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Legacy EMR Bloggers

Today I had an Italian friend of mine (I lived there for 2 years) find me on Facebook. I hadn’t seen or heard from the man in 10, almost 11 years. It was a joyous reunion and fun to catch up. I really hold relationships dear and truly love seeing people I haven’t seen in years.

One of the funny blogger stories I have was when I reached out to Christina Thielst from Christina’s Considerations. She loves to tell this story to people. First, you have to know that Christina’s blog was one of the first healthcare IT blogs I found when I began blogging 7.5 years ago. In fact, I must admit that I barely knew her name. I always just thought of her as the RHIO (there’s an old term for you) blogger.

Well, 6 years or so later I saw her name and picture on LinkedIn and so I decided to request that we connect. She politely replied that she declined my connection because she only connected with people she knew on LinkedIn. I was a little sad at the response, but replied that she probably had forgotten me and that we’d known each other’s blogs for many years. She then replied with a request to connect and an apology for not recognizing my name. It turns out she was like me and only knew the name of my blog and not my name.

As I thought about these long term relationships it’s fun for me to look back at which blogs were around when I first starting blogging about EMR. Here are a few that come to mind:

Neil Versel – I’m happy that I now consider Neil a friend, but when I first started blogging I looked to him and learned. He was and is a professional journalist and I was just a hack. I learned a lot from him and modeled a lot of what he was doing.

Healthcare Guy – I was always amazed at the stuff Shahid would write on his blog and enjoyed HITSphere which he created. Now he’s my partner in two businesses which we first talked about creating after we met in person at a HIMSS press room. I’m still amazed every time I’m on a call with Shahid. I like to just sit back, listen and learn from him.

HIStalk – I think Mr. H remembers those good old days. The funny thing is that when I first came across his posts they didn’t make much sense to me. They’re so full of industry jargon that it was like reading another language for me. Of course, now it’s often news and rumors I’ve already heard, but I still enjoy his wit. It’s like picking up the healthcare IT tabloids. You can’t look away. Plus, Inga is a sweetheart, even if she won’t tell me who she is. Maybe the Inga mystery is better.

Dalai’s PACS Blog – Sadly someone I have yet to meet in person. The PACS blog was and always has been an irreverent mix of many topics sprinkled with PACS talk. I have a feeling that the blog reflects the writer, which is why I’d love to one day meet him.

The Medical Quack – Barbara Duck has always been a good friend to me. I’ve always hated her blogger design, but she seems to like it. Barbara and I first met on the EMR Update forum (where I really cut my EMR teeth), and she’s always been a kind, but passionate lover of healthcare. I still remember how brave she was to be developing an EMR on her own (she’s since shut it down).

Candid CIO – Still one of my favorite blogs to read. I think Will is one of the smartest hospital CIOs that I’ve met. He has great insight and a great view of his job as CIO. Plus, I love a hospital CIO that’s willing to take time to blog.

The Healthcare Blog – I’m not sure if this one started a little after mine or if I just didn’t find it until after. Although, it was one of the early ones and had great writers like David Kibbe and Vince Kuraitis. Plus, the always interesting Matthew Holt. It’s not exclusively healthcare IT (which is my love), but a huge portion of it is about health IT.

When I think about all of these blogs that have been there since the beginning it’s fun to see so many of them still around and blogging today. That’s a special commitment. Although, I also realized that when it comes to blogs, you might call us the Legacy EMR bloggers. To use my own analogy, are we the Jabba the Hutt EMR bloggers? In some ways I think I am. The question is whether a blogger does better with age like a fine wine or if it just rots and gets thrown out.

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May 23, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Filed Under: EHR  Electronic Health Record  Electronic Medical Record  EMR  Healthcare IT
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The Cult of Cool in a World of EMRs

I realized two things the other day. Things I’ve been in denial about. Things I just couldn’t bring myself to admit to anyone else in the world of healthcare IT.

