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Our Health Privacy Paranoia

Posted on November 21, 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.

Katherine’s recent post on using EMR data to Market to patients got a lot of really interesting discussion about how this data should be used and if it’s ok to use the EMR data for marketing. The majority of comments were quite scared of the idea of EMR data being used for marketing. Most saw that their could be benefits, but saw it as a slippery slope and we should be careful going down that path. Most wanted an opportunity to opt out from such a policy.

Mark H. Davis offered a little different view in his comment about the need for privacy in this and other healthcare situations. Here’s what Mark said:

And now for a slightly different take…

I have no issues with my hospital using its knowledge of my health situation to provide me with targeted opportunities that might be beneficial. I see it as potentially a positive and proactive outreach. They will need to be sensitive in doing this, however, but in my region, the hospital system is pretty tightly woven into the community, anyhow, and would be rather affected by any backlash. And honestly, sometimes I feel like we make an overblown fuss about health data privacy just because everybody else is making a fuss about it, without stepping back and examining the actual impacts. For example, my mailman, with only slight observation, could easily deduce the health issues my wife, children and I have been treated for. The folks behind me in line at the drug store could do the same. Even most doctor’s offices I visit do a poor job of protecting privacy within the office itself. Just last week, I had to forcibly ignore the conversation taking place in an adjacent examination room. It was easily audible. Anyone who signs in at their PCP can see who has checked in earlier, for what doctor, for what time. Anyone who signs the pharmacist waiver form at the CVS can see who has signed in front of them. The prevalence of OTC meds makes it easier to tell what your fellow shoppers’ ailments are just by looking at their shopping cart. And somehow, we still co-exist. I’m not saying we shouldn’t protect ourselves against a massive data breach that could have dire consequences in the form of identity theft and other fallout. I’m just asking everyone to be honest about how serious they really are about privacy. It’s easy to pick on a hospital system without recognizing other areas where we turn a blind eye.

Mark does a great job articulating how many healthcare situations expose our healthcare data without any major issues. Yet, people tend to get far more worked up over the potential idea of an EMR data breach.

Certainly I’m not advocating for reckless behavior when it comes to healthcare data and securing it properly. We need to make a thoughtful effort to ensure that patient data is kept secure and private. However, let’s be reasonable in our expectations about what’s possible and reasonable.

Could Meaningful Use Be Axed In Fiscal Cliff Battle?

Posted on November 20, 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.

In past items, my colleague John and I have weighed in on the issue of whether a change of administration could endanger the Meaningful Use program.  We concluded, in summary, that the program has too much momentum to fall to the budget axe that easily.

Now, in the light of an article by a colleague, I’m rethinking my view a bit. In an excellent column for Health Data Management, Joseph Goedert suggests that the so-called “fiscal cliff” has changed everything for the Meaningful Use program. Though the still-sitting president who backed HITECH’s $20 billion spend stayed in office, the House of Representatives remains controlled by the opposition party.

Goedert argues that during the debate over the fiscal cliff negotiations, someone’s going to look at the fat, juicy $20 billion allocated to health information technology — probably the Republicans who have already slammed the program publicly — and target it for budget cutting.  He argues that Democrats are unlikely to push back too hard, given that HITECH is hardly a “sacred cow” that legislators fear to touch.

And then, he says, comes a disaster for the health IT community:  “Whatever federal funds are left to support electronic health records, meaningful use, health I.T. workforce training, health information exchanges, best practices dissemination, regional extension centers and anything else in the HITECH Act will be gone.”

In Goedert’s view, the only way to save HITECH is for individual physicians hospitals to go on a lobbying tear, pounding their representatives and senators, if they don’t want to see Meaningful Use become a casualty of party politics.

I think Goedert has a point.  As he reminds us, eight Republican leaders in the House and Senate finance and health committees have already demanded proof that Meaningful Use is worth the money. And a recent House hearing held to investigate the subject suggests that some members still aren’t satisfied.  Things could get ugly.

ImagineMD EHR Closes Doors and Amazing Charts Acquired

Posted on November 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.

