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Hospital Competition Hinders HIE – Some Solutions to the Problem

Posted on July 31, 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 response to my post about the Real HIE Problem, Tim Dunnington provided this powerful insight into a major challenge that are faced by HIEs. However, more importantly, Tim provided some suggestions on how to solve the problems.

I work for an HIE system vendor, ICA. One of the challenges we see our HIE’s face is FUD (Fear, Uncertainty and Doubt) around sharing patient data. The fear arises in sharing data with other participants that are direct competitors. The competition between participants can lead some participants to refuse to share “their” patient data with other participants, creating complex sharing rules based on these relationships, and meaning that the view of a patient’s record will change depending on what facility you happen to be in. This results in the patient’s medical record not being complete. The patient, meanwhile, is not aware of these nuances and is not aware that their record is incomplete due to these competitive issues. I can’t say we have an answer as to how to solve this, but it’s definitely a potentially large roadblock, larger I think that EMR adoption itself.

I would say in response to these issues:
* The EMR determines what data is shared, so you (as a customer of the EMR) should have some control over what exactly is shared and when
* The HIE will not by any means have a “complete dump’ of your database; the EMR sends out a limited amount of data about the patient or the encounter
* The interoperability standards are set up to keep participants from attempting what I call “patient surfing,” keeping the availability of data to those patients for which you have an established relationship. This means that your competition cannot simply download every one of your patient records, as they have no access to a means to query for all your patients.
* Auditing and regulatory measures ensure that attempts to access records for purposes other than direct patient care are caught and properly sanctioned.

I’d love to hear your thoughts and perspectives on the challenge of data sharing in a HIE. Do you think that Tim’s suggestions are good?

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.

EMR Device Connectivity, RECs, and Meaningful Use Resources

Posted on July 29, 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.

Time again to take a quick look around the twittersphere to see the various discussions happening around EMR and EHR. I should take a poll and see how many of my readers are on Twitter and how many haven’t yet found the beauty that is Twitter.


I agree that device connectivity and integration is going to be very important as we move towards EHR. In fact, I don’t think that integration is getting enough focus and emphasis in hospitals. I think we need to see more of that or we’re going to run into troubles and miss out on some great opportunities.


This tweet is actually pretty obvious. You can basically only work with a REC if you’re going to go after meaningful use. Are there any RECs that will work with you if you’re not planning to pursue meaningful use? I’m still skeptical that many RECs have provided a good return on the money they’ve received.


This really is a nice resource that Farzad points out. However the thing that stuck out to me was the objectives of meaningful use:
1. Improve Quality, Safety, Efficiency
2. Engage Patients & Families
3. Improve Care Coordination
4. Improve Public and Population Health
5. Ensure Privacy and Security for Personal Health Information

Do you think that meaningful use is meeting these objectives?

Verizon’s Take: How HIT Can Transform Healthcare

Posted on July 27, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Every day, readers here wrestle with how health IT can improve patient care and remove costs from our monstrously bloated system.  And even though we share many of the same conclusions, the struggle is likely to continue for quite some time.

That being said, it never hurts to find out what big, super-mega-deep-pocketed giants of IT and telecom have to say on HIT trends, if only as an exercise. Not only does it tip their hand a bit as to where they’re headed, it adds more fuel to the fire. Here’s some trends Verizon’s big thinkers see as leading to care transformation:

  • Telemedicine:  An also-ran for decades, has telemedicine finally come into its own with abundant cheap bandwidth and relatively cheap mobile devices available?  Verizon says yes. The big V says telemedicine can suck $31 billion in annual costs out of the system.
  • mHealth:  This is a obvious one. But for the record, Verizon agrees that mHealth’s flexibility — with 10K health apps in the iTunes store alone — can do much to manage chronic disease, monitor patients and suchlike.
  •  Fraud detection becomes fraud prevention:  Interesting. Verizon, which, naturally, has a fraud prevention solution, argues that today’s claim analysis can catch fraud and abuse well before the claims are paid. Is Verizon thumping its chest or can this realistically be done folks?
  • Cloud computing spreads patient information: Verizon’s honchos say cloud computing will not only make healthcare businesses more efficient, it will make sharing of patient EMRs easier. (Methinks there may be a technical problem there, though; don’t you still need to be using compatible subsets of, say, HL7 to communicate, cloud or no? And isn’t that the problem overall?)

