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Healthcare IT Twitter Roundup

Posted on March 17, 2016 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 a huge fan of sucking the nectar out of Twitter and providing me own commentary on what people are sharing.


This would be a good step forward. Machine to machine communication can be a lot more accurate.


When you see some of the amazing things they’re starting to discover in genetics, you can see why many are focusing on genetics. However, Pat’s point is a good one that we should focus on other social determinants of health (SDOH) also since they can have a lot of impact.


This is where the cloud is so powerful. Cloud computing is going to be the solution to this problem.


I see more and more efforts to include the patient voice. Love this!

Analytics is the Driver for Useful Health Services at Philips

Posted on March 16, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Although pioneer health care organizations jumped into risk sharing and fee-for-value without a good grounding in data, they have come to recognize the critical role analytics play over the past few years. Results of a 2015 survey of ACOs show that, “Nearly 85 percent of respondents report they have in place advanced analytics software to analyze disparate data sets.” The data tends to be limited (mostly claims and EHR data) and data sharing is still rare between organizations, but basic practices such as identifying high-risk patients are becoming more widely seen.

Philips has been in health care informatics for a long time, gradually building a data platform with analytics capabilities and basing more and more services on this platform. I talked to Dr. ck Andrade, Director of Product Management of Philips’ HealthSuite Digital Platform, to find how their basic analytics drive their services.

Like the ACOs mentioned earlier, Philips allows a single organization to combine and mine data of different types. Philips does not combine data from different unrelated organizations–in fact, to respect privacy, they don’t peek at user data at all. The platform is intended to aid institutions with precisely the types of data integration that are now so difficult. Now it is being incorporated by Philips into their own high-level services, showing how analytics can be a platform for building businesses.

Philips’s HealthSuite digital platform offers FHIR APIs. EHR data is read in through the vendors’ APIs when they’re available, by using the platform’s other interoperability capabilities, or through the CCD-A format. Imaging support was announced on February 18. Genomics is being pursued. Finally, device data can be taken in through several sources. Philips Device Cloud manages 8 million connected devices today, and a recently announced integration with Validic connects to data from 130 different device vendors over a wide range of protocols.

Clearly, all these data sets are interdependent. For instance, an image is of no value without the patient history that comes from an EHR.

What sorts of questions can all this data answer? The Philips platform provides a framework for aggregating data, running analytics, and exposing results through an API. The same API is used internally by Philips to develop its solutions, by customers to write apps, and by third-party developers to develop clinical solutions or packages for healthcare analytics: for instance, data scientists testing predictive models. As an example of the API’s power, it can offer access to blood glucose, wellness measures, responses to past medications, mood, and stress for diabetes patients. Healthcare organizations can run their algorithms against this data to suggest the current insulin dose and track fluctuations in glucose level.

Most customers use such information for simple interventions such as letting someone know they forget to do a reading or that the reading is outside the normal range. The platform can find patients with similar demographics and find duplicates caused by such common errors as misspelled names. A more sophisticated use of analytics would check how people are responding to medication, or how different interventions produce different effects.

The API supports both data push and data pull. Pull may be chosen for data that needs to be read several times a day.

Now Philips is enjoying the fruits of its labors by offering services based on its analytics, which are constantly getting richer. Here are examples operating at three levels of care:

  • Inpatient: Philips’s eICU tracks patients from ICU through follow-up. Tools provided by Philips take in, analyze, and form data into visualizations on dashboards.

  • Outpatient: Philips’s in-hospital and ambulatory telehealth programs are aiding transitions. Data from the inpatient EHR can be connected to data from the patient at home and from different health care providers using Philips services. Patients can upload data, using eCare Companion, allowing providers to monitor them using the same model as inpatient care. This is crucial for outpatient care, where each care coordinator might have to monitor hundreds of patients. A dashboard, eCare Coordinator, organizes critical information for the clinician. For instance, a dashboard can highlight the five people with the most disturbing trends. If a patient’s blood pressure rises even though he reports taking his medication, a clinician can prescribe a medication change.

