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Informed Consent: Let Go of the Status Quo

Posted on October 1, 2018 I Written By

The following is a guest blog post by Shahid Shah.

We’ve all heard it before: “healthcare is slow to adopt new technologies.” In fact, we’ve heard it so many times that we just accept it as gospel and don’t give it much thought.

It’s not true though.

For example, I remember when the iPhone was first released, it was easily adopted by doctors because it gave them something they craved: increased freedom by having access to information on the go.

What’s probably true is that “healthcare institutions are slow to adopt new technologies that impact status quo.

Why is that?

Because the perceived cost of maintaining the status quo is smaller than the cost of the innovation (e.g. product or solution), even if that innovation is free.

When the cost of not doing something new is low, nothing will change: and bad leadership is often able to keep the cost of maintaining status quo very low. Poor leaders add hurdles, like requiring unknowable ROI analyses, for introducing innovation but don’t penalize maintenance of status quo. This means that it’s easier to not introduce anything new – because the cost of not innovating is low but the cost of innovating is high.

Let’s take a look at digital patient consent as an example of an innovation – obtaining patient consent to perform a healthcare service is something that no hospital can do without. Called “informed consent”, this is a document that patients are required to sign before any procedure or health service is delivered. You’d think that because this form is the initial and primary document before almost any other workflow is started, that it would be the first to be digitized and turned into an electronic document.

Unfortunately, it’s 2018 and informed consent documents remain on paper. Thus:

  • JAMA reports that two-thirds of procedures have missing consent forms
  • JAMA reports that missing consent forms cause 10% of procedures to be delayed, costing hospitals over $500k per year
  • Joint Commission reports over 500 organizations annually experience compliance issues because of missing consent forms. There’s almost a 1 in 4 chance that your own organization has this compliance problem.
  • A recent JAMA Surgery paper estimated that two thirds of malpractice cases cited lack of informed consent, which increases liability risk
  • Superfluous paperwork directly contributes to clinician burnout
  • Patients often don’t understand their procedures or aren’t properly educated about the service they’re about to use

Today, many healthcare institutions go without automation of consent documents – which I’m calling the status quo. Even though this document is essential, and its non-digital status quo creates many financial, clinician, and compliance burdens, it’s not high in the list of priorities for digitization or automation.

As I enter my third decade as a health IT architect, after having built dozens of solutions in the space that are used by thousands of people, I still find it difficult to explain why even something as simple as an informed consent isn’t prioritized for automation.

It’s not because solutions aren’t out there – for example, FormFast’s eConsent is a universally applicable, easy to deploy, and easy to use software package with a fairly rapid return on investment. With eConsent software, clinicians aren’t interrupted in their workflows, patients are more satisfied, compliance becomes almost guaranteed, and procedures aren’t delayed because of lost paperwork.

A senior network engineer at East Alabama Medical Center recently wrote “the comparison of creating a form in the EHR vs. an eForms platform? There is no comparison. We are saving thousands of dollars by using eForms technology and the form creation is simple.”

Why do you think even something essential like patient consent forms remain on paper? Drop us a line below and let us know why the status quo is so powerful and what’s keeping your organization from adopting electronic forms solutions.

Note: FormFast is a proud sponsor of Healthcare Scene.

HIMSS Social Media Ambassador Debate: FHIR and Patient Focus

Posted on June 8, 2016 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.

While at HIMSS, I had a chance to do a “debate” with my good friend, partner and fellow HIMSS Social Media Ambassador, Shahid Shah. This was facilitated by Healthcare IT News, and the debate was moderated by Beth Jones Sanborn, Managing Editor of Healthcare Finance. Shahid and I had a good debate on the topics of healthcare interoperability and FHIR. Plus, we talked about the need for healthcare IT companies to focus on the patient and whether they deserve the bad rap they get or not. Enjoy the video debate below:
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The “Feature List” Disconnect from Healthcare Problems

Posted on April 22, 2016 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 the big takeaways coming out of the Healthcare IT Marketing and PR Conference is that most health IT companies are still spouting out the features they offer and very few actually talk about the problems they solve. This is a huge mistake for a health IT company, but it’s also a big reason why most hospital executives don’t want to hear from you.