I’m old, and I’m not cool.

I’ve hidden these two flaws fairly well, but a recent high-profile tech acquisition has forced me to let the cat out of the bag. I’ve never used Tumblr (or Instagram for that matter), and I can’t force myself to close my Yahoo! account. I’ve checked that email address for the last 12 years. I fondly remember when my boyfriend/husband set it up for me in an Internet café in Amsterdam. He had been demanding for some time that I rid myself of my @uga.edu address. Graduation was looming and it was time for something more adult, more cool.

My how times change. It’s people like me, apparently, that are holding Yahoo! back and what prompted it to purchase Tumblr. As I’m sure you’ve heard (especially if you’re not cool like me and listen to NPR all the time), it paid over a billion dollars to acquire the micro-blogging site in an effort to get its ads in front of Tumblr’s 100 million users – most of which are young, cool and influential amongst their peers. It’s a demographic most marketers can only dream about having dropped in their laps. Now it’s up to Yahoo! to not screw it up, as CEO Melissa Mayer so succinctly said during a recent conference call.

News of the acquisition got me wondering, are EMRs cool? I think there’s certainly a hip factor around certain parts of healthcare IT. Openness, innovation, mobile health, social networking and bow ties seem to be in right now, but I’m not sure I’d go so far as to call any one particular EMR cool. Though athenahealth and Practice Fusion jump to mind as fairly cool from a branding perspective. Epic certainly seems to have won the word-of-mouth game, so perhaps it can be lumped into the cool category as well.

Perhaps the fact that only three brands come to mind is a good thing. I hope that most companies are spending more time focused on development than branding. Surely players in this most sacred of spaces would never acquire one company over the other purely to latch onto a coolness factor? I could understand the business acumen behind the decision to acquire a start up in the “hopes of gaining an edge in growth,” which is how a recent Wall Street Journal article described the Yahoo!/Tumblr transaction. Goodness knows there’s no shortage of start ups in healthcare right now.

How do you define cool in today’s world of healthcare IT? Is it about technology, branding or some unidentifiable “je ne sais quoi?” Share your comments with me below.

John’s Editorial Note: If Jenn’s not young and cool, then the rest of us are in real trouble.

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May 22, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company’s social media strategies for its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

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Balancing EHR Change vs Train

I was talking with Heather Haugen from The Breakaway Group (A Xerox company) today and in our discussion she used the word “train”, but I heard the word “change”. I always love a good play on words and so it was interesting for me to consider the difference between change and train in an EHR implementation.

Every EHR implementation I’ve been apart of walks a fine line between users wanting the EHR software to change versus the need for an EHR user to change. One of the most common phrases out of a doctor’s mouth during an EHR implementation is, “Why did the EHR vendor implement that feature like this? Did they not talk to a doctor? This makes no sense.” We’ve dug in previously to the concept of EHR vendors consulting doctors during their EHR development so we won’t go into that further now. Every EHR vendor consults doctors, but no two doctors practice alike. So, it’s normal that every doctor would wonder why certain features are implemented the way they are implemented.

When faced with this issue, the doctor is faced with an important decision with two options. The first option is to work with the EHR vendor and convince them to change how their EHR works. In a large hospital EHR vendor situation, this can be almost impossible. Plus, even if that EHR vendor does like your suggested change it’s going to take months and sometimes years before that change is implemented in the EHR software, tested, and released all the way to you the end user. Yes, these changes can go faster with a SaaS EHR, but it still will likely take months before the change reaches the end user.

In some cases, you can wait for the change to be made before using that EHR feature. However, more often than not a doctor is going to have to train on how the EHR vendor has implemented the feature. This highlights to me why having great EHR training is so important. Sure, many of the things in an EHR will be intuitive, but great EHR training is still always beneficial. EHR software is too complex to just pickup and use. Plus, even if you can use the basic EHR features, good training points out the ways to optimize the EHR workflow.