  • Consumer health and wellness: Healthwatch uses the same analytics as other services, but for healthy living instead of recovery from illness. For instance, analytics can track different types of vital signs for people who have been identified as prediabetic. A self-management platform, which offers instant feedback as well as a look at progress over time, can measure activity and other contributors to health. Although it can run separately from any health care provider, users can share logged data with their providers.

Philips also builds some services on others. For instance, the Lifeline program for fall detection, which has been available for some time, now uses its Caresage predictive analytics for the frail and elderly. This turns Lifeline from a reactive to a predictive platform. Using analytics on a person’s frequency of falls, and patterns in their incidence, it can warn if another fall is likely.

March brought with it announcements for a whole set of new services were announced, such as for sleep and respiratory problems, for healthy seniors, and for intensive care units. I believe these advances aren’t due merely to Philips’s size and investments. They have learned how to make use of a flexible, integrated platform. It’s the direction all health providers need to head in.

EHR Hosting Demystified – What to Look For (and Look Out For), on Your Way to the Healthcare Cloud

Posted on March 15, 2016 I Written By

The following is a guest blog post by Joe Cernik from eMedApps.

As I write this post I’m trying to reach the cloud. I’m on my third-in-a-row delayed flight segment on this week’s business trip – ARGH!  Ascending to the cloud these days is mostly easy though. My music is there, as are my photos, bank accounts and even my fitness stats collected on my wrist while I’m jogging or while I’m sleeping. Cloud computing has become ubiquitous and healthcare has embraced the transition. Health IT vendors are rapidly migrating EHR, PM and RCM solutions from client-server formats to on-demand, pay-as-you-go cloud hosted solutions.

According to healthcare analyst IDC, organizations that use on-site data storage spend 32% more on IT support than organizations that use an outside hosting provider. From infrastructure costs of servers and support staff to application deployment and ongoing maintenance costs, on-premises software can be a high-touch, high-cost model. Most EHRs are either in the cloud today, or claim cloud compatibility. The cloud promises scalability, interoperability and business continuity – but where do you start to evaluate solutions and define your own path to the cloud?  Here are a few basics to get you going.

Ready, set, cloud….

Step 1: Understand hosting and cloud approaches and determine which type is right for you.

Insourced Hosting: A model also called managed services, managed client-server, or managed on-site hosting, where the hosting vendor provides end-to-end management of your complete EHR/PM system including the hardware and software systems installed at your facility. In essence, your hosting vendor becomes a member of your team, in-house, and manages the infrastructure that you own – generally in a client-server configuration. You’re not in the cloud yet, but this may be a first step in that direction if you’re ready to get out of the EHR/PM management business.

Outsourced Hosting: Also called remote hosting, hosted off-premise, and cloud hosting, outsourced EHR hosting locates your critical EHR/PM applications in a datacenter facility – outside of your LAN-based practice or clinic. EHR and patient data is stored on remote servers accessed via secure Internet connections. Fully outsourced remote hosting shifts the expense of procuring, managing and maintaining your EHR application and servers from your facility and your IT team to a fully managed datacenter. Servers are owned, managed, and refreshed by the hosting company.  Now, you’re in the cloud.

Hybrid Model Hosting: Also called hosted client/server in the cloud and managed hosting, this model allows your organization to place your servers into a secure datacenter. This hybrid model between insourced hosting and outsourced hosting allows your organization to leverage existing capital investments in servers and investments in EHR application licenses, but moves the ongoing management and maintenance of this infrastructure investment to an internet accessible, secure remote site. Rather than installing and managing your application on a server in your office, the installation is managed on your server(s) in a controlled data center environment. Your users log into your remote server through a web browser.

Step 2: Understand Compliance and Regulatory Considerations (HIPAA, PHI, MU) Before You Sign a Contract

Your EHR hosting partner should be an EHR application expert, have demonstrable hosting expertise, and meet all regulatory and security protocols.  While this statement may seem obvious, note that no matter which type of hosting solution you consider or eventually adopt, your hosting provider and their facilities must meet all physical, procedural, operational, and technical readiness criteria established for hosting of protected healthcare data. Make certain to evaluate partners for compliance with all HIPAA/HITECH rules and, for outsourced or hybrid solutions, SOC 2 Type II and SOC 3 centers with certificates including: PCI DSS Level 1 and SSAE 16.

