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Retail Clinics Are Not the Enemy, Inconvenience Is!

Posted on June 16, 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.

Check out this incredible insight that Gabriel Perna shared on Twitter:

What a great insight and something that most of the entrenched healthcare people don’t understand. Retail clinics are not the enemy, inconvenience is.

In many ways, it reminds me of the approach that taxi cabs took to Uber and Lyft. Taxis described them as evil as opposed to understanding why consumers wanted to use Uber and Lyft instead of a taxi cab. If the taxi cab industry would have understood the conveniences that Uber and Lyft provided customers, they could have replicated it and made Uber and Lyft disappear (or at least they could have battled them more effective than they’ve done to date).

Gabriel Perna further describes the issues of retail clinics and AMA’s approach to retail clinics in his article and this excerpt:

There are many reasons for this phenomenon [growth of retail clinics], but more than anything though, retail clinics are convenient and many physician offices are not. Because of this, the AMA shouldn’t be trying to treat the retail clinics as some kind of foreign invader, but rather use their rise to prominence as a way to guide physician practices forward. For instance, getting in to see a doctor shouldn’t be a three-week endeavor, especially when the patient is sick and needs attention immediately. However, that’s what has happened. Personally, I’ve been told “the doctor doesn’t have anything open for at least a month” more times than I can count.

It’s simple supply and demand. If you or your child needs to see someone immediately because of an illness and your doctor’s office can’t take in you for a week, and there happens to be a retail clinic down the street, guess where you’re going? Any hesitations you may have over your care being fragmented, the limited ability of your retail clinic physician, or anything else will go out the window pretty quickly.

I agree completely with the idea that convenience is key. However, what Gabriel doesn’t point out is that the fact that doctors have a 3 week waiting list for patients is why they don’t care about offering convenience to their patients. They have enough patients and so they don’t see why they should change.

You can imagine the taxi cab industry was in a similar position. They had plenty of people using their taxi service. They didn’t see how this new entrant could cause them trouble because they were unsafe and whatever other reasons they rationalized why the new entrant wouldn’t be accepted by the masses. Are we seeing the same thing with retail clinics vs traditional healthcare? I think so. Will it eventually catch up to them? I think so.

What’s even more interesting in healthcare is that retail clinics are just one thing that’s attacking the status quo. Telemedicine is as well. Home health apps and sensors are. AI is. etc etc etc. All of these have the potential to really disrupt the way we consume healthcare.

The question remains: Will traditional healthcare system be disrupted or will they embrace these changes and make them new tools in how they offer care? It took the taxi cab industry years to adapt and build an app that worked like Uber and Lyft. However, it was too late for them. I don’t think it’s too late for healthcare, but it’s getting close.

The Challenge of Being a Patient with a Rare Disease – #PatientStories

Posted on June 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.

The following is a guest blog post by Chelsea Freund who blogs at The Sick and the Dating. This post is part of our series of Patient Story blog posts where we ask patients to share their first-hand experiences with healthcare.

Do you believe in coincidences? Back in 2007, I decided to go back to school to become an R.N. I had been volunteering at Phoenix Children’s Hospital as a “bedside hugger” – which is exactly what it sounds like – and decided that I wanted to be a pediatric nurse, so I was studying away. The subject was advanced medical terminology, and specifically I was on the GI tract. I had been feeling terrible all day. I hadn’t been able to eat, hadn’t had any appetite. There was a nagging pain on my right side that wouldn’t go away. Finally I forced myself to eat something but it really didn’t sit well and the pain became increasingly worse.

I continued studying. I came across a paragraph or two that outlined the symptoms of appendicitis. I stopped. I thought to myself, “No way.” But by that time I couldn’t completely straighten up, and I re-read the paragraphs again. I probed my lower right quadrant. Yes, pain, there was definitely pain. I was sweating. I was also by myself and feeling a little silly; my roommate was off somewhere with her boyfriend, so it was up to me to make something happen. I had two thoughts: 1) I’ll go to the hospital that’s a mile away, and at worst, I’ll feel like an idiot, and 2) I’m going to check ahead in my book to see what else the universe has in store for me. The next chapter was on the eyes. (This is significant.) I drove myself to the hospital, hobbled up to the front desk doubled over, and it turned out my appendix was close to bursting.

