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When Scribes Don’t Pay Off

Posted on June 30, 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.

Since scribes first hit the scene, there’s been a lot of debate about the benefits of having them in place, as well as what duties they should handle.

Critics have suggested that using scribes only sidesteps the need to look at larger industry issues. On the other hand, some physicians have found scribe support to be a big relief. Many have reported that scribes have reduced their paperwork and reestablished their face-to-face connection with patients.

Those happy doctors include Peter Leavitt, primary care physician with Bend, OR-based St. Charles Family Care. Dr. Leavitt told a local newspaper that using the scribe cut the two hours per day he spent entering notes into the EMR by 40 percent.

But Leavitt won’t have scribes available much longer. St. Charles Health System, the PCP practice’s parent organization, has decided to drop scribe support for primary care offices on July 1st. The health system said that the $480,000 it invested in scribes didn’t produce enough benefits to justify the expense.

Starting in spring of last year, St. Charles has gradually brought a total of 20 scribes on board.  In an effort to test out their impact, the system brought scribes to only four of the clinics.

St. Charles hoped that rollout within the primary care practices would boost physician morale, increase patient throughput and give doctors time to improve their chart notes and documentation. As it turned out, however, adding the scribes didn’t accomplish what execs had hoped.

Yes, the roughly 20 doctors who used scribes seem to be happier once they came on board. But the scribe experiment seemed to fail by other measures. The clinicians were only able to see one-half patient more per day, which didn’t meet execs’ expectations. What’s more, documentation didn’t improve, in part because scribes can’t perform key functions like ordering tests, Leavitt suggested.

What’s more, the health system ran into some unexpected obstacles. In particular, some patients refused to let scribes stay in the exam room, and others would only share private information with the doctor once the scribe left the room.

It’s impossible to say whether the results seen by St. Charles would be duplicated elsewhere. After all, there are a ton of potential confounding factors which could have influenced the results of this trial, including the nature and level of training the scribes had received and the extent to which the clinics‘ existing processes could support workflow improvement.

Though we’ll never know for sure, it could be that if the scribes had a better education or the workflow around documentation was improved, St. Charles would have gotten better results. And it could be that the EMR is so hard to use that even scribe use couldn’t put a dent in the problem.

Regardless, we don’t need to know much to conclude that the health system may have significantly undervalued the benefits of physician satisfaction. I don’t know what dollar value execs assigned to the happiness of doctors, but even a raw number based on physician recruitment costs and the time needed to train them on your EMR would might capture such benefits.

Meanwhile, I’d argue that the metrics St. Charles used to measure scribe value – patient throughput and improved documentation — may or may not be the best way to approach the problem. I’d love to see a similar pilot rolled out which measures success strictly by patient and doctor satisfaction levels.  After all, you can’t lose by making physicians and patients happy.

Artificial Intelligence in Healthcare Series: Women in Technology

Posted on June 29, 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

Meeting with Lauren Hayes, the model behind Amelia, an AI cognitive agent.

What I Learned from Lauren Hayes: the Face of Artificial Intelligence.

This month I was invited to a workforce summit with companies interested in Artificial Intelligence (AI) cognitive agents in New York City. I had the opportunity to hear from great thinkers about AI, including research about workforce transformation from the McKinzie institute. I also met Lauren Hayes, the face behind Amelia, a cognitive agent for IPsoft specializing in customer experience.

Michael Chui – Partner at the McKinsey Global Institute.

One of the most impactful things for me personally was Lauren’s perspective about women in technology. Lauren has worked as a partner for a Jacaranda Ventures focusing on early stage startups, and served as an executive and communications expert, as well as being a model for Wilhelmina models. As a veteran of the technology space Lauren commented on male dominated events  “One of my past jobs as a Director of Communications & PR included hosting events that typically ended up being 90% male. The audience was comprised of our investors, partners, and C-level business development folks. It’s always sad when there’s no line for the women’s restroom.”  Her  grace in dealing with the dynamics taught me two valuable lessons: Be fiercely positive and seek out your people.

Today Lauren works in technology as a Founder at Ritual and the face of a cognitive agent that interfaces with customers for several industries, (patients for a healthcare system.) What does current customer experience look like? In my experience- not great. There is a definite need to improve the experience for patients online and many companies and healthcare systems have solutions that help improve outcomes and cost.  My personal strategy? Get on the phone and press as many buttons as I can, while hoping a real human comes on the line since I don’t remember my insurance ID number. Or my account number with the power company.

