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2015 – The Year Doctors Got Pissed Off

Posted on December 31, 2015 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.

My mother-in-law would be angry at me for the title of this post, but I think it’s the best description of how doctors feelings have changed in 2015. Most of the doctors I talk to are really pissed off with the state of healthcare. This has been coming for years though. I remember years ago talking to my orthopedic surgeon friend (one of the highest paid specialties for those following along at home) about how his life as a doctor had changed dramatically and he wasn’t nearly as happy doing the work now as he was even a few years ago.

Back when I was talking to my orthopedic surgeon friend this was pre-MU and so much of his complaint had to do with declining reimbursement. However, now it seems that the click happy, requirements of meaningful use which add no clinical value to the doctor or patient are starting to drive everyone nuts. Additional declines in reimbursement and ICD-10 didn’t help things either. They just through gas on an already flaming fire. It’s no surprise that Physician satisfaction is at an all time low. Unfortunately, that’s not measured by Washington.

Taking the brunt of this dissatisfaction is the EHR. In some cases, EHR’s deserve the blame. Some of them are awfully implemented and poorly designed. Some of them are relics from another life that somehow are still around. I’m reminded of Mr. Histalk’s comment that healthcare is where 80s technology goes to die. I think that’s the case with many EHR software out there.

However, I also think that in many ways the EHR is just the whipping boy. The EHR takes the blame when all they did was implement the reimbursement and regulation requirements that doctors said the EHR had to implement if they wanted them as a customer. Remember that reimbursement requirements and meaningful use have very little to do with improving patient care. If they were about patient care, we’d see very different requirements and we’d see an EHR that doctors appreciated a lot more than the behemoths we have today.

Considering the path that healthcare is taking, it’s easy to see why doctors are pissed off. 2015 was a brutal year for them. We’re trying to shift business models and I predict that most doctors will be the ones caught in the cross fire. The government and payers certainly aren’t going to take cuts. Patients and doctors are each going to take it on the chin during the transition. I think most doctors see this coming and realize it’s not going to be pretty. Most are too busy churning through patients that they don’t have time to do anything about it.

While doctors are upset at all the changes and what healthcare has become, I do think there’s reason to be hopeful. I’ll write more about that tomorrow as I look at the healthcare trends which get me really excited. While healthcare has plenty of problems, one thing it has as an advantage is a crop of really amazing people. For the most part, doctors, nurses, and other healthcare staff are some of the most caring, kind, thoughtful, and helpful people I know. The few bad apples often ruin it for the majority of health care workers who really want to make your life better. This alone should be cause for optimism. Tomorrow we’ll talk about other trends which make me optimistic about health care.

Time For A Health Tracking Car?

Posted on December 30, 2015 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.

Several years ago, I attended a conference on advanced health technologies in DC. One of the speakers was Dr. Jay Sanders, president and CEO of The Global Telemedicine Group. And he had some intriguing things to say — especially given that no one had heard of a healthcare app yet and connected health was barely a vision.

One of Dr. Sanders’ recommendations was that automobile seat belts should integrate sensors that tracked your heart rhythm. After all, he noted, many of us spend hours a day behind the wheel, often under stressful conditions — so why not see how your heart is doing along the way? After all, some dangerous arrhythmias don’t show up at the moment you’re getting a checkup.

Flash forward to late 2015, and it seems Dr. Sanders’ ideas are finally being taken seriously. In fact, Ford Motor Co. and the Henry Ford Health System are co-sponsoring a contest offering $10,000 in prize money to employees creating smartphone apps linking healthcare with vehicles. While this doesn’t (necessarily) call for sensors to be embedded in seat belts, who knows what employees will propose?

To inspire potential entrants, the Connected Health Challenge sponsors have suggested a few ideas for possible designs, including in-vehicle monitoring and warnings and records access from the road. Other suggestions included appointment check-ins and technology allowing health data to be transmitted to providers. The contest kicks off on January 20th.

In some ways, this isn’t a huge surprise. After all, connected vehicles are already a very hot sector in the automotive business. According to research firm Parks Associates, there will be 41 million active Internet connections in U.S. vehicles by the end of this year.

