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Hospital Competition Hinders HIE – Some Solutions to the Problem

Posted on July 31, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

In response to my post about the Real HIE Problem, Tim Dunnington provided this powerful insight into a major challenge that are faced by HIEs. However, more importantly, Tim provided some suggestions on how to solve the problems.

I work for an HIE system vendor, ICA. One of the challenges we see our HIE’s face is FUD (Fear, Uncertainty and Doubt) around sharing patient data. The fear arises in sharing data with other participants that are direct competitors. The competition between participants can lead some participants to refuse to share “their” patient data with other participants, creating complex sharing rules based on these relationships, and meaning that the view of a patient’s record will change depending on what facility you happen to be in. This results in the patient’s medical record not being complete. The patient, meanwhile, is not aware of these nuances and is not aware that their record is incomplete due to these competitive issues. I can’t say we have an answer as to how to solve this, but it’s definitely a potentially large roadblock, larger I think that EMR adoption itself.

I would say in response to these issues:
* The EMR determines what data is shared, so you (as a customer of the EMR) should have some control over what exactly is shared and when
* The HIE will not by any means have a “complete dump’ of your database; the EMR sends out a limited amount of data about the patient or the encounter
* The interoperability standards are set up to keep participants from attempting what I call “patient surfing,” keeping the availability of data to those patients for which you have an established relationship. This means that your competition cannot simply download every one of your patient records, as they have no access to a means to query for all your patients.
* Auditing and regulatory measures ensure that attempts to access records for purposes other than direct patient care are caught and properly sanctioned.

I’d love to hear your thoughts and perspectives on the challenge of data sharing in a HIE. Do you think that Tim’s suggestions are good?

Funny Physician Exam Room EHR Etiquette Video

Posted on July 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 usually reserve the various EHR videos I find for the Healthcare Scene EHR video website. However, this one was too funny to not share with a wider audience. Here’s the YouTube description for the video:

Meaningful Use of Electronic Health Records (EHRs) involves more than implementing an EHR. It involves interacting with patients and the computer in the exam room in a way that is productive and enhances the interaction between the patient and the physician. Learn about how Reliant Medical Group (formerly known as Fallon Clinic) uses Kaiser Permanente’s LEVEL technique to ensure a successful patient encounter.

While I’ve said that the video is funny, it also does bring out some really important points about physician exam room EHR etiquette. When I first started watching the video I was wondering how they were going to get physicians to actually take the time to watch the video. Then, about half way through I was laughing at the video which made me watch through more of it. I’m not sure if the humor was intentional or not, but I expect those reading this site will get a good laugh at the video embedded below while seeing some important points on EHR etiquette.

Thanks to Carl Bergman for pointing the video out to me.

EMR Device Connectivity, RECs, and Meaningful Use Resources

Posted on July 29, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

Time again to take a quick look around the twittersphere to see the various discussions happening around EMR and EHR. I should take a poll and see how many of my readers are on Twitter and how many haven’t yet found the beauty that is Twitter.


I agree that device connectivity and integration is going to be very important as we move towards EHR. In fact, I don’t think that integration is getting enough focus and emphasis in hospitals. I think we need to see more of that or we’re going to run into troubles and miss out on some great opportunities.


This tweet is actually pretty obvious. You can basically only work with a REC if you’re going to go after meaningful use. Are there any RECs that will work with you if you’re not planning to pursue meaningful use? I’m still skeptical that many RECs have provided a good return on the money they’ve received.


This really is a nice resource that Farzad points out. However the thing that stuck out to me was the objectives of meaningful use:
1. Improve Quality, Safety, Efficiency
2. Engage Patients & Families
3. Improve Care Coordination
4. Improve Public and Population Health
5. Ensure Privacy and Security for Personal Health Information

Do you think that meaningful use is meeting these objectives?

Verizon’s Take: How HIT Can Transform Healthcare

Posted on July 27, 2012 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 @annezieger on Twitter.

Every day, readers here wrestle with how health IT can improve patient care and remove costs from our monstrously bloated system.  And even though we share many of the same conclusions, the struggle is likely to continue for quite some time.

