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Is Healthcare Delivery Not ‘Sexy’ Enough for Investment?

Posted on September 1, 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.

On the latest #hcldr tweetchat, guest hosts Pam Ressler @pamressler and Pippa Shulman @drpippa posed an interesting question – why hasn’t the delivery of healthcare been an area of innovation? or put another way – is healthcare delivery not sexy enough to warrant investment?

Ressler and Shulman used the example of online retail giant Amazon. Among its many innovations, Amazon came up with a new way to deliver the retail experience. They found a way to deliver goods to people where and when they wanted it. Their approach to delivery was so good that it has since become the expected norm for anything purchased online.

Ressler and Shulman wanted to know why healthcare delivery wasn’t getting the attention it needed.

Shulman’s comment makes for an interesting thought exercise. Instead of just asking what it would be like if Disney ran your hospital. What if we asked what would happen if FedEx, Dominos or Amazon did. It would be fun to see uniformed “delivery agents” speed-walking through the hospital carrying meals and oxygen tanks.

Deanne Kasim @DKasim agreed with Shulman and Ressler:

Kasim’s “need it, want it” statement really struck a chord with the #hcldr community. It’s not just a case of delivering care in the way that patients want it (ie: Telehealth), we need to think about delivering it in when and where patients need it. Telehealth during regular business hours is helpful, but imagine how much more successful it would be if it were available after-hours when most people are home from work. The same with text messaging and email communication.

Kat McDavitt @katmcdavitt tweeted her frustration with this timing mismatch:

Dr. David Tom Cooke @DavidCookeMD went further and provided a great example of how appointment-booking could use an Amazon-upgrade.

Later in the chat, Dr. Cooke provided an compelling idea. Instead of trying to make healthcare delivery attractive for investment by making it “sexy” (which many believed would be very hard), why don’t we just present it as it is – a difficult and challenging problem.

I believe one of the best ways to spur investment is to have a bold pioneer show the world how successful they can be. Amazon showed the world how shopping online could be as-good-as (and now even better than) shopping in-person. FedEx showed us that next-day delivery could be done affordably and reliably. I believe it will take a healthcare pioneer to help blaze the trail for innovation in healthcare delivery.

For a time, Turntable Health in Las Vegas was one such pioneer. Zubin Damania MD, better known as @ZDoggMD, created a wholistic practice – one that made health a relationship rather than a transaction. They used technologies to engage patients in their care and they helped their patients with prevention as much as treatment.

James Legan MD, who practices in Montana, is another pioneer who projects his EHR so that patients can see what he is entering. He has also linked his EHR to a cloud-based customer-relationship-management (CRM) system so that his practice can be more efficient in the way they serve the community.

There are also practices like Access Healthcare in North Carolina and Izbicki Family Medicine in Pennsylvania that are demonstrating the benefits of direct primary care for both patients and physicians.

Hopefully there is a physician practice pioneer out there today that will become the beacon that will attract more investment in healthcare delivery. If you know of one, please email me or put their name in the comments section.

Positive Patient Experience with an EHR is Possible

Posted on August 30, 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 a rare healthcare experience – something that I had only read about in blogs and on Twitter – a physician showed me what he was entering into him EHR while I sat beside him in the exam room! I’m not ashamed to admit that my first thought was “I can’t believe this is really happening”.

The doctor must have noticed how I quickly moved my seat closer to the large monitors because he chuckled and asked me: “How long have you been in healthcare?”. After sharing a laugh he went on to say “It’s rare that patients take a keen interest in what I’m keying into the system. It’s usually other healthcare people that want to see what’s going on. Are you a nurse or a physician?”

When I told him I was in Healthcare IT field he smiled and said “Ah that would have been my third guess.”

For the next 20 min he would type a line of notes, point to the screen and then share his reasoning with me. I asked him questions on clinical terms that I did not understand, at which point he would bring up a resource that had a definition. If he didn’t have a ready resource, he explained it as best he could and then encouraged me to look it up on a trusted site like Mayo Clinic’s.

Near the end of the appointment, the doctor asked me if I was involved with EHRs. When I asked him why, he said the most intriguing thing – “because it’s clear to me that the people who design EHRs (a) have never actually seen a patient in an exam room – it’s ridiculous how awful the screens are and (b) never thought that one day doctors would sit beside patients to let them see what they are entering.”

The latter statement has been churning through my mind ever since.

There is little doubt that the majority of EHRs are less-than-well-designed. Physicians everywhere complain about the amount of clicking required to navigate their EHRs and the number of fields they have to enter. The prevailing opinion is to improve EHRs by getting closer to physicians and actually studying how they really conduct a patient visit. This will certainly yield positive results.

