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Physician Burnout

Posted on July 26, 2016 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 the HIMSS Annual conference, I talked with Vishal Gandhi, CEO of ClinicSpectrum, about a popular topic at the conference and well beyond: Physician Burnout. You can watch the full video interview I did with Vishal below:

Physician Burnout is such an important topic and I love that Vishal commented that physician satisfaction (the remedy to burnout) is good patient care and an appropriate reward. As it is today, the trend is to ask doctors to compromise good patient care and we’re paying them less in the process. Is there any wonder why physician burnout is so rampant?

Vishal also commented that healthcare technology is used more for documentation than patient care. He argued that the tech piece has focused far too much on documentation as opposed to focusing on the patient. I’d argue that if we focused the tech on the patient, doctors would appreciate technology much more and would be less burnt out.

Finally, I’m always interested to hear what non-EHR technologies Vishal and ClinicSpectrum have launched to make a practice more efficient and profitable. He outlines a bunch of them in the video above. Take a listen and see if some of them can make your life easier and your practice more profitable. It’s time we start considering technology outside the EHR that can make a practice better.

What is MACRA? – MACRA Monday

Posted on July 25, 2016 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.

As we mentioned at the end of last week, we’re excited to start a new series of blog posts called MACRA Monday. Over the next months (and possibly year(s)), each Monday we’ll step through the MACRA legislation and share the details of MACRA with you the reader. Many of you might have read our Meaningful Use Monday series which we wrote for a couple years leading up to meaningful use. This will be similar. You can find all the latest MACRA Monday posts here.

Before we begin, it’s worth mentioning that CMS has posted all the latest updates and details related to MACRA here. That’s largely where we’ll get our information for this series, but hopefully we can provide it to you in a more digestible format. Plus, we’ll add in our own opinions, views, and comments that will hopefully add even more value. At the end of the day, like it or not MACRA and value based care is heading your way. Knowing the details about it will better help you make decisions for the future of your practice.

In all of the CMS presentations on MACRA, they always start off with a slide that includes the same image. So, I thought it would be appropriate to start off MACRA Mondays with this image as well.
CMS Move to Value
No matter what happens to MACRA and other government programs, this slide illustrates the goals that CMS wants to achieve in healthcare. They want to shift the reimbursement from the current fee for service model into alternative payment models that pay for quality and value. CMS has said that they’ve already achieved their 30% goal for 2016. I think they’re being generous with their numbers, but that’s a topic for another day. Regardless of the details, CMS has clear goals to shift the healthcare system to a value based care model. MACRA is one major element of that effort.

What is MACRA?
The recent study by Deloitte found that a large portion of doctors are unaware of MACRA. Some had heard of MACRA, but didn’t know any more details. That’s a pretty scary thing considering MACRA will impact most ambulatory practices that participate in Medicare.

At the core of the MACRA legislation was two main goals: replace the Sustainable Growth Rate (SGR) and create a single framework – quality payment program. In the case of SGR, MACRA was the long-term solution to the annual “Doc Fix” or “SGR Fix” which literally shut down our government as congress debated how to address it. Along with replacing SGR, MACRA also streamlined multiple quality reporting programs into APMs (Advanced Alternative Payment Models) and MIPS (Merit-based Incentive Payment System).

We’ll talk in more detail in future MACRA Mondays about which programs ended up where and what they look like under MACRA. For now, we’ll just say that the new APM and MIPS programs consolidated programs such as PQRS, the Value Based Modifier, Meaningful Use (Officially called the Medicare EHR Incentive Program), ACOs, and PCMH to name a few.

Before I end this intro to MACRA, it’s worth noting that the MACRA rule is still only a proposed rule. So, everything we talk about now is talking about what’s part of the proposed rule. Certainly, any and all of this could change. The MACRA comment period ended June 27, 2016 and CMS received 3,710 formal comments (some of them extremely lengthy). However, given past changes to proposed rules (or lack thereof), I’d be surprised if anything changed too dramatically. We’ll talk more about possible changes in a future post.

We’ll be back next week with another MACRA Monday talking about who will be impacted by MACRA and whether your practice should be worried about participating in the APM or MIPS program.

What’s the Impact of MACRA on Small Practices?

