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Halamka Ponders The Need to Leave Medicine If We Continue Our Current Trajectory

Posted on May 5, 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.

The famous Dr. John Halamka, Hospital CIO, Doctor, Former member of the HIT Policy committee, blogger at Life as a Healthcare CIO, recently read the 962 page MACRA NPRM and he wrote up a detailed look at the IT elements of MACRA. The post is worth a read if you’re interested in MACRA. Especially if you don’t want to spend the 20 hours reading it that he spent.

MACRA aside, he ends his post with this bombshell of a comment:

As a practicing clinician for 30 years, I can honestly say that it’s time to leave the profession if we stay on the current trajectory.

A doctor in the comments shared a similar view to Dr. Halamka:

Wow, I feel exactly the same as you do. As a front line ortho provider in a small group. I think now I get the message. CMS and ONC wants us out of private practice, either retire, or join as a salaried doc or hospital employee. That is the only justification for this 1000 page nightmare.

We’ve written a lot about physician burnout and many doctors distaste of all this government regulation, but having someone like John Halamka comment like this is quite telling. What’s scary for me is that I don’t see much light at the end of the MACRA tunnel from a physician perspective. Do you?

Too Many Healthcare Apps

Posted on May 4, 2016 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.

As we all know, if we want something, there’s probably an app for that. From head to toe, from bank to restaurant to club, in most places in the world, there’s probably an app to meet your needs.

Apple is rightly lauded for its contribution in this area. While it didn’t invent the smart phone as such — early devices mashing together PDAs and connected computing preceded the march of i-Everything by some time — but obviously, it popularized this technology and made it usable to virtually everyone, and for that it deserves the kudos it has gotten.

But as we work to build mobile healthcare models, I’d argue, the notion of there being an app for each need is falling flat. Healthcare organizations are creating, and clinicians prescribing, targeted apps for every healthcare niche, but consumers aren’t showing a lot of interest in them.

Healthcare consumers have shown interest in a subsection of health app categories. According to a study completed last year, almost two-thirds of Americans would use a mobile app to manage health issues. The study, the Makovsky/Kelton “Pulse of Online Health” survey, found that their top interests included tracking diet/nutrition (47%), medication reminders (46%), tracking symptoms (45%) and tracking physical activity (44%).

But other research suggests that consumers aren’t that enthused about other categories of healthcare apps. For example, a recent study by HealthMine concluded that while 59% of the 500 respondents it surveyed had chronic conditions, only 7% used digital disease management tools.

I’ve made the following argument before, but I think it’s worth making again. From what I’ve observed, in talking to both providers and patients, the notion of developing a multitude of apps covering specialized needs is a failed strategy, reflecting the interests of the healthcare industry far more than patients. And as a result, patients are staying away in droves.

From what I’ve observed, it appears that healthcare organizations are developing specialized apps because a) that strategy mirrors the way they are organized internally or b) they’re trying to achieve specific outcomes (such as a given average blood sugar level among diabetics). So they build apps that reflect how they collect and manage data points within their business.

The problem is, consumers don’t care what a facility or clinician’s goals are, unless those goals overlap with their own. They certainly don’t want to open a new app every time they take on a new health concern. And that sucks the benefit right out of app-creation efforts by healthcare providers. After all, aren’t people with multiple conditions the expensive patients we’d most like to target?

What’s more, apps designed to capture data aren’t terribly motivating. Clinicians may live or die on the numbers, but unless those numbers come with a realistic path to action, they will soon be ignored, and the app discarded. Consider the humble bathroom scale. For most people, that one data point isn’t particularly helpful, as it says nothing about where to go from there. So people generally give up when they’re neither motivated nor taught by the apps they download.

To be successful with mobile healthcare, providers and clinicians will need to back the development of apps which guide and sustain users, rather than turn them into data entry clerks.  It’s not clear what should replace the current generation, but we need to turn to a more patient-centric model. Otherwise, all our efforts will be wasted.

Health Organizations Failing At Digital Health Innovation

Posted on May 3, 2016 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.

