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An Interview with Dr. Nan Nuessle (@DrNanN) – #HITsm Spotlight

Posted on October 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.

For the past few months we’ve been doing a summary of the #HITsm chats that happen each Friday. I once heard Michael Gaspar, who does social media at HIMSS, describe Twitter hashtags as a community of users. I think this is definitely true when it comes to the #HITsm hashtag. With that in mind, I thought it would be interesting to learn more about the members of the #HITsm community and to learn from the members of the #HITsm community.

The first in this series of #HITsm spotlights is with @DrNanN (Nanette Nuessle, MD). She gives some amazing insights. Enjoy!

When did you get involved in social media? What got you started with it?
I got started in social media 2 years ago. I was at a national meeting of pediatricians. One of my colleagues said I needed to be on Twitter. I told her I didn’t know anything about it. She grabbed my phone, asked how the kids in my practice address me, then handed the phone back and said, “you’re on twitter.” I didn’t do anything but follow for 2-3 months. I didn’t really try to build a following until about 18 months ago. Now, I have nearly 4,000 followers.

What benefits have you received from social media?
Social media has given me a way to talk with patients outside the 10-20 minute office visit. I can post information that is specific to my practice, or tell them of late-breaking news. It gives me a vehicle for discussing that late-breaking news with other professionals. My attention to these 2 things has greatly improved my ongoing education. Finally, it has opened career paths that allow me to help other physicians who are transitioning to the use of electronic health records and social media.

Looking at the world of healthcare IT, what do you see as the most important things happening today?
The single most important thing in healthcare today is the budding widespread use of electronic health records. We must remember that this practice is in it’s infancy. It is still the most powerful tool to reach physicians since the development of the stethoscope.

As a doctor, what’s your view of the current EHR world?
The EHR world is in it’s infancy. I have been sending prescriptions electronically since 2005, and using electronic health records for even longer. Many providers are just starting into this world. The potential to change the face of medicine is obvious. We can get the record of a walk-in patient before the front desk finishes registering them for their visit. We have access to all visits and all studies done in-house at all times. However, there are still kinks being worked out that will improve efficiency for providers. This includes day-to-day ease of using an ehr, as well as sharing between different clinical entities (interoperability).

What is the most promising technology for pediatricians?
We live in a mobile society. Most adults don’t live in the same neighborhood or town where they grew up. Most children don’t stay with the same pediatrician from birth to their 18th birthday. For the pediatrician, the HIE is going to be crucial. This will allow us to track immunizations and routine labs for all children as they move through their childhood.

If you could wake up tomorrow and have one part of healthcare solved, what would it be?
I have 2 wishes, Magic Genie. One is to solve interoperability. The other is to see prenatal care and immunizations made free for all people living in the US. The first will revolutionize healthcare in the US, the second will revolutionize health itself.

What health IT issue do you see out there that not enough people are talking about?
Efficiency. Everyone is talking about Meaningful Use and Interoperability. These are certainly important issues. However, without efficiency, providers are going to continue to fight the use of ehrs. Before using an EHR, I routinely saw 30-32 patients a day. Now, I am exhausted at 20-25, depending upon the EHR. My staff complain that it takes over 10 minutes to “room” a new patient because of all the data entry involved. Rooming a new patient used to take 2-4 minutes. Consequently, we are working harder but seeing fewer patients. This translates to less money. Unless we address the issue of efficiency, EHRs will never reach their full potential.

Where or to whom do you look in order to stay up with all that’s happening in healthcare IT? What’s part of your daily routine?
I keep up with healthcare IT in 2 ways. One is by reading daily electronic newsletters, particularly HealthCareITNewsDay.The other is by networking with others in the field.

Any final thoughts?
Electronic health records are in their infancy. For them to grow, we need to nurture providers into this field. There has to be more dialogue between physicians, nurses and IT professionals. We speak different languages. We need to sit down at the table together and share our thoughts without letting our personalities get in the way. I think if this is done the potential in the field of healthcare IT is limitless.

