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EMR Twitter Roundup

Posted on November 21, 2017 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.

Always fun to do some searches on Twitter and find some interesting content. In this roundup, we cover a lot of ground starting with a lawsuit that could be the first crack in breaking the damn wide open.


This picture is hilarious for this story. That part aside, I’ll be personally surprised if this case is successful. However, you can be sure that every EHR vendor out there is watching this case careful. It would be a big deal if eCW does lose.


This is a huge problem. However, it’s not a problem with the EHR. In fact, the EHR could be the solution to the problem as it creates a usable clinical display while still satisfying the billing requirements. Even better would be for us to streamline our billing requirements so that EHR vendors didn’t have to produce these thousands of pages of documentation in order to bill and get paid by insurance companies.


We all know about this challenge. In fact, I’ve heard this used as the rationale for why some people used the term EMR instead of EHR. However, more disturbing is that Matthew doesn’t know that you can remove EHR from the autocorrect table in Word and not have that problem. Kind of reminds me of a lot of EHR complaints. EHR users complain about things that have solutions if they just knew how to use the EHR properly.

5 Tips for HIPAA Compliance

Posted on November 20, 2017 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.

Planet HIPAA had this great article that shared 5 tips to ensure an effective HIPAA program. The reality is that HIPAA is a pretty flexible program that in many cases is open to some interpretation by the medical practice. There are exceptions, but HIPAA is generally about reducing risk as opposed to strict compliance. That’s reflected in this list of 5 tips from Planet HIPAA:

1. Conduct a Risk Assessment/Analysis

2. Create, Review and/or Update all HIPAA policies and procedures

3. Provide Workforce HIPAA Education

4. Conduct regular HIPAA Audits

5. Use Security Technologies

Most of the items on the list aren’t rocket science. However, my guess is that most medical practices will go through this list and realize that they have work to do. Whether it’s not doing a HIPAA risk assessment regularly (yes, sadly this still happens), or whether it’s not documenting or training, most practices will have something they could improve when it comes to HIPAA compliance. How’s your practice doing? My guess is you know where you’re lacking.

My favorite tip on this list was to use security technologies. HIPAA has some really good elements that help a practice protect PHI, but HIPAA does not equal secure. There is plenty more that a medical practice needs to do to ensure that their practice is secure and protected against the malware, ransomware, viruses, and other online threats that exist and are bombarding their IT infrastructure from every angle. HIPAA is required by law, but security beyond HIPAA is required to avoid a cybersecurity disaster in your organization.

The sad reality for many small practices is that they aren’t keeping up with the HIPAA requirements. This was illustrated by this story from Dr. Jayne:

One of my friends admitted that she had her work laptop stolen and didn’t report it to anyone despite it containing protected health information. That sort of thing is one of the perks (or hazards, depending on how you look at it) of owning your own practice and not fully understanding the huge number of laws that impact our practices. At least she realized after attending the conference that she should have taken additional action.

Dr. Jayne described most small medical practices’ feelings perfectly when she said the “perks (or hazards, depending on how you look at it)” of owning your own practice. Ignorance is bliss until you’re stuck on the front page of the paper or in some lawsuit. I’ll never forget the doctor who told me “They won’t throw us all in jail.” Maybe not, but they won’t be afraid to send you all fines.

An ounce of prevention is worth a pound of cure. This seems quite appropriate when it comes to HIPAA and security in a medical practice.

Technology and Health – Fun Friday

Posted on November 17, 2017 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.

It’s Friday. Time for a break from the minutiae of government regulations and other fun topics like MACRA and MIPS. We’re doing our part to help with physician burnout…or at least that should be the goal of the relatively off topic Fun Friday blog posts we do.

This week we have two cartoons for your viewing pleasure. The first one is one that many of us have experienced. I wonder how much this type of thing really comes up in a doctor’s office (ie. too much social media). I’m sure it’s an issue in mental health.

This second cartoon hits a little close to home as a professional blogger.

For the record, I don’t drink caffeine and I couldn’t be at my computer more than 12-14 hours a day. I also may or may not have an addiction to ultimate frisbee (ie. exercise).

Happy Friday!

