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The FHIR Backpedal, Voice Interfaces, OpenNotes, and Complacency – Twitter Roundup

Posted on December 6, 2018 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.

Let’s take a quick trip around the Twittersphere and share some of the best healthcare related tweets we’ve seen recently. Plus, we’ll add a little commentary for each tweet as well. We hope you’ll add your commentary on Twitter with @healthcarescene and in the comments.


This might be a media back pedal. Everyone I’ve talked to that really understood FHIR has always said that the FHIR standard was not the end all be all interoperability solution. In fact, they specifically noted its limitations. Of course, that didn’t keep many outlets from reporting FHIR as the cure all. Glad to see they’re finally reporting on FHIR accurately. It’s good, but not a cure all interoperability solution.


Anyone that’s heard Colin Hung speak knows this is going to be a great webinar. Voice search and voice interfaces have become extremely popular. If you want to learn how they’re impacting healthcare, sign up for Colin’s webinar.


Powerfully simple story.


I think Aimee underestimates the power of complacency. However, I hope she’s right since long term complacency will feel really bad.

Amazing Nurse Story

Posted on December 5, 2018 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.

Nurses are amazing and they are often the unsung heroes of healthcare. When I think about the times I’ve spent in hospitals I have almost zero memories of the doctors, but I have a lot of great memories of the nurses.

I was reminded of this fact when reading this pretty untraditional nurse story that @rn_critcare shared. I wonder how many times healthcare IT developers think about these kinds of unique situations that nurses face. Ok, they aren’t all this large, but they are just as nuanced.

As told by @rn_critcare:
Today in my role as nurse I wore many hats. Let me tell you a story about how the day went… #NurseLife
#medtwitter

Came in this am to discover my pt from yesterday had imaging overnight that revealed catastrophic injuries, along with her sepsis and multi-system organ failure

Within 1/2 hr her fiance approached me about calling in a chaplain, which I assume is to do final prayers. He informs me that he wants to marry her. Today.

I’m not sure b/c pt is sedated and fully ventilated, with no hope of waking up.

Spend next few hours calling chaplains/priests/ministers. Keep in mind it’s Sunday AM and church is happening soon.

I find out that if we can show “intent to marry” that a ceremony can be performed. Photos of pt trying on dress are used. A minister agrees to come after church.

Preparations are being made. Family is happy that we can do this for their loved ones.

Except Pt starts to deteriorate. Cushing triad. Call family in and discuss options. They have a family member willing to perform ceremony, if only for symbolic reasons now…

Hair is washed and braided. I give the sisters some sheets and scissors for a makeshift wedding dress (new) while I go collect flowers from other rooms around the unit. (borrowed)

Flowers are placed in braids along with headband & veil. A blue blanket is draped at end of bed.
Everyone lines up outside the unit and begin the parade into the room. So. Many. People. Can hardly make my way around but secure a post at the med pumps and monitor.

Music is being played, someone has a guitar and another has a drum.

The chaplains words are brief but loving. Asks him does he take her… I do. Asks does she take him, bridesmaids all reply “she does”

Everyone in tears

They are now all in song with only the drum being played, which I feel is shaking my entire soul
Everyone singing Stand by Me and I’m in tears.

Pt stabilizes somewhat. I realize it’s now afternoon and I haven’t had a break or worse, my coffee! I decide to step away for a few minutes. Go outside for air. Find myself at grocery store across the street…

Purchase cake and have 2 hearts drawn with their initials, some bubbly (sparkling juice), and plastic champagne flutes. There was a wedding after all… New groom takes bottle outside with fam, pops the cork & comes back for mini reception.

So much love

I decide to get some charting done. Post-op comes back across the hall and I’m called to help. CRRT machine beeping next door and tend to that. Realize I still haven’t eaten. Grab a cookie from the desk (weekend tradition from consultants)

Pt begins to fail again.

Family called back in, this time the air has changed. It’s heavier and somehow feels hotter than hours before.

The guitar is being played and everyone is singing Amazing Grace. Am I singing along? Maybe. Not sure with this lump in my throat.

Have to turn away and pretend like I’m tending to something very important, which turns out is the wall, but it’s holding me up now, and the singing and drumming is getting louder and I’m just trying to keep it together, keep her comfortable… Won’t be long now…

Her children are at her side now telling her they love her, how wonderful she is, how much they love their step-dad, don’t worry they will take care of him.

