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The Week of Women in Healthcare

Posted on August 22, 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.

#XXinHealthWeek
Twitter fans – particularly #HITchicks – may have come across the hashtag above this week as part of the larger XX in Health Week, an initiative of Rock Health to connect and empower female visionaries to drive change in healthcare. I’m all for driving change, and know from personal experience that women, whether in the home or workplace, tend to be masters of multitasking, putting out small fires as needed, and soothing bruised egos and fragile psyches. We seem well suited to the task of driving change, but not surprisingly, are not well positioned to do so.

According to a slide deck put together for the XX in Health Week, women make up just 14% of healthcare companies’ BODs, and 0% of Fortune 500 healthcare company CEOs.  The statistics are a bit more hopeful when looking strictly at hospitals, according to the recent “Women in the Hospital C-Suite” report from Billian’s HealthDATA:

bhdchart

I’m not sure when we’ll get to female leadership numbers that are acceptable, or who will make that call. It will be nice when, as mentioned in the slide deck, we recognize leaders not by their gender but by their ability to lead.

Health 2.0
Atlanta has its own Health 2.0 movement – a meetup group focused on startups in healthcare IT that is finally getting some momentum. Numbers for female leadership are good. One of three companies that pitched at the most recent event was led by a woman. Brandi March of NovitaCare – a mobile solution that helps patients and the family members who serve as their caregivers manage and coordinate care in one central location – started the company after taking on the role of caregiver for her ailing mother. She described the task of obtaining and organizing her mother’s records, sharing news with other family members, trying to stay organized and trying to make sure six or seven different providers were all on the same page as a “nightmare.” And so NovitaCare was born.

novitacareready

All in all it’s been a good week for women in healthcare. It will be interesting to see if the statistics mentioned above have changed by this time next year. I feel like there are plenty of unsung female visionaries driving healthcare change RIGHT NOW. Please share the story of someone you know via the comments below.

EMR Costs Outweigh Benefits, Physicians Say

Posted on August 21, 2013 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.

Nobody likes paying for something that’s expensive but not that valuable. But that’s the position many physicians feel they’re in when they buy an EMR, FierceHealthIT reports.

A new study by athenahealth concludes that while physicians do feel EMRs deliver benefits, the expense they have to take on outweigh the benefits EMRs deliver. The EMR vendor surveyed 1,200 physicians, 70 percent specialists and 30 percent primary care doctors to learn more about their attitudes toward EMRs, FHIT said.

The study wasn’t all bad news for EMR use. Thirty-eight percent of doctors had a “somewhat favorable” opinion, and 31 percent had a “very favorable” opinion of EMRs. That being said, 51 percent of responding physicians said that the financial benefits of EMRs don’t outweigh the cost, athenahealth found.

The study found that physicians were more familiar with EMRs than they were when athenahealth did its 2012 Physician Sentiment Index. But doctors’ willingness to buy an EMR  has actually fallen, probably because those who haven’t done it at this late date are particularly resistant. Meanwhile, one thing that hasn’t changed since last year is that doctors don’t think EMRs are made with their practice needs in mind.

Sadly, these results aren’t much of a surprise. While some doctors are adapting to their EMR installation, they’re still struggling with clunky interfaces and questionable vendor support.  Some practices have spent years waiting for their pre-EMR productivity to come back, and have found that it just isn’t happening.

But here and there there are some signs that vendors are “getting it.” For example, I really liked a story John wrote about how EMR vendor Elation requires programmers to shadow a physician as part of the hiring process. To my mind, this kind of thinking is far more likely to bear fruit than the existing system, which puts programmers at a considerable remove from their product’s end users.

The truth is, we’re never going to reach the point where all physicians are EMR boosters, but it’d be nice if we at least reached a point where most saw EMRs as being worth the (big) pricetag.

Windows 8 Enables Healthcare Tablet Adoption

Posted on August 20, 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.

