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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.

A Missing and Ignored Patient Narrative

Posted on February 24, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Sometimes I feel like the discussion of the patient narrative and open notes make me want to scream.  Step away from the new Health trend and back to improving access for every patient. Patient Experience and specifically Patient Narrative has been a theme of the HIMSS healthcare conference this year, from patient data and records to open notes and patient advocates. I have to admit- I love watching what people have done and what companies think of.

It reminds me of my German class on the Literature of the Holocaust. Our professor stood up and introduced the Holocaust as unique because the German Jews could read and write, so they had records. Without records, the voices of countless have been lost. Their voices died with them. Patient Narrative is similar. It’s teaching us so much about better workflow and records and getting better outcomes. Max Stroud gave a great presentation about her sister’s experience with lung cancer and managing patient records. They both admitted that it was difficult for them despite being well educated and knowledgeable about healthcare.

At HIMSS everyone looks at shiny new products with novelty pens and some alternate universe where it makes sense that we all need another plug in to our electronic medical record to really “make a difference” for patient health.

Right before HIMSS some of my late husband’s medical school classmates came to visit me and go to ongoing education in Park City. I asked them what they thought about patient involvement and one of them discussed the reality of emergency room care in impoverished areas.  They discussed losing faith in patients and how to deal with trauma patients. I remember the jokes about drug seekers. I told them about being at dinner in suburban Utah when an acquaintance casually mentioned we should do Molly on our way to yoga. The doctors I told laughed it off and said Molly really wasn’t that serious. Those narratives aren’t on our health records and the healthcare system is hemorrhaging cost with its lack of ability to treat them. Patients in some rural areas have access to care issues that telehealth doesn’t always bridge the gap for.

Is patient narrative just the next buzzword so we can distract ourselves from poverty and violence and human trafficking and corporate identity theft? Are we just talking louder to drown out the patients that healthcare is failing? Not every company or hospital group can afford to go to HIMSS. Participants have relatively good access to care and a lifestyle of relative privilege. Exhibitors are selling something and it certainly isn’t about the unglamorous parts of medicine.  The undocumented patient narrative will never climb the walls of privilege in a system with an entire industry of payor complexity and government regulation.  There were so many companies and even in telemedicine in rural areas and patient narrative presentations I didn’t see the patient stories like the ones I heard from my friends.

We are distracting ourselves from the complete lack of availability of care for economically disadvantaged patients by geeking out over the shiny data with our fellow zealots.  We can learn new things and find interesting new companies and many places are getting better, but we need a new record and involvement from a group that could never come to HIMSS. A narrative for the illiterate, uninformed, impoverished forgotten stories.

 

“We’re All Patients”

Posted on February 15, 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.

Ever since the first #HITsm Chat of the year, I’ve been rolling around the idea of “We’re All Patients.” It was kicked off by what I think was probably a well-intentioned tweet by Andrey Ostrovsky, MD who asked to hear from patients:

This led someone to say “Aren’t we all patients at some point?” which got this response from Erin Gilmer along with a whole firestorm of other comments:

First, let’s applaud Dr. Ostrovsky for asking for the patient perspective and let’s not let the firestorm of defining patients overwhelm the fact that he wanted to hear from patients. That’s a dramatic shift from the past where patients might have been an afterthought. Dr. Ostrovsky was asking for patient input 11 minutes into a 1 hour chat. That’s a big improvement.

Second, if you look at the literal definition of patient, it says “a person receiving or registered to receive medical treatment.” By pure technical definition, it’s true that we’re all patients. Hard to imagine an adult that hasn’t received medical treatment at some point. However, when we say that “We’re all patients” it misses the point of why I think Erin Gilmer and Carolyn Thomas, who wrote the post that Erin linked to, said that we’re not all patients.

The reality is that even if we’ve all been to a doctor before, it doesn’t mean that we’re talking from our view as a patient. Many times when you go to a conference or are participating on a Twitter chat, you’re not having a discussion from your view as a patient. Often you’re talking from a work perspective or from a provider perspective and not from a patient perspective.

We know this happens a lot because you’ll often hear at conferences “This isn’t what I want personally, but this is my perspective on it.” Just because you have been a patient at one point doesn’t mean you’re speaking from that perspective at a conference, Twitter chat, blog post, etc. That’s true for me too when writing these blog posts. I’ll write from a wide variety of perspectives depending on the topic and post. It’s often not from the patient perspective.