Study: EMRs Improve Ambulatory Care

Posted on October 30, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study done by researchers from the Weill Cornell Medical College has concluded that community-based physicians who move to EMRs can improve care meaningfully.

The study, which was done in collaboration with New York’s Health Information Technology Collaborative, gathered baseline year data gathered from 500+ physicians in ambulatory practices and 75,000 patients with five different health plans in New York’s Hudson Valley.  They then compared quality scores for EMR-using physicians and those without EMRs.

Researchers concluded that 56 percent of physicians who were using EMRs scored significantly higher on quality of care provided, particularly in managing chlamydia, diabetes, colorectal cancer and breast cancer.  A combined score across nine quality measures also also suggested that EMRs helped generated better care than paper-based records overall.

What made the study results particularly interesting, researchers said, was that the physicians using EMRs used off-the-shelf systems which hadn’t been specialized to achieve these kind of results.

Researchers seem to think that the improved ambulatory results are just the tip of the iceberg:

EHRs may improve the quality of care by making information more accessible to physicians, providing medical decision-making support in real time and allowing patients and providers to communicate regularly and securely,” says Dr. Rainu Kaushal, director of the Center for Healthcare Informatics and Policy and the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell. “However, the real value of these systems is their ability to organize data and to allow transformative models of health care delivery, such as the patient-centered medical home, to be layered on top.” 

Interesting. I would have assumed that reminders and warnings had generated , as they certainly help doctors make sure overworked doctors are on target with tests, avoid drug interactions and the like. But researchers like Dr. Kaushal and her colleagues seem to think that the big EMR payoff will come as EMR systems change the core models doctors use to deliver care.

Given that new models are all but inevitable at this point, I guess we’ll get to find out!

What Are the Problems with EMR Documentation Today?

Posted on October 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.

While at AHIMA 2012, I asked Susan Sumner, Executive Vice President of Ambulatory Services at Accentus Inc. about some of the problems with EMR documentation today. Here’s her video answer with her views on narrative EMR documentation vs point and click EMR documentation:

Clinical Data Access, New Open Source EHR, and Striiv – Around Healthcare Scene

Posted on October 28, 2012 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.

Hospital EMR and EHR

Call Me Maybe at #CHIME12

One of the most popular songs among teens recently is “Call Me Maybe.” Well, at CHIME 2012, a music video of this song was created, featuring many of the participants in #CHIME12. It’s a fun little video, and the song sure is catchy.

Senators Join Initiative to Scrutinize Meaningful Use

After four GOP leaders have demanded that HHS Katherine Sebilus account for “failures” they found with Meaningful Use. Recently, a few senators have joined in the fight as well. Several questions were raised about EMRs, Medicare, and Meaningful Use. Is this the push that was needed in order to get Congress interested in the future of EMRs?

EMR and HIPAA
SXSW Accelerator Event for Health Startups

SXSW has long been known as an amazing music, film and now IT event. In fact, many people laud the event as a great place where creative people from all industries come together. This year SXSW has a whole health IT campus and a section of their Startup Accelerator competition that’s just devoted to healthcare IT startups. It will be a great place for healthcare IT to mix with the rest of the IT startup world. Plus, I expect a number of very interesting health IT companies to launch in the SXSW accelerator.

Access to Clinical Data Too Easy Via Phone

Most doctor’s offices will verify information by asking for a name and birthdate. However, this system could easily be compromised. Is there a better way to verify this type of information, before discussing medical issues? This post talks about different ideas, and how patient portals might be the solution.

New Open Source (Free) EHR Offering Developed by A Doctor

A new open source EHR is about to be released. And it was developed by a physician. Michael Chen, MD,  the doctor behind it, was interviewed on EMR and HIPAA. He discusses why he wanted to create an open source EHR, future plans, and any challenges that might be associated with it in this post.