Step 3: Evaluate the Costs

Because there is no upfront cost for the software, and an organization is not required to buy a server, a cloud-based EHR may be less expensive than the onsite client/server setup. If one of your greatest hurdles to adopting an EHR is the initial cost of installation, an outsourced hosting model may be worth considering.

Some practices may also prefer to view their EHR expenses as a recurring operational expense (similar to a utility bill) rather than a capital investment. If your practice or clinic has already invested in on-premises infrastructure but want to consider a move to an outsourced hosting model, a hybrid approach may be a good first step with a full transition to an operational expense model on your next hardware refresh cycle.

Models vary among hosting vendors, and some vendors offer contract terms and conditions that offer hosting packages tailored to your revenue projections or offer low introductory pricing that increases over time. Variable models should be evaluated over a five-year cost-of-ownership timeframe to accurately compare costs across vendor plans.

Clear the fog…move to the cloud.

The way organizations procure and deploy IT infrastructure is undergoing a significant transformation. Don’t be confused by the transition – cut through the fog and get to the facts on a hosting solution that will help you meet your business AND patient care goals.  That solution may include ascending to the cloud – there’s a lot of great music already there. Now, let’s see if my plane will make it into another type of cloud today.

Health IT at SXSW – What Can Healthcare Learn?

Posted on March 14, 2016 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.

It’s been fun to watch the evolution of healthcare at SXSW. When I first went 4 years ago (wow, I can’t believe that was 4 years ago), healthcare was just trying to find its place in the mass of a conference that is SXSW. I was one of the judges for the health IT startup pitch competition and healthcare had graduated to having its own campus at SXSW. However, the sessions were pretty light and there weren’t that many of the people you’d expect in healthcare IT to be there.

4 years later, some of the people you’d really want at the event aren’t there, but some very interesting startup healthcare IT companies are at the event. Plus, thanks to things like IoT (Internet of Things) and the interest in wearables, SXSW has done a good job featuring many of the health tech startup companies which fit into those larger trends. In fact, health is often one of the biggest parts of these larger trends.

There are so many healthcare IT conferences out there to choose from so I understand why many in healthcare don’t venture to the insanity that is SXSW. Plus, I think that it’s hard for many in healthcare to realize that SXSW is more than just a music festival (something that’s not been true for a long time) and more importantly to convince their bosses that they’re not just going to Austin to have fun.

I personally think that some of the ethos and culture of SXSW are what’s needed in healthcare. One of the key experiences that SXSW tries to cultivate is the mixing of various creative cultures in order to spark new and surprising creativity. That means that sometimes a tech startup entrepreneur will be spending time with a musician or film executive. This mixing of cultures can lead each person to surprising new insights into their business. The startup entrepreneur might find a new way to attract an audience for their product based on something the musician does to spread his music. The musician might learn about new tech that could create new layers to their music from the startup entrepreneur. You get the idea.

Healthcare could benefit from some outside influence. Just to be clear. This doesn’t mean that you throw out the culture that you know. Definitely not. It does mean you get exposure to another culture that can help expand your thinking. Over time we all get somewhat narrow minded in our thinking. Exposure to new ideas helps to expand our minds.

The same is even true within different departments in healthcare. How often does your lab interact with radiology or radiology with your ED or your pharmacy with your clinicians? If you work in a hospital you know what I’m talking about. We get stuck in our ruts and often don’t leave them. It’s nice and comfortable in our ruts and so we don’t see why we should leave them. That’s poison to an organization that wants to innovate. Take a lesson from SXSW and cultivate experiences and opportunities for different cultures to mix and learn from each others unique perspectives and experiences.

Randomized Clinical Trial Validates BaseHealth’s Predictive Analytics

Posted on March 11, 2016 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

One of the pressing concerns in health care is the validity of medical and health apps. Because health is a 24-hour-a-day, 365-day-a-year concern, people can theoretically overcome many of their health problems by employing apps that track, measure, report, and encourage them in good behavior. But which ones work? Doctors are understandably reluctant to recommend apps–and insurers to cover them–without validation.

So I’ve been looking at the scattered app developers who have managed to find the time and money for randomized clinical studies. One recent article covered two studies showing the value of a platform that provided the basis for Twine Health. Today I’ll look at BaseHealth, whose service and API I covered last year.