Posted on July 22, 2016 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 recently had a chance to sit down and chat with Tom Giannulli, MD, Chief Medical Officer of Kareo and Michael Sherling, MD, MBA, Chief Medical Officer and Co-founder of Modernizing Medicine, to talk about the impact of the MACRA legislation on small practices. Both of these CMOs at EHR vendors rode the meaningful use wave and now they’re preparing to ride the new MACRA wave as well. So, they were the perfect people to talk about the impact of MACRA on small practices and how a small practice should prepare themselves for the new MACRA legislation. If you’re a small practice that’s wondering about MACRA (or doesn’t even know what it is), then take the time to watch the video below to see what it means for small practices.

After our formal interviews, we always like to hold what we call the “after party.” We never know how it’s going to go. Sometimes people join in and offer their insights and ask questions and sometimes they don’t. In this case, we continued our conversation about the MACRA and small practices, but we also talked about the impact that legislation like MACRA has on an EHR vendors development lifecycle. You can learn more about MACRA in the video below:

This post was a great way to wrap up the week and also for us to announce a new blog post series we’re starting on Monday called MACRA Monday. Long time readers may remember the Meaningful Use Monday series of blog posts we did every Monday for a few years. This will be similar as we dive into the MACRA legislation and help small medical practices understand the details of what’s coming in MACRA. Watch for that on Monday!

Team Training Can Produce Great Results

Posted on July 21, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study suggests that team training of healthcare staffers can cut patient mortality and also reduce medical errors. The study, which was conducted by multiple universities and two federal agencies, also found that such training improved staff members’ learning skills and use of such skills, as well as boosting financial outcomes, clinical performance and patient satisfaction.

Participants in the research program included Rice University, the Johns Hopkins University School of Medicine, the University of Central Florida, the U.S. Department of Defense and the Michael E. DeBakey VA Medical Center. The researchers conducted a meta-analysis of 129 prior studies, which looked at programs designed to improve team-based knowledge, skills, attitudes and problem-solving interactions, as well as developing coordination, cooperation, communication and leadership skills.

To conduct their analysis, researchers looked at the impact of team training programs among 23,018 participants. The studies being analyzed looked at how team training affected quality of care, customer service, patient satisfaction and other relevant variables. Participants in the team trainings included clinicians, allied health staffers, support staffers and healthcare students. The trainings were conducted at facilities ranging from small clinics to large hospitals in the U.S. and abroad.

Researchers found that team training can reduce patient mortality by 15%, and reduce medical errors by 19%. The training program also boosted employees’ learning of new skills by 31% and on-the-job use of such skills by 25%. In addition, the training improved financial outcomes of healthcare organizations by 15%. And team training was associated with a 34% improvement in clinical performance and 15% growth in patient satisfaction, researchers said.

While this study didn’t address health IT teams, it’s easy to see how such cross-disciplinary efforts might help IT staffers succeed.

As Rick Krohn of HealthDataManagement aptly puts it, health IT teams often cope with “a spaghetti bowl of boutique applications, systems and external linkages,” which creates major stresses and leaves little time for outreach. In other words, as things stand, keeping rank and file HIT staffers from burning out is a challenge – and keeping them aware of end user needs is a daunting task.

But if health IT managers have at least sporadic team meetings with outside departments that depend on them – including clinical, financial and operational units – a big uptick in learning, sharing and coordination may be possible. As the study underscores, people have to be taught how to work with their partners in the organization, no matter how professional everyone is. Fostering a cooperative exchange between health IT front-liners and users can make that happen.

Artificial Intelligence Can Improve Healthcare

Posted on July 20, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In recent times, there has been a lot of discussion of artificial intelligence in public forums, some generated by thought leaders like Bill Gates and Stephen Hawking. Late last year Hawking actually argued that artificial intelligence “could spell the end of the human race.”

But most scientists and researchers don’t seem to be as worried as Gates and Hawking. They contend that while machines and software may do an increasingly better job of imitating human intelligence, there’s no foreseeable way in which they could become a self-conscious threat to humanity.

In fact, it seems far more likely that AI will work to serve human needs, including healthcare improvement. Here’s five examples of how AI could help bring us smarter medicine (courtesy of Fast Company):

  1. Diagnosing disease:

Want to improve diagnostic accuracy? Companies like Enlitic may help. Enlitic is studying massive numbers of medical images to help radiologists pick up small details like tiny fractures and tumors.

  1. Medication management

Here’s a twist on traditional med management strategies. The AiCure app is leveraging a smartphone webcam, in tandem with AI technology, to learn whether patients are adhering to their prescription regimen.