A lot of activity lately in the EHR world and I think this is just the beginning. ImagineMD posted an “Important Notice” (quoted at the bottom of this post) on their website that said that they’re no longer providing ImagineMD services. The interesting thing is that a respected EHR consultant that I know absolutely loved the Imagine MD EHR. This guy had worked with hundreds of EHR software, so he knew the difference. Sadly, as often happens in business it’s not enough to have a great product. You also have to be able to market that product well. Looks like ImagineMD went out with their heads held high and didn’t leave their doctors high and dry. That’s always good since even an assisted transition is hard.

In other unrelated news, today it was also announced that Amazing Charts was acquired by Pri-Med. This is an interesting acquisition since Amazing Charts has a nice EHR footprint and Pri-Med wasn’t previously in the EHR space. Although, it does seem that Pri-Med’s physician connection could be really beneficial to Amazing Charts. I’m going to try and do an interview with Amazing Charts and Pri-Med which I’ll post on EMR and HIPAA or EMR and EHR.

ImagineMD is part of the EHR consolidation that everyone said is coming. We just can’t sustain 300+ EHR vendors. However, the Amazing Charts acquisition isn’t part of EHR consolidation. It’s similar to the ADP Acquisition of AdvancedMD where Neil Versel aptly pointed out wasn’t the expected EHR consolidation. Add these changes to large EHR vendors shutting down EHR software like MyWay and GE Centricity Advance and were slowly winnowing down the number of EHR vendors out there.

ImagineMD Client Notice:

Dear Clients of Imagine MD:

This notice is to inform you that as of September 30, 2012 (the “Effective Date”), we will no longer be providing Imagine MD Services as defined in the End User License Agreement – Terms of Use as set forth on our website at https://secure.imaginemd.com/Public/docs/terms.pdf (the “Services”). The Services may or may not include, without limitation, electronic prescribing “eRx”, meaningful use attestation services, and other related services. After the Effective Date, you will no longer have access to any of our Services and we will terminate all access codes that we have provided to you.

Following termination of Services we will return to you, or, upon your written instruction, transfer to another party, all patient records, including personal information you have provided to us or we have created and maintained on your behalf. Such information will be provided in an encrypted format. You will be contacted in the near future regarding this transfer of information. The files will include information through the period ending September 30, 2012, or the date as of which you request such data, whichever occurs first. Thirty days after the information is transferred, we will destroy all patient records and we will not retain a copy of the information. Additionally, we will provide you with a log of all relevant disclosures, if any, of protected health information that you may need to fulfill your obligations under the Health Insurance Portability and Accountability Act of 1996 with regard to the provisions and accounting of such disclosures.

We are terminating all of our services as we are in the process of exiting the business. All of us at Imagine MD thank you for using our services.

If you have any questions, please contact us by email at info@imagine-md.com or call us at (877) 394-7774.

eHealth Made EASY, LLC (a/k/a Imagine MD™)

Full Disclosure: Amazing Charts is an advertiser on this site.

Will Meaningful Use Affect M&A In The EMR Space?

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.

As some of you may recall, Allscripts is said to be floating the possibility of selling out to a venture capital firm. This follows several months of tumult at the board level, including some who might have been helpful in keeping its merger with Eclypsis moving forward.

I’ve been thinking about this deal for a while, wondering whether it would come to fruition and if so, what would make it happen. And I’ve realized an Allscripts deal, or other EMR company sale, might give us a window into just how valuable Meaningful Use criteria have proven to be. Let me explain.

If I was a EMR vendor looking for an acquisition or merger, I’d certainly look at the usual metrics, including the customer list, code base my target had in house, maturity of the product line, the extent to which in-house programming talent could support the roadmap and so on. (Naturally, I’d go over its books in depth too.)

But that’s not all. These days we have some new perspectives from which to evaluate the success of EMR vendors, a set of standards which are fairly unique in the software business.  Two important examples: We can look at how successfully a vendor’s customers have been able to meet Meaningful Use goals to date, and how far along the HIMSS EMR Adoption Model customers are as well.

