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All I Want for Christmas is a Doctor’s Appointment

Posted on December 20, 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.

A friend of mine had a very timely – and telling – prayer request at church the other day. She asked the Lord to help those in need of doctor’s appointments make them in a timely manner, both in terms of receiving care soon, and getting face time with a doctor before insurance deductibles roll over or cancelled policies end. It’s a prayer I’m sure many patients have been uttering just before they pick up the phone to see when their doctor’s next available appointment is; one that is all the more urgent for those with chronic conditions.

I have based past decisions on which new doctor to use based on their window of open appointments. Can’t see me for three weeks? Then you don’t get my business. Time is of the essence in healthcare these days. Patients want doctors’ time, and doctors don’t seem to have enough to go around. (Nor do they feel adequately compensated for it.)  Healthcare IT – patient portals, CPOE, natural-language processing systems, etc. – is certainly playing a role in helping doctors and ancillary staff get back some of that time. (Though many doctors contend entering data into EMRs is eating up a lot of that time savings.)

Some have postulated that healthcare IT, particularly digital health tools, will actually cause us to need doctors less. This counters the notion that we will soon see (if we aren’t already) a physician shortage, and an even greater lack of appointment availability thanks to the 27 million newly insured who will take advantage of their new policies in 2014. I’m not quite convinced that digital health devices and apps will cause me to go to the doctor any less. They may make the waiting in between my appointments less anxiety inducing, but I know myself too well to think I’d ever scale back on face time with my doctor. Perhaps those with chronic conditions feel differently. I’d be open to telemedicine and virtual visits, but those don’t seem to be on the radar of providers in my area.

Healthcare IT can certainly save time and improve access to care, but I don’t see how it can convince people to enter the healthcare field, which is where the true appointment availability problem seems to stem from. As a recent article at HealthcareFinanceNews.com points out, “retirement age physicians outnumber young members entering the ranks; over-worked physicians want to reduce their hours and care for fewer patients; and [there is a] general disenchantment with the state of healthcare.”

It’s a sad state of affairs when put that way. So what’s the answer? How can the healthcare industry – healthcare IT in particular –  work to ensure that prayers for timely appointment availability are no longer routine? Feel free to share your ideas in the comments below.

Dr. Nick, CMIO of Nuance Talks About Their Acquisition of Quantim and J.A. Thomas & Associates

Posted on October 4, 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.

While at AHIMA 2012, I had a chance to sit down with Dr. Nick van Terheyden, CMIO of Nuance Communications, to learn a little bit more about the recent Nuance acquisitions of Quantim (HIM division of QuadraMed) and J.A. Thomas & Associates. I asked Dr. Nick to describe how these acquisitions will fit into Nuances portfolio in the following video.

“Non Structured Data Is More Valuable to Practitioners Than Discrete Research Oriented Data”

Posted on June 19, 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.

In my post on the EHR Bubble, Don B offered this strong statement:

“Recognizing the non-structured information is more valuable to the practitioner than discrete researcher oriented data.”

I love people that make strong statements and this is no exception. This is a comment that will no doubt hit people the wrong way when you consider how much focus things like meaningful use have focused on discrete data. I can already hear the chorus of doctors asking why meaningful use wants all this discrete data if the non-structured data is where the value is for practitioners.

There are a lot of nuances at work that are worth discussing. I agree with Don B that at this point in time the non-structured information is more valuable to a physician than the discrete data. I’d also extend that comment to say that non-structured information will likely always have value to a practitioner. There are just certain parts of physician documentation that can’t be discrete or at least cost far too much to make them discrete. I’m sure the EHR narrative crowd out there will love this paragraph.

Although, even proponents of the EHR narrative realize the value of discrete data elements. That’s why companies like Nuance and MModal are investing so much money, time and effort into their various NLP (Natural Language Processing) and CLU (Clinical Language Understanding) offerings. The key question for these companies has never been whether there was value in discrete healthcare data, but in how you capture the discrete healthcare data.

When thinking about discrete healthcare data I hearken back to a post I did in 2009 that asserts the Body of Medical Knowledge Too Complex for the Human Mind. This concept still resonates with me today. The core being how does a physician take in all the patient data, device data, lab data, medical data, research data, etc and provide the patient the best care possible. This will never replace the physician (I don’t think), but I expect the tools will become so powerful that a physician won’t be able to practice medicine without them.

Much of the power required for computers to assist physicians in this way is going to come through discrete data.

Over the next 2-3 years we’re going to start seeing inklings of how healthcare will improve thanks to discrete data (often captured through and collected by an EHR). Then, in the next 5-10 years we’re going to see how healthcare couldn’t survive without all the detailed healthcare data.

Medical Siri on the iPhone and iPad

Posted on November 11, 2011 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 regular physician readers, Brian, left the following comment on my post about the mythology of the Perfect EMR.

The reality is that we are now comparing EMR to our iPhone 4s’s. Our consumer technology is so far ahead of hospital technology that it is jarring and annoying to use work tech. This is what I want: “Siri, give me a differential for elevated amylase. Thank you. Now order CBC, Chem 14, TSH and free T4. Good. Now I will dictate. The patient is a 41 year old man with abdominal pain…”

Certainly we could have a long discussion about the difference in consumer technology and popular healthcare technology. However, I couldn’t help but wonder how many doctors have tried out Siri on their iPhone in order to get healthcare information. I bet this is pretty common. Although, I wonder how good the answers are that Siri gives.

If you’re a medical provider that’s used Siri for accessing health and medical information, I’d love to hear about your experience. I bet there are probably also a bunch of funny experiences trying to use Siri for medical info. I’d love to hear those as well.

Are there ways that “Siri” like technology could and should be implemented in EMR and EHR software?