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Helping the Small Practice Physician Survive with Dr. Tom Giannulli

Posted on November 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.

In case you haven’t seen, I’ve been doing a whole series of video interviews over on EHR Videos. There are some really great videos in the series chock full of insights into what’s happening in the world of EHR and Healthcare IT.

The following video is an example of the type of great video interviews we’ve been doing. In this interview, I talk with Dr. Tom Giannulli, CMIO of Kareo about how a well done EHR vendor can help a small practice physician survive. This has become a really popular topic for a number of ambulatory focused EHR vendors. Along with these topics, I ask Dr. Giannulli about the former Epocrates EHR he helped create which is now owned by Kareo and is offered as a Free EHR.

What do you think about Dr. Giannulli’s comments about helping the small practice physician survive? Will EHR vendors play an important role in making this happen? I look forward to seeing your thoughts in the comments.

A Patient Perspective on Meaningful Use

Posted on November 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.

I came across this great xtranormal video that looks at meaningful use from a patient’s perspective. I’ve posted some videos like this before. In fact, I’ve started creating a whole YouTube playlist of Funny Healthcare IT Videos. If you’re deep in the trenches of meaningful use, then you’ll enjoy this one (or not depending on how you look at it).

Unbundling EMR, First eRx, Essential EMR, and “Know Your Strengths”

Posted on November 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 think the concept of unbundling the EMR is really interesting. I’m not sure I agree with some of the classifications, but I can definitely see a model where much of the EMR system is done by separate software. Reminds me of the good old days where people were talking about clinical groupware. Same concept, but described a different way.


I love that this was shared on Twitter. Props to Doctor Natasha for sending it. It is very exciting to do. Although, I think the more interesting part of this tweet is the flood of responses Doctor Natasha got from so many other doctors. Check them out here.


I’m not sure what I think about Epic on Steroids. Considering the amount of configuration to make Epic work in your organization, I guess every organization needs to infuse some steroids into it. I was intrigued by the last comment about not imagining taking care of patients without it. This is a growing contingent of doctors. Soon we’ll see the shift where EHR is just a feature and not the future.


Nice tweet during the Digital Health Conference. It’s always great for any organization to know what they’re good at and what they’re not good at. Although, it’s much harder for an organization to actually do it. We’d all like to think we could do anything great, but the reality is much different. Realizing this takes quite a bit of humility. The question is whether you’ll be compelled to be humbled (ie. Failed EHR implementations) or whether you are honest enough with yourself to recognize your strengths and weaknesses.

athenahealth Partners With Quality Group To Research EMR Patient Safety

Posted on November 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.

While it’s known that EMRs have been involved with, and probably responsible for, patient harm and even death, research is incomplete and sketchy on what risks are the most pressing and how to avoid them. Plus, we’re always balancing these risks with the potential benefits of EMR as well.

One recent study by the Pennsylvania Patient Safety Authority concluded that EMR default settings for medications caused adverse events in more than 3 percent of cases reviewed by the organization.

But that’s just one study, which can only do so much to help on its own. To get a better grip on such issues, EMR and practice management vendor athenahealth has partnered with Patient Safety Organization Quantros to examine the impact that EMRs are having on patient care. The research project is being funded by athenahealth, according to  a piece in Medical  Practice Insider.

athenahealth is offering its national network of about 47,000 providers free access to Quantros’ Safety Event Manager reporting tool, allowing athena’s EMR clients to submit patient safety data directly to the Quantros Patient Safety Center. Delivering the safety data through a PSO like Quantros insulates providers from liability by offering discovery protections when the practices report and analyze a potential issue, Medical  Practice Insider reports.

As one might expect, athena is mounting the experiment to find out when use of its EMR might have contributed to a  potential adverse event, such as, for example, when the EMR fails to warn a physician that a prescribed drug would interact with a drug the patient is already taking.

The bottom line, for athena, is to analyze the data for patient safety trends, and use it directly to improve its technology, said Tarah Hirschey, athena’s senior manager of patient safety, to Medical  Practice Insider.

Don’t Count on Your EMR to Master Patient Engagement

Posted on November 14, 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.

So said one tweet in the recent stream from the Health IT Leadership Summit, an event I’ve been heavily involved in organizing for the last 10 months.

rptweet

That particular statement came from the morning keynote by Jeff Arnold, CEO of Sharecare. Arnold, who also founded WebMD, spoke to the power of social networking and analytics as part of a broader patient engagement strategy. It was a sentiment expressed in nearly every session I attended that day, by hospital and vendor executives alike.