While both are interesting, Meaningful Use is more important, as it’s such a politically fraught, complicated and rapidly evolving set of standards. In short, I’d argue that if a vendor’s customers are doing well with MU, then it’s likely the vendor is doing something right.

Now, you can’t draw a straight line between the quality of a vendor’s product and how well its customers  have done in qualifying  for Meaningful Use. Implementation is ultimately the hospital or doctor’s responsibility, even if the provider pays for EMR vendor consulting to get things going. And there’s lots of ways things can go wrong that have little or nothing to do with the product.

Still, I predict that Meaningful Use success is going to become a more important metric in EMR vendor M&A as time goes by. After all, the more bragging rights a company has regarding Meaningful Use success, the more they can improve the acquiring vendor’s profile. That’s gotta matter.

EMR Masters, Smart EHR, and Congressional Hearing on Meaningful Use

Posted on November 18, 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 think this is definitely the case. I wish that EMR would embrace its place as the database of healthcare and enable an entire eco system of people to provide the add on functionality.


I always love seeing a provider asking for something I’ve been writing about for a long time. We need smart EHR, but as you see from the first tweet in the Twitter roundup I don’t think one company is going to make them smart. It’s going to take an ecosystem to make them as “smart” as they need to be.


I saw another tweet somewhat related to this. It asked if meaningful use was going to fall off the fiscal cliff. My short answer is: No.

EMR Value Diminished If Patients Can’t Access Care

Posted on November 16, 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.

A new study from the august Commonwealth Fund has just come out, offering a portrait of primary care practices in ten countries. The study had a lot of interesting data to offer, including news of primary care reforms to meet the needs of aging populations and improve chronic disease care.

One of the key data points drawn from the CF study was that two-thirds of U.S. PCPs reported using EMRs in  2012, up from 46 percent in 2009. That’s obviously a big improvement, though the U.S. still lags behind the U.K.,  New Zealand and Australia in EMR implementations and use of IT generally.

At the same time, it seems that U.S. citizens still face serious financial obstacles in getting primary care. Fifty-nine percent of U.S. physicians surveyed said that their patients often have trouble paying for care. That’s a big contrast with other countries included in the study, including Norway (4 percent), the  U.K. (13 percent) and Switzerland (16 percent). These numbers make sense when you consider that the U.S. is the only country surveyed that doesn’t offer universal health coverage.

Putting aside humanitarian reasons to be troubled by money obstacles to PCP access, there are other issues to consider. To me, the most obvious is the selection bias imposed by financial barriers to care.

Consider one of the big goals a medical home hopes to accomplish, managing chronic conditions effectively across the primary care practice’s population.  PCPs can make great use of an EMR to work on such goals, from issuing reminders to get preventive care to tracking patient progress across different demographics to test the impact of new interventions.

The thing is, the power that is a well-tuned EMR is not at its best if the interventions are mostly aimed at those who fit a certain socio-economic profile.

Admittedly, few small PCPs need to be worried about selection bias from a scientific standpoint, as they’re seldom gunning for the next journal article presentation, but looking at the country as a whole, we’re missing out on the collective learning we can generate with clinical data analytics.  It seems to me that we’re going to have to address this problem directly if we want to leverage EMRs for the greater public good.

New Healthcare Facility Experiences IT Growing Pains

Posted on November 15, 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.

Well, dear readers, if it’s not one thing it’s another. Our family has been plagued by broken bones (documented in a recent blog), as well as the sinusitis and bronchitis that have plagued so many other families as of late. Like a typical mother, I put off going to the doctor in the hopes that the malady would run its course, as my colds typically do. But after four weeks (one spent on holiday in the Virgin Islands), I woke up with new, more intense symptoms, and so decided to seek professional help. (I’ll leave it to you to determine if the copious amounts of rum punch and lengthy amount of time spent getting to and from Tortola in any way impacted my condition.)

I was faced with several options: try to get seen by my primary care physician, who, since my move, is now inconveniently located. (Note to self: seek new PCP closer to home.) Try my luck at the Walgreens clinic nearby. Or, go to the urgent care center down the street.