The rest of their big 10, well, you read and tell me whether you think they’re worth noting. If this represents the cutting edge of Verizon’s thinking, I’m not impressed. But I’ll give a call to the Verizon press contact and see if I can get more info. I’ll keep you posted.

The Intersection of EMRs and Health Information Management

Posted on July 26, 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.

It was with great regret that I canceled my trip to Healthport’s first HIM Educational Summit earlier this week. (A rampant stomach bug claimed me as the last victim in our family of four, and so I thought my healthcare conference colleagues would, in fact, appreciate my absence.) I had been scheduled to moderate a discussion on the exchange of personal health information within an accountable care organization (ACO) – a topic that I thought I knew a lot about, until I began researching the subject. Turns out that to truly grasp this topic from a health information management (HIM) perspective, you need to be well versed in the current state of ACOs, Office of Civil Rights audits, HIPAA rules and regulations, privacy and security breach prevention strategies, the bring-your-own-device movement …. Needless to say, HIM professionals seem to have their hands full at the moment, as they will likely interact with a few if not all of the aforementioned areas in the coming months.

I especially had been eager to see if this cartoon from Imprivata got a few chuckles from my audience. Pretty timely, no?

Courtesy of Imprivata

I was also looking forward to attending a number of sessions, including:
“The Effects of EHR on HIM”
“Where HIM & MU Intersect, and What’s in it for You”
“Meaningful Use: Countdown to Attestation”
“Is Your PHI Protected? Security Measures you Need to Know About”
“The Brave New World of HIEs”

In prepping for the event, I came across a great list of “The Top 10 Trends Impacting HIM in 2016.” Note that EHR and related technologies top the list. I guess it’s safe to say that concerns around them aren’t going away any time soon.

Courtesy of Precyse

I’d love to have readers weigh in on what relationship HIM professionals have with their EMR counterparts in the hospital setting. How do they impact your workflow? Is Meaningful Use making your lives easier or harder? And how in the world are you going to find the time to worry about 2016, when it seems you’ve got enough on your plate in 2012?

Please share your thoughts in the comments below.

Revenue Cycle Management Interview with Rishi Saurabh – GE Healthcare

Posted on July 25, 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.

As most of you know, I had the chance to attend the ANI 2012 conference in Las Vegas that’s put on by HFMA. This conference is a hospital CFO’s home since all of the major players in the healthcare financial management space were in attendance. Around every corner was another Hospital CFO it seemed.

While at the conference, I was able to corner the Global Product Marketing Manager at GE Healthcare, Rishi Saurabh, for a short video interview about revenue cycle management. In the video Rishi provides his insights into the biggest challenges facing hospitals today and also provides some insight into how GE plans to approach these challenges. I hope you enjoy the video:

Will Billing Separate EMR Winners From Losers?

Posted on July 24, 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 @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The other day, I was speaking with a sales exec from a medical billing company, who commented that his company interfaces with about 200 of the leading EMRs.  His comment got me thinking.

I believe we haven’t thought enough about billing when we consider what will drive consolidation in the EMR market. Whether vendors offer it through offering their own practice management system or an easy-to-work-with infrastructure, billing counts a great deal. And the EMRs that aren’t integrating seamlessly aren’t exactly in the driver’s seat in medical practices.

Vendors aren’t in the easiest position when it comes to being a good billing partner. They can offer a suite with practice management available as an add-on, but doctors may not want the whole thing. They can offer an EMR + PM suite that’s already integrated, but what if the practice doesn’t like one of the two?  Some vendors are partnering with companies that make third-party billing applications, but if the other party were to pull out abruptly that strategy could enrage customers.

Still, vendors that balance these factors right have a powerful advantage. After all, practices WANT to get Meaningful Use dollars, but they NEED to get paid. I know that billing would be one of the first things I’d consider if I was shopping for a medical office EMR.

What I’m really saying here is that while most of us agree that a big EMR firm consolidation is coming, we haven’t talked much about the role of strong billing support in an EMR’s market viability. I think we should. I’d love to know if you’ve seen medical office software that really has a strong billing approach, and what you like about it. Thoughts, anyone?

