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Why ICD-10?

Posted on March 24, 2014 I Written By

At least half a dozen folks have asked me to explain why HHS is mandating the transition to ICD-10. So I thought I’d write a blog post about the subject.

First, I’ll examine some of the benefits that proponents of ICD-10 site. Then, I’ll examine the cost of transition from ICD-9 to ICD-10.

There are about a dozen frequently cited reasons to switch from ICD-9 to ICD-10. But they can be summarized into three major categories:

1) The US needs to catch up to the rest of the world.

2) The more granular nature of ICD-10 will lend itself to data analysis of all forms – claims processing, population health, improved interoperability, clinical trials, research, etc.

3) ICD-9 doesn’t support the latest diagnoses and procedures, and ICD-10 does.

Regarding #1, who cares? Coding standards are intrinsically arbitrary. Sequels are not necessarily better than their predecessors.

Although #2 sounds nice, there are a lot of problems with the supposed “value” of more granular data in practice. Following the classic 80-20 rule of life (80% of value comes from 20% of activity), the majority of codes are rarely used. By increasing the number of codes six-fold, the system is creating 6x the opportunities to inaccurately code. There is no reason to believe that providers will more accurately code, but the chances of incorrect diagnosis are now significantly higher than they were before. Garbage in, garbage out.

Below are some specific examples of how increasing the number of codes will affect processes in the healthcare system:

Payers – payers argue that making codes more granular will improve efficiency in the reimbursement process by removing ambiguity. There is nothing further from the truth. Payers will use the new granularity to further discriminate against providers and reject claims for what will appear to be no reason. With 6x the number of codes, there are at least 6x as many opportunities for payers to reject claims.

Clinical trials – ICD-10 proponents like to argue that with more granular diagnosis codes, companies like ePatientFinder can more effectively find patients and match them to clinical trials. This notion is predicated on the ability of providers to enter the correct diagnosis codes into EMRs, which is a poor assumption. Further, it doesn’t actually address the fundamental challenges of clinical trials recruitment, namely provider education, patient education, and the fact that most patients aren’t limited to trials by diagnosis codes, but rather by other data points (such as number of years with a given disease and comorbidities).

Public health – ICD-10 proponents also claim that the new coding system will help public health officials make better decisions. Again, this is predicated on accuracy of data, which is a poor assumption. But the greater challenge is that the most pressing public health issues of our time simply don’t need any more granularity in diagnosis codes. Public health officials already know what the top 20 public health problems are. Adding 6x the number of codes will not help address public health issues.

Regarding #3, why do we need to reinvent the entire coding system and make the entire system more granular to accommodate new diagnoses and procedures? Why can’t we continue to use the existing structure and simply create new branches of the ICD tree using alphanumeric characters? Why do we need to complicate every existing diagnosis and procedure to support new diagnoses and treatments? We don’t. There are plenty of letters left to be utilized in ICD-9 to accommodate new discoveries in medicine.

Next, I’ll provide a very brief summary of the enormity of the cost associated with transitioning from ICD-9 to ICD-10. The root of the challenge is that a string of interconnected entities, none of whom want to work with one another or even see one another, must execute in sync for the months and years leading up to the transition. Below is a synopsis of how the stars must align:

EMR vendors – EMR vendors must upgrade their entire client base to ICD-10 compliant versions of their systems in the next couple of months to begin testing ICD-10 based claims. Given the timescales at which providers move, the burden of MU2 on vendors, and the upgrade cycles for EMR vendors, this is a daunting challenge.

Providers – providers don’t want to learn a new coding system, and don’t want to see 6 times the number of codes when they search for basic clinical terms. Companies such as IMO can mitigate a lot of this, but only a small percentage of providers use EMRs that have integrated with IMO.

Coding vendors – like EMR vendors, auto-coding vendors must upgrade their clients systems now to one that supports dual coding for ICD-9 and ICD-10. They must also incur significant costs to add in a host of new ICD-10 based rules and mappings.

Coders – coders must achieve dual certification in ICD-9 and ICD-10, and must double-code all claims during the transition period to ensure no hiccups when the final cut over takes place.

Clearinghouses – clearinghouses must upgrade their systems to support both ICD-9 and ICD-10 and all of the new rules behind ICD-10, and must process an artificially inflated number of claims because of the volume of double-coded claims coming from providers.

