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The Same EHR “Chain of Events”

Posted on December 31, 2014 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.

I recently came across this interesting perspective on the EHR industry on the MGMA blog. Here’s one of the perspectives shared on the blog post:

Miske said his practice’s previous eight EHR selections have followed the “same chain of events”:
*Heavy research, tons of demos
*Implementation
*Training and research
*Relentless tweaking
*Stagnant use
*Systematic bugs reveal themselves
*Issues become unreasonable
*Tech support starts to lack

For his practice’s ninth EHR, Miske refused to settle for inferior quality or employing counterintuitive fixes, such as saying, “let’s hire more people to deal with the inadequacy of the program.”

“Being of the technological mindset that I am, this is unfathomable – the EHR/PM system needs to be a tool and a wonderful tool. Just like our ultrasound machine that allows us to perform 4D miracles without issue daily,” he says.

I have to start by addressing that the above comments are by someone who has done 8 EHR selections. Sure, that means they’ve had a lot of experience with EHR implementations, but from my experience it also likely indicates an internal issue that all 300 EHR vendors would likely face with that practice.

I was recently talking to an EHR implementation manager at an EHR company. They recounted to me how their sales people would bring them a new sale and comment that “this EHR implementation should be easy since they’ve already had 3 EHRs previously.” He then commented that those always end up being the worst implementations since there’s likely some organization problem that needs to be fixed before doing the EHR implementation. Certainly having some understanding of how EHR and software work helps during an EHR implementation, but so many failed EHR implementations often means that something else is at play beyond the EHR.

Personally, I haven’t seen the chain of events that he describes. I’ve seen certain pieces of what he describes, but not all EHR implementations follow that pattern. The last 3 items on the list are things I’ve seen a lot of places with a bunch of EHR vendors.

Bugs are a reality of software use. The key is how the EHR vendor reacts to your bug reports. That will make all the difference in your organization. This is why I’ve said many times that you should cultivate a close connection to your EHR vendor. When you find and report these bugs, having a good relationship with your EHR vendor will be critical to make sure your report is heard.

In the beginning of your EHR implementation, you’re likely to get special attention. So, take the time early to really figure out any pain points the software is causing you. You’ll likely get a quick response. As you become a long time user, you’ll have to rely on a deeper relationship.

If all else fails, remember that the squeaky wheel gets greased. Be careful not to ruin your relationship, but there are a lot of ways to get your concerns heard and addressed. Don’t be shy if a change really matters to you and your organization.

An Integrated Approach: Building Profits by Integrating Your GI Practice

Posted on December 30, 2014 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.

EMR and EHR sponsor, gMed, has recently put out a new whitepaper called An Integrated Approach: Building profits by integrating your GI practice. I’ve always thought that specialty specific features like the surgery center software that gMed offers are a big reason why specialty specific EHR vendors are so popular. This whitepaper makes a good case for why an integrated software package is an advantage for a GI practice.

Below are the two “money” graphics from the whitepaper, but the whitepaper has some lists of benefits and challenges that are well worth considering as well. Not to mention a case study from an actual GI practice.

GI Not Integrated EHR

GI Integrated EHR

What do you think of the integrated versus not integrated approaches that are presented? Are there some things that gMed isn’t covering that are worth considering?

Looking Back at 2014: Thermidor for Health Care Reform?

Posted on December 29, 2014 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://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.

As money drains out of health care reform, there are indications that the impetus for change is receding as well. Yet some bright spots in health IT remain, so it’s not yet time to announce a Thermidor–the moment when a revolution is reversed and its leaders put to the guillotine. Let’s look back a bit at what went right and wrong in 2014.
Read more..

The Journey to Perfection

Posted on December 28, 2014 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.

One of the reoccurring learnings I’ve had this year revolves around judging something new against perfection as opposed to comparing something new against the status quo. I see this over and over in the EHR and Healthcare IT world.

Pairing this idea with the idea in the tweet, I wonder if too often we’re found trying to achieve perfection in healthcare that we are afraid to take the journey to perfection.

I’m chewing on this idea this weekend. What are you thinking about this weekend?

Keeping Your Head Above Water

Posted on December 26, 2014 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.

This Holiday season my wife and I decided to visit my in-laws in the frozen tundra of upstate NY with our 4 children. Why we would leave the beautiful Las Vegas winter for upstate NY can only be explained by love. Although, we’ve been richly blessed since the weather in Las Vegas has been colder than upstate NY. Someone’s watching out for us. However, you can imagine that a trip with 4 children between the ages of 2-10 is a non-stop experience.

As I thought over what the holidays are like with 4 children in someone else’s house over the holidays, I could see a lot of parallels with health IT leadership. Having 4 kids during the holidays really means that you’re always on edge watching and waiting for the next fire. Yes, I often feel like a fireman that’s in charge of putting out lots of fires created by the children. Although, sometimes it takes the form of chief hostage negotiator as you try and negotiate something with a 5 year old. It’s an all encompassing experience that doesn’t leave much time for sitting back and enjoying the holidays.

Most people I know in healthcare IT are in a similar situation. They’re so overwhelmed by the number of large projects they have on their plate that they don’t have even a second to sit back and survey their work. There are so many fires to put out that they don’t have time to really find the root cause of the fire so they can put it out. The idea of sitting back and surveying and appreciating the journey seems out of the question.

Much like with my children, if I don’t take any time to really understand what’s happening, it’s going to lead to a bad place. You have to take time to evaluate what’s happened and figure out the best way forward. If you don’t, your life will be miserable.

