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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.

A Small Practice View of Healthcare IT Coming Out of #HIMSS16

Posted on March 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.

This week as I slowly recover from the #HIMSSHaze that sets in after spending a week with 41,000 of your closest friends and 1300+ vendors, I’m taking a second to think about how the small physician practice fits into the future of healthcare IT that was presented at HIMSS 2016.

As the graphic at the bottom of this post shows, just over 40% of attendees at HIMSS are providers. Of course, provider is a pretty broad term and that has to also be paired with the other number on that chart that 30.5% of attendees are part of the C-Suite. Even scarier is that only 2.2% of HIMSS registrations identified themselves as clinicians.

Those who read this blog regularly likely remember that I already wrote about physicians and patients missing at HIMSS. These numbers seem to prove this out. It’s unfortunate, because that means that the physician voice is largely going to be missing in many of the conversations that happen at a show like HIMSS.

With this in mind, it’s not surprising that I think the future for the small practice is on shaky ground. Many of the solutions presented at HIMSS are going to be hard for a small practice to afford. At some point these health IT solutions will be so good that they’ll become the standard of care. Once that happens, where does that leave the small practice provider who can’t afford these high tech solutions?

Considering many small practices aren’t joining in these conversations, I think it’s going to leave many small practices up a creek without a paddle. No doubt there’s a large portion of the physician population that are betting that retirement will come before this becomes a reality. Others probably think that the worst that could happen is that they’ll have to work for a large organization.

Despite this rather negative outlook on the future of small practices, there is some hope. When you look at the work that Farzad Mostashari is doing at Aledade to make accountable care and valuable based reimbursement available to the small practices you can see a future where small practices can survive even in this changing reimbursement landscape.

I think there are two models that I see emerging to allow small practices to keep some autonomy and survive in this changing healthcare world. First, small practices have to join together with other small practices to be able to create a large enough entity to be able to share in the costs associated with this future technology and to be able to compete with much larger hospital systems. Second, we need organizations like Aledade that help small practices survive by spreading their resources across a diverse group of small practices.

There is strength in numbers. So, whether the small practices form together themselves or whether health IT vendors essentially create a network of small practices, either option requires small practices to combine their efforts in order to survive. It reminds me of this clip from the film Finding Nemo. Small practices need to start “Swimming Together!”

Here’s a look at the registration numbers for HIMSS 2016:
HIMSS 2016 Registrations by Title and Worksite

Hyperportalotus: Condition Whereby Patient Has Too Many Healthcare Acquired Portals

Posted on March 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.

In case you missed the last day of HIMSS 2016 (which is most of you since the keynote area was pretty empty), you missed a number of interesting keynote sessions and other education sessions. However, as I thought through the sessions that day, this comment from a patient attending one of those sessions really stood out to me:

Based on the reaction of the crowd to this comment and my own experience talking with thousands of doctors and patients, this is a very common problem. Meaningful use encouraged providers to have a patient portal, but this had the unintended side effect of what I’d call portal proliferation.

The patient who commented about her “hyperportalotus” said that she knew that she had portals for most of her providers, but she couldn’t keep track of which provider was on which portal. No doubt she was embarrassed when she couldn’t remember how to log in to that many portals as well. Plus, the last thing any sick person wants to do is go searching through 9 portals to find the one that has the information they need.

What concerns me most about Hyperportalotus is that I don’t think there’s a clear pathway to treating this debilitating problem. There are some treatments that make it better, but the problem still remains and I don’t see a cure for the problem coming anytime soon. Is the government going to come out with a portal non-proliferation treaty? I don’t think so.

Before I get a wave of pitches that you’ve solved this problem, I’ll make it clear that I don’t think the patient being an HIE of one is a scalable solution. That idea might work for some patients, but it won’t work for most. Plus, the complexity of each portal having their own format and design causes so many issues with the concept of the patient being the repository and aggregator of their health information.

I’d love to hear how people think this will play out? We got a bunch of doctors on the portal. Now what?

#HIMSS16 Twitter Round Up #4 – Keynote Speakers

Posted on March 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.

Today HIMSS 2016 had 2 keynote speakers that were well worth the price of admission. They both entertained, informed and inspired. Here’s a few insights from each from my live tweeting their sessions (the first is a must read for those who care about marketing and the HITMC community):

Dr. Jonah Berger

Peyton Manning

How amazing that sportscenter was reporting from the HIMSS conference on what Peyton Manning said in his keynote and how that related to his chances of returning or retiring? Pretty crazy stuff indeed.

My final thought on HIMSS 2016 (Although join us for this video discussion (blab) about HIMSS 2016 next week):

#HIMSS16 Twitter Round Up #3

Posted on March 3, 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.

Time again for a quick look around the Twittersphere from the HIMSS 2016 conference in Las Vegas.


I talked with Rasu about this at RSNA. The problem with this is that simple is harder to do.


