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EMR, EHR, and Health IT Jobs

In our current economic client, it’s been quite interesting for me to keep an eye on the EMR, EHR and Health IT job market. While many in the country are out of work, those with healthcare and IT experience are usually in very high demand across the country.

I recently heard this quote from Michael Dell (founder of Dell):

“If we set up a new site to hire 100 software or storage or networking engineers, we have to go find them one at a time and seek them out and convince them and cajole them to come work for us. If we set up a warehouse or distribution center and we have 100 jobs there, we will have a line of 10,000 people waiting outside to try to get those jobs.”

I think we’re seeing something similar in healthcare IT. As long time readers will probably know, we have our own EMR, EHR and Health IT job board. Here are two of the jobs that were recently posted on the job board:

Senior Healthcare IT Project Manager
Senior IT Systems Analyst

Watching that job board and also seeing the jobs that are submitted on the Healthcare Scene LinkedIn group is interesting. You definitely see the trend that Michael Dell mentions. There are a lot of skilled jobs available, and not enough skilled people to fill those jobs.

I’ll be interested to see how this evolves in a post-HITECH era. Right now if you have EHR experience and expertise, there are a wide variety of jobs available to you. I’m sure there are pockets and communities where this isn’t the case, but across the country there are people looking for people who know and understand EHR. Many of the top EHR consulting firms can’t get enough people on board to support their projects. Plus, we’re only at about 50% adoption (depending on whose numbers you prefer).

I expect the above trend to continue at least through the end of meaningful use and likely well beyond that. As I often tell people, healthcare is going to be around forever and using technology to improve healthcare isn’t going anywhere either.

January 31, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

Frontline Female Veterans Likely to Benefit from New VA Telemedicine Project

As anyone in healthcare will tell you, the U.S. government has an interesting sense of timing. A day after the Pentagon announces it plans to end its ban on women in frontline combat, the VA announces that it has awarded grants to VA facilities that are launching women’s health projects, including establishing telehealth services for female veterans living in rural areas. Coincidence, or well-timed marketing/public relations strategy?

According to the VA’s press release announcing the grants, “Women serve in every branch of the military, representing 15 percent of today’s active duty military and nearly 18 percent of National Guard and Reserve forces. By 2020, VA estimates women Veterans will constitute 10 percent of the Veteran population.”

No mention was made in the release, of course, of the 237,000 jobs that will be available to women in the armed forces now that the combat ban has been lifted. I wonder if that 10-percent figure might jump a little once 2016 rolls around and arguments amongst government agencies regarding combat roles that should remain closed to women are laid to rest.

Telehealth grants were awarded to 10 facilities, and, according to the VA, will be used to provide services including tele-mental health, tele-gynecology, tele-pharmacy and telephone maternity care coordination.

While I applaud Secretary of Veterans Affairs Eric K. Shinseki’s statement that “[t]hese new projects will improve access and quality of critical health care services for women,” I’m not quite sure where I stand on the underlying issue – why aren’t female veterans already given 100 percent access to care at VA facilities, and why does the government seem to be planning for an increased need for healthcare services? But that speaks to a bigger problem that is probably best addressed elsewhere.

January 30, 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 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.

EMR Vendors Want Meaningful Use Stage 3 Delay

A group of EMR vendors have joined the chorus of industry organizations asking that Meaningful Use Stage 3 deadlines be moved up to a later date.  The vendors also want to see the nature of Stage 3 requirements changed to put a greater emphasis on interoperabilityInformation Week reports.

The group, the HIMSS EHR Association (EHRA), represents 40 vendors pulled together by HIMSS.  Members include both enterprise and physician-oriented vendors, including athenahealth, Cerner, Epic, eClinicalWorks, Emdeon, Meditech, McKesson, Siemens GE Healthcare IT and Practice Fusion.

In comments submitted to HHS, the vendors argue that MU Stage 3 requirements should not kick in until three years after a provider reaches Stage 2, and start no earlier than 2017. But their larger request, and more significant one, is that they’d like to see Meaningful Use Stage 3′s focus changed:

“The EHRA strongly recommends that Stage 3 focus primarily on encouraging and assisting providers to take advantage of the substantial capabilities established in Stage 1 and especially Stage 2, rather than adding new meaningful use requirements and product certification criteria. In particular, we believe that any meaningful use and functionality changes should focus primarily on interoperability and building on accelerated momentum and more extensive use of Stage 2 capabilities and clinical quality measurement.”