Patients Showing Positive Interest In NY-Based HIE

Posted on November 16, 2017 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 few months ago, I shared the story of HEALTHeLINK, an HIE serving Western New York. At the time, HEALTHeLINK was announcing that it had managed to obtain 1 million patient consents to share PHI. The HIE network includes 4,600 physicians, in addition to hospitals, health plans and other providers.

This month, HEALTHeLINK has followed up with another announcement suggesting that it’s making significant progress in getting patients and physicians connected and perhaps more importantly, interested in what it can do for them. In particular, the study suggested that consumers were far more aware of the HIE’s existence, function and benefits than one might’ve assumed.

The study found that 90% of respondents said they knew their doctors use EHRs, a percentage which differed but remained high across all demographic groups study. Respondents also knew that their doctor could send and receive medical information back and forth with other healthcare providers involved in their care using EHRs.

Not only that, 51% of respondents felt that the use of EHRs by doctors and hospitals made healthcare “more safe,” though 24% said EHRs made no impact on their care and 18% said EHRs made care “less safe.” Fifty-eight percent of respondents said that electronic access is good for healthcare, and 24% answered “strongly yes” when asked whether electronic access was beneficial.

When asked whether electronic access is good for healthcare, 24% of respondents said “strongly yes” and 58% said “yes.” Things looked even more positive for the future of the HIE when patients were specifically aware of HEALTHeLINK, with 57% of this group of patients rating care as “more safe.”

Those who rated care as “more safe” using HEALTHeLINK also included respondents with a two-year degree, those who visited Dr. more than 15 times a year and those who fell into 35 to 44-year-old age bracket.(However, it is worth noting that 41% to respondents said they weren’t aware of the name HEALTHeLINK.)

The only significant downside mentioned by HEALTHeLINK users was a lack of face time, with 37% reporting that their doctor or healthcare professional was spending too much time on a laptop or computer, and another 11% saying that this was a significant problem. (Another 60% had no issue with this aspect of the electronic medical records use process.)

Despite those reservations, when asked if they were willing to cut their doctor to use the HIE to give the other providers instant access to medical records, 57 percent said “yes” and 24% said their answer was “strongly yes.”

Lest this begin to sound like a press release for HEALTHeLINK, let me stop you right there. I am in no way suggesting that these folks are doing a better overall job of running its business than those in other parts of the country. However, I do think it’s worth noting that HEALTHeLINK’s management is building awareness of its benefits more effectively than many others.

As obvious as the benefits of health information sharing may seem to folks like us, it never hurts to remind end users that they’re getting something good out of it — and if they’re not, to find out quickly and address the problem.

Twitter Highlights from AMIA17

Posted on November 15, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week I had the privilege of attending the 2017 American Medical Informatics Association (AMIA17) annual conference in Washington DC. I thoroughly enjoyed the experience and came away with new appreciation for the work informaticists do. Check out this blog for key AMIA17 takeaways.

One of the most enjoyable aspects of AMIA17 was the quantity and quality of the live-tweeting. My twitter feed hadn’t been that active at a healthcare conference since HIMSS17. There were no less than 20 attendees actively tweeting throughout the conference.

Below is a selection of memorable AMIA17 tweets.

I wasn’t familiar with Carol Friedman’s work, but her lovely tribute video was riveting – almost Hidden Figures-esque. Friedman not only had to overcome being a female data scientist, she was one of the few in her field to believe Natural Language Processing could be applied to healthcare. Her acceptance speech was filled with humor and funny stories.

One of the major announcements at AMIA17 was the creation of a new open access journal – called JAMIA Open. This new publication will be AMIA’s attempt to break down one of the biggest barriers to innovation – a lack of access to research papers. It will be interesting to track the progress of JAMIA Open in the months and years to come.

A very interesting concept discussed at AMIA17 was the use of EHR audit logs as way to identify areas for improvement. This included finding opportunities where retraining might be needed and where bottlenecks exist in clinical workflows. Suddenly it’s not so bad that EHRs record every action…or maybe it is if you are a bottleneck.

Genomics is very exciting. Carolyn Petersen, an Editor at Mayo Clinic, tweeted one out an interesting use case during AMIA17 – using genomic info to prevent adverse drug reactions. Amazing.

