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“You’re Already Your Own Doctor”

Posted on July 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.

The always thoughtful Rasu Shrestha, MD, shared this image and tweet on Twitter:

I really appreciate Rasu pointing out how much of our health is influenced outside of the doctor’s office. Also, I love that Rasu is asking for participatory medicine and for patients to demand to be participants in their care. However, I wonder if the quote he shared from Tom Ferguson, MD is a bit too far: “You’re Already Your Own Doctor.” Of course, what’s amazing is that Dr. Ferguson was saying this in 1985. That’s surprising, but I wonder if the statement actually discourages doctors from having patients involved in their care.

I get the idea that many patients have been treated poorly in the past. However, how future patients respond will often determine how doctors will respond to them in the future. It doesn’t take many bad experiences for doctors to not want to have patients involved in their care. So, patients should demand participation in their care, but they should do so with respect.

What’s ironic is that those same patients who want doctors to respect them and respect their input as patients, treat their doctors with disrespect. I understand that many patients get burnt out. However, it’s amazing how care providers turn off when they’re disrespected. If the goal is to create more patient involvement in their care, we have to be careful not to burn bridges for other patients. I think calling the patient a doctor is going to far. Once again, it’s about participation in your care and not the patient becoming the doctor.

Mary Meeker’s Internet Trends Report – What It Means for Healthcare

Posted on July 2, 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.

If you’re not familiar with the famous Mary Meeker Internet Trends Report, then I’m glad to introduce it to you. It’s one of the most influential reports when it comes to what’s happening on the internet. The report is massive and covers a wide variety of topics. So, let’s check it out as a community and share the things that stand out to us and how these internet trends will impact healthcare.

The two trends that stood out to me were voice and personalization.

The graphs related to the quality of voice and the skills related to voice are astounding. It’s not that shocking to suggest that voice is the new interface. I see it first hand with my kids who are all about Alexa to get their questions answered. I’m increasingly doing it as well. Voice is going to change so many things including healthcare. It won’t be long before we’re asking Alexa (or choose your favorite voice app) to schedule an appointment, order a refill, or any number of healthcare related applications.

Along with the consumer voice applications, I also see voice entering the enterprise. In the next 5 years, I believe that exam rooms are going to be revolutionized by voice. The EHR interfaces that currently drive doctors nuts are going to be replaced by voice powered interfaces. It will take longer to fully spread, but we’re already starting to see this voice powered future.

The other trend that stood out for me was personalization. This is a scary trend for many people. However, that’s not true for the next generation. In fact, the fact that healthcare is not personalized is shocking. Not only does personalization not scare the next generation, it’s an expectation. Chew on what that means for the future of healthcare. That’s a massive sea change.

The great thing with personalization is that the data is now available to personalize the experience. We just haven’t seen the applications implemented in healthcare yet. It’s starting to happen though and a couple years from now it will increasingly be a requirement for modern healthcare providers.

Those are two trends that stood out to me. Take a look through the report and let us know what surprised you in the comments of this post or on Twitter with @HealthcareScene.

Healthcare Interoperability Insights

Posted on June 29, 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 came across this great video by Diameter Health where Bonny Roberts talked with a wide variety of people at the interoperability showcase at HIMSS. If you want to get a feel for the challenges and opportunities associated with healthcare interoperability, take 5 minutes to watch this video:

What do you think of these healthcare interoperability perspectives? Does one of them stand out more than others?

I love the statement that’s on the Diameter Health website:

“We Cure Clinical Data Disorder”

What an incredible way to describe clinical data today. I’m not sure the ICD-10 code for it, but there’s definitely a lot of clinical data disorder. It takes a real professional to clean the data, organize the data, enrich the data, and know how to make that data useful to people. IT’s not a disorder that most people can treat on their own.

What’s a little bit scary is that this disorder is not going to get any easier. More data is on its way. Better to deal with your disorder now before it becomes a full on chronic condition.

Mobile App Streamlines Physician Query Process

Posted on June 28, 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.

Most physicians would tell you that they already spend too much time on documentation and coding. Adding insult to injury, after the coding job is done we often have to explain their decisions to medical coders, a process which can take as long as 20 minutes, according to vendor Artifact Health.