So, we’ve finally got vendors like walled-garden-player Epic finding a reason to fight for interoperability. It took being clubbed by the development requirements of Stage 3, which seems to have EHRA members worried, but it happened nonetheless.

While there’s obviously self-interest in vendors asking not to strain their resources on new development, they still have a point which deserves considering.  Does it really make sense to push the development curve as far as Stage 3 requires before providers have gotten the chance to leverage what they’ve got?  Maybe not.

Now, the question is whether the vendors will put their code where their mouth is. Will the highly proprietary approach taken by Epic and some of its peers become passe?

January 29, 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. Contact her at @annezieger on Twitter.

The Story of the Colorado Beacon Consortium’s ACO Plans

There are a lot of aspects of the HITECH act that don’t get much attention. Sure, the majority of the spending is the EHR incentive money and meaningful use. So, we should focus on what’s happening with that money. However, much less attention gets paid to the other parts of the HITECH act since it’s only a few hundred million dollars (yes, I laughed when I typed that).

I do find it ironic that the “beacon” communities part of the HITECH act haven’t gotten much exposure at all. The whole idea of a beacon is to be seen by everyone, no? I’m sure each beacon community has had to submit some sort of lengthy reporting to ONC about their beacon community. I’m all about government holding people accountable for the money that they spend, but wouldn’t it be better if the beacon communities had to become true beacons in healthcare?

This rant comes on the heels of me watching this video from the Colorado Beacon Consortium. The video is professionally done and does a good job trying to capture the provider viewpoint of what they’re doing. It’s a little dry to watch, but really tries to show how the physicians and patients have benefited from technology.

Have you seen other examples of what the beacon communities are doing? I’d love to see more.

January 28, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

EHR Benefit, Goodhart’s Law, and EHR Interoperability


Thanks to Sherry for pointing us out to this example of the benefit of EHR. I hope that Sherry’s dad does well in surgery and recovers well.


I think that Charles might be on to something here. The interesting thing to me is that it’s very likely that looking back on the HITECH act, the most valuable part will just be shining the spotlight on EHR. It’s woken a lot of healthcare organizations up to EHR and what was happening with EHR that were in a cozy slumber. I think that’s the most important thing we can do to move healthcare IT forward.


I don’t see this getting better any time soon. Check out the entire Twitter thread for this message to get the full context of the discussion. I’m still bamboozled by why we can all see the value of exchanging data, the technical details have been solved (see HIMSS interoperability showcase) and yet we’re still not sharing data.

January 27, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

When The EMR *Is* The Problem

The other day, I sat in an office while a nurse practitioner entered data into an EMR.  The visit was a follow-up, so there wasn’t a lot to record, but somehow, it took a good 45 minutes nonetheless.  While the nurse’s long stenciled fingernails couldn’t have helped her typing speed much, the real problem seemed to be the EMR, which kept locking up and seemed to be harboring someone else’s data. (It had my weight at 50 plus pounds more than I am, a data problem to be avoided if you’re hoping to track patients for health risks.)

Now, I do think some of the responsibility for the crazy quilt of mistakes and processing problems can be laid at the feet of the nurse, who didn’t seem particularly well oriented to the system and as noted, clearly couldn’t have passed a high school typing test. I also doubt she had to mispronounce my name three times as she moved from one screen to another.  Clearly, she wasn’t big on bedside (office-side?) manner.

The thing is, I think she wanted to be helpful, wanted to be personal and most importantly, wanted to be careful with the interview and med prescriptions. The problem was, she was so embedded in the process of using the EMR that the higher purpose of having it there in the first place was all but lost. Though she seemed bright enough, the nurse had trouble compensating for the demands of the system.

The bottom line, as I see it, is that even if the nurse will never win any IT prizes, the situation was not her fault.  It was that the EMR absorbed all of the nurse’s attention and concentration, leaving me feeling somewhat peripheral to the situation at best. Yes, she could probably make some improvements in how she interacts with patients, but if taking her eyes off the screen means she forgets critical details, that’s not going to happen.

This experience left me wondering: How often are good clinicians being turned into distant, vexed and struggling professionals who barely acknowledge that the patient is there twiddling their thumbs?  And how can the health system afford this kind of timewaste and error-prone user patterns?  I don’t know the answer to either question but I think we should find out.

January 25, 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. Contact her at @annezieger on Twitter.