At present, according to Parks, the connect car applications consumers are most interested in include mapping/navigation, information about vehicle performance, Bluetooth technology and remote control of vehicles using mobile phones. But that could change quickly if someone finds a way to interest the well-off users of wearables in car-based health tracking. (A possible direction for Fitbit, perhaps?)

Ordinarily, I’d have some doubts about Henry Ford Health System employees’ ability to grasp this market. But as I’ve reported elsewhere on Healthcare Scene, Henry Ford takes employee innovation very seriously.

For example, last year HFHS awarded a total of $10,000 in prizes to employees who submitted the best ideas for clinical applications of wearable technology. Not only that, the health system offers employees a 50% share of future revenues generated by their product ideas which reach the marketplace.

Now, it’s probably worth bearing in mind that the wearables industry is far more mature than the market for connected health apps in automobiles. (In fact, as far as I can tell, it’s still effectively zero.) Employees who participate in the challenge will be swinging at a far less-defined target, with less chance of seeing their ideas be adopted by the automotive industry.

Still, it’s interesting to see Ford Motor Co. and HFHS team up on this effort. I think something intriguing will come of it.

An Improved Interface for Lab Tests

Posted on December 29, 2015 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.

Electronic health records have been the butt of complaints for years (and in fact, doctors are getting less satisfied with them over time), but we don’t really know how to make them better–if we did, we would have fixed them long ago. Two principles raise the hope of improving the usability of EHRs in the future:

  • Involve the clinicians themselves intensively in design.
  • Allow access by third parties who can experiment with new innovations.

One specific improvement in user interface design is now being proposed: a better organized display for lab tests. This deserves more news coverage in its own right, and additionally illustrates the two principles at work. I talked recently to Dr. Robert Coli, the chief proponent of the design.

A uniform display format

Current lab results tend to be presented as incomplete and badly fragmented data, instead of the complete, integrated, and actionable information that physicians and patients need. Fragmented data wastes a lot of space, doubles or triples the number of screens to scroll and pages to turn, and lacks the connections that could help physicians draw conclusions. Confusion over test results slows down physicians and increases the risk of errors, both of omission and comission. Doctors might reorder tests merely because they are time-constrained and have trouble finding what they need: the results of recent tests and historical trends.

The proposed user interface adheres to a uniform format developed by doctors, with input and feedback from doctors and nurses to ensure it is clinically intuitive. It will help physicians as well as patients view and share test results displayed by EHR, PHR, and HIE platforms. A group of Rhode Island physicians have supported its development and unsuccessful efforts to distribute it as a commercial product for more than 20 years. Various levels of display are illustrated on their web page.

Their key advance, based on principles of human-centered design, is to group tests by organ systems (a classification that already exists in medicine) and then to display them chronologically within clinically logical categories and subcategories. In one example, the first three subcategories of the first main test category, “MICROCHEM TESTS,” displays about 50 clinical lab tests that are most frequently ordered and repeated. The less commonly ordered and less frequently repeated lab tests are displayed in the fourth subcategory, with Microbiology results presented in subcategory five. Clicking on rows will display useful details, including reference ranges and units.

In the second main test category, “SUBSPECIALTY TESTS,” imaging, endoscopic and other testing modalities are indexed by organ system and clinical specialty in alignment with physicians’ common thought flow and workflow.

According to Coli, existing displays are packed with fragmented data. They use five times as much space, are more confusing, and make it difficult to find individual test results or to follow trends over time. The same flawed user interface design seems to have persisted for an astonishingly long time. Figure 1 shows a printed hospital report of lab results dating from the 1970s, while Figure 2 shows a modern EHR display using the same suboptimal design. Both reporting formats list tests in a rather haphazard order over short time periods, include an enormous amount of useless white space, and are laid out inconsistently to that doctors cannot find important information quickly even after considerable practice.

lab_results_old

Figure 1. Old paper lab results report

lab_results_new

Figure 2. Putatively modern electronic display of lab results

Often, user interface advocates call for customizable interfaces. But Coli argues that for lab and other test results, consistency is generally more important than customizability. A single, platform-neutral, uniform report display will allow doctors to quickly learn how to find the information they are seeking and apply these skills throughout their careers, at any point of care. The format could also be the basis for other enhancements, such as showing a chart with a normal range and the patient’s actual result, and using color to highlight anomalies. Specialty-specific customized views of cumulative results and Clinical Decision Support (CDS) applications for optimizing cost-effective test selection can also be developed as value-added enhancements to the standard reporting format.