Lauren is part of the future of healthcare as AI automates repetitive tasks. A little background on the potentials and current benefits can start with the patient as a consumer. Many healthcare companies use an automated system when a patient calls with medical questions or personal patient information. They may want a copy of their records and need identity confirmation or need to know if they should make an appointment with a doctor or go to a local emergency room. These questions can be answered through digital tools and phones.

Systems can range in sophistication from a series of recordings to a chat bot to an artificial intelligence cognitive agent and a human with highly specialized training and clinical knowledge. Not to brag, but at one of my jobs the company asked me to be the voice for their system so I can relate to being the face of AI. A cognitive agent can use artificial intelligence technology and interact with a clinical framework to help patients get great care. This can be paired with the clinical bounds of a program like Health Navigator and use natural language processing to help patients get appropriate support quickly and in the context of their personal history and insurance or healthcare information. Adoption and development of these technologies will see huge positive impact on patient outcomes and security.

I interacted with Lauren on twitter before the conference to discuss working as a woman in tech. The thing that struck me meeting her was her grace. Some people have powerful positive energy and I wonder how we can teach that type of interaction to a machine learning system. We can teach a system to have an asymmetrical appearance like humans. Artificial intelligence engines are learning to identify customers by voice and appearance. The human experience in medicine is also about presence and connecting us digitally. I asked Lauren what she thought about working with Amelia, and about being a woman in Technology. Mainly I wanted to understand the way she has established expectations and boundaries.

Janae: What is it like working in technology as a woman?

Lauren: This is not specific to one of the roles I’ve held particularly, whether at IPSoft or any of my other jobs, however, I think in some of the male dominated industries, there’s a feeling as though you have to prove yourself and get over the “female hump” before a conversation with someone who expects to be talking to another man. I’ve had past jobs that bred a bit of a “bro” culture, where there are no women in high-level positions and I think that really trickles down and impacts the rest of the culture. It goes without saying that I’ve also overheard and been part of situations where sexist comments were made, or where visitors of the company assumed the first girl they saw was an assistant/office manager, etc.

Janae: What do you wish men understood about being a woman in tech?

Lauren: “That the same way racism is still rampant in the US, the same goes for sexism. Even when there’s not overt instances or actions that are clearly offensive, there are small, every day micro instances of things that are said under the breath or actions that are hard to prove clear wrongdoing that still add up and take a toll over a period of time.”

Janae: What do you love about working with Amelia?

Lauren:  “I think Amelia can potentially have such a positive impact on the workforce and ultimately world. After all, to date, she’s the most sophisticated AI in history. Throughout history we’ve changed our jobs to leverage technology. AI is going to do that too. I heard a lot of the execs presenting at the conference talking about how they are changing the structure of their teams in order to have Amelia take on a lot of the high volume repetitive queries and let their staff evolve to take on more exception cases that help them have more interesting conversations with customers. I think most of us would prefer to spend our time on tasks we find challenging and rewarding and less on repetitive chores. That idea of freeing up our day to spend more time doing things we love really appeals to me.”

Overcoming general fatigue from interactions that question credibility based on gender can be hard to grasp. Repetitive music and actions that themselves are harmless have been weaponized into torture. Constant references about appearance can be difficult. Talking to Lauren about women in technology was positive. For women, the sum is greater than it’s parts. The result for providers can be burnout or a lack of empathy for patient requests.

Artificial intelligence will restructure workforce roles and take some of the stress of repetitive tasks and recording. Building positive interactions while filtering through repetitive actions that lead to burnout can provide better support. Physician time can be used for helping and connecting on a personal level. I was grateful for the time I had discussing women in technology and the future. Establishing boundaries in workforce interactions can be like structuring the bounds of a healthcare customer service system. Creating purposeful positive interactions improves the system. Be fiercely positive to other women in technology.

Everything Old is New Again at Lenovo #HIThinkTank Event

Posted on June 28, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week in Durham NC, 35 healthcare innovators gathered at the Lenovo offices to discuss three trendy topics: Value-base care, connected health and virtual care. Dubbed the Health Innovation Think Tank #HIThinkTank, it was the first summit-style event hosted by Lenovo Health.

#HIThinkTank was designed to be an opportunity for audience members to learn about the latest innovations from leading academics, technology companies and healthcare organizations. I went into the event expecting to hear about the latest in artificial intelligence, big data, predictive analytics and genomic medicine. It did not turn out to be that kind of event…and it was all the better for it.

I would say that the overall theme of #HIThinkTank was innovation through the application of old ideas in new ways. In other words, everything old is new again in healthcare.