I didn’t get to finish my nursing degree. The school system that I had chosen cut out evening classes for nurses and I needed my day job in the tech field in order to survive. But what I learned in school proved invaluable.

I have three-ring binders full of my medical records that I carry with me to new doctors. In the past almost seven years, I have tallied up all of the new doctors I have seen – including those in the ER – and the count is now at 59. This is where my nursing school comes in handy. I can easily communicate using the correct terminology, plus I understand what they are referring to 98% of the time – rarely do I have to ask for an explanation. Friends tell me either that it was a waste that I went to school and that I didn’t get my degree, or that I can finish it out later, and I tell them that I’m pretty sure that I went for this purpose alone: to be a patient, and specifically to be a rare disease patient.

I have been a patient all of my life. Some people are lucky in that they rarely get sick. I was that kid who always sat out from gym class because my asthma was strangling me, or I was allergic to the chlorine in the pool so I emerged from the water with great, big hives. I was always in the middle of or recovering from some upper respiratory or lung infection.

As a young adult in my 20s, I lost all of my hair over my entire body. It’s okay, I had been losing it in increments when I was much younger; it just decided to take a hike permanently when I hit 28. At age 31, I was diagnosed with Hashimoto’s. It’s also not a show stopper – I just have a really tough time losing weight and controlling my body temperature. Going through nursing school actually gave me an advantage over other students because I already understood these processes, and in turn I had a much easier time communicating with my doctors.

I was 36 when I came down with my mystery disease in July of 2010. I have never cursed my student loans – not once. I didn’t have a lot of catching up to do in the medical field to be my own advocate, because this road has been very lonely. I have to advocate a lot while also being very sick. Not once have I ever had someone come with me to appointments or the hospital.

The very first encounter I had with a neurologist was a disaster, but I knew enough not to take his answer as the final word. He performed an EMG on my limbs, checking me for myasthenia gravis, because my face was paralyzed on one side when I was upright and I would get ptosis in both of my eyelids (but they would go back to normal immediately when I tilted my head parallel to the floor), and I had a lot of trouble walking. We agreed I likely didn’t have MS or even Hashimoto’s encephalopathy according to the MRIs I had done. The EMG came out with normal results. He wrote in my chart that what I had must be psychosomatic and sent me on my way.

I started to do a lot of research at that point. After going through 14 doctors in various disciplines, I ended up being helped by a neurosurgeon through Barrow Neurological Associates in Phoenix, simply because I demanded a lumbar puncture since that was the only test I hadn’t had done in the past year. My symptoms resolved for 12 hours, so we repeated the test 4 days later, and the exact same thing happened. We decided to insert a shunt.

However, we didn’t know I would be allergic to the shunts. I had 10 surgeries in less than 4 years. My body clogs and strangles and breaks the shunts in rebellion, now only days after surgery. My neurosurgeon gave up on trying to keep a working shunt in me. But I feel like we found something out in the process that we wouldn’t have found out if the failures wouldn’t have kept happening only because we moved the location of the shunts, and that is that the membranes in my brain are extra thick. My neurosurgeon has only seen that in one other patient in his lifetime.

After my neurosurgeon stopped operating on me, I moved back to Minnesota so my family could help to care for me – I can’t be upright for any length of time before my face becomes paralyzed and my eyelids are 80% closed, and the pressure in my cranium builds to an intolerable level. After I moved, a former acquaintance happened to find my dormant account on Twitter. He had actually been looking for a former client with the same first name, but was happy to reconnect. When he read my blog, he encouraged me to actively use Twitter to make connections and join chats. It’s because of his tutelage that I’ve been a guest on podcasts, became a product blogger, and have been in contact with various researchers, so I’m forever grateful.

