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PointClickCare Tackling Readmissions from Long-Term and Post-Acute Care Facilities Head-On

Posted on January 12, 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.

Transitioning from an acute care to a long-term/post-acute care (LTPAC) facility can be dangerous.

According to one study, nearly 23% of patients discharged from a hospital to a LTPAC facility had at least 1 readmission. Research indicates that the leading cause of readmission is harm caused by medication (called an adverse drug event). Studies have shown that as much as 56% of all medication errors happen at a transitional point of care.

By the year 2050 more than 27 million Americans will be using LTPAC services. The majority of these LTPAC patients will transition from an acute care facility at least once each year. With this many transitions, the number of medication errors each year would balloon into the millions. The impact on patients and on the healthcare system itself would be astronomical.

Thankfully there is a solution: medication reconciliation

The Agency for Healthcare Research and Quality (AHRQ) states: “Patients frequently receive new medications or have medications changed during hospitalizations. Lack of medication reconciliation results in the potential for inadvertent medication discrepancies and adverse drug events—particularly for patients with low health literacy, or those prescribed high-risk medications or complex medication regimens.”

Medication reconciliation is a process where an accurate list of medications a patient is taking is maintained at all times. That list is compared to admission, transfer and/or discharge orders at all transitional points both within a facility and between facilities. By seeing orders vs existing medications, clinicians and caregivers are able to prevent drug-interactions and complications due to omissions or dosage discrepancies.

What is surprising is the lack of progress in this area.

We have been talking about interoperability for years in HealthIT. Hundreds of vendors make announcements at the annual HIMSS conference about their ability to share data. Significant investments have been made in Health Information Exchanges (HIEs). Yet despite all of this, there has been relatively little progress made or coverage given to this problem of data exchange between hospitals and LTPAC facilities.

One company in the LTPAC space is working to change that. PointClickCare, one of the largest EHR providers to skilled nursing facilities, home care providers and senior living centers in North America, is dedicating resources and energy to overcoming the challenge of data sharing – specifically for medication reconciliation.

“We are tackling the interoperability problem head-on,” says Dave Wessinger, co-founder and Chief Operating Officer at PointClickCare. “The way we see it, there is absolutely no reason why it can take up to three days for an updated list of medications to arrive at our customer’s facility from a hospital. In that time patients are unnecessarily exposed to potential harm. That’s unacceptable and we are working with our customers and partners to address it.”

Over the past 12 months, the PointClickCare team has made significant progress integrating their platform with other players in the healthcare ecosystem – hospitals, pharmacies, HIEs, ACOs, physician practices and labs. According to Wessinger, PointClickCare is now at a point where they have “FHIR-ready” APIs and web-services.

“We believe that medication reconciliation is the key to getting everyone in the ecosystem to unlock their data,” continues Wessinger. “There is such a tremendous opportunity for all of us in the healthcare vendor community to work together to solve one of the biggest causes of hospital readmissions.”

Amie Downs, Senior Director ISTS Info & App Services at Good Samaritan Society, an organization that operates 165 skilled nursing facilities in 24 states and a PointClickCare customer, agrees strongly with Wessinger: “We have the opportunity to make medication reconciliation our first big interoperability win as an industry. We need a use-case that shows benefit. I can’t think of a better one than reducing harm to patients while simultaneously preventing costly readmissions. I think this can be the first domino so to speak.”

Having the technology infrastructure in place is just part of the challenge. Getting organizations to agree to share data is a significant hurdle and once you get organizations to sit down with each other, the challenge is resisting the temptation just to dump data to each other. Downs summed it up this way:

“What is really needed is for local acute care facilities to partner with local long-term and post-acute care facilities. We need to sit down together and pick the data that we each want/need to provide the best care for patients. We need to stop just sending everything to each other through a direct connection, on some sort of encrypted media that travels with the patient, via fax or physically printed on a piece of paper and then expecting the other party to sort it out.”

Downs goes on to explain how narrowing the scope of data exchange is beneficial: “I definitely see a strong future for CCDA data exchange to help in medication reconciliation. Right now medication information is just appended to the file we receive from acute care facilities. We need to agree on what medication information we really need. Right now, we get the entire medication history of the patient. What we really need is just the active medications that the patient is on.”