But what if we designed an EHR that was meant to be displayed on a big screen? One that had screens that the patients would see as the doctor entered his or her notes? I believe that designing for this type of usage would result in a more significant improvement in usability and have a more positive impact on patient experience than building EHRs based on better observation of physician workflow.

Consider the phenomenon of open kitchens in the restaurant industry. For diners, being able to watch the kitchen staff prepare meals helps to pass the time while waiting for your order. It also allows the diner to see how talented the chefs are – because they can see them working. For staff, an open kitchen often means that the restaurant has put a lot of thought into optimizing food prep workflow. After all, no one would choose a layout that had staff constantly bumping into each other in full view of diners.

If a company designed an EHR that could be shared with patients, they would not only improve the interface for physicians, but they would also provide a means for that physician to improve the overall patient experience.

I hope that more physicians adopt the practice of sharing their EHR screens with patients during a visit. Doing so will immediately improve patient experience and will push vendors to improve their solutions at a far greater pace.

Everything Old is New Again at Lenovo #HIThinkTank Event

Posted on June 28, 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 in Durham NC, 35 healthcare innovators gathered at the Lenovo offices to discuss three trendy topics: Value-base care, connected health and virtual care. Dubbed the Health Innovation Think Tank #HIThinkTank, it was the first summit-style event hosted by Lenovo Health.

#HIThinkTank was designed to be an opportunity for audience members to learn about the latest innovations from leading academics, technology companies and healthcare organizations. I went into the event expecting to hear about the latest in artificial intelligence, big data, predictive analytics and genomic medicine. It did not turn out to be that kind of event…and it was all the better for it.

I would say that the overall theme of #HIThinkTank was innovation through the application of old ideas in new ways. In other words, everything old is new again in healthcare.

The day started with Rasu Shrestha MD, Chief Innovation Officer at UMPC Enterprises, emphatically stating that we are “in a time of tremendous opportunity in healthcare” and that it was “time for us to move from ‘doing digital’ to truly ‘being digital’”. Shrestha went on to explain that our challenge now was to reimagine clinical processes/workflows in light of modern technologies and methodologies. Like the re-engineering wave that swept through manufacturing in the 1980s, Shrestha believes it’s time to engage all stakeholders and collaborate on reworking healthcare.

Shrestha was followed by Juliet Silver of Perficient who gave us all a dose of reality by telling her personal healthcare story. The day Silver’s husband was diagnosed with cancer was the day she became an advocate – “Google searching and academic research quickly became my constant companions as we struggled to make sense of his disease.” Silver made specific mention of how she had to manually obtain paper copies of her husband’s medical records in order to share them with members of his care team and what a difference that made in his care. She hinted that patients may be the key to truly solving healthcare’s interoperability problem as they are the one stakeholder with the most to lose/gain.

After Silver, several speakers made their case for a return to a more community-based approach to healthcare – one that harkens back to the days of early pioneers when physicians, nurses and members of the community worked together to keep each other healthy.

Holly Miller MD of MedAllies presented the results of a local implementation of CMS’s Comprehensive Primary Care Plus (CPC+) program – a program that stressed simple post-discharge follow-up as a way to reduce readmissions and keep overall healthcare spending to a minimum. Miller specifically mentioned how community doctors do this all the time.

This was echoed by Marty Fattig, CEO of Nemaha County Hospital, a 16-bed facility 60 miles south of Omaha NE. Fattig spoke at length about the successful EHR, HIE data sharing and population health initiatives by his staff. Particularly noteworthy was his repeated statement: “We may not have the financial or technical resources of the large networks, but we get stuff done because we are all driven to improve the health of our community peers. It makes a big difference that we see our patients at church, at the grocery store and at the post office.” Ironically this old fashioned community approach to delivering healthcare is now the goal of many healthcare organizations.

In the afternoon Steve Aylward of Change Healthcare and Dr Sylvan Waller led the discussion on virtual care by first reminding the audience that over 90% of virtual visits still happen via the phone. Video consults is the fastest growing area of virtual care, but it has a long way to go to catch up to the telephone. Dr Waller said it best “In 30 years #telehealth will finally become the overnight success everyone expects it to be”. Both Aylward and Waller stressed that we cannot lose sight of these “older technologies” that work for patients when we think about innovation.

For me, what drove home this theme of old-is-new-again was the afternoon tour of the Lenovo model data center. This new highly efficient and “green” room prominently featured Lenovo’s latest innovation – direct water-cooled servers. The new NeXtScale WCT server series boasts high pressure water lines that physically run through the server and draw heat directly away from the quad CPUs. Back in the early 90’s I remember getting a tour of an IBM facility (not far from Lenovo’s facility in Durham) that still had a functioning 308X mainframe that featured…you guessed it…water cooling technology.