I think we can already benefit from AI and automation even if the silos aren’t broken down. We shouldn’t wait.


Certainly we can’t predict things 100%, but we can predict many things with pretty solid accuracy if we have the right data points. We shouldn’t allow the fact that we can’t predict perfectly keep us from doing our best to predict future healthcare conditions.


This shift is certainly in the air at HIMSS. Payers are following CMS’ lead.


My only complaint with this picture is that they should be juggling about 300 more items.

#HIMSS16 Twitter Round Up #2

Posted on March 2, 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.

Time again for a quick look around the Twittersphere from the HIMSS 2016 conference in Las Vegas.


I’m not sure getting run over is the right analogy. I agree that organizations that don’t change will fail. However, if they’re getting run over, then it’s likely by a really slow moving vehicle. Kind of reminds me of the analogy of the frog in the pot of boiling water. The changes happening in healthcare are happening so slowly that many don’t recognize what’s coming.


I think this is such a poor analogy that needs to die. Exchanging data in a money transaction is so simplistic. Exchanging healthcare data is at least an order of magnitude more complex.


I’m going to be chewing on this one for a while. What do you think?


I’m biased to this since it’s from an article I wrote. Does anyone think the future of healthcare won’t be built on the back of data?


We’re just getting started in genomics, but hopefully as we do we’ll learn the lesson from other healthcare IT that we have to present the data in a useful manner or it won’t be used.


I’ve heard this talked about a lot at HIMSS. Can we just start stating it as fact? Patients will come in with more info. That’s reality. Now let’s figure out how to make the most of the change.

#HIMSS16 Twitter Round Up #1

Posted on March 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.

One of my favorite blog posts is the Twitter round up of interesting tweets plus a little commentary on each tweet. So, here goes the first look at some of the interesting tweets I’ve seen coming out of the HIMSS 2016 conference.


This was the way the HIMSS conference keynote started out. It’s better in person, but was a pretty cool display of technology.


Interesting layout. I think that very few of our efforts have reached the 4th act of the play.


I think this is one of the big themes coming out of HIMSS16. A lot of companies and people are interested in what can be done to improve someone’s health outside of the doctor’s office or hospital. However, I’ve also seen first hand what a challenge that can be.


I agree 100%. The challenge we face in healthcare today is that we have far more regulation than a culture of innovation.


I’m still really chewing on this one. I think the message is we should be more sympathetic of the challenges patients face. However, I think we also should be sympathetic of the challenges that healthcare providers face as well.

Of course, there are a lot more tweets on the #HIMSS16 hashtag. Those were a few that I found insightful. Let everyone know what you found interesting in the comments.

Preview Videos of HIMSS 2016 in Las Vegas

Posted on February 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.

I got a unique chance to get an early preview of some of the HIMSS 2016 Annual conference and talk to a number of the people behind the HIMSS conference. Check out these videos to learn a bit more about what to expect at the HIMSS Annual conference and highlights of a few areas and sessions you might not know about. Plus, you get a great look at the HIMSS 2016 keynote area.

HIMSS Spot Activities and HIMSS Social Media

The HIMSS “Living Room”

HIMSS Keynote Stage and a Preview of HIMSS Sessions

Finding Patient and Connected Health Sessions at HIMSS

Meet the HIMSS Social Media Team – #GoesBeyond

Posted on February 19, 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.

A few weeks ago, I took part in an initiative that Greythorn (Full Disclosure: Greythorn pays to post jobs on our Healthcare IT Central job board) started around the great hashtag #GoesBeyond. Using that hashtag they’re asking people to recognize people in healthcare IT that are doing amazing work. You can read my first #GoesBeyond post that recognized the work of Steve Sisko.

For my next #GoesBeyond post I want to recognize the whole HIMSS Social Media team. Many people don’t realize how much work this team puts in to make HIMSS one of the most social media driven conferences in the world and far and away the most tweeted healthcare conference in the world.

That’s why I’m highlighting the whole HIMSS social media team for #GoesBeyond. I hope many others who read this will take part in the #GoesBeyond effort and highlight other people in the healthcare IT community that deserve recognition. There’s nothing better we can do for the community than to show gratitude for each other.

The HIMSS social media numbers don’t lie. Check out the Twitter activity alone around HIMSS:
HIMSS-Social-Media-Growth
While most people are familiar with the @HIMSS account which boasts 74,753 followers (and growing), I’m sure that many don’t realize that the HIMSS LinkedIn group has 166,325 members. These are extraordinary numbers and they don’t happen by happen stance. This kind of growth only comes through consistent focused effort in creating and sharing amazing content and engaging and facilitating the discussion on each platform.

What’s impressive is that it’s not a large team that makes all this stuff happen. Here’s the 4 main team members:

Say what you will about the HIMSS machine, what makes this group of social media ninjas special is that they truly do care about healthcare and want to find the best way to improve healthcare through the use of technology. Each one of them truly is a mission driven individual.