One of the researchers I connected with has discovered the lymph node system in the cranium, which was previously thought not to be present. We traded a few emails, but the biggest barrier is that I’m a human, and he works mainly with rats. It’s a big leap to go from rodent to human in his world, even if we can both see the possibilities. So though there may be some sort of connection between my thick membranes and his newly-discovered brain lymph node drainage system, he’s probably not going to look at me until my brain is ready for slides.

Since I’ve moved to Minnesota, it’s been very difficult to convince doctors to see me, much less keep me as a patient. In fact, after five unsuccessful tries to get in, I now have an official letter from the Mayo Clinic telling me they will not see me because I’m too rare to diagnose or treat. I had one neurologist tell me she was “just a neighborhood neurologist,” so there wasn’t anything she could do for me. I had a rheumatologist tell me to do Thai Chi, and then write in my records that I was being non-compliant for not doing it, even though my severe vertigo doesn’t even allow me to stand in a shower. I’ve had endless doctors pat me on the knee and tell me that they couldn’t help me but they were sure “someone” could.

I finally settled on a neurologist – I think she was the 58th doctor to see me – because she ordered the tests I asked for, and even one I didn’t: I wanted an upright MRI because everything happens with my symptoms when I’m upright, and I got a cognitive function test to boot. When the upright MRI showed that all of my ventricles collapsed and I have a tumor, she attempted to refer me to a neurosurgeon. The neurosurgeon sent a letter back saying that “nothing looked out of the ordinary.” I’m no expert, but then again, I’m no slouch – and I just happen to know that looking at my corpus callosum on the MRI, it should not look like Charlie Brown’s crumpled up hair swoop. The search continues for any neurosurgeon in the state of Minnesota who can handle my case. The neurologist has agreed to keep me as a patient, but her nurse often calls and starts with, “The doctor doesn’t think she needs to see you, but if you feel like you want to see her, you can.” That’s not exactly the welcoming committee.

I do have a few excellent doctors. I wish I could clone my GI doctor and carry him around in my pocket and take him out when I need a pep talk. He has the best bedside manner and has taken the time to talk to me about what is happening with me besides my intestinal tract because he’s truly interested and he wants to help. I think my pain doctor is a standup guy too; he’s in the process of moving to another medical group and deliberately chose one that didn’t have a non-compete clause. It meant less money for him, but it also means he can keep seeing the same patients. He has learned to respect me because he recognizes that I do my research and I’m a rule follower.

I have another doctor and diagnosis simply because of coincidence, and it’s a big one. While I was trekking around and being rejected by so many doctors, a friend called me up and said, “Why don’t you make an appointment with this mast cell activation syndrome doctor? It seems like you have a lot of the symptoms.” I thought to myself, “Well, why not? I’m making all of these appointments. What’s another appointment?” It turns out that that particular doctor takes a year to get into for the initial appointment. There was a cancellation, so I got in within eight months. And I did get the diagnosis. And it’s the reason my body rejects the shunts. And this doctor moved to Minnesota a year before I did. I have been assured that he won’t send me away like all of the other doctors.

So if we are in the same city and we happen to meet, I might show you my stupid human trick, which is to tilt my head so that the fluid moves around in my cranium and my face becomes un-paralyzed and I can see again. If you have the time, I may whip out my binders of medical records. I can explain everything to you. You just need to believe what you are seeing and keep an open mind.

Thanks to Chesea for sharing her story. Be sure to read other

Christina Farr’s TEDx Talk Asks “What If the Patient Knows Best?”

Posted on June 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.

One of my favorite healthcare IT journalists is Christina Farr. She’s skipped around a few publications over the years, but she’s currently writing for CNBC about large tech companies like (Apple, Alphabet(Google), etc) that are getting into the healthcare and biotech world. Plus, she covers a lot of healthcare IT startup companies.

