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Treating a Healthy Patient

Posted on November 21, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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 first coined the concept of what I call treating a healthy patient back in 2011. I’ve always loved the concept of a doctor actually treating someone who thinks and feels completely healthy. The challenge is that this type of relationship is very different than what we have in our current health system today.

While our current model is very different, I’m hearing more and more things that get me back to healthcare treating an otherwise healthy patient. Although, someone recently pointed out to me that we’re not really treating a healthy patient, because we’re all sick. We just each have different degrees of sickness. It’s a fine point, but I still argue we’re “healthy” because we feel “healthy.”

This analysis points out one layer of change that I see happening in healthcare. This change is being able to detect and predict sickness. Yes, that still means a doctor is treating a sickness. However, I see a wave of new sensors, genetics, and other technology that’s going to absolutely change what we define as “sick.”

This is a massive change and one that I think is very good. I recently read an article by Joseph Kvedar which commented that we’re very likely to seek medical help when we break our arm, because the pain is a powerful motivating factor to get some help. Can this new wave of sensors and technology help us know the “pain” our bodies are suffering through and thus inspire us to seek medical attention? I think they will do just that.

The problem is that our current health system isn’t ready to receive a patient like this. Doctors are going to have to continue to evolve in what they consider a “disease” and the treatment they provide. Plus, we’ll likely have to include many other professionals in the treatment of patients. Do we really want our highly paid doctors training on exercise and nutrition when they’ve had almost no training in medical school on the subjects? Of course, not. We want the dietitian doing this. We’ll need to go towards a more team based approach to care.

I’ve regularly said, “Treating a healthy patient is more akin to social work than it is medicine.” Our health system is going to have to take this into consideration and change accordingly.

Treating a healthy patient won’t solve all our healthcare problems. In fact, I’ve wondered if in some ways treating a healthy patient isn’t just shifting the costs as opposed to lowering the costs. Regardless of the cost impact, this is where I see healthcare heading. Yes, we’ll still need many doctors to do important procedures. Just because you detect possible heart issues doesn’t mean that patient won’t eventually need a heart bypass surgery some day. In fact, a whole new set of medical procedures will likely be created that treat possible heart issues before they become straight up heart issues.

What other ways do you see the system moving towards or away from “treating healthy patients”?

Which Comes First in Accountable Care: Data or Patients?

Posted on September 30, 2014 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.

The headlines are stark and accusatory. “ACOs’ health IT capabilities remain rudimentary.” “ACOs held back by poor interoperability.” But a recent 19-page survey released by the eHealth Initiative tells two stories about Accountable Care Organizations–and I find the story about interoperability less compelling than another one that focuses on patient empowerment.
Read more..

Are Limited Networks Necessary to Reduce Health Care Costs?

Posted on September 10, 2014 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.

Among the dirty words most hated by health care consumers–such as “capitation” and “insufficient medical necessity”–a special anxiety infuses the term “out-of-network.” Everybody harbors the fear that the world-famous specialist who can provide a miracle cure for a rare disease he or she may unexpectedly suffer from will be unavailable due to insurance limitations. So it’s worth asking whether limited networks save money, and whether they improve or degrade health care.
Read more..

EHRs Don’t Make Errors, People Do

Posted on July 31, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

An intriguing blog title, I know. I saw it on Bill Crounse, MD’s blog post and couldn’t resist extending the discussion. This is a really challenging topic and so it’s definitely worth of discussion.

On the one hand it’s clear to me that EHR software isn’t perfect. However, paper charts weren’t perfect either. On the other hand, people aren’t perfect either. Unfortunately, we don’t want to admit our imperfection and our society has gotten to the point that imperfections are unacceptable.

In the blog post mentioned above, Dr. Crounse offers the following suggestions and I’ll add my own commentary for each:

Involve the Patient Right from the Start – I’m hopeful that some of the companies working on this problem will get widespread adoption. The patient could definitely be more involved in entering their patient data before the visit even happens and thus relieve the burden on the clinician. This is a challenging problem to solve though when you consider the vast array of physician preferences.