Perhaps I shouldn’t have been surprised by the importance engagement played in the Summit’s sessions and networking discussions. It’s certainly the topic du jour of industry media and seems to weigh heavily on the minds of healthcare providers. Everyone wants to know, how do we do this? How can we get patients to truly engage, beyond tracking a few numbers on the latest digital health gizmo? How can we get providers to engage as well? Sending and receiving secure emails is great, but effective patient engagement that directly affects outcomes could be so much more than that.

lftweet

If sessions and conversations at the Summit were any indication, the key will be to combine traditional patient data (like that found in an EMR), with data mined from social networks, and then filter that through big data tools for predictive analysis. Much easier written or tweeted about than achieved, I assume, but it’s a positive sign all the same.

watweet

That’s very true, and I think you’d be hard pressed to find a CIO who says they DON’T care. After listening to several hospital executives speak at the Summit, I got the impression that they care immensely, but aren’t quite sure where to turn for technology and processes that will enable their organizations to interpret engagement data into actionable knowledge.

Take a look Storified Twitter insight from the Summit via “#HealthITSummit Sessions Spotlight Social’s Role in Patient Engagement,” and then let me know via the comments below which healthcare organizations seem to be heading in the right direction when it comes to social analytics and patient engagement.

DoD May Keep Its EMR Until 2018

Posted on November 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.

Though it had previously announced plans to update its system by 2017, the Department of Defense is now looking for contractors who can support its current EMR, the Armed Forces Health Longitudinal Technology Application (AHLTA), through 2018, according to iHealthBeat.

The DoD and VA have been working for years to integrate their separate systems,but seemingly have little to show for their efforts. The two sprawling agencies kicked off their effort to create an integrated record, the iEHR, back in 2009. The idea was to offer every service member to maintain a single EMR throughout their career and lifetime, iHealthBeat reports. But the effort has been something of a disaster.

The iEHR project was halted in February 2013, with officials deciding to work on making their current EMR systems more interoperable. A few months later, DoD Secretary Chuck Hagel wrote a memo stating that the agency will consider a commercial EMR system. Most recently, the DoD asked 27 EMR vendors to provide demos of possible EMR replacements, according to iHealthBeat.

In DoD’s pre-solicitation notice, DoD announced that it would extend the contract for AHLTA’s underlying Composite Healthcare System, which is the back end of the military EMR.  The Composite Health System handles laboratory tests, prescriptions and scheduling.

That being said, the DoD is also moving along with its iEHR plans once again, a gigantic project which the Interagency Program Office estimates will cost somewhere between $8 billion and $12 billion. A contractor named Systems Made Simple recently won the contract to provide systems integration and engineering support for creating  the iEHR.

Folks, if you can follow the twists and turns of this story — they’ve giving me whiplash — you’re a better person than I am. So far as I can tell, the DoD changes its mind about once a quarter as to what it really wants and needs. Seems to me that Congress ought to keep that birch rod handy that it used on HHS over the HealthCare.gov debacle. Isn’t somebody going to get this thing once and for all on track?

Top Three Things that You Can Do to Minimize the Challenges of Meaningful Use

Posted on November 12, 2013 I Written By

The following is a guest blog post by Steve Baker.
Steve Baker
With all the talk about Electronic Health Records (EHR) in the medical industry these days, it is easy to be overwhelmed about the complexity. One aspect of EHR is Meaningful Use (MU) and the associated three stages for attesting. MU presents some challenges, but it can also be an opportunity to improve your business and enrich your patient relationships.

Depending on where you are in the process, your challenges may be different from someone else’s. In working with optometrists around the country and listening to a lot of feedback, I see common themes that can apply across all disciplines to help overcome MU challenges. Here are the top three things that you can do to keep moving forward and ultimately turn those challenges into positive opportunities:

  1. Evaluate your situation
  2. Develop a plan
  3. Use a Certified EHR system

Evaluate your situation

Take a look at where you are right now and decide if this is where you want to be. Do you know the requirements for MU Stage 1, 2 and 3? What is your goal to improve office efficiencies and your relationships with your patients? How does MU fit into helping your practice?

Think about the MU objectives as the road map to help you get to where you want to be. For a refresher, MU Stage 1 started in 2011, and Stage 2 starts January 1, 2014. Stage 3 is projected to begin in 2016. For each Stage, there are Core Objectives and Menu “optional” objectives from which to choose. For example, for Stage 1, there were 13 required core objectives and five to choose from the list of 10 menu objectives (total of 18 objectives to achieve). Stage 2 has 17 core objectives and three to choose from the list of 6 menu objectives (total of 20 objectives to achieve).

For those who have not started yet, you can attest for Stage 1 and Stage 2 in 2014. Timeline specifics and associated incentive funds can be seen in this chart published by CMS.
EHR Incentive Payments Chart

Develop a plan

Do you know your workflow from patient recruiting through exam to retention? Who conducts your office training? What is your goal for patient engagement in the office and outside of it? Have you documented these items? Do you have systems in place to accomplish your goals? If you haven’t done this yet, you’re not alone.

There are many practitioners who have not started yet, so there is a sense of urgency to get going in 2014. In 2012, for example, there were 40,000 optometrists in the United States, according to statistics from the American Optometric Association. A little over 12,000 ODs have attested for Stage 1 MU (HealthData.gov). That’s approximately 30 percent of the optometric space attesting to Stage 1 MU.

