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Another Wrecking Ball Healthcare Parody

Posted on October 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.

Well, it seems like this is the week of the Wrecking Ball Healthcare Parodies. In case you missed it, yesterday I posted the Nuesoft Wrecking Ball Parody on EMR and HIPAA. Today I came across another healthcare parody of Miley Cyrus’ Wrecking Ball by none other than the incomparable ZDoggMD. Check out ZDoggMD’s version embedded below:

EMRs Get Personal with 23andMe

Posted on October 18, 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.

I had the pleasure of visiting the dentist this week. My dental hygienist and I end up having pretty lengthy conversations as we catch up on the previous six months. It’s almost like therapy in that you get to lay down the whole time, talk a bit, listen a bit, talk some more. At any rate, we commiserated about our experiences with cancer; I with my near-brush with melanoma and she with melanoma and then some. Due to her history with several kinds of cancer, she is thinking about having her daughter take a look at genetic testing service 23andMe.

The company’s $99 spit kit can generate reports on 256 health conditions and traits including inherited traits, carrier status for those traits, genetic health risks, likely drug responses, and updates on your DNA as they become available. As a recent Fast Company article on the company and its founder Anne Wojcicki notes, 23andMe’s mission is to bring the “power of genetic testing to everyday consumers so they can better manage their own health care, and [to use] the aggregated data from those tests to help doctors, scientists, hospitals, and researchers discover new cures for diseases that emanate from troublesome genetic mutations.”

As I left my dentist’s office, which ironically had just switched from paper to digital, I thought about the likelihood of genetic data ever finding its way into a personal health record or EMR. The Fast Company piece mentioned one doctor who pretty much didn’t want to have anything to do with his patient’s genetic data, which I duly noted she presented to him on sheaves of paper. One is a mighty small sample, of course, and so I can’t help but wonder what other providers think the value of this kind of data has, and how likely they might be to try and incorporate it into a medical record. 23andMe’s terms of service do state that, “Genetic Information that you choose to share with your physician or other health care provider may become part of your medical record and through that route be accessible to other health care providers and/or insurance companies in the future.”

But how will it get there? Is there an interface in the works? A partnership between 23andMe and an up-and-coming PHR or EMR? The company entered into a Parkinson’s study last year with Cleveland Clinic, so it obviously has direct relationships with providers. A news release announcing the study noted that findings from the study would not be placed in Cleveland Clinic patients’ medical records. Why not?

Genetic testing seems to be about empowering patients to take more proactive roles in managing their health today in an effort to prevent what might happen to their health in the future. It would make sense to share these test results with providers who can aid in that journey. I’m hoping providers in the audience can tell me if it makes sense for them to join in their patient’s genetic journey, or if they’re more likely to opt out. Please share your comments below.

Does EHR Have an Image Issue?

Posted on October 17, 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 incredibly struck by a comment Tom Cox, MD made in reply to Katherine Rourke’s post about “Teaching to the EMR Template.” Here it is in case you missed it:

Of course this is happening. And, physicians in practice see it happening. But, we are powerless to change the system as many of us are held captive by our employer’s choice of EHR. EHR’s are less about health care and more about monitoring of healthcare. So, whether or not the ‘note’ is helpful to others is not important.

We’ve certainly written about EHR backlash a number of times before including my prediction of a coming Physician EHR revolt. However, Dr. Cox’s words about being powerless are quite a challenge and frankly scary.

What’s even more disheartening for me is that EHR doesn’t have to be this way. Sure, billing requirements are onerous and do put some pressures on doctors that do nothing to improve healthcare. The same could be said for meaningful use. However, there are plenty of EHR benefits to consider as well. Unfortunately, I think most of those are getting overwhelmed by some of the bad stories (and there are bad stories).

Many like to blame the news outlets for only covering the bad EHR examples. Certainly I won’t be arguing against laying some of the blame on those of us covering EHR. A disaster can often be easier to write about than an EMR success story. Plus, they’re easier to find. Not to mention readers can’t help but read it. However, I believe there’s something more happening here.

There’s plenty of blame that can be placed on the EHR vendors who do a shoddy job. We can throw some blame on doctors who don’t go through a rigorous EHR selection process or who skimp on EHR training. There’s certainly plenty of blame to go around for why EHR needs an image overhaul.

The challenge with the image of something like an EHR is that there’s no one person that holds responsibility for that image. There’s an entire industry that shapes the image of EHR. The only way to change it is for the industry to change. I only hope the fact that EHR is nearly a requirement for practicing medicine today won’t mean that bad actors will continue to scar the EHR image. My hope is renewed when I meet with EHR vendors who do have the physician and patients best interest in mind.

