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My #BlueButton Patient Journey: Where Are the Smiley Faces?

Posted on January 22, 2014 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.

Smiley faces and patient payment barriers were on my mind yesterday as I spent a few minutes in the patient portals I use (powered by Cerner, and athenahealth, in case you’re interested). I’ll get to my thoughts on user experience in a sec.

First, an update on the Blue Button Connector, which I may have explained in an earlier post. The Connector is an ONC-powered website that will offer consumers an easy way to find providers, payers and other healthcare organizations that participate in the Blue Button initiative. It will also offer developers a way to access Blue Button + technology, “a blueprint for the structured and secure transmission of personal health data on behalf of an individual consumer. It meets and builds on the view, download and transmit requirements in Meaningful Use Stage 2 for certified EHR technology,” according to the ONC.

Originally slated for debut in mid-January of this year, ONC has let it be known that it will delay the release so that when it does go live, it will work well. I’m sure I don’t have to point out the recent events that likely prompted this decision. I’m all in favor of delay to ensure everything works well. A beta version is expected to launch just before or at HIMSS. I may have to reach out to the folks at ONC to see about getting an invite to participate. Stay tuned.

Now, back to my user experience with one of my patient portals. I recently logged into the athenahealth-powered portal to cancel an upcoming appointment. It seemed easy enough to schedule a new appointment, but there was no button or quick link to cancel. I sent a secure message through the portal to the appointment department noting my need to cancel. Because it was less than 24 hours until said appointment, I also called the office as a point of courtesy to make sure they knew of my request. The receptionist who answered told me that sending a message to cancel an appointment is the best option through the portal, as that prompts staff to get back in touch with patients to see if they need to reschedule. A valid point, I thought. I realized not long after that call that I’ll need to reschedule an appointment with a different provider, as my current one is during HIMSS. Hopefully rescheduling will be just as painless.

My recent encounter with the Cerner-powered portal was almost just as painless, leaving me with three observations to share. The first being that I messaged my provider and was pleased to get a response back first thing the next morning. The second being that I attempted to look into a payment balance through said portal, but was put off by the fact that the portal directed me to a third-party site for which I have to set up another account. I wonder why the payment/billion function isn’t embedded into the portal. I’m sure there are underlying reasons patients aren’t aware of, but it sure would be a nice value-add. Unfortunately, I’m the type of patient who, when I encounter a barrier to payment, will set the bill aside and let it languish far longer than it needs to.

And the third being that I, as someone with no medical training, would far prefer smiley faces to numbers when it comes to lab results. Let me explain. Here is what I’m greeted with when I first log into the portal:

portalstats

These numbers don’t mean much, as I’m not aware of what levels are appropriate for my age, weight, height, etc. I think it would be much easier to understand if a smiley or frowny face were placed next to each number, with a small link to some sort of resource that could help me better understand each figure. I think perhaps we tend to overcomplicate things since we have so much technology at our fingertips. At the end of the day, as a patient, I want fast access to my portal and easy to understand information within it.

What are your thoughts on patient portal user experience? Have you seen any emoticons used in clinical settings? Let me know your thoughts via the comments below.

EMRs costly to health system

Posted on January 21, 2014 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

A recent New York Times article caught my eye the other day.  The author focused on the seeming corruption of physicians bilking patients out of tons of money for unnecessary procedures and the havoc wreaked on the American public as we try to keep the rising costs of healthcare down.

The most interesting part of the piece was the amount of blame placed on doctors as the culprits (which in the extreme examples cited was probably warranted).  Of course, as an industry insider, I can tell you that there was so much under the surface that the writer either failed to comprehend, did not know about, or simply chose to ignore.  Judging by the comments from medical providers, I wasn’t alone in my thinking.

Although not her fault, the author bought into MGMA data that was grossly wrong, for example.  I can’t imaging too many dermatologists making just $175,000 annually in 1995.  From a wasted $800 fee that my clinic had to pay to gain access to a data set when we tried to offer a competitive salary to an endocrinologist in our clinic in 2011, I can tell anyone that the data we viewed grossly overestimated the average endocrinologist salary.  The MGMA data we bought was based on only 15 doctors in only 5 practices in the entire mid-Atlantic region who were apparently making an average of over $300,000 annually.  A Medscape survey quoted a more believable $168,000 annually for an endocrinologist.