The day started with Rasu Shrestha MD, Chief Innovation Officer at UMPC Enterprises, emphatically stating that we are “in a time of tremendous opportunity in healthcare” and that it was “time for us to move from ‘doing digital’ to truly ‘being digital’”. Shrestha went on to explain that our challenge now was to reimagine clinical processes/workflows in light of modern technologies and methodologies. Like the re-engineering wave that swept through manufacturing in the 1980s, Shrestha believes it’s time to engage all stakeholders and collaborate on reworking healthcare.

Shrestha was followed by Juliet Silver of Perficient who gave us all a dose of reality by telling her personal healthcare story. The day Silver’s husband was diagnosed with cancer was the day she became an advocate – “Google searching and academic research quickly became my constant companions as we struggled to make sense of his disease.” Silver made specific mention of how she had to manually obtain paper copies of her husband’s medical records in order to share them with members of his care team and what a difference that made in his care. She hinted that patients may be the key to truly solving healthcare’s interoperability problem as they are the one stakeholder with the most to lose/gain.

After Silver, several speakers made their case for a return to a more community-based approach to healthcare – one that harkens back to the days of early pioneers when physicians, nurses and members of the community worked together to keep each other healthy.

Holly Miller MD of MedAllies presented the results of a local implementation of CMS’s Comprehensive Primary Care Plus (CPC+) program – a program that stressed simple post-discharge follow-up as a way to reduce readmissions and keep overall healthcare spending to a minimum. Miller specifically mentioned how community doctors do this all the time.

This was echoed by Marty Fattig, CEO of Nemaha County Hospital, a 16-bed facility 60 miles south of Omaha NE. Fattig spoke at length about the successful EHR, HIE data sharing and population health initiatives by his staff. Particularly noteworthy was his repeated statement: “We may not have the financial or technical resources of the large networks, but we get stuff done because we are all driven to improve the health of our community peers. It makes a big difference that we see our patients at church, at the grocery store and at the post office.” Ironically this old fashioned community approach to delivering healthcare is now the goal of many healthcare organizations.

In the afternoon Steve Aylward of Change Healthcare and Dr Sylvan Waller led the discussion on virtual care by first reminding the audience that over 90% of virtual visits still happen via the phone. Video consults is the fastest growing area of virtual care, but it has a long way to go to catch up to the telephone. Dr Waller said it best “In 30 years #telehealth will finally become the overnight success everyone expects it to be”. Both Aylward and Waller stressed that we cannot lose sight of these “older technologies” that work for patients when we think about innovation.

For me, what drove home this theme of old-is-new-again was the afternoon tour of the Lenovo model data center. This new highly efficient and “green” room prominently featured Lenovo’s latest innovation – direct water-cooled servers. The new NeXtScale WCT server series boasts high pressure water lines that physically run through the server and draw heat directly away from the quad CPUs. Back in the early 90’s I remember getting a tour of an IBM facility (not far from Lenovo’s facility in Durham) that still had a functioning 308X mainframe that featured…you guessed it…water cooling technology.

All in all, I walked away from #HIThinkTank feeling encouraged about the future of healthcare. It was refreshing to be at an innovation event and hear about actual successful implementations rather than pie-in-the-sky promises. The event reaffirmed my belief that technology alone is insufficient to fix healthcare. Those of us in HealthIT need to do more than just create cool products, we need to help clients re-engineer their internal processes to better utilize those products to improve community health.

As Dr Shrestha said – It’s time for us to stop doing digital and truly be digital.

New Research Identifies Game-Changing Uses For AI In Healthcare

Posted on June 27, 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.

In recent times, the use of artificial intelligence technology in healthcare has been a very hot topic. However, while we’ve come tantalizingly close to realizing its promise, no application that I know of has come close to transforming the industry. Moreover, as John Lynn notes, healthcare organizations will not get as much out of AI use if they are not doing a good job of working with both structured and unstructured data.

That being said, new research by Accenture suggests that those of us dismissing AI tech as immature may be behind the curve. Researchers there have concluded that when combined, key clinical health AI applications could save the US healthcare economy as much $150 billion by 2026.

Before considering the stats in this report, we should bear Accenture’s definition of healthcare AI in mind:

“AI in health presents a collection of multiple technologies enabling machines to sense, comprehend, act and learn, so they can perform administrative and clinical healthcare functions…Unlike legacy technologies that are only algorithms/tools that complement a human, health AI today can truly augment human activity.”

