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HIM and Where It’s Heading with Charlie Saponaro

Posted on January 23, 2015 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.

Lately I’ve started to really see the importance of HIM In the future of healthcare. I like to break HIM work into: managing the record (ie. Avoid Lawsuits), improving the coding/documentation (ie. More $$), and HIPAA compliance (ie. Avoid penalties). While their future has been questioned during the shift to EHR, I think they have a very important future in these areas.

With this as background, I did an interview with Charlie Saponaro, President and CEO of Medical Record Associates, to talk about the State of HIM. We talk about some major HIM trends like remote HIM and outsourced HIM for example. If you’re over HIM, in HIM or interested in the future of HIM, you’ll enjoy this chat with Charlie.

Athenahealth Goes After Hospitals and Tavenner Steps Down

Posted on January 22, 2015 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 were two big pieces of news this week that I thought I’d discuss. Hopefully you’ll also add your thoughts and insights in the comments.

1. Athenahealth Moves Into Hospital Market With Acquisition Of Atlanta Startup RazorInsights
I thought the announcement of this acquisition was really interesting. Literally the day before this came out, someone asked me what I thought of Athenahealth. After some discussion, they said do you think they’ll take on Epic and Cerner. I quickly responded, “Well, they don’t have an inpatient EHR, so they don’t have a dog in the fight.” Well, now they do have a dog in the fight. Of course, RazorInsights still isn’t a big competitor of Epic and Cerner. However, if I know Jonathan Bush, that’s the ambition. At least that’s what his numerous cloud rants lead you to believe that he thinks he can take down Epic and Cerner with one single word: Cloud. We’ll see what RazorInsights can do under the Athenahealth umbrella.

2. CMS Leader Marilyn Tavenner Steps Down
Neil Versel has a great article covering Tavenner’s departure. His comments are pretty interesting when it comes to her staying low-profile and away from the media during her tenure at CMS. She’s certainly taken a lot of heat from the botched rollout of Healthcare.gov and other programs.

Personally, I’ll most remember her for her promise at HIMSS 2014 that ICD-10 was going to happen and that healthcare organizations better be ready. Of course, we know how that story played out with Congress passing a few lines in the SGR bill to delay ICD-10 another year. Given Tavenner’s promise, I’m quite sure she was blind sided by Congress’ move as well.

I’m not sure her departure is a good or a bad thing for healthcare. I’m sure that the healthcare behemoth will move along like it always has. Best of luck to her wherever she lands. No doubt working in the government in a high profile position is a rather thankless job that usually pays below market wages.

Who do you think will take Tavenner’s position at CMS? Does it matter?

Healthcare IT Marketing and PR Conference – and the #HITMC Twitter Chat

Posted on January 21, 2015 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.

Regular readers likely noticed the banner ad at the top of EMR and EHR which links to the Healthcare IT Marketing and PR conference (HITMC) that we organize. This event is shaping up to be absolutely fantastic. We’ve just started adding the speakers to the conference website, but I’m thrilled by the quality and variety of speakers that we’ll be having at HITMC 2015.

For those not familiar with the event, we bring together a few hundred of the very best Healthcare IT marketing and PR professionals. This year we’ll be hosting it at the nicely remodeled SLS Las Vegas hotel. No doubt you’ll see members of the HITMC community all over the hotel throughout the two days of the conference. Plus, this year we’re doing some early bird social events to really give attendees a great opportunity to connect.

Along with connecting with your peers, HITMC 2015 will include two days of amazing content on a wide variety of topics. Some of these topics will include:

  • Content Marketing
  • Best Practices for Social Media Marketing, Email Marketing and Search Engine Optimization (SEO)
  • Lead Nurturing
  • Effective PR
  • Marketing Automation Tools
  • Event Marketing
  • Case Studies from Health IT Companies
  • Much much more…

If you’re interested in healthcare IT marketing and PR, you’ll absolutely love this event. Along with all the learning, connecting, and sharing at the event, we also have some fun together too. Early bird registration for the event ends on 1/31/15, so register now to save $500.

For those interested in getting a small flavor for the event, we’re hosting a #HITMC twitter chat on Tuesday, 1/27 at Noon ET (9 AM PT). We hope that many of you can join us as we chat about the challenges associated with healthcare IT marketing and PR.

