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Healthcare Waiting Room Cartoon – Fun Friday

Posted on September 15, 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.

It’s late on a Friday and so you know that means it’s time for a Fun Friday blog post. What we do in healthcare is extremely serious, but we shouldn’t take ourselves too seriously. Plus, there’s nothing like a great cartoon to point out the absurdity of some of the things we see happening in healthcare.

This first healthcare cartoon is a sad look at the waiting room, but with a subtle joke about how long health reform takes as well.

I’ll leave the health reform stuff to other people. However, the waiting room issues are something that technology can help alleviate.

This next cartoon says Healthcare, but I think it applies to a lot of healthcare IT as well:

Happy Friday everyone! Have a great weekend!

EHR Medical Malpractice Risk

Posted on September 14, 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.

In an article by Gabriel Perna, he highlighted 5 ways the EHR has become a medical malpractice risk:

You should read the whole article to see more details on each of the 5 risks, but here’s the summary list:

  1. Copy and Paste
  2. Use of Templates
  3. Alert Fatigue
  4. Clinical Decision Support Alerts
  5. Missing Information

As the article notes, EHRs aren’t currently involved in most medical malpractice cases today, but there’s a huge potential for that to change. Gabriel hightlights some ones that are worth considering, but I thought it was interesting that his list includes using the EHR incorrectly or the EHR failing you in some way. His list doesn’t include people who choose not to use one.

Certainly, it’s not the case today that using an EHR is considered medical malpractice, but will it get there?

I believe that it will. I think that the EHR and the associated smart systems that will be bolted onto the EHR will become the standard of care that’s required of doctors that are seeing patients. I see this as similar to a doctor negligently failing to order the appropriate tests for a patient and therefore delaying diagnosis. I think we could see the same thing happen with a doctor who doesn’t use the EHR and related tools and therefore doesn’t identify the correct diagnosis when they could have if they’d used the technology.

No doubt malpractice related to the use or non-use of technology like EHR software is just getting started. That’s why there aren’t many EHR related malpractice cases yet, but I have little doubt they’re coming.

What are you doing in your practice to minimize your EHR medical malpractice risk?

How Does Age Impact Patient Satisfaction?

Posted on September 13, 2017 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

If you walked into the average medical practice on any given day, you would see patients ranging in age from 1 to 101. Understanding and adapting to the needs of such a diverse group of patients is challenging. Many offices are struggling with this, and patient dissatisfaction is at an all-time high.

In the Patient-Provider Relationship Study, recently commissioned by Solutionreach, researchers found that one in three patients are likely to switch practices within the next couple of years.

The question is why. What is happening to patient loyalty? And more importantly—what can medical offices do to stem the tide?

In addition to studying patient switching preferences, the study also examined the dynamics of generational satisfaction and preferences, posing the following questions:

  • What impact does age have on patient satisfaction and retention?
  • What role does it play in patient loyalty?
  • Which services create satisfaction for the different generations?

A Closer Look at How Age Impacts Patient Satisfaction

To better understand how age impacts patient retention, it is important to take a closer look at the results from each of the key age groups.

  1. Millennials—Satisfaction levels among the youngest cohort were dismal. Millennials are the least satisfied with all aspects of the practice, including the doctor, office team, and practice logistics. In fact, a stunning 81 percent say that they are not completely satisfied with their medical office. Unsurprisingly, millennials are also extremely likely to switch practices in the upcoming years. Nearly half—46 percent—of millennials say they will probably move on to a new medical practice in the next couple of years.
  2. Gen X—The satisfaction levels of Gen Xers lies somewhere between millennials and boomers. The numbers are still concerning, however. Two out of three Gen Xers are not satisfied with their medical office. Around 35 percent say they will probably change practices in the near future.
  3. Baby Boomers—While millennials are three times more likely to switch providers than boomers, there are still a significant number of unhappy patients in this demographic. Nearly 60 percent of boomers are not completely satisfied with their medical office and one in five will switch practices in the near future.

Regardless Of Age—Technology Boosts Patient Satisfaction

It’s easy to assume that everyone who moves on to a new practice does so because they move or change insurance providers. The truth is a growing number are switching for other reasons.