Few healthcare providers are prepared to harvest benefits from digital health innovations, a new study suggests. The study, by innovation consultancy Enspektos LLC, concludes that digital health innovation efforts are fairly immature among healthcare organizations, despite the enormous wave of interest in these technologies.

While this should come as no surprise to those of us working in the industry, it’s a little depressing for those of us — including myself — who passionately believe that digital health tools have the potential to transform the delivery of care. But it also reminds providers to invest more time and effort in digital health efforts, at least if they want to get anything done!

The study, which was sponsored by healthcare IT vendor Validic, chose 150 survey participants working at health organizations (hospitals, pharmaceutical firms, payers) or their partners (technology firms, startups and the like) and asked them to rate digital health innovation in the healthcare industry.

The results of this study suggest that despite their high level of interest, many healthcare organizations don’t have the expertise or resources needed to take full advantage of digital health innovations. This tracks well with my own experience, which suggest that digital health efforts by hospitals and clinics are slapdash at best, rolling out apps and doling out devices without thinking strategically about the results they hope to accomplish. (For more data on digital health app failures see this story.)

According to Enspektos, only 5% of health organizations could demonstrate that they were operating at the highest level of proficiency and expertise in digital health innovation. The majority of health organizations worldwide are experimenting with and piloting digital health tools, researchers concluded.

Apparently, digital health is moving slowly even with relatively mature technologies such as mobile platforms. One might think that mobile deployments wouldn’t baffle IT departments, but apparently, many are behind the curve. In fact, health organizations typically don’t have enough technical expertise or large enough budget to scale their digital health efforts effectively, Enspektos researchers found.

Of course, as a digital health technology vendor, Validic is one of many hoping to be the solution to these problems. (It offers a cloud-based technology connecting patient-recorded data from digital health apps, devices and wearables to healthcare organizations.) I’m not familiar with Validic’s products, but their presence in this market does raise a few interesting issues.

Assuming that its measures of digital health maturity are on target, it would seem that health organizations do need help integrating these technologies. The question is whether a vendor such as Validic can be dropped into the technical matrix of a healthcare organization and bring its digital health program to life.

My guess is that no matter how sophisticated an integration platform they deploy, healthcare organizations still have a tremendous amount of work to do in thinking about what they actually want to accomplish. Most of the digital health products I’ve seen from providers, in particular, seem to be solutions in search of a problem, such as apps that have no bearing on the patient’s actual lifestyle and needs.

On the other hand, given how fluid digital health technology is at this point, perhaps vendors will be creating workflow and development models that healthcare organizations can adapt. It remains to be seen who will drive long-term change. Honestly, I’m betting on the vendors, but I hope more healthcare players step up, as I’d like to see them own this thing.

When Providing a Health Service, the Infrastructure Behind the API is Equally Important

Posted on May 2, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://radar.oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

In my ongoing review of application programming interfaces (APIs) as a technical solution for offering rich and flexible services in health care, I recently ran into two companies who showed as much enthusiasm for their internal technologies behind the APIs as for the APIs themselves. APIs are no longer a novelty in health services, as they were just five years ago. As the field gets crowded, maintenance and performance take on more critical roles in offering a successful business–so let’s see how Orion Health and Mana Health back up their very different offerings.

Orion Health

This is a large analytics firm that has staked a a major claim in the White House’s Precision Medicine Initiative. Orion Health’s data platform, Amadeus, addresses population health management as well as “considering how they can better tailor care for each chronically ill individual,” as put by Dave Bennett, executive vice president for Product & Strategy. “We like to say that population health is the who and precision medicine is the how.” Thus, Amadeus can harmonize a huge variety of inputs, such as how many steps a patient takes each day at home, to prevent readmissions.

Orion Health has a cloud service, a capacity for handling huge data sets such as genomes, and a selection of tools for handling such varied sources as clinical, claims, pharmacy, genetic, and consumer device or other patient-generated data. Environmental and social data are currently being added. It has more than 90 million patient records in its systems worldwide.

Patient matching links up data sets from different providers. All this data is ingested, normalized, and made accessible through APIs to authorized parties. Customers can write their own applications, visualizations, and SQL queries. Amadeus is used by the Centers for Disease Control, and many hospitals join the chorus to submit data to the CDC.

