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JCAHO Parody Video – Fun Friday

Posted on April 28, 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.

It’s Friday, so time for a little humor. Every week we could likely choose one of ZDoggMD‘s videos. Ever since he lost his job running a clinic, he’s been on a tear creating healthcare videos. What else is a doctor with no clinic going to do when he’s in Vegas? Now we know the answer.

I could have chosen a ton of different videos, but I think this one is going to really hit home with a lot of people who’ve had to deal with JCAHO in their organization.

Here are two lines from the video which made us laugh the most:

“JCAHO, I wrote an entire note, using only poo emojis”

and

“I got an email from a lovely gentleman, who was a Nigerian prince…Having some financial difficulties…And I gave him my EHR password.”

Only ZDoggMD!

Docs Are Tired of Being Force Fed IT That Makes Things Worse

Posted on April 27, 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.

When I look at the world of healthcare IT and EHR, there are a lot of things to be proud about. In the 11+ years that I’ve been blogging about EHR, I’ve seen a massive progression in the use of technology in healthcare. I know a lot of doctors that implemented EHR the right way and are seeing a lot of value from it. It makes their workflow more efficient and helps them take care of their patients better. They can’t imagine practicing medicine without an EHR and other technology.

On the other hand, I know even more people that feel like they were force fed technology that ended up making their practice worse. I don’t want to absolve the practice of any responsibility since they chose to chase the government money and/or they kicked their heels in and made the EHR implementation as miserable as possible since they were against it in the first place. Both situations usually ended up with things getting worse for the doctor.

While those at ONC proudly proclaimed that EHR adoption was going through the roof (and it was), they essentially burned out a whole generation of physicians on the value technology could bring to their practice. In many ways, MACRA is doubling down on these same things.

I wish that every government health IT program had one requirement tied to it. Does this improve patient care or improve efficiency? If they can answer this question affirmatively with proven facts, then they should regulate, incentivize and legislate it. If it doesn’t or we don’t know, then they should do the work required to find out.

I don’t know a single doctor that when shown the evidence of the benefits to their patients and their practices doesn’t want to adopt technology. If we’d given them the time to evaluate EHR properly, learn from their peers, and implement EHR in a rationale way, most doctors would love their EHR and be happy to use it.

The challenge is where do we go from here. The damage of rushed EHR implementations is done. However, we should choose to stop doubling down on requirements that don’t improve safety, quality, and efficiency. Implementations will improve and EHR satisfaction will improve if we just stop trying to force feed doctors.

Collaborating With Patients On Visit Agendas Improves Communication

Posted on April 26, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Maybe it’s because I spent many years as a reporter, but when I meet with a doctor I get all of my questions out, even if I don’t plan things out in advance. I realize that this barrage may be unnerving for some doctors, but if I need to fire off a bunch of questions to understand my care, I’m going to do it.

That being said, I realize most people are more like my family members. Both my husband and my mother feel overwhelmed at medical visits, and often fail to ask the questions they want answered. I don’t know if they feel pressured by the rapid pace of your typical medical visit, afraid to offend their doctor or have trouble figuring out what information will help them most effectively, but clearly, they don’t feel in control of the situation.

Given their concerns, I wasn’t surprised to learn that letting patients create and share an agenda for their medical visit – before they see their provider – seems to improve physician-patient communication substantially. New research suggests that when patients set the agenda for their visit, both the patient and their doctor like the results.

Study details

The paper, which appeared in the Annals of Family Medicine, said that researchers conducted their study at Harborview Medical Center, a safety-net county hospital in Seattle. The researchers recruited patients and clinicians for the study between June 9 and July 22, 2015 at the HMC Adult Medicine Clinic. The 67-clinician primary care clinic serves about 5,000 patients per year.

When participating patients came in for a visit, a researcher assistant met them in the waiting room and gave them a laptop computer with the EMR interface displayed. The participating patients then typed their agenda for the visit in the progress notes section of their medical record. Clinicians then reviewed that agenda, either before entering the exam room or upon entering.

After the visit, patients were given a survey asking them for demographic information, self-reported health status and perceptions of the agenda-driven visit. Meanwhile, clinicians filled out a separate survey asking them for their gender, age, role in the clinic and their own perceptions of the patient agenda.

After reviewing the survey data, researchers concluded that using a collaborative visit agenda is probably a good idea. Seventy nine percent of patients and 74 percent of clinicians felt the agendas improved patient-clinician communication, and both types of participants wanted to use visit agendas agenda (73 percent of patients and 82 percent of clinicians).

Flawed but still valuable

In closing, the authors admitted that the study had its technical limits, including the use of a small convenient sample at a single clinic with no comparison group, It’s also worth noting that the study drew from a vulnerable population which might not be representative of most healthcare consumers.

