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Clinical Insights from Social Media Data: Amplifying Patient Voice with Symplur

Posted on May 31, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed

What data from social media can help healthcare organizations?

One of the biggest challenges of online and social data is the sheer volume of unstructured data. Can your physician read all your tweets and postings? Hopefully not. Physicians have data and work overload, a daily report of steps taken from activity trackers or online social media use hurts their ability to treat patients. HealthIT solutions can help process this data and find patterns and changes.

I had a conversation with Audun Utengen about actionable insights into healthcare from his company, Symplur. At Datapalooza he participated in a panel and mentioned the rich amount of patient data that can be found on twitter (shocked gasp followed by a furrowed brow). Symplur signals tracks online engagement.  You can find healthcare insights from conversations really quickly. They provide tools that help healthcare providers get patient insights where they are naturally interacting. There is value in meeting patients where they are, and patients are discussing their healthcare online.

Originally, the assumption was that patients would not say things online. Sensitive topics do not naturally show up in social media use- fewer people are discussing gonorrhea online than receive treatment for gonorrhea. Providers assumed that things which are protected patient information would not show up on twitter. They were wrong. As most social media users know- it’s shocking what people will post online. Not every aspect of health is on twitter but patients want to engage online.  They go to twitter because they want their voices to be heard. They want things to change. They can’t be ignored on twitter. They want their voices to be heard by people in decision-making positions.

Patient’s online discussion have positive impacts on organizations. The key is to be proactive about patient engagement online. Stanford did a study looking about patients’ engagement at conferences. Typically, you will find 1 patient in the top 1 percent of influencers. While this number is low, conferences which have a higher percentage of patients active as top influencers have a greater reach. Want to increase your Healthcare voice and conference audience? Engage patient advocates online. Engaging patients is commercially valuable in amplification. Future patients get more insight as well.  Audun Utengen and I looked at the data from Datapalooza and found that 11 of the top 100 influencers were patients.  That is way ahead of the median number for all healthcare conferences- in 2016 the average number of top influencers that were patients at a conference was one.

“They did a great job giving patients a voice at the conference. I am impressed.”

-Audun Utengen, Co-Founder of Symplur

Healthcare Stakeholder breakdown of the top 100 influencers ranked by the Healthcare Social Graph Score.

Datapalooza had a higher than average reach and a unique blend of participants. Audun Utengen described some of the unique features of the conference:

“The social conversation from the conference was very dynamic. From the 9,366 tweets, 80% included at least one mention. Lot’s of connections were made and we witnessed the typical “flattening of healthcare” that social media is known for by breaking down the barriers between the stakeholder groups. Below is a network analysis graph showing the flattening and the conversational patterns between Twitter account and their healthcare stakeholder groupings.”

Conversations blend between different stakeholders in the healthcare conversation at Datapalooza

The ability for many stakeholders to access information and interact with each other in one place is one of the advantages of twitter. Using hashtags can help stakeholders learn about content about a specific topic quickly. One of the things Symplur is allows is the visualization of keywords surrounding conversations on twitter. When looking at the conversations from Datapalooza the topic of “patients” was very high. Unsurprisingly, “data” is the topic of focus. Patient, Health and Patients rounded out the top conversation topics.

Keyword Frequency Analysis Graph

Symplur Signals have been used for over 200 healthcare studies. They partner with academic research centers seeking more information from online conversations. Companies can also look at competitors in their area and see how they compare. Does a nearby provider have more positive mentions on social media?

Data from online interactions can also give insights into patient health. Social usage has unique implications for mental health. Frequently, online behavior change can predict mental health change. Pediatricians and Providers are in a position to see online behavior in their area and help families understand the implications. If bullying is a problem in your area providers can know their patients will have higher stress levels and provide resources and support. Certain behaviors and even emojis indicate a higher risk of depression. A suicide that will predictably happen based on social data will not show up in clinical records. Listening to what patients want us to hear will help provide greater support.

