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What Software Will Replace EHR?

I’m usually a very grounded and practical person. I’m all about dealing with the practical realities that we all face. However, every once in a while I like to sit back and think about where we’re headed.

I’ve often said that I think we’re locked into the EHR systems we have now at least until after the current meaningful use cycle. I can’t imagine a new software system being introduced in the next couple years when every hospital and healthcare organization has to still comply with meaningful use. Many might argue that meaningful use beyond the current EHR incentive money might lock us in to our existing EHR software for many years after as well.

Personally, I think that a new software will replace the current crop of EHR at some point. This replacement will likely coincide with the time an organization is up for renewal of their current EHR. The renewal costs are usually so high that a young startup company could make a splash during renewal time. Add in a change of CIO and I think the opportunity is clear.

My guess is that the next generation of healthcare documentation software will be one that incorporates data from throughout the entire ecosystem of healthcare. I’m not bullish on many of the current crop of EHR software being able to make the shift from being document repositories and billing engines into something which does much more sophisticated data analysis. A few of them will be able to make the investment, but the legacy nature of software development will hold many of them back.

It’s worth noting that I’m not talking about the current crop of data that you can find outside of the healthcare system. I’m talking about software which taps into the next generation of data tracking which goes as far as “an IP address on every organ.” This type of granular healthcare data is going to change how we treat patients. The next generation healthcare information system will need to take all of this data and make it smart and actionable.

To facilitate this change, we could really use a change in our reimbursement system as well. ACOs are the start of what could be possible. What I think is most likely is that the current system will remain in place, but providers and organizations will be able to accept a different model of payment for the healthcare services they provide. While I fear that HHS might not be progressive enough to do such a change, I’m hopeful that by making it a separate initiative they might be able to make this a reality.

What do you think? What type of software, regulations and technology will replace our current crop of EHR? I don’t think the current crop of EHR has much to worry about for now. However, it’s an inevitable part of a market that it evolves.

April 15, 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.

Making Meaningful Use of Hospital Social Engagement Strategies

My latest healthcare field trip took me to the Health 2.0 Atlanta Meetup group, a blossoming community of startup professionals, investors and folks like me who want to stay abreast of innovation happening on the fringes of our industry. Previous events have been dedicated to startup showcasing, but this most recent meetup turned the tables by gathering a panel of marketing executives from three of Atlanta’s most well-known health systems – WellStar, Piedmont and Emory.

I think if this panel had gotten together last year, or even two years ago, all the talk would have been around how to market their EMRs to current and prospective patients. (WellStar and Piedmont are on Epic, while Emory is on Cerner.) EMRs were mentioned once or twice. The big theme that seemed to run throughout the series of moderated questions was … wait for it … patient engagement. More specifically, all three panelists stressed the importance of using social media as a patient acquisition and retention tool. As Sandra Mackey, Executive Director of Marketing at Emory, so succinctly stated, social media is no longer a “need to have,” but rather a “must have.”

Matt Gove, CMO and SVP of External Affairs at Piedmont, noted that he has been able to demonstrate solid ROI from the health system’s social media efforts, connecting the dots between Piedmont messaging in Facebook feeds to booked appointments and revenue-generating procedures. Both Piedmont and WellStar have turned to third parties like Brightwhistle, Tailfin and ReachLocal to help them pinpoint the best places for social messaging. Gove’s efforts have been so successful that he has focused more staff on social media management, and now integrates social media into more campaigns than ever before.

All three panelists seemed to agree that marketing spend going forward won’t be on big media like radio and T.V. ads, but rather on messaging that reaches a patient’s inbox or Facebook feed. Mackey noted that people are growing up on social media now, and they wouldn’t dream of going anywhere but to their social networks for healthcare recommendations. Her comment directly correlated to Gove’s simple wish for physicians to do their jobs well. A positive experience lends itself to stories that can be shared among patients’ social networks, potentially garnering that hospital exponential exposure and brand recognition.

I wonder how hospitals will adapt their social engagement strategies over the next year. What will be top of mind for hospital marketing executives in 2014 and beyond? Give me your take by leaving a comment below.

November 22, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

Leadership Discussions at Healthcare CIO Conference

This week I get to enjoy the company of 750 attendees at the healthcare CIO conference organized by CHIME (officially called the CHIME Fall CIO Forum). It’s always an amazing experience to break bread and learn from people who are dealing with some of the hard challenges of healthcare IT.

One topic that’s always present at CHIME events is a discussion of leadership. So, it was extremely appropriate that Jim Collins was the opening keynote. The guy just exudes leadership. Here’s some of the tweets I sent out during his keynote.

October 9, 2013 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.