Nonetheless, researchers feel these data points to a broader trend, in which patients have become increasingly comfortable with electronic health data. “The patient cogeneration of visit notes, facilitated by new EMR functionality, reflects a shift in the authorship and “ownership” of [their data],” the study points out. (I can’t help but agree that this is the case, and moreover, that patients’ response to programs  like Open Notes support their conclusion.)

I’m not sure if my mom or hubby would buy into this approach, but I imagine that if they did, they might find it helpful. Let’s hope the idea catches fire, and helps ordinary consumers take more control of their clinical relationships.

Could AI And Healthcare Chatbots Help Clinicians Communicate With Patients?

Posted on April 25, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

AI-driven chatbots are becoming increasingly popular for a number of reasons, including improving technology and a need to automate some routine processes. (I’d also argue that these models are emerging because millennials and Gen Z-ers have spent their lives immersed in online-based social environments, and are far less likely to be afraid of or uncomfortable with such things.)

Given the maturation of the technology, I’m not surprised to see a number of AI-driven chatbots for healthcare emerging.  Some of these merely capture symptoms, such as the diabetes, CHF and mental health monitoring options by Sense.ly.

But other AI-based chatbots attempt to go much further. One emerging company, X2ai, is rolling out a psychology-oriented chatbot offering mental health counseling, Another, UK-based startup Babylon Health, offers a text-only mobile apps which provides medical evaluations and screenings. The app is being pilot-tested with the National Health Service, where early reports say that it’s diagnosing and triaging patients successfully.

One area I haven’t seen explored, though, is using a chatbot to help doctors handle routine communications with patients. Such an app could not only triage patients, as with the NHS example, but also respond to routine email messages.

Scheduling and administration

The reality is that while doctors and nurses are used to screening patients via telephone, they’re afraid of being swamped by tons of electronic patient messages. Many feel that if they agree to respond to patient email messages via a patient portal, they’ll spend too much time doing so. With most already time-starved, it’s not surprising that they’re worried about this.

But a combination of AI and healthcare chatbot technology could reduce their time required to engage patients. In fact, the right solution could address a few medical practice workflow issues at one time.

First, it could triage and route patient concerns to doctors and advanced practice nurses, something that’s done now by unqualified clerks or extremely busy nurses. For example, the patient would be able to tell the chatbot why they wanted to schedule a visit, with the chatbot teasing out some nuances in their situation. Then, the chatbot could kick the information over to the patient’s provider, who could, with a few clicks, forward a request to schedule either an urgent or standard consult.

Perhaps just as important, the AI technology could sit atop messages sent between provider and patient. If the patient message asked a routine question – such as when their test results would be ready – the system could bounce back a templated message stating, for instance, that test results typically take five business days to post on the patient portal. It could also send templated responses to requests for medical records, questions about doctor availability or types of insurance accepted and so on.

Diagnosis and triage

Meanwhile, if the AI concludes that the patient has a health concern to address, it could send back a link to the chatbot, which would ask pertinent questions and send the responses to the treating clinician. At that point, if things look questionable, the doctor might choose to intervene with their own email message or phone call.

Of course, providers will probably be worried about relying on a chatbot for patient triage, especially the legal consequences if the bot misses something important. But over time, if health chatbot pilots like the UK example offer good results, they may eventually be ready to give this approach a shot.

Also, patients may be uncertain about working with a chatbot at first. But if physicians stress that they’re not trying put them off, but rather, to save time so they can take their time when patients need them, I think they’ll be satisfied.

I admit that under ideal circumstances, clinicians would have more time to communicate with patients directly. But the truth is, they simply don’t, and pressuring them to take phone calls or respond to every online message from patients won’t work.

Besides, as providers work to prepare for value-based care, they’ll need not only physician extenders, but physician extender-extenders like chatbots to engage patients and keep track of their needs. So let’s give them a shot.

EMR and EHR Reaches 2000 Posts Published

Posted on April 24, 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.

We’re taking a small break from our regularly scheduled MACRA Monday program to bring you this special announcement. This post is the 2000th blog post on EMR and EHR! Check out the admin view I woke up to this morning:

I’m pretty excited by this achievement since I nearly sold this blog about 8-9 years ago. Plus, this blog was kind of started on a lark to help someone who wanted a place to blog. 21 blog posts later, he got a new job and couldn’t blog anymore, so I continued it without him.

As EMR and EHR has progressed, we’ve worked hard to focus the content of the site on the ambulatory market and have expanded beyond the topics of EMR and EHR into anything that might be useful to an ambulatory organization. I’m happy to say that EMR and EHR is approaching 5 million pageviews.