All in all, I walked away from #HIThinkTank feeling encouraged about the future of healthcare. It was refreshing to be at an innovation event and hear about actual successful implementations rather than pie-in-the-sky promises. The event reaffirmed my belief that technology alone is insufficient to fix healthcare. Those of us in HealthIT need to do more than just create cool products, we need to help clients re-engineer their internal processes to better utilize those products to improve community health.

As Dr Shrestha said – It’s time for us to stop doing digital and truly be digital.

#HIMSS17 Mix Tape

Posted on January 24, 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.


On February 19th 2017, the annual HIMSS conference (#HIMSS17) will be held in Orlando FL. It will once again be the largest gathering of Healthcare IT folks in North America with over 45,000 people expected.

Every year I look forward to HIMSS. It is the best place to see what is happening in the industry, hear the challenges that lay ahead and see what the smart minds in #healthIT are investing in. Although the sessions, keynotes and exhibit hall are all amazing, the best part of the conference is meeting people face to face – especially at the meetups and spontaneous get-togethers. I love catching up with friends that I haven’t seen in a year and meeting new ones for the first time.

For the past couple of years, I have used HIMSS as an opportunity to compile a soundtrack for healthcare – a Mix Tape that can be enjoyed during the conference (see last year’s Mix Tape here). This annual HIMSS Mix Tape is a fun way to reflect on where we have been and where we are going. As with prior years, I asked friends and colleagues on social media for the song they believe best represents healthcare. I also asked them to explain their selection.

Below are the songs chosen for the #HIMSS17 Mix Tape. What would your selection be? Let us know in the comments.

Enjoy.

You’ll be back – Hamilton. Chosen by Regina Holliday @ReginaHolliday.

Because that song could be the words of any doctor who wants his patient compliant and silent and any government that denies care. Hence we must have revolution.

Shine – Camouflage. Chosen by Nick Van Terheyden @drnic1.

After many potential choices ranging from the deep and dark Wadruna by Helvegen through “America” by Young the Giant that celebrates the immigration to the uplifting dance song that captured what seemed to transpire for the year was “Don’t Stop the Madness” by DJ Hush and featuring Fatman Scoop (what an awesome name) I settled on Shine. That captured the spirit of what I need this year: This is the world where we have to live / there’s so much that we have to give / so try to Shine Shine Shine within your mind / Shine from the Inside / if you Shine Shine Shine within your mind.

Can’t you hear me knockin – Rolling Stones. Chosen by Linda Sotsky @EMRAnswers.

In my own life, I started my Mothers  fight for data 17 years ago. As collective patients, caregivers and advocates we are STILL  knockin and screamin “give me my damned data” Can’t you hear us knockin?

Faith – George Michael. Chosen by Rasu Shrestha MD @RasuShrestha.

My HIMSS17 playlist is inspired by some of the best singers we said goodbye to in the last 12 months – an acknowledgement that, even as we continue to push the envelope in healthcare in so many ways, life is fragile, beautiful and melodious in every one of our ups and downs. Other finalists: When Doves Cry (Prince), Rebel Rebel (David Bowie) and The Heat is On (Glenn Frey)

We’re not Gonna Take It – Twisted Sister. Chosen by Mandi Bishop @MandiBPro.

The disenfranchised, the chronically or severely ill, the caregivers, and the underserved communities will rise up and be heard in the face of healthcare weaponization. We will not remain silent. We will not take it.

Sit Still Look Pretty – Daya. Chosen by Geeta Nayer MD @gnayyar

I chose this to represent the HIT chicks movement in health tech. Increasingly women are coming to the table and taking senior leadership roles in health tech which we so very much need as women remain the primary healthcare decision maker in the home with “doctor mom” being the go to for any and every illness first! Spouses rely on their wife to be the care takers when parents get older and when kids are sick and need to run to the pediatrician etc. Also, HIMSS for the first time is giving the women in tech awards which itself is a big statement.

Bring on the Rain – Jo Dee Messina and Tim McGraw. Chosen by John Lynn @techguy

We’ve got challenges all around us in healthcare, but I say “Tomorrow’s Another day, and I’m thirsty anyway, so Bring on the Rain.”  Things will get better in healthcare because so many amazing people work in healthcare and battle through the rain.