Payers – payers must upgrade their systems to receive both ICD-9 and ICD-10 claims, process both, and provide results to clearinghouses and providers about accuracy to help providers ensure that everyone will be ready for the cut over to ICD-10.

The paragraphs above do not describe even 10% of the complexity involved in the transition. Reality is far more nuanced and complicated. It’s clear from the above that the likelihood that all of the parties can upgrade their systems, train their staff, and double code claims is dubious. The system is simply too convoluted with too many intertwined but unaligned puzzle pieces to make such a dramatic transition by a fixed drop-dead date.

Lastly, switching to ICD-10 now seems a bit shortsighted in light of the changes going on in the US healthcare system today. ICD-10 is already a decade old, and in no way reflects what we’re learning as we transition from volume to value models of care. It will make sense to change coding schemes at some point, but only when it’s widely understood what the future of healthcare delivery in the US will look like. As of today, no one knows what healthcare delivery will look like in 10 years, let alone 20. Why should we incur the enormous costs of the ICD-10 transition when we know what we’re transitioning to was never designed to accommodate a future we’re heading towards?

At the end of the day, the biggest winners as a result of this transition are the consultants and vendors who’re supporting providers in making the transition. And the payers who can come up with more reasons not to pay claims. Some have claimed that HHS is doing this to reduce Medicare reimbursements to artificially lower costs. Although the incentives are aligned to encourage malicious behavior, I think it’s unlikely the feds are being malicious. There are far easier ways to save money than this painful transition.

The ICD-10 transition may be one of the largest and most complex IT coordination projects in the history of mankind. And it creates almost no value. If you can think of a larger transition in technology history that has destroyed more value than the ICD-9 to ICD-10 transition in the US, please leave a comment. I’m always curious to learn more.

You might be an #HITNerd If…

Posted on March 23, 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.

You might be an #HITNerd If…

HIPPA and HIMMS make your skin crawl.

Find all our #HITNerd references on: EMR and EHR & EMR and HIPAA and check out the new #HITNerd t-shirts, hat, and phone cases.

NEW: Check out the #HITNerd store to purchase an #HITNerd t-shirt of cell phone case.

Note: Much like Jeff Foxworthy is a redneck. I’m well aware that I’m an #HITNerd.

Taking the Anxiety out of Healthcare IT (and Cost of Care)

Posted on March 21, 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’m prone to anxiety when it comes to unexplained aches and pains, though I tend to internalize it in an effort to not come across as a hypochondriac. I’m sure I let my inner, extreme worrier come through just a tad during a recent doctor’s appointment. I was visibly relieved to learn that what I had been quietly fretting about for weeks was in fact quite normal. My relief must have been extremely visible, because my doctor was quick to explain that what patients often consider irregular, doctors treat as run of the mill. What I lose sleep over, they don’t bat an eye at. (If only her practice offered a patient portal with secure email, so that we could correspond about my health at our leisure.)

She then told me of a recent trip to the doctor with her mother, and that she had a newfound appreciation for the patient’s side of the visit as she saw things from her mother’s point of view. It was quite refreshing to hear. I might temper my anxiety before my next appointment by playing this mobile game, should it ever be made available in the app store. According to a recent study published in Clinical Psychological Science, 25 minutes of play reduces levels of stress and anxiety. Researchers are looking to see if the effects are the same with shorter bursts of playtime. It’s got to be a cheaper (and healthier) alternative than a prescription for Xanax, right?

Speaking of healthcare costs, I read with interest the news that not only did Castlight Health’s IPO perform better than expected, but that it also partnering with the Leapfrog Group to analyze hospital survey data. Castlight seems poised for success because it is striving to do what healthcare desperately needs done – to bring transparency to and better understanding of healthcare costs in this country. With the Leapfrog project, it seems they are set on tackling quality, safety and patient satisfaction, too. It would be nice, as a patient, to have one trusted resource to go to for consumer-friendly healthcare information so that we could make smart decisions for our families and ourselves.

It would be interesting for a company like Castlight to combine financial, quality, safety and satisfaction data with a notation as to whether hospitals and physicians use EHRs. I noticed that recent results from the latest NCHS Data Brief from CDC show that 42.8% of physicians in Georgia have EHRs – not significantly different than the national average, according to NCHS survey findings. Only nine states ranked above the national average for EHR usage.