This was an extremely interesting question posed by Dr. Danny Sands. In the OpenNotes session he attended the presenters found that physicians were more honest in their documentation notes than they were with the patients they were seeing face-to-face. This makes for an intriguing scenario when patients gain access to those notes after a visit.

One of the more prolific live-tweeters at AMIA17 was Dr Wayne Liang. I enjoyed reading his tweets from sessions that I was unable to attend. This tweet stood out for me. He expertly summarized the 5 ways HealthIT systems could be improved to allow for better data analytics.

Another active live-tweeter was Pritika Dasgupta, PhD student at University of Pittsburgh Department of Biomedical Informatics. This tweet nicely summed up how sensitive the issue of decision support tools has become. Patients and clinicians both want the latest and greatest tools that will lead to the best outcomes. From that perspective, evidenced-based decision support tools can be very effective. However, medicine is more than simply a set of if/and/or statements. It is truly a craft and there is a concern that we lose something when we try to reduce patients to a set of input parameters.

It is always a special treat to listen to a Ross D Martin live performance. At AMIA17 he performed his latest creation – a theme song for #digituRN, an initiative to transform nursing through digital innovation. You can listen to the song on YouTube.

Shout out to Pritika Dasgupta, Dr Wayne Liang, Carolyn Petersen, Rebecca Goodwin, Dr Paul Fu Jr, Dr Arlene Chung, Jenn Novesky, Scott McGrath, Dr Danny Sands, Ross Martin, Alex Fair and Michael Rothman. It was fun to live-tweet with you at AMIA17.

New EHR Virtual Assistant: Samantha from NoteSwift

Posted on November 14, 2017 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.

Sometimes in a blog post, it’s much easier to show something than it is to write about something. That’s definitely the case with the recently announced EHR Virtual Assistant from NoteSwift called Samantha. That’s why I asked NoteSwift to create a demo video of Samantha at work so you could see what they’re doing. Check out the video demo of Samantha working with Allscripts Professional below.

Samantha currently works with Allscripts Professional EHR and athenaClinicals EHR and they’re looking at integrating with other EHRs in the future.

When NoteSwift first reached out to me with this tool I told them that it sounded a lot like the voice recognition and NLP solutions that I’d seen previously. I remember one EMR a long time ago that had really deeply integrated voice navigation that got pretty close to this type of interface. Plus, I’d seen demos of NLP that would pull out the granular data elements from a narrative text before.

The key question for me was how tightly integrated the voice recognition and NLP technology was with the EHR software. As you can see from the demo above it’s quite integrated. I do still have some questions on what the learning curve for some of the specific voice commands will be for the NLP to work properly and document the visit the right way. Plus, similar to voice recognition I’m interested to know if the mistakes you have to correct are as time intensive as just clicking the boxes yourself. I’m sure there will be the full spectrum of experiences.

One thing that really impressed me about NoteSwift’s implementation of Samantha was the verification process that the doctor goes through near the end of the video (about 2 min and 12 seconds in for those keeping track at home). I’ve always thought that, at least for now, this was an essential part of using NLP in the medical world. The doctor still needs to verify that everything is accurate before moving on. The way NoteSwift has implemented this is quite slick.

In talking with Wayne Crandall, the President and CEO of NoteSwift, he also told me that Samantha can work with any input mechanism including voice recognition from Nuance or MModal. He even told me that some doctors believe they can type faster than they can do speech recognition which isn’t a problem for Samantha either. The real magic of Samantha is in taking a narrative text, however it’s produced, parsing the structured data, assigning the coding and entering it into the correct areas of the EHR.

Pretty slick solution and one that I think many doctors would like to try so they can stop their slow death by a million clicks.

MIPS Penalties Include Medicare Part B Drugs – MACRA Monday

Posted on November 13, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

I’m sure most regular readers can tell that we’re pretty worn out and tired of MACRA, MIPS, and related government regulation. No doubt you’ll see us posting fewer MACRA Mondays going forward, but we’ll still try to cover major MACRA events as they occur. We just won’t be publishing MACRA Monday every Monday like we’ve been doing.