Happy EMR Doctor

EMR Use Improves Primary Care: New Study

While there has been some debate about if EMR improves patient care, a recent study indicates that it does; at least in some health specialties. Over 7000 patients with coronary artery disease and diabetes were studied over the course of nine months, and the results ruled in the favor of EMRs. Dr. Michael West has found in his own personal observations, EMR does indeed improve patient care as well.

Smart Phone and Health Care

Five Challenges of mHealth

While mHealth has many advantages and has improved health care in many ways, there have been some challenges that have come about. These challenges include privacy, data security, and funding.

Striiv Ups the Standard for Pedometers — Games, Challenges, and Charity Incorporated

A new generation for the classic pedometer has been created. Striiv recently released a $99 pedometer that really gives the old kind a makeover. It incorporates fitness games, goals, and a charity to convince people to get walking. For those that don’t want to spend $99 on a pedometer, the (free) mobile app is available for the iPhone, and has a lot of the same functions.

Meaningful Use and Big Data, Payment Reform, and Evidence-Generated Medicine – #HITsm Highlights

Posted on October 27, 2012 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.

Topic One: Is Meaningful Use enabling big data in health care? Why or Why Not? #bigdata

Topic Two: Will payment reform make data sharing a strategic imperative? Why or Why Not?

T3: What are the most underutilized sources of data in health care? #bigdata

Topic Four: What data might be used for evidence-generated medicine?

Charles Woodson, Patient Engagement and EMRs

Posted on October 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.

Just when I feared I’d have nothing to write about for this week’s post (despite the interesting news of the NFL’s love of electronic medical records), my husband unfortunately breaks his collarbone. This mountain biking mishap necessitated a variety of healthcare-related trips – a clinic for X-rays, orthopedic surgeon’s office for prognosis and treatment, and our local pharmacy with a handwritten prescription for a much-needed painkiller.

Perhaps the most important visit my husband made was to the World Wide Web, looking up all the information he could find about treatment, length of recovery, worst-case scenarios (which the Web is great at providing), and words of encouragement. Being that this happened on Sunday, Oct. 21st, he had to sift through quite a few Google pages to get through all the news surrounding Charles Woodson’s broken collarbone. Normally, we don’t pay any attention to football, unless it has to do with the Georgia Bulldogs (hoping for a win over Florida this weekend!), but it was pretty hard not to read up on the Green Bay player’s predicted six-week recovery.

Eventually, around page six of Google search results, my husband came across several mountain biking forums that had active discussions around riders’ recent collarbone injuries. My husband was in heaven – all of a sudden his six weeks of recovery now didn’t seem so long, now that he had fellow injured cyclists to commiserate with. (He’s taken to posting daily updates about his progress, and has received positive feedback already!)

Forums like these seem like perfect opportunities for patient engagement. The odds of a doctor weighing in on any given forum are probably pretty slim, but I wonder if those odds would increase if a healthcare institution sponsored the forum. For example, the practice of my husband’s orthopedic surgeon could offer an online community/forum for patients and non-patients to discuss the challenges around a particular problem, such as broken collarbones. The doctors within the practice might be tasked with posting a comment or two each week. Perhaps an alert or message could be programmed to pop up in a patient’s EMR, reminding the doctor to let patients know about these online resources. A service like this would certainly have saved my husband time in connecting with fellow patients, and it seems like a great marketing opportunity for providers.

I’m sure there are HIPAA-related concerns with an idea like this, and I wonder if the providers’ participation could somehow be tied into meeting patient engagement requirements as they pertain to some future stage of Meaningful Use, or accountable care requirements.

Are you aware of any vendors offering technology like this? Do you know of any physicians offering/sponsoring online communities? Please let me know in the comments below, especially if they pertain to collarbones!