In other words, the consulting firm sees AI as far more than a data analytics tool. Accenture analysts envision an AI ecosystem that transforms and serves as an adjunct to the many healthcare processes. That’s a pretty ambitious take, though probably not a crazy one.

In its new report, Accenture projects that the AI health market will reach $6.6 billion by 2021, up from $600 million in 2014, fueled by the growing number of health AI acquisitions taking place. The report notes that the number of such deals has leapt from less than 20 in the year 2012 to nearly 70 by mid-2016.

Researchers predict that the following applications will generate the projected $150 billion in savings/value:

  • Robot-assisted surgery: $40 billion
  • Virtual nursing assistants: $20 billion
  • Administrative workflow assistance: $18 billion
  • Fraud detection: $17 billion
  • Dosage error reduction: $16 billion
  • Connected machines: $14 billion
  • Clinical trial participant identifier: $13 billion
  • Preliminary diagnosis: $5 billion
  • Automated image diagnosis: $3 billion
  • Cybersecurity: $2 billion

There are a lot of interesting things about this list, which goes well beyond current hot topics like the use of AI-driven chatbots.

One that stands out to me is that two of the 10 applications address security concerns, an approach which makes sense but hadn’t turned up in my research on the topic until now.

I was also intrigued to see robot-assisted surgery topping the list of high-impact health AI options. Though I’m familiar with assistive technologies like the da Vinci robot, it hadn’t occurred to me that such tools could benefit from automation and data integration.

I love the picture Accenture paints of how this might work:

“Cognitive robotics can integrate information from pre-op medical records with real-time operating metrics to physically guide and enhance the physician’s instrument precision…The technology incorporates data from actual surgical experiences to inform new, improved techniques and insights.”

When implemented properly, robot-assisted surgery will generate a 21% reduction in length of hospital stays, the researchers estimate.

Of course, even the wise thinkers at Accenture aren’t always right. Nonetheless, the broad trends report identifies seem like reasonable choices. What do you think?

And by all means check out the report – it’s short, well-argued and useful.

2018 QPP Proposed Rule: What it Means for MIPS & Quantifying the Impact on Specialty Practices – MACRA Monday

Posted on June 26, 2017 I Written By

The following is a guest blog post by Justin Barnes, Board Advisor at iHealth Innovations. This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

The Centers for Medicare and Medicaid Services (CMS) recently released a Proposed Rule highlighting recommended updates to the 2018 reporting period of the Quality Payment Program (QPP). Like flexibilities extended in 2017, the proposal seeks to further reduce reporting burdens on small practices and rural providers in the program’s second-year reporting period.

Merit-based Incentive Payment System (MIPS) reporting track updates include:

  • Increased low-volume exemption thresholds (<200 patients or <$90,000 in payments)
  • New virtual group options for solo practitioners and groups with 10 or fewer Eligible Clinicians
  • Extending “pick your pace” flexibilities into 2018
  • Postponing introduction of the Cost category to MIPS composite scores
  • Factoring MIPS performance improvements into quality scores
  • Permissions for facility-based providers to report through the facility where they do most of their work instead of the practice
  • Permitting the use of 2014 CEHRT in 2018 reporting

The Rule introduces new MIPS bonus point opportunities for:

  • The use of 2015 CEHRT
  • The care of complex patients

Recommendations also extend small practice relief including:

  • Up to 5 bonus points for practices with 15 or fewer Eligible Clinicians
  • Hardship exemption for Advancing Care Information category measures
  • Additional points on Quality measures that don’t meet completeness requirements

Comments on the Proposed Rule are due by August 21, 2017. Physicians have until October 2, 2017, to begin collecting performance data for the inaugural 2017 MIPS reporting period.

Calculating MIPS: The Financial Impact on Specialty Practices

Results from a crowdsourced survey fielded by Black Book Research among nearly 9,000 physician practices from February through April of 2017 reveal that 94 percent of physician participants were unaware or unsure of how to predict their 2017 MIPS performance scores. Seventy-seven percent of practices with three or more clinicians reported intentions to purchase MIPS compliance technology solutions by the fourth quarter of this year, largely driven by an inability to independently determine earning potential under MACRA.

Orthopedics, cardiology and radiology are among the highest incentivized specialties under MIPS. To help specialty practices quantify the fiscal impact MIPS poses, we evaluated average Medicare earnings by specialty to establish the MIPS calculations below. These estimates are based on bare minimum earnings and losses that could be greater for practices with larger Medicare patient populations and/or more physicians. (Calculations are strictly illustrative estimates.)