At Least One Patient A Day

Posted on January 14, 2015 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 ophthalmology friends posted this video. I’m sure that many doctors can relate to patients like this. It reminds me of someone who told me they wish their was a health grades where the doctor can rate the patients the same way that patient rate the doctors. That’s probably not a productive approach, but it definitely shares the sentiment of many doctors who have challenging patients. Like most things in life though, it only takes a few bad apples to spoil the bunch. I’m not sure what can be done to deal with these challenging patients. Either way, this video highlights one of the challenges of being a doctor: difficult patients.

Apervita Creates Health Analytics for the Millions

Posted on January 9, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://radar.oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Health officials are constantly talking up the importance of clinical decision support, more popularly known now as evidence-based medicine. We’re owning up to the awkward little fact–which really should embarrass nobody–that most doctors lack expertise on many of the conditions they encounter and can’t read the thousands of relevant studies published each year. New heuristics are developed all the time for things such as predicting cardiac arrest or preventing readmissions after surgery. But most never make their way into the clinic.

Let’s look at what has to happen before doctors and patients can benefit from a discovery:

  1. The researcher has to write a paper with enough detail to create a working program from the heuristic, and has to publish the paper, probably in an obscure journal.

  2. A clinician or administrator has to find the article and line up staff to write and thoroughly test a program.

  3. If the program is to be used outside the hospital where it was created, it has to be disseminated. The hospital is unlikely to have an organization set up to package and market the program. Even if it is simply put out for free use, other institutions have to learn about it and compile it to work on their systems, in order for it to spread widely. Neither the researcher nor the hospital is likely to be compensated for the development of the program.

  4. The program has to be integrated into the doctor’s workflow, by being put on a menu or generating an alert.

Evidence-based medicine, therefore, is failing to tap a lot of resources that could save lives. A commonly cited observation is that research findings take 17 years to go into widespread practice. That’s 17 years of unnecessary and costly suffering.

I have often advocated for better integration of analytics into everyday medical practice, and I found a company called Apervita (originally named Pervasive Health) that jumps off in the right direction. Apervita, which announced a Series A round of funding on January 7, also has potential users outside of clinical settings. Pharma companies can use it to track adverse drug events, while payers can use it to predict fraud and risks to patients. There is not much public health data in the platform yet, but they’re working on it. For instance, Leapfrog group has published hospital safety info through their platform, and Diameter Health provides an all-cause 30-day readmissions prediction for all non-maternal, non-pediatric hospitalizations.

Here’s how the sequence of events I laid out before would go using Apervita:

  1. The researcher implements her algorithm in Python, chosen because Python is easy for non-programmers to learn and is consequently one of the most popular programming languages, particularly in the sciences. Apervita adds functions to Python to make it easy, such as RangeCompute or tables to let you compute with coefficients, and presents these through an IDE.

  2. The researcher creates an analytic on the Apervita platform that describes and publishes the analytic, along with payment terms. Thus, the researcher derives some income from the research and has more motivation to offer the analytic publicly. Conversely, the provider pays only for usage of the analytic, and does not have to license or implement a new software package.

  3. Clinicians search for relevant analytics and upload data to generate reports at a patient or population level. Data in popular formats such as Excel or comma-separated value (CSV) files can be uploaded manually, while programmers can automate data exchange through a RESTful web service, which is currently the most popular way of exchanging data between cooperating programs. Rick Halton, co-founder and Chief Marketing Officer of Apervita, said they are working on support for HL7’s CCD, and are interested in Blue Button+ button, although they are not ready yet to support it.

  4. Clinicians can also make the results easy to consume through personalized dashboards (web pages showing visualizations and current information) or by triggering alerts. A typical dashboard for a hospital administrator might show a graphical thermometer indicating safety rankings at the hospital, along with numbers indicating safety grades. Each department or user could create a dashboard showing exactly what a clinician cares about at the moment–a patient assessment during an admission, or statistics needed for surgical pre-op, for instance.

  5. Apervita builds in version control, and can automatically update user sites with corrections or new versions.

I got a demo of Apervita and found the administration pretty complex, but this seems to be a result of its focus on security and the many options it offers large enterprises to break staff into groups or teams. The bottom line is that Apervita compresses the difficult processes required to turn research into practice and offers them as steps performed through a Web interface or easy programming. Apervita claims to have shown that one intern can create as many as 50 health analytics in one week on their platform, working just from the articles in journals and web resources.

The platform encrypts web requests and is HIPAA-compliant. It can be displayed off-platform, and has been integrated with at least one EHR (OpenMRS).