The following is a guest post by Scott Thie, Vice President, Healthcare and Education, Panasonic
Scott Thie - VP of Healthcare and Education at Panasonic
Technology is evolving at light speed, and the way healthcare providers work is changing with it.

Mobile computing technology that was unimaginable five years ago is now commonplace, and has driven efficiency and productivity in healthcare by leaps and bounds. Doctors, nurses and healthcare administrators now have the ability to work from virtually anywhere, storing data “in the cloud” and staying constantly linked to the patient and one another.                   

One of the primary computing devices enabling this mobile evolution has been the tablet – a light weight, powerful and easy-to-use device that has gone from a niche product to widespread healthcare enterprise adoption. Tablets are an excellent way to boost mobility and workflow efficiency, and their role in healthcare continues to grow. Tablets’ portability, flexibility and ease of use have made them a great fit for health business applications of all kinds. In fact, over the next five years total shipments of tablet computers to enterprises around the world are expected to increase at a compound annual growth rate of 48%, according to Infinite Research.

It’s clear that tablets offer improved productivity and mobility, but this technology evolution has not come without its growing pains. In many cases, tablets are so attractive to users that many of them have not waited for their employers to issue them; they’ve brought their own personal devices to work. In other cases, healthcare providers have issued devices to their staff that are better suited for consumer use and lack critical security, durability and functionality features. This has resulted in a fragmented IT management landscape consisting of myriad devices with different operating systems, security challenges and support needs.

Recently, the technology industry has seen a shakeup that could play a large role in addressing this issue. Last fall, Microsoft released Windows 8, the most dramatic overhaul of its operating system since 1995. Offering a redesigned interface and several new features, the operating system is built for mobility, security and manageability. And when paired with enterprise-class hardware, Windows 8 opens the door for healthcare providers to embrace the benefits of tablets, without sacrificing on security, functionality and management capabilities.

Windows 8 Advantages

One of the most obvious benefits of Windows 8 is its redesigned metro interface. Built to take advantage of touchscreen technology, the interface offers enterprise professional users the fast and fluid efficiency and personalization found on today’s popular consumer devices. The operating systems use of swipe, tap and drag gestures allows users to easily switch between applications and multitask. While multitasking is a business reality, it’s a challenge for some tablet operating systems, potentially limiting worker productivity. The Windows 8 interface also includes live updating tiles, which can help business users retain situational awareness.

With the recent boom in mobile devices, many healthcare IT departments have been forced to integrate incoming tablets – with alternative operating systems and potential security risks – into legacy device management, security, and system integration structures. It can be difficult to securely and efficiently integrate mobile devices with newer operating systems like Android or iOS into a legacy Windows IT infrastructure, and often puts healthcare administrators into a “troubleshooting” mode instead of devoting their resources to ensure optimal patient care.

Designed with mobile productivity in mind, Windows 8 allows providers to avoid compromising on mobility, functionality and security by integrating seamlessly with legacy enterprise IT infrastructure. With Windows 8, users have the ability to use the same operating system in desktop and tablet environments. Not only is the IT department supporting a single operating system, users benefit from a seamless and familiar operating environment across all their devices.

Security is a critical need in healthcare technology, and Windows 8 offers several features not found in many other tablet operating systems. Secure Boot, for example, is a boot-up process that helps prevent malware from running at startup. Unlike some mobile app download services, Microsoft vets each app included in the Windows Store for quality and safety before making it available for download.

From an IT management perspective, a key benefit of Windows 8 is its ability to work with existing software and hardware. Many business-critical applications, especially in the healthcare segment, are designed to run on Windows. It’s also integrated into the enterprise in other ways, such as the many third-party cloud and software-as-a-service providers using Active Directory for identity management. Windows 8 works with mobile device management (MDM) systems as well, including offering features to secure devices from unauthorized use.

Choosing the Right Device

Equally important as the operating system is the right hardware. Purpose-built tablets, designed specifically for challenging environments, offer the durability, ease of use and warranty support that healthcare providers require, without compromising on security or manageability.