So far, Orion Health resembles some other big initiatives that major companies in the health care space are offering. I covered services from Philips in a recent article, and another site talks about GE. Bennett says that Orion Health really distinguishes itself through the computing infrastructure that drives the analytics and data access.

Many companies use conventional relational database as their canonical data store. Relational databases are 1980s-era technology, unmatched in their robustness and sophistication in querying (through the SQL language), but becoming a bottleneck for the data sizes that health analytics deals with.

Over the past decade, every industry that needs to handle enormous, streaming sets of data has turned to a variety of data stores known collectively as NoSQL. Ironically, these are often conceptually simpler than SQL databases and have roots going much farther back in computing history (such as key/value stores). But these data stores let organizations run a critical subset of queries in real time over huge data sets. In addition, analytics are carried out by newer MapReduce algorithms and in-memory services such as Spark. As an added impetus for development, these new technologies are usually free and open source software.

Amadeus itself stores data in Cassandra, one of the most mature NoSQL data stores, and uses Spark for processing. According to Bennett, “Spark enables Amadeus to future proof healthcare organizations for long term innovation. Bringing data and analytics together in the cloud allows our customers to generate deeper insights efficiently and with increased relevancy, due to the rapidity of the analytics engine and the streaming of current data in Amadeus. All this can be done at a lower cost than traditional healthcare analytics that move the data from various data warehouses that are still siloed.” Elastic Search is also used. In short, the third-party tools used within Orion Health are ordinary and commonly found. It is simply modern in the same way as computing facilities in other industries–così fan tutte.

Mana Health

This company integrates device data into EHRs and other data stores. It achieved fame when it was chosen for the New York State patient portal. According to Raj Amin, co-founder and Executive Chairman, the company won over the judges with the convenient and slick tile concept in their user interface. Each tile could be clicked to reveal a deeper level of detail in the data. The company tries to serve clinicians, patients, and data analysts alike. Clients include HIEs, health systems, medical device manufacturers, insurers, and app developers.

Like Orion Health, Mana Health is very conscious of staying on the leading edge of technology. They are mobile-friendly and architect their solutions using microservices, a popular form of modular development that attempts to maximize flexibility in coding and deploying new services. On a lark, they developed a VR engine compatible with the Oculus Rift to showcase what can creatively be built on their API. Although this Rift project has no current uses, the development effort helps them stay flexible so that they can adapt to whatever new technologies come down the pike.

Because Mana Health developed their API some eighteen months ago, they pre-dated some newer approaches and standards. They plan to offer compatibility with emerging standards such as FHIR that see industry adoption. The company recently was announced as a partner in the Commonwell Alliance, a project formed by a wide selection of major EHR vendors to pursue interoperability.

To support machine learning, Mana Health stores data in an open source database called Neo4j. This is a very unusual technology called a graph database, whose history and purposes I described two years ago.

Graphs are familiar to anyone who has seen airline maps showing the flights between cities. Graphs are also common for showing social connections, such as your friends-of-friends on Facebook. In health care, as well, graphs are very useful tools. They show relationships, but in a very different way from relational databases. Graphs are better than relational databases at tracing connections between people or other entities. For instance, a team led by health IT expert Fred Trotter used Neo4J to store and query the data in DocGraph, linking primary care physicians to the specialists to which they refer patients.

In their unique ways, Mana Health and Orion Health follow trends in the computing industry and judiciously choose tools that offer new forms of access to data, while being proven in the field. Although commenters in health IT emphasize the importance of good user interfaces, infrastructure matters too.

I Really Don’t Want to Be Your “Worst” Patient

Posted on April 29, 2016 I Written By

The following is a guest blog post by M. Maxwell Stroud, Lead Consultant at Galen Healthcare Solutions.
Max - Healthcare IT
“I really don’t want to be your “worst” patient. Really, I don’t.”  These are the words that I think to myself as I prepare to ask my new specialist if he has interfaces with either of the hospital labs in my hometown 40 miles away.  My provider humors me and lets me know that if I go to one lab he will get a fax, and another and he will be able to view the results in a portal.  Sigh.