I’ve also learned with my family that it’s important to rely on others. In my family’s case, sometimes this is my wife. Other times my in-laws or a trusted babysitter. In the work environment, you need to have people you trust to “babysit” your projects while you take some time off. Sometimes that’s time off to set the strategic direction for your organization. Other times it’s time off to just have a break from work so you can return back with fresh eyes and a renewed soul.

Another lesson learned is to keep things in perspective. It’s easy to go off on my kids when they do something wrong. However, that easy knee jerk reaction is often detrimental to them and to me. Keeping the impact of what they did in perspective is vital to getting ahead of the curve. The same is true in health IT leadership. Make sure you really understand the impact of someone’s actions or decisions before you make your decision. Blowing up on someone over something trivial just creates a culture that is afraid to do anything. That paralyzes the organization and leads to major problems.

Those are a few of the lessons I’ve been thinking about this holiday season. The great part is that I love my children and really have an amazing opportunity to impact their life for good. Turns out that we have that same opportunity in healthcare as well. We just have to stop frantically trying to keep our head above water and instead relax and devise a thoughtful go-forward strategy.

Merry Christmas!

Posted on December 25, 2014 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.

I hope everyone’s enjoying their Christmas. Here’s a look into mine (with 2 of my beautiful children). Merry Christmas!

wpid-20141225_193231.jpg

The Future of Privacy

Posted on December 24, 2014 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.

I realize that it’s Christmas Eve, but this tweet caught my eye and so I thought I’d share.

This is the season of over sharing. With that in mind, I think the discussion of privacy is an important one to have.

2015 Healthcare IT Conference Planning

Posted on December 23, 2014 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.

As the year comes to a close, I’m starting to think about my conference plans for 2015. I traveled quite a bit to some amazing conferences in 2014 and I’m sure I’ll be doing more of the same in 2015.

Ever since August 2014, I’ve been listing my Health IT and EHR conference plans on EMR and HIPAA for others to see. Hopefully it’s a great resource for those trying to navigate the Healthcare IT conferences.

I imagine I’ll probably do a similar schedule of events this year. So far I only have CES, HIMSS, and the Health IT Marketing and PR Conference on my spring conference calendar. Thankfully, the spring conference season is much calmer for me.

I’d love to see and hear what conferences are on your radar for 2015. Are there health IT conferences I should consider adding to my list? I always love to hear about new ones, so please share in the comments or on our contact us page. Along those same lines, let me know which are your must attend health IT conferences. Thanks in advance for sharing with myself and the broader EMR and EHR community.

Congress Getting Real About Interoperability – Kills Paul’s Unique Patient ID Gag Rule

Posted on December 22, 2014 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

Correction: Brian Ahier looked at this post and made a better search through the legislation. When I searched, I used the same words that had been in use since 1998, which mentioned HIPAA and a national ID. As you can see in his post, the new language does not. I did not use the health ID language. I apologize for the error and thank him for his correction.

Sometimes what Congress leaves out is as important as what it puts in. The CRomnibus Act has an example for HIT. In its hundreds of pages, Congress took three actions to promote HIT interoperability. Two have been widely reported: It ordered ONC to report on interoperability data blocking and to spell out other impediments.

The third action, which I haven’t seen reported, was an omission. Ron Paul’s unique patient ID gag rule is no more.

In 2000, then Representative Paul (R-TX) put a rider on HHS’ appropriation blocking HIPAA’s call for a unique, patient ID. It prohibited, “planning, testing, piloting, or developing a national identification card.” Given Paul’s statements, this meant no patient ID development. By making it impossible to even think about a unique patient identifier, ONC could not assess the full range of interoperability options.

Each spending bill since 2000 has had the rider, until now. Noting remotely similar is in the bill. I’m still trying to find out who and when this was dropped.

What’s clear, though, is that Congress is serious about interoperability and has given ONC a clear field to develop a real plan. A bad gag rule is gone.

Next Generation Digital Natives

Posted on December 19, 2014 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.

I saw the tweet and picture above and couldn’t help but laugh. My children do stuff like this all the time and I love it. Of course, my children aren’t talking about being paged (they don’t work in healthcare), but they definitely know all about technology. In fact, at a recent parent teacher conference, my 7 year old’s teacher talked about how well she did on the computer and how she could navigate any of the technology with ease. Yep, I was a really proud parent at that moment.

Why share this on an EMR blog? Well, a part of me has my head in the cloud (pun intended) as I’m considering the various gifts I’m giving my children this year. My wife and I are all about the technology, but also technology that helps them use their creativity. Lest you worry, we also have incorporated plenty of balls and other things they can use outside. However, I think this shift is an important sign of what’s to come.

Think about how different the EHR world would be if all of healthcare were digital natives that just understood how technology worked. I recently was asked by an older friend (ironically he’s an ortho doc) to help him and his wife get the Apple TV working in their home. I’d never used it before, but I’d used something kind of similar. At one point I asked her if she knew how to do something with it (she didn’t know), and then I proceeded to just figure out how it worked.

The reality is that I didn’t know the Apple TV interface at all, but I did know intuitively how things like that were designed. Some of that comes from experience with so many different software packages. Some of that comes from having done some programming. The next generation healthcare IT user is going to have this literally built into who they are. Look at the hour of code initiative if you want to see why I think everyone is going to have at least some programming experience.

Every EHR trainer is reading this and imagining how different their EHR training classes would have gone if those attending were all digital natives. That’s far from the reality today and so we have to do things differently, but it will be what we find in the future.