Digital Health Takes Off in 2012

Posted on July 23, 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.

So far, 2012 has been a good year for the digital health world. According to Rock Health’s weekly newsletter, there is 73% more funding for digital health right now than this time last year. Rock Health created a presentation with their mid-year report, which can be found at the bottom of this post.

Some key findings from the report,  according to the newsletter, that were found in the report included:

-68 digital health companies have raised over $2M

-92 investors

-Common themes: physician tools, sensors, home health, and data

-Bay Area dominates funding, with 28% of overall funding.

There have been some significant deals over the first half of 2012. The report shows that the four biggest deals were:

  1. Castlight Health, which “enables employees to compare costs and quality of healthcare services” received $100 million in funding from T. Rowe Price and Redmile Group
  2. GoHealth, a health insurance comparison website, received $50 million from Norwest Equity Partners
  3. Kinnser Software, which creates web-based software solutions, received $40 million from Insight Venture Partners
  4. AirStrip Technologies, who created a mobile platform that records and receives real-time data from hospital monitoring systems, received $39 million from Sequoia and Qualcomm Life

The digital health industry is definitely on the rise. This reports shows that, and other interesting findings. It will be exciting to see how much the digital health world grows and changes over the next half of 2012

What’s Next For Physician Tablet Use?

Posted on 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.

Not long ago, Manhattan Research released a study offering details on how doctors’ consumption of digital devices and media is progressing.  The survey, which surveyed 3,015 physicians in 25 specialties, looked at doctors who were online in the first quarter of 2012.

Among the most interesting — if not surprising — findings was that tablets have more or less officially hit the medical mainstream. According to the research firm, tablet use among doctors has nearly doubled since last year, hitting a whopping 62 percent in this year’s study.  You also won’t be shocked to learn that iPads dominate medical tablet use, in part due to their high-res screen and ease of  use.

Why the greater rush to adoption?  I think the following comment, which Monique Levy of Manhattan Research made to InformationWeek, offers a nice insight:   “It used to be that you had to solve the problems of security access, validation, and data security first and then adopt,  (but) what’s happened is that the system has turned upside down. We’re now at adoption first and solve the problem later.”

As Levy notes, the first wave of adoption has been driven largely by access to lower-risk information, and less for patient data. We can expect to another round of resistance when physicians are tethered to EMRs largely by tablets, she predicts.  I’d add that as long as there’s no native client physicians can use to access EMRs on the iPad, it will make things worse.

Given that resistance, maybe medical use of tablets will expand in other areas first. According to IT prognosticators and researchers at the Gartner Group, top medical uses of tablets also include waiting rooms, e-prescribing, diagnostic image viewing and appointment scheduling. (I’m amazed more practices aren’t doing the waiting room check-in thing.) Maybe one of these other areas will evolve breakout apps before doctors are really hooked up with patient data on their tablet.

Does Meaningful Use Destroy Doctors’ Skills?

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

About two weeks ago, I saw a patient who was referred for a new diagnosis of hypocalcemia (low blood calcium levels).  I ran a few additional appropriate lab tests and will be seeing him back this week or next.  This weekend, however, I had some spare time to read back through the sections of two medical textbooks dealing with a more detailed discussion of this issue.

How apropos, I thought, when reading a recent post on the Health Care Blog, titled The Destructiveness of Measures.  This post says such a powerful amount in such a short blog span, that I needed to highlight and share it.  It succinctly describes what the government is currently trying to do to a highly trained labor force who’s best asset is their ability to think about patients with complex medical problems.  Every minute spent filling out online forms to report meaningful use data to the government could be better spent in reviewing and updating their medical knowledge set.  Both tasks focus on patient’s and their medical problems, yet one is a much higher yield for patient care and physicians’ sharpness in providing higher quality care than the other, which could be completed by a person with a high school education.

Let’s not dumb down our physician’s knowledge levels by asking them to complete such inane tasks as generating Meaningful Use data sets.  Are the physicians the right personnel for such a clerical job?  Absolutely not.  Airline pilots can’t maintain their flying skills by running the beverage cart.  Doctors are no different.