospital a spending growth target that it has to meet for its Medicare patients.

I like the idea of benchmarking, but that can get really messy really quickly. The more I learn about value based reimbursement the more I worry that we’re just making things more complex without actually solving healthcare’s core problems.

What Does Health Informatics Mean to You?

Posted on March 23, 2016 I Written By

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

A couple of weeks ago, I was involved in a great discussion about health informatics and what it actually entails. This wasn’t the first time I have been involved in this type of discussion as informatics has been a buzzword in healthcare for several years now. Since no two organizations are structured exactly the same, Informatics can mean different things to different people.

For me, I have seen informatics in practice as those roles involved in building and optimizing the electronic medical record (EMR) and clinical workflows. Informatics professionals ensure data is being collected appropriately so that it can be used for further healthcare decision making and operations. This was a daunting new task several years ago when Meaningful Use first came into play. I remember many articles and statistical reports stating there was a major shortage of IT professionals who were going to be needed to help organizations meet Meaningful Use criteria and perform the role of health informatics.

I do not see informaticists as being confined to any particular department of a healthcare organization but rather they are professionals that are skilled in applying technological and data science techniques to healthcare practices. I have seen many roles such as IT, HIM, and licensed clinical professionals take on informatics responsibilities to address the needs of the changing healthcare environment. Informatics needs the collaboration of these different skillsets to bridge the gap between the technology and healthcare consumer outcomes using data and research.

When we start to look at informatics as it relates to healthcare research methodologies, I believe this is where informatics starts to split off into a more refined usage of data. This goes beyond the EMR workflow optimization and into the realm of using the data to build registries, look at cause and effect relationships, and review patterns and trends in healthcare treatment and outcomes. Since most of us healthcare professionals are at different stages of EMR implementation and optimization, there are some early adopters testing the waters and beginning to understand the value of all of the healthcare data that has become readily available. I am excited to see what the future holds for health informatics and how these tasks will be aligned with the HIM professional’s skillset.

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

Quick Hitting Thoughts on CDS (Clinical Decision Support)

Posted on March 21, 2016 I Written By

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

I’m finally starting to go through all my notes from HIMSS. Part of that is because I’ve been busy after HIMSS. Part of it is because I like to recover from what I call the #HIMSSHaze. Part of it is that I like to see what still resonates a few weeks after HIMSS.

With that in mind, I was struck by a number of quick hitting comments that I noted from my interview with Dr. Peter Edelstein, CMO at Elsevier. Dr. Edelstein is a fascinating guy that I’ll have to have on a future Healthcare Scene interview. In the meantime, here are some of the quick hitting thoughts he shared about CDS (Clinical Decision Support).

One key point he made is that it seemed like many organizations didn’t have a strategy for CDS. He also aptly pointed out that the same seemed to apply to big data. I agree with him wholeheartedly. If we were to go to a healthcare organization and ask them their CDS strategy I don’t think most of them would have an answer. I think if we dug in, we’d probably find that most of them have essentially deferred their CDS strategy to their EHR vendor. Does anyone else feel like this is a problem?

When I asked Dr. Edelstein what would be his suggested strategy on adopting CDS, he suggested that he’d want to make sure that the CDS solution worked across all provider types. Next he compared the pull CDS solutions (Reference resources, etc) to wearing seat belts in a car and the push CDS solutions (Order sets, care plans, etc) to an airbag in a car. While we certainly need both sets of solutions, he suggested that we should make more of an effort to get the push CDS solutions implemented in healthcare.

I thought the analogy was a great way to look at the various types of CDS solutions. Plus, I agree that we need more push solutions in healthcare. The pull solutions are necessary for some of the most challenging problems, but we all know that when a doctor is busily going about their day they often choose not to check with the pull solutions when they should. The push solutions can be integrated into their workflow so that providers can more easily address any potential issues from within the flow of their day.