The sheer volume of social data can mask its usefulness. Online activity and data can be difficult to process for many clinicians. In a world of ever-increasing data and patients reporting everything from steps taken a day to now online behavior many providers have data overload. Data insight tools such as Symplur filter data into a format that allows physicians and systems to use it to improve patient outcomes.

EHR Lifecycle

Posted on May 30, 2017 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.

Far too many organizations look at the EHR go live as the end all be all to EHR implementations. Unfortunately, this fallacy in thinking has caused many EHR implementations to suffer after the EHR go live. The reality of an EHR implementation is that it’s never done.

This was highlighted really well in this graphic that The Advisory Board Company put out about the EHR life cycle. They compare the EHR lifecycle to that of raising a child. The most poignant part of this chart to me are the final 3 phases of the EHR lifecycle which are all after the EHR go live event. These final 3 phases are listed as ongoing. In other words, these final 3 phases will never end.

See the details in the graphic below (click on it to see a larger version):

If you don’t have a process in place to improve your EHR use, performance, and the benefits you receive from your EHR, then you should get one now.

Memorial Day

Posted on May 29, 2017 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’ve probably shared something like this before, but it’s good to always remember. I think the same sentiment is true for many fighting the good fight in healthcare.

Quick EHR Twitter Roundup

Posted on May 26, 2017 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 use to do these types of posts a lot more. Not really sure why I stopped them since so much good information and so many good discussions are happening on Twitter. In these Twitter roundups, I select a few tweets to highlight and then add a few lines of my own commentary. I hope you enjoy. If you don’t like them, I’d love to hear that as well.


We’ve seen a lot of investors get really interested in the EMR and healthcare space. However, once they see the regulations they usually go running. No doubt it’s ripe for disruption and there’s a lot of disatisfaction and poor use of technology. However, most VCs underestimate what it takes to get into healthcare.


I’ll admit that I hadn’t seen an offer like this for a while. We use to see things like this all the time, but most EHR vendors have moved away from selling EHR software to leveraging their current EHR customers. I think that’s part of why we’ve seen the change in marketing. I feel bad for the salespeople still trying to sell EHR. Those that remain certainly have known about EHR and have chosen not to get one and so EHR sales today have to be a real challenge.


I actually don’t think Justin’s suggestion is that daring. However, I expect most doctors would think that it was a daring suggestion. There’s still a lot of resistance to this idea, but patients will continue pushing for it.

What I found more interesting about Justin’s tweet is the idea of a next-gen EMR. We’ll have to cover this in a future post, but I wonder if people think that a next-gen EMR will come along that will replace the current crop of EMR software. Or will the current EMR become a next-gen EMR. I’d love to hear your thoughts on how the next generation EMR will come to be.

Quadruple Aim of Healthcare Infographic

Posted on May 25, 2017 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.

There’s been a lot of talk about the triple aim of healthcare and the need to refocus many of the EHR and healthcare IT solutions on the triple aim. Many of the concepts are really good, but the triple aim is certainly not all encompassing.

This was highlighted really well by this infographic (see below) by Caradigm which suggests a 4th aim that should be added: Improving the work life of health care providers, including clinicans and staff.

The most ironic part of the infographic is the final section which talks about how technology solutions can be used to make providers’ lives better and decrease physician burnout. While I agree that technology solutions could and should help with this problem, the reality is that many of them have just made this problem worse. We could talk about whether the EHR is the whipping boy for regulations, but the EHR definitely is getting the blame for a lot of physician burnout. Will we turn the corner and start seeing technology as an enabler of this 4th aim? Or maybe I should say when will we see this?

Patient Engagement and Patient Experience

Posted on May 24, 2017 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 got tied up on some big projects today and so for today’s post I’m going to point you to some really great resources being shared around patient engagement and patient experience from the Patient Engagement Summit hosted by the Cleveland Clinic.

Here are two images that were shared from the summit which give you a flavor for the types of conversations and knowledge that was being shared at the Patient Engagement Summit.


Note: Adrienne Boissy, MD, MA, noted that the chart above comes from this article.

