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Hospitals Still Grappling With RCM Tech Infrastructure

Posted on May 18, 2018 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 www.ziegerhealthcare.com.

While revenue cycle management isn’t the sexiest topic on the block, hospitals need to get it right or they won’t be able to pay their bills. One key element needed to accomplish this goal is a robust tech infrastructure that helps RCM specialists get their job done.

However, it seems that many hospitals are struggling to manage RCM data and pick out the right vendors to support their efforts, according to a report published by Dimensional Insight in collaboration with HIMSS Analytics. To conduct the research, the two organizations reached out to 117 senior-level decision-makers in hospitals and health systems.

According to the survey, more than two-thirds of health systems use more than one vendor for RCM. But that might be a bad idea. The research also found that organizations using more than one RCM vendor seem to face bigger issues with denials than those using only one RCM solution. Regardless, the execs said that denials were the biggest RCM challenge for health systems today.

Pulling together RCM data is a struggle too, respondents said. More than 95% of health systems reported that the way data is collected is a challenge. Also, nearly all respondents said that collecting RCM data from disparate sources is also difficult.

One reason why it’s tough for hospitals to put effective RCM technology in place may be that health information management directors and managers aren’t at the top of the influencer list when it comes to making these decisions.

When asked who the key stakeholders were in RCM. 91.5% said that the CFO was the most important, followed by the head of revenue cycle, who was ranked as important by 62.4% of respondents. Meanwhile, only 48.7% of respondents saw the health IT leaders as key stakeholders in the RCM environment. In other words, it looks like tech leaders aren’t given much clout.

When it came to technical infrastructure for RCM, respondents were all over the map. For example, 34.5% were working with an EMR and 3+ vendors. Another 12.1% used in EMR with one vendor, followed by 11.2% with 3+ vendor solutions, 6.9% using an EMR plus two vendors and 4.3% using two to vendor solutions. Clearly, there’s no single best practice for managing RCM technology in hospitals.

Not only that, some hospitals aren’t doing much to analyze the RCM data they’ve got. According to the survey, 23.9% said that 51 to 75% of the RCM process was automated, which isn’t too bad. However, 36.8% of hospitals reported that less than 25% of the revenue cycle process was driven by analytics. Also, roughly a third of respondents said that collecting data from diverse sources was extremely challenging, which can cripple an analytics initiative.

Taken as a whole, the report data suggests that hospitals need to improve their RCM game dramatically, which includes getting a lot smarter about RCM technology. Unfortunately, it looks like it could be a long time before this happens.

Lessons Learned from the 2017 AHIMA Information Governance Survey – HIM Scene

Posted on May 16, 2018 I Written By

The following is a guest blog post by Stephanie Crabb, Co-Founder and Principal at Immersive as part of the HIM Scene series of blog posts.

The American Health Information Management Association (AHIMA) 2017 Information Governance (IG) survey follows previous surveys administered in 2014 and 2015 to identify trends and offer insights associated with the healthcare industry’s understanding and adoption of IG. The good news from the 2017 survey is that awareness of IG, at least among the 1500+ survey respondents, is high with 84.6 percent reporting that they are familiar with IG. The bad news from the survey is that 51.6 percent of those same respondents report that lack of awareness or misunderstanding of IG is a barrier (the most significant barrier reported) to IG adoption in their organizations.

Who participated?

While the 2017 survey garnered more participation from outside the health information management professional community than previous efforts, it is important to note that the majority of respondents identified themselves as health information managers (HIM-ers). AHIMA’s work to raise IG awareness and educate the healthcare industry since 2012 has been significant and is to be commended. The body of knowledge created and published and the work completed is extraordinary; it has certainly paid off with its own constituents. Perhaps the survey demonstrates that there is still work to be done with additional stakeholders or that we need to do more to demonstrate the knowledge and capabilities that HIM-ers possess to support IG efforts.

IG Adoption, Drivers and Benefits

Based on what we see, read and experience, in every sector of the industry information and the data from which it is created are at the center of nearly every strategic and tactical activity. So why the disconnect, or the slow pace of formal IG adoption? Why did only 14.8 percent of respondents report an “initiated” IG program as illustrated below? Further, why did percent of respondents report that IG is not considered a priority in their organizations?