A tear falls down her cheek and now everyone is sobbing. My sobs are internalized and I keep my eye on the monitor…

New groom is by her side and I whisper in his ear that she has passed, as this sacred news is shared with a spouse first.

The new groom is now a widow.

One by one the people exit the room, each one reaching out for a hug. Each hug brings me a little closer to the inevitable spill over of tears. My heart aches for them. There are no words, my eyes pleading with them to accept my sincerest condolences…

They need help with funeral home. Explain of course I can help guide them, this is unchartered territory and I do this all the time. My insides are screaming ALL THE TIME!

Call funeral home, with request to leave braids untouched… Veil and flowers too.

I finish my charting. Realize there’s no supper break happening either. Wash my pt up. Gently remove the countless tubes and IVs. Use hushed tones as I explain to her what I am doing, because even in death we deliver honour and dignity.

Take a new nurse down to morgue with me, because it’s a teaching hospital after all. Carry on chatting as though my spirit isn’t weeping inside.
Get back to unit.

Take a long overdue drink of water.

No time for tears.

There’s an admission on the way.

#nurselife

A Digital Roadmap to Improved Patient Access – An Interview with Richard McNeight

Posted on December 4, 2018 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.

We recently interviewed Richard McNeight, Executive Vice President & Chief Digital Officer at Health First, to learn about there efforts to implement new patient access and provider data management solutiuons from Kyruus.
In this interview, Richard McNeight offers some great insights into patients’ expectations and ways his organization is trying to meet these expectations.

What led you to the decision to invest in more patient access technologies?

“Dramatically improved consumerism” is one of our key Integrated Delivery Network (IDN) digital strategic goals. The first and most important consumer priority is to “Find a Provider.” Not just any provider, but the right provider that can best treat the exact condition, has significant experience treating it with high-quality outcomes and has performance ratings for success.

What kind of buy-in did you need to go in this direction?

As Chief Digital Officer, my first responsibility was to develop an IDN digital strategic plan, which identified provider search as the most demanded customer request. The digital strategy was first approved by our Strategic Planning Council. Once adopted by our Executive Team, the initial collaboration was with our Marketing Department, which confirmed the most important consumer initiative was to “Find a Doctor.” A requirements specification was then developed for a provider portal, with input from all major IDN stakeholders, and a request for approval (RFP) process solicited bids for the provider portal solution, ultimately resulting in the selection of Kyruus.

What benefits do you expect to achieve from the implementation of ProviderMatch?

The key benefit we will achieve using the Kyruus ProviderMatch tool is meeting our customer’s goal to find the “right provider.” This is achieved by allowing the patient to complete a robust search by entering their “clinical condition” in simple, easy-to-understand textual language. ProviderMatch leverages a taxonomy of more than 18,000 clinical terms, which helps match the patient’s condition to a provider who specializes in treating that condition. This is in addition to the normal search criteria and qualifiers such as geolocation, insurance network, provider gender and more.

Which challenges do you still face when it comes to patient access?

The biggest challenge we see in implementing Kyruus is appropriately defining the “Scope of Practice” for each provider, narrowing it to only the top conditions that provider specializes in treating. Related to that is the discussion we will be having with our providers as to acceptable and accurate provider quality rating, frequency of procedures performed and outcome results that will be displayed in the search results profile for the provider.

How have your providers reacted to the idea of allowing online appointment booking to patients?  What did you do to get them on board?

Over the last year, we have methodically been preparing for online scheduling by standardizing and minimizing the number of appointment templates for our employed providers, initially for primary care providers, and by the end of this year, for most specialists.

Where are you looking next when it comes to improving the patient’s experience?

As defined in our IDN digital strategy for consumerism, after “Find a Doctor,” the next three online features our customers want most are:

  • Make an Appointment – Online scheduling, providers (Kyruus DirectBook), diagnostic procedures, urgent care and more than 20 additional online scheduling activities
  • Price Transparency – Cost estimation, ease of payment and bill simplification
  • View my Medical Record – Easy, single mobile-enabled access to their unified health record

Once our customer finds the “right provider,” they will have the option to either immediately schedule an appointment online using ProviderMatch DirectBook or be shown a phone number to call to schedule the appointment. Our digital roadmap addresses technology solutions and implementation timelines for all of the other consumer experience features listed above.

