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E-Patient Update: Video Visits Need EMR Support

Posted on July 11, 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.

From what I’ve read, many providers would like to deliver telemedicine consults through their EMR platform. This makes sense, as doing so would probably include the ability to document such visits in the same way as face-to-face encounters. It would also make it far easier to merge notes from telehealth visits into existing records of traditional care.

Unfortunately, there’s little reason to believe that this will be possible anytime soon. If nothing else, vendors won’t face too much pressure from providers until the health insurers routinely pay for such care. Or one could argue that until providers are living on value-based care models, they have little incentive to aggressively push care to lower-cost channels like telemedicine. Either way, EMR vendors aren’t likely to focus on this issue in the near term.

But I’d argue that providers have strong reasons to add EMR support to their telemedicine efforts. If they don’t take the bull by the horns now, and train patients to see video visits as legitimate and worthwhile, they are unlikely to leverage telehealth fully when it becomes central to the delivery of care. And that means, in part, that providers must document video consults and integrate that data into their EMR anyway they can. After all, patients are already beginning to understand that it data doesn’t appear in their electronic record, it probably isn’t important to their health.

It seems to me that the lagging EMR support for telemedicine visits springs in part from how they grew up. Just the other day, I had a video visit with a primary care doc working for one of the major direct-to-consumer telehealth services. And his comments gave me some insight into how this issue has evolved.

As sometimes happens, I ended up straying from discussion of my health needs to comment on HIT issues with the visit, notably to complain about the fact that I had to reenter my long list of daily meds every time I sought help from that service. He agreed that it was a problem, but also pointed out that the service’s founders have assumed that their users would almost exclusively be seeking one-off urgent care. In fact, he noted, none of the data collected during the visit is formatted in a way that can be digested easily by an EMR, another result of the assumption that clients would not need a longitudinal record of their telemedical care.

Admittedly, this service is in a different business than hospital or ambulatory care providers with a substantial brick-and-mortar presence. But my guess is that the assumptions upon which the direct-to-consumer businesses were founded are still shared by some traditional providers.

As a patient, I urge providers to give serious thought to better documenting telehealth today, rather than waiting for the vendors to get their act together on that front. If your clinicians are managing relationships by a video visits today, they will be soon. And when that happens I want a coherent record of my digital care to be available. Letting all that data fall through the cracks just doesn’t make sense.

When Will Doctors Teach Patients to Not Come In for a Visit?

Posted on July 8, 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’ve been thinking and writing a lot about the shifting medical reimbursement world. Technology is going to be an enabler for much of this shift and so understanding the changes are going to be key to understanding what technology will be needed to facilitate these changes.

As part of this thinking, I recently wondered when a doctor will start teaching patients when they shouldn’t come for a visit. I realize this is a bit of a tricky space since our current liability laws scare doctors from providing this kind of information. Dealing with these liability laws will be key to this shift, but if we want to lower the cost of healthcare and improve the patient experience, we need to make this change.

Turns out, we already do this in healthcare, but it’s not so formal. Plus, it’s usually the older, more experienced doctors that do it (from my experience). I think the older doctors do this for a couple unique reasons. First, hey’ve had years of experience and so the patterns of when someone should go to a doctor or not are very clear to them since they’ve seen it over and over for 30 years. Second, they aren’t as worried about patients returning in the future, so they’re not afraid to educate the patient on when they shouldn’t come for a visit. Third, these older doctors are likely tired of seeing patients for something that’s totally unnecessary.

We’ve had an older pediatrician that did this for us and our children and we loved the experience. In some ways, I think he just liked to hear himself talk and we loved it as parents. There’s no handbook you get as a parent and so we wanted to learn as much as possible about how to take care of our child. Since we had 4 children, we were able to use that knowledge pretty regularly, but even so, it was hard to remember 6 months or a year later what the doctor had told us. It was all very clear when he explained it in the exam room, but remember when to take them to the doctor and when to wait it out was often forgotten 6 months later.

The decision of when to go to the doctor and when not to go to the doctor is always a challenge and I always forget when I should and when I shouldn’t. Far too often my wife and I error on the side of caution and take our kids in for needless visits. We don’t want to be irresponsible parents and not take them. With my own personal health, I likely wait too long to go to the doctor because I’m busy or I can just tough it out when a quick visit to the doctor would make my life better and avoid something worse.