A closer look at what respondents had to say about the barriers to IG adoption is useful. The survey offered respondents a list of commonly-cited barriers to IG adoption across all industries and asked them to select their top three, resulting in the following:

For many, the term “governance” implies bureaucracy, expense, complexity, misplaced power and control, among other negative connotations. This may offer some context for these survey results and explain, in part, the top responses.

IG is a complex discipline, no doubt. However, everyone can identify IG or IG-like work that is getting done in their organization every day; it is just not formalized, organized or recognized as such. Sadly, much of that work is buried or siloed, in part, because it is not connected to a strategic imperative where it might gain greater visibility and appreciation as an IG effort.

The data around low IG adoption are even more confusing when we look at what respondents had to say about what they think does or should drive IG efforts. The survey demonstrates that there is no shortage of compelling and meaningful drivers to spur action. While the survey did not provide respondents with the same response choice options for “drivers” and “benefits” there was a connection and association reflected in the responses to these two questions.


These responses reflect an impressive number of business units, departments and individuals–workforce and patients—that can truly be served by and through IG.

What’s Changed from 2014 to 2017?

In 2014, 43% of respondents reported that a formal IG program had been initiated compared to 14.8% of respondents in 2017. What contributes to this dramatic change? Does it reflect organization abandonment of previously initiated IG efforts? Does it reflect that respondents are more educated today so what they labeled as IG in 2014 was not really IG? This area may warrant further exploration in future survey efforts.

In 2014, respondents cited “strong agreement” with regulatory compliance (80 percent), improvement in patient care and safety (73 percent) and the need to manage and contain costs (61 percent) as the top three drivers for IG, followed by analytics and business intelligence (53 percent). Interestingly, trust and confidence in data was the lowest rated driver. In 2017, data quality and trust ranked second. Analytics and business intelligence tops the list of drivers, patient safety falls to the middle and regulatory compliance is at the very bottom of the list.

The most promising insight from the 2017 survey is that data governance (DG) is a growing priority and reality in healthcare. Thirty percent of respondents reported a “formal structure” for DG in their organization. There is still a bit of confusion between IG and DG as disciplines. DG is one of the competencies in AHIMA’s IG Adoption Model and often referenced as a sub-domain of IG in other reference models. Simply stated, data are the building blocks of information, so DG is requisite to IG. One takeaway from the survey is that healthcare organizations are progressing along a path that positions DG as a precursor to IG, rather than a component of IG.

Conclusion

While the drivers for IG seem to have shifted over the time that AHIMA has spent surveying the industry, there is a universality to the vision and expectation that healthcare wants and needs to put its data and information to work to accomplish its ambitious and complex mission. Much of AHIMA’s and its IG partners’ work to document the experiences of IG pioneers is available at IGIQ.org.

Have ideas about how we can better study the topic of IG and deliver meaningful insights to you? Please share your comments.

About Stephanie Crabb
Stephanie is Co-Founder and Principal at Immersive, a healthcare data lifecycle management company where she leads program and solution development, knowledge management and customer success. Stephanie brings 25 years of experience in the healthcare industry where she has served in program/solution development, client service and business development roles for leading firms including The Advisory Board Company, WebMD, CTG Health Solutions and CynergisTek. She has led a number of program and product launches with an emphasis on competitive differentiation, rapid adoption, client satisfaction, and strategic portfolio management.

Prior to her work at these firms Stephanie worked for a large Maternal and Child Health Bureau grantee working on the national Bright Futures and Healthy Start initiatives to develop and document best practices in the care continuum for pediatrics and infant mortality, and to inform federal and state health policy initiatives in these areas.

Stephanie holds her A.B. and A.M. from the University of Chicago. Stephanie serves as the Scholarship Chair of CNFLHIMSS, on AHIMA’s Data Analytics Practice Council and recently completed a two-year term on the Advisory Board of the Association for Executives in Healthcare Information Security (AEHIS) of CHIME.

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

Beth Israel Deaconess Launches Health Innovation Center

Posted on May 7, 2018 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 www.ziegerhealthcare.com.

In yet another example of a health system bringing innovation home, Beth Israel Deaconess Medical Center has launched an in-house center combining the feel of a startup incubator and the vast reach of a globally-known provider.