History of the proposal

Coli rebelled at lab test displays back in the days of paper, and developed his current format when starting his own practice in 1979. Enthusiasm grew among his colleagues, but he could not drive adoption outside the circles of clinicians who knew and respected him. Amazingly, he has kept up his efforts over the years, and saw the passage of HITECH as the opening he needed.

Between 2011 and 2013, Coli accepted an invitation from Direct Project Coordinator, Arien Malec, to attend weekly virtual meetings of the Standards & Interoperability (S&I) Framework as it developed HL7-balloted implementation guides, pilot projects, and reference implementations for key lab-related standards. Although the Framework’s scope of work did not include standardizing the presentation of test results for physicians and patients, it was relevant to other Framework efforts, including EHR-LIS open source lab results reporting, lab test ordering, and an electronic directory of lab services standards. Coli’s proposal also drew approval from the judges of the eHealth Initiative’s 2015 Innovation Challenge.

Coli is currently investigating possible work with the Healthcare Services Platform Consortium (HSPC) to implement the standard reporting format over SMART on FHIR. And he’s in the process of connecting with all the right consortia actively seeking to advance interoperability, including the CommonWell Health Alliance and the Argonaut and Sequoia projects. Recognizing the spread of open source solutions in health care, Coli is offering these public/private sector consortia and leading standards organizations a royalty-free license to a patent that his company holds on the format.

Still, vendors have taken little notice of the lab results format. This is why a third-party market is so important. There is no reason for suffering clinicians to wait until one implementation detail rises high enough on some vendor’s checklist to have it done. Tools and standards have advanced to the point where innovations like this can be developed and disseminated quickly.

FDA Limitations Could Endanger Growth Of mHealth

Posted on December 28, 2015 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.

mHealth technology has virtually unlimited potential. But until the FDA begins putting its stamp of approval on mHealth tools, many providers won’t take them seriously. And that could be a big problem for mHealth’s future.

Unfortunately, early signs seem to suggest that the FDA is in over its head when it comes to regulating mHealth. According to speakers at a recent FDA Law Institute conference, it could be years before the agency even has a solid idea of how to proceed, Bloomberg reports.

Jeffrey Shapiro, a member of the Washington, D.C. law firm of Hyman Phelps & McNamara P.C., told the conference the FDA just isn’t equipped to handle the flood of new mHealth approaches. “Experience has shown that the FDA’s almost 40-year-old regulatory framework is a bad fit for much of today’s health IT with its networked ecosystems, rapid iterative improvement, deep collaboration between providers and end-users and focus on clinical decision support rather than direct diagnosis or treatment,” he told the audience.

The FDA dismisses the notion that it’s not prepared to regulate mHealth technologies. Bakul Patel, the agency’s associate director for digital health, told Reuters that the agency is planning to fill three new senior health scientist positions focused on digital health soon. That’s an encouraging step, though given that there are more than 165,000 health apps on the market, probably an inadequate one.

Sure, few of those app developers will apply for FDA approval. And the agency only plans to demand approval for technologies that are designed to be used as an accessory to a regulated medical devices, or transform a mobile platform into a regulated medical device. mHealth devices it has already approved include Airstrip Remote Patient Monitoring, the AliveCor Heart Monitor for iPhone and McKesson Cardiology’s ECG Mobile.

On the other hand, if Shapiro is right, the FDA could become a bottleneck which could severely stunt the growth of the U.S. mHealth industry. If nothing else, mHealth developers who seek FDA approval could be faced with a particularly prolonged approval process. While vendors wait for approval, they can keep innovating, but if their proposed blockbuster product is in limbo, it won’t be easy for them to stay solvent.

Not only that, if the FDA doesn’t have the institutional experience to reasonably evaluate such technologies, the calls it makes as to what is safe and efficacious may be off base. After all, apps and remote monitoring tools don’t bear much resemblance to traditional medical devices.

In theory, upstart mHealth companies which don’t have the resources to go through the FDA approval process can just proceed with their rollout. After all, the agency’s guidelines for requiring its approval are reasonably narrow.