A Private HIE is a Vendor Neutral Archive Applied to EHR

I’ve been really fascinated by the work many hospital systems are doing to create a private HIE in their organization. As I wrote, I think that private HIE could lead to a nationwide HIE. It’s still a bit of a long shot, but I think it has more promise than the other HIE initiatives I’ve seen in action.

Along with my interest in private HIEs, I’ve also been fascinated by the switch to Vendor Neutral Archives (VNA) in the radiology space. In a VNA, you can store any medical image in the archive and it doesn’t matter what device you use to capture or view the image. Think about the flexibility that this provides. You’re no longer locked into a certain piece of imaging equipment or to a certain viewing application. Instead, you can switch as needed.

As I consider these two areas, it seems that a private HIE is the first step to having a vendor neutral archive. In fact, I’m not sure why more people haven’t applied the principles of vendor neutral archives to the EHR world. I imagine the challenge is in the complexity of the data. Sure, DICOM isn’t a simple piece of data either, but at least there are some DICOM standards that most medical imaging companies follow. The same can’t be said in the EHR world.

The problem now is that the term HIE has so much failure associated with it. I imagine that’s why we moved from RHIO to HIE as well. However, I think that the change from creating an HIE to a vendor neutral archive for EHR data would be a dramatic shift in thinking. This could be an important decision for a large hospital system. Instead of just trying to share data from EHR to EHR, what if they created a vendor neutral archive of all their EHR data such that your future EHR was built around that VNA instead of around a specific piece of software. I’m not sure there are many hospital CIOs brave enough to look this far out.

What do you think of the VNA concept applied to EHR? Is a private HIE the start of a VNA for EHR?

June 17, 2013 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 Doesn’t Do Big Data Yet…It Does BI

It seems like healthcare big data is the topic du jour lately. Everyone seems interested in how they can tap into the big data in healthcare. I’m not sure what’s caused the flood of healthcare big data people. I expect that some of it comes from the rush of EHR implementations that have happened thanks in large part to the EHR incentive money. I imagine there’s a whole group of hospital CIO’s that are wondering how they can leverage all of that EHR data to benefit their institution and patients.

I think it’s great that healthcare has finally seemed to realize that there’s a lot of value found in healthcare data. The problem is that in every other industry, what we call healthcare big data isn’t very big data at all. In fact, most other industries would describe most of the healthcare data efforts as pretty simple business intelligence. Yes, there are pockets of exceptions, but most of the data initiatives I’ve seen in healthcare don’t even approach the true meaning of the words big data.

I’m not saying that there’s anything wrong with this. In fact, I loved when I met with Encore Health Resources and they embraced the idea of “skinny” healthcare data. Maybe it was a way for them to market their product a little different, but regardless of their intent they’re right that we’re still working on skinny data in healthcare. I’d much rather see a bunch of meaningful skinny data projects than a true healthcare big data project that had no results.

Plus, I think this highlights the extraordinary opportunity that’s available to healthcare when it comes to data. If all we’re doing with healthcare data is BI, then that means there is still a wide open ocean of opportunity available for true big data efforts.

I think the biggest challenges we face is around data standards and data liquidity. Related to data standards is the quality of the data, but a standard can often help improve the data quality. Plus, the standard can help to make the data more liquid as well.

Yes, I’m sure the healthcare privacy experts are ready to raise the red flag of privacy when I talk about healthcare data liquidity. However, data liquidity and privacy can both be accomplished. Just give it time and wait for the healthcare data revolution to happen.

April 15, 2013 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.

ICD-10 Implementations and EHR Workflow Optimization

These two topics don’t necessarily go together, but they were both short and sweet thoughts I’d written down at one of the many healthcare IT events that I’ve attended this Fall (Thankfully I don’t have any travel on my schedule until HIMSS).

Here’s the first one that was said by an EHR vendor:
“Not All ICD-10 Are Created Equal”

Obviously the idea here is that this EHR vendor believes that his EHR has produced a higher quality ICD-10 engine than many of the others he’s seen on the market. It’s interesting that an ICD-10 engine could be so different when the output is exactly the same (a number). Although, when you get into the complexities of how a doctor may go about finding the right ICD-10 code, it makes more sense. Maybe we need to have an ICD-10 lookup challenge with each EHR vendor at HIMSS 2013. Would be interesting to see the results.

This next one was an interesting insight info one of the side effects of meaningful use on EHR adoption. This came from a former hospital CIO and current hospital EHR consultant who said, “There’s no time to optimize as you go anymore, because you have to get to meaningful use to get the EHR incentive money.”