You can find more great content like this by checking out the hashtag #PESummit on Twitter.

Few Practices Rely Solely On EMR Analytics Tools To Wrangle Data

Posted on May 23, 2017 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.

A new survey done by a trade group representing medical practices has concluded that only a minority of practices are getting full use of their EMR’s analytics tools.

The survey, which was reported on by Becker’s Hospital Review, was conducted by the Medical Group Management Association.  The MGMA’s survey called on about 900 of its members to ask how their practices used EMRs for analytics.

First, and most unexpectedly in today’s data-driven world, 11 percent of respondents said that they don’t analyze their EMR data at all.

Thirty-one percent of respondents told MGMA that they use all of their EMR’s analytical capabilities, and 22 percent of respondents said they used some of their EMR’s analytics capabilities.

Another 31 percent reported that they were using both their EMR’s analytics tools and tools from an external vendor. Meanwhile, 5 percent said they used only an external vendor for data analytics.

According to Derek Kosiorek, CPEHR, CPHIT, principal consultant with MGMA’s Health Care Consulting Group, the survey results aren’t as surprising as they may seem. In fact, few groups are likely to get  everything they need from EMR data, he notes.

“Many practices do not have the resources to mine the data and organize it in ways to create new insights from the clinical, administrative and financial information being captured daily,” said Kosiorek in a related blog post. “Even if your practice has the staff with the knowledge and time to create reports, the system often requires an add-on product sold by the vendor or an outside product or service to analyze the data.”

However, he predicts that this will change in the near future. Not only will EMR analytics help groups to tame their internal data, it will also aggregate data from varied community settings such as the emergency department, outpatient care and nursing homes, he suggests. He also expects to see analytics tools offer a perspective on care issues brought by regional data for similar patients.

At this point I’m going to jump in and pick up the mic. While I haven’t seen anyone from MGMA comment on this, I think this data – and Kosiorek’s comments in particular – underscore the tension between population health models and day-to-day medical practice. Specifically, they remind us that doctors and regional health systems naturally have different perspectives on why and how they use data.

On the one hand there’s medical practices which, from what I’ve seen, are of necessity practical. These providers want first and foremost to make individual patients feel good and if sick get better. If that can be done safely and effectively I doubt most care about how they do it. Sure, doctors are aware of pop health issues, but those aren’t and can’t be their priority in most cases.

Then, you have hospitals, health systems and ACOs, which are already at the forefront of population health management. For them, having a consistent and comprehensive set of tools for analyzing clinical data across their network is becoming job one. That’s far removed from focusing on day-to-day patient care.

It’s all well and good to measure whether physicians use EMR analytics tools or not. The real issue is whether large health organizations and practices can develop compatible analytics goals.

MIPS Eligibility Letters and Physician Reputation – MACRA Monday

Posted on May 22, 2017 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 is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Anshu Jindal has a great post up on the My MIPS Score website that talks about the MIPS Eligibility letters that so many people have been waiting for to know if they are required to participate in MIPS or if they are exempt from participating in MIPS.

Here’s a sample eligibility letter that they shared:
MIPS Eligibility Letter from CMS

There are a number of interesting options available based on if your group TIN is eligible to be included in MIPS or not and if your providers are eligible or not at the NPI level. In the post mentioned above, Anshu does a nice analysis of the financial impact of choosing to participate in MIPS at the TIN level vs the individual provider level or vice versa. The financial impact can be quite large for your organization and so you’ll want to go through that post and see what this means for your practice.

As they also mention in their post, the short-term financial impact of not participating in MIPS could be more than most people realize. However, not having a MIPS composite score could have an even larger impact on your long-term reputation. The more I’ve considered this idea, the more I’ve realized that a lot of practices that choose to opt out of MIPS are going to get blindsided by this.