Dr. Eldestein also pointed out that Wikipedia is still the most commonly used reference resource despite many studies which have illustrated the medical errors that exist on it. Why do they use it? It’s because it’s simple to use and easily accessible. This is a great illustration of why we need the right CDS information to be more easily available to the doctor at the point of care at the moment they need it.

Definitely some great insights into CDS. What’s great about CDS is that at this point pretty much everyone is using some form of CDS. We’re also seeing CDS integrated more deeply into EHR software. I expect this trend will continue and will become much more sophisticated.

It does beg the question, what’s your healthcare organization’s CDS strategy?

What Happens After We Get Access to Our Medical Records?

Posted on March 18, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Over the past few years, there has been a growing choir of patient voices asking for access to medical records. It started with a few courageous e-patients asking for their data – most notably David deBronkart aka @ePatientDave and Regina Holldiay @ReginaHolliday.

Now with the proliferation of tracking devices and wellness apps, more and more people are joining the choir including: vendors, government agencies and leading medical institutions. Although progress is still slow, it is now possible to imagine a day when all patients will have free and open access to their medical record.

This week’s #hcldr tweetchat asked the question…So What Next? What would be the first thing you would do if you had complete access to your own medical record? Below are some of the more interesting and notable answers.

Correcting errors in the medical record in order to avoid future adverse events was the most popular answer from the #hcldr community. Sharing the medical record was a close second:

There were a few data geeks in the #hcldr crowd who saw access as an opportunity to mine the record:

I think @mloxton is spot on with his tweet. I would definitely do the same – mostly to find out if there was a pattern in my medical record that could help predict future health issues. Armed with that information I would then make changes to my current behavior.

The most interesting use of medical record data came from Andy DeLaO @CancerGeek:

I’m thinking the world could use a few more @CancerGeeks…even virtual ones.

Matthew Katz MD had the most thought-provoking tweet relating to medical records:

Nothing comes without a price and Katz’s tweet certainly highlights a potential headache if the level of health literacy is not improved ahead of open access to medical records. I have faith though, that over the next few years we will see many more startups with technologies that can read medical records and produce plain-language interpretations as well as recommendations. That utopia can’t come soon enough.

For a curated summary of the #hcldr chat see this Storify.

What would you do if you had access to your medical record?

Healthcare Analytics Biggest Competitor – Excel

Posted on March 16, 2016 I Written By

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

This tweet highlighted an interesting observation I had after experiencing so many healthcare analytics pitches going into and at HIMSS. I’ll set aside the email comment for now (email is still very powerful if done right) and instead focus on Excel. Here’s what I discovered about healthcare analytics:

Excel is a healthcare analytics company’s biggest competitor.

It’s crazy to think about, but it’s true. When a healthcare organization is evaluating healthcare analytics platform the “legacy system” that they’re usually trying to replace is Excel. I can’t tell you how many times I heard analytics vendors say that “Hospital A was doing all of this previously on a bunch of Excel spreadsheets.” If you work at a hospital, you know that you have your own garden of Excel spreadsheets that are used to run your healthcare organization as well.

When you think about the features of Excel, it’s no wonder why it’s so popular in healthcare and why it’s a challenging competitor for most healthcare organizations. First, it’s free. Ok, it’s not technically free, but every healthcare organization has to buy it for a lot of reasons so that cost is already in their standard budget. Second, every computer in the organization has a copy of Excel on it. Third, the majority of people in healthcare are familiar with how to use Excel. Since we love to talk about healthcare IT usability, Excel is extremely usable. Fourth, Excel is surprisingly powerful. I know many healthcare analytics organizations could argue its limitations, but Excel is more powerful than most people realize.

That’s not to say that Excel doesn’t have its weaknesses. I’m sure that most organizations have experienced time wasted trying to figure out which Excel file has the accurate data or is the most up to date. No doubt you’ve experienced the multiple copy problem where 2 people are editing the same file and now you have 2 versions of the same file that need to be merged. Document management software has helped with this situation in many regards as it locks the file when someone starts to edit it and things like that. However, it’s still often a problem.