In addition to working on FHIR and APIs, BJ Boyle, Director of Product Management at PointClickCare, is also leading a data sharing initiative for those instances when there is no fellow EHR platform to connect to. “We are working towards something that is best described as a ‘Post-Acute Care Cloud’ or ‘PAC Cloud’,” explains Boyle. “We’re designing it so that hospital case managers can go to a single place and get all the information they need from the various SNFs they refer patients to. Today, when HL7 integration isn’t possible, case managers have to be given authorized access to the SNF’s system. That’s not ideal.”

PointClickCare has already taken an initial step towards this vision with an offering called eINTERACT. According to the company’s website eINTERACT allows for the “early identification of changes in condition…and the sooner a change in condition is identified, the quicker interventions can be implemented to prevent decline and avoid potential transfers” which is key to managing patient/resident health.

It’s worth noting that John Lynn blogged about LTPAC readmissions in 2014. Unfortunately at the macro/industry level, not much has changed. Dealing with readmissions from LTPAC facilities is not particularly exciting. Much of the attention remains with consumer-monitoring devices, apps and gadgets around the home.

Having said that, I do find it encouraging to see real progress being made by companies like PointClickCare and Good Samaritan Society. I hope to find more examples of practical interoperability that impacts patient care while touring the HIMSS18 exhibit floor in early March. In the meantime, I will be keeping my eye on PointClickCare and the LTPAC space to see how these interoperability initiatives progress.

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 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

Poll: Providers Struggle To Roll Out Big Data Analytics

Posted on April 10, 2017 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

A new poll by a health IT publication has concluded that while healthcare organizations would like to roll out big data analytics projects, they lack many of the resources they need to proceed.

The online poll, conducted by, found that half of respondents are hoping to recruit data science experts to serve as the backbone of their big analytics efforts. However, many are finding it very difficult to find the right staffers.

What’s more, such hires don’t come cheaply. In fact, one study found that data scientist salaries will range from $116,000 to $163,500 in 2017, a 6.4 percent increase over last year’s levels. (Other research concludes that a data scientist in management leading a team of 10 or more can draw up to $250,000 per year.) And even if the pricetag isn’t an issue, providers are competing for data science talent in a seller’s market, not only against other healthcare providers but also hungry employers in other industries.

Without having the right talent in place, many of providers’ efforts have been stalled, the publication reports. Roughly 31 percent of poll respondents said that without a data science team in place, they didn’t know how to begin implementing data analytics initiatives.

Meanwhile, 57 percent of respondents are still struggling with a range of predictable health IT challenges, including EMR optimization and workflow issues, interoperability issues and siloed data. Not only that, for some getting buy-in is proving difficult, with 34 percent reporting that their clinical end users aren’t convinced that creating analytics tools will pay off.

Interestingly, these results suggest that providers face bigger challenges in implementing health data than last year. In last year’s study by, 47 percent said interoperability was a key challenge. What’s more, just 42 percent were having trouble finding analytics staffers for their team.

But at the same time, it seems like provider executives are throwing their weight behind these initiatives. The survey found that just 17 percent faced problems with getting executive buy-in and budget constraints this year, while more than half faced these issues in last year’s survey.

This squares with research released a few months ago by IT staffing firm TEKSystems, which found that 63 percent of respondents expected to see their 2017 budgets increase this year, a big change from the 41 percent who expected to see bigger budgets last year.

Meanwhile, despite their concerns, providers are coping well with at least some health IT challenges, the survey noted. In particular, almost 90 percent of respondents reported that they are live on an EMR and 65 percent are using a business intelligence or analytics solution.

And they’re also looking at the future. Three-quarters said they were already using or expect to enhance clinical decision making, along with more than 50 percent also focusing laboratory data, data gathered from partners and socioeconomic or community data. Also, using pharmacy data, patient safety data and post-acute care records were on the horizon for about 20 percent of respondents. In addition, 62 percent said that they were interested in patient-generated health data.

Taken together, this data suggests that as providers have shifted their focus to big data analytics– and supporting population health efforts – they’ve hit more speed bumps than expected. That being said, over the next few years, I predict that the supply of data scientists and demand for their talents should fall into alignment. For providers’ sake, we’d better hope so!

mHealth Apps May Create Next-Gen Interoperability Problems

Posted on November 20, 2015 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

According to a recent study by IMS Health, there were 165,000 mHealth apps available on the Google Play and iTunes app stores as of September. Of course, not all of these apps are equally popular — in fact, 40% had been downloaded less than 5,000 times — but that still leaves almost 100,000 apps attracting at least some consumer attention.

