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Patient Data Sharing and EMR Usability

Posted on December 7, 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 been a while since we’ve done a Twitter roundup, so it was time to do one again. This time we highlight 3 recent tweets that will make you go hmmmmm. Lots of great insights from amazing people.


More and more people are open to sharing their records. However, there’s still a lot of education needed for people that are afraid that sharing their records could harm them. While there is that risk, it’s important to remember that not sharing your records could harm you too.


Is this the right balance or resonsibility? Should vendors, leaders, and clinicians all be responsible? Is the reason EMRs aren’t usable is that it takes all 3 of these groups working together to make it usable?


I’ll just leave this one here without comment. Lots to chew on in this image!

“Doctor on Board” Experiences for Women Doctors and Over Reliance on Devices in Healthcare

Posted on November 30, 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.

My good friend, Wen Dombrowski, MD (better known as @HealthcareWen for those of us on social media), recently shared her experience on a KLM International flight where the announcement came over the loudspeaker, “Is there a doctor on board?”

Her story and experience provide a great message and reminder that we still have a ways to go when it comes to our biases around gender and race. Plus, in true Wen fashion, she also provides a great reminder about over-reliance on technology and the lost art of “laying hands on a patient” medicine.  Not to mention a usability and design lesson as well. So, I knew I had to share it with Healthcare Scene.

Here’s her story and lessons learned (shared with permission):

“IS THERE A DOCTOR ON BOARD? (Someone had fainted)
I get up and ask staff who needs help. They say they already have enough doctors, thanks.

I brief a sigh of relief and am grateful that other doctors offered to help, because it’s challenging to practice medicine on a plane. So I go use the restroom. But…

On my way back to my seat, I notice there is activity happening up the aisle around the scene. From the back of the plane it looks like the volunteers are trying to do a procedure so I’m guessing maybe they are putting in an IV? But it is so dark in the plane with the interior lights off in sleep mode.

So I go up to the scene to quietly shine the light from my phone onto the procedure…
I’m appalled to find 2 guys are fumbling to put on a blood pressure cuff. It is a simple cuff for well-known home BP machine, nothing fancy. I watch them try to figure out over and over and over again how to wrap the BP cuff around the passenger’s arm… inside out…upside down… they can’t figure out the direction and Velcro…can’t get the BP cuff onto the passenger. By the way, the patient was awake, cooperative, with normal habitus, so there were no barriers from that perspective.

After watching the 2 guys repeatedly struggle with this, I offer to help.
The airline flight attendant rebukes me, “Please sit down. Are you a nurse? because we already have 2 doctors”(while we watch these guys scrambling to figure out how to put on a BP cuff).
I tell her, “I’m a Doctor & a doctor certified in 3 Specialties.”

The 2 guys say they’ve got it under control (while still trying to put on the cuff backwards etc), they say they are an Internist and a Nephrologist.
(I think to myself what a sad state of Medicine to have Internal Medicine and Nephrology not know how to check a BP! It would be understandable if they were orthopedics or psychiatrists or ENT, but blood pressure management is the bread and butter of those 2 specialties.)

Meanwhile, while they struggle to get the BP cuff velcro’d around passenger’s arm, I ask if anyone has checked passenger’s pulse — Is it Fast or Slow? Regular or Irregular? Strong or Weak? Clammy or not? This would provide valuable triage info and could be been done in 5 seconds by one of the guys who wasn’t holding the BP cuff. I ask again if they or I could check the passenger’s pulse, but they ignored this (seemed like neither of them knew how or didn’t think it was important). I wanted to jump in to do it myself, but there wasn’t enough physical space.

After more than 10 minutes struggling, the “doctors” finally got the BP cuff around the passenger’s arm.

I’m sharing this story because:

1. I’m shocked at the sad state of Medicine that doesn’t know how to nor value laying hands on patients as part of assessing patients (flashback to the practical skills Housecalls and field medicine has taught me). The guys were waiting for “the machine” to tell them “the numbers.” I’m sad at the lost “art” of medicine – lack of common sense handson skills & not looking at the qualitative data, just waiting for the quantitative device data. A lot of valuable time was lost in caring for this passenger. (And while I love technology, sensor devices, and clinical decision support tools – I wonder/worry what will happen to future physician’s common sense and clinical reasoning skills?)

2. And sad about the lack of team mindset of these 2 guys, who insisted on doing it themselves, the blind leading the blind. Not accepting help from female colleague. Not acknowledging what they don’t know nor allowing for help.

I know they meant well and were just trying to help, but sometimes helping comes in the form of teamwork.

There’s a lot that I don’t know in medicine and I’m happy to delegate/consult that to others. But geesh, at least I know how to check a Pulse and Blood Pressure.