I wonder how many others have seen this change as well. I’ve no doubt seen the rush to implement EHR in order to show meaningful use and get access to the government money for EHR. It’s just unfortunate to think that the process is rushed by the dangling carrot. Rushing an EHR implementation can lead to very bad results in the long term. Many EHR users will be dissatisfied. EHR does not solve bad workflows. In fact, it often accentuates whatever bad workflows may exist.

December 11, 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.

From #AMIA: Interoperability Held Back By Politics

When a recent AMIA panel was asked why health IT interoperability was still in its infant stages, members’ responses were the same we’ve been hearing for, I don’t know, a decade or more.  Let’s say that there didn’t seem to have been a lot of hope in the room.

According to Healthcare IT News, true interoperability between health systems is still beyond us due to the same-old, same-old reasons:  Hospitals with hundreds of systems, vendors with proprietary databases, varied standards, health systems that don’t want to share data and a lack of interoperability support from policymakers.

Ultimately, the fact that these obstacles haven’t been overcome is as much a matter of politics as integration problems, the magazine reports:

Charles Jaffe, MD, CEO of standards development organization Health Level Seven International (HL7) described a “circle of blame” involving government agencies and regulators, hospitals and healthcare systems, technology vendors, clinicians, academicians like those at AMIA and, yes, standards development organizations (SDOs), such as HL7. “The policy always preempts the technology,” said Jaffe.

My feeling is that this circle of blame would dissolve in a millisecond if a compelling financial case could be made for interoperability.  Anything might help at this point.

Hey, just prove that interoperability saved a health system $2 a patient somehow, and they might be made to invest in needed changes. Or convince vendors that they’d move even a few units of their product if their systems were freely interoperable, and they’d probably be more cooperative.

At this point though,  you’ve got cross-cutting turf wars going on, with vendors and health systems and standards organizations each pursuing an agenda of their own. And honestly, why shouldn’t they?

With plenty of financial and institutional risk involved, and questionable rewards, I’m not sure how gung-ho I’d be on interoperability if I were a healthcare CIO or vendor exec.

Bottom line: If you want interoperability, it’s got to have a more tangible payoff for everyone involved.

November 12, 2012 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.

Highlights from Ed Marx Hospital CIO Strategy Talk at #CHIME12

I was really excited when I found out that Ed Marx’s, CIO of Texas Health Resources, talk at CHIME 2012 was one of the encore presentations since I’d missed it earlier in the week. Thankfully he didn’t disappoint. Here are some tweets I sent during his talk with some additional commentary on what he said.


I loved his comment on the need for hospitals to have a strategy when it comes to mobile health. He acknowledged that even with a strategy in place it’s a pretty crazy environment right now, but he said that he couldn’t imagine where they’d be if they had no strategy. It’s a good acknowledgement that mobile health is here to stay and it’s better to have a proactive approach to mobile health.


Great advice. Far too often I see people trying to swing for the fences instead of being happy with a single. Many hospital organizations could use a quick win for morale sake. Then, with that confidence they can work on the bigger, longer term goals.


There are a lot of ways to learn. Ed Marx pointed out that every hospital CIO should be on social media. I’d argue that the reason they should be on social media is to learn. Learn from customers. Learn from colleagues. Twitter is an amazing platform for learning and listening. You don’t have to broadcast on social media if you don’t want.


I love the transparency that Ed strives to achieve. Putting your performance review for all to read is a brave choice. Although, he made a good point. His performance review wasn’t just a reflection of him, but was a reflection of the entire organization in many ways.


Such a great way to describe the idea of getting out of the office and working with people from other departments. The challenge with this is that many people aren’t very good at this type of social interaction. Some people have this naturally, but others have to work really hard to make it happen. This type of description can help some who have this challenge I think.


I was amazed that he said this was the most important thing. I’ve always loved the value of looking to multiple sources for inspiration. Very important and useful!


Ed suggested that most CIO’s could identify the CEO’s top priority, but not the top 10.


I think it’s true that many hospital CIO’s live in partial fear for their jobs. I guess we all do to some extent. I’m not sure this tweet is going to change things, but hopefully it’s a challenge for many who have avoided risks. Thoughtful risks can work out very well if done right.


Beautiful description of leadership, but hard to achieve.

One other major point that Ed made that I didn’t tweet about had to do with the idea of a project not being an IT project. Ed described the need for IT to make themselves open and available to lead those projects. Although, in order for that to happen, they have to create a trusted leadership role within the organization.

For example, instead of talking to the CEO, CFO, board, etc about project timelines, projects completed, and missed schedule, talk to them about ROI and improved patient care. However, to do so takes a real focus on measuring the costs and benefits of each project.

October 19, 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.