I bypassed Walgreens because I’ve had insurance issues there in the past. (As I drove past, I noticed they are excitedly welcoming back Blue Cross Blue Shield customers.) I faced the same problem at the urgent care center, so decided to try my luck at a previously unconsidered option – the new WellStar Acworth Health Park.

Larger than a typical medical office, but smaller than a typical WellStar hospital, the health park offers a variety of services – urgent care; pediatrics; a variety of specialists; pharmacy; and family, internal and OB/GYN medicine, among other services. I was pleasantly surprised to find that its café offers Starbucks coffee.

Just a few months old, its interior and exterior are pristine – open, airy spaces, fountains and lots of glass accents are certainly a nice change from the typical, closed-in feel of most phsyicians’ offices I’ve visited. The staff was welcoming, sympathetic and accepting of my insurance, much to my relief.

It even had a concierge/upscale feel. Complimentary single-serve coffee was available in the urgent care waiting room, as were a variety of cold beverages. A good portion of the waiting area was given over to kids’ amusements, which I hope my girls will never have to amuse themselves with! I definitely appreciated the wifi throughout the facility. These little perks are so nice when a long wait is in front of you and you’re well enough to take advantage of them.

Being that it is a new facility, it is still experiencing growing pains, most noticeably in the need for additional physicians. Fortunately, I didn’t arrive on a day where patients were wrapped around the building waiting for the doors to open, as the pharmacist told me has happened before. Nevertheless, I did wait a considerable amount of time on the single physician on staff that day. Even he mentioned the need for additional MDs in the face of great community need.

He was cheerful and paid attention to my concerns, even apologizing for the paper prescriptions. Turns out WellStar plans to transition from NextGen to Epic early next year, and is waiting for that process to start in order to bring the health park on board with new, system-wide electronic medical records and e-prescribing. He was very enthusiastic about the conveniences afforded by healthcare IT, which makes me think perhaps I should consider a WellStar physician in my search for a PCP closer to home.

The pharmacy was experiencing its own growing pains, most notably with its consumer-facing payment system, and phone lines. But, the staff’s smiling faces, good attitudes and a fresh cup of coffee helped allay any frustration on my part.

Coincidentally, I came across a press release later that day detailing WellStar’s just-announced partnership with Piedmont Healthcare. They’ve teamed up to form the Georgia Health Collaborative, which, according to Piedmont’s press release, will enable the two “to share intellectual knowledge concerning clinical care and seek cost reductions through economies of scale.”

I’m all for economies of scale, but hope my family won’t have to experience them via unexpected or put-off illness anytime soon.

Results of EHR Motivation Poll

Posted on November 14, 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.

A few months back I posted a poll asking “Which Factor most influences your EHR use?” I was really interested to see the results of this poll since I often think that most clinics are so blinded by the EHR stimulus money that they lose touch with the reality of running a clinic.

Here’s the results from the poll:

As you can see, the results are pretty dramatic. At least the majority of readers of EMR and EHR are implementing an EHR for something more than the EHR incentive money. This is a very heartening thing for me. Not that any clinic should ignore meaningful use and the EHR incentive, but I’m glad that most are focusing on the benefits of an EHR to their clinic more than meaningful use and government handouts.

This gives me added motivation to start a series of posts on EMR and HIPAA about the various EMR and EHR benefits not related to EHR incentive money. I hope that series will help those implementing an EHR find all the benefits possible from EHR use. Watch for that over the next couple days.

ICD-10 Benefits for Population Health

Posted on November 13, 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’ve asked many people why we haven’t had more stories on the benefits of ICD-10 since so many other countries have been using ICD-10 for many years.

In the following video I asked Doris Gemmell, BSc, MBA, CHIM, Director of Coding Services at Accentus Inc. about the benefits of ICD-10 to population health and she provided an answer from her ICD-10 experience in Canada.

You should also check out this video where Doris Gemmell talks about the patient benefits of ICD-10. Plus, Doris also has a blog.

From #AMIA: Interoperability Held Back By Politics

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

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.