Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Insights from Dr. Eric Topol at #SHSMD14

Posted on October 16, 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.


Patient care will eventually win, but sacred cows still have a lot of fight in them.


I’m still chewing on this one. I definitely love the idea of remote visits. Not sure it’s the smartest patient room.


This trend is definitely happening. Although, if you sound out Iwwiwwiwi, it sounds a lot like whining. I’m not sure that’s a good thing. Either way, I think the market is going to push towards on demand medicine.


I’d love to hear more about this topic. I think the first step is identifying the real cost problem. Seems like these top drugs could provide a really good start.

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..

Rise of the Digital Patient Infographic

Posted on September 17, 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.

The social people behind CDW Healthcare are doing a good job putting out some great content on social media. A great example of this is this Digital Patient Infographic that they recently posted:
mHealth_DigitalPatient_Infographic_0914_1000

I recently took part in a webinar with Dodge Communications (I’ll add a link to the webinar once it’s available) yesterday and I made the comment that telemedicine is more efficient for the patient, but I wasn’t sure telemedicine was more efficient for the doctor. There might be a disconnect of benefits there that needs to be reconciled.

As I look at the infographic above, I’m reminded of something similar. The stats in the infographic and just some basic common sense says how much patients would love to do an eVisit. If this is the case, why is it that healthcare hasn’t filled this customer demand? I think the answer is the disconnect of benefits.

What are your thoughts?

Also, since CDW created the infographic above, It’s worth mentioning that CDW also listed this blog on their list of Top 50 Health IT blogs for 2014. I’m not sure I agree that it’s the top 50 health IT blogs since EMR and HIPAA and a number of other Healthcare Scene blogs aren’t on the list, but there are a lot of great bloggers on the list just the same.

HealthTap Offerings Track the Evolution of Health Care

Posted on August 15, 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.

Health care evolves more quickly in the minds of the most visionary reformers than in real health care practices. But we are definitely entering on a new age:

  • Patients (or consumers, or whatever you want to call them–no good term has yet been developed for all of us regular people who want better lives) will make more of their own decisions and participate in health care.
  • Behavior change will be driven by immediate interventions into everyday life, and health care advice will be available instantly on demand instead of waiting for an annual visit to the doctor. Health care will be an integrated into life activities, not a distinct activity performed by a professional on a passive recipient.
  • Patient information will no longer be fragmented among the various health care providers with whom the patient comes in contact, but will be centralized with the patients themselves, integrated and able to support intelligent decision-making.
  • Mobile devices will be intimately entwined with daily behavior, able to provide instant feedback and nudges toward healthy alternatives.

I have seen this evolution in action over several years at HealthTap, a fascinating company that ties together more than 10 million patients a month and more than 62,000 doctors. I interviewed the charismatic founder, Ron Gutman, back in 2011 before they had even opened their virtual doors. At that time, I felt intrigued but considered them just a kind of social network tying together doctors and patients.

Gutman’s goals for health care were far greater than this, however, and he has resolutely added ratings, analytics, and other features to his service over the years. Most recently, HealthTap has moved from what I consider a social network to a health maintenance tool with continuous intervention into daily life–a tool that puts public health and patient empowerment at the top of its priorities. And it may go even farther–moving from seeking help on illness to promoting health, which Gutman describes simply and winningly as “feeling good.”

The center of the offering is a personal health record. Plenty of other organizations offer this, most famously Apple’s HealthKit. HealthTap’s personal health record is unique in supporting the service’s search feature, where patients can search for advice and get results tailored specifically to their age, medical conditions, etc.–not just the generic results one gets from a search engine. It also ties into HealthTap’s new services, including real time virtual consults with doctors.

09-TAKE-ACTION-Customized-Checklists-HealthTap
Sample update from HealthTap

Gutman is by no means interested in maintaining a walled garden for his users; he is looking for ways to integrate with other offerings such as HealthKit and with the electronic health records used by health providers. He says, “The only entity that will win the game is the one that adds the most value to the user.”

Other new features tied in to the HealthTap services include:

  • A recommendation system for apps that can improve health and well-being. The apps are rated by the doctors within the HealthTap system, must be in Apple App Store or Google Play, and must be approved by the FDA (unless they are part of the large, new category of apps that the FDA has chosen not to regulate).
  • Off-the-shelf checklists to help patients manage medication, keep track of healthy behaviors, etc. As part of HealthTap Prime, a concierge service ($99 per year for the first person and $10 for each additional family member), the user can get personalized checklists from doctors, as well.
  • With the concierge service, subscribers also have the opportunity to directly contact a doctor any time, 24/7, on all popular mobile platforms, using live video, voice, and text.
  • The “Get Help” module in the HealthTap app provides useful checklists through all mobile devices, and even Android wearables. Patients can get reminders, useful links to relevant content, and other content pushed to their devices, at a pace they choose.