What If You Live Tweeted an EHR Go Live?

Posted on December 3, 2018 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.

Have you ever wondered what an EHR go live is like? Ok, those of you who have been through one probably don’t want to relive that experience and may even have a little PTSD from the experience. However, as an EHR addict myself, I couldn’t resist watching the Golden Valley Memorial Healthcare (GVMH) in Clinton, MO live tweet their MEDITECH Expanse go live on the @gvmhe Twitter account.

I loved this kind of transparency and documenting of a go live. Pretty cool to see the process. The only thing I wish they would have done is used a hashtag throughout and shared it with others that were tweeting about the go live. If they had, then it would have been easier to find great tweets like this one from their CMIO Bill Dailey, MD:

I won’t share the full go live stream since you can go and read it on the @gvmhe account. However, here were some tweets that stood out.


This is an exciting and nerve wracking part of any go-live.


I’m sure the team will look back on this picture fondly. Plus, they’ll probably note all the people who were too busy to get in on the picture.


One of the best and worst parts of a go-live. The countdown clock which shows you how long until the real work begins and how much time you have left to finish your preparations. It’s always ironic that there’s always more prep that could be done, but you have to go live anyway.


You have to have a little fun during the go live.


The stress is real. Is there an ICD-10 for EHR go lives?


It’s like New Year’s, but less champagne and kissing. I like the matching shirts though.


Another stressful clock


War room in action!


The inevitable issues of getting your vendors on the phone. I wonder how effective this tweet was in helping the vendor respond. Especially since the tweet above was the 2nd one.


The moment before go live.


15 minutes later!


Don’t forget the power of food during a go live.


Must be a pretty happy Christmas gift to have the go live done and with relatively few hiccups.


The reality of the first few days.


I wonder how they measured this, but pretty interesting to consider.


Monday with a full day of patients. Congrats GVMH!

I left off a number of things, so go and check out the full @gvmhe Twitter feed. Plus, you can follow along to see how the first few weeks on MEDITECH Expanse goes for them. I hope they keep tweeting once all the go live staff leave. That’s usually a challenging time as well.

Top 10 Health Technology Hazards

Posted on November 23, 2018 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 the years, it’s always been interesting to take a look at the Top 10 Health Technology Hazards reports that the ECRI Institute puts out each year. Healthcare IT always seems to show up on the list which is interesting since I hear very few healthcare IT salespeople talk about the risks of their systems vs the benefits.

I’m not exactly sure when ECRI puts out these annual reports, but the 2019 report is already out. However, before we look at the Top 10 Health Hazards for 2019, I like to look back at what was on their list from 2018:
1. Ransomware and Other Cybersecurity Threats to Healthcare Delivery Can Endanger Patients

2. Endoscope Reprocessing Failures Continue to Expose Patients to Infection Risk

3. Mattresses and Covers May Be Infected by Body Fluids and Microbiological Contaminants

4. Missed Alarms May Result from Inappropriately Configured Secondary Notification Devices and Systems

5. Improper Cleaning May Cause Device Malfunctions, Equipment Failures, and Potential for Patient Injury

6. Unholstered Electrosurgical Active Electrodes Can Lead to Patient Burns

7. Inadequate Use of Digital Imaging Tools May Lead to Unnecessary Radiation Exposure

8. Workarounds Can Negate the Safety Advantages of Bar-Coded Medication Administration Systems

9. Flaws in Medical Device Networking Can Lead to Delayed or Inappropriate Care

10. Slow Adoption of Safer Enteral Feeding Connectors Leaves Patients at Risk

And now a look at the list of healthcare technology hazards for 2019:
1. Hackers Can Exploit Remote Access to Systems, Disrupting Healthcare Operations