  1. Virtual clinicians

Though it may sound daring, a few healthcare leaders are considering giving no-humans-involved health advice a try. Some are turning to startup Sense.ly, which offers a virtual nurse, Molly. The Sense.ly interface uses machine learning to help care for chronically-ill patients between doctor’s visits.

  1. Drug creation:

AI may soon speed up the development of pharmaceutical drugs. Vendors in this field include Atomwise, whose technology leverages supercomputers to dig up therapies for database of molecular structures, and Berg Health, which studies data on why some people survive diseases.

  1. Precision medicine:

Working as part of a broader effort seeking targeted diagnoses and treatments for individuals, startup Deep Genomics is wrangling huge data sets of genetic information in an effort to find mutations and linkages to disease.

In addition to all of these clinically-oriented efforts, which seem quite promising in and of themselves, it seems clear that there are endless ways in which computing firepower, big data and AI could come together to help healthcare business operations.

Just to name the first applications that popped into my head, consider the impact AI could have on patient scheduling, particularly in high-volume hostile environments. What about using such technology to do a better job of predicting what approaches work best for collecting patient balances, and even to execute those efforts is sophisticated way?

And of course, there are countless other ways in which AI could help providers leverage clinical data in real time. Sure, EMR vendors are already rolling out technology attempting to help hospitals target emergent conditions (such as sepsis), but what if AI logic could go beyond condition-specific modules to proactively predicting a much broader range of problems?

The truth is, I don’t claim to have a specific expertise in AI, so my guesses on what applications makes sense are no better than any other observer’s. On the other hand, though, if anyone reading this has cool stories to tell about what they’re doing with AI technology I’d love to hear them.

Study: Doctors Made More Note-Taking Errors With EHRs Than Paper

Posted on July 19, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study appearing in the Journal of the American Medical Informatics Association has concluded that a sample group of physicians made more data entry errors with a new EHR than in comparable paper records, according to a HealthcareITNews item.

Researchers studied progress notes created at a Michigan hospital, Beaumont Hospital of Royal Oak, Michigan, between August 2011 and July 2013. They looked at 500 notes created during that period, some of which were prepared before the EHR implementation in 2012 and some after. The charts contained five specific diagnoses which always include physical findings, including permanent atrial fibrillation, aortic stenosis, intubation, lower limb amputation and cerebrovascular accident with hemiparesis.

Upon analysis, they found that rates of inaccurate documentation were 24.4% with the EHR, versus 4.4% with paper records. Residents had fewer inaccuracies (5.3% vs. 17.3%) and omissions (16.8% vs. 33.9%) than attending physicians.

While this is no reason to throw the EHR baby out with the bathwater – after all, the physicians in question were learning a system for the first time – it’s still a troubling set of statistics. They are even more troubling given that EHR documentation errors can sometimes create patient safety problems of their own, especially in fast-moving care settings like the emergency department.

“There are new categories of patient safety errors” taking place in EDs that didn’t exist before EHR use became commonplace, according to Raj Ratwani, scientific director for MedStar Health’s National Center for Human Factors in Healthcare in Washington, D.C., who spoke with Kaiser Health News. For example, EHRs that only allow doctors to edit records for one patient at a time can make it harder to track ED patients, according to MedStar physician Zach Hettinger.

Without a doubt, the healthcare industry can’t afford to have its IT infrastructure creating new categories of safety errors or even making mistake-ridden documentation more common. Not only does this defeat the key goals for putting EHRs in place (improving care quality and efficiency), it could lead to a net increase in safety problems.

But as peanut-gallery observers like myself have been shouting for ages, the answer to the problem is fairly straightforward. EHR user interaction design has to be improved dramatically, and soon. This isn’t exactly a secret, but it seems that the issue is still treated largely as an academic discussion rather than one of immediate practical importance for providers.

I’m not sure why we haven’t made more progress on the user experience front in EHR design – or rather, which of the reasons can actually be addressed in our lifetime – but something’s gotta give.

Physicians Still Struggle To Find EHR Value

Posted on July 18, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study by Physicians Practice magazine suggests that medical groups still aren’t getting what they want out of their EHRs, with nearly one-fifth reporting that they’re still struggling with an EHR-related drop in productivity and others still trying to optimize their system.

Physicians Practice surveyed 1,568 physicians, advanced practice providers across the U.S. as part of its 2016 Technology Survey. Nearly a third of respondents (31.9%) were in solo practice, and 34% in 2 to 5 physician practices, with percentages largely dropping as practice sizes grew larger.