Why are they so dissatisfied?

Picture the average patient in your mind. What characteristics about them have changed over the past few decades?

The biggest thing is that we have become unbelievably attached to technology—it’s rare to find any of us without either a phone, tablet, or computer. We use technology for virtually everything.

This is the area in which medical practices are struggling to keep up. Solutionreach’s study found that this is the exact category in which patients are least satisfied with their medical office. This is true regardless of age. Millennials, Gen Xers, and baby boomers all want more technology.

The biggest gap between what patients want and what medical practices offer is around texting. Texting has been the most used form of communication for over a decade now, but according to the survey less than 30 percent of practices offer any texting options. Today, every office should be able to:

  • Send a text—94 percent of millennials and 87 percent of Gen Xers want to receive texts from your office. But it’s not just the “youngsters.” Two out of three baby boomers also want you to text them.
  • Receive a text—While some offices have started sending out reminder texts, far fewer actually have the ability to have a patient initiate text messaging through the office number. Eighty-seven percent of millennials and seventy-nine percent of Gen Xers say that they want to be able to text their doctor. Once again, boomers are also on board—58 percent say they want to send a text to their medical practice.

Today’s patient lives are completely intertwined with technology. Medical practices will need to adapt to using technology in new ways to connect with patients or risk losing one in three patients in the coming two years.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff. Learn more about the Patient-Provider relationship survey here.

Challenging Physicians’ Digital Health Fears

Posted on September 12, 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.

Like you, I thought I’d read everything about the reasons some doctors struggle with adopting digital health. Then, the following article showed up on my radar. While it covers some familiar ground, it’s a fairly nuanced take on physician objections to integrating digital health into their practice.

The article, “Top 10 Reasons Doctors Fear Digital Health,” comes from Brennan Spiegel, MD, MSHS, a gastroenterologist and co-creator of the MyGiHealth app.  Given his digital health involvement, he obviously has a dog in the fight, but to my mind, that doesn’t detract from the value of what he had to say.

All ten of his observations make sense, but in the interests of brevity I’ll pick out a few that I found particularly interesting. Below, I’ve summarized some of the concerns expressed by his colleagues, then shared a condensed version of his responses:

“Use digital health devices in my practice? How the world will I have time to check all the data?”

His response:  We need to train a new type of specialist called a “digitalist” who will monitor, interpret and act upon remote patient data. They will reside in an e-coordination facility and remotely track data from biosensors, portals, apps and social media. (EDITOR’S NOTE: To see how an e-coordination center works today, check out this piece on the Mercy Virtual Hospital.) Their job will be to combine the data with clinical parameters and knowledge about the patient’s medical history then act on what they’ve learned.

* “What is my legal liability here? What if remote data show that somebody is doing poorly, but nobody checks it? What if the patient dies when there was clear evidence something bad was going to happen?”

His response: Until you have a digitalist watching your back, you cannot take responsibility – including legal responsibility – for monitoring, interpreting and acting upon the data. As I see it, that will be the digitalist’s responsibility.

* “Digital devices are cool, but most people quit using them before long. How could digital health make any difference if our patients refuse to use the stuff?

His response: To make inroads with chronic illnesses like diabetes, heart failure or obesity, we need to change behavior. One way to achieve this comes from Joseph Kvedar at Partners HealthCare. Dr. Kvedar’s team not only personalizes its apps but hyper-personalizes them. By integrating everything from the time of day, step counts, local weather and levels of depression or anxiety, these apps can send pinpoint messages to patients at the right time and place. This approach may work to foster behavioral change.

* “How will digital health improve the value of care? Can it both improve outcomes and lower costs? Until it can prove that it can, insurance won’t pay for it.”

Proving that digital health solutions provide economic value to health systems is the toughest and yet most important obstacle to taking digital health into the mainstream. As more and more digital health solutions roll off the assembly line, we need to see them subjected to formal health-economic analysis as with any other medical innovation.

I don’t know about you, but I found this to be an intriguing discussion, especially the notion of a “digitalist” responsible for remote data management and response. I look forward to talking to Dr. Spiegel someday (perhaps at the Connected Health show!) and getting more of his insights.