Most doctors don’t understand why various parts of an EHR workflow can’t be easily changed. They just think change should happen easily. Ironically, the doctor then proceeds to resist any change to how they want to work.

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May 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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Three Tips For EHR Transitions

Moving a medical practice from paper to an EHR is no picnic.  Staff and physicians both may find the process difficult, and the changes they have to make to be threatening. But there are approaches you can take which can make the process easier.  Here’s a nice triad of suggestions from EHR implementation manager Amanda Guerrero:

* Make workflow changes gradual:

Too often, medical practices assume that they can implement an EHR without making major changes to their workflow.  The reality is, however, that many processes which worked fine on paper don’t work when you switch to using EHRs, Guerrero notes. So how do you go about making changes without upsetting and confusing staff and clinicians?  The idea, she says, is to make sure changes happen gradually. Giving people time to adapt to changes helps a lot with staff morale. (It doesn’t hurt to explain how the changes will benefit both staff and patients, either.)

* Ask for feedback:

Bearing in mind that changes to workflow will have to be made, how do you choose which changes come first? One way, Guerrero says, is to ask the people who are using the EHR which processes are slowing things down the most.  Be sure, she recommends, to include doctors, nurses, front desk and even billing staff in collecting feedback — after all, virtually any part of the practice can be affected by the EHR.  Once you’ve figured out which areas are the most troublesome, arrange them in order of importance so you can take them on in the most effective manner.

* Educate patients:

Now that Meaningful Use has pushed practices into making patient health data available to them, it’s time to encourage them to use it. That being said, patients may be overwhelmed by the amount of data being presented, especially when interpreting lab results, Guerrero suggests.  To reduce the impact of this change on patients, and avoid confusion, make sure you help them understand what they’re looking at and how it can help them improve their healthy, she says. And make sure let patients know you’re available to help answer questions.

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May 20, 2013 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.

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Healthcare Innovation – #HITsm Chat Highlights

Before we get to the regular #HITsm recap, John got together with a couple of other members of the #HITsm community and did a Google Plus hangout during this week’s chat. It’s a little random, but there were some good discussions about the #HITsm chat topics. We’d love to hear feedback about what we did. We’re considering doing something similar in the future, but with a little more focused discussion.

Topic One: What does #healthcare innovation mean to you? How do you define it?

Topic Two: Do you see innovation in #medicine different than in public health, if so how?

 

Topic Three: What are effective methods of globally diffusing innovative ideas/tech when it comes to getting healthcare user buy-in?

Topic Four: Can you name any examples of tech & innovations developed in U.S. that have translated elsewhere, & vice versa?

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May 18, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

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What flows through you into the world?

On this lovely Friday I thought I’d throw out something that I heard at TEDMED that was quite profound. One of the organizers asked the following question that had impacted his life:

What flows through you into the world?

It’s a powerful concept to consider what we’re doing of good in the world. In fact, he asked some follow up questions for those of us in healthcare.

Are you in healthcare to do good? Or just to make money? Or just to provide for your family? Or just because you have no other choice?

I remember when I first got my job in healthcare I was really empowered by the idea that maybe something I did could help save someone’s life. It’s amazing how the mundane gets in the way of that broader vision. Although, I feel pretty good about what flows through me into healthcare IT and EHR. It just can always be more. I hope you’ll join me in thinking about this idea this weekend.

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May 17, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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Apps Open Up a New World of Health Value

Parents, do you remember the days before smart devices? The days before you could hand your kid a tablet or phone in exchange for at least 20 minutes of uninterrupted quiet? I hope I’m not alone in the personal love/hate relationship I have with smart devices. One minute I find myself using them as a virtual babysitter just to get through a conference call at home. The next, I find myself wishing I could program them to shut off after 20 minutes so that my kids (and my husband) don’t wind up looking like the “humans” in Wall*e. (I’ve heard the Kindle Fire has this option. Anyone know if an iPad can be made to do the same?)