I have for a long time kept all of my care to one healthcare organization in town – in part because I am a firm believer in one chart for one person and I personally don’t want to have to deal with the mess of coordinating all of my records or manually schlepping things from office to office.  I love the concept of “one source of truth” and I know how far away we really are from that.  So why venture out of town and (gasp) to different healthcare organization?  Because that is where the best specialist was that was seeing new patients and mine had left town.

As a patient, I get to make that choice.  I get to decide where I get my care – as I should.  I also make the choice knowing that it will result in me having two distinct medical records in orgs 40 miles away from each other.  I also know that it means I am, at times, going to have to put on my advocacy hat and make sure that my records are correct, that my labs got where they need to go and that everyone has the information that they need so that I can get the best care.

Wait. What?  The patient is the only person in this continuum of care who is making sure the right person has the right data at the right time?  Yep.  Some might say that I am a control freak or that I need to relax a little – but I am informed by the life experiences of the patients that have been a part of my life.  I have seen what happened when my father got admitted to the hospital without an accurate medlist available.  I have seen the binder that my sister has to carry with her on the train that has her MRIs and PET scans to take to her next oncology appointment in the city.

It blows my mind that just a little over a month ago I was at the largest healthcare IT conference in the country (HIMSS16) discussing interoperability, and now I am on the phone with the nurse at the clinic because she cannot find my lab results … “Oh wait” she says “they are in the print and scan pile.”  Great.  Just great.

I have heard the argument that patients are not interested in their data.  There is a chance I could be an outlier – I live my life in a world of health data and I am acutely aware of how it is used in my care and the care of others.  I really think the truth is you don’t know how important it is to you until it becomes important to you.  One life event, one family member’s crisis, one rare diagnosis – and you begin to understand that you are the most important person in your own healthcare.

We have centered record keeping around the physical location of care.  This makes sense when you think historically.  Patients used to be less mobile, receive care locally and lived locally.  Additionally, the role of the “legal medical record” is a legal representation of the care provided and decisions made by a healthcare organization.  Organizations still need to document medical decision making, but patients are becoming more and more mobile.  People move from city to city, or even within health networks in the same town.  In the digital age, even if the legal medical record lives with the provider —  the data needs to follow the patient.

We can do better by patients and consumers.  The information is there, it is just not yet connected in the way that will make it available, actionable and meaningful to everyone who needs it.  It’s not just about finding an easy button to import discrete data, but also a culture change.  Truly putting the patient at the center of the data is simultaneously mission critical and more than a little revolutionary.

About M. Maxwell Stroud
M. Maxwell Stroud, MSW MSW is a Lead Consultant at Galen Healthcare Solutions with a professional background in both healthcare and social work. Max has been consulting in Health IT for over 8 years.  She has worked with every aspect of health IT in ambulatory care including facilitating clinics through the transition from paper to electronic formats, supporting teams through major system-wide upgrades as well as add-on implementations and integration projects.       Max has a passion for collaborative process and building processes that bring all stakeholders to the table to build systems that meet the needs of the business organization, the providers and the patients.  Max can be found on Twitter at @MMaxwellStroud

Lessons Learned from Patient Engagement Efforts in Louisiana

Posted on April 28, 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.

We recently sat down to talk with Jamie Martin and Linda Morgan from the Louisiana Health Care Quality Forum (LHCQF) about their efforts to promote patient engagement in Louisiana. They’ve taken a unique approach to encouraging the use of health IT and getting patients engaged in their healthcare and so we wanted to share their lessons and experience with the rest of the world.

In our conversation we talk about what is patient engagement, the importance of having providers ready for patients that want to engage, different approaches to promoting patient engagement statewide, the proliferation of portals and the challenge that provides, and the value of incorporating patients into all of your efforts through a patient advisory board. If these topics interest you, then you’ll enjoy this chat with Jamie Martin and Linda Morgan.

Unfortunately, we had a little tech issue half way through our chat, so you only get the first 30 minutes above, but there’s plenty of meat in that 30 minutes. Luckily that was the majority of the chat, but I’m sure we’ll have Linda and Jamie back again to talk to us about their ongoing efforts and other things like the risque ad option they considered using but didn’t. Of course, their bosses might be glad that part got cut off. Either way, it’s great seeing people so passionate about improving healthcare in their state.