Cardiology Practices
Estimated average payment adjustment for a 5-clinician cardiology practice in 2019 alone: $43,601
Number of cardiology-specific QPP measures: 20

Orthopedics Practices
Estimated average payment adjustment for a 6-clinician orthopedics practice in 2019 alone: $34,603
Number of orthopedics-specific QPP measures: 21

Radiology Practices
Estimated average payment adjustment for a 6-clinician radiology practice in 2019 alone: $30,117
Number of radiology-specific QPP measures: 22

Note: The above projections assume the full incentive and penalty will be paid out as outlined in the MACRA law. However, the positive and negative payment adjustments will be scaled so the program is budget neutral. This means that the positive payment adjustments will have to be offset by penalties.

Navigating the Transition to MIPS
As clinicians prepare for reporting under MIPS, establishing specialty-specific expertise on financial, clinical and technical objectives can help practices thrive rather than just survive.

Tips as you for prepare for MIPS:

  • Know your reporting options and pick your path.
  • Choose measures that play to the strengths of your specific specialty practice. Review your current billing codes and Quality and Resource Use Report to help determine these areas.
  • Do a technology asset inventory to make sure you can track the required CQMs.
  • Customize your EHR for track your selected measures or ID an outsource vendor to assist.
  • Work towards minimum reporting requirements to avoid a penalty with a stretch goal to report on the full required measures to maximize positive adjustment earnings potential.

Additional resources:
QPP website
An overview and support documentation is available at the CMS QPP website here.

MIPS EDU Program
A new “Quality Payment Program in 2017: Pick Your Pace Web-Based Training” course with Continuing Education Credit is available through the Learning Management System. Learn more here.

2017 CMS-Approved Qualified Clinical Data Registries
Additional specialty-specific measures are available via approved 2017 QCDRs to meet MIPS reporting requirements. Options for cardiology, radiology and orthopedic practices are included. Learn more here.

About the Author:
Justin Barnes is a nationally recognized business and policy advisor who serves as Chairman Emeritus of the HIMSS EHR Association as well as Co-Chairman of the Accountable Care Community of Practice. As Board Advisor with iHealth, Justin assists providers with optimizing revenue sources and transitioning to value-based payment and care delivery models. Justin has formally addressed Congress and the last three Presidential Administrations on more than twenty occasions on the topics of MACRA, value-based medicine, accountable care, interoperability, consumerism and more. He is also host of the weekly syndicated radio show “This Just In.” Justin can be found on Twitter at @HITAdvisor.

Doctors without Planets – Doc Vader

Posted on June 23, 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.

The incomparable ZDoggMD has been creating a whole series of videos for his alter ego’s alter ego, Doc Vader and has even launched a website for Doc Vader. There are some really funny videos and a lot of them touch on healthcare IT.

The latest Doc Vader video is called Doctors Without Planets:

What’s amazing is that the Doc Vader character actually came out of a sponsored video that ZDoggMD did with Dr First. Here’s the Doc Vader, Episode 1: The Pager Menace video that started the character:

Happy Friday everyone and thanks to ZDoggMD for putting out such funny content.

Is Your Health Data Unstructured? – Enabling an AI Powered Healthcare Future

Posted on June 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.

If you asked a hospital IT executive how much of their data is unstructured data, most of them would reasonably respond that a lot or most of their data was unstructured. If you asked a practice manager or doctor how much of health data is unstructured, they’d likely respond “What do you mean?”

The reality is that most doctors, nurses, practice managers, etc don’t really care if their data is structured data or not. However, they should care about it and more importantly they should care about how they’re going to extract value out of the structured and unstructured data in their organizations.

The reality in healthcare, as the above tweet and image point out, is that much of the data we have and are going to get is going to be unstructured data. Our systems and software need to handle unstructured data in order to facilitate the AI powered healthcare future. That’s right. An AI powered healthcare future is coming and it’s going to be built on the back of structured and unstructured healthcare data.

I think the reason so many healthcare providers are concerned with this AI powered future is that they know the data they currently have is not very good. That’s going to be a problem for many organizations. Bad data is going to produce bad AI powered support.

We shouldn’t expect technology to solve our problems of bad data but, technology will amplify the state of your organization. If your organization is doing an amazing job creating high quality health data, then the AI powered future will propel you in amazing ways to be an even better organization. However, the opposite is also true. If your health data is poor, then these new AI powered systems are going to highlight how poorly your organization is being run. I get why that’s scary for many people.