Christina Farr recently gave a TEDx talk at TEDx Oslo where she shared her perspective on the move from a doctor-dominated healthcare model to an empowered patient model where patient and doctor work together to find the best care solution together.

If you care about patients, take 12 minutes to listen to Christina’s TEDx talk embedded below and think about what her message means for you. It’s a good one.

Patient Engagement and Patient Experience

Posted on May 24, 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 got tied up on some big projects today and so for today’s post I’m going to point you to some really great resources being shared around patient engagement and patient experience from the Patient Engagement Summit hosted by the Cleveland Clinic.

Here are two images that were shared from the summit which give you a flavor for the types of conversations and knowledge that was being shared at the Patient Engagement Summit.


Note: Adrienne Boissy, MD, MA, noted that the chart above comes from this article.

You can find more great content like this by checking out the hashtag #PESummit on Twitter.

Myth: Healthcare Is Different From Other Industries

Posted on May 5, 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.

If you don’t follow David Chou on Twitter, then you’re missing out on some really great content. This is particularly true if you’re a healthcare leader. A good example of this was the following tweet that David shared:

The topic of whether healthcare is different from other industries is an important one that’s worth discussing. The chart above and the research by McKinsey&Company would suggest that healthcare isn’t all that different from other industries. However, I think there’s a nuance in their reality check.

The nuance is that healthcare have similar expectations of healthcare as they do with other non-healthcare companies. However, that doesn’t assume that healthcare consumers act the same as they do in other industries.

There are great examples of this. When you’re in the back of an ambulance after a heart attack, you’re not acting like much of a consumer. They’re taking you to the hospital of their choice and you’re going to largely get the care that the ED feels you need. In what other industry does this occur? There are other examples like elective procedures in healthcare that are very much an experience like other industries.

What the study illustrated above does teach us is that even if the consumer decision making process in healthcare is different, there are core expectations that we have regardless of how we chose to interact with the healthcare system or not. There are some universal tenants and expectations that healthcare should remember:

  • Providing great customer service
  • Delivering on expectations
  • Making life easier
  • Offering great value

I’ve started to see more and more healthcare organizations worry about these tenants of a great patient experience. When you see it broken out like the above, it sounds so simple. Implementing the ideas can be amazingly tricky. However, this is exactly where I see healthcare headed.

The Disconnect Between Where Wearables Are Needed and Where Wearables are Used

Posted on April 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.

No one can argue that we haven’t seen an explosion of wearable devices in the healthcare space. In most cases, they’ve been a consumer purchase, but there are a few cases of them being used clinically. While we’ve seen a huge uptick in wearable use, there seems to be a massive disconnect between those who use them and those who need to use them.

This was highlighted to me recently when I heard someone say that at the recent Boston Marathon they predicted that almost every athlete running the Boston Marathon had some sort of tracking device on them to track their running. Runners love to track everything from steps to heart rate to speed and everything in between. I wish the Boston Marathon did a survey to know what devices the runners used. That would be a fascinating view into which wearables are most popular, but I digress.

When I heard this person make this observation, I quickly thought “That’s not who we need using wearables if we want to lower the cost of healthcare.”

With some exceptions, those who run the Boston Marathon are in incredible shape. They exercise a lot (maybe too much in some cases) and most of them eat quite healthy. These are the outliers and my guess is that they’re not the people that are costing our healthcare system so much money. That seems like a fair assumption to me.

Yes, the people we need using these wearables are those people sitting on the couch back at home. We need the unhealthy people tracking their health, not healthy people. While not always the case, unhealthy people don’t really want to track their health. What’s more demotivating to your healthy goals than being in a FitBit group with a marthon runner that always destroys you?

This is a challenging psychological problem that I haven’t seen any wearable company address. I guess there’s too much money to be made with healthy people that want to track themselves that they don’t need to dive into the psychological impact of wearables on unhealthy people. However, that’s exactly what we’re going to need to do as wearables become more clinically relevant and can help us better understand a patient’s health.

The Personalization of Healthcare and Healthcare Chatbots

Posted on April 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.