It’s not clear yet whether this emerging model will be more powerful than plain old incubators, but there are a lot of resources at play here. (It’s worth pointing out that only one of the factors that distinguish it is that the center will be based at a Harvard teaching hospital.}

The Health Technology Exploration Center will be led by John Halamka, MD, MS, chief information officer of the Beth Israel Deaconess system. As the health systems press release rightly notes, Halamka already has his fingerprints on many important advances in health IT, including patient portals, unique web-based medical records, and advances in secure patient data exchange. It also notes that he has brought together collaborations with global HIT thought leaders such Google, Amazon, Apple and the Bill & Melinda Gates Foundation. (Did we mention that the man is non-stop?)

The HTEC’s first focus areas will come as no surprise. They include helping patients manage their own health using mobile application; improving patient education and care through natural language interfaces; optimizing medical decision-making with dashboards and analytics; and enhancing patient/clinician communication using new devices and programs.

Though the press release doesn’t make a big thing of it, the website makes it clear that a lot of what its leaders would like to do haven’t been paid for just yet. However, the health system has already laid out its plans for when it gets enough contributions to support the program.

If the HTEC is fully funded, the system would make investments in faculty, staff and infrastructure that would help it take on local national and international partnerships. HTEC would also generate research intended to usher in breakthrough healthcare technology options.

I’d like to take a minute and say that not only is this great, it should be more commonplace than it is. Yes, few healthcare organizations have the clout and resources that a system affiliated with Harvard has, and that’s unlikely to change. But that doesn’t mean smaller facilities are out of the running.

What I’d like to see for virtually every facility to capture more of the value it creates during the process of everyday patient care. Given the extent to which healthcare data is shareable, recordable and integrable, providers don’t have to stop what they’re doing to amass data and expertise that benefit everyone in the profession. I believe it’s not only possible but necessary.

“The Current Model for Healthcare is Not Sustainable?” – Why Not?

Posted on April 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.

I’ve heard this phrase over and over:

The Current Model for Healthcare is Not Sustainable?

It’s especially prominent on social media and at conferences. Sometimes they change the word model to costs or some other related word. The message is clear. Healthcare is screwed up and people are pissed that it costs so much. On that I agree with them in many respects. However, I don’t agree that the current model isn’t sustainable. In fact, today I saw it and asked them why it wasn’t sustainable.

No one could give me a good answer.

However, to be clear I clarified that I wasn’t suggesting that we shouldn’t try to change the current model and that we shouldn’t try to stop the crazy healthcare cost curve. I also didn’t argue with the dire consequences that will happen if we don’t change healthcare from its current model. We should do all of those things.

It’s one thing to argue that we could or should do something and quite another to say that the current trajectory is unsustainable.

Healthcare has been surprisingly good at sustaining all of its bad characteristics. In fact, in many ways the bad things in healthcare are actually incredibly profitable.

In response to my question about why the current model is not sustainable I got the following story:

I was behind a lady at CVS who decided not to get her meds because she needed to pay her electrical bill. This cannot be sustainable.

A sad story and no doubt there are hundreds more like it. It’s heartbreaking to read and something we should work to fix. However, don’t wait for the healthcare organizations to fix it. This gets a little twisted, but think it through. If that lady chooses not to take her meds, what happens? Does the doctor get paid less? No. Does the hospital get paid less? No. In fact, if she doesn’t get her meds and gets really sick, the hospital is going to make a ton of money. (Yes, I know about value based care and hospital readmissions, but that’s a small percentage of overall revenue).

I’m not suggesting that any healthcare provider goes around saying that patients shouldn’t be compliant with their medications because it would be good for their hospital business. Even I’m not that cynical. However, if we were in any industry that’s what we’d want people to do. However, in other industries if you chose not to get your medications you’d have a bad experience (ie. you’d get sicker) and then you’d want to use me less. Healthcare is the opposite. If you get sicker you use me more.

The reality is that healthcare is not a true market. Go and read Dan Munro’s book Casino Healthcare to see what I mean. Healthcare is complex and it hides its issues behind that complexity.

I’m sure that some people reading this are going to offer up some pockets and small examples where this isn’t true in healthcare. Great. We need more of that and soon. We need it because healthcare is costing our nation too much money. We need it because healthcare is costing businesses too much money. We need it because many people aren’t getting the care they need because they can’t afford it. We need it for a lot of reasons.