Specialties represented included pediatrics (17.5%), family medicine (16.2%), OB/GYN (15.2%), psychiatry (12%), internal medicine (10.6%), surgery (2.9%), general practice (2.7%) and “other” at 22.9% (led by ophthalmology). As to business models, 63.3% of practices were independently-owned, 27.9% were part of an integrated delivery network and the remaining 8.8% were “other,” led by federally-qualified health centers.

Here’s some interesting data points from the survey, with my take:

  • Almost 40% of EHR users are struggling to get value out of their system: When asked what their most pressing technology problem was, 20.3% said it was optimizing use of their EHR, 18.9% a drop in productivity due to their EHR, and 12.9% a lack of interoperability between EHRs. Both EHR implementation and costs to implement and use technologies came in at 8%.
  • EHR rollouts are maturing, but many practices are lagging: About 59% of respondents had a fully-implemented EHR in place, with 14.5% using a system provided by a hospital or corporate parent. But 16.8% didn’t have an EHR, and 9.5% had selected an EHR (or a corporate parent had done so for them) but hadn’t fully implemented or optimized yet.
  • Many practices that skip EHRs don’t think they’re worth the trouble and expense: Almost 41% of respondents who don’t have a system in place said that they don’t believe it would improve patient care, 24.4% said that such systems are too expensive. A small but meaningful subset of the non-users (6.6%) said they’d “heard too many horror stories.”
  • Medical group EHR implementations are fairly slow, with more than one-quarter limping on for over a year: More than a third (37.2%) of practices reported that full implementation and training took up to six months, 21.2% said it took more than six months and less than a year, 12.8% said more than a year but less than 18 months, and 15.7% at more than 18 months.
  • Most practices haven’t seen a penny of return on their EHR investment: While just about one-quarter of respondents (25.7%) reported that they’d gotten ROI from their system, almost three-quarters (74.3%) said they had not.
  • Loyalty to EHR vendors is lukewarm at best: When asked how they felt about their EHR vendor, 39.7% said they were satisfied and would recommend them, but felt other vendors would be just as good. Just over 16% said they were very satisfied. Meanwhile, more than 17% were either dissatisfied and regretted their purchase or ready to switch to another system.
  • The big EHR switchout isn’t just for hospitals: While 62.1% of respondents said that the EHR they had in place was their first, 27.1% were on their second system, and 10.8% their third or more.

If you want to learn more, I recommend the report highly (click here to get it). But it doesn’t take a weatherman to see which way these winds are blowing. Clearly, many practices still need a hand in getting something worthwhile from their EHR, and I hope they get it.

CMS Opens Door to Possible MACRA Delay

Posted on July 15, 2016 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.

In related news to yesterday’s meaningful use REBOOT relief legislation, Andy Slavitt, Acting Administrator of CMS, testified about MACRA before the Senate Finance committee. In his hearing, Senator Orrin Hatch (R-Utah), chairman of the committee commented “Physicians will only have about two months before the program goes live. This seems to be a legitimate concern. Considering the MACRA law does give CMS flexibility as to the start of the physician reporting period, what options is CMS considering to make sure this program gets started on the right foot?”

In response to this Slavitt responded that CMS was open to options such as postponing implementation and establishing shorter reporting periods (both of which were widely requested during the MACRA comment period).

Both Slavitt and Senator Hatch talked about the importance of the MACRA legislation not killing the small practice physician. A delay and shorter reporting periods would be a great start. However, so many small practices have been burned by meaningful use that it might be too late for MACRA. It seems that MACRA is dead on arrival for many physicians based on historical experience with meaningful use and certified EHR. I’m not sure CMS could do anything with MACRA to really stem the tide.

This is reflected in a survey that Deloitte recently did to assess physician’s awareness of MACRA. The survey found that 21% of self-employed physicians and those in independently owned medical practices report they are somewhat familiar with MACRA versus 9% of employed physicians surveyed. 32% of physicians only recognize the name.

Basically, physicians barely even know about MACRA. Although, I’m quite sure if we asked them if they liked the MACRA government legislation they’d all say an emphatic No! (Kind of reminds me of Jimmy Kimmel’s Life Witness News) It’s too bad, because if doctors have already been participating in PQRS and Meaningful Use, MACRA won’t be that bad. Of course, the same can’t be said for those that haven’t participated in either program.

During the hearing mentioned above, Senator Hatch highlighted Andy Slavitt’s comment that “the focus must be focused on patients and not measurement.” Plus, he suggested that more needed to be done in this regard. Andy Slavitt responded that they need to reduce the documentation requirements so doctors can spend more time with patients.