Always attuned to the technical difficulties of data use, I asked Halton how the users of Apervita analytics could make sure their data formats and types match the formats and types defined by the people who created the analytics. Halton said that the key was the recognition of different ontolgies, and the ability to translate between them using easy-to-create “codesets.”

An ontology is, in general, a way of representing data and the relationships between pieces of data. SNOMED and ICD are examples of common ontologies in health care. An even simpler ontology might simply be a statement that units of a particular data field are measured in milliliters. Whether simple or complex, standard or custom-built, the ontology is specified by the creator of an analytic. If the user has data in a different ontology, a codeset can translate between the two.

As an example of Apervita’s use, a forward prediction algorithm developed by Dr. Dana Edelson and others from the University of Chicago Medical Center can predict cardiac arrests better than the commonly used VitalPAC Early Warning Score (ViEWS) or Modified Early Warning Score (MEWS). Developed from a dataset of over 250,000 patient admissions across five hospitals, “eCART” (electronic Cardiac Arrest Triage) can identify high-risk hospital ward patients and improve ICU triage decisions, often as much as 48 hours in advance.

The new funding will allow Apervita to make their interface even easier for end-users, and to solicit algorithms from leading researchers such as the Mayo Clinic.

Halton heralds Apervita as a “community” for health care analytics for authors and providers. Not only can the creators of analytics share them, but providers can create dashboards or other tools of value to a wide range of colleagues, and share them. I believe that tools like Apervita can bridge the gap between the rare well-funded health clinic with the resources to develop tools, and the thousands of scattered institutions struggling to get the information that will provide better care.

The Inside of a CT Scanner

Posted on January 5, 2015 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.

This picture is just awesome. As I’m at CES 2015 this week I’ll be looking at the latest digital health companies. However, we often forget some of the amazing technologies like a CT scanner that we have in healthcare. Healthcare is awesome!

Keeping Your Head Above Water

Posted on December 26, 2014 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.

This Holiday season my wife and I decided to visit my in-laws in the frozen tundra of upstate NY with our 4 children. Why we would leave the beautiful Las Vegas winter for upstate NY can only be explained by love. Although, we’ve been richly blessed since the weather in Las Vegas has been colder than upstate NY. Someone’s watching out for us. However, you can imagine that a trip with 4 children between the ages of 2-10 is a non-stop experience.

As I thought over what the holidays are like with 4 children in someone else’s house over the holidays, I could see a lot of parallels with health IT leadership. Having 4 kids during the holidays really means that you’re always on edge watching and waiting for the next fire. Yes, I often feel like a fireman that’s in charge of putting out lots of fires created by the children. Although, sometimes it takes the form of chief hostage negotiator as you try and negotiate something with a 5 year old. It’s an all encompassing experience that doesn’t leave much time for sitting back and enjoying the holidays.

Most people I know in healthcare IT are in a similar situation. They’re so overwhelmed by the number of large projects they have on their plate that they don’t have even a second to sit back and survey their work. There are so many fires to put out that they don’t have time to really find the root cause of the fire so they can put it out. The idea of sitting back and surveying and appreciating the journey seems out of the question.

Much like with my children, if I don’t take any time to really understand what’s happening, it’s going to lead to a bad place. You have to take time to evaluate what’s happened and figure out the best way forward. If you don’t, your life will be miserable.

I’ve also learned with my family that it’s important to rely on others. In my family’s case, sometimes this is my wife. Other times my in-laws or a trusted babysitter. In the work environment, you need to have people you trust to “babysit” your projects while you take some time off. Sometimes that’s time off to set the strategic direction for your organization. Other times it’s time off to just have a break from work so you can return back with fresh eyes and a renewed soul.

Another lesson learned is to keep things in perspective. It’s easy to go off on my kids when they do something wrong. However, that easy knee jerk reaction is often detrimental to them and to me. Keeping the impact of what they did in perspective is vital to getting ahead of the curve. The same is true in health IT leadership. Make sure you really understand the impact of someone’s actions or decisions before you make your decision. Blowing up on someone over something trivial just creates a culture that is afraid to do anything. That paralyzes the organization and leads to major problems.

Those are a few of the lessons I’ve been thinking about this holiday season. The great part is that I love my children and really have an amazing opportunity to impact their life for good. Turns out that we have that same opportunity in healthcare as well. We just have to stop frantically trying to keep our head above water and instead relax and devise a thoughtful go-forward strategy.

