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Epic EMR Training, Glucometer Workflow, New Media Meetup & MU Success


I think this is true for all EMR software, but particularly so for Epic. It’s always amazing how many skimp on EMR training and then pay the price for it later.


It’s a little hard to see, but illustrates the challenge associated with connecting these external data devices. It’s going to take a while for this to be commonplace and normal. I do find it interesting that they’re using Direct and the hardest interface to build (sending info to the EHR) is “Out of Pilot Scope.” I guess they don’t want to take on the hard stuff in the pilot.

These next 2 tweets are a little self serving since they point to posts on my EMR and HIPAA site. If you’re not subscribed to that site, you should go and do that now. Plus, one of these tweets is about a party at HIMSS, so I don’t imagine I’ll get any complaints there.


I hope to see many of you at HIMSS 2014!


I appreciate Dr. Webster recognizing this as a good one. While I’m biased, I think it’s a really important topic that needs more discussion. Although, I’m pretty sure it won’t be getting me an invite to any ONC dinner parties.

January 26, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

The Patient Medical Record, Usable Health IT, and Return of Blackberry — Around Healthcare Scene

EMR, EHR, and HIPAA

EHR Benefit — Space Savings

This is the next installment of EHR Benefits. Some clinics claim that the space saving that comes with having an EHR is definitely a benefit. It’s usually more of a benefit for smaller practices, but can also benefit larger ones. One way is that the elimination of a document room could make room for another office.

Redesigning The Patient Medical Record, the Healthcare Challenge’s Results

This is a guest post by Carl Bergman from EHR Selector. The post dicusses the results of the Healthcare Design Challenge put on by by the VA and the ONC. First place went to Nightingale and second place StudioTACK. There were also a few other rewards given out. Bergman also talks about several problems with this challenge.

Hospital EMR and EHR

Patients Question Clinical Decision Support Use

A new study published in Medical Decision Making found that patients aren’t as thrilled about computer-assisted decision making. The study revealed some interesting findings, like patients don’t trust physicians who use CDS. For those that use this, the study may be a bit unnerving, but it’s interesting nonetheless.

One Vendor’s Take On Building Usable Health IT

This post contains the views of Joe Condurso, president of CEO of health IT vendor PatientSafe, on building usable health IT. He offers several recommendations. They include responding to context, being mobile, and starting from a mobile design.

Smart Phone Healthcare

BlackBerry’s “Hail Mary” Pass for mHealth

Although BlackBerry used to be the device of choice among physicians, it has been crowded out with the introduction of newer devices. However, BlackBerry is trying to get back in the game with the release of some new devices which they believe offer something unique. Will doctors switch back, or is BlackBerry grasping at straws?

Track Infants Growth With BeCuddle iPhone App

A new iPhone app has been released to help parents keep track of their infants growth. BeCuddle has a variety of features, including the ability to track medication, record milestones, and just help a parent make sure their child’s health is right on track.

February 3, 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.

Results of EHR Motivation Poll

A few months back I posted a poll asking “Which Factor most influences your EHR use?” I was really interested to see the results of this poll since I often think that most clinics are so blinded by the EHR stimulus money that they lose touch with the reality of running a clinic.

Here’s the results from the poll:

As you can see, the results are pretty dramatic. At least the majority of readers of EMR and EHR are implementing an EHR for something more than the EHR incentive money. This is a very heartening thing for me. Not that any clinic should ignore meaningful use and the EHR incentive, but I’m glad that most are focusing on the benefits of an EHR to their clinic more than meaningful use and government handouts.

This gives me added motivation to start a series of posts on EMR and HIPAA about the various EMR and EHR benefits not related to EHR incentive money. I hope that series will help those implementing an EHR find all the benefits possible from EHR use. Watch for that over the next couple days.

November 14, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

What’s Your EHR Motivation?

Ever since I first got a job implementing an EMR system, I’ve been fascinated with the idea of the benefits that could be had with using an EMR. In fact, back in 2006, I started a list of EMR and EHR benefits on my EMR and HIPAA blog. I haven’t touched the page in a while, so I think I’m going to do a series of posts on EMR and HIPAA about each possible benefit.

Before I dive into those details, I thought it would be interesting to post a poll about what is motivating a physician’s use of EHR. This is a simple poll, and it’s meant to be simple. Notice that it says most influences. We all know that both things influence decisions. I did add the “Other” option though for those that might want to share something else.

I think this poll will be quite revealing. I’ll be sure to share the results in a future post.