I guess this is why we see so many health decision tree apps out there. They try and take the collective knowledge and help you as a potential patient know if you should go in for the doctor visit or not. However, most of them are really afraid to make a hard conclusion that you shouldn’t go to the doctor. Instead, they all end with some sort of disclaimer about not providing medical advice and that you should consult a healthcare professional for medical advice. I’m not sure how we overcome the liability of really offering a recommendation that doesn’t need the disclaimer. Although, this is exactly what many of us need.

What do you see as the pathway forward? Will the consumer health apps be our guide as patients? Will doctors start spending time educating us on when to come for an office visit and when not to come? Will they want to do this thanks to ACOs and other value based reimbursement? Will doctors leverage the consumer health apps or a PHR tool to help their patients with retention of the concepts they teach them about when to come in for a visit?

Duplicate Work in Healthcare

Posted on July 7, 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.

One of my favorite stories is the time we implemented an EHR in the UNLV health center. At first, we decided to do a phased implementation in order to replace some legacy bubble sheet software that was no longer being supported. So, we just implemented enough of the PM system to handle the patient scheduling and to capture the charge data in the EHR. Of course, we were also a bit afraid if we implemented the full EHR, the staff would revolt.

A week or two into the partial implementation, something really amazing happened. First, some of the providers started to document the patient visit in the EHR even though they still had to document it in the paper chart as well. I asked them why and they just said, “It was there and I thought it would be good to have my info in the note.”

Second, some of the providers started asking me why they had to do duplicate work. They really hated having to enter the diagnosis and charge codes into the EHR and then document them again in the paper chart. Plus, they followed up that they could see the other section of the notes in the EHR and “why couldn’t they just use that instead of the paper chart.” The reality was: Doctors hated doing duplicate work!

Once I heard this, I ran to the director of the Health Center’s office and told her what they’d said. We both agreed, why wait? A week or so later we’d moved from paper charts to a full EHR implementation.

There were a lot of lessons learned from this experience. First, it’s amazing how people want to use the new system when they can see that it’s possible. They basically drove the EHR implementation forward. However, what was interesting to me was the power of “duplicate work.” We all hate it and it was a driving force for using technology the right way.

While we used the concept of duplicate work for good, there’s a lot of duplicate work in healthcare which drives patients and healthcare staff totally nuts. However, we don’t do anything about it. This was highlighted perfectly in a recent e-Patient update from Anne Zieger. Go and read her full account. We’ll be here when you get back.

What’s astounding from her account is how even though doctors hate duplicate work for themselves, we’re happy to let our patients and support staff do duplicate work all the time. I’ve seen some form of Anne’s experience over and over. Technology can and should solve this. This is true across multiple clinics but is absolutely true in the same clinic where you handle the workflow.

I get that there are reasons why you may want a staff to verify a patient’s record to ensure it was entered correctly and is complete. That’s absolutely understandable and would not have likely been an issue for Anne. However, to disregard the work a patient had done on their intake paperwork is messed up. Let alone not tapping into a patient’s history that may have been entered at another clinic owned by the same organization or collecting/updating the info electronically through a patient portal. I’m reminded of @cancergeek’s recent comment about the excuse that “it’s how we’ve always done it.”

In the past this might not have mattered too much. Patients would keep coming back. However, the tides of consumerism in healthcare are changing. Do you enjoy doing duplicate work? Of course not! It’s time to purge duplicate work for patients and healthcare staff as well!

No, The Market Can’t Solve Health Data Interoperability Problems

Posted on July 6, 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.

I seldom disagree with John Halamka, whose commentary on HIT generally strikes me as measured, sensible and well-grounded. But this time, Dr. Halamka, I’m afraid we’ll have to agree to disagree.

Dr. Halamka, chief information officer of Beth Israel Deaconess Medical Center and co-chair of the ONC’s Health IT Standards Committee, recently told Healthcare IT News that it’s time for ONC and other federal regulators to stop trying to regulate health data interoperability into existence.

“It’s time to return the agenda to the private sector in the clinician’s guide vendors reduce the products and services they want,” Halamka said. “We’re on the cusp of real breakthroughs in EHR usability and interoperability based on the new incentives for outcomes suggested by MACRA and MIPS. {T}he worst thing we could do it this time is to co-opt the private sector agenda more prescriptive regulations but EHR functionality, usability and quality measurement.”

Government regs could backfire

Don’t get me wrong — I certainly appreciate the sentiment. Government regulation of a dynamic goal like interoperability could certainly backfire spectacularly, if for no other reason than that technology evolves far more quickly than policy. Regulations could easily set approaches to interoperability in stone that become outmoded far too quickly.