Is Revenue Cycle Management Getting Transgressed with Meaningful Use Stealing the Focus?

This is the next in a series of posts I’ve been doing focused on Revenue Cycle Management (RCM). It’s been a fun series to do as I’ve explored more of the details of RCM and learned a lot along the way. Although, as is usually the case, the more that I learn the more I realize I still need to learn. I will be attending ANI in Las Vegas later this month, so I’m sure I’ll have plenty more RCM related topics to write about after that event.

This post was inspired by a comment Madelyn made on my Is Revenue Cycle Management Sexy? post:

You’re making a really important point with this story and it’s a topic we’ve discussed at length in my company. The availability of incentive funds is causing so much thought and energy to be focused on EHRs, but if a practice or hospital’s RCM is a mess, they’re losing far more money than the Meaningful Use dollars could ever reimburse them for.

What an extremely important question! I’m afraid far too many clinics are falling into this trap.

Each day I’m amazed a little bit more on the far reaching impacts of meaningful use on healthcare and EHR. There’s been amazing array of unintended consequences that are associated with meaningful use and the EHR incentive money and most of them aren’t good consequences. Sure, there are also some really great benefits to the government EHR stimulus money, but my fear is that they benefits won’t outweigh the negative consequences and the taxpayers will be out a cool $36+ billion.

Why do so many practices and physicians become so irrational when they hear about “free” government money for EHR? This I don’t have an answer to, but I hope by pointing it out more doctors will take a step back and do what’s right for their clinic. I’d expect in most cases this will involve EHR and technology, but Madelyn makes a really important point:

If your RCM is a mess, you could lose far more money than you gain from meaningful use.

June 7, 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.

Increase in Patient Self Pay Increases Collection Risks

There is a major trend that is happening in healthcare that is going to impact the economics of healthcare in a major way. This trend is the increase in Patient Self pay. There are a number of factors which are causing more patients to pay for their medical expense including lost jobs and employers dropping health insurance coverage. I’ve heard a number of people predicting the move to a patient focused payment model with high-deductible insurance plans. In fact, this New York Times article says “The share of employees enrolled in high-deductible plans surged to 13 percent in 2011 from 3 percent in 2006, according to Mercer Consulting.”

Personally I think this is a great thing for healthcare since I’ve long been a proponent that any healthcare reform needs to put the consumer (patient if you prefer), not the insurer or the government at the center of the healthcare financial system. However, this change also poses a risk for practices and hospitals since the risk inherent in collecting self-pay balances rises in parallel with this increase in patient self pay.

How then are EHR vendors and revenue cycle management companies dealing with this shift to patient self pay?

This certainly won’t be a comprehensive list of ways that revenue cycle management can help with patient collections, but it will show a few ways technology can help now and in the future.

EHR software can integrate a Patient Pay Estimator to provide patients a close approximation of their final bill which helps a practice collect payment before they leave. The software physicians use to estimate the patient total for an office visit are going to have to get better and more accurate. I don’t have the numbers in front of me now, but I’ve seen multiple studies that illustrate well how the key to good patient collections is to get the money while they’re present. Once the patient leaves your office your ability to collect from that patient drops dramatically.

I know I’ve been to a lot of doctors where I get to the front desk and they don’t know what to charge me. Far too often they just say, don’t worry about it, we’ll send you a bill in the mail. If they just had the right information available to them, they could collect the money on the spot and not have to worry about collecting it from me later. An EHR can really facilitate this process if it has a good patient liability estimator built into the EHR.

In the cash or check world, it was much harder to set up budget plans or recurring payment. Now there are more and more systems out there where you can store a person’s payment information and set up the recurring payment to happen automatically. This will likely be a key trend going forward.

I’ve even seen some of the larger EHR vendors who have programs that offer financial assistance. In fact, the really large EHR vendors have whole financing divisions that can assist patients who have financial issues related to their healthcare. I wonder how deeply these financing options can be integrated into EHR software, but I could see it as a big advantage to have it as an integrated part of the payment workflow. I’m always amazed at how quickly you can be approved for a credit card or financing a car. I expect this type of financing will be pushed down throughout the various layers of healthcare. Will it become a differentiating factor in a large EHR vendor versus a small EHR vendor?

Another interesting idea to stem the patient payment problem is to accept prepayments. Meaningful Use is bringing the patient portal and PHR software back to the forefront of many EHR implementations. If you have patients filling out the paperwork for their office visit, why not collect the co-pay at the same time? Pre-payment could become a really great way to avoid revenue cycle management issues on the back end.

I’d love to hear other people’s thoughts related to patient payment and revenue cycle management trends. What can be done to help avoid the patient self pay collections issues?

May 4, 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.