However, we don’t need these changes because healthcare is going to collapse if we don’t change. In fact, to paraphrase Dan Munro, most in healthcare are profiting from its dysfunction. That’s why it’s so hard to change. Sadly, I don’t see anything that tells me we’ll stop paying either. The current model is surprisingly resilient and sustainable.

Of course, that’s not to say outside forces couldn’t change things. They can and they should. Patients are paying way too much for healthcare and we should be pissed and push for change. Businesses are paying too much for healthcare and we should be pissed and push for change. Government pays more for healthcare than anyone else and they’are paying too much for it. They should be pissed and push for change.

Just don’t expect providers or even payers to disrupt themselves. They’re all enjoying a shockingly sustainable business model. IT can only do so much when it comes to solving the business model issues.

Workers’ Comp ROI – Disclosures For Workers’ Compensation Purposes – HIM Scene

Posted on April 10, 2018 I Written By

The following is a HIM Scene guest blog post by Don Hardwick, Vice President, Client Relations and Account Management at MRO.

Even under the best of circumstances—excellent staff, streamlined workflows, the latest technology— Release of Information (ROI) is a precarious process. Specific rules apply to different categories of requests. One area of complexity and confusion is the disclosure of Protected Health Information (PHI) for workers’ compensation purposes. While the ROI process for workers’ comp requests is similar to the process for “regular” requests, the type of information allowable for disclosure is different unless the request is accompanied by a patient authorization.

According to HHS guidelines, “The HIPAA Privacy Rule does not apply to entities that are either workers’ compensation insurers, workers’ compensation administrative agencies, or employers, except to the extent they may otherwise be covered entities.” However, the rule recognizes the legitimate need of these entities involved in workers’ compensation cases to access PHI according to state or other laws. Due to variability among such laws, the Privacy Rule permits disclosures of PHI for workers’ compensation purposes in different ways.

Disclosures without individual/client authorization. In most cases, an employer or insurance carrier is permitted to request and receive information pertaining to the injury—on behalf of the company or on behalf of the client—without an authorization. So employers, insurance companies or their attorneys can obtain information on behalf of the insurance company or on behalf of the client. Typically an attorney would get an authorization from the client. However, the employer, the payer or an attorney representing the payer can generally request those records without individual authorization.

Disclosures with individual authorization. The Privacy Rule permits covered entities to disclose PHI to workers’ compensation insurers and others involved in workers’ compensation systems if the individual (patient/client) has provided an authorization for the Release of Information to the entity. The authorization must meet specific Privacy Rule requirements.

When considering a workers’ comp claim, we can only disclose PHI pertaining to the event that initiated that particular claim. For example, suppose a patient had five admissions in 2017, and was injured January 2018. The employer may want to determine if the patient had preexisting injuries or conditions where the most recent injury occurred. If the January 2018 injury was secondary to a problem that already existed with this patient, the requester generally cannot obtain prior information without a HIPAA valid authorization.

The main point is that rules and regulations pertaining to workers’ compensation claims differ depending on the type of request for information and the type of requester.

About Don Hardwick
As Vice President of Client Relations and Account Management, Hardwick oversees all client relations initiatives including implementation and account management. Prior to joining MRO, he was CEO and President of Record Enterprises Inc., a Health Information Management (HIM) company that provided hospitals with an outsourcing program for patient release of information, medical coding and medical/confidential record storage. Previously, he was CEO and president of MedRecs Law Inc., a record acquisition company. Additionally, he was a manager in the healthcare consulting division of Ernst & Young and worked as the Director of HIM at Saint Margaret Hospital in Montgomery, AL and Southampton Memorial Hospital in Franklin, VA. Hardwick is a past President of the Virginia Health Information Management Association (VHIMA) and the recipient of East Carolina’s Allied Health Sciences Distinguished Alumni Award. He holds a B.S. in Health Information Management.

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

An HIM Perspective of What Was Shared at #HIMSS18 – HIM Scene

Posted on March 9, 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.

Today is the final day of the HIMSS 2018 Annual Conference. While there are nearly 44k attendees at the conference and 1350 vendors, I didn’t meet a single HIM professional. I certainly didn’t meet all 44k attendees, but it’s safe to say that the HIM community wasn’t well represented at the HIMSS conference. It’s unfortunate because healthcare IT initiatives can really benefit from the HIM perspective.