Before investing in a tablet deployment, verify that the device will offer the features your care providers and healthcare facility demand. Something as simple as a user-replaceable battery, which many consumer devices lack, could be a potential life-saver for doctors and nurses remotely accessing critical patient data. In other cases, it may be as simple as a tablet with a daylight-viewable screen, which ensures a clinician can work efficiently regardless of lighting challenges. Some hospital workers may need a device that can be used with a digitizer pen for signature capture or an all-touch interface for easy manipulation of medical images or text.

The most common causes of mobile computer failures are drops and spills. These dangers are magnified for healthcare mobile workers. Tablets should be engineered to be rugged enough to withstand a fall to a hard surface, sealed to withstand spills and dust, and easily sanitized help to ensure reliable operation.

With computer hardware such as tablets, it’s also important to understand the difference between price and cost. Even at an enterprise level, it’s natural to gravitate toward the lowest sticker price. However, if that device has a high failure rate, hinders productivity, lacks enterprise-level support or has a short standard warranty, it will end up costing more in the long run – not just in replacement costs but also labor costs, inefficiency, the loss of critical data, reduced patient satisfaction and more. Think about products in terms of their total cost of ownership in order to get the most for your money.

Tablets represent a turning point for the healthcare industry, with the promise of new efficiencies, methods of decision-making and competitive advantage. By making the right technology decisions, healthcare providers can ensure their physicians, nurses and medical staff are equipped to take advantage of these gains without compromise.

Scott Thie is Vice President of the Healthcare & Education Sectors for Panasonic System Communications Company of North America (PSCNA). He is a 24 year veteran of the technology industry and has been with Panasonic since 1998.

Scott began his career at Panasonic as an Area Sales Manager. He was promoted to Regional and then National Sales Manager before his current position. Scott has been recognized several times with awards including Rookie of the Year and Area Sales Manager of the Year. He successfully developed Panasonic’s Field Service Vertical and managed its growth for five years. During his career, he has held positions in sales and sales management, as well as management of marketing, business development and sales engineering. Scott’s current challenge is driving growth and extensively expanding PSCNA’s Healthcare Sector. Before joining Panasonic, Scott was District Sales Manager at Alps Electric, a company specializing in printers and OEM PC components. He was also Regional Sales Manager for Philips Electronics. Scott holds a BS degree in marketing with a minor in sales management from Ferris State University.

Modernizing Medicine EHR Vendor Raises $14 Million

Posted on 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.

Modernizing Medicine®, the creator of the Electronic Medical Assistant® (EMA™), a cloud-based specialty-specific electronic medical record (EMR) system, announced today that it has received $14 million from Summit Partners, a global growth equity investor. –Source

I’ve been a big fan of Modernizing Medicine since I first came across them. Their approach to EHR is very smart and very different than many of the EHR software out there. They’re extremely focused on the specialties that work well with their visual method of documentation and that documentation method is something unique.

I’ll be interested to see if Modernizing Medicine plans to use this $14 million to expand beyond their current specialties or whether they plan to stay as a specialty specific EHR. I’m a big fan of specialty specific EHR software and so I hope that it’s the later. You have to compromise so many things when you expand an EHR to support so many different specialties. The number of doctors still not using Modernizing Medicine’s EMA EMR is still large enough for them to do very well.

Interoperability vs. Coordinated Care

Posted on August 19, 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.

Andy Oram asked me the following question, “Is the exchange of continuity of care documents really interoperability or coordinated care?

As it stands now, it seems like CCDs (continuity of care documents) are going to be the backbone of what healthcare information we exchange. We’ll see if something like Common Well changes this, but for now much of the interoperability of healthcare data is in CCDs (lab and radiology data are separate). The question I think Andy is asking is what can we really accomplish with CCDs?

Transferring a CCD from one doctor to the next is definitely a form of healthcare interoperability. Regardless of the form of the CCD, it would be a huge step in the right direction for all of the healthcare endpoints to by on a system that can share documents. Whether they share CCDs or start sharing other data doesn’t really matter. That will certainly evolve over time. Just having everyone so they can share will be of tremendous value.