I have to apologize for the rather longwinded intro to my EMR thought of the day, which is the cost of EMRs to the healthcare system in America. It seems that not too long ago it was much cheaper to use paper charts. Currently, most EMR systems are simply expensive recording tools. Some of them don’t even really generate insightful or easy to read medical notes, although what they do produce may be argued by some EMR vendor companies and end users to be some form of documentation that loosely qualifies for generating a bill for an office note or medical procedure (wide spectrum of quality here).

Some EMR systems are free but most are costly, either lump sum up front with ongoing annual maintenance fees, or pay-as-you-go monthly rentals of depository databases where data from medical notes is stored. Why is the medical establishment wasting all of this money when research has shown again and again that EMR systems do not produce more safety or efficiency of providing healthcare for anyone?

With incentive programs from the US government driving and pushing doctors to set up their own EMR systems for the past 4-5 years, unfortunately, this has been a horribly misguided, misplanned, and costly experiment by probably well meaning individuals who found it un-PC to admit their mistakes. Personally, I wish the government had stayed out of it and let the market forces do what they do best, provide cheaper and cheaper hardware and software options over time until the value of EMR systems eventually sunk or swam the market on their own.

I personally use a free version of an EMR system, which works fairly well (with various glitches here and there during periodic system upgrades). However, I am in the minority since most of my colleagues in the Washington, DC area are either still working on paper charts or have shelled out gazoomba bucks to use a costly EMR system. I am willing to wager that the DC market is not too different from everywhere else in America in that respect. Although I love my EMR system for its organization and ability to electronically prescribe medications with a few clicks of the mouse, I think it remains equally important to consider that the EMR experiment in America is largely failed to produce any significant tangible results and only costs the entire system more, which in the end will be passed on to the consumer.

No EMR system makes doctors more money. The carrot and stick incentive model that the U.S. government used to promote EMR use is small and will be short lived. With ongoing EMR costs to medical providers, this technology has already begun placing another money suck on the healthcare system. Paper and ink are far cheaper by simple math. The only way it makes fiscal sense to continue the EMR market as a cost saving measure is to make all EMR systems of zero cost to the medical providers who use them, which will probably never happen. This is the only way that additional costs cannot be passed on to patients (cleverly couched, of course by well meaning doctors who need to keep their own costs down). Challenging as it may seem, I am hoping that someday someone can think of a positive solution to this important problem.

HIE Cuts Back On Excess Imaging, But Savings Aren’t Huge

Posted on I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For years now, we’ve been told that HIEs would save money and reduce redundant testing by hospitals and doctors.  Until recently, such has mostly been the stuff of anecdote rather than hard results.  But a new study comparing hospitals on an HIE with those that were not seems to offer some of the hard evidence we’ve been waiting for (though the cost savings it finds aren’t spectacular overall).

According to a piece in Healthcare IT News, a new study has come out which demonstrates a link between HIE participation and the level of imaging performed in hospital emergency departments.

The study, which was done by Mathematica Policy and the University of Michigan, found that when hospitals were joined in an HIE, the number of redundant CT scans, x-rays and ultrasounds fell meaningfully, generating savings in the millions of dollars.

To conduct the study, Mathematica and the U of Michigan compared the level of repeat CT scans, chest x-rays and ultrasounds for two groups.  One group consisted of 37 EDs connected to an HIE; the other group was 410 EDs not connected to an HIE.  Researchers collected data on the two groups, which were based in California and Florida, between 2007 and 2010, using the state emergency database and HIMSS Analytics listing of hospital HIE participation.

The researchers found that hospital EDs participating in an HIE reduced imaging across all the modalities compared with hospitals not participating in an HIE.  For example, EDs using an HIE worth 13 percent less likely to repeat chest x-rays, and 9 percent less likely to repeat ultrasounds.