But in reality, it seems unlikely that providers will adopt mHealth devices and apps wholesale until they get the FDA stamp of approval.  Whether they geniunely consider non-approved devices to be too lightweight for use, or fear being sued for using questionable technology, providers seem unlikely to integrate mHealth technology into their daily practice without the agency’s green light.

Given these concerns, we’d best hope that the FDA doesn’t begin requiring its approval for EMRs. Or at the very least, we should be glad that it didn’t jump in early. Who knows where EMR infrastructure would be if vendors had had to play patty-cake with the FDA from day one?

Happy Holiday! – How Much Love Did You Put Into Your Giving?

Posted on December 25, 2015 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 is enjoying this Holiday season. Here’s a quote which hit me as I thought about what I’d give to those I love this Christmas. Now I’m working to remember it as I receive so much from so many I love.
Mother Teresa Giving Quote

Healthcare IT Vendor Blogs

Posted on December 24, 2015 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.

After 10 years and 9404 blog posts later, I’ve come to know a little something about blogs. You might also say that I’m totally bias about the power of a well written blog. The reality is that blogging is just a simple way for anyone to publish content online. Blogging has really opened up the opportunity to publish great content to everyone.

With that said, it’s not easy sustaining a blog with great content. The tyranny of time is real and however far ahead you get on your blog, time will eat that away before you can blink your eye. It takes a real commitment to keep a blog up to date with regular content.

To honor some of these efforts, I thought it would be fun to share some of my favorite healthcare IT vendor blogs. It’s great to acknowledge the effort these vendors put into creating great content. Sure, they likely want to get more exposure for their companies. That’s a given, but that doesn’t diminish that many healthcare IT vendors are creating amazing free content on a regular basis on their blogs. Here’s a quick look at a few that I enjoy.

Information Advantage Blog by Iron Mountain – This blog focuses deeply on the challenge of health information management and topics such as: health information governance, medical records scanning, health data storage, etc. Those in the AHIMA and HIM community will really enjoy the blog, but there’s a little something for anyone interested in healthcare IT.

HL7 Standards by Corepoint Health – Most of you are likely familiar with this blog since it’s the home of the #HITsm Twitter chat. They post the host and topics for each week’s #HITsm chat, but they do much more. The HL7 Standards blog has a wide variety of amazing healthcare IT content from a diverse group of guest bloggers. They rarely put up a post that’s not worth a read.

Kareo Blog by Kareo – The Kareo blog is home to Kareo product updates and the #KareoChat, but they also regularly post some great content. Kareo has long been the advocate for the independent small practice physician. Therefore, you can imagine that their content is all focused around that audience.

CloudView Blog by athenahealth – This blog is a reflection of the athenahealth CEO, Jonathan Bush. You never know what to expect. No doubt Jonathan Bush has created a culture at athenahealth that’s trying to push boundaries and we often see that reflected on the athenahealth blog. In fact, the best posts on the athenahealth blog come from Jonathan Bush himself. I also love that the CEO of the company is present on the blog. Some might argue that it’s not really Jonathan writing the post, but when you read his posts it’s all Jonathan coming through in the message.

There are many more great healthcare vendor blogs out there. If you have some favorites or ones I should check out, please share them in the comments. If we get enough recommendations we’ll do a follow up post featuring other healthcare IT vendor blogs.

Enjoy the light reading this holiday weekend!

Full Disclosure: I’ve written a few posts over the years for the Kareo and Iron Mountain blogs.

The New World of Health Monitoring

Posted on December 23, 2015 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 thought that this image was really interesting in the context of another post about the medical smart phone. Ironically, I think the image below actually only depicts a small part of the health monitoring that’s coming. I’m sure that scares the heck out of many people and excites many people. It’s a hard balance. Personally, I’m on the excited side of things. Chew on this graphic as you open your various health tracking devices this Christmas.
New Extreme Health Monitoring

The Case For Dumping EMR Interoperability Goals

Posted on December 22, 2015 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.

The new year is upon us, and maybe we should consider some new approaches, or even throw out accepted wisdom. Why not consider some major pain points and reconsider how we’re handling them?

In that spirit, my question is this: Should we give up on the idea that EMR vendors will ever allow their data will be interoperable? While this conclusion isn’t exactly a no-brainer, many of us have certainly toyed with the idea. So let’s take ‘er out for a spin.