It’s kind of like the fax machine or email. Just getting people on the system and able to communicate was the first step. What people actually send through those channels will continue to improve over time. However, until everyone was on email, it had limited value. This is the first key step to interoperable patient records.

The second step is what information is shared. In the forseeable future I don’t seeing us ever reaching a full standard for all healthcare data. Sure, we can do a pretty good job putting together a standard for Lab results, Radiology, RXs, Allergies, Past Medical History, Diagnosis, etc. I’m not sure we’ll ever get a standard for the narrative sections of the chart. However, that doesn’t mean we can’t make that information interoperable. We can, are, and will share that data between systems. It just won’t be in real granular way that many would love to see happen.

The idea of coordinated care is a much harder one. I honestly haven’t seen any systems out there that have really nailed what a coordinated care system would look like. I’ve seen very specific coordinated care elements. Maybe if we dug into Kaiser’s system we’d find some coordinated care. However, the goal of most software systems haven’t been to coordinate care and so we don’t see much on the market today that achieves this goal.

The first step in coordinating care is opening the lines of communication between care providers. Technology can really make an impact in this area. Secure text message company like docBeat (which I advise), are making good head way in opening up these lines of communications. It’s amazing the impact that a simple secure text message can have on the care a patient receives. Secure messaging will likely be the basis of all sorts of coordinated care.

The challenge is that secure messaging is just the start of care coordination. Healthcare is so far behind that secure messaging can make a big impact, but I’m certain we can create more sophisticated care coordination systems that will revolutionize healthcare. The biggest thing holding us back is that we’re missing the foundation to build out these more sophisticated models.

Let me use a simple example. My wife has been seeing a specialist recently. She’s got an appointment with her primary care doctor next week. I’ll be interested to see how much information my wife’s primary care doctor has gotten from the specialist. Have they communicated at all? Will my wife’s visit to her primary care doctor be basically my wife informing her primary care doctor about what the specialist found?

I think the answers to these questions are going to be disappointing. What’s even more disappointing is that what I described is incredibly basic care coordination. However, until the basic care coordination starts to happen we’ll never reach a more advanced level of care coordination.

Going back to Andy’s question about CCDs and care coordination. No doubt a CCD from my wife’s specialist to her primary care doctor would meet the basic care coordination I described. Although, does it provide an advanced level of care coordination? It does not. However, it does lay the foundation for advanced care coordination. What if some really powerful workflow was applied to the incoming CCD that made processing incoming CCDs easier for doctors? What if the CCD also was passed to any other doctors that might be seeing that patient based upon the results that were shared in the CCD? You can start to see how the granular data of a CCD can facilitate care coordination.

I feel like we’re on the precipice where everyone knows that we have to start sharing data. CCD is the start of that sharing, but is far from the end of how sophisticated will get at truly coordinated care.

Dilbert Digital Health Cartoon

Posted on August 18, 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.

How can you not love Dilbert? I once heard Scott Adams speak at a conference and it was spectacular. I laughed the whole time and left with an important message. Neil Versel says he spoke at HIMSS in 2005. I can only imagine what he’d say about Healthcare today.

Oh yes, you probably want to see the Dilbert Digital Health cartoon. I’d put it here, but it seems right to have you click the link and check it out on Meaningful Healthcare IT News since he found it.

I love digital sensors. There’s certainly plenty of FUD around them, but for every bad thing there’s a handful of great benefits.

I hope you enjoy a little weekend humor.

EHR Programmer Shadows Physician

Posted on August 16, 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.

I was recently browsing through blogs and came across this post on the Elation EMR blog about their practice of having developers shadow a physician as part of their hiring process. What an amazing idea! I loved this paragraph which says a lot about the health IT industry:

I was terrified. I’d worked in healthcare IT for years, but even when I worked at startups I’d been three or four steps removed from the patients and even the clinician users. Being at the point of care, watching someone’s grandfather discuss his current prescriptions with his longtime primary care provider was revolutionarily human to me—and incredibly intimidating. Add to that the pressure that I didn’t have the job yet; this was one of the final stages of my job interview.