In the beginning, I was the main blogger on the site, but I certainly haven’t done this alone. To all those people who contributed to EMR and EHR over the years, I can’t thank you enough:

Anne Zieger – 429 posts
Jennifer Dennard – 143 posts
Andy Oram – 106 posts
Katie Clark – 44 posts
Carl Bergman – 45 posts
Priya Ramachandran – 40 posts
Dr. Jeff – 21 posts
Janae Sharp – 5 posts
Julie Maas – 5 posts
Colin Hung – 1 post
Guest Bloggers – 53 posts
*Note: Many of these people also blog on other Healthcare Scene blogs as well.

The nice thing is, we’re really just getting started. We have a lot more planned for EMR and EHR. One thing we’re working on is doing a number of blog post series on topics that matter to ambulatory practices similar to what we’ve done with MACRA Monday. These series will be deep dives into topics that matter to ambulatory practices.

From these blog post series, we’re also going to generate a list of the various companies in that space similar to what we’ve done with EHR companies in the past. One challenge we see ambulatory practices face is they don’t know all of the companies out there that are creating innovative solutions that can make their practice run more efficiently. Hopefully these new resources will help them cut through all the noise and discover companies they’ve likely never heard of before.

It’s an exciting time in the industry because I think that practices are now ready to move beyond the EHR. Don’t get me wrong, the EHR has had a good run and will continue to be an integral part of every practice. In fact, we still have a lot of work to do to get value out of the EHR. However, we need to explore what else practices need to be successful in this ever-changing healthcare world. We’ll be exploring this question in our next 2000 blog posts.

Thanks to all of you who keep reading and please let us know on our contact us page how we can help you even more.

The Disconnect Between Where Wearables Are Needed and Where Wearables are Used

Posted on April 21, 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.

No one can argue that we haven’t seen an explosion of wearable devices in the healthcare space. In most cases, they’ve been a consumer purchase, but there are a few cases of them being used clinically. While we’ve seen a huge uptick in wearable use, there seems to be a massive disconnect between those who use them and those who need to use them.

This was highlighted to me recently when I heard someone say that at the recent Boston Marathon they predicted that almost every athlete running the Boston Marathon had some sort of tracking device on them to track their running. Runners love to track everything from steps to heart rate to speed and everything in between. I wish the Boston Marathon did a survey to know what devices the runners used. That would be a fascinating view into which wearables are most popular, but I digress.

When I heard this person make this observation, I quickly thought “That’s not who we need using wearables if we want to lower the cost of healthcare.”

With some exceptions, those who run the Boston Marathon are in incredible shape. They exercise a lot (maybe too much in some cases) and most of them eat quite healthy. These are the outliers and my guess is that they’re not the people that are costing our healthcare system so much money. That seems like a fair assumption to me.

Yes, the people we need using these wearables are those people sitting on the couch back at home. We need the unhealthy people tracking their health, not healthy people. While not always the case, unhealthy people don’t really want to track their health. What’s more demotivating to your healthy goals than being in a FitBit group with a marthon runner that always destroys you?

This is a challenging psychological problem that I haven’t seen any wearable company address. I guess there’s too much money to be made with healthy people that want to track themselves that they don’t need to dive into the psychological impact of wearables on unhealthy people. However, that’s exactly what we’re going to need to do as wearables become more clinically relevant and can help us better understand a patient’s health.

The Personalization of Healthcare and Healthcare Chatbots

Posted on April 20, 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.

At HIMSS 2017, I did a plethora of videos where I was interviewing people and even more where people were interviewing me. Many of those videos are just now starting to leak out onto the internet. One of those videos where I was interviewed was with the team from Availity. They had a great team there that interviewed a bunch of the HIMSS Social Media Ambassadors including me.

I’ll admit that I was pretty tired when I did this interview at the end of the day, right before the New Media Meetup at HIMSS. However, I think the interview shares some high-level views on what’s happening in healthcare IT and important topics coming out of the conference. Check out the full video to learn the details:

I like that I talked about the personalization of healthcare and then healthcare chatbots in the same video interview. Some people might see these as opposites. How can talking with a healthcare chatbot be more personal than a human?

The answer to that question has two parts. First, a chatbot can quickly analyze a lot more information to personalize the experience than a human can do. Notice that I said personalization and not personal. There’s a subtle but important difference in those two words. Second, I didn’t clarify this in the video, but the healthcare chatbot will not fully replace the care provider. Instead, it will just replace the care provider from having to do the mundane tasks that the providers hate doing. Done correctly, the healthcare chatbot will fee up the providers to be able to focus on providing patients a more personalized and personal experience. That’s something we would all welcome in healthcare.

All of this health data we are amassing on patients is going to make both the healthcare chatbot and the human healthcare provider better able to give you a personalized experience. That’s a great thing.

Since in the video I also recommended that people follow Rasu Shrestha, MD, you may also want to check out the video interview Rasu did with Availity:

I love the idea that we go to conferences to not just learn something, but to unlearn things. Rasu is great!

A New Definition of EHR

Posted on April 19, 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.