BaseHealth’s risk assessment platform is used by doctors and health coaches to create customized patient health plans. According to CEO Prakash Menon, “Five to seven people out of 1,000, for instance, will develop Type II diabetes each year. Our service allows a provider to focus on those five to seven.” The study that forms the basis for my article describes BaseHealth’s service as “based on an individual’s comprehensive information, including lifestyle, personal information, and family history; genetic information (genotyping or full genome sequencing data), if provided, is included for cumulative assessment.” (p. 1) BaseHealth has trouble integrating EHR data, because transport protocols have been standardized but semantics (what field is used to record each bit of information) have not.

BaseHealth analytics are based on clinical studies whose validity seems secure: they check, for instance, whether the studies are reproducible, whether their sample sizes are adequate, whether the proper statistical techniques were used, etc. To determine each patient’s risk, BaseHealth takes into account factors that the patient can’t control (such as family history) as well as factors that he can. These are all familiar: cholesterol, BMI, smoking, physical activity, etc.

Let’s turn to the study that I read for this article. The basic question the study tries to answer is, “How well does BaseHealth predict that a particular patient might develop a particular health condition?” This is not really feasible for a study, however, because the risk factors leading to diabetes or lung cancer can take decades to develop. So instead, the study’s authors took a shortcut: they asked interviewers to take family histories and other data that the authors called “life information” without telling the interviewers what conditions the patients had. Then they ran the BaseHealth analytics and compared results to the patients actual, current conditions based on their medical histories. They examined the success of risk assignment for three conditions: coronary artery disease (CAD), Type 2 diabetes (T2), and hypertension (HTN).

The patients chosen for the study had high degrees of illness: “43% of the patients had an established diagnosis of CAD, 22% with a diagnosis of T2D and 70% with a diagnosis of HTN.” BaseHealth identified even more patients as being at risk: 74.6% for CAD, 66.7% for T2D, and 77% for HTN. It makes sense that the BaseHealth predictions were greater than actual incidence of the diseases, because BaseHealth is warning of potential future disease as well.

BaseHealth assigned each patient to a percentile chance of getting the disease. For instance, some patients were considered 50-75% likely to develop CAD.

The study used 99 patients, 12 of whom had to be dropped from the study. Although a larger sample would be better, results were still impressive.

The study found a “robust correlation” between BaseHealth’s predictions and the patients’ medical histories. The higher the risk, the more BaseHealth was likely to match the actual medical history. Most important, BaseHealth had no false negatives. If it said a patient’s risk of developing a disease was less than 5%, the patient didn’t have the disease. This is important because you don’t want a filter to leave out any at-risk patients.

I have a number of questions about the article: how patients break down by age, race, and other demographics, for instance. There was also an intervention phase in the study: some patients took successful measures to reduce their risk factors. But the relationship of this intervention to BaseHealth, however, was not explored in the study.

Although not as good as a longitudinal study with a large patient base, the BaseHealth study should be useful to doctors and insurers. It shows that clinical research of apps is feasible. Menon says that a second study is underway with a larger group of subjects, looking at risk of stroke, breast cancer, colorectal cancer, and gout, in addition to the three diseases from the first study. A comparison of the two studies will be interesting.

e-MDs Acquires McKesson’s Portfolio of Ambulatory EHR Software

Posted on March 10, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post will likely be a little bit of inside baseball for many, but I think it’s a really important subject to cover since it’s going to impact so many practices and so many doctors. The news just came out that e-MDs was acquiring the suite of ambulatory EHR software owned by McKesson. For those keeping track at home, these are 6 of the assets acquired from McKesson: McKesson Practice Choice™, Medisoft®, Medisoft® Clinical, Lytec®, Lytec® MD, and Practice Partner®.

This shouldn’t be a surprise from a McKesson perspective. At HIMSS I heard multiple stories of people talking with McKesson staff who didn’t even know the names of their EHR software. Sad, but true. The only question for McKesson is will Paragon get sold off next?