3. Not to mention the persistently gender biased attitudes of flight crews who decline help from female physicians, to the detriment of everyone’s safety. This problem has been documented many times by other Female & Minority Physicians, for example: http://www.idealmedicalcare.org/blog/female-physicians-told-to-sit-down-shut-up-and-get-out-of-the-way-during-emergencies-as-patients-nearly-die/

4. The BP cuff was basic and not at fault per se. But these crisis moments highlights opportunities to design it better, to improve its usability and accessibility for laypeople and those who aren’t familiar with it. Perhaps the BP machine company could print pictures on the cuff itself that show the up/down and in/out directions of how to apply the cuff.”

Thanks Wen Dombrowski, MD for sharing this story and your insights.

A Look at the Future of Healthcare

Posted on November 22, 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.

I saw this tweet from David Chou and thought that it was a good predictor of where healthcare is heading as we move to a value based care world. Check it out below:

When people see this graphic, they always point out how small of an impact healthcare delivery has on your health. That’s an important point, but I’m more interested in knowing how the other 90% impact health and the innovations in healthcare that are embracing these areas.

This graphic seems like a great indicator of where healthcare needs to head and where I believe it will head. The best innovations in health will be around influencing behavioral factors and genetics. What do you think? What companies do you know that work in these areas that we should be watching more closely?

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!

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.

Accomplishing Great Things in Healthcare

Posted on November 6, 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.

I’m just finishing off my busy healthcare IT conference season. It’s amazing how many healthcare IT conferences want to pack themselves into October and the start of November. My last one is this week and then it’s pretty slow until the new year. That makes me happy even though I love meeting so many people at conferences and hearing so many first hand perspectives.

However, with this scheduling in mind, I thought I’d keep this post short and sweet and share this really interesting quote from Anatole France that was shared by Shereese:

I was talking to a healthcare entrepreneur today and I said that running a business is hard. He said that if it was easy, everyone would do it. I guess that’s true. It takes a whole lot of work and effort to build a great business that can do amazing things. The same is true for anyone wanting to improve healthcare. it takes work, dreams, plans, and belief.

The Whole Healthcare System is Burnt Out

Posted on November 2, 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.


We’ve all seen charts and graphs like the one above. Physician burnout has become a real problem. The EHR has largely become the scapegoat for the physician burnout, but I believe it’s much more complex than that. There are a lot of pressures on doctors that are causing burnout and even physician suicide (a topic which many don’t like to talk about).

Physician burnout is indeed an important topic and one that needs to be addressed. However, I recently saw someone tweeting about physician burnout and in response, someone suggested that we should be talking about Patient Burnout as well. The idea really resonated with me. Especially because I’d never heard anyone talk about patient burnout despite it being a real problem. To better understand the effort, I asked Erin Gilmer to host this week’s #HITsm chat on Patient Burnout. I think we’ll learn a lot about this topic during the chat.

This week I’m at the CHIME Fall Forum with a wide variety of healthcare CIOs. During one of the keynotes, the speaker mentioned physician burnout and it prompted the following tweet:


Indeed. Many healthcare CIOs are burnt out as well. They have so many regulations, so many intiatives, cybersecurity issues, and much much more that’s hitting them from every angle. it’s no wonder that they’re burnt out.

This all made me realize, the whole healthcare system is burnt out. Is there anyone in healthcare that isn’t a little burnt out? Some deal with it better than others, but there’s a lot of burnout all around in healthcare.

This tweet captured the issue of burnout nicely.


How then do we fix all this burnout? I wish I knew the answer. Acknowledging it is the first step, but that still leaves us a long way from a solution. Hopefully we can work towards it for everyone involved.

What Kind of CIO Are You?

Posted on November 1, 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.

Leave it up to David Chou to provide the perfect visual for the path that many healthcare CIOs find themselves on and what they need to do to get on the right path.

The problem that’s described in this graphic is real. I’ve met many healthcare CIOs that just want to “keep the lights on.” Their goal is to just provide the tech and let other people figure out the business. The problem with this thinking is that you’re just making yourself a commodity that’s easily replaceable since you’re not adding to the bottom line of the business.

What’s not illustrated in this graphic is how hard it is to get off the treadmill of putting out fires and starting to think strategically about where you need to take your organization. Those fires feel so pressing that it’s easy to fill all your time with things that don’t strategically help your organization in the long run.

The good news is that the solution is simple. Start allocating more time thinking strategically about what your IT organization is doing to improve your organization by increasing revenue, lowering costs, improving efficiency, and higher quality care. Yes, you still have to balance this with still maintaining the infrastructure. However, I see more and more CIOs delegating the infrastructure challenges so they can spend the time needed to make sure that IT is a strategic part of their organization and not just a commodity service.