Why Delaying the Transition to 2015 Edition Technology Would Be a Problem for Patients and Families – MACRA Monday

Posted on September 11, 2017 I Written By

The following is a guest blog post by Erin Mackay, Associate Director, Health Information Technology Policy and Programs, National Partnership for Women & Families.  This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

The National Partnership for Women & Families recently weighed in on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule for 2018 updates to the Quality Payment Program (QPP). In our comments, we express concerns that many of the proposed requirements would have a chilling effect on the country’s badly needed transition to a health care system that rewards quality and value over volume. Of particular concern to us is the proposed delay in clinicians’ transition to the 2015 Edition electronic health record (EHR) certification requirements.

Putting off requirements to use more advanced health IT would be a one-two punch to health transformation. First, new models of care that demand high-quality, efficient practices and coordinated care rely on robust health IT. Likewise, these new models only succeed when patients have the information – about their medications, health status, diagnoses and treatment received – they need to participate in their care and make informed decisions with their health care teams.

Here are three ways the proposed rule would delay critical functionalities that are foundational to a patient and family-centered health care system:

1) Delaying Availability of APIs for Consumer Access
It would undermine the commitment to patient engagement to delay the availability of application programming interfaces (APIs) as a way for patients and their caregivers to access, download and share health data. When available, APIs will let consumers choose from a range of apps that pull in health data from various health care providers and hospitals, helping form a comprehensive picture of their health and health care and facilitating information sharing. Gone will be the days when patients and family caregivers struggled to remember passwords for multiple patient portals, or were able to view only one aspect of their medical history at a time.

2) Slowing More Robust Collection of Demographic Data
To enhance health equity, we must first be able to identify disparities by gathering standardized, granular demographic data. Right now, certified EHRs are not designed to distinguish among Chinese, Indian or Vietnamese patients, for instance, instead collapsing these identities into a single “Asian” category. Similarly, EHRs cannot currently store structured information about patients’ sexual orientation or gender identity. In both these examples, this information has clinical relevance and is vital for improving health outcomes. For example, too often transgender individuals do not receive appropriate “gendered” preventive screenings such as Pap tests, mammograms and prostate exams.

3) Failing to Capture Information on Social Determinants of Health
In addition to better demographic information, to best support providers in delivering patient- and family-centered care, EHRs should also capture information about non-clinical factors pertinent to individuals’ health. The 2015 Edition includes a new criterion to capture relevant social, psychological and behavioral data. This includes information on financial resource strain, educational attainment, stress, depression, physical activity, alcohol use, social connection and isolation, and intimate partner violence. At the individual level, this information could help clinicians and care teams determine treatment options that address the unique needs of the patients and families they serve. To improve population health, clinicians, hospitals and community organizations need this information to identify communities that need additional support in order to get and stay healthy.

Conclusion
Overall, the proposed rule for QPP 2018 raises a number of concerns for the National Partnership, particularly the proposed delay of 2015 Edition certified health IT products. We strongly encourage CMS to maintain the current requirements and timeline for clinicians transitioning to the 2015 Edition to provide the necessary infrastructure for the kind of patient- and family-centered health system our country urgently needs.

Healthcare Execs Have Varied Opinions On Patient Access To Medical Data

Posted on September 8, 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.

Not long ago, I wrote an item about an alleged exchange between Epic CEO Judy Faulkner and former Vice President Joe Biden. Reportedly, Faulkner questioned whether patients actually need their full medical records or are capable of understanding them.

Even if that particular exchange didn’t take place as written (Epic challenges the account) it still leaves me wondering whether her supposed views are widespread in the industry.

Now, I may have at least one answer. A recent write-up in Becker’s Hospital Review suggests that healthcare leaders are conflicted as to what part of medical records patients need, the circumstances under which they should have access to their records and if patients should own them. The article, which includes comments from five different healthcare execs, includes a wider range of view than I had expected.