Maybe all of this is just the reality of the post EHR golden age environment.

Are Most EHR Consulting Companies Really Staffing Companies?

Posted on October 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.

While at the CHIME Fall CIO Forum, I had the great opportunity to sit down with Sheri Stoltenberg, CEO of Stoltenberg Consulting and Shane Pilcher, VP of Stoltenberg Consulting. I say it was a great opportunity, because I had the chance to sit down with both of them at HIMSS as well and both times were a fantastically interesting opportunity. Considering they have over 50 years of experience in healthcare, they can offer some really deep perspectives on the industry.

Over time, I’m sure I’ll do many posts pulling out some of the topics we discussed. Many of them revolved around the idea of healthcare data analytics. Although, the conversation was unlike any other healthcare analytics discussion I’ve had (and I’ve had many). Instead, for this post I want to consider a realization I had during our conversation. Here’s the question that came to my mind:

Are Most EHR Consulting Companies Really Staffing Companies?

This came to mind when Sheri Stoltenberg was talking about their goal to provide more value to the organizations they work with beyond just extra hands on deck. When I think about the institutions I’ve talked to, they often treat EHR consulting companies more like a temp agency than they do a consulting company. Granted, it’s a temp agency with highly skilled workers, but in many respects it’s more about staffing than it is consulting.

Don’t get me wrong. There’s nothing wrong with a staffing company. In fact, the services these EHR consulting companies provide when it comes to staffing can be incredibly valuable to an organization who needs some temporary people with specific skills. That’s much better than having to hire and then fire a whole bunch of staff in your organization.

I just wonder how many organizations really hire an EHR consultant to consult their organization about how that organization should prepare for the future? I don’t think a consultant is required to help an organization better understand their readiness for the future, but it’s one method. My fear is that many organizations are so overwhelmed by the operations of their organization that they don’t take the time to strategically look to the future. Maybe there’s a space for a consultant who’s constantly considering the future to add value to an organization overwhelmed by operations and regulations.

Doctors: EMRs Can Be Quality Obstacles

Posted on October 15, 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.

Many doctors believe that today’s EMRs are difficult to use and stand in the way of quality care at times, according to a new RAND Corporation research report covered by Healthcare IT News.

The RAND report comes from a project, sponsored by the American Medical Association, which was designed to identify what influences doctors’ professional satisfaction.

To research the report, RAND surveyed 30 physician practices in six states–Colorado, Massachusetts, North Carolina, Texas Washington and Wisconsin. RAND researchers also visited each of the practices on site, conducting in-depth interviews with 220 doctors, medical administrators and allied health professionals to see what drives doctors’ satisfaction with their work lives.

One key finding of the report was that being able to provide high-quality care is a primary factor in job satisfaction for physicians — and that anything which hinders them from doing so is a source of stress. And one critical factor that doctors feel impedes their ability to deliver good care is the requirement to use EMRs, Healthcare IT News notes.

Doctors who responded to the survey told RAND that current EMR technology gets in the way of face-to-face discussions with patients, demands that physicians spend too much time on clerical work and lowers the accuracy of medical records by encouraging the use of template-generated notes, according to Healthcare IT News.

What’s more, doctors told RAND that they’re unhappy that EMRs have been more costly than expected, and that the lack of interoperability between various EMRs has been a major frustration, as  it keeps them from easily sending patient data where it’s needed and when it’s needed.

Medical practices are trying to reduce doctor frustration by hiring staffers to perform many tasks involved in maintaining electronic records. And practices are attempting to improve physician satisfaction in other ways, such as giving them more independence in structuring clinical activities and allowing more control over the pace and content of the care they provide.

Still, it’s telling that as many as one-fifth of practices might switch EMRs, searching for an system that solves problems rather than creating new ones.  Whatever practices are doing to help physicians achieve satisfaction with their current EMR, it doesn’t seem to be working very well.

Investors To Take Greenway Medical Private

Posted on October 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.

Health IT vendor Greenway Medical Technologies has agreed to be taken private by investment firm Vista Equity Partners for $644 million.  The deal, which comes less than two years after the company went public, will roll up Greenway with Vitera Healthcare Solutions LLC, a privately-held EMR vendor which is owned by Vista Equity, Reuters reports.

Vista has agreed to pay $20.35 per Greenway share, about 19 percent more than the stock’s Tuesday close of $17.13 on the New York Stock Exchange. The price is more than the Greenway shares have seen through its existence as a public company. (According to Reuters, the shares saw a lifetime high of $19.44 in November.)