I think if we did a survey of healthcare IT programmers, we’d be saddened to know how many of them have never been part of a clinical interaction. I bet a huge percentage of these programmers’ only point of reference for healthcare was when they went to the doctor themselves.

At TedMed I ran into a former Epic programmer who confirmed what I describe above. They were there to program something to spec. They weren’t there to understand the clinical context of what they were creating. There is something very different between a programmer involved in the design process and one just designing to spec.

Obviously, Elation EMR takes the opposite focus on their approach to EHR development. The above policy adds some depth to Elation EMR Founder Kyna Fong’s post asking “Is You EHR Clinically Valuable?“. I love when a company doesn’t just talk about something, but their actions reflect their values.

I bet many EHR vendors would be embarrassed to ask their staff if they have ever shadowed a physician. No doubt, the number would be very low.

Medical Bills, Patient Portal Insight and HIT Friends in Need

Posted on August 15, 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.

HIT Friends Support a Great Cause
Blogging and social networking are of course great drivers of information and thought leadership, and they can also be very effective in spreading the word of friends in need. I found out through these avenues about the healthcare challenges of three-year-old Little James, recently diagnosed with a brain tumor, and the fundraising efforts of Todd Stein at Amendola Communications to alleviate the burden of his mounting medical bills. You can read about his healthcare challenges here. Prayers and donations are immediate needs. I wonder if any organization out there might step up and match donations.

Speaking of Medical Bills
On a lighter note (sort of), I laughed out loud when I saw an explanation of benefits for my recent surgical procedure.

savings

Thankfully, I do not truly owe anywhere near that amount due to insurance coverage. I shudder to think how the uninsured pay for life-saving procedures they can’t afford. Yes, hospitals can work out monthly payment plans for anyone, but if an extra $50 a month means less gas in the tank to drive your kids to school … I now find myself tediously combing over statements from the hospital and explanation of benefit statements from my insurance company to make sure they match up.

More Healthcare Cost Transparency News
A company called Change Healthcare is getting into the cost transparency game, having just secured $15 million in funding to further develop its Transparency Messenger product, which, according to the company, compiles health plan and claims data to devise algorithms that determine cost of service. It then uses health plan holders’ or employees’ demographic information and personal preferences for care to look for savings.

Customer Service in Healthcare
In contrast to the financial distress that comes with unexpected medical procedures, I must share with you a thank you note from my surgical team. While I appreciate the gesture, I’m wondering if they’ve charged me for it!

thankyou

All kidding aside, this gesture highlights the increasing importance providers are placing on customer service. To learn more, check out “Why Customer Service Matters in the Healthcare Industry,” by James Merlino, MD, of the Cleveland Clinic.

Patient Portal
I haven’t yet logged back into my patient portal – thankfully having no need to right now. My last doctor’s visit prompted me to ask if I could access my latest pathology report via the portal. My doctor sidestepped the question and promptly presented me with a paper copy, which will likely be a good thing, as he and my dermatologist don’t seem set up to share patient information electronically. That seems to be a provider choice, and not necessarily due to poor portal design.

Speaking of patient portals, I highly recommend you take a look at Dr. Michael Koriwchak recent blog over at WiredEMRDoctor.com. “My First Year with a Patient Portal” gives us patients a better idea of what works and what doesn’t from the practice perspective.

Cutting Down On EMR Implementation Struggles

Posted on August 14, 2013 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 blogs like this one, we spend a lot of time talking about the frustrations doctors face when adapting to use of an EMR. But what if there were ways EMR implementations could be less painful for doctors (and their staff)? According to Dike Drummond, MD, there’s three major ways to minimize the pain and improve the process of putting an EMR in place in a medical practice.

