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ICD-10 Implementations and EHR Workflow Optimization

Posted on December 11, 2012 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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.

mHealth is Coming of Age

Posted on I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

Last week I had the pleasure of attending my first mHealth Summit in Washington, D.C.

The tone and rhetoric of this year’s meeting seemed a great deal different than what I read about last year’s meeting.  Gone was the doctor bashing by keynote speakers.  Instead we heard talks like the one from NIH director Dr. Francis Collins.   His literature review showed there are only 30 published, randomized, and controlled studies of mHealth technology.  Of those studies only 6 showed that mHealth showed a statistically significant improvement in patient care. He admonished the audience to subject mHealth technology to the same rigorous, statistically relevant testing that is given to other potential advances in health care.

Bravo.  Music to my ears.  That is something everyone in mHealth needs to hear.

Other speakers and panelists shared similar views.  I was also pleased to hear several acknowledgements of the critical role physicians must take in mHealth.  Until that point I had wondered if some mHealth proponents thought they needed doctors at all.

I was delighted to meet Arthur Lane, Director of Mobile Healthcare Solutions at Verizon Wireless.  Readers of my blog may recall I (unfavorably) reviewed Verizon’s home monitoring program for congestive heart failure (CHF) patients.   After discussing with Arthur my concerns about the program I realized we were very much on the same page.  He is aware of the literature, including the Yale study showing no benefit for home monitoring of CHF patients.  He has a very grounded approach to solving the issues raised by the medical literature.  That conversation changed my opinion of the project.  I like what they are doing.

I was also a panelist in a discussion entitled “Converting to mHealth: How to Drive Change”.  We had a very spirited discussion before a standing-room-only crowd.  I was very impressed with the moderator and the other panelists as well as the questions from the audience.  Much of the discussion addressed the relationship of doctors to health IT folks and the relative role of each in driving mHealth forward.  The discussion demonstrated that this is a complex issue with emotions on both sides.  I’ll have more to say about this in a future post.

It was gratifying to come home with my faith as least partially restored.  mHealth has matured over the past year.  And perhaps my own feelings about mHealth have matured as well.