Greenway has said that stockholders owning about 50.9 percent of its shares have agreed to tender in their holdings and vote to push the deal through. All of Greenway’s directors and some of its executive officers have also agreed to do so, according to the Reuters report.

Vista must have seen tremendous value in hooking up Vitera with Greenway. After all, it’s willing to take on a financially wobbly company that lost $5.1 million in its 2013 fiscal year ending June 30 and pay a premium for it. Although Greenway has regularly commented that many of their revenue issues stem from their move to a monthly revenue model.

If nothing else, the deal bulks up both sides to a level that can only help during an era of EMR consolidation. According to the two companies, the combined entity will serve almost 13,000 medical organizations and 100,000 providers. The new health IT company will be marketed under the Greenway brand.

This transaction made me think about a recent post by my colleague John Lynn regarding the status of the EMR vendor marketplace. It’s his view that we’re past the “Golden Age of EHR Adoption” and that things will be tougher for vendors than ever before. Assuming he’s right — and his thesis is pretty hard to argue — we should see a lot more consolidation deals taking place in the near future.

HIPAA and ICD-10 Courses

Posted on October 11, 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.

One of the real telling things I learned this week as I traveled to the MGMA Annual Conference and then the CHIME Fall Forum was how unprepared organizations are for ICD-10 and HIPAA Omnibus. It was amazing the stories I heard and I’m sure these will be topics I write about much more in the future.

One of the stories I heard was a medical practice who was asked if they were ready for ICD-10. The practice said that they were ready. Then, they were asked what they’d done to prepare for ICD-10. Their response was that their vendor said that they were ready for ICD-10.

We could really dig in to reasons why that practice might want to verify that their EHR vendor is really ready, but we’ll save that for future posts. What was amazing to me was that this practice thought they didn’t need to do anything to train their doctors and coders on ICD-10 to be ready for the change. They’re in for a rude awakening.

At a minimum, these organizations should look at a course like the Certificate of ICD-10-CM Coding Proficiency (20% discount if you use that link and discount code). The course looks at the key changes in coding with the implementation of ICD-10. Plus, it’s a course that looks to bridge your ICD-9 knowledge to ICD-10. Once you start digging into this content, you realize why your organization better have some ICD-10 training or you’re organization will suffer.

The same applies to HIPAA. So many people don’t realize (or remember) that as part of HIPAA compliance you need to have regular HIPAA training for your staff. This is particularly true with all of the changes that came with HIPAA omnibus. How many in your organization know the details of the changes under HIPAA omnibus?

An online courses like the Certified HIPAA Security Professional are such a great option since you can work on them when you have time and come back to them later while helping to protect you against a HIPAA audit. Plus, the course linked above includes a HIPAA “Business Associate Agreement” downloadable template which I’m quite sure many organizations still need. I recently asked a doctor’s office I was working with for their EHR business associate agreement. They told me they didn’t have one (more on that in future posts). Really? Wow!

Certainly each of these courses and training take some commitment to complete. Although, when your colleagues ICD-10 reimbursement becomes an issue or the HIPAA auditor knocks on your door, you’ll sleep much better knowing you’ve made the investment. Those who don’t will likely pay for it later.

Fall Healthcare Conferences: So Many Options, So Little Time

Posted on October 10, 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.

Fall conference season is in full swing, and while I didn’t have the opportunity to attend StrataRx or Health 2.0, I was able to follow along via very active tweet streams. I have had the opportunity to attend several regional events, and have several more lined up in the coming weeks. Here is a brief list of those, along with reflections and expectations.

mHealth: Engaging the Masses and Making It Work for Your Bottom Line
This evening event, put on by the Technology Association of Georgia’s Health Society, featured panelists from Kaiser, Cigna, Intel and Accelarad. The back and forth between the four different stakeholders illuminated a number of challenges healthcare as an industry is facing when it comes to broad adoption and regular utilization of mobile health tools. They all want to fit those tools into a business model that not only helps to improve outcomes, but also generates revenue at the same time. (On a side note, I found it very interesting to learn from the Cigna panelist that Aetna is the payer with the best mobile health tools.)

Georgia HIMSS Trade Faire
This daylong event offered a variety of sessions, keynote speakers and an exhibit hall, all situated in Building C of the sprawling Georgia World Congress Center. My favorite session by far was “Georgia Leads the Way: Patient Engagement in Cancer Care.” Stakeholders from Georgia Tech, Cancer Navigators, and the Georgia Department of Community Health were on hand to explain how the ONC-funded program is helping providers engage their patients as full partners, and to show how those patients can actively participate in managing their cancer through the use of mobile technology. It was encouraging to me to know that programs like this are available to people that live north of metro Atlanta.