Not only that, I sympathize with Halamka’s desire to let independent clinical organizations come together to figure out what their priorities are for health data sharing. Even if regulators hire the best, most insightful clinicians on the planet, they still won’t have quite the same perspective as those still working on the front lines every day. Hospitals and medical professionals are in a much better position to identify what data should be shared, how it should be shared and most importantly what they can accomplish with this data.

Nonetheless, it’s worth asking what the “private sector agenda” that Halamka cites is, actually. Is he referring to the goals of health IT vendors? Hospitals? Medical practices? Health plans? The dozens of standards and interoperability organization that exist, ranging from HL7 and FHIR to the CommonWell Health Alliance? CHIME? HIMSS? HIEs? To me, it looks like the private sector agenda is to avoid having one. At best, we might achieve the United Nations version of unity as an industry, but like that body it would be interesting but toothless.

Patients ready to snap

After many years of thought, I have come to believe that healthcare interoperability is far too important to leave to the undisciplined forces of the market. As things stand, patients like me are deeply affected by the inefficiencies and mistakes bred by the healthcare industry’ lack of interoperability — and we’re getting pretty tired of it. And readers, I guarantee that anyone who taps the healthcare system as frequently as I do feels the same way. We are on the verge of rebellion. Every time someone tells me they can’t get my records from a sister facility, we’re ready to snap.

So do I believe that government regulation is a wonderful thing? Certainly not. But after watching the HIT industry for about 20 years on health data sharing, I think it’s time for some central body to impose order on this chaos. And in such a fractured market as ours, no voluntary organization is going to have the clout to do so.

Sure, I’d love to think that providers could pressure vendors into coming up with solutions to this problem, but if they haven’t been able to do so yet, after spending a small nation’s GNP on EMRs, I doubt it’s going to happen. Rather than fighting it, let’s work together with the government and regulatory agencies to create a minimal data interoperability set everyone can live with. Any other way leads to madness.

Providers: Today’s Telehealth Tech Won’t Work For Future

Posted on July 5, 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 has concluded that while healthcare leaders see major opportunities for growing their use of telehealth technologies, they don’t think existing technologies will meet the demands of the future.

For the study, which was sponsored by Modern Healthcare and Avizia, researchers surveyed more than 280 healthcare executives to see how they saw the future of telehealth programs and delivery models. For the purposes of the study, they defined telehealth as encompassing a broad mix of healthcare approaches, including consumer-focused wireless applications, remote monitoring of vital signs, patient consultations via videoconferencing, transmission of still images, use of patient portals and continuing medical education.

The survey found that 63% of those surveyed used telehealth in some way. Most respondents were with hospitals (72%), followed by physician groups and clinics (52%) and a grab bag of other provider organizations ambulatory centers in nursing homes (36%).

The most common service lines in use by the surveyed providers included stroke (44%), behavioral health (39%), staff education and training (28%) and primary care (22%). Other practice areas mentioned, such as neurology, pediatrics and cardiology, came in at less than 20%. Meanwhile, when it comes to telehealth applications they wish they had, patient education and training was at the top list at 34%, followed by remote patient home monitoring (30%) and primary care (27%). Other areas on providers’ wish lists include cardiology (25%), behavioral health (24%), urgent care (20%) and wound care (also 20%).

Not only did surveyed providers hope to see telemedicine extended into other service lines, they’d like to see the technologies used for telehealth delivery change as well. Currently, much telehealth is delivered via a computer workstation on wheels or ‘tablet on a stick.’  But providers would like to see technology platforms advance.

For example, 38% would like to see video visits with clinicians supported by their EMR, 25% would like to offer telemedical appointments through a secure messaging app used by providers and 23% would like to deliver telemedical services through personal mobile devices such as tablets and smartphones.

But what’s driving providers’ interest in telehealth? For most (almost 75%) consumer demand is a key reason for pursuing such programs. Large numbers of respondents also cited the ability to improve clinical outcomes (66%) and value-based care (62%).

That being said, to roll out telehealth in force, many respondents (50%) said they’d have to make investments in telehealth technology and infrastructure. And nearly the same number (48%) said they’d have to address reimbursement issues as well. (It’s worth mentioning, however, that at the time the study was being written, the number of states requiring reimbursement parity between telehealth and traditional care had already risen to 29.)