2015 Healthcare IT Conference Planning

Posted on December 23, 2014 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 the year comes to a close, I’m starting to think about my conference plans for 2015. I traveled quite a bit to some amazing conferences in 2014 and I’m sure I’ll be doing more of the same in 2015.

Ever since August 2014, I’ve been listing my Health IT and EHR conference plans on EMR and HIPAA for others to see. Hopefully it’s a great resource for those trying to navigate the Healthcare IT conferences.

I imagine I’ll probably do a similar schedule of events this year. So far I only have CES, HIMSS, and the Health IT Marketing and PR Conference on my spring conference calendar. Thankfully, the spring conference season is much calmer for me.

I’d love to see and hear what conferences are on your radar for 2015. Are there health IT conferences I should consider adding to my list? I always love to hear about new ones, so please share in the comments or on our contact us page. Along those same lines, let me know which are your must attend health IT conferences. Thanks in advance for sharing with myself and the broader EMR and EHR community.

Next Generation Digital Natives

Posted on December 19, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I saw the tweet and picture above and couldn’t help but laugh. My children do stuff like this all the time and I love it. Of course, my children aren’t talking about being paged (they don’t work in healthcare), but they definitely know all about technology. In fact, at a recent parent teacher conference, my 7 year old’s teacher talked about how well she did on the computer and how she could navigate any of the technology with ease. Yep, I was a really proud parent at that moment.

Why share this on an EMR blog? Well, a part of me has my head in the cloud (pun intended) as I’m considering the various gifts I’m giving my children this year. My wife and I are all about the technology, but also technology that helps them use their creativity. Lest you worry, we also have incorporated plenty of balls and other things they can use outside. However, I think this shift is an important sign of what’s to come.

Think about how different the EHR world would be if all of healthcare were digital natives that just understood how technology worked. I recently was asked by an older friend (ironically he’s an ortho doc) to help him and his wife get the Apple TV working in their home. I’d never used it before, but I’d used something kind of similar. At one point I asked her if she knew how to do something with it (she didn’t know), and then I proceeded to just figure out how it worked.

The reality is that I didn’t know the Apple TV interface at all, but I did know intuitively how things like that were designed. Some of that comes from experience with so many different software packages. Some of that comes from having done some programming. The next generation healthcare IT user is going to have this literally built into who they are. Look at the hour of code initiative if you want to see why I think everyone is going to have at least some programming experience.

Every EHR trainer is reading this and imagining how different their EHR training classes would have gone if those attending were all digital natives. That’s far from the reality today and so we have to do things differently, but it will be what we find in the future.

Making JustShowMeTheDoctorNetwork.com A Reality

Posted on December 17, 2014 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.

Ok, that website really isn’t a project, but a website that has that functionality would be awesome. I recently had this problem. I was getting new health insurance and I wanted to know if our regular doctors would be part of the new insurance plan’s network. What a pain in the butt. Even the health insurance companies website made it difficult to know if they accepted the plan. The networks were named different than the insurance. Just plain ugly!

Turns out that Fred Trotter is doing what he can to help solve the “out of network” insurance game. Since it’s Fred Trotter you know it’s based on freeing the data. The post is well worth a read, but highlights why figuring out if your going to an in network or out of network provider is important and how the insurance companies are making it difficult to get access to this data.

Fred also points out a possible solution to a problem found in the text of the Notice of Benefit and Payment Parameters for 2016 (don’t you love how quickly the government works?). This new rule would essentially require insurance companies to provide an updated directory of providers and possibly requiring that they provide it in a machine-readable format. Seems like a small thing, but it would make a big difference.

However, this is the money quote from Fred about the government proposal above:

This would solve the problem. Anyone who wanted to could create a website that showed what plans any given provider accepted, would be able to easily do so.

But they key word here is “propose”. Insurance companies in this country benefit greatly from the confusion about in network and out of network, and so do some unethical healthcare providers. There will be lots of people who oppose this proposal.

I hope that I have made the case that this information needs to be open and machine readable. If your convinced, then you can find the comment page to support this policy here. If you disagree with us, and you still want to submit a comment, you can use this page.

Comments on this rule are due by 12/22 which doesn’t leave people much time to chime in. As someone who’s had to deal with this challenge recently, I hope that this rule is passed. I can’t wait for an entrepreneur to take this data and create a beautiful map overlay of the doctors in my network. Would make searching for a doctor in your insurance plan so much easier.