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Connected Health Conference Tops Itself–But How Broad is Adoption? Part 3 of 3

Posted on November 9, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The previous section of this article looked at advances in health care, as well as some warnings about their efficacy at the Connected Health Conference. In sessions about experiments in altering care, people managing the new programs stressed that commitment and expertise are not enough; these programs call for structural and culture change within organizations. One speaker pointed out that quality programs must assess not just an individual clinician, but the whole system that intervenes in patient care.

In its 12th year, the Connected Health Symposium is more successful than ever: the most attendees, most exhibitors, and biggest sponsorship ever. More to the point, I noticed more sessions this year focusig on immediate, practical logistics of getting new programs in place. But a number of adoption issues remain:

  • Many pilot programs weren’t designed to be sustainable and scalable; even when successful, they weren’t adopted by the larger organization. Some speakers blamed these dead ends on a lack of an individual champion, others on the lack of organizational structures for promoting change.

  • Payers expect to see a return on investment within three years, but patients take much longer to show benefits of health. This isn’t rational. One speaker pointed out that while an insurer’s patients will move on, it will gain new patients that another insurer invested in. So a long-term investment will raise all boats. However, the fossilized financial models remain in place

  • Cost savings can slip away from you. Robert Perl, executive director and CEO of The Permanente Medical Group, reported that the use of electronic health records at Kaiser Permanente improved care but did not lower costs. The savings all went into the very expensive EHR itself, as well as the extra time physicians had to spend entering data because of the EHR’s design. But Kaiser chose to install Epic, so one could ask Dr. Perl why he expected the outcome to be any different.

  • It’s also disheartening to hear visitors from other countries. One would think that Britain and Canada, with their more broadly designed health care systems, would have solved the problems with data exchange and cost control that the U.S. struggles with. But reports suggest they’re just as bad off. The Canadian speaker said that after his PCP retired, no records were sent to his new one. Britain’s integration data efforts are still a “work in progress,” according to Anne Avidon, Head of Global Health Innovation at the Life Sciences Organisation of UK Trade & Investment. South Africa is also lagging on interoperability and data exchange. Semih Sen, a health care executive from Abu Dhabi, pointed out that “health care is the only industry left that isn’t global” and suggested some reforms, such as cross-border licenses.

My impression, overall, is that strides are being made in using data, engaging with individuals around their health needs, and providing innovative treatment options–but mostly outside the traditional institutions of health care. Those institutions are still trying to figure out how to achieve the organizational change that can permit them to participate in the health care revolution. And some are pouring money into experiments that they eventually abandon or can’t get financial benefit from because the environment is against them.

Next year, perhaps more institutions will find the way forward.

Healthcare vs Sickcare, MU Undermines EHR Usability, and Kaiser Monkey Game

Posted on July 15, 2013 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 might seem a little self serving since I sent this tweet in reply to Georg Margelis’ comment. It’s a really good question though and one I’ve been starting to think about recently. I’ve often heard that the really sick people are the ones that cost healthcare so much money. My question is whether keeping them healthy just delays the costs or whether keeping them healthy actually costs less money long term.


This is such an important topic. I’ve been commenting more and more on this subject. I’ve wondered if a usable EHR can be created that satisfies MU. I imagine it depends on how you define usable.


This is a pretty cool Monkey game from Kaiser. Although, the real value in this article is better understanding some of the approaches that Kaiser is taking to healthcare. So many people salivate over working with Kaiser. It’s good to understand what they are and aren’t looking for if you’re looking for that relationship.

Opening up the Pandora’s Box of Patient Portals

Posted on May 2, 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.

I received an interesting email in my inbox last week from a hospital informatics friend. He recently overheard several primary care physicians talking about the patient portal soon to be coming their way, and they were not enthusiastic about the technology.

“They were complaining about an upcoming patient portal,” he wrote, “where all lab results are visible to the patient. They worry that the flood of calls wanting more info on each lab result, especially the insignificant, will unnecessarily tax primary care. This will lead to the need for countless hours of education, and reassurance that tests not within the textbook definition of ‘normal’ aren’t always cause for concern.”

Being a patient myself, I can certainly understand where they’re coming from. I am the type who wouldn’t hesitate to call about a line item I didn’t understand or that seemed abnormal on my lab results, assuming Google (much to every doctor’s chagrin) couldn’t give me a clearer picture.

This fear of patient portals leading to unnecessary communication with the patient is not just confined to the doctors above. I heard conversation around this very topic at the iHT2 conference I wrote about last week. Some providers, like Kaiser Permanente and Geisinger, have been successfully using patient portals for years. Others, like West Georgia Health, are just beginning to plan for implementation.

I asked Thomas Graf, MD, Chief Medical Officer, Population Health, at Geisinger, what advice he has to give to facilities that are just beginning their patient portal journey. He did not hesitate in answering: “Don’t be afraid. Chaos will not ensue.” He went on to say that Geisinger physicians did not find themselves inundated with patient requests for clarifications and explanations of insignificant results. Their workflows were in fact made more efficient.

Getting back to the note from my friend, he went on to ask, “Is there such a thing as too much information, or is HIT finally democratizing medicine enough that patients will be motivated to understand more about their own healthcare? Do the docs have a point, or have they just historically been lazy about communicating with patients, and now have to come to grips that patients can see the man behind the curtain?”

I don’t think it’s a question of laziness. I think it’s a question of access and time. Ten years ago, some of us didn’t have a small computer in our pockets, readily available to offer medical information whenever we needed it. So, we turned to the phone and called our doctor. Today, as I mentioned above, patients are much more likely to research symptoms and conditions online before initiating conversation with their PCP. Some doctors might groan about Google, but wouldn’t they rather have a motivated patient – someone who wants to learn about their condition – rather than an apathetic one?