As a healthcare executive you’re inundated with marketing and sales pitches and after a while they all start to look the same. Plus, many (some might say most) of those pitches require the hospital executive to try and translate a long list of features into the problems that executive is trying to solve. It’s no wonder that most hospital executives barely look at these pitches and often aren’t aware of the opportunities for innovation that exist for the problems they’re trying to solve.

Think about how many healthcare IT companies could list the following set of features in their sales and marketing:

  • Data Analytics
  • FHIR Enabled
  • HIPAA Compliant
  • EHR Integration
  • Machine Learning
  • Mobile Optimized
  • Real Time Processing
  • etc

I could keep going on, but you get the point. I’m reminded of something Shahid Shah said at our session at HIMSS. No one in healthcare has an interoperability problem. His point isn’t that interoperability isn’t important or valuable. His point was that no one is trying to solve interoperability. They have other problems they are trying to solve and data sharing (ie. interoperability) might be the solution. However, when they think about their problems and challenges interoperability is not on that list.

Hospital systems definitely have plenty of problems they’re trying to solve. Here’s just a few examples to give you a flavor of problems hospital executives are working to solve:

  • Improving HCAPHS Scores
  • Reducing Hospital Readmissions
  • Improving Provider Efficiency
  • Ensuring Accurate Patient Identification
  • Lowering Sepsis Numbers
  • etc

This list never ends. These are problems that hospital executives are working to solve and understanding which problems are vexing a hospital executive is key to getting them interested in the solutions. I think this small change would make it so hospital executives dread the wave of marketing and sales pitches a little less. The reality is that most of these executives are looking for great solutions. It’s just often hard for them to know what problems your company can really solve.

Of course, the next challenge is showing proof of your ability to solve the problem. However, at least that gets a hospital executive one step closer to finding solutions to their problems and challenges.

Interview with Shahid Shah About HealthIMPACT Conference

Posted on March 25, 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.

The following is an interview with Shahid Shah about the upcoming HealthIMPACTconferences he’s helping to organize. The next one is in Houston on April 3rd and a few discount seats for HealthcareScene readers remain open. Register here using IMPACT10 as the code.

It seems like there is a health IT conference every day.  What will make this conference unique?

The first thing unique about HealthIMPACT is the length and locations – we’re choosing single day and “local” to many areas of the country (southeast, southwest, etc.) because busy people can’t take more than 1 day and probably can’t afford to travel. The second unique aspect is that we’re focused on “actionable intelligence” coming not from pontificators but those “in the trenches” doing the grunt work of health IT every day. The third, and perhaps the most unique, is that we teach audiences what kinds of tech to buy, what not buy, how to spot real trends from hype, and how not to fall prey to prevailing myths. This is going to be a no-nonsense, no fluff, no hype, “just answers” event. It’s not so much a “conference” but an educational event – audience members can even earn CME credits if they’d like. The fourth, and something useful for software and technology vendors and buyers alike, is a customized meeting with one or more CIOs or other tech-focused buyers that developers can use as a mini “focus group” to test ideas and ask buyers questions that will help improve products and sales.

What’s special about the format of the conferences?

The format is “no long speeches, no PowerPoint-centric presentations, all panels and interviews with high interactivity”. By making sure that there are no speeches we don’t have to worry about “death by PowerPoint” or folks presenting a viewpoint that audiences can’t easily interact with. The panels topics are focused on problems that audience members are regularly facing in their daily work environments. The panel members are all working “in the trenches” and coming prepared to interact with the audience. That’s why we say “no fluff, just answers”.

What kind of audience attends your conferences?

We have a list of attending organizations and their titles available here. We get CIOs, CFOs, CTOs, HIM, architects, engineers, consultants, and product vendors from both hospital / health system and ambulatory physician practices. It’s a mixed audience but I think what’s in common is that they’re all “in the trenches” folks solving hard technical problems every day.

What are some of the main topics that will be discussed at these conferences?

  • How IT can support the overarching financial, operational, and clinical goals of your organization
  • HIEs in your region and provider participation in them
  • Technologies that support value driven care and population health management
  • Cloud based systems in healthcare
  • Programs that drive patient engagement
  • Leadership strategies that drive innovation
  • Predictive analytics that improve care delivery
  • EHR implementation and meaningful use
  • ICD10 compliance, readiness and physician training

Where can people go to learn more about the conferences?
You can find more information on the HealthIMPACT website and if you use the discount code IMPACT10, you’ll receive a 10% discount for being a Healthcare Scene reader.