Cautionary Tale – Dylan LeBlanc. Chosen by Steve Sisko @ShimCode

A cautionary tale is a story with a moral message warning of the consequences of certain actions, inactions, or character flaws. Healthcare players – CMS, other government agencies, large vendor companies, special interest groups and others – seem to be stuck in a continual cycle of Dictate, Demand, Deviate and Destroy. Half-baked programs, ‘standards,’ reimbursement schemes, “quality measures,” and other mandates are dictated to providers, health plans and others on the receiving end.  Then revisions, waivers and deviations are made over the course of a year or two before they’re eventually destroyed. When will we learn from these cautionary tales? Don’t offer up help that you know that I won’t be needin’ / Cause I do it to myself, like I never get tired of bleedin’

You Can’t Always Get What You Want – Rolling Stones. Chosen by Don Lee @dflee30

Too often in healthcare we only want to look at solutions that solve for 100% of the possibilities, have proven ROI and that are already being used by our peers. That severely limits the possibilities for improvement. There’s no such thing as a sure thing. So, for 2017 I hope we can break this cycle and focus on incremental improvements. Take some shots. Be willing to fail. Think: “what can I do today that won’t require a huge budget and 1000 meetings, but might make something 5, 10 or 20% better?”.5% better today is better than “we might possibly be able to be 100% better 36-48 months from now”. So, “you can’t always get what you want, but if you try, sometime you find, you get what you need”

Livin’ On The Edge – Aerosmith. Chosen by Matt Fisher @Matt_R_Fisher

The whole healthcare industry is balancing on a razor’s edge in many respects. What will happen with the ACA, can EMRs meet their promise and what will value based cared do? All of these unanswered questions mean that these lyrics hold true: Tell me what you think about our situation / Complication, aggravation / Is getting to you

One Step Away – Casting Crowns. Chosen by Jennifer Dennard @JennDennard

While it’s a praise song at its core, its title makes me think of how close the healthcare industry is to interoperability. And yet there are still a few “small” hurdles we need to overcome. (Plus, my daughter is singing this song in her school talent show, so I have developed quite a soft spot for it!)

Record Year – Eric Church. Chosen by Joe Lavelle @Resultant

In hope that all my #HealthIT / #PatientAdvocate / #SoMe / #ThoughtLeader colleagues ignore and overcome the nonsense of the current political climate to keep making HUGE progress on the most important healthcare initiatives like Telemedicine, Interoperability, a National Patient ID,  Care Coordination, alternate payment models like Direct Primary Care, and more.  Let’s all have a Record Year in 2017!

Fight Song – Rachel Platten. Chosen by Max Stroud @MMaxwellStroud

This goes out to all the people in HealthIT that are working diligently for their vision of the future of healthcare.   In a year of major political shifts and possible policy changes, it will be important to maintain focus on our passions and continuing to move toward innovation and improvement of HealthIT.   This goes out to patient advocates from #epatients to the walking gallery, To the folks living the #startupgrind because of thier passion for a better tomorrow, and to the #HealthITChicks working towards gender parity. Like a small boat / On the ocean / Sending big waves / Into motion / Like how a single word / Can make a heart open / I might only have one match / But I can make an explosion”

Crosseyed and Painless – Talking Heads. Chosen by David Harlow @healthblawg.

There was a line/ There was a formula. But we are now in a post-factual environment. Facts all come with points of view/ Facts don’t do what I want them to/ Facts just twist the truth around. We need to focus on achievable goals, on implementing solutions that make sense independent of regulatory engines that have driven so much of health IT over the past eight years.

What Do You Mean – Justin Bieber. Chosen by Lygeia Ricciardi @Lygeia

There’s a lot of talk in health IT that you can’t take it at face value. For example, everyone says they support interoperability, and yet… we’re not there yet. Also, there’s a lot of talk about patient engagement, but is it really about involving patients in their care… or just getting them to better “comply”? Finally, is Trump really going to get rid of Obamacare, or just rebrand it? What *do* you mean?

Addicted to Love – Raymond Penfield. Chosen by Charles Webster MD @wareFLO

Raymond Penfield was 94 when he recorded Addicted to Love and became an Youtube sensation. He made it to 98. Here is his obituary. BTW he was a graduate from the University of Illinois as was I! I hope I have as much energy and spirit and health into my 90s!

Video Killed the Radio Star – Buggles. Chosen by Joe Babaian @JoeBabaian

Why? Because times are changing and status quo is being cast aside.

Truckin’ – Grateful Dead. Chosen by Brian Ahier @ahier

Because this ♫♪♪♪♫♪? ♫♪ What a long strange trip it’s been ♫♪♪♪♫♪?

Under Pressure – David Bowie and Queen. Chosen by Colin Hung @Colin_Hung

Healthcare in the US and around the world has never been under more pressure than it has now. Patients are expecting more (as they should!), governments are trying to regulate everything from drug prices to reimbursements, employers are looking to curb healthcare costs and there is tremendous pressure on the healthIT industry to work together. To me, this song is the perfect collaboration – an example of what happens when two amazing artists come together. We need more of this type of collaboration in healthcare. Plus there is one verse that is very applicable to 2017: And love dares you to care for / The people on the (People on streets) edge of the night / And loves (People on streets) dares you to change our way of / Caring about ourselves

For a full #HIMSS17 Mix Tape Playlist on Spotify, click here or play the embedded player below.