My day was topped off by a lovely reception hosted by the Health Forward Alliance at the Metro Atlanta Chamber’s scenic rooftop. The alliance is looking to bring innovative thought leaders to the healthcare community to inspire new ways of thinking. It’s a great idea, as I think sometimes healthcare folks get stuck in their healthcare bubble, rarely exposing themselves to fresh perspectives from different industries.

AHIMA
October 27 – 30 at the Georgia World Congress Center in Atlanta
I’m excited that AHIMA is in Atlanta this year. No flight delays or strange smelling hotel rooms for me this year. Being that I do technically live in North Georgia, I’ll unfortunately have quite a commute. In my mind, that is all the more reason to soak up as much of the conference as possible. I haven’t combed through the educational session descriptions yet, but I do know I’m looking forward to hearing on Tuesday about connected health from Travis Good, MD, who writes a terrific blog on the topic; and to the Henry Winkler/Marlee Matlin téte a téte Wednesday morning. I had no idea they had such an inspiring story to tell.

Health IT Leadership Summit
November 12, the Fox Theatre, Atlanta
Full disclosure: I’m part of the marketing committee for this event. Nevertheless, I am excited about hearing from WebMD founder and current Sharecare CEO Jeff Arnold. Sharecare is doing some interesting things in the consumer engagement space, effectively trying to bring it to the masses. I hope Arnold will touch on why he thought the time was right to get such an endeavor started, and how he keeps visitors coming back again and again. That seems to be a main sticking point with most engagement tools I read about these days.

I’d love to know of any events coming up I should make a point to attend, as well as your thoughts on any that I mentioned above.

Leadership Discussions at Healthcare CIO Conference

Posted on October 9, 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.

This week I get to enjoy the company of 750 attendees at the healthcare CIO conference organized by CHIME (officially called the CHIME Fall CIO Forum). It’s always an amazing experience to break bread and learn from people who are dealing with some of the hard challenges of healthcare IT.

One topic that’s always present at CHIME events is a discussion of leadership. So, it was extremely appropriate that Jim Collins was the opening keynote. The guy just exudes leadership. Here’s some of the tweets I sent out during his keynote.

Could High Deductible Plans Save Small Practices?

Posted on October 8, 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’ve had a number of really interesting conversations with EHR vendors around the future of small practices in healthcare. In fact, many EHR vendors are focusing their marketing efforts around saving the small practice (more on that in a future post). Although, one topic that’s come up multiple times recently is how the new high deductible plans might be a tremendous opportunity for small practices.

To give credit where credit is due, I first heard this idea from Dr. Tom Giannulli (Check out this Google Hangout I did with Dr. Tom), CMIO of Kareo.

The core concept I took from talking with Dr. Tom and have since morphed with other viewpoints is that patients with high deductible plans can be more selective about who they visit for their care. This presents an opportunity for small physician practices to provide a personalized service to those patients that a large group practice or hospital owned system can’t or won’t provide.

Of course, at the core of this question is whether the small practice does offer a more personalized service than a large group practice. There are many arguments to be made that a small practice can offer a better service. In some ways it’s the eternal battle between mom and pop vs big company. We all love the idea of mom and pop locations that know are name and know our needs. In many ways small practices can provide this same level of service and relationship which is hard to create in a large group practice that’s ruled by numbers.

However, I think one challenge to this idea is that large groups could provide some services which small practices can’t or won’t provide as well. Of course, this assumes that they aren’t too distracted and immovable to actually implement change. I expect that we’ll see some patient facing services that do much better in a large group practice and that would be nearly impossible in a small practice. For example, once telehealth visits become popular, a large group practice could implement a 24×7 telehealth service for patients with emergent needs. A small practice couldn’t do this (although, they could partner with someone to offer something close).

The point is that the battle for these high deductible patients is just beginning. I usually like to put my money on the faster, more nimble organization. The problem is that many small practices aren’t that nimble. In fact, healthcare isn’t nimble (see Mandi’s post today about Inflicting Agile on the Waterfall World of Healthcare). Although, small practice can be nimble if they chose to do so.

Coming full circle, does this present an opportunity for EHR vendors? Can the small practice focused EHR vendors offer a set of features to small practices that enable them to offer a more personalized service to patients? I think there is this opportunity starting with features as simple as e-communication with the clinic, online payments, and personalized care. The real challenge for these EHR vendors is how to balance customer service focused features that patients will love against the onslaught of government regulations which bog down their development teams.