September 6, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Purpose of Meaningful Use

Lately I’ve been quite disturbed as I’ve read all sorts of commentary about the “Purpose of Meaningful Use.” Here’s one such comment on meaningful use that I read recently:

My impression is that EMRs and meaningful use were about getting Americans to practice evidence-based and comparative effectiveness medicine towards a more streamlined and cost-effective US Healthcare System

Some of you might remember when I questioned the “meaning” of meaningful use as described by Farzhad Mostashari. So, this is not a new subject for me to consider.

Here’s the problem:

The purpose of meaningful use was to be sure the ARRA money was spent on software that doctors actually end up using. Everyone has then taken meaningful use whatever direction they want.

We can certainly talk about the possible impacts and unintended consequences of meaningful use, but let’s not confuse the possible impacts with the purpose of the legislation.

It turns out that meaningful use is actually accomplishing its purpose as I describe it above. At least in Medicare where meaningful use is a requirement there aren’t EHR companies gaming the EHR incentive money like they are in Medicaid. Sure, with self attestation you could lie about your “meaningful use” of an EHR, but I have yet to see it and think it is very unlikely.

You may have noticed that I don’t write about meaningful use as much here on EMR and EHR. That’s because on EMR and HIPAA I (with some great help) have been doing a weekly Meaningful Use Monday series over the past year. Check it out if you’re interested in the details of meaningful use.

August 8, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

EHSD, Computing In Front of Patients, EMR Workflow, and more – This Week in HealthCare Scene

Didn’t have a chance to read everything that other HealthCareScene.com websites had to offer this week? Here is a round-up of some of the best articles this week

EMR and HIPAA

EHSD – EHR Hunt Stress Disorder

Are you “worn out, drug out, and generally pooped” about the search for the perfect EMR? If so, the diagnosis might be what Dr. Gregg describes as EHSD — the EHR Hunt Stress Disorder. Sometimes it is hard to know which EHR company to go with, with over 600 out there. Knowing how to narrow the options down quickly might make the decision a little bit easier, and EHSD less severe.

The Happy EMR Doctor

Readers Speak About Computing in Front of Patients

Should not only use, but discuss, EMR in front of patients? Dr. Michael West recently wrote about computing in front of patients. Readers responded about their thoughts on it and hardly any had negative feelings. In this post, Dr. West responds to the comments readers left and how he feels that EMR is here to stay.

Wired EMR Doctor

EMR Workflow Continues to Evolve

Over the last seven years, Dr. Michael Koriwchak has implemented electronic medical records into his practice. While there has been some trial-and-error involved, the skills his staff and him have concerning EMR continually become more fine-tuned. Dr. Koriwchak talks about two different types of workflow, and which one he prefers. He reflects on how the combination of “successful web portal with a sophisticated workflow engine operated by staff” allows a practice to use EMR even more efficiently.

Smartphone Healthcare

New Friend Request . . . From the Family Doctor? 

Social Media is becoming more and more popular, so doctors and hospitals everywhere are jumping on the bandwagon. Would you follow your doctor on Twitter or Facebook, or is that crossing the line for a patient-doctor relationship? The pros and cons of the growing trend for medical professionals going virtual are discussed.

Hospital EMR and EHR

Issues to Consider When Offering Hospital-Subsidized EMRS

Hospitals have started offering subsidized EMRs recently to physicians. While these might be tempting to accept, a physician must be careful about the conditions on which the EMR is accepted. Before accepting a hospital-EMR deal, be sure to read this list of questions to ask the hospital offering it.

EHR and EMR Videos

Smoking Cessation With the Waiting Room Solutions EMR System

There are quite a few preventative measurements required for EHR Incentive Meaningful Use and CQM Compliance. A video from Waiting Room Solutions provides a “how-to” video on how to use the Web-based EMR system for Smoking Cessation.

May 13, 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.

Happy Holidays!

I was preparing to write another post on EMR and EHR before running out to finish some last minute shopping. I think I’m going to splurge and buy my wife an iPad. Shh…don’t tell her. Good thing she’s long since stopped reading my blogs (I have far too many). Anyway, I was getting ready to write a post and realized this is the Friday before the Christmas weekend.

So…
Merry Christmas for those who celebrate it like I do. Happy Holidays for those who don’t celebrate it.

If you still want something more as you try to make the time pass quicker, go and read this post I did on EMR and HIPAA about all the Healthcare Scene writers.

Otherwise, enjoy your weekend and we’ll catch you on the other side. Also, let’s not forget the true meaning of the season and life: taking care of others. I think that’s something we can all embrace.

December 23, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Healthcare Data Security, Healthcare Breaches, and EMRs

We’ve posted about it earlier on this blog as well, and it’s a point worth reiterating – most data breaches are not the result of hordes of internet hackers out to get your computer system, they’re due to human errors or negligence.