Since many HIM professionals weren’t in attendance, I thought it would be beneficial to share some insights into trends I saw at HIMSS 2018 that could be beneficial to HIM professionals.

AI (Artificial Intelligence)
AI was the hottest topic at HIMSS 2018. It seemed like every vendor was saying that they were doing some sort of AI. Of course, many used the AI term very broadly. It included everything from simple analytics to advanced AI. In some ways, that’s corrupted the term AI, but what’s clear is that lots of companies are using data to provide insights and to automate a wide variety of healthcare work.

Another great insight I heard was that revenue cycle management and other financial areas are a great place to start with AI because they’re seen as less risky. When you’re applying AI to clinical use cases, you have to worry a lot more about being wrong. However, the consequences aren’t nearly as damaging when you’re talking about the financial side of healthcare.

Information Governance and Clean Data
At HIMSS 2018 I heard over and over the importance of having clean data. If AI was the hottest topic at HIMSS 2018, none of that AI will really matter or provide the value it should provide if the data is inaccurate and not trusted. This is why the work that HIM professionals do to ensure effective information governance is so important. It’s almost cliche to say bad data in leads to bad insights out. However, it’s cliche because it’s true. HIM needs to play an important role in making sure we have accurate data that can be trusted by AI applications and therefore the providers that receive those insights.

Texting Patients Is Not a HIPAA Violation
No doubt this will feel like news for many of you. It may even scare many HIM professionals. However, OCR Director Severino made it clear that Texting Patients is Ok. I won’t dive into the details here, but read the article by Mike Semel which outlines what was said at HIMSS 2018 in regards to texing patients.

Healthcare Chatbots
I didn’t see any healthcare chatbots that are solving HIM’s problems. However, when you look at the various healthcare chatbots out there, there’s no reason why a healthcare chatbot couldn’t do amazing things for HIM professionals. Here’s a framework for healthcare chatbots that companies should consider. What mundane tasks are well defined that could be automated by a healthcare chatbot? When you ask this question, you’ll see how chatbots are something HIM professionals should embrace. There’s a lot of mundane HIM work that could be done by a chatbot which frees them to work on the more challenging HIM issues.

Patient Access to Medical Records Is No Longer Controversial
While some specific individuals have fears related to access to medical records, it’s been proven across every type of healthcare organization that providing patients’ access to their medical records is right thing to do. The fears people have are unfounded and that patients find this extremely valuable. I heard one person say that they no longer will do visits with doctors who will not give them access to their records.

Those were some high level insights from a HIM perspective. Lots of exciting things when it comes to technology and HIM. What do you think of these changes, announcements, and trends? We’d love to hear your thoughts and perspectives in the comments.

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

The Full Spectrum of Information Governance – HIM Scene

Posted on February 7, 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.

Information governance is such an important topic across so many areas of healthcare. It impacts almost every organization and quite frankly takes the full organization to buy in to ensure proper information governance. Doing it right is going to be essential for any healthcare organization to work efficiently and effectively in the future.

While information governance impacts everyone in healthcare, I have to give credit to AHIMA and their HIM professional community for leading the way on the topic of information governance. A great illustration of this leadership is in the AHIMA Information Governance Adoption Model Competencies (IGAM):


*Thanks to HIM professional, Katherine Downing for sharing it on Twitter.

I think a lot of people that work in a hospital and healthcare system don’t recognize a lot of these areas of information governance. At least they don’t look at them from that lens.

My favorite part of this model is that it starts with creating the right information governance structure and the strategic alignment. If you don’t get the right people assigned as part of their job to work on information governance, it will never happen. Plus, if you don’t realize how information governance aligns with the organizations priorities, then you’ll fall short as well.

How far along are you in your information governance efforts? Have you incorporated all of the above elements into your information governance strategy? We’d love to hear your experiences, insights, and perspectives in the comments.

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

Excitement Mixed with Realism at Top Of Mind 2018

Posted on December 18, 2017 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.

The recent #TopOfMind2018 conference hosted by the Center of Connected Medicine was one of the best events of 2017. A stellar lineup of speakers was matched by an equally outstanding group of attendees. Together this combination created an atmosphere of realistic excitement – a unique mixture of exuberant enthusiasm for the latest healthcare technology (Artificial Intelligence, Machine Learning, Cybersecurity, Home Monitoring) tempered by sobering doses of reality (lack of patient access and poor usability).