I’m off on a tangent here, but I have to ask, when will all 50 states get above 50%? When will everyone be above the national average? With budgets tightening, hospitals closing, and IT deadlines looming, I have a feeling it will be later rather than sooner – if at all.

What do you think? When will your state reach 100%? How do you relieve stress before a doctor’s visit? Would knowing a physician had competitive prices and secure messaging impact your decision to book an appointment? Please share your thoughts in the comments below.

What if the FDA Started Regulating EHR?

Posted on March 20, 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.

In the world of mobile health, we’ve often talked about what will happen if the FDA starts to regulate the various mobile health apps out there. In fact, the FDA has come out with some pretty detailed guidelines on what mobile health applications and devices need FDA clearance. To date, the FDA has stayed away from any regulation of EHR software.

On my ride to the airport after the Dell Healthcare Think Tank event, we had an interesting and engaging conversation about the FDA when it comes to EHR software. Some of the discussion was around whether the FDA would start regulating EHR software.

Shahid Shah suggested that it was extremely unlikely that the FDA would touch EHR software at least until meaningful use was complete and the current President was out of office. He rightfully argues that this administration has hung their hat on EHR and the FDA wasn’t going to step in and stop that program. Plus, Shahid suggested that ONC wouldn’t let the FDA do it either. Janet Marchibroda from the Bipartisan Policy Center was hopeful that Shahid was right, but wasn’t as confident of this analysis.

After hearing them discuss this, I asked them the question:

What would happen to the EHR Market if the FDA started regulating EHR?

Shahid quickly responded that the majority of EHR vendors would go out of business and only a small handful of companies would go through the FDA clearance process. Then, he suggested that this is exactly why the FDA won’t regulate EHR software. FDA regulation of EHR would wipe out the industry.

This is a really interesting question and discussion. The reality is that there are a lot of similarities between EHR software and medical devices. One could make a really good case for why the FDA should regulate it like medical devices. One could make a case for the benefit of some rigor in the development of EHR software. However, there’s no appetite for such a change. In fact, the only people I’ve seen calling for it are those who think that EHR is unusable and potentially harmful to patients. I’m not sure FDA regulation will make them more usable though.

Now, juxtaposition the above conversation with this post by William Hyman titled “A Medical Device Recall of an EHR-like Product” In this case, the FDA announced McKesson’s voluntary recall of it’s Anesthesia Care system. This software was tightly integrated with other FDA regulated medical devices. I wonder what this means for other EHR software that is starting to integrate with a plethora of FDA cleared medical devices and other non FDA cleared medical devices.

I’m personally with Shahid in that I don’t think the FDA is going to touch EHR software with a long pole. At least, not until after meaningful use. After meaningful use, I guess we’ll see what they decide to do.

Is your company comfortable committing to a social media plan that will actually have impact?

Posted on March 19, 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.


The above video was shot by Chuck Webster (the man synonymous with EHR workflow) during the Social Media and Influencer session that I participated in at HIMSS. Chuck has done a nice job putting together the video clips of me talking during that session on his blog. Here’s a look at some of the other clips he’s put together:

“The key is — How are you interesting? And how are you valuable? — to the people you’re interacting with.”

“Why are you doing social media?” Sales, something broader, brand experience….?

On curation “We read everything so you don’t have to!” vs “If it’s great content, people will read it.”

“The beauty of social media is it shouldn’t cost you much to start.”

“Is your company comfortable committing to a social media plan that will actually have impact?”

“I love negative engagement!… It’s beautiful! … people will respect you even more.”

Thanks Chuck for recording the session. I hope that many of my readers get some value out of the videos. Plus, I’d be remiss if I didn’t also mention my upcoming Health IT Marketing and PR Conference. If you are interested in the topics I discuss in these videos, then come and enjoy 2 days hearing from a few of the brightest minds in the health IT marketing and PR world. Not to mention some bright minds from outside of health IT as well.

What We Can Health IT Learn From Dancing with the Stars

Posted on March 18, 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.

A lot of my readers probably don’t know that along with creating the Healthcare Scene blog network, I also have a network of talent reality TV blogs. For some reason, people don’t understand how a techguy could start a health IT blog network and also cover shows like Dancing with the Stars and So You Think You Can Dance. There’s so much synergy between the two networks. Ok, not really, but I’m always surprised how many people in healthcare IT watch these shows as well.