Some of these features–such as the recommended apps and personalized checklists–go beyond advice and constitute a type of treatment that is subject to legal liability. HealthTap has covered all its bases insuring doctors have insurance against mistakes.

The numbers show that HealthTap is a big community; comments received from Gutman about patients who say they’ve saved their lives show that it is an effective one. I think the choices they’ve made are insightful and illustrate the changes all health care institutions will have to make in order to stay relevant in the twenty-first century.

4 Things Your Patient Portal Should Include

Posted on May 30, 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.

Karen Gallagher Grant has a great blog post up on the MRA Health Information Services blog that talks about the ideal patient portal. She breaks it down into 4 things that a patient portal should provide:

  1. Information that is meaningful
  2. Easy access for patient review for data integrity
  3. Dashboard information about prescriptions that combine pharmacy information and clinical information
  4. Appointment scheduling

And 5 things she’d ideally like to see in a patient portal:

  1. Details about my next appointment
  2. Wellness tips
  3. Access to home health through telemedicine solutions
  4. Customized decision support via nationwide clinical data repositories
  5. Patient exchange of information

I found these lists really interesting, but I asked myself “Is this what we really want in a patient portal?

I think the number thing people want in a patient portal is access to a provider. Sure, it’s great to be able to access your paper records, your prescription history, your appointment list, and even some health information. Although the health information is never going to be as good as what Dr. Google can provide.

I was surprised that almost nothing (except the Telemedicine solution) talks about the patient portal being used to connect with the doctor. This is the most compelling reason for a patient to use the portal. They want to connect with someone. Notice the emphasis on the one, that means with an actual person. Yes, in many cases this can be the front desk, the biller, or the nurse, but patient portals see the most value when the portal is a way for a patient to connect to a person. Then, the rest of the resources become more valuable and used as well.

The problem is that most of the patient portals out there don’t do a good job connecting people. Although, maybe I’m just biased because of the Physia Connect messaging product we’ve developed and the docBeat messaging company I advise. However, seeing these two products helps me realize how beneficial it can be to make healthcare communication simple. Once we do that, it opens up whole new windows of opportunities.

Will Telemedicine Really Lower Costs?

Posted on May 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 was talking with the mobile health lead at one of the large telcom providers recently and we had a good discussion about telemedicine and its possible impact for good or bad on healthcare. She asked a really good question, “Will telemedicine lower the cost of healthcare or just add new touch points?

The translation to that question is whether telemedicine will replace other healthcare costs or if it will just create new healthcare costs that never existed before. I should say that her feeling was that telemedicine would end up lowering costs, but the question is well worth asking. In fact, even if the answer is that telemedicine will lower healthcare costs, there are many on the payer side of the equation that aren’t as confident.

The reality is that a telemedicine visit likely could raise costs. The idea of having to uproot yourself, go to the doctors office, wait in the waiting room, wait in the exam room, etc is a really big deterrent that stops many of us from going to the doctors. The idea that I could click on a link and see a doctor from the comfort of my own home with no wait times (or at least I’m waiting at home where I can get other things done) will definitely cause us to see the doctor more often.

This means that the real question isn’t whether telemedicine will increase the number of visits to the doctor (and more visits equals more costs). Let’s assume that we do see the doctor more often in a telemedicine enabled world. This then begs the question of whether these extra visits will reduce the long term costs of healthcare.

Using our assumptions above, it suggests that we’ll visit the doctor earlier under telemedicine than we would today. Could these early visits catch a disease earlier? Could these early visits avoid a hospitalization or other expensive healthcare cost? Could early treatment of an issue prevent someone from having a visit (or dozens of visits) later? Looking at it from a different angle, can telemedicine make a doctor more efficient?

This impact won’t likely happen immediately, but is the long term hope of what telemedicine can become and how it could lower healthcare costs. I personally lean towards telemedicine being able to realize these goals. Although, we won’t know until we figure out the way to reimburse a doctor for a telemedicine visit. Not to mention overcoming the physician licensing issues with telemedicine. Each of those will happen though and then we’ll really know if telemedicine lowers the costs of healthcare or not.

Forrester’s Take On Computing Trends For Next Year

Posted on December 31, 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 @annezieger on Twitter.

Recently, Forrester Research’s J.P. Gownder released a list of six broad tech trends he feels will dominate 2014. While they’re not healthcare-specific, I thought our readers would appreciate them, as they are relevant to the work that we do.