Ease the Documentation Burden on Clinicians – This is mostly a knock on our current billing system. If we make the switch to value based reimbursement can we ease the documentation burden on clinicians? That’s worthy of its own post and some deeper thought. Sadly, I think in the short term it likely means more documentation burden for clinicians. I don’t see this happening soon, but it’s a noble goal.

Prohibit Templates, Cut and Paste – I generally disagree with this one. Ironically, the title of the post illustrates my issue with it, “Electronic Health Record solutions don’t make errors, people do.” It’s not templates and cut and paste that’s the problem as much as it is rushed physicians who don’t use it appropriately. I think one word describes most of the issues: laziness. I know. When I use a template for my blog posts or email blasts, I get lazy on them sometimes too. Fortunately, my blog posts or emails don’t have people’s lives hanging on them. So, maybe Dr. Crounse has a point. It’s just too easy to screw up templates and copy/paste.

Share Information with Patients – I’ve long been a proponent of the patient being aware of the information in the paper chart. I know that many doctors fear this. Usually they reference the fear that patients won’t understand the information that’s in the chart. I’ve just not seen this to be the case in practice and the benefits of the patient being able to be involved in their chart is so much more valuable than any perceived risk. The harder part is that I haven’t seen any system which creates a simple way for the patient to update/correct/verify information in a chart. Access is a great step forward, but the next steps is to empower the patient to assist in the patient chart quality control process.

As long as we have imperfect humans using imperfect EHR software, errors are going to happen. However, we can do better than we’re doing today. I like the ideas that Dr. Crounse suggested. I’d love to hear any ideas you have as well.

athenahealth Partners With Quality Group To Research EMR Patient Safety

Posted on November 15, 2013 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.

While it’s known that EMRs have been involved with, and probably responsible for, patient harm and even death, research is incomplete and sketchy on what risks are the most pressing and how to avoid them. Plus, we’re always balancing these risks with the potential benefits of EMR as well.

One recent study by the Pennsylvania Patient Safety Authority concluded that EMR default settings for medications caused adverse events in more than 3 percent of cases reviewed by the organization.

But that’s just one study, which can only do so much to help on its own. To get a better grip on such issues, EMR and practice management vendor athenahealth has partnered with Patient Safety Organization Quantros to examine the impact that EMRs are having on patient care. The research project is being funded by athenahealth, according to  a piece in Medical  Practice Insider.

athenahealth is offering its national network of about 47,000 providers free access to Quantros’ Safety Event Manager reporting tool, allowing athena’s EMR clients to submit patient safety data directly to the Quantros Patient Safety Center. Delivering the safety data through a PSO like Quantros insulates providers from liability by offering discovery protections when the practices report and analyze a potential issue, Medical  Practice Insider reports.

As one might expect, athena is mounting the experiment to find out when use of its EMR might have contributed to a  potential adverse event, such as, for example, when the EMR fails to warn a physician that a prescribed drug would interact with a drug the patient is already taking.

The bottom line, for athena, is to analyze the data for patient safety trends, and use it directly to improve its technology, said Tarah Hirschey, athena’s senior manager of patient safety, to Medical  Practice Insider.

100% Interoperability, Quantified Self Data, and Data Liquidity – #HITsm Chat Highlights

Posted on March 30, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Topic 1: Do you think the healthcare system WANTS 100% interoperability & data liquidity? Why/why not?

 

Topic 2: As consumer, what are YOUR fears about your health data being shared across providers/payers/government?

 

Topic 3: What do you think payers will do with #quantifiedself data if integrated into EHR? Actuarial/underwriting?

 

Topic 4: Could there be a correlation between your fear of data liquidity and your health?

 

Topic 5: What could assuage your fears? Education? Legislation? Regulation? Healthcare system withdrawal?