Since last night was the premiere of Dancing with the Stars, I thought I’d apply some of the things I’ve seen in Dancing with the Stars (DWTS) to healthcare. For those not that familiar with the show, this is the 18th season of DWTS and that’s a great run for any show. However, the ratings have slowly started to dip for the show. DWTS has always done well when it came to total viewers (10+ million), but has always had issues attracting the viewers advertisers want to pay for (adults 18–49). The past couple seasons they’ve made some tweaks to the show, but this season they’ve made quite a few major changes to the show to try and engage a new audience and reach that special adults 18–49 demographic.

Now let’s compare this to healthcare IT. How many healthcare organizations are found doing a balancing act between the younger tech savvy crowd and the more risk averse older crowd? I think a lot of them are and more will be doing so in the future. On the one hand you have the doctor who is ready to retire early because she doesn’t want anything to do with EHR and health IT. On the other hand you have the resident who hates going to a practice that doesn’t have an EHR because he can type faster than he writes.

Much like in DWTS, if you cater to the one, you alienate the other. It’s a tough balance. Last night on the premiere of DWTS the show made a number of major changes to try and cater to the younger demographic. I have dozens of emails from the older demographic complaining about the changes. Most are crying for the good old days when they had something that was familiar and the way they liked the show to be. Many of them felt alienated and wondered if the show cared about them.

Does this sound a bit like what some of the health IT therapists (sometimes called CMIOs) feel when they’re talking with some of their older colleagues? They feel alienated by the new technology and long for the good old days. I’ll never forget the nurse who told me she hated EMR because she couldn’t draw the male and female gender symbols. For some reason it was so much better than the Male/Female drop down box (which is ironic because I’m not sure how she drew Male to Female Transgender, but the dropbox handled it just fine).

Much like Dancing with the Stars, there comes a point where you have to do some things that will alienate some of your most ardent fans in order to grow and continue to be viable. Finding the balance between too much alienation and too much catering to the new crowd is a very tough challenge. However, every organization needs to take these risks.

The key to all these changes is creating a culture around change at your organization. Most organizations try the big bang style of healthcare IT implementation. Sometimes it’s necessary, but it’s not the best way. The better way is to create a culture where the organization takes a thoughtful approach to implementing great technology as part of the normal business method. Make sure that whatever changes are implemented have a purpose and it’s communicated well. The combination of multiple small changes made in your organization can accomplish far more in your organization than the big bang IT implementation. Plus, all those small changes add up to a big change for your organization without the same end user alienation.

Matching Healthcare IT Project Plans to Reality

Posted on March 17, 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.

I’m traveling today to the Dell Healthcare Think Tank Event, hosting a G+ hangout discussing HIPAA with Mac McMillan, battling some allergies (where was that allergy warning app when I needed it?), finishing up plans for the Health IT Marketing and PR Conference, and still keeping all the other projects I have moving forward. So, today I thought I’d keep it simple and share this insightful quote from Eric Haglund’s Appropriate IT blog:

It is possible to force a project plan to match reality but impossible to force reality to match a project plan. So why is it the latter is attempted more then the former?

-S. Yetter

I don’t know Eric, but I love blogs from in the trenches people like Eric. Too bad he stopped blogging back in the middle of 2009. The great part is that even though he wrote the blog post back in 2009, it’s still just as insightful in 2014.

I look forward to participating in a discussion around this quote.

Physician Designed EHR, EHR MU Documentation, and Top EHR Ratings Lists

Posted on March 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.


I really hate this discussion. It reminds me of the republican-democrat debates. They always go too far and both sides (in this case Physicians and EHR vendors) often only see their side and miss the opposite viewpoint. It’s very polarizing. The best situation is the mix of both sides of the equation. Plus, you usually need someone who can help translate and moderate between the two viewpoints. That’s much easier said than done. You can definitely learn a lot about an EHR vendor when you learn if they’re more physician designed or tech designed.


Many people unfamiliar with these standards probably don’t undstand this tweet from Mandi since they assume it’s a standard and so the ONC documentation should be good enough, no? The reality is that every implementation of the ONC standard is different and you have to have documentation of how that EHR vendor implemented the standard.