For example, Daryl Kallevig, CIO of Aitkin, MN-based Riverwood Healthcare Center, argues that there are times when it might not be beneficial to let the patient see their entire record:

“Physicians and clinicians document in notes things they would hope patients may never see – [like] mental health patients or drug-seeking patients that come into our emergency room…[Also], if they’ve had an ongoing relationship for a number of years, would that patient or that physician want to see that compromised by a statement in a medical note? There has to be discretion in what is released to the patient.”

Keith Safian, former president and CEO of Sleepy Hollow, N.Y.-based Phelps Hospital, has a problem with the idea of patients owning their data:

“Patients should have unlimited access to the data, but since they did not create it and are not responsible for maintaining it, they do not own it…If the patient owned it, he or she could demand a hospital or practice destroy ‘his’ or ‘her’ medical record, which a hospital cannot do for many reasons.”

Another interviewee, CEO Grant Geiger of New York City-based EIR Healthcare, suggests that as clinical and technical models change, the whole notion of patient data stewardship will evolve:

“As we [look] beyond the EHR and we think about the adoption of [Internet of things] functionality… we need new guidelines and regulations in place for the future of healthcare. We are going to collect more data from patients in the next five years than we have in the past 10.”

In the interest of simplicity, I’ve edited out some of the nuances from these comments. Regardless, I think you will agree with me that they offer some food for thought.

I do have a couple of things I’d like to challenge:

  • Having written about the success of the Open Notes project, I’m not sure I agree with Kallevig that patient should be protected from the content of their records. My feeling is that in most cases, the patient would rather know what they say and deal with any comments they don’t like than miss important notes because of the care.
  • I take issue with Safian’s notion that patients shouldn’t own their records because it might be inconvenient for providers. Even if patients don’t own the records, or want to do something with them that’s impermissible by law, providers should at least think of patient is having moral ownership of the information. Any records request they make should be honored if possible, evaluated in light of their needs rather than it affects the healthcare organization.

That being said, I largely found the comments to be worth reading and considering. We can’t spend too much time thinking about patient access to records, not only for ethical reasons but also because we need to figure out how to use records to build engagement.

How about you, readers? To what extent would you like to see patients have access to and/or on their medical records? And why?

Connecticut Medical Society Launches HIE When State Can’t Pull It Off

Posted on September 7, 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.

The Connecticut State Medical Society had had enough. Its members had waited 10 years for the state of Connecticut to launch a functioning HIE, to no avail, so the Society decided to take matters into its own hands.

Now, the state’s physicians, healthcare facilities, and assorted other providers are sharing data via the medical society’s new HIE, CTHealthLink.  Participants who use the HIE not only share data but also have access to reports designed add value to physician consults and improve outcomes.

The CSMS project must have been daunting, but at least it had a model to use. Its approach is based on a provider-backed HIE in use in Kansas, the Kansas  Health Information Network (KHIN). KHIN brought the Kansas Hospital Association, the Wichita Health Information Exchange and greater Kansas City HIE eHealthAlign together.

If you read the HIE project overview, it becomes clear that CSMS wants to help members navigate MACRA requirements.  “The goal is to empower physicians as they transition to the new alternative payment models involving quality reporting, advancing care information, and improvement activities,” the CSMS notes on the CTHealthLink site.

Prior to the CTHealthLink rollout, CSMS leaders worried that clinicians would miss out on Medicare and Medicaid incentives provided for participating in an HIE, and be subject to penalties instead, according to Matthew Katz, Executive Vice President and chief executive officer of the physician group, who spoke to The CT Mirror.

Under MIPS, all physicians and many other clinicians can get incentives for participating in a HIE, an attractive prospect. However, the flipside of this is that eligible providers who don’t participate in MIPS by the end of 2017 would see a 4% cut in their Medicare reimbursement in 2019, obviously attractive prospect. Small wonder that the CSMS couldn’t wait longer.

The state’s clinicians have been quite patient to date. According to the Mirror, Connecticut’s first HIE effort was in 2007, when they attempted to create network specifically for Medicaid. Though the network was backed by a $5 million grant, it failed, as few physicians had adopted digital medical records at the time.

Between 2007 and 2016, the state followed up with two more efforts to connect state providers. Both efforts failed to create a functioning system, despite having $18 million in funding to back its efforts.