Artifact hopes to take the pain out of the burdensome physician query process. It offers a mobile app allowing doctors to answer coding queries which it says allow them to resolve problems within just three clicks. Physicians can also access the platform on the desktop.

Its approach bears some relationship to a new product from vendor Change Healthcare, which has just launched RCM technology which helps doctors address claims documentation requests. Change’s Assurance Assist Module, which is part of its Assurance Reimbursement Management suite, can anticipate the documentation needs of eight payers, the company said.

I am interested in both of these approaches because I know that physicians are already struggling to manage medical coding within their own practices. Hospital queries are a challenging part of that mix and feels like a major chore for providers. In fact, if Artifact’s research is correct and each traditional query takes 20 minutes to resolve, physicians could conceivably end up a little time to do anything else.

So far, Artifact seems to be rolling along impressively. The vendor says that more than 50 hospitals have come on board with its technology, including five institutions from Johns Hopkins Medicine. According to the vendor, these hospitals solve physician response rate of almost 100% and average response time within 48 hours for all periods.

Meanwhile, the hospitals found that the time it took for claims to get paid (days in Accounts Receivable) fell substantially, Artifact reports.

Lest it sound like I’m an Artifact investor, let me raise the questions I ask every time I get a look at a new health IT startup:

  • What does the software cost?
  • How long does it usually take to go live with the platform?
  • How much man- or woman power will it take to install and maintain the software?

At the moment I don’t know. As we all know, not only the initial investment, but also implementation and maintenance can catch hospitals by surprise.

The truth is, it’s likely any vendor addressing aspects of hospital RCM will be somewhat expensive and somewhat complex to install. I wish there were workable benchmarks giving hospital leaders a preliminary sense of their potential investment.

Regardless, this is a worthwhile area for RCM vendors to attack. Even if all this technology did was give doctors some relief, it might reach ROI over time. When you consider that tools like these can help coders get clean claims out of the door, it’s even better.

Approaches For Improving Your HCAHPS Score

Posted on June 27, 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.

Improving your HCAHPS scores gets easier if you make smart use of your existing technology infrastructure. To make that work, however, you have to know which areas have the greatest impact on the score.

According to healthcare communications vendor Spok, hospitals can boost their scores by focusing on five particularly important areas which loom large in patient satisfaction. Of course, I’m sure these approaches solve problems addressed by Spok solutions, but I thought they were worth reviewing anyway. These five areas include:

  • Speed up response to the call button
    Relying on the call button itself doesn’t get the job done. If calls go to a central nursing station, it takes several steps to eventually get back to the patient, it’s possible to drop the ball. Instead, hospitals can send requests directly from the call button to the correct caregiver’s mobile device. This works whether providers use s a Wi-Fi phone, smartphone, pager, voice badge or tablet.
  • Lower the noise volume
    Hospitals are aware that noise is an issue, and try everything from taking the squeak out of meal cart wheels to posting signs reminding all to keep the conversations quiet. However, this will only go so far. Spok recommends hospitals take the additional step of integrating the monitoring of equipment alarms with staff assignments systems, and as above, routing nurse call notifications to the appropriate patient care providers mobile device. Fewer overhead notifications means less noise.
  • Address patient pain faster
    To help patients with the pain as quickly as possible, give staff access to your full directory, which allows nurses to quickly locate provider contact information and reach them with requests for pain medication orders. In addition, roll out a secure texting solution which allows nurses to share detailed patient health information safely.
  • Make information sharing simpler
    Look at gaps in getting information to patients and providers, and streamline your communications process. For example, Spok notes, if communication between team members is efficient, the time between a test order and the arrival of the phlebotomist can get shorter, or the time it takes the patient transport team to bring them to the imaging department for a scan can be reduced. One way to do this is to have your technology trigger automatic message to the appropriate party when an order is placed. Also, use the same to approach to automatically notify providers when test results are available.
  • Speed up discharge
    There are many understandable reasons why the patient discharge process can drag out, but patients don’t care what issues hospitals are addressing in the background. One way to speed things up is to set up your EMR to send a message the entire care team’s mobile devices. This makes it easier for providers to coordinate discharge approval and patient instructions. The faster the discharge process, the happier patients usually are.