Along with not necessarily speaking from your own patient perspective, it’s fair to say that just because you were a patient for some “injury or episode of illness”, it doesn’t mean you can share the perspective of a patient with a chronic condition. That’s a very different situation and one that largely has to be lived to fully comprehend.

The reality is that we need to involve as many different patient voices in our discussions as possible if we want to create solutions that benefit patients the most. On that, I think almost everyone agrees. Studies have shown that having a wide diversity of viewpoints, opinions, and perspectives provides a much better solution.

At the end of the day, we can all only share our own personal experience. I don’t want chronic patients talking for me. Chronic patients don’t want non-chronic patients talking for them. In fact, many chronic patients don’t want other chronic patients talking for them. etc etc etc

Instead, we should do everything we can to incorporate multiple perspectives into all the work we do. That’s where we’ll get the best results. We shouldn’t be so arrogant that we try to speak for someone else. However, we also shouldn’t demonize someone that tries to show empathy and raises the voice of another’s perspective either. The reality of complex problems is that we can all be right depending on perspective. So, let’s embrace as many perspectives as possible. We are all humans and most of us want healthcare to be better.

UPDATE: In a great discussion on Twitter with Erin Gilmer that was prompted by this post, Erin highlights a point that I didn’t cover well in the above commentary. She pointed out that many chronic patients’ voices have been marginalized in the past. I’d take it even a step further and say they’ve not only been marginalized but often ignored.

The reality is that the “healthy” patients have more voices making sure their (my) needs are heard. Chronic patients are smaller in number and so it’s more challenging to have their voices heard. Not to mention the last thing you want to do when you’re dealing with chronic illness is make your voice heard. However, in an impressive manner, many patients with debilitating illnesses do just that.

Erin also made a good point that we shouldn’t use “We are all patients” as an excuse to not involve expert patients at the table. We should definitely elevate their voices. As an advisor to many health IT startup companies and having written about thousands of companies, the challenge of incorporating all these voices and perspectives into a product is impossible. There are always gives and takes with limited resources. However, far too many don’t even make a sincere effort. That’s what’s sad.

This post is about elevating more patient voices from a wide variety of perspectives. That produces the best outcomes and discussions.

Are the Independent Doctors that Remain the Disruptors, the Tough Ones?

Posted on February 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.

We’ve seen a dramatic shift in healthcare over the past 3-5 years. More and more small group and independent practices have been selling to much larger health systems. Plus, we’ve seen a consolidation of health systems as well. The move to larger and larger health organizations has happened and I’ve heard many predict that we’ll never go back.

While I know there are pressures that indicate this might be the case, I also wonder if the independent doctors and small group practices that remain are the real industry disruptors. Are they the tough ones that survived through the challenging healthcare environment?

With this thought in mind, I looked up the definition of “survival of the fittest”:

the continued existence of organisms that are best adapted to their environment, with the extinction of others, as a concept in the Darwinian theory of evolution.

Sounds a bit like the independent practice to me. Those independent practices that still exist have had to adapt to the changing healthcare world. The ones that remain are likely the most “fit”. We’ve also seen a lot of other independent practices go “extinct.”

Does this give us hope? On the one hand, I can see how those independent practices that remain are strong and can adapt well. I hope that they do it so well that they disrupt the whole healthcare system in a good way. I think that the health system is generally better with more independent practices. There are a certain ownership and patient kinship that happens with independent practices that is often missing in larger health systems that treat doctors like machines that need to produce certain numbers. It’s unfortunate for healthcare that this is being lost.

The thing that scares me most about this trend is that most of the independent doctors seem to be older doctors. Most of the younger doctors I know are just fine going to the large health systems. They don’t want to take on the risk of starting their own practice. If the younger generation isn’t willing to fight the independent practice fight, then independent practices will die.

How many doctors at large health systems have created real disruptive innovation? Not very many. That’s a scary thought that should all have us worried about the future of the independent doctor. Once it’s gone. It will be hard to see how it could come back.

If you don’t think this is a big deal. Think back to the last time you called your cable provider. There’s a reason they’re ranked the lowest in customer service. They have very little competition to force their hand. The loss of independent practices will mean very little competition for the big healthcare organizations. That’s a bad thing for all of us.