Here are some recent cases of patient data that has emerged from EMRs in unexpected places:
Lost in Break-In: By now, we’ve all probably already shaken our collective heads over the Tricare data breach involving data for 4.9 million military patients. Scientific Applications International Corp. (SAIC), one of Pentagon’s principal contractors, was the outfit that was responsible for the data loss, which was stolen from a break-in into a SAIC employee’s car. The data was contained in backup tapes, and contained information such as SSN, addresses and phone numbers of patients, and personal health data.

There are several perplexing things about this story – a) the statement on Tricare’s website claiming nothing important was really lost: “The risk of harm to patients is judged to be low despite the data elements involved since retrieving the data on the tapes would require knowledge of and access to specific hardware and software and knowledge of the system and data structure” per this story.
b) SAIC’s success with HHS contracts – SAIC was awarded a lucrative $15 million contract by HHS, despite the breach.

Posted on a Homework Help forum: According to this NYT story and its follow-up, patient records (names, diagnosis codes, account numbers, admission codes) from emergency visits for a six month period at Stanford Hospital, CA, were posted online. Supposedly, a Stanford vendor sent the data to a prospective contractor as part of a testing exercise. The contractor posted it all online, on a website offering tutoring help no less, without realizing it was actual patient data. The story says Stanford had the data removed from the website, and reported the breach to federal and state authorities, as well as the patients. Stanford is arguing that none of its staff has done anything wrong, and that it severed its relationship with the contractor. To me, this is the proverbial buck being passed.

Lost in the Subway: The first NYT story mentions how the paper records of 192 patients left on a subway by an employee of Massachusetts General Hospital in Boston. The hospital has agreed to pay a $1 million federal fine for HIPAA violations.

So to summarize some lessons learned from these data breaches:
Loss of paper records is worse than the loss of electronic records: This should be obvious to anyone who’s not a schoolgirl with a fancy diary guarded by a lock.

Your data is only as safe as your weakest link: If you’re farming out your data to vendors, then you have to know what policies your vendor has in place. If your vendor subcontracts further, then you have to keep going down the line till you are reasonably assured of data safety. When the hammer falls, it is *you* who will be coughing up the fines.

Prep with Data-handling Policies and Procedures that you and your staff religiously follow: The data was lost in very human ways – data left inside a car, posted by an untrained contractor. This just means you need to have robust, and enforced, policies in place for how patient data is handled by your employees. Maybe in your company this means that your employees can’t take work home, or that they must clear their workspaces of any patient data before they leave. Decide what makes sense in the context of your business, and maybe hire someone to enforce these rules.

Give kickbacks to HHS: If you’re in the business of contracting with the government, seriously figure out how SAIC has managed to stay in HHS’ good books. I wish I were kidding with this one.

October 10, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

EMR and Healthcare IT Article Run Down

I imagine most of my readers know that I’ve launched the Healthcare Scene blog network. EMR and EHR is one member of the blog network along with 7 other blogs that have been announced with 6 more blogs that will be announced shortly (Have you found them already?). We’re growing rapidly and expanding the number of people that are sharing great content with the world of healthcare IT and in particular EMR and EHR. The goal of providing a platform for the independent Healthcare IT voice is becoming a reality.

It’s a really exciting thing to be a part of. The most exciting part of it all is the amazing people that I get to work with and the content they create. Here’s a quick glimpse at some of their content with my thoughts on their posts.

EMR and HIPAA
Neil Versel recently started posting a regular weekly column on EMR and HIPAA. Check out his latest post on clinical decision support and an update on Dr. Larry Weed. Reading articles like that from Neil help me to appreciate more fully the history of healthcare IT. I’ve admittedly showed up late to the party, but Neil provides some interesting perspectives based on his knowledge and experience in healthcare IT. Here’s my favorite quote from his article:

“Patients may surmise that a physician who uses a [decision support system] is not as capable as a physician who makes the diagnosis with no assistance from a DSS.” I then noted that Weed has been saying for more than 50 years that physicians shouldn’t have to rely on their memory to make clinical decisions when computers can help them process an increasingly voluminous knowledge base.

Meaningful HIT News
Neil’s blog Meaningful Healthcare IT News is also a member of the Healthcare Scene blog network. How can you not enjoy a post entitled Skype for “Redneck Telehealth”? Sometimes, you’ve got to do what you’ve got to do.

Happy EMR Doctor
What doctor isn’t interested in reading another doctor’s perspective on “Getting a Life with Electronic Medical Records,” “Gag Orders and Bad EMR Systems,” and a Doctor’s issues with PQRI Incentive Money? Those are the latest topics from Dr. West over on Happy EMR Doctor. Of course, now that Dr. West has gotten the blogging bug, his EMR gave him a life and his new blog has taken it back. I always appreciate a practicing doctor’s perspective.