Jim Tate recently posted about the Real MIPS Timeline which included:

  • Phase 1 – Denial
  • Phase 2 – Shock/Anger
  • Phase 3 – Acceptance

You should read his full writeup, but he’s right. There’s a lot of denial that’s going to lead to shock and anger until the majority of healthcare have to finally accept that MIPS and MACA aren’t going anywhere.

Jim Tate also wrote another important piece related to the MIPS penalties and Medicare Part B drugs. You can read the full details of the change, but for those too lazy to click over, here’s the summary:

  • Many organizations argued that Medicare Part B Drug Costs Shouldn’t be Included in the MIPS Penalties (I mean…payment adjustments)
  • The MACRA Final rule still includes Medicare Part B drug costs (for the majority of people) in the MIPS reimbursement and eligibility calculations

If you’re a practice with a high volume of part B drugs, you better start figuring out your MIPS strategy now! Otherwise, that payment adjustment is going to hit pretty hard.

Thanks Jim for the great insights into MACRA and MIPS. If you need help with MIPS, be sure to check out Jim’s company MIPS Consulting.

Elderly Doctor May Lose Medical License Due In Part To Lack Of Computer Skills

Posted on November 10, 2017 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.

Do physicians need to be computer-literate to run a safe and effective medical practice? The question has come into high relief recently as an 84-year-old New Hampshire physician fights to get her medical license reinstated.

Dr. Anna Konopka, who recently lost her license due in part to a lack of computer skills, is suing the New Hampshire Board of Medicine in an effort to get it reinstated.

Back in September, Konopka had signed an agreement to surrender her license with the medical board. The agreement settled pending allegations regarding her “record-keeping, prescribing practices, and medical decision-making,” according to an article in Ars Technica. The agreement reportedly permits her to apply to regain her license, but to succeed in doing so she’d have to prove that she did no wrong.

In her interview with the publication, the elderly physician denied any misconduct and said she was under duress when she voluntarily surrendered her license previously. She has said that she wants to continue practicing medicine, but does not want to participate in what she calls “electronic medicine.”

“I am getting the patients from the system [her term for the medical bureaucracy surrounding the use of EMRs today], and I see how badly they are mistreated and misdiagnosed or not diagnosed at all,” she told Ars Technica. “Therefore, I am not going to compromise patients’ lives or health for the system.”

For what it’s worth, Konopka’s troubles with the state medical board didn’t arise from computer use or lack thereof. They were triggered when a formal complaint was filed with the board alleging that she treated a young patient with asthma incorrectly.

The dispute resulted in a formal reprimand from the medical board in April 2017. The board also required her to undergo 14 hours of medical training as a condition of continuing to practice. After that, other investigations followed, including disputes over the scope of her original agreement with the medical board.

Ordinarily, Konopka’s struggles for reinstatement might never have come to public view. What differentiates them from others is the role her unwillingness to use computers has played in the process. Specifically, unless she learns to use the Internet, she won’t be able to comply with the state’s new law requiring her to access an online opiate monitoring program. (As part of her attempts to regain her license, she’s agreed to do so.)

It’s hard to tell who is right in this particular case, but the situation does raise interesting questions about the role of computer use in medical practice generally.

Should physicians be required to use computers as part of their practice in this day and age, and if so, what level of competency should they be required to attain? Are there specific pieces of software, such as EMRs, they have become as important to medicine as a stethoscope was in a prior era? Should use of health IT software be a required part of all medical training at this point?

I don’t have any answers to these questions, and you may not either. But if a doctor’s license can be threatened, even in part, by failing to use computer technology, we’d better work on finding some.

Wearables Makers Pitching Health Trackers For Babies

Posted on November 9, 2017 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.

When my older son was born, we relied on a low-tech “sense of hearing” solution to track crying alerts from his crib at the other end of the hallway.

But were he born today, my son would never have settled for such pedestrian technology. Today’s discriminating newborn expects his parents to collect a wide array of data points and conduct advanced analytics on them to optimize his health.

You think this is ridiculous? Wipe that smile off of your face, you slackers. Ever sensitive to the expanding needs of today’s modern baby, wearables manufacturers have begun testing health trackers designed to monitor their tiny bodies, according to an article appearing on the CNN.com site.