What do you think about independent practices? Are the ones that remain the strong ones? Will the independent practices survive in healthcare? I look forward to reading your thoughts on social media and in the comments.

The Quality Disconnect in Healthcare

Posted on February 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.

There’s a big problem with the current healthcare model. There’s no real financial incentive to make sure you’re practicing the highest quality care possible. Doctors don’t get paid for quality. Patients don’t select a doctor based on the clinical quality of the doctor since the patient has no way of measuring a doctor’s clinical quality. The clinical quality a doctor provides doesn’t move the needle on her business.

Certainly, I’m not saying that doctors don’t provide quality care. It is also true that over time a doctor could grow a reputation as a poor quality doctor, but those are usually only the extreme cases that end up in court with big medical class action lawsuits.

What’s amazing is that most doctors can’t event evaluate the quality of another doctor. An orthopedic surgeon has no way to evaluate how well an ENT is doing quality wise. Doctors of the same specialty could evaluate a colleague’s clinical quality, but that doesn’t happen in the current system.

In a perfect world, we could create payments based on the quality of care a doctor provides. That makes a lot of sense and it’s what we do in a lot of other industries. We pay people who provide higher quality more than we pay people who provide lower quality. The problem in healthcare is that we don’t have any good way to measure quality.

While I believe there’s no good way to measure quality, that doesn’t mean that it won’t keep organizations from trying. In fact, that’s the basis of much of MACRA and the PQRS program before it. Same goes for Accountable Care Organizations (ACOs). These are all efforts to evaluate the quality of care that’s being given and reimburse based on those quality indicators. Most doctors will tell you, that’s not a very good system if you want quality.

What’s screwed up about these quality measures is that they do nothing to actually lower the cost of healthcare. Poor quality care only represents a small portion of the massive premium we pay for healthcare in the US. The real costs come from outrageous drug pricing, pallative care, medical liability fears, and chronic conditions. Those are the four areas we should really be focusing our efforts on. The problem is that there’s not a lot of will in healthcare to address these challenging issues.

Slick Setups to Make Your Health Clinic’s Processes Simple

Posted on December 26, 2016 I Written By

The following is a guest blog post by Eileen O’Shanassy.

Medical technologies have come a long way since the days of manual appointment and check-in books, clip-board health information, gathering forms, and huge patient medical chart walls. Today, health clinics can enjoy far more simple and efficient processes with only a few changes to traditional methods of providing healthcare. Consider these following four easy-to-use and inexpensive technologies for your own health clinic.

Touchscreen Check-In Desks
You do not have to pay your front office staff any longer to check in patients. With this slick setup, a patient walks up to a desk that features a wide, large LCD monitor located inside the waiting room or near the receptionist’s desk. Instructions at this touchscreen check-in desk explain to the patient that they only need to tap the screen and then tap out the letters of their name using large virtual buttons to check themselves into your clinic. In some clinics that offer a variety of diagnostic and treatment services, patients also select a clinic area.

Health Information Kiosks
A lot of front office staff time is wasted every day providing patients with information that is already available on your clinic’s website or local affiliated health system’s site. With the slick setup of a health information kiosk, your front office staff can direct patients to the kiosk and return to other tasks. Beyond information about the services offered at your clinic and local healthcare systems, health information kiosks can also be set up to provide patients local news and weather conditions, health and safety tips, emergency alerts, and even details about local restaurants and businesses.

Identification Scanning Software
One of the slowest processes at a clinic with new patients is establishing a record that contains accurate personal and health information. Some healthcare systems now provide clinics with the ability to quickly access information about patients already in their medical data storage programs. This is done electronically via scanning software that can be used with a patient’s driver’s license, medical insurance card, or a special system healthcare card. This type of slick setup also makes it possible for your clinic to save important information about a patient who is entirely new to the area and share it with local specialists and their staff members in hospital and other facilities.

These are only a few examples of the types of slick setups that can make traditional processes in your health clinic simple. These and other cutting edge methods can also result in positive testimonials that attract more new patients to your clinic.

About Eileen O’Shanassy
Eileen O’Shanassy is a freelance writer and blogger based out of Flagstaff, AZ. She writes on a variety of topics and loves to research and write. She enjoys baking, biking, and kayaking. Check out her Twitter @eileenoshanassy. For more information on medical data storage and new technology check out Health Data Archiver.