Smart Phone Health Care
I’d been covering a number of mobile health care and mHealth related topics on this and my EMR and HIPAA blog, but the topic has become so popular that I knew it was time to start a mobile health care related site of its very own. I’m now doing it in partnership with David. He’s been churning out some interesting posts about Cell Phones Saving Lives in Africa and a Mobile App that Could Detect an Acute Stroke. I’ve always seen one of the major developments of mobile health happening in the developing world where the IT networks aren’t yet in place. Mobile phones can have such a tremendous impact for good. It’s beautiful to learn about. Although, mobile health is still in its infancy in the developed world as well. Personally, I’ve been trying to kick around some mobile gaming app that would encourage activity (ie. movement). Far too many of us sit in front of our computers all day. Healthcare would be so much better if more people just moved (written as I sit in front of my computer).

EMR, EHR and Healthcare IT News
This site is still very young, but just hit it’s 100,000 pageview mark. That’s a result that I would have never been able to predict. Although, news like the one posted today about the First Medicare EHR Stimulus Checks is something that many find interesting. If you know of other news we should be posting, let us know.

EMR and EHR Screenshots
The most recently announced member of the Healthcare Scene blog network is a website called EMR and EHR Screenshots. There’s still a lot I want to do to improve the interface for viewing the various EMR and EHR screenshots, but I think the concept is really interesting. My goal is to aggregate as many of the EMR and EHR screenshots as I can get. Hopefully that will mean even screenshots from the same EMR and EHR software as it releases new versions of the software. I’d love to have screenshots of CPOE, ePrescribing, scheduling, charting, diagnosing, etc. Basically if you’re interested in knowing what an EMR looks like or what it looked like previously, we’re hoping to provide you that view into an EMR’s development. A lofty vision. We’ll see how many EMR and EHR vendors, doctors, and other users will support it.

See what I mean when I talk about the amazing content that’s being generated. This doesn’t even include the great posts that Katherine Rourke is doing on this blog and my own posts (which could be classified as good or bad).

As I mentioned, I have 6 more blogs to be announced shortly. So, keep an eye on Healthcare Scene to see what will be announced next.

May 19, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Accountable Care Organizations (ACO) – Hospitals Buying Up Practices

Everyone in healthcare is currently talking about the recently released proposed rule on Accountable Care Organization (ACO). In fact, I posted on EMR and HIPAA a guest post about the ACO Legislation and its ties with healthcare IT, meaningful use and EMR. It’s definitely worth a read.

This move to ACO’s (and to some extent healthcare IT) were described nicely by Maria Todd on Twitter:

As many have said, the ACO train has left the station. In an October article, HIStalk posted about the movement of hospital organizations acquiring physician practices and offered some lessons learned from similar movement back in the 1990′s.

An interesting analysis: hospitals are buying up primary care practices to prepare themselves to become Accountable Care Organizations, which could be the end of the line for small, independent practices. Hospitals are looking at increasing PCP salaries like a Wall Street analyst looks at price-to-earnings ratios, knowing that internists and family practitioners generate hospital revenues at nine times their average salaries, while expensive specialists generate a multiple of only five times their salary. For industry noobs, it’s time for hospitals to get taken to those 1990s cleaners all over again, because:

  1. Docs sell out precisely because they don’t want to work  as hard for their new hospital employer as they did for themselves (duh).
  2. Hospitals are notoriously bureaucratic and inefficient managers, making them particularly unsuited for running a low-overhead medical practice in every way from EMRs to personnel policies to regulatory compliance.
  3. Private practice docs hate and distrust everything about hospitals except the money they have and don’t usually change their opinions or behaviors just because they sell them their practices.
  4. Doctors resent taking orders and being told how to practice medicine, especially from suit-wearing hospital MBA-types who fancy themselves business experts despite always having worked for a paycheck instead of themselves, making it likely all these deals will fall apart in 4-5 years like they did last time around, with the docs scrambling to start up new practices without the benefit of a location, an EMR, or patients that they sold away to the local hospital in a frenzy of co-opetition.
  5. Patients aren’t much more enthused about hospitals than doctors are, so they aren’t exactly thrilled to see the big sign go up over their friendly little doctor’s office knowing it’s the same folks with ED waits, bad cafeteria food, and terrible parking.

I’ll be really interested to see how these ACO organizations play out and if it is indeed the end of the small physician practice. Although, my gut feeling say that this is cyclical.

While hospitals buying physician practices is one method for creating an ACO, I’d love to hear other models that might be used to create an ACO. Feel free to sound off in the comments with your thoughts and ideas.

April 5, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.