I had the honor today to host the #HITsm Twitter chat. For those not familiar with the #HITsm chat, you just join every Friday at Noon ET and watch the tweets that are sent using the #HITsm hashtag. There are usually 4-5 questions that are discussed over the hour chat. Since I was the host, I created the questions this week. I chose to focus the chat on the latest happenings with meaningful use. The transcript of the chat is found here.
I just took a look at the stats for the chat on Symplur and saw that the chat had 68 participants that sent out 474 tweets which had 3,196,079 impressions. You have to be a little careful looking at impressions since that’s potential impressions, but it’s still interesting to consider the possible reach of a chat.
There were some really interesting tweets during the chat, so here are the questions and a few (ok, more than a few since I got carried away) of my favorite tweets:
Topic 1: What are your thoughts on the AMA’s MU letter? Will we see any of their changes put in place?
Read: AMA Provides Blueprint to Improve the Meaningful Use Program
T1: ONC and CMS are limited by law to how they can change the #MeaningfulUse program. #hitsm
— Keith W. Boone (@motorcycle_guy) October 17, 2014
Limited, but still possible to change many things.
T1 AMA #MeaningfulUse letter mentions 'workflow' 25 times. http://t.co/egk000iR54 (pdf) read it & weep. Gonna take workflow tech IMO #HITsm
— Charles Webster MD (@wareFLO) October 17, 2014
Predictable from Chuck, but he makes an interesting point.
#HITsm T1: Finally! this tied to the call for a new approach by The Health IT Policy and the Health IT Standards committees is a BIG DEAL
— John Traeger (@SquakMtn) October 17, 2014
Is it a big enough deal to get things to change.
@ehrandhit agree! Docs are struggling and AMA voice is very powerful. Hopefully reason will win out this time. #HITsm
— Stephanie Zaremba (@s_zaremba) October 17, 2014
Such a missed opportunity that many of the these ideas weren’t listened to during the rule making process.
T1: "reducing the reporting burden on physicians" what about the burden on #HIM and #IT!? #HITsm
— Erin Head (@ErinHead_HIM) October 17, 2014
I’m sure nurses would have a similar comment.
Topic 2: Will the Flex-IT act be passed? Is passing it a good or a bad thing?
Read: Killing Meaningful Use and Proposals to Change It
T2: have not heard anyone againt FLEX-IT Act. Also, w/o it, no doc will be able to switch EHRs in 2015 and do #MU. Locks in bad tech #HITsm
— Stephanie Zaremba (@s_zaremba) October 17, 2014
Great point. If you want to switch EHR, you’ll have to forgo meaningful use for a year. That will stop many from switching EHR software.
T2: Passing it = good for providers, but delays in releasing MU3 is going to set us up for another 2014 in 2017. #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
More delays?
T2: One theory is that Flex-IT will prolong MU. Without it, MU will die on the vine and that could be a good thing. #HITsm
— EMR, EHR and HIT (@ehrandhit) October 17, 2014
Should MU be kept on life support, or should we let it die?
@ehrandhit Could be a good thing. But the standards will continue, and need to be understood and implemented appropriately #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
Good question on the place of standards post-MU.
#HITsm T2: I'm not sure Flex-IT would help much; seems more like pandering to the foot dragging institutions
— John Traeger (@SquakMtn) October 17, 2014
It will help many who want MU money. Many won’t get MU money if this doesn’t pass.
T2 At this "stage",don't think institutions r dragging their feet but a genuine lack of not having ones' act together.Remedy=time #hitsm
— Bernadette Keefe (@nxtstop1) October 17, 2014
Some are dragging their feet, but there are enough that aren’t that can’t make it that it’s worth considering the change.
Topic 3: The EHR penalty exemption was reopened. Will we see more opportunities for organizations to avoid the EHR penalties?
Read: Meaningful Use Hardship Exceptions Reopened
Hardship exemptions stemming from recent final rule flexibility could = final nail in #MU coffin IMO. Program collapsing on itself. #HITsm
— Stephanie Zaremba (@s_zaremba) October 17, 2014
I think that Flex-IT would take out those nails and reopen the coffin and discover that MU has one last breathe.