Ultimately, the study concluded that if all of the hospital EDs in California in Florida were participating in HIEs, the two states could save about $3 million annually by avoiding repeat imaging.  This is just fine, but this translates to $3 million in lost revenue for those hospitals. Once you split up $3 million across that many hospitals, you don’t end up with an impressive amount per hospital, but it’s still a cut to revenues. A cut in revenue isn’t a strong motivator to implement an HIE even if it does help to lower healthcare costs.

This is why it’s a real challenge to get many hospitals on an HIE. When you throw in the technical issues involved in HIE membership, it could be quite some time before the majority of hospitals jump on board without more external incentives.

Where the Jobs Are: Demand for EHR/HIT Certifications

Posted on January 20, 2014 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com.For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manager doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst, a role he recently repeated for a Council member.

There are dozens of EHR/HIT certification program and counting. A few years ago, I got a CPHIMS. I did it in hopes it would open some work doors. I thought it was useful, well developed and administered, etc., but going fulltime running the EHRSelector.com took me in a different direction. Still, I’ve wondered which certification programs offer the most opportunity and where are they located?

With help from John’s newly acquired Healthcare IT Central job board, I found answers to these questions. HealthcareITCentral has one of the largest, if not the largest collection of HIT positions. Using its advanced search, I looked for jobs, in the last 30, days that required specific certifications.

A few caveats about this review:

  • Each certification counts as one position. For example, if one job posting listed ComTIA, CPHIMS and CPEHR, I counted it as three jobs, one for each certification.
  • General certifications only. For practical reasons this report only covers general certifications that have a one word abbreviation. Finding other certifications, such as eClinicalWorks Certified, etc., requires searching for phrases, which HealthcareITCentral currently doesn’t support (or John needs to teach me how to do). No doubt Epic certification and Cerner certification would be high on this list if it was included.
  • Dynamics. The results I found for these certifications are a snapshot. The job market and the openings that HealthcareITCentral lists constantly change. What is true now, could change in a moment. However, I believe this can give you a good idea of the relative demand that exists.

Certifications Reviewed

Table I lists the certifications and for which I found at least one opening.

Table I

Certifications With Open Positions

1

CCA

9

CHTS

2

CCDP

10

CompTIA

3

CCS

11

CPEHR

4

CCS-P

12

CPHIMS

5

CEMP

13

CPHIT

6

CHDA

14

CPORA

7

CHPS

15

RHIA

8

CHSP

16

RHIT

 

Table II, lists the certifications that had no openings in the last 30 days. I also did a quick check to see if any of these had any jobs listed at all. It appears that there were no open positions for these certifications, though as I note above matters can quickly change.

Table II

Certifications Without Open Positions

1

CAHIMS

8

CMUP

2

CEOP

9

CPCIP

3

CHTP

10

CPHIT

4

CHTS

11

CPHP

5

CHTSP

12

CPORA

6

CICP

13

HWCP

7

CIPCP

Certification Demand

I found that the system listed 1,500 or so positions in the past month. See Chart I. Of those, 440 or 30 percent mentioned one of these certifications.

Of all the certifications, AHIMA’s were most in demand. AHIMA’s prominence among the certifications reviewed is remarkable. It’s three programs account for two thirds of the certification positions.

Its RHIA (Registered Health Information Administrator) was mentioned 101 times. RHIA accounted for about 22 percent of the openings with RHIT (Registered Health Information Technician) slightly less at 94.

RHIA’s designed to show a range of managerial skills, rather than in depth technical ability. If you consider certifications proof of technical acumen, then the strong RHIA demand is a bit counter intuitive.

Where the RHIA has a broad scope, the close second, RHIT, is more narrowly focused on EHRs and their integrity.

In third place, but still with a substantial demand is CCS (Certified Coding Specialist), which as the name implies focuses on a specific ability.

Check out the top 5 certification job categories on Healthcare IT Central:
RHIT Jobs
RHIA Jobs
CCS Jobs
CompTIA Jobs
CCA Jobs

Certification Demand by Location

After looking at certification demand, I looked at demand by location. To do this I merged all the certification job openings into a single list. That is, I added those for RHIA, RHIT, etc., and then eliminated duplicates. This reduced the total from about 390 to 280.