Why We Store Data in an EHR

Posted on April 27, 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.

Shereese Maynard offered this interesting stat about the data inside an EHR and how that data is used.


I then made up this statistic which isn’t validated, but I believe is directionally accurate:


Colin Hung then validated my tweet with his comment:

It’s a tricky world we live in, but the above discussion is not surprising. EHRs were created to make an office more efficient (many have largely failed at that goal) and to help a practice bill at the highest level. In the US, you get paid based on how you document. It’s safe to say that EHR software has made it easier to document at a higher level and get paid more.

Notice that the goals of EHR software weren’t to improve health outcomes or patient care. Those goals might have been desired by many, but it wasn’t the bill of goods sold to the practice. Now we’re trying to back all this EHR data into health outcomes and improved patient care. Is it any wonder it’s a challenge for us to accomplish these goals?

When was the last time a doctor chose an EHR based on how it could improve patient care? I think most were fine purchasing an EHR that they believed wouldn’t hurt patient care. Sadly, I can’t remember ever seeing a section of a RFP that talks about an EHRs ability to improve patient care and clinical outcomes.

No, we store data in an EHR so we can improve our billing. We store data in the EHR to avoid liability. We store data in the EHR because we need appropriate documentation of the visit. Can and should that data be used to improve health outcomes and improve the quality of care provided? Yes, and most are heading that way. Although, it’s trailing since customers never demanded it. Plus, customers don’t really see an improvement in their business by focusing on it (we’ll see if that changes in a value based and high deductible plan world).

In my previous post about medical practice innovation, Dr. Nieder commented on the need for doctors to have “margin in their lives” which allows them to explore innovation. Medical billing documentation is one of the things that sucks the margins out of a doctor’s life. We need to simplify the billing requirements. That would provide doctors more margins to innovate and explore ways EHR and other technology can improve patient care and clinical outcomes.

In response to yesterday’s post about Virtual ACO’s, Randall Oates, MD and Founder of SOAPware (and a few other companies), commented “Additional complexity will not solve healthcare crises in spite of intents.” He, like I, fear that all of this value based reimbursement and ACO movement is just adding more billing complexity as opposed to simplifying things so that doctors have more margin in their lives to improve healthcare. More complexity is not the answer. More room to innovate is the answer.

The Virtual ACO

Posted on April 26, 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.

“Virtual ACOs may be the next big thing for small practices,” says our host Dr. Tom. “I want to talk about how independent practices can lead and not just follow the shift to value-based care.”

Who here has looked at or talked to someone about virtual ACOs?

My guess is that most small practices haven’t really heard about it. Maybe it has to do with most doctors being too busy to consider other innovation. I’ll admit that the idea of a virtual ACO is a new one to me and so I was interested in the discussion that Dr. Tom from Kareo led on virtual ACOs.

The concept of a virtual ACO makes sense. Basically use technology to provide coordinated care across the care system. In fact, that’s what most patients think is already happening with their care, but we know it’s generally not happening. We all know it should and most doctors would embrace the ability to have the right information in the right place so that their patients get the right care. I don’t know anyone who’s against that principle.

However, as was pointed out in the chat linked above, the financial model for a virtual ACO is up in the air. There’s no clear financial model that makes sense. The care model makes sense, but the financial model is a mess.

Dr. Tom did make this assertion in the virtual ACO discussion:

Although S. Turner Dean responded with something we’ve talked about quite a few times before:

I love Dr. Tom’s optimism that this new world of value based reimbursement simplifying things, but I’m not sure it will be any simpler than fee for service. That’s not even taking into account the fact that we have the whole infrastructure set up to handle fee for service and that we know how it works. Set that aside and I’m still not sure that a virtual ACO would be any less complicated than our current fee for service world.

What do you think of the concept of a virtual ACO? Will it simplify medicine? Will it help doctors love their work again? Will it help the independent physician practice survive?

Full Disclosure: Kareo is an advertiser on this blog.