2. “Clean” Mattresses Can Ooze Body Fluids onto Patients

3. Retained Sponges Persist as a Surgical Complication Despite Manual Counts

4. Improperly Set Ventilator Alarms Put Patients at Risk for Hypoxic Brain Injury or Death

5. Mishandling Flexible Endoscopes after Disinfection Can Lead to Patient Infections

6. Confusing Dose Rate with Flow Rate Can Lead to Infusion Pump Medication Errors

7. Improper Customization of Physiologic Monitor Alarm Settings May Result in Missed Alarms

8. Injury Risk from Overhead Patient Lift Systems

9. Cleaning Fluid Seeping into Electrical Components Can Lead to Equipment Damage and Fires

10. Flawed Battery Charging Systems and Practices Can Affect Device Operation

In a bit of a surprising result to me, the only thing on the list that qualifies as healthcare IT to me is the first one focused on hackers accessing health IT systems and disrupting the healthcare operations. It’s no surprise that hackers are on the list, but I’d have thought more health IT components would be on there. Even something like inappropriate alerts or incorrect information in the EHR or even health IT system downtime.

I’m not sure if we should applaud healthcare IT for not really making the list or whether it’s more of an indication of the other things being more hazardous. What is an important takeaway from these lists is that healthcare organizations have a lot of different hazards to deal with in their environment. Poorly implemented health IT is only one of them.

Sharing Records with Patients is the Right Thing to Do – OpenNotes

Posted on November 21, 2018 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’ve been a big fan of the OpenNotes effort for a long time. While I’ve heard every excuse in the business for why patients shouldn’t have access to their chart, all of those reasons have fallen flat. Much of that is thanks to the good work of the people at OpenNotes.

If your organization has not embraced opening up your chart notes to patients, what’s holding you back? The case for opening your notes to patients is clear.

If you want a more humorous look at this, check out this video featuring e-Patient Dave and clip’s from Seinfeld.

I’m not sure how I missed this video when it first came out, but it’s timeless. Plus, there’s no one better to share this message than e-Patient Dave whose life was literally saved because he demanded access to his chart.

No doubt, a lot of things have changed in the 20 years since the above episode aired. One of those things is patients desire to access their chart and technology’s ability to deliver the chart to the patient at basically no cost.

If your organization hasn’t embraced OpenNotes, I encourage you all to do so now. They can answer all your questions and address all your doubts. Join the Movement and improve the care you provide patients.

Apple Health, Opioid Challenge, Safety Risk Heat Maps, and athenahealth Acquisition

Posted on November 20, 2018 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.

We’re back again with a quick roll around Twitter in a round up of some of the interesting tweets we’ve seen shared. This was quite a diverse set of tweets, so I think there will be something of interest for everyone in this Twitter Round Up.


This tweet is a little annoying for me. I know Matthew has the best of intentions, but there’s no way I’d call and ask my provider or hospital to take part in this. I’m an Android user. This type of access does nothing for me. Apple users seem to forget that. Plus, it’s worth mentioning that there are more Android users out there than Apple users. It’s great that Apple is doing this, but it’s not the game changing thing that so many make it out to be.


Numbers like this always take me back. I just have to keep reminding myself that the opioid crisis wasn’t created over night and it won’t be fixed over night either.


Love this type of collaboration and creativity. One of the big things missing in healthcare is getting doctors off the reimbursement treadmill so they can take part in these types of creative activities. Also, a heat map of patient safety risk is pretty interesting to consider.


No doubt, we’ll hear a lot more about this acquisition in the future. As soon as Jonathan Bush was out as CEO, this company and people’s perception of this company changed. He was the heart and soul of the company and it’s going to be much different going forward. As far as the hospital piece of this tweet. I’ll be really interested to see if private equity is brave enough to continue Jonathan Bush’s ambitious hospital EHR strategy. I won’t be surprised if they pull the plug on it, but time will tell.

What’s the Future of Open Source EHR, Vista?

Posted on November 19, 2018 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 was going through some old draft posts (as I mentioned yesterday) and found a post that was started by Nate DiNiro which said “Will the VA and DoD help tip the scales on VistA adoption with OSEHRA?” Granted, this post was first started back in 2011. It’s amazing how much has changed since then.

We all know about the DoD’s selection of Cerner and Leidos to replace their EHR. In a more surprising move was the VA’s decision to sole-source their EHR selection of Cerner based on the idea that it was essential they go with Cerner after the DoD selected Cerner. Certainly a topic for another blog post.

We’ve certainly heard many complaints from those in the VA community that are going to have a really hard time giving up Vista which was basically tailored for many of their unique needs. However, there seems to be nothing stopping that ship now.