Isn’t patient engagement the name of the game these days? Hopefully, doctors will be pleasantly surprised at the benefits their portal brings to patient care. They might also be surprised at the new level of engagement their patients now have access to.

Funny Physician Exam Room EHR Etiquette Video

Posted on July 30, 2012 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 usually reserve the various EHR videos I find for the Healthcare Scene EHR video website. However, this one was too funny to not share with a wider audience. Here’s the YouTube description for the video:

Meaningful Use of Electronic Health Records (EHRs) involves more than implementing an EHR. It involves interacting with patients and the computer in the exam room in a way that is productive and enhances the interaction between the patient and the physician. Learn about how Reliant Medical Group (formerly known as Fallon Clinic) uses Kaiser Permanente’s LEVEL technique to ensure a successful patient encounter.

While I’ve said that the video is funny, it also does bring out some really important points about physician exam room EHR etiquette. When I first started watching the video I was wondering how they were going to get physicians to actually take the time to watch the video. Then, about half way through I was laughing at the video which made me watch through more of it. I’m not sure if the humor was intentional or not, but I expect those reading this site will get a good laugh at the video embedded below while seeing some important points on EHR etiquette.

Thanks to Carl Bergman for pointing the video out to me.

Health IT List Season, The Unhealthy Side Effects of Meaningful Use, and My Coupon Doc: This Week at HealthCare Scene

Posted on July 15, 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.

EMR and HIPAA

Health IT List Season – A list of Lists

It is the season of Health IT lists, and #HIT100 is one of the most popular lists right now. This post discusses some of the logistics behind #HIT100, as well as some other health IT lists that are floating around the Internet recently. Have you seen a great list lately?

Kaiser’s Mobile Health Approach

Recently, John had the opportunity to talk with the head of the Mobile Center of Excellence at Kaiser Permanente, Brian Gardner. Gardner talked about Kaiser’s approach to mobile health, how physicians at Kaiser use mobile devices, and some video pilots that have been done. This post goes more into that conversation, and shows how Kaiser is working toward implementing more mobile health in their practice.

Wired EMR Practice

The Unhealthy Side Effects of Meaningful Use

There are all sorts of incentives to  Meaningful Use, and for implementing EMR. However, there is a downside to HIT. In this post, Dr. Michael Koriwchak, along with Dr. Hal Sherz, discuss potential adverse consequences to Meaningful Use. It may cripple innovation and prevent future technology from being developed. Be sure to read this post on the unhealthy side effects of Meaningful Use.

Smart Phone Health Care

My Coupon Doc Makes Health Care More Affordable

Medications and health care costs can be expensive, there’s no question about that. There are lots of discounts to be found, but finding legitimate discounts can be hard to do. Luckily, MyCouponDoc.com makes the process easier with its database of coupons and discounts. Next time you have an expensive medication to buy, don’t forget to consult My Coupon Doc first.

SCOTUS Decision Likely to Indirectly Affect mHealth

The recent SCOTUS decision is affecting health care in many ways. But many were asking the question, will, and if so, how, it affect mHealth? David Lee Scher, MD, recently talked about five ways mHealth will be affected. mHealth isn’t the sector of health care being affected the most, but it won’t be left untouched.

Also, don’t forget to check out EMR Screenshots and EMR and Health IT News! There’s a lot of great items on these pages that aren’t highlighted during the weekly roundup.

Could EMRs Make Patient Satisfaction Scores More Meaningful?

Posted on May 3, 2012 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.

A lot has already been written about whether or not EMRs lead – directly or indirectly – to higher patient satisfaction scores, but I’ve yet to find anything on those scores being included in the patient’s record itself. The idea occurred to me this past weekend, as I was on the phone with a survey firm asking patient satisfaction questions on behalf of Kaiser Permanente.

The visit in question was routine and had gone well, so my ratings were high, and the call was quick. Would the doctor who had been involved ever see my direct responses? Do doctors see these scores in aggregate, or can they look them up by individual patient? Would they feel themselves more accountable if they could see how a patient rated their last encounter while looking at that person’ EMR?

I supposed it could go either way. A healthy, highly satisfied patient’s record would display high scores and vice versa. That person’s doctor could look at these scores before the next encounter to see what could be improved upon, what to keep doing, or what to start doing with other patients of a similar condition. I wonder  if the ability to view a particular patient’s satisfaction scores wouldn’t somehow make the doctor feel even more accountable for their patient’s health – if they’d have more “skin in the game,” so to speak.

Perhaps it could have a negative effect. Low satisfaction scores could lead to an emotionally charged appointment if a doctor doesn’t fully understand why the scores were given.

After my phone call, I did wonder if other health systems send out patient satisfaction surveys electronically, making them accessible via an email or a patient’s portal. The ability to respond digitally would seem to also enable the ability to make personal comments on the scores – something I was not given the option to do on the phone call. I’ve filled out paper satisfaction surveys from other providers, but don’t recall comment boxes being included. Come to think of it, I filled out the paper survey mainly because the hospital told me I had the chance to win a prize if I did so. I wish my phone survey had offered that incentive!

Patient satisfaction scores are important, of course, especially in this day and age of accountable care. I just wonder if they’re not being given enough transparency by hospital management. If doctors could see the good and the bad on a microscopic rather than macroscopic level, would they strive to produce better outcomes?

Let me know what you’ve heard or seen lately in the comments below.