Of course, addressing the patient care workflow goes well beyond the type of technology hospitals use for coordination and messaging. Getting this part of the process right is a good thing, though.

Financial Perspectives from the HFMA Annual Conference

Posted on June 26, 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 always enjoy attending the HFMA Annual Conference (Formerly known as ANI) which brings together healthcare CFOs and others in the healthcare financial management community. Or as someone once told me, this use to be a conference of CPAs. In spite of its roots, there was an interesting mix of people at HFMA including health IT professionals, HIM professionals, and of course CFOs at the conference.

In one of my interviews at the conference, I sat down with Dan Berger, Director of Healthcare at AxiaMed. We had a wide-ranging conversation about healthcare payments and payment processing, but he struck me pretty hard when he talked about what would happen if a hospital or health systems payment processing went down. We talk a lot about EHR downtime and encourage healthcare organizations to have downtime procedures, but we don’t talk about payment downtime.

In some ways, this may be an appropriate response to downtime. If the EHR is down, that could impact patient care and literally patients lives. So, EHR downtime should be important. However, from a financial perspective payment processing downtime is a really big deal for healthcare organizations as well. The problem is that no patient will complain if you can’t collect their payment. The patients won’t go to the news with stories of payment processing issues. However, your business office will definitely feel it if the cash stops flowing.

This example is a simple reminder of how healthcare is a business. You see that in full view when you’re at a conference like HFMA’s annual conference. In some ways that’s a good thing since healthcare organizations have to be financially sound if they want to fulfill their missions. However, sometimes that can be taken too far as some people treat patients as a number on a spreadsheet.

I have seen some hope here at the conference. There are quite a few companies working hard to personalize the payment experience, to make pricing and payment information available to patients in ways it hasn’t been available before, and efforts to improve things like legible bills. These are small things, but they make a big difference to a patient.

I was also impressed with a number of companies that were using financial data to understand the patients better and when combined with other data can really personalize the care a patient is provided. A great example of this is Clarify Health Solutions which is making patient financial data useful and optimizing the patient journey. This is challenging stuff, but the data is getting there and companies are starting to see success and build up data that can be used by any healthcare organization.

What’s become more and more apparent to me is how challenging all of these healthcare problems are and how many people have to be influenced for change to happen. The wide variety of stakeholders that can hijack a great project is amazing. Dan Berger from AxiaMed who I mention at the start of this article commented on how payment processing used to be largely owned by the business office. He went on to share that now he’s seeing the CISO get involved and even the CIO. In many cases the CISO has veto power over vendors that don’t meet a healthcare organization’s security needs. Given all the security issues healthcare faces that’s generally a good thing. However, these types of group decision making do make the process of adding new innovations to your organization more complicated.

Healthcare Communication with Candice Friestad, Director Informatics at Avera Health

Posted on June 25, 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.

Ensuring proper communication in healthcare has become an incredibly important topic in every hospital and healthcare system. No doubt much of this has been pushed along by doctors, nurses, and patients use of mobile communication in their personal lives. The explosion of communication technology has been a challenge for many organizations who are stuck with legacy infrastructure, but it also provides a tremendous opportunity to improve healthcare communication over all.

We saw this first hand at the HIMSS 2018 conference when we talked with Candice Friestad, Director Informatics at Avera Health. She joined us at the Voalte booth to talk about their choice to use the Voalte platform in their organization. Candice also talked about what surprises they experienced when implementing the Voalte platform and their users’ reaction to it.

Beyond that, Candice talked about how Voalte allowed them to more easily find various providers and avoid the phone tag that’s common in many healthcare organizations. Candice also shared how they’re working to handle alarm fatigue as is required by the join commission and how choosing a central communication platform for alarms was key to addressing this issue. She also dives into key integrations they’ve created and a unique use case around athletic trainers at football games.