This study underscores some important reasons why providers are embracing telehealth strategies. Another one pointed out by my colleague John Lynn is that telehealth can encourage early interventions which might otherwise be delayed because patients don’t want to bother with an in-person visit to the doctor’s office. Over time, I suspect additional benefits will emerge as well. This is such an exciting use of technology!

Happy Fourth of July!

Posted on July 4, 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.

EMR and EHR - 4th of July

I’m taking a break today and spending some time with family. I hope you’re doing the same. Despite the craziness that we see on the news every day, I still feel lucky to live in an extraordinary country. Having lived in a number of other countries, it gives me a great appreciation for the things we do have. It’s too bad the media seems to focus so much effort and energy on the things that divide us.

A big thank you to all those in the healthcare profession that are working on this day. I can only imagine the horrors that come from fireworks on this holiday. Thanks for taking care of us even on holidays.

Will Doctors Start Prescribing “Coloring Books”?

Posted on July 1, 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.

The always brilliant Jane Sarasohn-Kahn recently published a great post talking about the health benefits of coloring books on her Health Populi blog. Here’s an excerpt from what she calls the Health Populi Hot Points (Note: Her Hot Points are the best part of her points):

Health Populi’s Hot Points:  As anxiety and depression permeate the public health burden in the U.S. and beyond, people seek solutions and hacks to live well. Based on the market demand for coloring books, it’s clear adults are picking up Crayolas, Sharpie’s, and colored pencils as an antidote to stress and sadness.

Coloring is part of artistic expression; as more people engage with arts, the healthier they can be, based on advice from The National Center for Creative Aging. The Center hosted a conference in 2014 focused on the role of artistic expression in the lives of older adults to improve health and wellbeing. Studies have shown that for people over 65, those involved in weekly art programs had fewer doctor visits and took less medication than people without creative opportunities.

Dr. Marc Agronin, Medical Director for Mental Health and Clinical Research at the Miami Jewish Health Systems (MJHS), Florida’s largest long-term care organization, noted, “a growing body of evidence indicating that creative programs for older adults improve the health and wellness of older adults.”

Consider this a form of full-on consumer-directed health.

Jane’s post has more details on the adult coloring book trend and some of the benefits. You can go and read the full post. We’ll be here when you get back.

After her reading her post, I wondered if we’d ever see a doctor “prescribing” a coloring book to a patient. Based on some of the benefits she describes, we probably should have doctors prescribing them. However, I think it’s going to be a long time before we actually see it happening.

For some reason I think that prescribing something as simple as a coloring book doesn’t feel like medicine. I’m sure many doctors would discount coloring books as medicine. However, patients are as much of the problem as doctors. If I paid the co-pay to see my doctor and he prescribed coloring books, I’d likely feel like I didn’t get my money’s worth.

Certainly, we could debate the medical benefits of adult coloring books (I’m certainly no expert and would happily look at other evidence), but the principle is the point. Are there simple solutions like an adult coloring book that could be just as powerful for our health as the prescription pad? I think so.

I’m reminded of my experience working in a counseling center. I’ll never forget when one of the counselors informed me that studies had shown that exercise had a greater benefit to those with depression than even drugs. However, it’s easier to prescribe a drug than it is to convince a depressed patient to work out. Not to mention many patients likely wouldn’t appreciate a prescription to exercise more.

I think this is just one more reason why it’s not likely doctors that will shift the cost curve in healthcare. No doubt many of us listen to and trust our doctors in a unique way. However, I have a feeling that many of these messages about our health are more likely to be delivered by someone closer to a social worker, care manager, or nurse than our doctor. Being sent some adult coloring books by a care manager would likely be taken quite different than a doctor “prescribing” them to a patient.

Of course, as Jane aptly notes, anyone can buy a coloring book, so things like this are as much about consumer-directed health as it is a shift in what doctors and their medical staff do. In fact, the most successful doctors in this changing health system might be doctors who learn to empower their patients in their own efforts to improve their health.

EMR and EHR Update

Posted on June 30, 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.

The evolution of blogging has been interesting to me. I use to celebrate all sorts of milestones on my blogs. Now that we’re 10 years and over 10,000 blog posts into my healthcare IT blogging career, I sometimes take for granted what each blog accomplishes. I’ll try and fix that by covering a few of the latest stats for EMR and EHR:

  • 4.6 million pageviews
  • 1,789 blog posts
  • 3,887 comments
  • Average of 4.9 blog posts/week

Looks like my first post on EMR and EHR was way back on April 30, 2009. I’m pretty proud of what we’ve built at EMR and EHR over the past 7 years. Ironically, I actually started this blog for a guy named Jamie. I was busy blogging over on EMR and HIPAA. 5 blog posts in he got a new job which didn’t leave him the time to blog, so I took it over and have been blogging on it with a group of other amazing writers ever since.