Another problem with Excel as compared with a true analytics platform is when you want to go in and slice and dice the data. What’s possible with a true analytics platform is so much more powerful when you want to really dive in and chop up the data in unique ways.

While possible in Excel, most uses of Excel are backwards facing data analysis and tracking. You can do some near real-time data analysis in Excel, but newer analytics platforms do a much better job of real time analytics using the latest data.

Of course, the biggest problem long term with Excel is that it can’t scale. Once you reach a certain amount of data points or a certain amount of complexity in the data, Excel falls on its face. However, most healthcare organizations are still working on small data, so Excel’s worked fine.

I’m sure there are many more issues. Hopefully some analytics vendors will chime in with more examples in the comments or on their own blogs. However, it’s worth acknowledging that for many organizations it’s really hard for them to find a healthcare analytics solutions that’s so much better than Excel. Plus, many of these expensive analytics solutions fail when it comes to some of the things that makes Excel great (ie. Free, Usable, Ubiquitous).

GE Healthcare Is Still In The Game

Posted on March 14, 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.

Below is the recent press release from GE Healthcare.  Their EMR will be used in the Rio 2016 Olympics which is a great win for GE.  The product has come a long way and they are making some great strides.  The challenge is where will the product fall in a healthcare EMR ecosystem that is predominately Epic and Cerner.   Personally I know of a few organizations that are evaluating a transition away from the GE Centricity platform due to either a merger with a bigger healthcare system that already has an enterprise EMR or they had a bad experience with Centricity and are moving on.  It will be interesting to see in the next 2-3 years how many EMR vendors we will have left.  I will definitely keep an eye on GE to see whether the recent win with the Olympic games will help create positive momentum in 2016.

LAS VEGAS–GE Healthcare announced today the International Olympic Committee (IOC) has selected the company’s Centricity Practice Solution as the official electronic medical record (EMR) to be used by the medical teams of the Rio 2016 Olympic Games. This marks the first time that all athletes and spectators at the Olympic Games will have their health interactions managed by an electronic medical record. The announcement was made at the 2016 Health Information Management Systems Society (HIMSS) conference in Las Vegas.

Centricity Practice Solution will be used for managing data related to injuries and illness for athletes competing in the games as well as spectators, officials, athlete family members and coaches who require medical assistance throughout the Rio 2016 Olympic Games. For the competitors, the data managed during the Games will be used to help drive optimal, individualized care to help athletes compete at a world-class level.

“The Olympic Games is about providing the best possible service to athletes,” said Dr. Richard Budgett, Medical and Scientific Director for the IOC. “The gold medal of medical services is something that is integrated and comprehensive: a total package. Adding access to an electronic medical record is key to our drive towards the prevention of injury. Without a proper medical, longitudinal record, it’s difficult for us to do surveillance and see what injuries are most common in certain sports. This would impact our ability to prevent and measure our effectiveness. The EMR is going to be a cornerstone for our medical services going forward.”

Centricity Practice Solution will be available in English and Portuguese and will provide access to next generation workflows, analytics and data to potentially help optimize athlete performance. The information will be analyzed to spot patterns and provide insights for future Games planning. Additionally, medical teams will be able to access diagnostic images and reports from within the EMR to assist in providing world-class care quickly and efficiently. GE’s EMR will be accessible at any of the multiple medical posts throughout the Games and at the central Polyclinic in the Olympic Village where more complex care is delivered.

“By selecting Centricity Practice Solutions EMR, the IOC is extending the clinical care and data management capabilities pioneered by the United States Olympic Committee (USOC), which has used GE’s EMR platform for the past two Olympic Games in London and Sochi,” said Jon Zimmerman, General Manager, GE Centricity Business Solutions. “Incorporating an EMR platform into the healthcare services will enable medical staff at the Rio 2016 Olympic Games access to real time data, analytics and health information to help their athletes perform at peak capabilities.”

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.