One of the most engaging presentations was delivered by Jini Kim, Founder and CEO at Nuna. She opened by recounting her hilarious first-ever conversation with President Obama. Very early one morning (around 3am PT), Kim got a call on her cell phone from an unknown Washington number. When she answered the person on the other end introduced himself as President Obama. Kim reacted as I’m sure many of us would – with disbelief – and said as much to the caller. Obama laughed and said “I get that a lot, but seriously this is the President of the United States and I’m calling because your country needs you”. Kim compared that moment to feeling like a superhero being invited to join the Avengers.

Kim was one of six people handpicked by the President and his advisors to fix the failed Healthcare.gov website. For the incredible behind-the-scenes look at how this team was recruited and how they fixed the site, check out this amazing Time article.

In front of a slide that showed her company’s mantra, “Every row of data is a life whose story should be told with dignity”, Kim told story after story about how healthcare organizations would bring her in to help solve difficult healthcare problems. What Kim realized through that work was how badly health data is stored, protected and used.

In project after project, her team was tasked with bringing order to data chaos. One of the biggest challenges they encountered over and over again was bringing together massive amounts of data that was stored in different formats and used different terminologies.

Kim’s presentation was an effective counterbalance to the presenters just before her who had spoken excitedly about the future of Artificial Intelligence (AI). She cautioned the #TopOfMind2018 audience not to get too distracted by the shiny new AI object.

So much work needs to be done on the basics first before we can effectively apply AI. We need to get back to basics: data integrity and data cleansing. It’s not sexy, but if we don’t fix that then the more advanced technologies that layer on top will simply not work.

The session presented by Erin Moore, patient advocate and healthcare innovation consultant, made the biggest impact on the audience. For 45 minutes, she shared her deeply personal healthcare story, which started when her son Drew was diagnosed with cystic fibrosis seven years ago. Moore took the audience on an emotional roller coaster ride that mirrored her own family’s journey – from small wins (finding a doctor who would listen) to draining setbacks (medications changed without explanation) and from serendipitous windfalls (a researcher sent her an app that encouraged Drew to take his medication) to scratch-your-head moments (having to manually build Drew’s medical record by going to each provider and filling out forms in order for the information to be released).

There were two memorable takeaways from Moore’s presentation. First, was her story of how eye-opening it was for Susanna Fox, then Chief Technology Officer of the US Department of Health and Human Services, to spend the day shadowing Drew (virtually). Whenever Drew had to take his medication, Fox would pop a Tic-Tac. 500 Tic-Tacs and multiple hours waiting for appointments later, Fox had a new appreciation for how all-consuming it was to be the caregiver to someone who has cystic fibrosis. You can read more about Fox’s experience in her revealing blog post.

Second, was Moore’s double challenge to the audience:

  • To truly walk a mile in your end-users world when creating/designing the next generation products.
  • To make products truly interoperable.

The best unscripted moment of #TopOfMind2018 came from Amy Edgar, a #pinksocks #hcldr #TheWalkingGallery member. In one of the early Q&A sessions, she asked the speaker “How do we prevent digital health from becoming the next snake oil”. For a moment there was stunned silence as the room absorbed the full weight of Edgar’s comment.

For the rest of the day #TopOfMind2018 master of ceremonies Rasu Shrestha and other presenters made reference to snake oil. Edgar’s comment was even the inspiration for a recent HCLDR tweetchat that followed on the heels of the conference.

Overall #TopOfMind2018 was one of my most memorable conference experiences of 2018. The presentations were interesting. The venue was fantastic. Everything ran smoothly. Above all the people at the event were amazing.

Special Note: Thank you to Larry Gioia for organizing an amazing meetup during #TopOfMind2018 that was inclusive of #HITsm #HITMC #HCLDR #pinksocks and #TheWalkingGallery

An HIM Twitter Roundup – HIM Scene

Posted on December 13, 2017 I Written By

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

For those that aren’t participating on Twitter, you’re missing out. The amount of knowledge and information that’s shared on Twitter is astounding. The problem is that many people think that Twitter is where you go to talk about yourself. Certainly, that’s an option if you want to do that, but I find that consuming information that people share on Twitter is extremely valuable.