I appreciate Chandresh’s tweet more than most. I’ve often considered the idea of starting an EHR rating site. They are a dime a dozen and I don’t think any of them are very good. The best ones use some high level filters to help you narrow the search. This has some value, but isn’t really an EHR rating site. The problem with an EHR rating is the sheer scale of responses that you need to collect for it to be valuable. There are 300+ EHR vendors. There are 40+ specialties. There are practices from solo doctor up to hundreds in a multi specialty clinic. There are 50 states. There are hundreds of insurance plans. You get the picture. The number of randomly collected quality ratings you would need is impossible. I enjoy a good list as much as the next person, but just remember what I mention above when you see the next list of Top EHR vendors.

Then again. Maybe Chandresh and I should get together and do an EHR rating service based on if the EHR was a physician designed or tech designed EHR.

Training New EHR Users

Posted on March 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.

Todd Stansfield has a really great guest blog post over on EMR and HIPAA where he writes about “Learning by Doing.” While this principle applies to a lot of parts of life, I agree with Todd that it’s absolutely valuable when doing EHR training.

I was particularly intrigued by the process that Todd and The Breakaway Group use to train on EHR. I know they have a bunch of researchers at The Breakaway Group that have worked hard to understand the right way to train. However, what struck me is that I found exactly the same thing in my experience training users on EHR.

When I was working my full time job managing, implementing, upgrading, etc the EHR, I was also assigned to train any new staff that got hired by our clinic. Because of our clinic’s relationship with the local medical school and some general staff turnover, I got quite good at training new users on the EHR.

My process was really simple. I would first train the users on the workflow through the EHR. Then, to reinforce what I taught, I would have them go through the same workflow (ie. learning by doing). After I’d shown them what to do, they usually had to stumble through what I’d just taught them. However, once they stumbled through the second time and actually did it themselves, I can’t remember them ever asking me how to do it again. It was really quite amazing to watch. The questions I would get later were more about why, how, or advanced functionality.

Trust me, this is not an easy thing to do. When I was in the second phase of EHR training where I let them do it directly on the EHR, I had to really control my urge to just show them the solution. Sometimes I would literally stand up and walk away from the computer to prevent myself from just showing them how to do it. It’s almost irresistible to step in and do it. However, I had to resist that urge and let them fail and explore a little bit for them to really understand how it worked.

Of course, there’s a point where you might need to step in, because they just flat out don’t remember. That’s fine, but then that often means they’ll need to do that same step again so they don’t forget.

I saw first hand the concept of learning by doing. It’s a powerful one and more EHR vendors should employ it in their EHR training.

Epic Go Live Impossible Without #Web25

Posted on March 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.

The World Wide Web turned 25 this week, which gives us all cause to stop and reflect on its role in healthcare IT. It goes without saying that systems like electronic medical records would have a hard time really taking off without the Internet. Yes, they probably could exist without it, but if you think providers have workflow issues now …

I found out about the Web’s birthday on the very day I called my daughters’ pediatrician to schedule their annual well visits. The receptionist (who didn’t sound stressed at all) kindly informed me that they will be scheduling all future appointments into the new electronic medical record (Epic). Since that isn’t scheduled to go live until April 1, she took my appointment date and time down, and told me another staff member would call me back to let me know my appointments had been made in the new system.

It sounded like they are trying their hardest to avoid duplicate data entry into the old and new systems, but are having to rely on paper and pen to make sure everything ends up where it’s supposed to be come go live. Oh, the irony. I’ve got April 1 (April Fool’s Day, no less) circled on my calendar. I think I’ll give them a call back then to see if anyone sounds remotely stressed, or if things seem to be going smoothly.

This particular healthcare system probably won’t be in the “EMR Buying Frenzy” you may have read about recently. The numbers are downright shocking to me. HealthcareITNews.com reports, “[O]ne-third to half of all large hospitals are looking to trade out their old EMRs by 2016.” That is a ridiculous amount of money set to be spent by facilities that likely made similar investments in the not-too-distant past.

As a patient, I have to wonder how those second-round EMR purchases will affect the cost and quality of care. Will the price of procedures go up to help hospitals pay for these new systems? The money has got to come from somewhere. Just how frustrated will my physician be with new workflows, especially if they’ve JUST gotten used to the previous EMR? If any provider wants to chime in, please do in the comments below.

In another wonderful twist of irony, it is the World Wide Web that now allows me and other cost-conscious patients to research healthcare costs at our local facilities, not to mention come together online to commiserate about similar experiences. It will be interesting to see where the Web and healthcare IT are in another 25 years. Surely we’ll have achieved true interoperability by then!