Parental musings aside, I believe smart devices certainly do have their part to play when it comes to educating or even conditioning healthcare consumers, especially in the area of gamification. This point was driven home when I overheard my oldest say to my youngest as they played on the iPad, “Your health value isn’t high enough. You need to add more broccoli.”

smoothiemaster

“Smoothie Master” from TabTale was their game of choice. As the name implies, they were tasked with becoming masters of smoothie creation. I’m still not sure if this game is winnable in the traditional sense, but my seven year-old did explain to me that you could win points for adding healthy ingredients.

TabTale doesn’t seem particularly invested in promoting a healthy lifestyle, as it also has similar apps for mastering the art of making pizzas and hamburgers. But, their inclusion of a health value scoring system does make me wonder if this younger generation will grow up with an inherent sense of what behaviors will keep them healthy in real life. (The irony being that all the broccoli in the world won’t do them any good if they stay glued to the devices that are helping provide this type of education.)

Now, if I can just figure out a way to “gamify” the health value of the broccoli I fix at home so that my kids will eat it and think they have “won.” Let me know in the comments below if you’ve figured out a way to take virtual culinary successes offline and into the real world of kid-friendly cuisine.

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May 16, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company’s social media strategies for its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

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Geisinger Opens Doctors’ Notes To Patients

Geisinger Health System is kicking off a new program under which more than 100,000 patients will have access to their doctors’ notes. Patients will access the notes through the secure MyGeisinger online patient portal, reports Healthcare Informatics.

The initiative grows out of a pilot, funded by a $1.4 million grant from the Robert Wood Johnson Foundation. The OpenNotes project, which lasted 12 months, brought together 105 primary care doctors with more than 19,000 of their patients, in an effort to see how both patients and physicians were affected by the sharing of doctors’ notes after each encounter, according to Healthcare Informatics.

The study group included 24 Geisinger primary care docs and 8,700 patients.  The rest of the patients and doctors  were drawn from Harborview Medical Center, Seattle, Wash., and Beth Israel Deaconess Medical Center.

Results from the pilot, which were published in the October 2012 Annals of Internal Medicine, showed that patients strongly favored seeing their physician’s notes.  Also, tellingly, no doctors asked to opt out at the study’s end.

Findings showed that patients did indeed read their notes and felt more a part of the care process when they did. Roughly 11,200  patients (or about 82 percent) opened at least one note found in their EMR.

Of patients who opened at least one note, 77 to 87 percent across the three study sites said that OpenNotes made them feel more in control of their care.  Doing so also helped them adhere to their medication regimens, the magazine said. Only a few patients reported higher levels of worry, confusion or offense due to seeing the notes.

Patients liked having the notes access so much that 85 percent reported that it would influence their choice of providers in the future.

It seems that opening up a patient portal isn’t quite the pandora’s box that some thought it could be.

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May 15, 2013 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.

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When Patients Know More Than Doctors

With a title like that, I know I’m bound to get a visceral response from some doctors, but hear me out. As someone told me today, the thing I love about John is that you know he’s going to tell you what he really thinks. He’s not going to hold back. Hopefully that’s true. Plus, I certainly welcome other people to provide opposing viewpoints so that we can all learn together.

First I should make it clear that I’m a great patient. I have extreme respect for the doctors I work with and follow their care plans to a T. For example, as a child I took accutane. That requires you to take pills twice a day. I think there may have been 1 or 2 times I missed taking my pills in 6 months. That’s pretty good if I say so myself. Regardless, I’m quite good at following the doctors care plan for me. Over time I have developed what I call a trust but verify approach. I trust that the doctor is doing what’s best, but I do like to confirm my understanding of why it’s being done when its a complicated situation. I don’t do this for things like common coughs and colds.

With this in mind, I was kind of blown away recently when someone told me about their 20 year old son who’s a diabetic. This patient and his parents had been dealing with his disease for about 15 years. As part of dealing with the disease they’d studied it and the various treatment and management options in depth. As he said, “we set a Google Alert and have read every study and discussion about the topic for 15 years.”