What Your EMR Would Say If It Could Talk

Posted on October 25, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In this column we spend a lot of time talking about EMRs, but do we ever listen to them?  Maybe it’s time for an “EMR Whisperer” to turn up and tell us what EMRs are trying to tell us. Or since I don’t know where to find one, I’ll do some listening myself.

Here, for your consideration, are some messages EMRs are trying to share. Don’t take offense…they’re only trying to be honest.

-Anne

* Too many clicks?  I’ll bet you never say that to your World of Warcraft host.

* There’s not enough expansion slots in all of China to integrate that mess.

* So, I went down for a few hours.  Don’t I deserve a break now and then?

* Don’t lie — you’re planning to tear me out and replace me with a younger upgrade.

*  I wish you’d stop telling me F/U.

*  I’m not user-friendly?  What about that smiley I put at the end of that 600-page data dump?

* I thought you loved me for my intelligence, not my interface.

* Your doctors have been saying mean things about me. My feelings are hurt. :-(

*  Sure, I interoperate, but I always come back to you…

EHR Upcoding, Meaningful Use Stage 2, Interoperability, EHR Consolidation, and ACOs Video – Burning Topics with Dr. Nick

Posted on October 24, 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 recently sat down with Dr. Nick van Terheyden, CMIO of Nuance to talk about some of the Burning Health IT topics. In the following video Dr. Nick and I talk about EHR Upcoding, Meaningful Use Stage 2, Interoperability, EHR Consolidation, and ACOs. Enjoy and I hope you’ll extend our conversation in the comments.

Greenway Medical (GWAY) Keeps Momentum Post-IPO

Posted on October 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As readers may know, Greenway Medical Technologies is a health IT vendor that sells an integrated EMR and practice management solution, as well as interoperability tools.  The mid-sized vendor excited some criticism earlier this year when it decided to launch an IPO, as few vendors in its size class have done so to date. Naysayers argued that the moment wasn’t right for a company its size to compete with big health IT players for investors.

A few quarters later, Greenway’s stock is doing well, at about $18 per share, having started out at a $10 per share offering price. Analysts, myself included, aren’t surprised to see a well-positioned company in the ambulatory care space do well, but the $550 million firm has done better than expected.

Wall Street was taken by surprise by Greenway’s release of its 4th quarter results for fiscal 2012, in which the company reported revenue growth at 24 percent and raw profit margins at 60 percent (though overall profit stood at 16 percent after all other factors were considered).

What ‘s keeping the stock going seems to be nothing more than plain old fashioned dealmaking — and notably, larger deals that extend beyond lighting up one physician office at a time:

*  Greenway cut a deal with HIT vendor Relay Health (a McKesson subsidiary)  in which the two are offering HIE services.

*   Walgreens chose Greenway’s EHR to wire up its pharmacies for immunizations and health testing.

* Greenway snagged an agreement with Michigan Health Connect, the state’s largest HIE, to provide its technology for practices and clinics using the vendor’s solution.

If you’re seeing a pattern here, you’re not alone. Greenway isn’t just flogging its EMR/PMS to hospitals and medical practices, it’s providing the “last mile” HIE connectivity which has most providers scratching their heads.

Without a doubt, Greenway has formidable competition on the HIE technology side — a story we don’t have space for here — but it seems to me that the combo of having a EMR, PMS and HIE technology to offer is a huge plus.  Like the Wall Street folks, I’m interested to see if this combo keeps Greeway afloat. Things look pretty good at the moment.

Challenges and Risks Associated with Disclosure of Health Information in an EHR World

Posted on October 22, 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.

While at AHIMA 2012, I had a chance to sit down and talk with Rita Bowen, MA, RHIA, CHPS, SSGB, Sr. VP of HIM and Privacy Officer at HealthPort to talk about some of the challenges and risks associated with the disclosure of health information in this new world of EHR software. In this video, Rita talks about some challenges with EHR software disclosures that I bet a lot of people haven’t thought about before.