This is true for those that choose the most basic pick your pace option as well. When a potential future patient sees that you have a very low MIPS score on one of the consumer facing physician rating websites, they’re not going to know how to appropriately assess what a low MIPS composite score means. They’ll naturally (and quite often incorrectly) assume that a low MIPS composite score means that you’re a poor doctor. Most of these rating websites aren’t going to educate their end users on how to properly interpret the MIPS score and your reputation will suffer if you have no score or if you purposefully choose to get a low score.

I know quite a few doctors who are choosing to not participate in MIPS out of principle. In some areas where there is more demand for doctors in their specialty than supply, then it might not be a huge issue. However, in a lot of areas, not participating in MIPS could potentially have a significant impact on your reputation. Sad, but true.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

E-Patient Update: The Kaiser Permanente Approach To Consumer Health IT

Posted on May 19, 2017 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.

Usually, particularly when I have complaints, I don’t name the providers or vendors who serve my healthcare needs, largely because I don’t want to let my personal gripes overshadow my analysis of a particular health IT issue.

That being said, I thought I’d veer from that rule today, as I wanted to share some details on how Kaiser Permanente, my new provider and health plan, supports consumers with health IT functions. Despite having started with Kaiser – in this case the DC metro division – less than a week ago, being an e-patient I’ve had my hands all over its Web – and mobile-based options for patients.

I’m not going to say the system is perfect by any means. There are some blind alleys on the web site, and some problems in integrating clinical information into consumer records, but so far their set-up largely seems thoughtful and well-managed.

Having allegedly spent $4 billion plus on its Epic rollout, it’s hard to imagine how Kaiser could have realized that big a return even several years later, but it seems that the healthcare giant is at least doing many of the right things.

Getting enrolled

My first contact with Kaiser, after signing up with Healthcare.gov, was a piece of snail-mail which provided us with our insurance cards and a summary of our particular coverage. The insurance cards included my health plan ID/medical record number.

To enroll on the core Kaiser site, kp.org, I had to supply the record number, my birth date and a few other basic pieces of information. I also downloaded the KP app, which offers a far-more-elegant interface to the same functions.

Medical appointments

Once logged in, it was easy to choose a primary care doctor and OB/GYN by searching the site and clicking a selection button. If you wished you could review physician profiles and educational history as well as testimonial quotes from patients about that doctor before you chose them.

Having chosen a doctor, booking an appointment with them online was easy.  As with Zocdoc.com, you entered a range of dates for a possible consult, then chose the slot that worked for you. And if you need to cancel one of those appointments, it’s easy to do so online.

Digital communication

I was glad to see that the Kaiser portal allows you to email your doctor directly, something which is less common than you might think. (My last primary care group wouldn’t even put their doctors on the phone.)

Not only that, everyone I’ve talked to at KP so far– three medical appointments, as I was playing catch-up — has stressed that the email function isn’t just for show. My new providers insisted that they do answer email messages, and that I shouldn’t hesitate to write if I have questions or concerns.

Another way KP leverages digital communications is the simple, but effective, device of texting me when my prescriptions are due for a refill. This may not sound like much, but convenience matters! (I can also check med reminders by logging in to a custom KP meds app.)

Data sharing

Given that everyone at Kaiser uses the same Epic EMR, clinicians are of course more aware of what their colleagues are doing than my past gaggle of disconnected specialists. They seem quite serious about reading this history before seeing me, something which past physicians haven’t always done, even if I was previously seen by someone else in their practice.

KP also uses Epic’s Care Everywhere function, which allows them to pull in a limited summary of care from other Epic-based providers. While Care Everywhere has limits, the providers are making use of what they can.

One small wrinkle was that prior to two of my visits, I filled out a questionnaire online and when asked to submit it to my electronic patient record, did so. Nonetheless, I was asked to fill out the same questionnaire again, on paper, when I saw a specialist.

Test results

KP seems to be set up appropriately to share standard test results. However, I’ve already had one test, a mammogram, and in doing so found out that their data sharing infrastructure isn’t quite complete.

After being scanned, I was told that I’d receive my results via snail-mail, in about two weeks. I’m glad that this was a routine screening, rather than a test to investigate something scary, as I would have been pretty upset with this news if I was worried.