One major consideration is that EMR vendors have some very compelling reasons for keeping things as they are. Perhaps most notably, interoperability would mean that providers wouldn’t be trapped in deals with a single vendor, as they could just shift the data over to a new platform if the need arose. If I sold EMRs I’d fight tooth and nail to prevent my product from being dumped too easily.

As if that weren’t enough of a disincentive, EMR vendors would need to spend big bucks to achieve interoperability, with no direct reward in sight. Somehow, I doubt that they’re ever going to make such an investment to win some “nice guy” award from the industry.

And even if they could somehow achieve interoperability without breaking a sweat, we’ve got to contend with inertia. Making changes on that scale takes a great deal of effort, and EMR vendors have very little reason to do so.

Maybe the federal government could achieve interoperability through some kind of epic power play, like refusing to issue Medicare reimbursement to providers whose EMRs didn’t meet some ONC interoperability standard.

But even that kind of brute force wouldn’t solve the interoperability problem with one stroke. Such an approach would come with a raft of serious concerns. What interoperability standard would ONC use, and how long would it take to choose? Then, how long would vendors have to meet the standard?  How long would providers have to decommission their existing EMR — and let’s not forget, quite possibly interlocking HIT systems — and where would they get the money for the new/upgraded systems?

Not only that, it would it cost billions of dollars, without a doubt, to make this transition. It could take a decade before the transition was complete. A lot can happen to derail such an initiative over that amount of time, and market forces could render the premises of such an effort obsolete.

On top of that, any effort which encouraged providers to dump their existing EMR platform would greatly diminish, if not erase, the value of the billions of dollars invested in Meaningful Use incentives. A lot of effort has gone into workflow and interface designs that support MU compliance, and starting from scratch on a new platform would NOT be a walk in the park.  So meeting MU goals might be possible over time, but could fall by the wayside for the short term.

All told, it seems that we may be chasing our tails trying to push through interoperability. In theory it sounds good, but when you look at the details it seems unlikely to happen. That being said, the need to share patient data isn’t going to go away, so what alternatives might work? I’ll follow up with some additional thoughts.

Idiosyncratic Recommendations Based on Widespread Principles: the Health IT Policy Committee Report

Posted on December 21, 2015 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.

Congress received an odd document last week from an advisory committee on Health IT. It takes an unexpectedly new–and demandingly detailed–approach to the perennial problem of health record interoperability. However, if one analyzes the authors’ reasoning, it turns out to be based on unstated principles that are widely accepted in health care:

  1. The market is broken, and the government must intervene either through incentives or through requirements.

  2. The intervention should be based on operational or clinical goals, not dictating the adoption of specific technologies.

  3. Policy-makers should pick off low-hanging fruit through goals that produce potentially large benefits with relative ease.

Read more..

PHR Interaction with Doctors, A Shakespearean Tangle, and an iPhone EHR

Posted on December 18, 2015 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 regularly like to do a post that highlights interesting tweets from around the EHR and Healthcare IT twittersphere. Plus, I add in a bit of my own commentary. I hope you enjoy.


We’ve all known this for a long time. Glad to see that most doctors are finally realizing it too. With that said, I think we still have a long way to go when it comes to how we interact with patients through a PHR. However, we’re finally getting comfortable with the idea.


You need this part of the link above to understand the tweet:

Is ownership of medical data or workflow a Shakespearean comedy (happy ending) or tragedy (sad ending). At this point in time, the end result is not clear nor can an ending really be predicted. However, recognizing the issues can help draw focus and hopefully influence a better outcome.

It’s a fun question to ask. I think for most people it will be a generally happy ending. We usually end up with the right thing after we’ve exhausted all of our options (to modify a similar famous quote about the US). My only caution is that there may not be an ending to this. It will likely be a battle that will rage forever with give and take that goes on at least for our lifetimes.


I found this tweet ironic since I’d just had some searches to my website looking for an iOS EHR. It might be worth linking to my previous Apple EHR post. DrChrono built its brand on the back of an iPad EHR, so this isn’t a surprise. Of course, the proof is in the pudding as they say. I’ll hold out my judgment until I can hear from the doctors who actually use their iPhone as their EHR. As for the comment in the tweet above, I’m not sure it changes everything. We’ll still hear plenty of complaints from doctors on Epic and Cerner that they can’t do their EHR on their iPhone.