That being said, it never hurts to find out what big, super-mega-deep-pocketed giants of IT and telecom have to say on HIT trends, if only as an exercise. Not only does it tip their hand a bit as to where they’re headed, it adds more fuel to the fire. Here’s some trends Verizon’s big thinkers see as leading to care transformation:

  • Telemedicine:  An also-ran for decades, has telemedicine finally come into its own with abundant cheap bandwidth and relatively cheap mobile devices available?  Verizon says yes. The big V says telemedicine can suck $31 billion in annual costs out of the system.
  • mHealth:  This is a obvious one. But for the record, Verizon agrees that mHealth’s flexibility — with 10K health apps in the iTunes store alone — can do much to manage chronic disease, monitor patients and suchlike.
  •  Fraud detection becomes fraud prevention:  Interesting. Verizon, which, naturally, has a fraud prevention solution, argues that today’s claim analysis can catch fraud and abuse well before the claims are paid. Is Verizon thumping its chest or can this realistically be done folks?
  • Cloud computing spreads patient information: Verizon’s honchos say cloud computing will not only make healthcare businesses more efficient, it will make sharing of patient EMRs easier. (Methinks there may be a technical problem there, though; don’t you still need to be using compatible subsets of, say, HL7 to communicate, cloud or no? And isn’t that the problem overall?)

The rest of their big 10, well, you read and tell me whether you think they’re worth noting. If this represents the cutting edge of Verizon’s thinking, I’m not impressed. But I’ll give a call to the Verizon press contact and see if I can get more info. I’ll keep you posted.

The Intersection of EMRs and Health Information Management

Posted on July 26, 2012 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 Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

It was with great regret that I canceled my trip to Healthport’s first HIM Educational Summit earlier this week. (A rampant stomach bug claimed me as the last victim in our family of four, and so I thought my healthcare conference colleagues would, in fact, appreciate my absence.) I had been scheduled to moderate a discussion on the exchange of personal health information within an accountable care organization (ACO) – a topic that I thought I knew a lot about, until I began researching the subject. Turns out that to truly grasp this topic from a health information management (HIM) perspective, you need to be well versed in the current state of ACOs, Office of Civil Rights audits, HIPAA rules and regulations, privacy and security breach prevention strategies, the bring-your-own-device movement …. Needless to say, HIM professionals seem to have their hands full at the moment, as they will likely interact with a few if not all of the aforementioned areas in the coming months.

I especially had been eager to see if this cartoon from Imprivata got a few chuckles from my audience. Pretty timely, no?

Courtesy of Imprivata

I was also looking forward to attending a number of sessions, including:
“The Effects of EHR on HIM”
“Where HIM & MU Intersect, and What’s in it for You”
“Meaningful Use: Countdown to Attestation”
“Is Your PHI Protected? Security Measures you Need to Know About”
“The Brave New World of HIEs”

In prepping for the event, I came across a great list of “The Top 10 Trends Impacting HIM in 2016.” Note that EHR and related technologies top the list. I guess it’s safe to say that concerns around them aren’t going away any time soon.

Courtesy of Precyse

I’d love to have readers weigh in on what relationship HIM professionals have with their EMR counterparts in the hospital setting. How do they impact your workflow? Is Meaningful Use making your lives easier or harder? And how in the world are you going to find the time to worry about 2016, when it seems you’ve got enough on your plate in 2012?

Please share your thoughts in the comments below.

Revenue Cycle Management Interview with Rishi Saurabh – GE Healthcare

Posted on July 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

As most of you know, I had the chance to attend the ANI 2012 conference in Las Vegas that’s put on by HFMA. This conference is a hospital CFO’s home since all of the major players in the healthcare financial management space were in attendance. Around every corner was another Hospital CFO it seemed.

While at the conference, I was able to corner the Global Product Marketing Manager at GE Healthcare, Rishi Saurabh, for a short video interview about revenue cycle management. In the video Rishi provides his insights into the biggest challenges facing hospitals today and also provides some insight into how GE plans to approach these challenges. I hope you enjoy the video:

Will Billing Separate EMR Winners From Losers?

Posted on July 24, 2012 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 @annezieger on Twitter.