If you’re interested in healthcare communication and the above topics, watch the full video interview below to learn from an expert on the topic:

If you’d rather skip to various sections of the interview, just click the links below to be taken directly to that question:

A big thank you to Voalte for helping facilitate this interview and thank you to Voalte for sponsoring Healthcare Scene.

Some Physicians Get Personally Identifiable Information Via Texts Every Day

Posted on June 22, 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.

A new survey has concluded that despite efforts to better protect patient data privacy, a substantial number of providers are still getting unsecured messages that contain patient information.

The survey, which was performed by Black Book Market Research, analyze replies from 770 hospital-based users and 1279 physician practices. Researchers looked at how care teams were retaining secure communications.

The market research firm found that 30% of respondents received texts that included individually identifiable data every day. This result should curdle the blood of healthcare cybersecurity experts since I’m pretty sure most of these patients haven’t agreed to these unsecured texts.

However, both hospitals and physicians are pressing forward with platforms that protect patient data while linking teams together. The vast majority of respondents (94% of physicians and 90% of hospitals) told Black Book that mobile technology, in particular, could improve patient safety and outcomes.

The majority of respondents (85% of hospitals and 80% of physician practices) reported that they were committed to investing in secure communications platforms capable of tying together care teams, patients and families. And they’re in a hurry. In fact, 96% of hospitals expected to budget for or invest in comprehensive clinical indication platforms before the close of 2018.

That being said, 63% of study respondents said they were finding it difficult to get mobile technology buy-in from colleagues. Actually, that’s not too surprising. If you ask physicians to switch from an easy-to-use, effective tool like texting to an unknown communications platform, they’re likely to resist. They probably understand intellectually why using secure, collaboration-friendly software is a good idea, but the truth is that these platforms might disrupt physicians’ routines substantially.

Meanwhile, 90% of hospitals and 77% of physician practices that participated in the survey said they were using intrusion detection systems and secure email. However, this news isn’t that encouraging, as the majority of existing physician portals already offer secure email, and intrusion detection systems are pretty much a given by current standards.

The truth is, with healthcare data growing more valuable than ever and the threat landscape expanding rapidly, both hospitals and medical practices will need to step up their game substantially if they want to avoid security breaches. Investing in secure communications platforms is good, but it only addresses part of their security problems.

Over the long haul, both hospitals and doctors will have to get better at protecting both their mobile and enterprise data assets. There are good reasons to focus on secure mobile communications now, but providers can’t let it distract them from enterprise-wide security problems.

 

Your Big Data Assumptions May Be Flat-Out Wrong

Posted on June 21, 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.

It’s an article of faith in healthcare circles that leveraging big data stores can improve patient care. But what if this cherished assumption is flat-out wrong?

A new study published in the Proceedings of the National Academy of Sciences suggests that big data number-crunching might actually undermine providers’ ability to improve patient health.

To conduct the study, researchers from UC Berkeley, Drexel University and the University of Groningen compared data collected on hundreds of people, including both individuals with psychiatric disorders and healthy individuals. They found that group results didn’t capture some wide variations in symptoms from person to person.

Researchers concluded that big data analyses are a poor substitute for working with individuals, noting that these analyses are “worryingly imprecise” and that the variance between individuals is four times larger than those captured by big data. In other words, it concludes that big data analyses minimize differences between patients dramatically.

The authors said that it doesn’t work to generalize conclusions about individuals, whose emotions, behavior and physiology can vary greatly.

“Diseases, mental disorders, emotions, and behaviors are expressed within individual people, over time,” said study lead author Aaron Fisher, an assistant professor of psychology at UC Berkeley in a prepared statement. “A snapshot of many people at one moment in time can’t capture these phenomena.”

At this point, you’re probably thinking that this is terrible news. But Fisher believes that there are practical ways to address the problem. “Modern technologies allow us to collect many observations per person relatively easily, and modern computing makes the analysis of these data [points]  possible in ways that were not possible in the past,” Fisher said.

I don’t know about you, but I doubt that gathering loads of individual patient data will be as easy as Fisher suggests. Our current methods for documenting patient encounters in EHRs already impose significant burdens on physicians. Asking them to do more probably won’t fly, at least for the near term.