In contrast, CTHealthLink is steaming ahead. But there is a catch. At $50 to $120 per physician per month, joining the HIE can be pretty pricey, especially for large practices. For example. at $50 per physician per month, a medical practice of 1,200 physicians would pay approximately $720,000 per year, or as much as $1.7 million if the $120 monthly fee applied, noted Lisa Stump, chief information officer for Yale New Haven Health, who also spoke to the Mirror. This may very well inhibit the HIE’s growth.

Meanwhile, despite previous failures, the state of Connecticut hasn’t given up on creating its own HIE, this time with $14 million in federal and state funding. One of the key drivers is an effort to make Medicaid reporting simpler, which the state’s Department of Social Services is cheering on. The state’s HIE is scheduled to be functioning by the beginning of 2018. Maybe the fourth time will be the charm.

AI Making Doctors Better Is the Right Approach

Posted on September 6, 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 summer Bertalan Meskó, MD, PhD posted 10 ways that AI (Artificial Intelligence) could make him a better doctor. Here are his 10 ways:

1) Eradicate waiting time
2) Prioritize my emails
3) Find me the information I need
4) Keep me up-to-date
5) Work when I don’t
6) Help me make hard decisions rational
7) Help patients with urgent matters reach me
8) Help me improve over time
9) Help me collaborate more
10) Do administrative work

This is a great list of ways that AI can make doctors better. No doubt there are even more ways that we’ll discover as AI continues to improve. However, I love this list because it looks at AI from the appropriate point of reference. AI is going to be something that improves the doctor, not replaces the doctor.

I know that many people have talked about how technology is going to replace the doctor. The most famous of which is Vinod Khosla. However, you have to remember that Vinod is an investor and so he needs to drum up companies with ambitious visions. I believe his statement was as much about finding companies that will push the bounds of healthcare as much as it was his prediction for the future of healthcare. However, it no doubt created a lot of fear for doctors.

The reality is that some aspects of what a doctor does will be replaced by technology, but as the list above illustrates, that can be a very good thing for doctors.

AI is coming to healthcare. In some ways, it’s already here. However, the AI that’s coming today isn’t about replacing the doctor, it’s about making the doctor better. Honestly, any doctor that can’t embrace this idea is a doctor that shouldn’t have a medical license.

Should doctors be cautious in how quickly they adopt the technology and should they take the time to make sure that the AI won’t have adverse impacts on their patients? Absolutely. However, there’s a tipping point where not using AI is going to be much more damaging to patients than the risks that are likely to make headlines and scare many. Doctors need to be more driven by what’s best for their patients than fear inducing headlines.

AI will make doctors lives better in a wide variety of ways. It won’t replace the doctor but will enhance the doctor. That’s exciting!

Xerox Files Patents For Blockchain-Based Tech With Healthcare Applications

Posted on September 5, 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.

According to a site focused on blockchain technology, Xerox has filed patents for technology using blockchain to securely revise electronic documents. The patent application was filed in February of last year, but the move became news this month when it was reported by Coin Telegraph.

According to the site, the patent filings propose a network of nodes that can create and update documents and share data using blockchain technology. The system can be used by regional hospital organizations to exchange electronic health records, Xerox says in its application.

In a more-recent blog post, Xerox India’s director of global document outsourcing, Ritesh Gandotra, asserts that the use of blockchain can offer unique benefits.

“Historically, EHRs were never really designed to manage multi-institutional and lifetime medical records,” he writes. “…Adopting the blockchain structure to EHRs will help manage authentication, confidentiality, accountability and data sharing while allowing medical researchers to access insights into medical treatment.”

Xerox is hardly the first organization to take an interest in blockchain’s potential as a backbone for health data management. Not only that, but leaders in the industry are developing what look like practical models for using blockchain in this manner.