For those that aren’t familiar with the history of e-MDs, it was purchased by Marlin Equity Partners back in March 2015 and merged with Marlin’s MDeverywhere company. Marlin then went on to acquire AdvancedMD from ADP in August of 2015 as they started to stock pile ambulatory EHR vendors. With the acquisition of the McKesson assets, Marlin now owns a large number of ambulatory EHR vendors.

This shouldn’t really be a surprise to anyone. We all knew that 300 EHR vendors wasn’t sustainable long term and we know that the EHR market has matured now that the false market meaningful use created is over. Some consolidation was bound to happen and it’s no surprise that a private equity firm is rolling up these companies as they seek to find the benefits of scale. The press release notes that the combined company’s products and services are being used by nearly 55,000 providers nationwide after this latest acquisition. That’s quite a presence in the ambulatory space.

The unfortunate downside of this type of EHR roll up is that not all of these EHR software can survive under one roof. Some of them have got to go. The only question is which one(s) will survive. Unlike EHR vendor founders, private equity companies are disconnected from the original product and so it doesn’t hurt as much for them to shut down a weaker product line as they consolidate users on to what they consider the best software. I’d be shocked if we didn’t see this happen with a number of EHR software that are now under e-MD’s (and Marlin’s) roof.

I also won’t be surprised if Marlin and e-MDs continue with more acquisitions. There are still a few hundred other ambulatory EHR vendors out there.

Experiences and Perspective from #NatCon16

Posted on March 9, 2016 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 past couple days I’ve been enjoying a new experience at the National Council for Behavioral Health’s NatCon Conference. It’s been quite an experience for a techguy like me to dip my toes into the world of behavioral health. Plus, in many ways this takes me back since when I started my journey into the world of healthcare, I was charged with implementing an EMR into a university counseling center. I’m no doubt one of only a few bloggers that’s ever blogged about behavioral health EMR and the challenges of implementing a general medicine focused EMR (most of them anyway) in a counseling center.

As I noted in my previous post, what’s surprising is how many things behavioral health EMR has in common with the rest of the healthcare world. That theme seems to carry through.

However, today I had a couple more insights. First, we think we have it complex when it comes to medical care and sometimes it is very complex. However, the challenges that behavioral health professionals face is much more challenging and often absolutely gut wrenching. Hearing some of the stories just tugs at your heart in an extraordinary way. It definitely takes someone special to work in the behavioral health field. That’s especially true given the many stigmas they have to battle against. It was amazing to hear how many times the stigma of behavioral health was discussed at the conference. It’s unfortunate how much stigma holds us back.

Second, we need better collaboration between behavioral health providers and the rest of the healthcare system. In a private Q&A I saw with Dr. Kevin Pho (better known as @KevinMD), he clearly articulated how there’s only so much he can do to help a patient with behavioral health issues in his 10-15 minute appointment slot. We have to work together to solve these problems or it will never get better.

As I think about the need for collaboration and overcoming stigmas, I can’t help but think of the Twitter Chat session I attended at the conference. I’ve always been amazed by how an open platform like Twitter can bring together so many communities of people around a common cause. These communities can break down barriers and stigmas. It’s not easy, but it’s possible. I see it happening every day on social media. The news media likes to only cover the bad effects of social media, but there is a tremendous amount of good that comes from actively participating in social media as well.

All in all, #NatCon16 was an eye opening experience for a blogger like me. It gave me a reminder of how challenging behavioral health is, but also the tremendous opportunities that are available to do so much good in the world when we tackle these challenging problems and are successful.

A Small Practice View of Healthcare IT Coming Out of #HIMSS16

Posted on March 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week as I slowly recover from the #HIMSSHaze that sets in after spending a week with 41,000 of your closest friends and 1300+ vendors, I’m taking a second to think about how the small physician practice fits into the future of healthcare IT that was presented at HIMSS 2016.

As the graphic at the bottom of this post shows, just over 40% of attendees at HIMSS are providers. Of course, provider is a pretty broad term and that has to also be paired with the other number on that chart that 30.5% of attendees are part of the C-Suite. Even scarier is that only 2.2% of HIMSS registrations identified themselves as clinicians.

Those who read this blog regularly likely remember that I already wrote about physicians and patients missing at HIMSS. These numbers seem to prove this out. It’s unfortunate, because that means that the physician voice is largely going to be missing in many of the conversations that happen at a show like HIMSS.