Future Ready Technology and Data Discussion at the Dell Healthcare Think Tank

Posted on March 11, 2016 I Written By

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

I’m lucky enough to be heading to the SXSW conference again this year. I’m excited to see what interesting things are being said and done at a conference like SXSW. The broad variety of people that attend SXSW provide unique insights and perspectives that you often can’t find at other conferences. I’m sure I’ll be doing a post or two about the things I find at SXSW. Let me know if there’s something I should see while I’m there.

During SXSW I’m also going to slip away from the SXSW activities in order to take part in the Dell Healthcare Think Tank event (not associated with SXSW). I believe this is the 4th year I’ve been able to participate in the event and Dell always does a great job bringing together amazing people to talk about the challenges of healthcare IT. This year I expect no different.

The great part of the Dell Healthcare Think Tank event is that the full event is live streamed for free online so you can watch the discussion no matter where you’re at on Tuesday March 15th from 1-4 PM CT. Plus, the #DoMoreHIT hashtag on Twitter will be extremely alive during the Think Tank event. So you can follow along and even add your own comments and questions on the hashtag as you participate in the event from wherever you might be. Don’t be surprised if we bring up a Twitter comment on the live stream.

This year Dell has done a great job bringing together a diverse panel from many parts of healthcare and I’m especially excited by a number of panelists that represent the patient voice in the discussion. You can see the full list of moderators and panelists below.


  • Mandi Bishop – Healthcare Analytics Innovations & Consulting Practice Lead, Dell, #HIT100 influencer,@MandiBPro
  • Nick van Terheyden, MD – Chief Medical Officer, Dell, @drnic1


Future Ready Technology and Data in Healthcare - #DoMoreHIT

I hope you’ll take the time and join me on the 2016 #DoMoreHIT Healthcare Think Tank live stream and #DoMoreHIT hashgtag on Tuesday March 15th from 1-4 PM CT.

A Complete Patient Record and You

Posted on March 9, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have discussed the first steps to getting an enterprise imaging facility but what does this and a complete patient record mean for the average patient? If I were to stop someone walking down Las Vegas Blvd (I would shoot for the more sober hours) and ask them “Who owns your medical records?” I am sure I would get the same look and response over and over. The look of confusion and the response of “my doctor’s office?”  This is exactly what enterprise data sharing is set out to change.

A complete patient record for the patient means that a patient can go from their primary care physician to sub specialist without having to call ahead and have their records faxed over. It means that in the case of an emergency room visit they don’t have to worry about leaving with paperwork and getting it back to their primary care physician. It means their records follow them to whatever doctor they (or their insurance) choose.

For example, a couple weeks ago I won myself a trip to the emergency room after cutting a chunk out of my hand while slicing vegetables on a mandolin. (OUCH!) Not knowing my experience in healthcare IT, the resident, who came in first, was checking off all the boxes and asked “do you have a primary care physician?” In my pain ridden and snarky voice I responded “Why does it matter? Your computer can’t talk to hers anyway.” He got a chuckle and said I had a good point and then asked if I was in healthcare. But we have all been there. We have seen one physician only to turn around and have to tell the story all over again with the follow-up care physician because the records just aren’t there.

Not to mention I had pictures of the wound on my phone I had taken right after the incident. My follow-up physician asked that I send her these photos so she could take a look (because she didn’t have access to photos snapped in the ER). I asked her if she could put them into my patient record being my PCP? Her response, “no I don’t have a way to get them uploaded.” Similar to what Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital, said in his session at HIMSS16, he has multiple pics on his phone and there is nothing wrong security wise with that, but that’s not where the belong.

A complete patient record should include all medical data related to you. This includes images or all kinds whether an X-ray or photo snapped on an iPhone, textual reports (path, lab etc), and even larger data files including genome sequencing data, and digital breast tomosynthesis. I don’t think you would find one physician who would argue that any of your data is unimportant and can be left out.  In the wise words of John Halamaka, MD, CIO of Beth Israel Deaconess Medical Center the next time you ask why your patient record can’t be all in one and they (physicians or IT) respond because there is too much data to store, you should ask them “well how does Google do it then?”