The next step was to rank the states by their job numbers. Chart II for the top ten state openings shows this information two ways:

  • Blue Columns. Openings per state.
  • Green Columns. These show how a state’s jobs rank compared to its population share. For example, if a state is plus four then its jobs rank four levels above its population rank. Conversely, if a state is minus four, its share is four less than its population rank.

As you might expect, the states with the largest populations have the most jobs. California leads with 36 openings. However, there are some notable exceptions, such as Maryland.

Maryland has 21 jobs openings. This puts it fourth between Texas and New York. It is 15 ranks above where its population ranks it. Illinois, on the other hand has nine jobs. This puts it four ranks below its population standing.

 Chart II, Openings by State

Certifications are a response to the demand for persons with demonstrated skills. The question is whether a particular one will reward your time, cost and effort with something that is marketable. Demand alone can’t make that choice for you. Personal satisfaction can’t be discounted as a factor in any decision. I hope this short study may help you find the best fit for you.

Health IT Venture Funding For EMRs At Low Ebb

Posted on January 17, 2014 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.

For several years, most health IT venture funding has focused either on EMRs or data and network infrastructure to support EMRs.  With the EMR market arguably completely saturated, it seems the money is flowing in a different direction.

According to a new report by Mercom Capital Group covered in iHealthBeat, health IT venture capital funding hit  $2.2 billion across 571 deals in 2013, nearly double the $1.2 billion and 163 deals executed in 2012.

So where did the money go? According to Mercom, consumer-centric health IT companies raised $1.1 billion, personal health companies raised $198 million and social health companies raised $166 million last year.  The mobile healthcare sector raised almost $564 million, not surprising at all given the speed at which mobile health is accelerating.

Meanwhile, roughly $1.1 billion was raised by medical practice centric companies, including $179 million by population health companies, $162 million but practice management companies and a scant $166 million by EMR companies.

According to the report the top five venture funded companies of 2013 were Evolent Health, which raised $100 million, Practice Fusion, which raised $85 million, Fitbit, which raised $73 million, MedSynergies, which raised $65 million, and Proteus Digital Health, which raised $45 million.

So, as it turns out, Practice Fusion took the lion’s share of EMR venture funding last year, leaving the rest of the industry to scavenge for what remained in terms of VC interest.

What does it say in terms of the health of the EMR business?  Well, it’s not necessarily a sign of anything terribly negative in terms of EMR vendors’ future; after all, you’re not seeing a lot of new EMR companies jumping into the business, for good reason.

On the other hand, it does suggest that the market for EMRs has solidified, and is not perceived to have dramatic growth potential by VCs.  I suppose we shouldn’t be surprised or concerned for that matter. If EMR vendors aren’t in explosive growth mode at this point, it’s just because they’re serving the customers they’ve got. It could be worse.

McKesson and Meditech Named as First “Test EHRs” by CMS and ONC

Posted on January 16, 2014 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.

CMS and ONC just announced the first two “Test EHRs” are McKesson and Meditech. Here’s the details of their announcement:

As part of our and CMS’ ongoing effort to improve interoperability among certified Electronic Health Records Technology (CEHRT), we are pleased to announce McKesson and Meditech are the first two “Test EHRs,” selected from among certified EHRs. We strongly encourage others in the EHR technology developer community to participate in the program to become a CMS designated test EHR.

Under Stage 2 of Meaningful Use transition of care objective measure #3 [PDF – 218 KB]eligible professionals (EPs) and eligible hospitals/critical access hospitals (CAHs) must either:

– Conduct one or more successful electronic exchanges of a summary of care document, with a recipient who has EHR technology designed by a different EHR technology developer than the sender’s.

Or

– Conduct one or more successful tests with the CMS designated test EHR during the EHR reporting period

ONC and NIST conducted a pilot that ran from September through November of last year to finalize the test procedures. The pilot participants were AthenaHealthMcKesson andMeditech.

To find out more about becoming a CMS designated test EHR, read the “EHR Technology Developers” section of the FAQs on becoming a CMS designated test EHR and the “Developer Participant Information for Cross Vendor Exchange” document.

I find it interesting that AthenaHealth was a pilot participant, but isn’t one of the official “Test EHRs.” I wondered what happened there. Looks like a lot of EHR vendors will be able to at least connect to McKesson and Meditech.