That’s a pretty funny play on words by Nicholas DiNubile, MD. Well, it’s funny unless you’re the one that’s become the government tool. Dr. DiNubile also shared this picture with the above definition.

While I think that this picture is an exaggeration of reality for most doctors, what isn’t an exaggeration is administrative overheard a doctor has now is much greater than it was in the past. In most cases, the EHR hasn’t made it any better and what the EHR vendors have had to implement for meaningful use and now mACRA have generally made this worse.

Over the past couple weeks, I’ve had the good luck of spending a lot of time with my colleague Shahid Shah. Something he’s been sharing lately is that “Doing stupid faster isn’t innovation.” We see a lot of this in healthcare. Talking to one healthcare IT vendor he came to the realization that all his company does is stupid faster. It was a shocking thought for him and likely for many that read this.

As you look at your organization and where you want to take it, are you focused on true innovation or are you busy doing stupid faster? If you’re doing the former, keep fighting the good fight. If you’re doing the later, it might be time to take a step back and reconsider your path forward.

Is ICSA Labs Getting Out of the EHR Certification Business?

Posted on April 18, 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 got the following email that was received by ICSA customers:

Dear Valued Customer:

Your organization has received product testing and certification services as a customer of ICSA Labs, a division of MCI Communications Services, Inc., d/b/a Verizon Business Services (“ICSA Labs”).

I am writing to inform you that ICSA Labs will no longer be accepting new engagements for product testing and certification, or renewing expiring Statement(s) of Service. However, please be assured that we will continue to honor any existing, active Statements of Service that we may have with your organization, and to maintain any current certifications for the applicable term.

Thank you for your attention to this matter. If you have any questions, please contact icsalabsinfo@icsalabs.com.

Sincerely,

George Japak
ICSA Labs, Managing Director

Does this mean ICSA is withdrawing as an EHR Certifying body (ATCB)? I asked EHR certification expert, Jim Tate, which EHR certifying bodies remain if ICSA is pulling out and he said that right now Drummond, ICSA, InfoGard, and SLI are authorized to test and only Drummond, ICSA, and InfoGard are authorized to certify. You can find more details on the ONC website.

A part of me isn’t really surprised since the EHR certification business isn’t a great business. There are a limited number of clients and a limited amount of revenue available. Plus, under meaningful use, EHR certification became a commodity. That’s why CCHIT couldn’t survive. Seems like ICSA Labs is heading the same direction as CCHIT.

The bigger question I would ask is should EHR certification continue at all?

MACRA Stats – MACRA Monday

Posted on April 17, 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.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

I love a good stat. I realize that you can make stats tell you whatever you want. However, if you look at them with a critical eye, you can learn something about both the organization producing the stat and the population that the stat represents.

It’s no surprise that I found these MACRA stats shared by David Chou to be of great interest and a perfect MACRA Monday discussion.

The stat that stands out to me is the 51% of physicians who reported that they weren’t getting paid on a performance basis or that their compensation had a very small performance based piece to it. For those of us following the cutting edge of what’s happening in the world of healthcare, it’s sometimes important to remember that while the shift to value based reimbursement is happening, it still has a long ways to go.

I found David Chou’s tweet with these stats interesting when he said “Most physicians prefer the old model of payment vs MACRA.” I would look at these stats a bit differently than David.

I would suggest that these stats say that doctors prefer reimbursement models they understand and ones that pay them well. This is proven out in the stat that 71% of physicians surveyed would participate in value-based payment models if offered financial incentives to do so. It’s not really a shocking insight that doctors are happy to shift models if there are financial incentives to do so.

The challenge is that most doctors don’t think that a value based reimbursement model is going to pay them more for the work they do. They’re probably right. This explains why nearly 8 in 10 physicians surveyed prefer fee-for-service or salary for their compensation. If a new model came along that would pay them more than their current fee for service model, then they’d happily switch models.

Sometimes we make things too complicated. Physicians just want to be paid well for the work they do. Sounds like all of us no? The concern for most physicians is that these models are unlikely to pay them more. In fact, it’s quite possible they’ll pay them less or at least pay them the same for more work.

I haven’t seen any plan or projections to pay doctors more. In fact, the rhetoric in society is that we pay too much for healthcare (which is true). As a society, we all agree that we should be paying less for healthcare. However, as a healthcare provider or healthcare organization the idea of paying less for healthcare translates to getting paid less. Who’s going to take the hit when it comes to getting paid less? Providers? Hospitals? Pharma? Med device companies? Health IT Companies?

Could value based reimbursement models theoretically cost less and pay all of these stakeholders the same amount of money because patients were healthier? Works great in theory, but looking at the past history of these programs tells another story. So, it’s no wonder that most doctors would happily stay in the fee-for-service reimbursement world they know vs moving to value based reimbursement models.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.