Not only that, there’s the question of how to work with this new data. We’d all like to see patients get highly individualized care, but current systems used by providers probably aren’t up to the task just yet.

I guess the bottom line here is that while Fisher et al are on to something, it will probably be a long time before healthcare organizations get there. In the meantime, it’s good to see that researchers are challenging our assumptions and keeping us on our toes.

PESummit Day 2 – Being Vulnerable Opens Us to Deeper Connections

Posted on June 19, 2018 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.

Whether it was planned or by cosmic happenstance, Day 2 of the 2018 Patient Experience: Empathy and Innovation Summit (#PESummit) reinforced a theme from the prior day:

  • Making yourself vulnerable opens us up to deeper connections with others

On Day 1, Cleveland Clinic President and CEO, Tomislav Mihaljevic MD @TomMihaljevicMD shared a story of a patient that died in the OR (see my Day 1 summary for details). It was a very personal story. By sharing it Mihaljevic made himself vulnerable and instantly forged a connection with the thousands of attendees in the hall.

Most people find it difficult to share stories that make them uncomfortable – especially ones where we are at the center of the story. We don’t like to talk about our fears, our failures or our losses because we are afraid of what other people may think (which is another way of saying that we fear that we will be rejected). Yet paradoxically by making ourselves vulnerable in this way, we actually make it easier for others to connect with us. Adrienne Boissy @boissyad, Chief Experience Officer at Cleveland Clinic stated exactly that after Mihalijevic shared his story.

Day 2’s opening keynote speaker, Kelsey Crowe PhD, founder of Help Each Other Out, articulated how the fear of being a burden or being seen as needy, holds patients back from asking for help. In other words, its hard for patients to admit to being vulnerable:

Crowe went on to share how small gestures of kindness and empathy, made at the times of vulnerability made a tremendous difference in their care. A unique “gesture wall” that she deployed at a healthcare facility allowed patients to capture these wonderful moments for staff to read.

This theme of being open, honest and vulnerable as a way to connect with people was reinforced by the next keynote speaker, Michael Hebb, founder of Deathoverdinner.org, and Drugsoverdinner.org.

In fact, Hebb’s entire keynote featured story after story about how sharing the fears about the end-of-life opened up the conversation, providing families and loved ones with the chance to better connect.

Vulnerability was also featured by Day 2’s closing keynotes: Brennan Spiegel MD @BrennanSpiegel, Director of Health Services Research, Cedars-Sinai Health System and Zubin Damania MD @ZDoggMD

At the end of Brennan’s fascinating presentation on the clinical application for an efficacy of Virtual Reality, he shared a failure that counterbalanced the exceedingly positive stories that he had showed the audience. Like Mihaljevic, talking about a failure helped the audience connect with Brennan and the patient that had suffered a panic attack as a result of the VR simulation.

Vulnerability was also featured by Day 2’s closing keynotes: Brennan Spiegel MD @BrennanSpiegel, Director of Health Services Research, Cedars-Sinai Health System and Zubin Damania MD @ZDoggMD

At the end of Brennan’s fascinating presentation on the clinical application for an efficacy of Virtual Reality, he shared a failure that counterbalanced the exceedingly positive stories that he had showed the audience. Like Mihaljevic, talking about a failure helped the audience connect with Brennan and the patient that had suffered a panic attack as a result of the VR simulation.

As is normal for Damania (aka ZDoggMD), his session was energizing and entertaining. However, in the midst of live renditions of his favorite medical rap parodies and fun stories of his parents, Damania shared the story of Turntable Health – the novel practice he was forced to close in early 2017. “No one was more pissed off about it than me.” said Damania.

By sharing this painful part of his journey, Damania made himself vulnerable and judging by the body language, many in the audience could relate to his do-everything-right-yet-still-not-work-out feelings. That story gave context to Damania’s impassioned plee to join him in ushering in Health 3.0 – a vision for care partly based on the best parts of his Turntable Health experience.

Day 2 of PESummit even better than Day 1. I can’t wait for the final day tomorrow. Follow the conference hashtag – #PESummit for real-time updates!