A great example of this is their work creating the official HIMSS16 Hashtag Guide. A lot of social media people could have easily just hopped on some generic hashtags that anyone could have created around the buzzwords at the conference. Those hashtags would end up being as meaningless as the buzzwords themselves. Instead they created hashtags which represent directions we need to head and goals we should achieve.

For example, they used #Engage4Health to represent patient engagement, but that we are engaging patient with a clear purpose. The #HITworks hashtag is another great example where they’re working to extract the clear value that technology can provide healthcare. Of course, the #IHeartHIT hashtag which started last year tells the personal stories of how technology can impact healthcare.

My favorite place I’ve seen the HIMSS social media team “go beyond” is in the imagery they’ve created. Take a look through all the images shared on the #HIMSS16 hashtag and you’ll see that many of the best ones were created by this team. It’s no wonder that this team was recognized with the HITMC Award for Best Social Media Program last year.

HIMSS is right around the corner. Good luck to this team as they try to curate more tweets than anyone can handle. Not to mention all the new video activity we’re going to see on Periscope and Blab. They’re certainly worthy of the #GoesBeyond hashtag.

About #GoesBeyond
In this series, writers take time thank an individual who #GoesBeyond expectations to make an impact in their community or industry. Read other posts in this series on LinkedIn and Twitter, then write one of your own on your favorite blog, LinkedIn pulse, Medium or other platform. Use #GoesBeyond and @mention the person who has made such a big difference, then copy this paragraph so others know how they can participate, too.

Doctors and Patients are Largely Missing at #HIMSS16

Posted on February 16, 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 recently got an email from someone asking me if I knew of practicing doctors that would be at the HIMSS Annual conference in Las Vegas (Or as we affectionately call it, #HIMSS16). I was sadly struggling to find an answer to that question. In fact, as I thought back over my last 6 years at HIMSS conferences I could probably count on my hands and feet how many practicing doctors I’d spent time with at HIMSS.

Consider that HIMSS attendance has exploded over the years and I won’t be surprised if HIMSS attendance passes 50,000 people this year. No doubt I only meet a small subset of the attendees, but there certainly should be more practicing doctors at the event. It’s unfortunate for our industry that they’re not there since their voice is so crucial to the success of healthcare IT.

I’m sure HIMSS has a count of how many doctors (MD or DO) are at the event. However, those numbers are skewed since I know a ton of MDs and DOs who attend HIMSS, but they’re not actually practicing medicine anymore. They’re CMO’s at vendors or startup entrepreneurs or clinical informaticists or something else. Many of them never even practiced medicine after residency. Nothing against these people. Many of them have amazing insight into what’s happening in healthcare. However, they’re not dealing with the day to day realities of practicing medicine.

I understand why many practicing doctors don’t attend HIMSS. It’s hard for them to get away from the office and justify traveling to a conference at their own expense. Plus, HIMSS registrations aren’t cheap. I don’t know why at this point HIMSS doesn’t give practicing doctors a free registration to the conference. Even if they did this, I know some practicing doctors who have attended HIMSS that went away disenfranchised by the disconnect between what they heard at the show and what they experienced in their offices. It’s no surprise why they don’t return to future shows. However, keeping them away isn’t the way to change that disconnect. Having them at the conference is the way to fix the disconnect.

A similar commentary could be applied to patients at HIMSS as well. I’m always a little tentative to say that patients aren’t at HIMSS since all 50,000+ attendees are or have been patients in the health care system. So, patients are at HIMSS. However, there’s a difference between someone who’s been a patient and someone who’s at HIMSS to represent the voice of the patient.

There has been some efforts to include more patients at HIMSS, but it’s still an infinitesimally small number compared to the 50,000 attendees. One solution is for more of us to be more of a patient voice at HIMSS. The other solution is to bring more patients who will be advocates for that voice.

This isn’t to say that HIMSS is a bad event. It’s a great event. It just could be better with more doctors and more patients present. If we can’t bring 50,000 people together and 1300 exhibitors and do some good, then something is really wrong. I’ve seen and written about some of the amazing announcements, initiatives and efforts that have come out of HIMSS. I’m sure we’ll see more of that progress again this year.

Plus, let’s also acknowledge that many of the 1300 HIMSS exhibitors and 50,000+ attendees spend a lot of time working with and consulting with doctors and patients when creating, evaluating and implementing healthcare IT solutions. In some ways a vendor or hospital CIO who’s talked to hundreds of patients or hundreds of doctors represents the voice of the patient and the doctor much better than 1 patient or 1 doctor sharing their own “N of 1” view of what’s happening in healthcare.

The reality of healthcare and health IT is that we’re talking about extremely difficult challenges. That’s why we need everyone in the same boat and paddling in the same direction. HIMSS is that event for healthcare IT in many ways, but could even be more valuable if more doctors and patients were in attendance.