My #BlueButton Patient Journey – Laying the Groundwork

Posted on 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.

After taking the Blue Button Pledge, my next step is to get proactive with my medical records. As I may have mentioned in a previous post, I currently see four different doctors throughout the year. Three of those offer a patient portal. Two of them are in the same practice, and therefore use the same portal. Confused yet?

I think the key to being an engaged patient is to first make sure I can log in to each of these portals. I create bookmarks for them as well. I also make sure I know how to navigate through them and that all of my information is correct and up to date. I take care of the first two items by either looking back at papers given to me during my last office visit, or calling my PCP’s office to ask for a pin code.

Once I’ve looked through my information in each portal (powered by Cerner and athenahealth, respectively), I decide to go even further by messaging my PCP to let her know how my visit to a specialist went. If I don’t let her know now, I might forget many of the details when I see her again towards the end of the year. While I’m in there, I decide to look at my past bills to see why I’m still getting one for a balance I’m pretty sure I paid at my last office visit.

bluebuttondownload

Once those details are seen to, I decide to check out the portal used by two of my other doctors because I seem to remember seeing a Blue Button icon on one of the screens during my last log in. Sure enough, there is a link to “View, download or transmit health data.” Clicking this link takes me to a screen where I can “Support the Blue Button® initiative by downloading your health data and storing it in your personal records.”

I hit download and save them on my computer, but then I’m left wondering, “Now what?” I suppose uploading them to a thumb drive and taking them to whatever provider I see next might be helpful. But I have the sneaking suspicion they’d still prefer paper. Since my PCP’s portal doesn’t offer a Blue Button link to download my data, I decide to message my PCP again to let her know I’d like to see this offered. I wonder if she’ll appreciate the comment, and if she’s gotten the request from other patients.

I feel like my next step should be uploading my health data into some kind of personal health record, but which one? Where do I even start when it comes to selecting something like that? Honestly, the data entry involved with PHRs is off putting to me, which is probably why I haven’t created one up to this point.

What has worked for you and your family? Providers, are there PHRs you find easier to work with (assuming you interact with them at all?) I’d appreciate any reader suggestions and advice you’d care to give via the comments below.

Consumers Are Ready For Wearable Tech

Posted on January 15, 2014 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 they’re pretty, interesting and fun, I’ve never taken wearable devices that seriously as a force that could have impact on healthcare delivery in the here and now.  Well, it seems that I was wrong.  While it’s not certain that the health system can afford these devices — they don’t exactly come in at an easy consumer price point — it seems consumers are ready to use them if given the chance.

According to a new study by Accenture, more than half of consumers “are interested in buying wearable technologies such as fitness monitors for tracking physical activity in managing their personal health,” according to a report in Health IT Outcomes.

According to Accenture, consumers were primarily interested in devices like smart watches and wearable smart glasses such as Google Glass, even though these devices are not yet available commercially.  Consumers were also very interested in phablets, an emerging device category combining smart phone and tablet PC functions.

I can’t help think that this is a very positive trend.  For one thing, consumer wearables can be an important gateway to remote patient monitoring, something that’s less likely with devices that are used and put aside, like wired glucose monitors, pulse oximeters and blood pressure cuffs.

What’s more, wearables can fit into a healthcare ecosystem in which devices talk to one another and other wireless systems (such as their desktop, laptop or smart phone), whereas the other smart devices I’ve mentioned have less flexibility in that arena.

So, who pays for the wearables?  At least at first, it will probably make more sense for providers to invest in these devices and use them to conduct tests of remote patient monitoring and its impact on care.

But as consumers pick up the wearables themselves, providers might want to focus on building a network which seamlessly integrate these devices, as it seems almost a given that consumers will buy them when they’re available and affordable.  It will take years to get that right, so now it’s probably time to start. Get prepared for the Internet of everything!