The other day, I was speaking with a sales exec from a medical billing company, who commented that his company interfaces with about 200 of the leading EMRs.  His comment got me thinking.

I believe we haven’t thought enough about billing when we consider what will drive consolidation in the EMR market. Whether vendors offer it through offering their own practice management system or an easy-to-work-with infrastructure, billing counts a great deal. And the EMRs that aren’t integrating seamlessly aren’t exactly in the driver’s seat in medical practices.

Vendors aren’t in the easiest position when it comes to being a good billing partner. They can offer a suite with practice management available as an add-on, but doctors may not want the whole thing. They can offer an EMR + PM suite that’s already integrated, but what if the practice doesn’t like one of the two?  Some vendors are partnering with companies that make third-party billing applications, but if the other party were to pull out abruptly that strategy could enrage customers.

Still, vendors that balance these factors right have a powerful advantage. After all, practices WANT to get Meaningful Use dollars, but they NEED to get paid. I know that billing would be one of the first things I’d consider if I was shopping for a medical office EMR.

What I’m really saying here is that while most of us agree that a big EMR firm consolidation is coming, we haven’t talked much about the role of strong billing support in an EMR’s market viability. I think we should. I’d love to know if you’ve seen medical office software that really has a strong billing approach, and what you like about it. Thoughts, anyone?

What’s Next For Physician Tablet Use?

Posted on July 23, 2012 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 @annezieger on Twitter.

Not long ago, Manhattan Research released a study offering details on how doctors’ consumption of digital devices and media is progressing.  The survey, which surveyed 3,015 physicians in 25 specialties, looked at doctors who were online in the first quarter of 2012.

Among the most interesting — if not surprising — findings was that tablets have more or less officially hit the medical mainstream. According to the research firm, tablet use among doctors has nearly doubled since last year, hitting a whopping 62 percent in this year’s study.  You also won’t be shocked to learn that iPads dominate medical tablet use, in part due to their high-res screen and ease of  use.

Why the greater rush to adoption?  I think the following comment, which Monique Levy of Manhattan Research made to InformationWeek, offers a nice insight:   “It used to be that you had to solve the problems of security access, validation, and data security first and then adopt,  (but) what’s happened is that the system has turned upside down. We’re now at adoption first and solve the problem later.”

As Levy notes, the first wave of adoption has been driven largely by access to lower-risk information, and less for patient data. We can expect to another round of resistance when physicians are tethered to EMRs largely by tablets, she predicts.  I’d add that as long as there’s no native client physicians can use to access EMRs on the iPad, it will make things worse.

Given that resistance, maybe medical use of tablets will expand in other areas first. According to IT prognosticators and researchers at the Gartner Group, top medical uses of tablets also include waiting rooms, e-prescribing, diagnostic image viewing and appointment scheduling. (I’m amazed more practices aren’t doing the waiting room check-in thing.) Maybe one of these other areas will evolve breakout apps before doctors are really hooked up with patient data on their tablet.

EMR Advocate Tops the #HIT100

Posted on July 20, 2012 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 Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Red carpets, velvet ropes and glitzy award events are not typical fodder for healthcare IT blogs. The recent release of the annual #HIT100 list, however, does give our industry a nice, fun excuse to pat each other on the back. (I’d be remiss if I didn’t point readers to a slightly different take on the list from John Lynn, who thankfully is never afraid to mix things up a bit. Not to mention 5 Healthcare Scene bloggers made the list as well.)

While the #HIT100 didn’t give me a good reason to don an awards-worthy get up, it did give me a great excuse to chat with #1 on the list, Linda Stotsky, aka @EMRAnswers. Linda wears a number of different hats at Ignis Systems Corp., which provides workflow integration and electronic interfaces between EMR systems and lab vendors. She is currently Senior Solutions Manager and Healthcare Social Media Strategist, and handles strategic business development.