* Change your attitude

According to Drummond, doctors often start out hating EMR technology and resisting the idea it could ever be helpful. “We treat the computer and the programs as if they rose from the very fires of hell to torment us,” Drummond notes. As a result, physicians fail to embrace the technology and never learn how to use it well, leading to more unhappiness, he suggests.

Instead of being angry and frustrated, set yourself a goal of becoming a power user, Drummond advises his colleagues. Take all vendor training twice, and have your nurse and receptionist do so too; customize your EMR to offer the most personalized and elegant experience possible, including automating any repeat keystrokes; and sit and watch over the shoulder of well-versed colleagues to see what existing power users do. “Just one tip from a power user colleague can make a huge difference in each patient encounter,” he says.

* Don’t force paper and EMR to compete

Too often, medical practices overlay new documentation requirements for their EMR on top of their paper chart patient flow process, and results are usually pretty ugly, Drummond warns. Doing so “sets up a Death Match between your old flow systems and your new EHR,” he says.

The better strategy is find ways to integrate the two processes, he  suggests. It’s much better to find ways to alter the way you see patients so the EMR documentation gets built into your patient flow.  Refusing to accept this makes no sense, he argues.

Leverage your team

Doctors are used to being the one who steps out in front and leads the team, but in this case, it’s important for doctors to dig in and take advantage of the insights their team can offer.  Doctors should get everyone’s ideas on how to refine workflow through powerful brainstorming sessions.

To further the process, Drummond recommends doctors ask open-ended questions such as the following:

~  What do you see me doing that I can stop – or  you can do better?
~  What ideas do you have on how we can do things differently to make documentation easier?
~  How can we share the charting activities more effectively?

Drummond’s points are well-taken, but I’d go even further. Doctors don’t need to just adapt to an EMR and tailor it to their needs, they have to embrace digital tools — from smartphones and tablets to patient portals and e-mail — if they’re going to survive the next wave of medical practice.  But for starters, it certainly makes sense to stop hating on EMRs and learn how to make them work as a supportive tool. The advent of EMRs is inevitable, so why fight?

Data Ownership Disputes, Not Tech Challenges, Slow Interoperability

Posted on August 13, 2013 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.

Most of the time, when we discuss obstacles to interoperability, we focus on the varied technical issues and expense involved in data sharing between hospitals and doctors. And without a doubt, there are formidable technical challenges ahead — as well as financial ones  — on the road to full-on, fluid, national data exchange between providers.

But those aren’t the only obstacles to widespread interoperability, according to one health IT leader. There’s another issue lurking in the background which is also slowing the adoption of HIEs and other data-sharing plans, according to HIMSS head H. Stephen Lieber, who recently spoke to MedCity News. According to Lieber, the idea that providers (not patients) own clinical data is one of the biggest barriers standing in the way of broad interoperability.

“There is still some fine-tuning needed around how technology is adopted, but fundamentally it’s not a technology barrier. It’s a cultural barrier and it’s also a lack of a compelling case,” Lieber told MedCity News.

In Lieber’s experience, few institutions actually admit that they believe they own the data. But the truth is that they want to hold on to their data for competitive reasons, he told MedCity News.

What’s more, there’s actually a business case for not sharing data. After all, if a doctor or hospital has no data on a patient, they end up retesting and re-doing things — and get paid for it, Lieber notes.

Over time, however, hospitals and doctors will eventually be pushed hard in the direction of interoperability by changes in reimbursement, Lieber said. “Work is already being done in Washington to redesign reimbursement. Once Medicare heads down that path, commercial insurers will follow,” Lieber told the publication.

Lieber’s comments make a great deal of sense, and what’s more, focus on an aspect of interoperability which is seldom discussed. If hospitals and doctors still cling to a culture in which they own the clinical data, it’s most definitely going to make the task of building out HIEs more difficult. Let’s see if CMS actually comes up with a reimbursement structure that directly rewards data sharing; if it does, then I imagine you will see real change.