On the whole, I’m excited by these statistics. While there’s way too many health apps to consider at present, the spike in apps is a necessary part of the mobile healthcare market’s evolution. Over the next few years, clear leaders will emerge to address key mHealth functions, such as chronic care and medication management, diet and lifestyle support and health data tracking. Apps offering limited interactivity will fall off the map, those connected to biosensors will rise, IMS Health predicts.

That being said, I am concerned about how data is being managed within these apps. With providers already facing huge interoperability issues, the last thing the industry needs is the emergence of a new set of data silos. But unless something happens to guide mHealth app developers, that may be just what happens.

To be fair, health IT leaders aren’t exactly sitting around waiting for commercial app developers to share their data. While products like HealthKit exist to integrate such data, and some institutions are giving it a try, my sense is that mHealth data management isn’t a top priority for healthcare leaders just yet.

No, the talk I’ve overheard in the hallways is more geared to supporting internally-developed apps. For example, seeing to it that a diabetes management app integrates not only a patient’s self-reported blood sugar levels, but also related labs and recommended self-care appointments is enough of a challenge on its own. What’s more, with few doctors actually “prescribing” outside apps as part of their clinical routine, providers have little reason to worry about what commercial app developers do with their data.

But eventually, as top commercial health apps become more robust, the picture will change. Healthcare organizations will have compelling reasons to integrate data from outside apps, particularly if doctors begin viewing them as useful. But if providers and outside app developers aren’t adhering to shared data standards, that may not be possible.

Now, I’m not here to suggest that commercial mHealth developers are ignoring the problem of interoperability with providers. (Besides, with 165,000 apps on the market, I couldn’t say so with any authority, anyway.) I am arguing, however, that it’s already well past time for health IT leaders to begin scoping out the mobile health marketplace, and figuring out what can be done to help with data interoperability. Some sit-downs with top app developers would definitely make sense.

What I do know — as do those reading this blog — is that creating a fresh set of health data silos would be destructive. Creating and managing useful mobile health apps, as well as the data they generate, is likely to be important to next-generation health IT leaders. And avoiding the creation of a fresh set of silos may still be possible. It’s time to tackle this issue before it’s too late.

Interoperability Becoming Important To Consumers

Posted on June 26, 2015 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

The other day, I was talking with my mother about her recent primary care visit — and she was pretty po’d. “I can’t understand why my cardiologist didn’t just send the information to my family doctor,” she said. “Can’t they do that online these days? Why isn’t my doctor part of it?”

Now, to understand why this matters you need to know that my mother, who’s extremely bright, is nonetheless such a technophobe that she literally won’t touch my father’s desktop PC. She’s never opened a brower and has sent perhaps two or three e-mails in her life. She doesn’t even know how to use the text function on her basic “dumb” phone.

But she understands what interoperability is — even if the term would be foreign — and has little patience for care providers that don’t have it in place.

If this was just about my 74-year-old mom, who’s never really cared for technology generally, it would just be a blip. But research suggests that she’s far from alone.

In fact, a study recently released by the Society for Participatory Medicine and conducted by ORC International suggests that most U.S. residents are in my mother’s camp. Nearly 75% of Americans surveyed by SPM said that it was very important that critical health information be shared between hospitals, doctors and other providers.

What’s more, respondents expect these transfers to be free. Eighty seven percent were dead-set against any fees being charged to either providers or patients for health data transfers. That flies in the face of current business practices, in which doctors may pay between $5,000 to $50,000 to connect with laboratories, HIEs or government, sometimes also paying fees each time they send or receive data.

There’s many things to think about here, but a couple stand out in my mind.

For one thing, providers should definitely be on notice that consumers have lost patience with cumbersome paper record transfers in the digital era. If my mom is demanding frictionless data sharing, then I can only imagine what Millenials are thinking. Doctors and hospitals may actually gain a marketing advantage by advertising how connected they are!

One other important issue to consider is that interoperability, arguably a fevered dream for many providers today, may eventually become the standard of care. You don’t want to be the hospital that stands out as having set patients adrift without adequate data sharing, and I’d argue that the day is coming sooner rather than later when that will mean electronic data sharing.

Admittedly, some consumers may remain exercised only as long as health data sharing is discussed on Good Morning America. But others have got it in their head that they deserve to have their doctors on the same page, with no hassles, and I can’t say the blame them. As we all know, it’s about time.