If you’ve never done Twitter before, sign up (it’s free) and then you need to go in and follow about 50 HIM professionals and other healthcare influencers. You can start by following @healthcarescene. HIM professionals are easy to find. Just search for the term AHIMA or ICD-10 and you’ll find a lot of them to follow.

Ok, enough of the Twitter lesson. Just to show you some of the value of Twitter, here’s a quick roundup of HIM related tweets. Plus, I’ll add a little commentary of my own after each tweet.


This is becoming such an important role for HIM professionals in a healthcare organization. HIM staff can do an amazing work ensuring that the data that’s stored in an EHR or other clinical system is accurate. If the data’s wrong, then all these new data based decisions are going to be wrong.


I think upcoding stories are like an accident on the freeway. When you see one you just have to look.


I’m still chewing on this one. Looks like a lot of deep thoughts at the AHIMA Data Summit in Orlando.


The opioid epidemic is such an issue. We need everyone involved to solve it. So, it’s great to see HIM can help with the problem as well. I agree that proper documentation and EHR interoperability is a major problem that could help the opioid epidemic. It won’t solve everything, but proper EHR documentation is one important part.


This is an illustration of where healthcare is heading. So far we’ve mostly focused on data collection. Time to turn the corner and start using that data in decision making.

Healthcare Always Has a Why Not – Essential to Focus on the Why To

Posted on December 11, 2017 I Written By

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

I recently hosted two roundtables at the Digital Healthcare Transformation conference around the topics of IoT (Internet of Things) and Wearables. The discussion at these roundtables was fascinating and full of promise. Although, it was also clear that all of these healthcare organizations were trying to figure out what was the right strategy when it came to IoT and wearables in their hospitals and health systems. In fact, one of the big takeaways from the roundtables was that the best strategy right now was to have a strategy of experimentation and learning.

While good advice, I was also struck by a simple concept that I’ve seen over and over in healthcare:

If you want a reason not to do something in healthcare, you’ll find one.

It’s a sad, but true principle. Healthcare is so complex that if you want to make an excuse find a reason not to do something, then you can easily find it. In fact, you can usually find multiple reasons.

The most egregious example of this is HIPAA. HIPAA has been an excuse not to do more things in healthcare than any other excuse in the book. When someone says that “HIPAA won’t allow us to do this” then we should just start translating that to mean “I don’t want to do this and so I’m pulling my HIPAA card.” HIPAA certainly requires certain actions, but I know of almost anything that can’t be done in healthcare that could still satisfy HIPAA requirements. At a minimum, you can always ask the patient to consent to essentially wave HIPAA and if the patient consents then you’re not in violation of HIPAA. However, in most cases you can meet HIPAA security and compliance requirements without having to go that far. However, if you’re looking for a reason not to do something, just say HIPAA.

Another one I’ve seen used and is much harder is when someone says, “I think this risks the quality of care we provide.” Notice the emphasis on the word THINK. Healthcare providers don’t have to have any evidence that a new technology, workflow, process, etc actually risks the quality of care. They just have to think that it could reduce the quality of care and it will slow everything down and often hijack the entire project. Forget any sort of formal studies or proof that the changes are better. If the providers’ gut tells them that it could risk the quality of care, it takes a real leader to push beyond that complaint and to force the provider to spend the time necessary to translate why their gut tells them it will be worse.

If we focus on the Why Not in healthcare, we’ll always find it. That’s why healthcare must focus on the Why to!

Use the examples of IoT or wearables and think about all the reasons healthcare should use these new technologies. It’s amazing how this new frame of reference changes your perspective. Wearables can help you understand the patient beyond the short time they spend in the hospital or doctor’s office. Wearables can help you better diagnose a patient. Wearables can help you better understand a chronic patient’s habits. etc etc etc. You obviously have to go much deeper into specific benefits, but you get the idea.

What I’ve found is that once you figure out the “Why to” make a change or implement a new technology, then it’s much easier to work through all of the “Why nots.” In fact, it turns the Why Nots into problems that need to be solved rather than excuses to not even consider a change. You can solve problems. Excuses are often impossible to overcome.

I’d love to hear your experience with this idea. Have you seen Why Nots hijack your projects? What are some of the other Why Not reasons you’ve seen? Has the move to asking “Why to” helped you in your projects?