With this in mind, it’s not surprising that I think the future for the small practice is on shaky ground. Many of the solutions presented at HIMSS are going to be hard for a small practice to afford. At some point these health IT solutions will be so good that they’ll become the standard of care. Once that happens, where does that leave the small practice provider who can’t afford these high tech solutions?

Considering many small practices aren’t joining in these conversations, I think it’s going to leave many small practices up a creek without a paddle. No doubt there’s a large portion of the physician population that are betting that retirement will come before this becomes a reality. Others probably think that the worst that could happen is that they’ll have to work for a large organization.

Despite this rather negative outlook on the future of small practices, there is some hope. When you look at the work that Farzad Mostashari is doing at Aledade to make accountable care and valuable based reimbursement available to the small practices you can see a future where small practices can survive even in this changing reimbursement landscape.

I think there are two models that I see emerging to allow small practices to keep some autonomy and survive in this changing healthcare world. First, small practices have to join together with other small practices to be able to create a large enough entity to be able to share in the costs associated with this future technology and to be able to compete with much larger hospital systems. Second, we need organizations like Aledade that help small practices survive by spreading their resources across a diverse group of small practices.

There is strength in numbers. So, whether the small practices form together themselves or whether health IT vendors essentially create a network of small practices, either option requires small practices to combine their efforts in order to survive. It reminds me of this clip from the film Finding Nemo. Small practices need to start “Swimming Together!”

Here’s a look at the registration numbers for HIMSS 2016:
HIMSS 2016 Registrations by Title and Worksite

Providers Must Attest to 2015 EHR Incentive Program Requirements by March 11, 2016 at 11:59 PM EST

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.

The attestation deadline for the Medicare Electronic Health Record (EHR) Incentive Program is only 3 days away!

Eligible professionals, eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program must attest using the Medicare & Medicaid EHR Incentive Program Registration and Attestation System no later than Friday, March 11, 2016 at 11:59 p.m. ET.

Medicaid EHR Incentive Program participants should refer to their respective states for attestation information and deadlines. Certain Medicaid eligible professionals may use the Registration and Attestation System as an alternate attestation method to avoid the Medicare payment adjustment (80 FR 62900 through 62901).

To attest to the EHR Incentive Programs in 2015:

  • Eligible Professionals may select an EHR reporting period of any continuous 90 days from January 1, 2015 (the start of the 2015 calendar year) through December 31, 2015.
  • Eligible Hospitals/CAHs may select an EHR reporting period of any continuous 90 days from October 1, 2014 (the start of the federal fiscal year) through December 31, 2015.

Hyperportalotus: Condition Whereby Patient Has Too Many Healthcare Acquired Portals

Posted on March 7, 2016 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 missed the last day of HIMSS 2016 (which is most of you since the keynote area was pretty empty), you missed a number of interesting keynote sessions and other education sessions. However, as I thought through the sessions that day, this comment from a patient attending one of those sessions really stood out to me:

Based on the reaction of the crowd to this comment and my own experience talking with thousands of doctors and patients, this is a very common problem. Meaningful use encouraged providers to have a patient portal, but this had the unintended side effect of what I’d call portal proliferation.

The patient who commented about her “hyperportalotus” said that she knew that she had portals for most of her providers, but she couldn’t keep track of which provider was on which portal. No doubt she was embarrassed when she couldn’t remember how to log in to that many portals as well. Plus, the last thing any sick person wants to do is go searching through 9 portals to find the one that has the information they need.

What concerns me most about Hyperportalotus is that I don’t think there’s a clear pathway to treating this debilitating problem. There are some treatments that make it better, but the problem still remains and I don’t see a cure for the problem coming anytime soon. Is the government going to come out with a portal non-proliferation treaty? I don’t think so.

Before I get a wave of pitches that you’ve solved this problem, I’ll make it clear that I don’t think the patient being an HIE of one is a scalable solution. That idea might work for some patients, but it won’t work for most. Plus, the complexity of each portal having their own format and design causes so many issues with the concept of the patient being the repository and aggregator of their health information.

I’d love to hear how people think this will play out? We got a bunch of doctors on the portal. Now what?