This should be one of the big lessons we take away from the EHR experience. Healthcare organizations with poor workflows hoped that implementation of an EHR would help them fix their workflows. Instead of EHR fixing the workflows it just highlighted the poor workflows. Technology accentuates and accelerates your current state. It doesn’t usually fix it. You have to fix your organization and workflows first and then use technology to accelerate your organization.

The next step after that is what Rasu Shrestha highlighted when he said, “How can we move from ‘doing digital’ to ‘being digital’. Let’s not replicate analog workflows. Let’s rethink!”

5 Stages of Provider Dissatisfaction and Happiness

Posted on June 21, 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.

A couple weeks ago I posted an infographic on the 5 stages of patient frustration and the 5 stages of patient satisfaction. This week SCI Solutions came out with a new infographic which looks at the 5 stages of provider dissatisfaction and the 5 stages of provider happiness.

It was interesting that the infographic focused so much on the pains of prior auths. I agree that this is extremely painful for doctors and definitely leads to a lot of dissatisfaction. However, I’m surprised that they didn’t include the EHR and other regulations related to the EHR in their list of provider dissatisfaction. I’m sure EHR and prior auths would fight a good fight as to which is more annoying to doctors.

As for the provider satisfaction, the infographic focused so much on easy access to the right information. I agree that’s a valuable thing, but the most valuable thing is doctors getting quality time that helps their patients. We need to facilitate more of that in healthcare.

A Tribute to Larry Weed

Posted on June 20, 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 must admit that I didn’t really know about Larry Weed until in 2013 I saw Neil Versel interviewing him at HIMSS. I’d been getting to know Neil Versel pretty well at this point and I saw him hit the press room full of energy and totally engaged with a man who was 89 years of age. I was new to the press room then, but I now know well the look Neil gets when he has a good interview. It’s how he looked at HIMSS 2013 when I saw him interviewing the 89 year old Larry Weed.

After the interview, I was talking with Neil and he recounted to me that he’d just been able to interview Larry Weed. I could tell that this was a real highlight for him and that he was honored by the opportunity. This month, Larry Weed passed away and Neil Versel offered up this great tribute to Larry Weed’s work.

I love this Larry Weed quote that Neil shared in his tribute:

“The worst, the most corrupting of all lies is to misstate the problem. Patients get run off into the most unbelievable, expensive procedures … and they’re not even on the right problem,” Weed said during that memorable presentation in New Orleans.

“We all live in our own little cave. We see the world out of our own little cave, and no two of us see it the same way,” he continued, explaining the wide deviation from standards of care. “What you see is a function of who you are.”

We should all take a week or so to think about the most corrupting lie of misstating the problem and how our own experiences corrupt our views.

I also didn’t know that Larry Weed was possibly one fo the founding father’s of patient empowerment. As Neil notes:

Indeed, it could be argued that Weed was a founding father of patient empowerment. Back in 1969, Weed wrote a book called “Medical Records, Medical Education, and Patient Care.” In that, he said, “patients are the largest untapped resource in medical care today.”

Larry Weed also co-developed an early EMR and the SOAP note was his idea.

I often don’t think that those of us who take healthcare IT and EHR for granted today realize the rich history and evolution of technology in healthcare. Thanks Neil for sharing a small glimpse into that history and honoring a man who was an important part in it.

Everyone should take 2 minutes and go and read Neil Versel’s full tribute to Larry Weed.

MACRA Video Training – MACRA Monday

Posted on June 19, 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.

I did a quick search on YouTube for the term MACRA and it found 23,300 search results. It’s not surprising to find so much MACRA content. It seems to me that healthcare has an insatiable appetite for MACRA information.

While it’s great that so many organizations are producing MACRA content, no doubt some of it is not all that valuable and a bunch of it isn’t accurate. Case in point, the first video returned in the YouTube search for MACRA was a video from eClinicalWorks (eCW). Is there anyone that would want eCW to train them on government regulations after the recent eCW settlement that revolved around their decision to not properly certify their EHR and the meaningful use program? Maybe all the information is accurate, but that’s not where I’d go to for my source of MACRA information.

If you wanted a really brief, high level overview of MACRA, I found this 2 minute cartoon video from MediSync to be a nice intro to the intent of MACRA:

If you want a much more in depth look into MACRA’s MIPS program, you’ll want to check out Answers Media’s 25 videos in their The ABCs of MIPS series:

We all know that the government MACRA website is the first place to go for really high quality MACRA information. Do you have another go to source for your MACRA information that we should know about? Let us know in the comments.