Mobility:  Gownder is arguing that this year coming will see a “sustained mobile mind shift.” He argues that customers and employees are beginning to expect that the data they touch will be available to them in context on any device at the exact what would’ve need. He argues that customers will actively shun businesses that lack mobile applications.

Fragmentation:  While vendors would like to see us, as consumers, stick to one vendor and operating system, Gownder argues that just the opposite will happen in 2014, with people trading off between multiple devices and thriving across operating systems. This movement, driven by the seeming infinity of new mobile devices, makes things more difficult for health IT administrators, to be certain.

Wearables:  While the wearables devices your editor has seen strike her mostly as toys, Gownder is far more enthusiastic. He argues that next year will see commercial availability of a range of once theoretical wearables — and that enterprise wearables have a particularly rich future ahead of them.

Intelligent assistants:  For me, services like Siri and Samsung’s S-Voice are entertaining, but hardly add anything to the mix when it comes to what your phone tablet or PC can do. Gownder, however, believes that intelligent assistance will rise to prominence in 2014 as they become more sophisticated, interesting and useful.

Gestural computing: Expect to see new applications and scenarios for gestural computing this year, Gownder predicts, driven by phenomena like the presence of XBox Kinect in tens of millions of homes, the emergence of Leap Motion and the emergence of a new device known as Myo from Thalmic Labs. In this case he isolates healthcare specifically as a strong use case, in which professionals manipulate and navigate medical imaging using gestures.

Stores recognize you: Here’s one I can see direct healthcare applications for; next year, Gownder predicts, will be the year in which you walk into a store and the store “recognizes you” and tailors your experience accordingly. I can see this being relevant in virtually any public-facing healthcare setting, including the ED, medical clinics and perhaps even EMT settings. Sounds very much like John’s description of a “biometrically controlled healthcare system.

So which of these trends do you think will be the most important next year? How are you adopting them, if at all, in your healthcare organization?

Is Remote Monitoring Data A Blessing, Or A Distraction?

Posted on August 1, 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 @annezieger on Twitter.

This week, Venture Beat reported on some growing remote monitoring efforts in which a handful of Massachusetts hospitals are working to pull the data into their EMR. The hospitals are hoping to get their arms around a growing body of data which increasingly lives not only in wireless medical devices (such as glucometers and pulse oximeters) but also smartphones, smart wristbands, FitBit devices and other health-tracking technology.

One of the players involved in the new effort is Partners HealthCare, whose Center for Connected Health is focused on collecting and making use of such data. Its latest initiative sweeps patient data collected at home — such as blood pressure, weight and blood glucose — into the Partners EMR, making it accessible as part of routine clinical workflow. (The data collected by patients is transmitted wirelessly and automatically subsumed into the EMR.)  Patients can also review the data through a patient portal known as Patient Gateway.

According to Partners, this process is designed to change care delivery by allowing doctors to keep a close watch on patients when they’re not in the hospital or doctor’s office.

This is all well and good, especially for monitoring the chronically ill, whose condition may fluctuate dangerously and require timely intervention. But the question is, is this new flood of data going to be manageable for doctors?  Can a physician managing thousands of patients really give appropriate attention to every data point a FitBit or smartphone produces?  Certainly not.

Perhaps that’s why Kaiser Permanente recently told a conference that it was going to be rather picky as to what data flows into its EMR. According to Lead Innovation Designer Christine Folck:

“Don’t come to us telling us you can upload [data] into our electronic medical record. We don’t necessarily want it there. We have too much information in our electronic medical record. Kaiser Permanente was one of the first to go nationwide with our electronic medical record, we are fully integrated, but the problem is now everybody wants to upload into it. Our physicians don’t want it all there. They really don’t need to know how much exercise each of their patients is getting on a daily basis; they just don’t have time to process all of that.”

So, while there’s clearly benefit to tracking chronic conditions via remote monitoring, it seems clear that there will be some pushback from doctors, who can’t possibly absorb all of the data the healthier “quantified self” types are producing.  It looks to me like we’re going to have to narrow down what categories of data are actually helpful in an EMR and which aren’t.

Health IT Costs, Health IT Adoption, HIE and CommonWell – Pre #HITsm Thoughts

Posted on June 28, 2013 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.

Last week I took the #HITsm Chat topics and created a blog post about Healthcare Unbound. I enjoyed creating the post so much that I decided to do it again this week. Not to mention I’ll be on the road to Utah during this week’s chat and won’t be able to participate. (Side Note: If you live in Utah and want to do lunch, I’d love to meet and talk EMR or health IT. I’ll be in Hawaii in July if you want to do the same.)

The chat topics make perfect discussion items. Plus, I love that I have more of an opportunity to really dig into the topics in a blog post. You can’t dig in quite as much in 140 characters.