Why Secure Text Messaging Is So Much Better Than SMS

Posted on January 14, 2014 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 my most popular articles of 2013 was titled “Texting is Not HIPAA Secure.” Certainly HIPAA compliance is good enough reason for every healthcare organization to implement a secure text messaging solution in their office. Considering the number of organizations I hear are recklessly sending PHI over SMS, I expect this is going to come back and really hit some organization where it hurts. Plus, you won’t be able to hide since the carriers often save the SMS messages for easy discovery by a legal team (which is another reason why SMS isn’t HIPAA compliant). It might take a major HIPAA violation for the industry to wake up.

HIPAA violation issues aside, there are so many other reasons why a healthcare organization should consider using a secure text messaging solution as opposed to insecure SMS as many do today.

As most of you know, I’m adviser to secure messaging company, docBeat (Full Disclosure). As I’ve worked with docBeat, I’ve been amazed at how much more a secure messaging platform can do beyond the simple messaging that you get with SMS. All of these features make a secure messaging option not just a way to avoid a HIPAA violation, but also a better option than default SMS.

Here’s a look at some of the ways a secure messaging solution like docBeat is better than SMS:

Message Delivered/Read Status – I think this is one of the most underrated features of a secure message solution. With an SMS message you have no idea what’s happening with the message. You have no idea if the message has even been delivered to the recipient, let alone read. We’ve all had times where we receive a SMS message well after it was sent. In the case of docBeat, they have a status indication on each message so you know if the message has been delivered to the recipient and if it’s been read. A simple, but powerful feature.

Secure Text to Groups – While SMS is great for sending a message to one individual, it fails when you want to include an entire group in a conversation. The concept of group messaging is really powerful in so many areas of healthcare. Much like the reply to all in email, you have to be careful not to abuse a group text message, but it’s easier to manage since they’re usually short messages that are easily consumed. In docBeat, they offer this group text messaging to a predefined group of users or to an adhoc group that you create on the fly. I especially like this feature when you need help from any one of many doctors, but you’re not sure which is available to help.

Controlled Message Storage – While this has HIPAA implications, the ability to control and audit the messages that are sent is really valuable for an organization. In the wild world of SMS you have no idea what the carrier is doing with those messages. Once they’re on the phone, there’s not an easy way to wipe them off if something happens to the device. With a secure message solution you can control and audit the secure messages. This might include knowing how many messages are sent, how quickly the messages were read, where the messages are stored, etc.

Mobile and Web – In a healthcare organization there are often a lot of people you want to message who don’t have a mobile phone issued by the organization. This often means those people start using their personal device to SMS providers (not a good thing) or they just can’t participate in the messaging. docBeat runs on the iPhone, Android and the web. In most cases, the web option is a perfect way for the non mobile staff to participate in the messaging. Try making that a reality with SMS.

Quick Messages for Common Responses – While many people have gotten very fast at typing on their cell phone, it still takes some time. One way to streamline this is to use quick canned messages for responses you give all the time. It’s much easier to one click a message like “I’m on my way. Be there in a minute.” than to try and type that message into the phone.

Scheduled Messages – Considering the 24/7 nature of healthcare, there are often times when someone is working late at night, but the message doesn’t need to be read until the next morning. Scheduled messages are a perfect solution for this problem. You can create and schedule the message to get sent at a reasonable time rather than waking the doctor up needlessly.

Secure Attachments – While MMS mostly works, I’ve seen where some telcom providers don’t support attachments using MMS. Unfortunately, the telcom provider doesn’t tell you this and so you have no way of knowing that the attachment you sent never made it to the recipient. Plus, MMS works best for pictures. It doesn’t support the wide variety of document formats that a secure messaging provider can support.

Ability to Send Location with Text – While you have to be careful with this feature, it can be a really nice added value to your organization to know their location. Are they sending you a message at your hospital or at their kids soccer game? Knowing this little piece of information can change your workflow so the patient gets better care.

Message Expiration – We could call this feature the snapchat feature. As we saw with the popularity of snapchat, there are times when you may want a message to only live for a certain duration. As is the case with most data retention policies in healthcare, some organizations love this feature and some hate it. Of course, each institution can choose how they want to use this type of feature. In the SMS world, you don’t have a choice. You’re at the mercy of the telcom providers decisions.