@s_zaremba True. There are so many ways around actually attesting with new 2014 tech this year. #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
Lots of exemptions
T3: #HITsm “CMS received approximately 44,000 hardship exemption applications,”
— Dinesh Ramkrishna (@dineshrs) October 17, 2014
And we’re just getting started with submissions since they reopened it.
#HITsm T3: I fear that this is a symptom of the root problem; everyone sees this as a regulatory problem instead of systemic change needed
— John Traeger (@SquakMtn) October 17, 2014
The government would never just work on the symptom instead of the problem, would they?
Topic 4: Many doctors are becoming vocal about their dissatisfaction with EHR software. What will it take to make doctors happy with their EHR?
T4: For some doctors, it make take retirement to be happy with EHR software. #hitsm
— Keith W. Boone (@motorcycle_guy) October 17, 2014
Sad, but true.
T4: wearables that capture ET at the point of care and feed into EHR seamlessly while capturing mandated data points for interop? #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
Interesting idea. Much harder to execute.
T4: I think most doctor EHR dissatisfaction comes from reimbursement and MU requirements, not EHR per se. #HITsm
— EMR, EHR and HIT (@ehrandhit) October 17, 2014
Sadly, this means we won’t see a satisfying EHR anytime soon.
#HITsm T4: They won't be happy until 1: AI reaches the level of genius doctor advisor and 2: the culture of doctor knows all changes
— John Traeger (@SquakMtn) October 17, 2014
I love the concept of an EHR becoming a genius doctor advisor.
T4: docs might be the least educated consumers in the world when it comes to EHRs. They don't know to demand good UX. #HITsm
— Stephanie Zaremba (@s_zaremba) October 17, 2014
They’re too busy being doctors. Plus, it’s hard with 300 choices out there.
@ehrandhit Nothing. Nothing will make doc's happy. #HITsm
— jeremycoleman (@jeremycoleman) October 17, 2014
Ouch! Just ouch!
this! @mpanner EHR software not built for drs,which is the problem at many levels- built to satisfy a biz system that makes no sense #HITsm
— Madison Technology (@Madisys) October 17, 2014
True. Business, financial, and regulatory. Not clinical.
Topic 5: Share your favorite MU stories and anecdotes (good, bad, crazy, scary, hysterical, etc).
T5: 100s #patients "accidentally" shown #cancer Dx due to bad SNOMED, #HIPAA breach due to botched #EMR upgrade/MRN assignment logic. #HITsm
— Mandi Bishop (@MandiBPro) October 17, 2014
T5: A site asked to change their default med order source to written to meet CPOE. Apparently WPOE is a new measure for MU. 😉 #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
T5: "I know it doesn't make clinical sense, but we have to do it to meet MU and avoid the penalties." #HITsm
— EMR, EHR and HIT (@ehrandhit) October 17, 2014
T5: Waiting until last day of reporting period to send ALL summaries of care. Not really in the spirit of sharing data. 🙁 #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
Meanwhile – on the consumer side – "we're sorry Mrs. Jones but your lab results are only available on an iPhone" #patientengagement #HITsm
— Dan Munro (@danmunro) October 17, 2014
T5: #EHR upgrades 1 month before #MeaningfulUse reporting period start, unit-testing their #healthIT on prod #patients..list goes on. #HITsm
— Mandi Bishop (@MandiBPro) October 17, 2014
T5 When we went live with read only at Stanford there were tons of Docs who had trained at Kaiser and they wanted full access #HITsm
— Sherry Reynolds (@Cascadia) October 17, 2014
T5: "This patient received aspirin at discharge. Why no credit?" Well sir, you loaded new RxNorm codes that don't exist in cert. CQM #HITsm
— Sarah Bennight (@sarahbennight) October 17, 2014
Got a little long, but that shows you how much interesting information is discussed in just an hour Twitter chat. I look forward to hearing the ongoing conversation.