After moving, this diabetic patient went to see a new doctor who had just gotten out of medical school. A short discussion started and the patient quickly realized that he knew a lot more about his condition than his new doctor. What a challenging situation this must be for the new doctor.

I think most doctors are ok with this situation and have been dealing with chronic patients that know a lot about their disease for a long time. However, the availability of medical information is helping a lot of patients to be very well informed on their health issues. I wonder if a doctor use to treating well informed chronic patients has lessons we can apply to well informed general patients.

No doubt we’re in the stage of learning a new dance with a new partner. I’m not suggesting that we should change who’s leading the dance. The doctor should still be the lead for a lot of reasons. However, I am saying that the leader shouldn’t be surprised when their dance partner wants to provide some feedback on the choreography they’re doing. The leader might just find that working together they can produce even better results.

Side Note: It seems appropriate that I should use a dance analogy with the So You Think You Can Dance premiere tonight.

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May 14, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

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Bill Gates Puts a New Spin on the Great EMR Debate

I heard an interesting interview on NPR the other day with Bill Gates on the subject of polio eradication. The Bill & Melinda Gates Foundation has been working for a number of years now on the effort, and are intent on seeing that no child ever becomes paralyzed as a result of the disease. The interview got me thinking about money, as NPR host Robert Siegel grilled Gates about the cost of this hopefully final vaccination push in the three countries that still show cases of it each year – Afghanistan, Pakistan and Nigeria.

According to Gates, a nice tidy sum of $5.5 billion will be necessary to vaccinate enough children to finally push out the disease. The question arose as to whether or not this money will be spent wisely. Could it be put to better, more effective use fighting other healthcare conditions, such as malaria, that affect greater numbers of people? Gates made the point that once polio is eradicated, the enormous amount of money already being spent on fighting it can then be spent on these other issues – a statement that to me didn’t seem to sit well with Siegel.

Now, if you’re in healthcare, chances are money crosses your mind a few times a day. And if you use an EMR, you’ve likely voiced an opinion or two on whether it has lived up to its promised value. I think Gates’ point above on cost effectiveness of disease eradication – the most expensive disease gets eradicated first to free up its funds for other healthcare causes – can be applied to the EMR ROI debate.

Yes, healthcare is expensive. Yes, current and possibly future EMRs may not have the best interfaces or give the ideal user experience. But, given time (perhaps a lot of time), they will ultimately help springboard immense cost savings throughout the industry. I consider them the backbone of interoperability, especially when it comes to health information exchange and accountable care – two notions that might just become the norm once EMR utilization finally reaches critical mass.

Stage 2 Meaningful Use will likely see a shift in the market, and from what I’ve read thus far, is causing providers to think about Meaningful Use in a new way. It might be a hiccup in this journey to cost savings, but it will likely separate the wheat from the chaff as far as vendors go. Hopefully, only effective products will be left standing, which will in turn make it easier for providers to use EMRs in the most effective way.

Money will of course be on everyone’s minds at the upcoming HFMA ANI show in Orlando. This has got to be one of my favorite events as it is smaller than HIMSS but still has that bustling, breaking news vibe. I’ll be interested to hear from providers their opinions on the recent push for greater price transparency when it comes to hospital costs, and how they are feeling about EMRs as of late. It will also be interesting to see how vendors are helping these providers meet Stage 2 and patient engagement head on.

Will you be at the ANI show? Drop me a line in the comments below and let me know what you’re looking forward to learning about or seeing the most.

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May 13, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company’s social media strategies for its three key properties – Billian’s HealthDATA, Porter Research and HITR.com. She is a regular contributor to a number of healthcare blogs, and currently manages the Technology Association of Georgia Health Society’s social media channels. You can find her on Twitter @SmyrnaGirl.

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