Automatic Message Routing to On Call Individual – One of the great features of docBeat is the ability to identify the On Call individual in a group. This was originally applied to docBeat’s call forwarding functionality, but they recently applied it to their secure messaging as well. Now you can message a provider and if they’re not around it can be auto routed to the on call provider. A powerful concept that wasn’t possible before.

One Messaging Platform – This is going to take a while to see fully fleshed out, but those in healthcare are starting to get messages from a variety of sources: SMS, phone, EHR, HIE, Patient Portal, medical devices, etc. As it stands today, those messages have to be checked and responded to in a number of different ways and locations. Over time, I believe each of these messages will be integrated into one messaging platform. The beauty of a secure messaging platform like docBeat is that it can handle any type of message you throw at it. We’re not far off from the day where a doctor can check her docBeat message list and see messages from all of the sources above. The idea of a unified messaging platform is really beautiful and can’t come soon enough.

I’m sure I’m leaving off other examples that I hope you’ll share in the comments. As I look through this list of secure text messaging benefits over SMS, I think we’re at the point where many will choose a secure messaging solution in healthcare because of the added features and not just to try and avoid a HIPAA violation.

What’s Imaging Got to Do with EMRs?

Posted on January 13, 2014 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’ll continue documenting my New Year’s resolution / Blue Button pledge journey next week so that this week I can share a recent interview I did with Yassin Sallam, National/International Sales Director at BRIT Systems. A Twitter encounter turned into a very interesting post-RSNA conversation about the evolving relationship between medical imaging and EMRs.

In our current world of increasing interoperability and patient engagement, how do medical imaging systems interact with today’s EMRs?
For several years, medical imaging systems have provided the ability to interact and launch from EMR portals. However, in many cases the set-up, maintenance and cost uplift requirements prohibits extension to the patient. At times, even simply extending access to trusted partners within a health system or medical community is cost prohibitive. Plus, IT organizations are concerned about the increased probability of security breaches when widely extending electronic access to patient information.

Today, medical images are readily accessible from EMRs via URL links. Different vendors implement different schemes for security, however, so the integration can still be time consuming and expensive.

The industry has certainly recognized room for improvement, namely via patient portals. In my experience, portals consistently make the list of top-five priorities a healthcare CIO seeks to address. The emphasis is often on scheduling, appointment confirmation, lab results, and radiology reports. Technology available today allows for cost effective, efficient and meaningful image enabling platforms.

What role do (and will) imaging systems play in HIEs?
There are approximately 217 HIE networks in the US, and they range in maturity and list of priorities. Image access is an inevitable value-add for these health networks. Whether a provider is looking to reduce cost, or a patient’s exposure to radiation; transfer a patient from one surgical team to another; provide access to a second opinion; expedite therapeutic decisions to shorten the length of stay; or better manage population demands, the availability of medical imaging is an important factor. Platform infrastructure and industry standards can achieve functional, cost effective interoperable imaging systems.

Creating image access and enabling interoperability with EMRs and other hospital IT systems is the foundation of browser-based solutions. BRIT Systems hopes to add to the momentum of representing images at the forefront of patient records with our interoperable solutions.

I’m intrigued by the article you sent me regarding the Radiolopolis Radiology Network. When I think of social networking in healthcare, radiology isn’t the first thing that comes to mind. Why do you think social networking can be a vital part of today’s community of radiology practitioners?
Radiologists work under the pressure of producing quick turnaround, high quality, concise and accurate reports based on what they see in images. The quality of the report may be perceived to rely solely on the words of the radiologist. Consideration should be given to the holistic workflow, which includes: the procedure ordered, at times by the referring physician with no consultation of a radiologist; equipment utilized; skill level of the technologist operating the equipment; quality of the hardware used by the radiologist to view the images; and THEN the words of the radiologist.

Radiologists practice in a wide range of environments. Most do not have the support of specialists or peer consultation accessible in the short timeframe needed to meet service-level agreements. Social media is an outlet, when configured by Radiolopolis, for purposes of a practicing radiologist, that can assist in higher confidence reporting.

Also, we’ve all seen those beautiful ultrasound baby pictures. They give a whole new meaning to baby’s first picture. Who wouldn’t want to share those friends and family?