What sort of value do you think lists like the #HIT100 bring to the healthcare community?
The #HIT100 list recognizes the #HITsm and #HealthIT communities on Twitter. This community is comprised of clinicians, physicians, health IT consultants and patient advocates. The purpose of the list is to recognize co-contributors in healthcare social media. The value in our collective voice includes enhanced collaboration, networking, support, emerging technologies and expanding one’s understanding of healthcare from the perspective of others. We are a social pulse over a wide spectrum of the healthcare community. Together, we champion for interoperability, data security, patient safety and better outcomes. Social media reflects real-world “Interoperability.” One voice doesn’t do the talking any more. We all do.

When did you start using social networking professionally? When did you set up the @EMRAnswers Twitter handle, and why?
A large part of my professional life has revolved around networking through every available format. Social media merely amped up this capability.  I stumbled across Twitter in 2008, during a downsizing. I hoped to extend my circle of connections. I was hooked almost immediately. @EMRAnswers was born out of my knowledge of electronic medical records and data systems.

How has social media impacted you professionally?
I’ve taken several companies into the Twitter-sphere kicking and screaming to show them the value of #hcsm. The professionals I’ve met through social media are some of my closest and most trusted business associates and friends. It is much larger than our individual title, product or pain. What I’ve witnessed is that we are part of a social conscience that connects through a deeper sense of purpose. Our chats include personal observations, information, shared ideas, best practice, progress and goals. I equate it to a professional “Think Tank,” with a simple agenda. We want to leave information technology a better place because of our passion, our solutions and our purpose. It’s an exciting place to be and I am fortunate to be a part of it.  We connect as a collective voice for patient safety, interoperability, and meaningful “Use-ability.” I cannot imagine my professional life without social media being a large part of it.

What will you do with this newfound notoriety? Any plans to go to Disney World?
Absolutely. My bags are packed.  Are the tickets in the mail?

Seriously, though, how do you see social media impacting healthcare – both now and in the future?
Social media represents a new frontier for healthcare. It offers a venue unlike any other. It allows physicians, clinicians, service providers and patients to open the lines of communication. It allows hospitals and physician practices to promote wellness and sponsor support forums for patients dealing with chronic health issues. It provides a voice for physician and patient to open a dialogue outside of normal working hours.  Companies like Symplur have made it easier to find information through “The Healthcare Hashtag Project.” The communication channel social media opens up establishes the groundwork for future sustainability. Clinical trials are being conducted using social media to study medication adherence in chronic disease management. Healthcare consumers are using social media to find the best physicians, services and hospitals.  Social media provides healthcare organizations with an easy to use predictive analytics tool, available at our fingertips. We have only touched the tip of the iceberg.

EMR and EHR Passes 2 Million Pageviews

Posted on July 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 first started blogging about EMR, I use to mark every traffic milestone with a blog post. In many ways I miss those early days where it was exciting to think that anyone read my blog. It was amazing to think that my blog ticked over into digits when I hit 10,000 pageviews. Now we do close to 10,000 pageviews a day across Healthcare Scene.

One thing that hasn’t changed is that I’m still a stats addict. Although, I’m more refined on which stats I look at now. I’m more interested in trends and opportunities than I am in overall numbers. With that said, when I checked my stats for EMRandEHR.com today I paused for a moment when I saw that my stats program was reporting 2,002,454 views all-time.

What many don’t realize is that I only started this other blog because a Dr. Jeff asked me if I would create one. 21 posts into it Dr. Jeff got a job (at an insurance company I believe) and so he didn’t have time to blog any more. I hated the idea of the blog going to waste, so I would post to it occasionally. I also almost sold it about three years ago. Boy am I glad I didn’t. Little by little it continued to grow into a wonderful destination that I’m very proud of today.

One of the things I’m most proud of on EMR and EHR is all the great writers that participate on it. Over the years we’ve had Anne Zieger, Jennifer Dennard, Priya Ramachandran, Katie Clark, Katherine Rourke, David Lynn, Dr. West, and Dr. Jeff. Not to mention a whole series of guest posters. I’m lucky to associate with these great people. They’ve certainly become the voice of EMR and EHR in many ways. I just am along for the ride.

Here are a few other numbers that you might find interesting:
688 Posts
2,215 Comments
2,288 Tags (that’s how we categorize each post)
48,554 Spam Comments Blocked
1,734 email subscribers

Thanks everyone for reading EMR and EHR!