At HIMSS 2017, I did a plethora of videos where I was interviewing people and even more where people were interviewing me. Many of those videos are just now starting to leak out onto the internet. One of those videos where I was interviewed was with the team from Availity. They had a great team there that interviewed a bunch of the HIMSS Social Media Ambassadors including me.

I’ll admit that I was pretty tired when I did this interview at the end of the day, right before the New Media Meetup at HIMSS. However, I think the interview shares some high-level views on what’s happening in healthcare IT and important topics coming out of the conference. Check out the full video to learn the details:

I like that I talked about the personalization of healthcare and then healthcare chatbots in the same video interview. Some people might see these as opposites. How can talking with a healthcare chatbot be more personal than a human?

The answer to that question has two parts. First, a chatbot can quickly analyze a lot more information to personalize the experience than a human can do. Notice that I said personalization and not personal. There’s a subtle but important difference in those two words. Second, I didn’t clarify this in the video, but the healthcare chatbot will not fully replace the care provider. Instead, it will just replace the care provider from having to do the mundane tasks that the providers hate doing. Done correctly, the healthcare chatbot will fee up the providers to be able to focus on providing patients a more personalized and personal experience. That’s something we would all welcome in healthcare.

All of this health data we are amassing on patients is going to make both the healthcare chatbot and the human healthcare provider better able to give you a personalized experience. That’s a great thing.

Since in the video I also recommended that people follow Rasu Shrestha, MD, you may also want to check out the video interview Rasu did with Availity:

I love the idea that we go to conferences to not just learn something, but to unlearn things. Rasu is great!

Patient Access to Health Information is a Right

Posted on April 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.

I was browsing some old notes I’d taken to interesting resources and ideas. I came across some videos that ONC had created around the rights of patients when it comes to accessing health information.

Here’s a look at the first video:

The video is 3 minutes long and the information could have been shared in 30 seconds, but some of the points it shares are really good. For example, that it’s your right to be able to access your health information. Also, they make the point that you still have the right to get access to your health information even if you haven’t paid your bill.

It’s always amazing to me how many misconceptions there are out there when it comes to access to health information. We see HIPAA and other rules used as a reason to not provide patients their health information a lot and it’s often wrong.

The great thing is that over the 11 years I’ve been blogging, we’ve seen a real sea change in people’s perspectives on how and when you should have access to your patient record. That said, we still have a ways to go. Technology should make that record available to you whenever and wherever you want in near real time fashion. We see that in some organizations, but not enough.

These videos will never go viral, but they are a good information source for those patients who aren’t sure about their rights when it comes to access to their health information.

The Physician – Patient Disconnect

Posted on April 13, 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.

If you’ve been in healthcare for a while, then you know that there’s often a disconnect between patients and healthcare professionals. However, this divide was illustrated pretty sharply in some research that Conduent (previously known as Xerox) put out about the relationship.

Plus, to add to this disconnect, there was an even bigger divide between patients from different ages. In fact, they’re a very heterogeneous group. However, so many healthcare organizations treat them the same.

For a good illustration of these differences, take a second to look at this infographic:

The Sad State of Healthcare – Fun Friday

Posted on March 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 and so I often like to do something a little bit more fun as we head into the weekend. We call it Fun Friday. So, today I want to share two healthcare cartoons. They’re pretty funny, but they also kind of make you sick when you realize the truths that they illustrate. Hopefully, these cartoons can help remind us about some of the real problems we need to deal with in healthcare.

I’m sure a lot of us have had this experience. It’s sad that it happens as much as it does. We can certainly do better. Doctors and patients need us to do better.

This next cartoon seems appropriate given the current conversation about healthcare reform. It reminds me that there are a lot of factors that influence our healthcare costs and the legislation I’ve seen doesn’t do anything for a lot of the problem areas. To quote my friend Neil Versel from Meaningful Health IT News, “Health insurance is not health care.” He’s right and that seems to be getting lost in the current healthcare reform discussion and legislation.