Given these events, it brings up an interesting question about the future of Vista as the VA replaces their version of Vista with Cerner. The good news for those healthcare organizations on Vista is that it’s now open source. So, the software can persist as long as there is a community of developers behind it. The core question is how much of Vista’s ongoing development came from the VA versus the community.

The two players I’ve seen using the open source Vista EHR platform are MedSphere and WorldVista. I’ll admit that I haven’t seen too much news from either of them lately, but they both seem to be humming along.

I took a look at the ONC’s latest Health IT Dashboard stats for hospitals. In 2017 (their latest data), it reported 11 “providers with certified technology” for Medsphere and 1 for WorldVistA. Of course, this is just those who have taken part in the meaningful use government program. It’s reasonable to assume that some open source EHR customers probably didn’t want to take part in meaningful use. Plus, these numbers don’t include international Vista installs which obviously can’t take part in meaningful use.

Given these numbers and the VA pulling Vista out, I have a feeling it’s going to be a hard road ahead for Vista.

I’ll never forget when it was first announced that the VA was open sourcing Vista and that anyone that wanted a free EHR could have it. What was amazing is that the HIM manager I was working with found an article talking about this announcement and brought it to me. She wondered why we were paying for an EHR if Vista was available for free. It gave me a chance to explain to her that “free software” doesn’t mean it’s free to implement and manage. Not to mention the fact that this was a small ambulatory clinic that was likely not a good fit for the hospital focused Vista software.

What have you heard or seen with Vista? Has more been happening with the open source versions of Vista that I just haven’t seen? As a big open source user myself (my blogs run on pretty much all open source software), I’d love to see an open source EHR succeed. Unfortunately, it just hasn’t seen near the adoption it needs to really create that momentum yet.

Five Things to Look for When Choosing a Professional Consultant

Posted on November 15, 2018 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 a blogger, people always ask me if I run out of things to write about. It turns out that I never come close. Occasionally I’m not motivated to write or there are stories I don’t feel like writing that day, but there are always plenty of stories to write about. In fact, I have hundreds of draft blog post ideas sitting there waiting for me to write.

The problem with all these ideas sitting in my draft blog post folder is that many of them sink to the bottom as more ideas come in. So, every once in a while I like to go digging to see what blog ideas I never published and should have written.

That’s where today’s blog post came from. The team at Logicalis US sent me a great list of five things healthcare CIOs should look for when choosing a professional consultant. Check out the list below:

1. Have a Point of View: Having a point of view is very different from having technological expertise.  It’s about applying that expertise to develop an opinion about the best way to implement a particular technology or solution – and it’s about being so confident in that opinion that they’re willing to share their point of view with you. It does not, however, mean rigidly adhering to a single point of view when another option may work better. The key is to find a partner that has the expertise to advise you about what has worked well for other clients in similar scenarios, yet one who is open to what will work best in yours.

2. Eat their Own Cheerios: As clients move into the third platform and need help extending their capabilities, there are many consultants that can talk with them from a position of strength and experience.  But, if you want to limit the number of partners you have, look for solution providers that are deploying their own strategies and leveraging their own services where possible.  If they aren’t eating their own Cheerios, metaphorically speaking, then you shouldn’t either.

3. Promote Choice and Flexibility: If the partner you select offers its own cloud services, for example, that can be a plus.  But when your business needs dictate using another solution, the right professional consultant will lead the charge.  It’s critical, therefore, that the partner you select is objective enough to be truly vendor neutral, promoting choice and flexibility even when that means helping you select a solution or service that competes with its own.  Many partners are now adopting strategies to manage solutions beyond their own portfolio promoting a framework offering flexibility and choice all delivered with a high-quality, consistent end-user experience.  In the end, partnering with organizations like these will allow you to leverage volume and scale and achieve the best commercial economics while spending less time managing partner relationships.

4. Have a Wide Array of Experiences: A partner that has served clients across a number of industries will often have a wide array of experiences and best practices that can lead to creative solutions that a more linearly focused partner might not have in its toolbox.

