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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.

Near-Fatal Med Incident Leads Hospital To Redesign Alerts

Posted on June 13, 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 only took a couple of mistakes – but they nearly led to tragedy.

Not long ago, a patient with a deadly allergy to a common pain reliever was admitted to Brockton, Mass.-based Good Samaritan Medical Center. The patient’s allergy was recorded in the EMR. But somehow, despite the warning generated by the system, a nurse practitioner ordered the medication and a pharmacist approved it. The patient recovered but was forced to spend time in the ICU, according to a story in the Boston Globe.

When state and federal regulators descended upon the hospital, its leaders said that they felt alert fatigue was a factor in the error. Of course, this forced the hospital to address some complex issues and the path wasn’t simple. CMS almost booted Good Samaritan from the Medicare program over the issue, in part because it didn’t address the problem quickly enough.

Since then, parent company Steward Health Care has made changes to the EMRs at all of the facilities to cut the chances of patients being harmed by alert fatigue.

Today, if a new patient at any of the Steward hospitals has a serious drug to allergy, they must follow a new procedure. Under new rules, a pharmacist cannot place an order for any of the potentially harmful drugs until they speak with the doctor or nurse to discuss alternative treatments.

Dr. Joseph Weinstein, chief medical officer at the health system, told the newspaper that the new procedure forces staff who are “moving through screens at a rapid pace” to stop. “The two people have to sign off on [the prescription] together,” he said. “This is one of the safest ways to reduce alert fatigue.”

Steward also cut back the list of reasons providers can override analogy alert from 14 to 7 of the most important, giving them a shorter list of items to read through and check off as part of the process.

It’s good to see that Steward was able to learn from the medication error and improve the alarm systems across its entire hospital network. These changes are likely to make a difference in day-to-day patient care and reduce the odds of patient harm.

That being said, clinicians are still besieged by alerts generated for other reasons, and simplifying one process, however vital, can only shave off points of the larger problem.

It seems to me that vendors ought to be more involved in the process of refining alerts rather than making individual hospitals figure out how to do this. Sure, hospitals need to address their individual circumstances but vendors need to take more responsibility the problem. There’s no getting away from this issue.

2 Core Healthcare IT Principles

Posted on May 10, 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.

One of my favorite bloggers I found when I first starting blogging about Healthcare IT was a hospital CIO named Will Weider who blogged on a site he called Candid CIO. At the time he was CIO of Ministry Health Care and he always offered exceptional insights from his perspective as a hospital CIO. A little over a month ago, Will decided to move on as CIO after 22 years. That was great news for me since it meant he’d probably have more time to blog. The good news is that he has been posting more.

In a recent post, Will offered two guiding principles that I thought were very applicable to any company working to take part in the hospital health IT space:

1. Embed everything in the EHR
2. Don’t hijack the physician workflow

Go and read Will’s post to get his insights, but I agree with both of these principles.

I would add one clarification to his first point. I think there is a space for an outside provider to work outside of the EHR. Think of someone like a care manager. EHR software doesn’t do care management well and so I think there’s a space for a third party care management platform. However, if you want the doctor to access it, then it has to be embedded in the EHR. It’s amazing how much of a barrier a second system is for a doctor.

Ironically, we’ve seen the opposite is also true for people like radiologists. If it’s not in their PACS interface, then it takes a nearly herculean effort for them to leave their PACS system to look something up in the EHR. That’s why I was excited to see some PACS interfaces at RSNA last year which had the EHR data integrated into the radiologists’ interface. The same is true for doctors working in an EHR.

Will’s second point is a really strong one. In his description of this principle, he even suggests that alerts should all but be done away within an EHR except for “the most critical safety situations. He’s right that alert blindness is real and I haven’t seen anyone nail the alerts so well that doctors aren’t happy to see the alerts. That’s the bar we should place on alerts that hijack the physician workflow. Will the doctor be happy you hijacked their workflow and gave them the alert? If the answer is no, then you probably shouldn’t send it.

Welcome back to the blogosphere Will! I look forward to many more posts from you in the future.

EHR Alerts, Top 10 Health IT Topics, Gesture Based EHR, and Adverse Events

Posted on December 18, 2014 I Written By

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

I thought it might be valuable to highlight a few interesting tweets I’ve seen recently. Some of them come from the other Healthcare Scene blogs, but I think you’ll find interesting.


Have alerts helped your organization? Alert fatigue is a very real thing, but when calibrated effectively, I’ve seen them really benefit an organization.


This is a fun list of healthcare topics. Do you see any topics that should be added to the list?


We’ve heard about gesture based EHR many times before. Mostly in the surgery room and mostly as demonstration projects. I don’t think this will really go huge and mainstream in healthcare, but could likely get some pickup for very targeted use cases.


Carl does a really great job in this article talking about Adverse Events and the legislation that’s proposed around EHR adverse events. This is a really important topic that doesn’t get nearly enough attention.

Stanford EMR-Based Program Lowers Use of Transfusions

Posted on June 14, 2013 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.

Four  years ago, Stanford Hospital & Clinics decided to see if it could cut back on unnecessary blood transfusions, procedures which, though sometimes life-saving, also carry risk to patients and may needlessly use up limited blood supplies. Right now, blood transfusions happen in more than 10 percent of all hospital stays which include a procedure, and they’ve been named by the American Medical Association one of five most overused medical treatments.

To address the transfusion issue, Stanford created an alarm in its EMR which encouraged doctors to think twice before they went ahead with a transfusion order. Every time a doctor requests blood through the Stanford EMR, a pop-up appears which asks the doctor to explain the reason for the request and shares guidelines on blood use.  At that point, physicians can cancel the order if they so desire..

The program seems to have been a smashing success. The new prompt contributed to a 24 percent decline in use of red blood cells at Stanford between 2009 and 2012, according to Stanford’s Scope blog. What’s more, transfusions of all blood products at the hospital fell from more than 60,204 to 48,678 per year during that time.

In making this shift, Stanford is now on board with national trends. According to the American Red Cross, which supplies about half of the U.S.’s blood, blood use fell by 3 percent in 2011 and another 5 percent in 2012, Scope reports.

While saving precious, inherently limited blood supplies sounds like a good idea, I do wonder whether adding yet another alarm to override is the best way to accomplish this otherwise laudable goal. And this piece from Scope doesn’t say anything about whether they’ve tracked the outcomes of cases where transfusion was considered and rejected.

Still, if the transfusion reminder is easy to respond to, and dismiss if necessary, perhaps it’s worth the distraction to treatment teams. I guess the proof will be in the long-term patient outcomes of this intervention, which seemingly remain to be seen.