Advanced Analytics, Big Data, and IBM Watson: #HITsm Chat Highlights

Posted on February 16, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Topic One: @janicemccallum defines #BigData broadly as: “Advanced analytics for complex problem solving.” Do you agree?

 

Topic Two: Is the current base of evidence strong enough to support #BigData models? What additional data sources do we need?

Topic Three: IBM Watson was recently deployed at Memorial Sloan-Kettering for CDS. Will IBM dominate healthcare #BigData?

Topic Four: What will help advance & what will delay the use of #BigData models in healthcare?

Topic Five: Is the current hype surrounding #BigData good or bad for the future of evidence-based medicine?

Patient Engagement Adoption, Social Media and More — #HITsm Chat Highlights

Posted on February 2, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Topic One:What will be the main drivers for increased use and adoption of #patientengagement tools such as #socialmedia?

Topic Two: How can/should/will providers meet #meaningfuluse criteria by engaging #patients through #socialmedia?

 

Topic Three: What other topics will most powerfully intersect with #patientengagement at #HIMSS13?

 

Topic Four: What business problems are you trying to find solutions for at #HIMSS13?

Health IT in 2013 – #HITsm Chat Highlights

Posted on January 5, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Topic One:  How can apps help people keep their health resolutions?

Topic Two:  What health app do you use today, and how has it helped you become more engaged in your health?

Topic Three: Speaking of engaged, if you could tell the ONC to do one thing in 2013, what would it be, and what result would it produce?

Topic Four: Who will have the biggest impact in #healthIT in 2013 – hospitals, vendors, consultants, government, trade associations, others?

#HITsm and #hcsm Highlights Around Twitter – Healthcare and Social Media

Posted on December 22, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

If you are avid follower of the #HITsm Chats, you probably noticed it was MIA this week, and also will be next week. So, instead, here are a few interesting tweets I found from doing a search for #HITsm and #hcsm on Twitter. I highly recommend doing that every once in awhile…there’s some pretty interesting information to be found. With that, here are some of the highlights I found from those searches (it was hard to pick just a couple!) I saw a lot about social media, so I thought I’d focus on that today.

This is a really fascinating article. Did you know that 90 percent of people ages 18-24 trust health information found on social media? Kind of scary in some ways, since, well, there’s definitely some incorrect information out there. It also puts a lot of weight on the shoulders of those that do provide the information, to make sure it’s accurate, up-to-date, and informative. To be honest, I sometimes trust sites like WebMD more than my own doctor! Social media and mobile devices are here to stay in the healthcare world, that’s for sure. I think this article gives some good information on the pros and cons, as well as how healthcare providers can benefit, which brings me to the next post…

Well, this is the opposite of what I read (and preach) a lot. A waste of time? The previous article talked about how it can be very beneficial for healthcare providers. The main arguments are that there is no return on investment (ROI), it can be dangerous when it adds to the likelihood of a doctor being burnt out, and it’s just a fad that is going to blow over and isn’t worth investing time, unless you have a lot of time and want it to be a hobby, or your company has products and services the customer pays for. I don’t agree with these statements, and believe that it is worth putting the time and effort into…but I suppose only time will tell which side of the fence is correct.

Aren’t patients the most crucial aspect to any healthcare provider? So empowering them is so important, and this article talks about how social media is doing just that. It has five ways it empowers patience, which, in a nut shell, are:

  1. Connecting people suffering from a disease or ailment with others…so basically, helping people not feel so alone in their health struggles, and get support from others that “get it.”
  2. Patients can learn about different treatment options and about medical devices more easily. When a person just relies on their doctor for information, some of these options can be overlooked (and often are.)
  3. Patient’s who like being self-advocates are likely to become community advocates as well
  4. Patient’s are given a “voice” to talk about their experiences and thoughts
  5. There are social networks dedicated to certain diseases or conditions.

And finally, this doesn’t have anything to do with the other tweets I’ve mentioned, but it made me laugh. The sledding blogger on the far left looks familiar, doesn’t he?