Bill Could Cut Meaningful Use Reporting Period Drastically

Posted on April 25, 2016 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.

A bill has been filed in Congress that would slash the Meaningful Use reporting period from one year to 90 days. This seems to be a challenge to CMS, which has reportedly held firm in the face of pressure to cut the reporting period on its own.

Supporters of the bill, which is backed by a broad coalition of industry trade groups, argue that a 365-day reporting period is unduly burdensome for providers, and will become even more awkward as MACRA requirements fall into place. Cutting the reporting period “will continue the significant progress providers are making to harness the use of technology to succeed in new payment and care delivery models,” argued a coalition of such groups in a letter sent to CMS last month.

That being said, it’s not clear how the structure of Meaningful Use incentives will play out under MACRA. So the reporting period change may or may not be as relevant as it might have been before the MACRA rules were set to be announced.

CMS leaders have said that the upcoming Merit-Based Incentive Payment System (MIPS) – which will probably fall in place under MACRA in 2017 — is designed to unify incentive payments. Specifically, it integrates existing MU, PQRS and Value-Based Payment Modifier programs. MIPS payments will be based on a weighted score rating providers on four factors: quality (30%), resource use (30%), Meaningful Use (25%) and clinical practice improvement activities (15%). This suggests that a focus on reporting requirements is probably a matter of closing the barn door after the horse has left the stable.

On the other hand, since Meaningful Use isn’t going away completely, maybe cutting the reporting period required is necessary. If providers are being rated on a set of factors of which MU is just a part, reporting for an entire year could certainly impose an administrative burden. Why set providers up to fail by forcing them to overextend their resources on reporting?

I believe that reducing Meaningful Use requirements is a sensible step to take at this point. While there are probably those who would argue the point, I submit that MU has been pretty successful in motivating providers to rethink their relationship with HIT, and has even help a subset to completely rethink how they deliver care. Now, it’s time to move the ball forward, to a more holistic approach that goes beyond regulating care processes.

Admittedly, it’s possible that cutting the reporting period, or otherwise shifting the emphasis away from regulating HIT use, might cause some providers to slack off in some way. But to my way of thinking, that’s a risk we need to take. After investing many billions of dollars on promoting smart HIT use, we have to assume that we’ve done what we can, and focus on smart quality measures. With any luck, the new measures will work better for everyone involved.

How Many Doctors Take Time to Explore New Practice Innovations?

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.

Over the 10 years I’ve spent blogging about healthcare IT, I’ve had the chance to talk to more doctors than I can count. For the most part, I’ve been impressed by how incredible these doctors are and their desired to provide amazing care to their patients. Their desire to do the right thing for their patients is powerful and gives me a lot of hope for the future of healthcare.

While I think that most doctors hearts are in the right place, I fear that most of them don’t spend enough time thinking and planning for the future of their practice. When does a doctor spend time exploring new innovative opportunities to improve their practice? When does a doctor have time to try out new approaches or to think deeply about how they could improve the patient experience?

There are a few doctors that can spend time thinking about these types of things. They work for large health systems as employed doctors. Sure, they’re busy too, but do generally have less to worry about. However, these doctors have almost no power to implement or test and changes to the way they practice medicine and the patient experience.

I’m not really blaming doctors for this problem. I realize that they’re super busy people. I’m sure many of them would love the opportunity to spend time reinventing the practice of medicine and the patient experience. If they had the opportunity, they’d happily take it. The problem is that most of them don’t think they can get off the proverbial hamster wheel that requires them to see patients in 15 minute increments.

I think this is a problem and I don’t see any easy fixes.

If you’re a small practice, when was the last time you implemented something that really transformed the way you practice medicine for the better? When was the last time you implemented something that wasn’t part of a government mandate? When was the last time that you spent time talking with your patients about their experience at your clinic and ways that you could make it better?

I’m sorry to say that I think the answers would all reflect the reality in healthcare that we don’t spend enough time on progressing the practice of medicine. I’m sure that some doctors would argue that they’re fine with the status quo. They don’t see a reason to change. Short term that strategy could work. Long term I think that approach will come up wanting.