New Telemedicine Stats Bode Well for EMRs

With the recent projection that telemedicine will reach 1.8 million patients worldwide by 2017, I think it’s fitting to continue the discussion I started last week pertaining to the current ROI of EMRs. While current utilization based on scrambling to meet Meaningful Use for federal incentives may not be all it’s cracked up to be, I do believe EMRs will ultimately provide a fiscally sensible return on investment, especially if telemedicine technology becomes part of any given vendor’s standard EMR package/offering.

I decided to bounce the idea off Sande Olson, a Twitter friend (@sandeolson) and Senior Healthcare Consultant at Olson & Associates. Being a healthcare professional that has worked in telemedicine long enough to witness its evolution, Olson seemed a fitting expert to speak with on the subject of EMRs, telemedicine and the bottom line.

How have you seen the telemedicine landscape change over the last few years?
Olson: Until recently, telemedicine has been a niche industry. Early users recognized the potential value of telemedicine, but successful business models (showing a viable ROI) didn’t exist, and technology was costly. The challenge was reimbursement; who was going to pay for it?  Without reimbursement or a viable business model, telemedicine could not go viral.

The telemedicine landscape began to change with advancements in information and communication technology on the heels of The Affordable Care Act. The push for healthcare reform provided financial incentives to “nudge” healthcare providers towards EMRs. Reform mandates and the availability of government funding created new opportunities around technology. Telemedicine, a valuable if fledgling technology, became a buzzword around technology and healthcare reform.

Industries saw business opportunity as solution providers for an “industry poised to undergo radical change.” Entrepreneurs, inventors, investors and healthcare visionaries followed new and sometimes disruptive ideas. Care delivery tools moved from PCs to tablets, along with mobile apps.

The confluence of all these influencers is creating a potential tipping point for telemedicine; it only needs wider reimbursement and licensure portability. Our aging population and forecasted physician shortage will help continue to thrust telemedicine into the forefront of change. Telemedicine is already being used successfully; reimbursement is still a challenge. But, healthcare innovation is just getting started. We have challenging times ahead, but this is also the most exciting time to be in healthcare ever!

Do you think there’s been a trickle down effect from the Affordable Care Act in terms of increasing interest in and adoption of telemedicine?
There has been a trickle-down effect on telemedicine. The Affordable Care Act has increased interest in exploring the possibilities of telemedicine outside of previous niche markets. As I noted, it is the confluence of influencers around healthcare reform that continues to push the tipping point for telemedicine.

Do you think EMRs will prove their worth in the coming years by better facilitating more novel methods of healthcare delivery, like telemedicine, or integrating with consumer-friendly mobile health apps?
Will EMRs prove their worth? Well, data silos do not support healthcare’s philosophy of providing a continuum of care from cradle to grave. And, you cannot provide care without a medical record; you can’t measure outcomes. So, interoperability– across all silos– is critical to successful healthcare reform. EMRs today may fall a bit short, but they will create efficiencies and improve patient outcomes. They will get simpler to use. EMRs will assist in improving reimbursement and revenue cycles. And, future EMRs will push and pull data from HIEs, PHRs and mobile health apps; we are just not there yet.

January 24, 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 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.

A (Not So Silly) Vision For U.S. Health IT

Today, I logged into Twitter and what did I behold but this sweet little tweet by a health it strategist:

@ReasObBob: If headline was, “US has most useful, useable and interoperable #EHR and #HealthIT systems”, what would you think?”

My first thought was “cue the sitcom laugh track” and my responding RT included a hearty”LOL!!” Another retweeter said they’d think they were reading a parody by the famously snarky humor mag The Onion.

But hold on, here. Maybe Bob’s question can yield some useful responses that go beyond cynicism and humor. I’d like to lay out a few features of the health system the question envisions. This will be just a beginning — I’m sure many of you could outdo me by several orders of magnitude — but let’s get started.

Here’s just a few details of future history of the U.S. health IT system, as I’d prefer it to be. Tag, it’s your turn!

-Anne

* Useful:

- Health IT in the U.S. is accessible to every stakeholder (patient, clinician, researcher, others as needed)
- Health IT devices make it simpler, or easy, for every stakeholder to create a feedback loop in which add information, get relevant feedback and respond to that feedback
- Health IT is used to make healthcare collaborative
- Health IT tracks health status efficiently and plays a direct role in improving outcomes

* Useable:

-  Health IT takes advantage of  the best of consumer technology design (as it has already begun to do in the mobile sphere), for both  personal useability and tools for aggregating data
– The health IT tools professionals use do more to encourage development of products and services that bear t he end user in mind (i.e. the end user isn’t a second thought or an obstacle to work around)

* Interoperable:

- Health IT vendors work together across a highly compatible standard (similar to say, 802.11n in the wireless world) which puts the issue of walled gardens to bed permanently
-  Health IT vendors are rated on interoperability with the unified standard that governs the U.S. EMR world
- U.S. health IT is interoperable with EMRs in other countries

January 23, 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. Contact her at @annezieger on Twitter.