A year or so after I started EMR and EHR, I almost sold the blog for $50k. Considering the revenue this blog has generated since then and what it’s worth, I’m glad I chose not to sell it at the time.

Speaking of which, I’ve been lucky to have hundreds of great healthcare IT and EHR companies support this blog over the years. We started off largely selling EHR display ads and they still do quite well for us since our readers are often looking for the right EHR and healthcare solutions. Since then we’ve really expanded our healthcare IT marketing options to things like email marketing and sponsored content.

Thanks to the hundreds of advertisers that have and continue to support the work we do covering the healthcare IT and EHR industry. Plus, I can’t express my gratitude enough for the millions of readers who have visited EMR and EHR. Especially the many people who have shared our content, corrected our mistakes, extended the conversation, shared us on social media, and helped us continue to be the go to place for what’s happening in healthcare IT.

Here’s looking forward to another 7 years of excitement. I can only imagine where EHR and health IT will be 7 years from now. That’s what makes this field so exciting.

Physician Data Paradox

Posted on June 29, 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.

“[Doctors] are overloaded on data entry and yet rampantly under-informed.”
-Andy Slavitt at Health Datapalooza

This quote from Andy Slavitt at Health Datapalooza has really stuck with me. He calls it the physician data paradox. It’s an ugly paradox and is at the heart of so many doctors discontent with EHR software. Andy Slavitt is spot on with his analysis. Doctors spend hours entering all of this data and get very little return value from that data or the volume of health data that is being captured.

My friend Dr. Michael Koriwchak has made an interesting request. In a recent blab interview he was on he said that CMS should only require the collection of data they’re actually going to use.

My guess is that the majority of meaningful use data would not need to be collected if Dr. Koriwchak’s rule was in place. CMS hasn’t really even collected the data from doctors, so they’re certainly not using it. Some of the principles of meaningful use would still exist like interoperability and ePrescribing, but we wouldn’t be turning our doctors into data entry clerks of data that’s not being used.

Think about the reality of meaningful use data collection: CMS doesn’t use the data. Clinicians don’t use the data.

We’ve basically asked doctors and other medical staff to spend millions of hours collecting a bunch of data that’s not being used. Does that make sense to anyone? You could make the argument that the data collection is creating a platform for the future. There’s some value in this thinking, but that’s pretty speculative spending. Why not do this type of speculative data collection with small groups who get paid for their efforts and then as they discover new healthcare opportunities? We can expand the data collection requirement to all of healthcare once doctors can do something meaningful with the data they’re being required to collect.

In fact, what if we paid docs for telling CMS or their EHR vendor how EHR data could be used to benefit patients? I’d see this similar to how IT companies pay people who submit bug reports. Not using health data the right way is kind of like reporting a bug in the health system. Currently, there’s no financial incentive for users to share their best practices and discoveries. Sure, some of them do it at user conferences or other conferences, but imagine how much more interested they’d be in finding and sharing health data discoveries if they were paid for it.

If we finally want to start putting all this health data to work, we’re going to have to solve the physician data paradox. Leveraging the power of the crowd could be a great way to improve the 2nd part of the paradox.

Social Determinants of Health (SDOH) Chart

Posted on June 28, 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.

It seems like my latest kick is talking about Social Determinants of Health (SDOH) and their impact on our health and the health system (Note: I blame Mandi Bishop for this). Many of you might remember that I recently asked if doctors ever cared about SDOH. The topic also came up in the recent Health Disruptors chat where I asked pointed questions about SDOH from a practicing doctor. Dr. Vanagon’s responses were quite insightful.

During that chat, I started listing off some of the possible social determinants of health. I knew my list was lacking and I figured someone else had created a much better list. As fate would have it, this list popped up on my social news feed:

Social Determinants of Health (SDOH) Chart

Does anyone else get a bit overwhelmed when you see a full list like this? However, it also displays huge opportunities since our current health system is working on such a small portion of this chart. We’re going to have to expand what we’re doing if we truly want to lower the cost of healthcare as we know it. Although, it’s also important to note that doctors can only influence so much of what impacts our health.

Which SDOH factors do you think it would be best for our health system to work on first?