When you have a plan, it is easier to implement. Ryan Wineinger, OD, successfully evaluated his practice and developed a plan, and he is now implementing this plan. From Dr. Wineinger’s perspective, “It was critical for me to sit down and look at my practice, decide what I wanted to do and then connect with the right business partner to help me expand my plans and implement them. I’m better able to meet my patient needs now, I’m more streamlined using a cloud-based system, I’m not tied to my desktop computer and I’m ready to start achieving for MU Stage 2 in 2014.”

Use a Certified EHR system

Perhaps you’re still overwhelmed with how to build that plan and implement it. Use a Certified system from a company that will be your business partner. The company will help you to assess what you need based on requirements and your business goals. It will also help you to implement the system that is right for you and provide training and ongoing support to you and your staff. You should be able to efficiently and effectively manage your practice and better serve your patients as a result.

Here’s one example of how you can address a Stage 2 core objective of providing patients with the ability to view, download and transmit their health information. Identify an EHR partner who will help you to create a portal for your patients to go online to access and use their information. It’s imperative that the portal is simple for the patient to look at and use his/her exam and/or lab results and prescriptions. While in the portal, it is also a great opportunity for the patient to send you a secured e-mail or schedule an appointment. The key is to make it easy for the patient to connect with you and the practice in a way that is familiar to the patient. So make sure to account for this in your planning.

Meaningful Use a Challenge?

Yes, it is. But it is also an opportunity to reinvigorate your business, and move it forward. Consult with a practice management business partner to help you be successful. Selecting the right technology and business partner can be the difference between just getting by and moving forward with improving your business and enhancing patient relationships. Keep in mind that this is not a single moment in time but an ongoing process.

Through using up-to-date technology and systems, you can be more streamlined and efficient, and you can positively engage your patients inside and outside of the office. Most importantly, though, you will be positioned for future changes and growth.

Steve Baker is the president of Eyefinity®, a VSPGlobal® company that is the eyecare industry’s premier provider of innovative business solutions serving over 30,000 eyecare professionals with a total solution of integrated technology products and services to help the practitioner increase revenue and enhance patient care. Steve oversees the day-to-day operations of Eyefinity, including business growth, strategic planning, and product development. Steve holds a bachelor of science in computer science from California State University, Northridge, with a concentration in systems design and mathematics. He can be reached by e-mail at Steve.Baker@eyefinity.com.

Study Suggests That Health IT Can Boost Doc Productivity

Posted on November 11, 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.

We’ve all heard stories about medical practices whose productivity crashed when they brought an EMR on board, for reasons that range from workflow problems to training gaps to problems with a wonky system.  But if the following study is right, there’s reason to hope that health IT will actually improve productivity over time, according to a story in Medical Practice Insider.

According to research published in journal Health Affairs, physicians with health IT on board will be able to serve about 8 percent to 15 percent more patients than they could without health IT tools. And in practices where doctors have higher levels of EMR or portal adoption, the spike could be higher, according to the research, whose team includes former national coordinator David Blumenthal.

Meanwhile, practices that adopt emerging technologies such as remote care could allow doctors to perform 5 to 10 percent of care to patients outside of the office visit, and 5 to 15 percent of care could be performed asynchronously, reports Medical Practice Insider.

Another study cited by the article, done by the National Center for Health Statistics, notes that EMRs can offer varied clinical and financial benefits, such as greater availability of patient records at the point of care. And adjunct tools like e-prescribing capabilities and the ability to retrieve lab results can save time and effort, the NCHS study concludes.

These studies are encouraging, but they don’t say much about how practices can manage the workflow problems that keep them from realizing these results. While I have little doubt that health IT can increase productivity in medical practices, it’s not going to happen quickly for most.  By all means, assume your medical practice will eventually leverage health IT successfully, but it won’t happen overnight.

P.S. In the mean time, take a look at this list of factors in creating satisfied EMR users. It might help you speed up the day when productivity climbs.

Happy Veteran’s Day

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.

I think my emotions for this day are running at an all time high. My brother is deployed right now and so it really hits home thinking about the sacrifices that he and many before him go through to make sure that we still get to enjoy the many freedoms we have to enjoy.

I was recently reading through some of the stories from people who were in the midst of the World Wars. It’s really brutal to hear how many people died just living their normal lives. Not to mention the fears and other deprivations they went through during the war. Hopefully when you go to the store tomorrow or stop by a restaurant to get something to eat you’ll take a second to think about what a blessing it is that we can do that whenever we want. I know I’ll be doing the same.

The US is far from perfect, but it sure is a wonderful place to live. I feel blessed to live here where a little guy in Las Vegas can start a blog about EMR and provide for his family doing so. Pretty amazing really.

How Telehealth Connects Patients Healthcare Professionals Infographic

Posted on November 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.

How Telehealth Connects Patients Healthcare Professionals Infographic