Take those comments for what their worth. They’re hearing the right messages and I think they’re heading the right direction. Let’s hope we see that in the MACRA final rule.

Meaningful Use Relief from New REBOOT Legislation

Posted on July 14, 2016 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.

John Thune has introduced a new legislation called the Electronic Health Record (EHR) Regulatory Relief Act (S. 3173) to provide some relief to hospitals and eligible providers participating in the Medicare EHR Incentive Program (Better known as Meaningful Use). You can find the legislative text (ie. legalese) and the summary document (ie. readable).

This legislation was written by the “REBOOT members” John Thune (S.D.), Lamar Alexander (Tenn.), Mike Enzi (Wyo.), Pat Roberts (Kan.), Richard Burr (N.C.) and Bill Cassidy (La.) who previously released a white paper on their Health IT concerns.

Here’s a short summary of what the legislation would do:

  • Codify the 90-day reporting period for meaningful use
  • Remove the All-or-Nothing approach to Meaningful Use and set a 70% threshold
  • Increased flexibility in Hardship Exceptions

If I’m reading the legalese right, it also opens the door for the HHS Secretary to allow a 90 day reporting period for MIPS as well. It’s interesting that it wasn’t highlighted in the summary document.

Regardless, these are all changes that will be welcomed by the healthcare community. What I like most about these proposals is that I don’t think any of them will impact how a hospital or doctor was previously planning to use their EHR. At least it won’t impact care in any sort of adverse way. Doctors will still be using an EHR. However, it will provide some reporting relief and will open the door of meaningful use to organizations that wouldn’t have been able to comply previously. Of course, I’m sure there are a few people out there that will settle for nothing less than a repeal of meaningful use completely. I predict that such a thing will never happen.

What do you think of this proposed legislation? Are they enough? Should they be providing more relief? Will this change your meaningful use plans?

Smartphone Strategy May Cause Health Data Interoperability Problems

Posted on July 13, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Tonight I was out at my local electronics store looking over the latest in Samsung gear. While chatting with the salesman behind the Samsung counter, I picked up a wireless charging pad and asked what it cost. “Don’t bother,” he said. “That won’t work with your phone,” which happens to be a none-too-old Galaxy Note Edge.

New batteries? Same problem. I strongly suspect that the lovely VR gear, headset and smart watch on display suffer from the same limitations. And heaven knows that these devices wouldn’t work with products produced by other Android-compatible manufacturers.

Now, I am no communications industry expert. So I won’t hold forth on whether Samsung’s decision to create a network of proprietary devices is a smart strategy or not. Intuitively, my guess is that the giant manufacturer is making a mistake in trying to lock in customers this way, but I don’t have data upon which to base that claim.

But when it comes to health IT, it’s clearer to me how things might play out. And I’d argue that Samsung’s emerging strategy should generate concern among providers.

Interconnecting proprietary tech is far from new. In fact, Apple long ago won the battle to force its users onto its proprietary platform, and AFAIK, the computing and media giant has never back down from the stance, including where its telecommunications gear was concerned. But at least until recently, we’ve had interoperable Android phones and tablets to work with, which ran on a freely-available operating system that played nicely with other devices running the system.

But with the device maker moving away from “works on Android” to “works on Samsung Android devices,” the chain of interoperability is broken. This could lead to shifts in the telecommunications industry which don’t bode well for healthcare users.

On the surface, we are only looking at relatively petty IT concerns for HIT leaders, such as seeing to it that the Samsung user gets a Samsung charging pad. Like enterprises in other industries, health leaders will adapt to this inconvenience. But the problems don’t stop there.

If telecommunications manufacturers follow Samsung’s lead, and decide to add proprietary quirks to their devices, providers may pay the price. Depending on how these newly-proprietary devices are configured, and how they must be supported, it could become much harder to dig data out of them on an ongoing basis. That’s the last thing we need right now.

Not only that, what happens if proprietary differences between Android phones and tablets make it harder for them to communicate with medical devices, a tantalizing possibility which is just beginning to present itself? While we don’t yet know how devices such as infusion pumps to interoperate with mobile devices, nor the latter two with desktops, wearables and servers, we don’t want to close off options.

Bottom line, I may be crying wolf too soon, but these developments alarm me. I’d hate to see additional walls go up between various data sources, particularly before we even know what we can do with them.