In fact, there are already dozens of wearables for babies on the market, CNN found, including devices that monitor their heart rate, smart socks that track oxygen levels and a baby monitor button that snaps onto the child’s clothes. Any of these could cost a few hundred dollars. But there’s also smart thermometers and pacifiers, such as Vick’s or Blue Maestro’s Pacif-i, which start around $20 and go up from there, the site reports.

The CNN article also shares the tale of Crystal King, an Atlanta mom who’s monitoring her six-month son Avery using one of these emerging trackers.

The piece describes how using her cell phone, King can check her baby’s temperature on her cell phone and get app-driven alerts when it’s time for Avery’s next bottle feeding.

Meanwhile, if King picks up her tablet, she can also monitor her son’s breathing, body position, skin temperature and sleeping schedule. (Back in the Stone Age, I had to settle for keeping his body in position with pillow wedges and tracking his sleeping schedule using a little trick known as “staying awake.”)

As part of his work with CNN, Avery has been testing a number of different wearable devices. He seems to be a tough critic. On the one hand, he seemed pretty comfy wearing a biometric-tracking onesie while playing on his mat, but kept spitting out the smart pacifier, which was apparently a nonstarter.

Of course, we don’t actually know what Avery thinks about these devices, but his mom has developed some ideas. For example, King told CNN she thinks it would be good to help parents control the number of notifications they get from baby-monitoring apps and technologies.

If nothing else, equipping their baby with a health tracker may offer parents a little extra reassurance that their child is safe. He might still erupt in deafening screams at 3AM now and again, but if he’s wearing a health tracker, you might at least know why.

Patients May like Their Physician…But That Doesn’t Mean They’ll Stay

Posted on November 8, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Medical providers are dealing with a more impatient, demanding patient base than ever before. Armed with research, awareness, and a plethora of online data, today’s consumer patients treat their search for a medical provider in much the same way they would any purchasing decision.

They weigh the pros and cons of each provider, evaluating how each practice would fit their lifestyle and then make a decision.

Unfortunately, that is not the end of the process. Even after a patient chooses a specific practice, they are not even close to becoming loyal patients.

Smooth processes trump provider loyalty

It often surprises medical practices to discover that retaining patients has less and less to do with the medical competence of the office. Today, it may not be enough for a patient to simply like their physician.

For busy patients, the road to loyalty goes directly through the processes and procedures of an office. Studies back this up. Consider this. Sixty-one percent of patients say they are willing to visit an urgent care clinic instead of their primary care clinic for non-urgent issues. This is true regardless of whether they like their primary care provider or not.

The #1 reason they prefer urgent care? Because of difficulty scheduling appointments and long wait times with a primary care physician. According to a study by Merrit Hawkins, wait times have increased by 30 percent since 2014. Patients have noticed.

These long wait times were also noted as one of the key reasons patients will switch practices according to respondents of the Patient Provider Relationship study:

  • Sixty-eight percent say that wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

Reducing wait times is crucial to patient retention

In order to increase patient retention levels, practices must find ways to offset the frustration of long wait times. Consider implementing these three methods of wait-time optimization.

  1. Self-scheduling. It is common for doctors to have calendars booked out months in advance. This can cause patient frustration and turnover. When practices allow patients to schedule themselves, however, this frustration is minimized. With self-scheduling, they can quickly see which doctors are available and when. Since 41 percent of patients would be willing to see another doctor in the practice to reduce their wait, this is a simple way to optimize your scheduling without sacrificing patient experience.
  2. Communication. There are times when long waits are unavoidable. This is where communication is key. Studies show that 80 percent of patients would be less frustrated if they were kept aware of the issue. When you know an appointment is going to be delayed, send out an email or text letting them know.
  3. Texting. If your patient has a question, texting can save them a lot of time. Research shows that it takes just 4 seconds to send the average text message. Compare that to the several minutes it takes to make a phone call. Factor in playing phone tag and you’ve saved both time and headaches. Unfortunately, the Patient-Provider Relationship Study found that while 73 percent of patients would like to be able to be able to send a text message to their doctor’s office, just 15 percent of practices have that ability. Practices in that 15 percent will stand out from their competitors.

In this era of consumer-driven behavior, practices need to prioritize ways to create smooth processes for patients. Medical offices should look at ways to optimize their processes to reduce frustration and wait times for patients.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.