My conclusions

I don’t want to romanticize Kaiser’s consumer HIT services. After all, looked at one way, KP is only doing what integrated health systems are supposed to do, and not without at least a few hitches.

Still, at least on first view, on the whole I’m pretty happy with how Kaiser’s interactive functions are deployed, as well the general attitude staff members seem to have about consumer use of HIT tools. Generally speaking, they seem to encourage it, and for someone like me that’s quite welcome.

As I see it, if providers outside of the Kaiser bubble were as married to a shared infrastructure as KP providers are, my care would be much improved. Let’s see if I still if I still feel that way after the new health plan smell has worn off!

Women Executives in Telehealth American Telemedicine Association ATA2017

Posted on May 18, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed

Susan Dentzer, Charlotte Yeh, Janet McIntyre, and Janae Sharp at the American Telemed Women Executives in Telehealth Panel

One of the highlights of the American Telemedicine conference in Orlando Florida was excellent coverage of women in telemedicine and leadership.  They had a panel of women in leadership which focused on promoting women in telemedicine and had the best moderation of a panel I’ve seen at a conference.  Highlights of great advice for women in HealthIT were from that panel, and from speaking with women that were tasked with going to the conference as buyers in the telemedicine space.

Charlotte Yeh acted as moderator of the panel. She framed what the panel would cover and what they were not concerned with. She mentioned that we would not cover work life balance since that also applies to men and has been covered on many platforms.  Framing a conversation within the conference and healthcare setting made a huge impact.  Promoting women in telemedicine and HealthIT needs to have a specific framework.

Susan Dentzer, President and CEO of the Network for Excellence in Healthcare innovation suggested making an award for advancing women in leadership in Telehealth.  I’m a huge fan of medals for participation. Every day I get up and when I work out I suspect that I deserve a medal.  The medals for best contribution for advancing women next year should be an amazing ceremony at ATA.

Susan quoted Madeline Albright that “there’s a special place in hell for women who don’t support other women.” Think deliberately about creating something you want to be a part of. This year I’ve personally seen Max Stroud of Doyenne Connections simply create something she wanted to be a part of.

Julie Hall-Barrow invited leaders to find a young woman and become their mentor. Some of the women in leadership in healthcare are happy to promote other women but the promotion seems more strategic than like actual concern. Leaders should purposefully craft their ideal mentor relationship. ATA discussed creating a group dedicated to what women and companies in the telemedicine space would like to do with collaboration.

Paula Guy, when asked what she would tell a younger self, said “first of all I would tell myself not to get married so many times.” Her advice was hilarious and focused on not letting people tell you no. There is a power in knowing what you are capable of and surrounding yourself with other women who are also in that space. Paula’s advice was also to be part of a group that promotes mentors and other women working together.

Kristi Henderson spoke about not being afraid to push boundaries. Never settle until you get where you want to go. The advice and positive belief that women are capable of breaking through boundaries and leveraging their social connecting makes women poised for success despite being underrepresented.

Janet McIntyre, The Vice President of Professional services of the Colorado Hospital association, decided to approach Patrick Kennedy about coming to Colorado to help with the opioid epidemic there. He shared his family story and personal conviction about making a difference and Janet decided to invite him to help with her state.  Women need to be fearless in their ask and expect that people will want to help them succeed.

Rachel Dixon, director of Telehealth for AccessCare services, pointed out that women should have a safe space to discuss gender issues in their work. We can create a place to discuss which companies are working well with women in the telemedicine space and which ask about an older man partner or lack professionalism. I shared a story with her about a potential employer asking if he should consider my job only a work proposition.  Gender issues for a younger woman in leadership can be complex in navigating personal relationship. A soft intelligence network about how a company treats women is valuable for investors and employees.

I was impressed with the positive planning of women in healthcare leadership in telehealth. The thought leadership at this conference was one of the best organized in terms of giving organizations and individuals actionable plans for increasing female technology talent in leadership positions.