5. Be Able to Solve Business Problems Outside of IT: If one of the CIO’s top priorities is to be seen as a more strategic partner to the business, it’s important to have a consultant behind you that can think outside the box – and sometimes that means outside of IT.  Savvy consultants can often leverage common IT processes and service management protocols and apply them to businessproblems beyond the traditional realm of IT.  Can well-oiled ITIL-oriented processes around incident, problem and change leveraged through an ITSM platform, for example, be applied to a manufacturer’s warranty returns process? IT consultants that get to know your business can offer creative ideas that will help you solve vexing business problems in new and creative ways leading to innovation and strategic value.

I think these are some great ideas to think about. What’s been fascinating from my perspective has been the evolution of the term consultant in healthcare IT. During the golden era of EHR adoption, the term consultant largely became synonymous with temp staff. I think they preferred the term consultant because it was easier to justify the high temp staff rates if you called them consultants.

Now that EHR software is implemented, I’m interested to see if we see the return of the true consultant. I think we will. I’m just not sure how many of the “Temp Staff” consulting companies will be able to truly make the transition to consultant.

What else would you add to the list of things you look for when choosing a consultant? Are there red flags you watch for as well? Let us know in the comments and on Twitter with @HealthcareScene.

Will Remote Medical Coders Ever Return to the Hospital? – HIM Scene

Posted on November 14, 2018 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 week on the Journal of AHIMA blog, Elena Miller, Director of Coding Audit and Education at a healthcare system, posted this really fascinating question:

Will Coders Ever Return to the Office?

Elena does a good job of explaining how quickly remote work has become part of the medical coder’s life and the benefits it provides. However, she looks at large companies like IBM that are eschewing remote work and bringing their employees back to the office. It’s fair to wonder if the same thing will happen with medical coders who are requested to work from the hospital as opposed to their home.

I’d suggest that this is extremely unlikely to happen. First, I think it’s a mistake for IBM to bring everyone back to the office. Second, the reasons that IBM wants to bring everyone back to the office don’t apply to medical coders as much as it does IBM employees.

While IBM made a big splash with their announcement of bringing everyone back to their office, I think they’re going to regret this decision. They’re going to lose some of their best people who want to work remotely and that’s going to leave them in a bad place. Finding and keeping high quality people is the hardest thing to do at any company. The problem is that the most skilled people in your workforce can find a job anywhere at any time and your competitors are still offering remote work. It’s such a bad idea to lose all of these quality people by getting rid of remote work across the board.

I’m sure IBM needed to change the culture of the company where many remote workers weren’t being efficient in their work. That needs to be addressed, but banishing remote work across the board has all sorts of bad consequences. Don’t be surprised if IBM has made a bunch of exceptions for their highest performing people and if they go back on such a broad policy. A hospital or health system that does this will find the same problem and most can’t afford to lose their best medical coders who can certainly find remote coding work elsewhere if needed.

All of this said, the bigger issue is that remote coding work is quite different than most of the IBM jobs. Most IBM jobs benefit from collaboration and they’re hard to track as far as results. This is why they benefit from being in the same office with their colleagues with whom they need to collaborate and that can hold them accountable.

While medical coders certainly run into challenging cases where they benefit from collaboration, for the most part, medical coding is an individual sport. Plus, there are good ways to track coders productivity, accuracy, etc so you can hold them accountable for their work regardless of whether they’re at home or in the office. This is why I think it’s pretty unlikely that medical coders will return to the office.

Sure, there may be some edge cases where certain healthcare leaders who bring all their coders back as a way to send a message to staff. I think that’s what happened in the IBM case. However, much like I think will happen with IBM, those leaders will backtrack to remote coding soon enough. No doubt there will also be some edge cases where it makes sense to bring a specific coder back on site for training or other remediation for poor performance. Some medical coders may even request to be on site based on their own needs. However, if you can’t trust them to code remotely, my feeling is that you probably shouldn’t trust them to code at all.

Elena does make a great point in her article about remote coders not having the same opportunities to advance in their organization. Being present definitely matters if you are aspiring into leadership positions. What’s not clear to me is how many remote coders really aspire to leadership positions. Those that do seem to be doing remote coding on the side to supplement their income as they rise through the HIM leadership ranks. Maybe I’m wrong and there are a lot of remote medical coders that aspire to leadership in their organizations.

Let us know what you think in the comments and on social media @HealthcareScene. Will remote medical coders return to the office? Will remote coding hurt HIM professionals’ leadership opportunities?