For example, my colleague John Lynn recently shared an infographic outlining a use case for blockchain in healthcare. You’ll probably learn more by clicking through and looking at the infographic yourself, but in summary, the model outlines a process in which:

  • Health organizations direct administrative information to the blockchain via APIs and track clinical data in parallel using existing health IT
  • The blockchain stores each transaction with a unique identifier
  • When they need information, healthcare organizations query the blockchain
  • Patients share their identity with healthcare organizations, using a private key that links their identity to blockchain data

Not only that, high-profile industry thinkers like John Halamka, MD, CIO at Beth Israel Deaconess Medical Center, have developed their own models for the use of blockchain in healthcare. (In a Harvard Business Review article, Dr. Halamka describes a system for managing EHRs using blockchain which he and his co-authors call “MedRec.”)

What’s striking here is that while Xerox may have filed some patent applications, it probably doesn’t know anything we don’t. The applications it describes for blockchain in healthcare document management certainly sound fine, and may be the basis for something great in the future.

If you look around the web, however, you’ll see that virtually anyone with an interest in health IT is out there making predictions about its applications for healthcare. What will really be interesting is when we get beyond ideas — as intriguing as they can be — and pilot some real, concrete technology.

In the meantime, let the blockchain games continue. Obviously, Xerox won’t be the last company angling for a piece of this market. There’s little doubt it will come to something eventually, and the rewards will be great for the company that helps to shape its future.

Is Healthcare Delivery Not ‘Sexy’ Enough for Investment?

Posted on September 1, 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.

On the latest #hcldr tweetchat, guest hosts Pam Ressler @pamressler and Pippa Shulman @drpippa posed an interesting question – why hasn’t the delivery of healthcare been an area of innovation? or put another way – is healthcare delivery not sexy enough to warrant investment?

Ressler and Shulman used the example of online retail giant Amazon. Among its many innovations, Amazon came up with a new way to deliver the retail experience. They found a way to deliver goods to people where and when they wanted it. Their approach to delivery was so good that it has since become the expected norm for anything purchased online.

Ressler and Shulman wanted to know why healthcare delivery wasn’t getting the attention it needed.

Shulman’s comment makes for an interesting thought exercise. Instead of just asking what it would be like if Disney ran your hospital. What if we asked what would happen if FedEx, Dominos or Amazon did. It would be fun to see uniformed “delivery agents” speed-walking through the hospital carrying meals and oxygen tanks.

Deanne Kasim @DKasim agreed with Shulman and Ressler:

Kasim’s “need it, want it” statement really struck a chord with the #hcldr community. It’s not just a case of delivering care in the way that patients want it (ie: Telehealth), we need to think about delivering it in when and where patients need it. Telehealth during regular business hours is helpful, but imagine how much more successful it would be if it were available after-hours when most people are home from work. The same with text messaging and email communication.

Kat McDavitt @katmcdavitt tweeted her frustration with this timing mismatch:

Dr. David Tom Cooke @DavidCookeMD went further and provided a great example of how appointment-booking could use an Amazon-upgrade.

Later in the chat, Dr. Cooke provided an compelling idea. Instead of trying to make healthcare delivery attractive for investment by making it “sexy” (which many believed would be very hard), why don’t we just present it as it is – a difficult and challenging problem.

I believe one of the best ways to spur investment is to have a bold pioneer show the world how successful they can be. Amazon showed the world how shopping online could be as-good-as (and now even better than) shopping in-person. FedEx showed us that next-day delivery could be done affordably and reliably. I believe it will take a healthcare pioneer to help blaze the trail for innovation in healthcare delivery.

For a time, Turntable Health in Las Vegas was one such pioneer. Zubin Damania MD, better known as @ZDoggMD, created a wholistic practice – one that made health a relationship rather than a transaction. They used technologies to engage patients in their care and they helped their patients with prevention as much as treatment.

James Legan MD, who practices in Montana, is another pioneer who projects his EHR so that patients can see what he is entering. He has also linked his EHR to a cloud-based customer-relationship-management (CRM) system so that his practice can be more efficient in the way they serve the community.

There are also practices like Access Healthcare in North Carolina and Izbicki Family Medicine in Pennsylvania that are demonstrating the benefits of direct primary care for both patients and physicians.

Hopefully there is a physician practice pioneer out there today that will become the beacon that will attract more investment in healthcare delivery. If you know of one, please email me or put their name in the comments section.