Digital Signage Expo in Las Vegas – Healthcare Learning from Other Industries

In my recent post about the Presidential Inauguration and Healthcare, I commented how many times healthcare stays in its closed environment and doesn’t learn from the other industries. This is true in many parts of healthcare IT and that needs to change. While healthcare certainly has special needs and requirements, the attitude that healthcare can’t learn from other industries needs to be corrected if we want to improve healthcare as we know it.

I saw an example of this when I watched this video that talks about the Digital Signage Expo in Las Vegas. Look at some of the amazing digital signage technology they show in this video and think about how often you’ve seen them in healthcare.

The sad thing is that many people in healthcare have ignored these technologies with the excuse that they’ve been distracted by ICD-10, meaningful use, ACOs, etc. Certainly each of these items are big priorities, but many of the digital signage technologies mentioned in the video above could help a hospital or healthcare organization achieve their goals.

For example, one of the crazy ACO changes we’re going to see has to do with patient satisfaction. Yes, I know it’s crazy, but it’s coming. The more satisfied your patients are, the more you’re going to get paid. Could a virtual assistant video wall help to increase patient satisfaction? Could an interactive video wall that recognizes gestures provide the wow factor for the patients that visit your hospital? I think it could, but too many people in healthcare don’t get out of their office to learn about these technologies.

Near the end of the above video they say, “mobile is the action, the signage is the call to action.”

Think about this concept in healthcare. Imagine a video wall in your hospital that takes your hospital’s healthcare data and illustrates the challenges and costs of obesity to your health system. Then, alongside that digital illustration you have a call for patients to sign up for your weight loss program. Of course, this same concept could be applied to all of the healthcare initiatives your hospital is working on already.

There are a number of ways digital signage can be used in healthcare. Take a look at Leveraging Digital Signage in Hospitals for a number of examples and a post by Shahid Shah about using digital signage to create real service improvement. It would just be unfortunate if those in healthcare were “too busy” to take advantage of the technology options that are available out there.

I hope that many in healthcare will take part in the Digital Signage Expo (click image below for more details) so we can get some good cross pollination of ideas from what’s being done in other industries in healthcare.

At the recent Consumer Electronics Show (CES), I would walk up to a booth that I thought had no relation to healthcare. They’d see the words healthcare on my badge and almost every single time they’d say, “Oh, you’re in healthcare, this is how our technology applies to healthcare.” I expect the same thing will be true at the Digital Signage Expo.

I look forward to the day when healthcare is filled with amazing digital signage that engages patients and healthcare staff well beyond a static ad on the wall. The beautiful part is that the technology is already there. We just need to apply what’s being done in other industries to healthcare.

January 22, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.

Martin Luther King Jr. Holiday

I’ve mostly taken the day off today since my kids are out of school for the Martin Luther King Jr. Holiday. I have been keeping an eye on the Presidential Inauguration and its messages for healthcare.

Outside of that, my plan is to take a bit of a break from work and spend time with my kids. I know that between now and HIMSS is a complete sprint for me and so it’s nice to have a little break before I start sprinting.

I always take a second to think about and thank all those healthcare workers who don’t have today off because healthcare never stops. I’m deeply appreciative to those who make that sacrifice. Some try to diminish that sacrifice by saying it’s their job, but that doesn’t change the sacrifice in my mind. Particularly because it’s true on every single holiday.

For those of you not working, what’s your plans for today? Anything fun and exciting? We’re thinking about taking our kids hiking. Yes, that’s the beauty of living in Las Vegas.

I woke up this morning to my son making a 3 course breakfast for my daughter (cereal, pancakes, and toaster strudel). Sometimes it’s the little things in life that make it wonderful. Considering the battles my son and daughter have had, it’s nice to see him do something nice for her.

I hope everyone has a wonderful Martin Luther King Jr. Holiday.

January 21, 2013 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 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John 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 and Google Plus. Healthcare Scene can be found on Google+ as well.