Topic 1: Costs vs benefits. Will high costs always be the #1 barrier cited to #healthIT adoption?
We’ve seen an enormous shift in the cost of healthcare IT since I first started blogging about EMR 8 years ago. Cost use to be a much bigger issue when the cheapest EMR software you could find was about $30,000+ per doctor (in the ambulatory space). Plus, they expected you to pay the entire lump sum payment up front (many did offer financing). These days the cost of EMR software has dropped dramatically and fewer and fewer EHR vendors are using the lump sum payment model. This change means that costs are much more in line with a practice’s revenue.

These days, I’d say that those who use cost as the reason for not adopting health IT are really just using it as an excuse not to do it. There are a few rural providers where cost is more than just an excuse, but those are pretty few and far between. I’m not saying that cost isn’t an important part of any health IT project, but I’ve most often seen cost used as a mask for other reasons people don’t want to implement health IT. The most common reason is actually just a general resistance to change.

Topic 2: Why does ePrescribing have such widespread acceptance while #telehealth adoption is so low?
If providers could be reimbursed for telehealth, adoption would be high.

It is ironic that doctors don’t really get reimbursed for ePrescribing, but they do it at a high level. Although, the doctor does get reimbursed for the visit that generates the need for the prescription. A deeper investigation of why ePrescribing has had good adoption would be interesting. Certainly there are many doctors who miss their sig pad. However, once you have to record the prescription in the EHR, you might as well ePrescribe it.

Plus, there are some obvious reasons why ePrescribing is better. Whether it’s replacing the unreadable prescriptions or the drug to drug and allergy interaction checking that’s built into every ePrescribing platform, the benefits can be understood quickly.

The sad thing is that the benefits of Telehealth can be seen quickly as well, but you can’t get paid to do it.

Topic 3: #HIE as a noun or a verb? Does negative press for HIE org$ hinder health data exchange as a whole?
HIE is currently more of a noun than a verb. Verbs require action and we’re not seeing enough HIE action.

In some ways negative press could discourage healthcare organizations from participating in an HIE organization. However, negative press about HIE’s weaknesses can also put pressure on healthcare organizations to finally step up to the plate and have more HIE action and less HIE talk.

The biggest hindrance to HIE is business model, and good or bad press won’t do much to change that.

Topic 4: Is #CommonWell just a bully in a fairy godmother costume?
I love this question mostly because I sent the tweet that inspired it. Although, a smart health IT PR/marketer was the one who said it to me.

It’s a little too early to tell if the fairy godmother costume that CommonWell has on is real or fake. I think there path is paved with good intentions, but will the almighty dollar get in the way of them realizing these good intentions? I don’t know. I’m hopeful that it will be a success. I’m also glad that at least the conversations are happening. That’s a step forward from where we were before CommonWell.

Topic 5: Open forum: What #HealthIT topic had your attention this week?
There are so many topics that I discuss each week, but I think I’m most excited by the project announced this week to create a Common Notice of Privacy Practices. I hope their crowdfunding is successful and they get a lot of great healthcare organizations on board with what they’re doing. I also found the Vitera Healthcare acquisition of Success EHS quite interesting. EMR is slowly but surely consolidating.

Partners Integrates Mobile Data With EMR

Posted on June 25, 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 @annezieger on Twitter.

In a move that could realize much of the promise of wireless remote monitoring, Partners HealthCare system has made it possible for providers to view remotely-collected patient health data in its EMR.  The program was launched by Partners division The Center for Connected Health, which focuses on delivering new forms of patient care outside of standard medical settings.

For years, Partners has been running programs which collect patient data through a combination of remote-monitoring technology, sensors and Web-based tools. Their focus has included management of chronic diseases such as diabetes and high blood pressure, medication adherence and improved pregnancy outcomes and cardiac care outcomes. The Center’s remote monitoring database now stores over 1.2 million  patient vital signs.

Now, Partners has linked The Center’s proprietary remote monitoring database to its EMR, a step which moves the system in the direction of offering continuous chronic disease management. If a patient is participating in a remote monitoring program, Partners physicians can can now see a patient’s day-to-day vital signs, blood glucose levels, weight and other key health indicators directly within their records in the EMR.

The ultimate notion, according to the press release at least, is to  “put the patient at the center of their care while maintaining a close watch on their condition when they are not in the hospital or doctor’s office.”

While Partners didn’t say how many patients are involved in The Center’s programs, it’s doubtless a small fraction of overall Partners patient population. So despite the general coolness of what they’re trying to do, this is still more on the order of an experiment than a population health management program via remote monitoring.

Still, what Partners is doing is a large step in the right direction, and will doubtless realize some of the long anticipated benefits of remote monitoring for patients who are involved. Good show, folks.