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“Doctor on Board” Experiences for Women Doctors and Over Reliance on Devices in Healthcare

Posted on November 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.

My good friend, Wen Dombrowski, MD (better known as @HealthcareWen for those of us on social media), recently shared her experience on a KLM International flight where the announcement came over the loudspeaker, “Is there a doctor on board?”

Her story and experience provide a great message and reminder that we still have a ways to go when it comes to our biases around gender and race. Plus, in true Wen fashion, she also provides a great reminder about over-reliance on technology and the lost art of “laying hands on a patient” medicine.  Not to mention a usability and design lesson as well. So, I knew I had to share it with Healthcare Scene.

Here’s her story and lessons learned (shared with permission):

“IS THERE A DOCTOR ON BOARD? (Someone had fainted)
I get up and ask staff who needs help. They say they already have enough doctors, thanks.

I brief a sigh of relief and am grateful that other doctors offered to help, because it’s challenging to practice medicine on a plane. So I go use the restroom. But…

On my way back to my seat, I notice there is activity happening up the aisle around the scene. From the back of the plane it looks like the volunteers are trying to do a procedure so I’m guessing maybe they are putting in an IV? But it is so dark in the plane with the interior lights off in sleep mode.

So I go up to the scene to quietly shine the light from my phone onto the procedure…
I’m appalled to find 2 guys are fumbling to put on a blood pressure cuff. It is a simple cuff for well-known home BP machine, nothing fancy. I watch them try to figure out over and over and over again how to wrap the BP cuff around the passenger’s arm… inside out…upside down… they can’t figure out the direction and Velcro…can’t get the BP cuff onto the passenger. By the way, the patient was awake, cooperative, with normal habitus, so there were no barriers from that perspective.

After watching the 2 guys repeatedly struggle with this, I offer to help.
The airline flight attendant rebukes me, “Please sit down. Are you a nurse? because we already have 2 doctors”(while we watch these guys scrambling to figure out how to put on a BP cuff).
I tell her, “I’m a Doctor & a doctor certified in 3 Specialties.”

The 2 guys say they’ve got it under control (while still trying to put on the cuff backwards etc), they say they are an Internist and a Nephrologist.
(I think to myself what a sad state of Medicine to have Internal Medicine and Nephrology not know how to check a BP! It would be understandable if they were orthopedics or psychiatrists or ENT, but blood pressure management is the bread and butter of those 2 specialties.)

Meanwhile, while they struggle to get the BP cuff velcro’d around passenger’s arm, I ask if anyone has checked passenger’s pulse — Is it Fast or Slow? Regular or Irregular? Strong or Weak? Clammy or not? This would provide valuable triage info and could be been done in 5 seconds by one of the guys who wasn’t holding the BP cuff. I ask again if they or I could check the passenger’s pulse, but they ignored this (seemed like neither of them knew how or didn’t think it was important). I wanted to jump in to do it myself, but there wasn’t enough physical space.

After more than 10 minutes struggling, the “doctors” finally got the BP cuff around the passenger’s arm.

I’m sharing this story because:

1. I’m shocked at the sad state of Medicine that doesn’t know how to nor value laying hands on patients as part of assessing patients (flashback to the practical skills Housecalls and field medicine has taught me). The guys were waiting for “the machine” to tell them “the numbers.” I’m sad at the lost “art” of medicine – lack of common sense handson skills & not looking at the qualitative data, just waiting for the quantitative device data. A lot of valuable time was lost in caring for this passenger. (And while I love technology, sensor devices, and clinical decision support tools – I wonder/worry what will happen to future physician’s common sense and clinical reasoning skills?)

2. And sad about the lack of team mindset of these 2 guys, who insisted on doing it themselves, the blind leading the blind. Not accepting help from female colleague. Not acknowledging what they don’t know nor allowing for help.

I know they meant well and were just trying to help, but sometimes helping comes in the form of teamwork.

There’s a lot that I don’t know in medicine and I’m happy to delegate/consult that to others. But geesh, at least I know how to check a Pulse and Blood Pressure.

3. Not to mention the persistently gender biased attitudes of flight crews who decline help from female physicians, to the detriment of everyone’s safety. This problem has been documented many times by other Female & Minority Physicians, for example: http://www.idealmedicalcare.org/blog/female-physicians-told-to-sit-down-shut-up-and-get-out-of-the-way-during-emergencies-as-patients-nearly-die/

4. The BP cuff was basic and not at fault per se. But these crisis moments highlights opportunities to design it better, to improve its usability and accessibility for laypeople and those who aren’t familiar with it. Perhaps the BP machine company could print pictures on the cuff itself that show the up/down and in/out directions of how to apply the cuff.”

Thanks Wen Dombrowski, MD for sharing this story and your insights.

Google, Stanford Pilot “Digital Scribe” As Human Alternative

Posted on November 29, 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.

Without a doubt, doctors benefit from the face-to-face contact with patients restored to them by scribe use; also, patients seem to like that they can talk freely without waiting for doctors to catch up with their typing. Unfortunately, though, putting scribes in place to gather EMR information can be pricey.

But what if human scribes could be replaced by digital versions, ones which interpreted the content of office visits using speech recognition and machine learning tools which automatically entered that data into an EHR system? Could this be done effectively, safely and affordably? (Side Note: John proposed something similar happening with what he called the Video EHR back in 2006.)

We don’t know the answer yet, but we may find out soon. Working with Google, a Stanford University doctor is piloting the use of digital scribes at the family medicine clinic where he works. Dr. Steven Lin is conducting a 9-month long study of the concept at the clinic, which will include all nine doctors currently working there.

Patients can choose whether to participate or not. If they do opt in, researchers plan to protect their privacy by removing their protected health information from any data used in the study.

To capture the visit information, doctors will wear a microphone and record the session. Once the session is recorded, team members plan to use machine learning algorithms to detect patterns in the recordings that can be used to complete progress notes automatically.

As one might imagine, the purpose of the pilot is to see what challenges doctors face in using digital scribes. Not surprisingly, Dr. Lin (and doubtless, Google as well), hope to develop a digital scribe tool that can be used widely if the test goes well.

While the information Stanford is sharing on the pilot is intriguing in and of itself, there are a few questions I’d hope to see project leaders answer in the future:

  • Will the use of digital scribes save money over the cost of human scribes? How much?
  • How much human technical involvement will be necessary to make this work? If the answer is “a lot” can this approach scale up to widespread use?
  • How will providers do quality control? After all, even the best voice recognition software isn’t perfect. Unless there’s some form of human content oversight, mis-translated words could end up in patient records indefinitely – and that could lead to major problems.

Don’t get me wrong: I think this is a super idea, and if this approach works it could conceivably change EHR information gathering for the better. I just think it’s important that we consider some of the tradeoffs that we’ll inevitably face if it takes off after the pilot has come and gone.

EHRs and Keyboarding: Is There an Answer?

Posted on November 28, 2017 I Written By

When Carl Bergman isn’t rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

One of the givens of EHR life is that users, especially physicians, spend excessive time keying into EHRs. The implication is that much keyboarding is due to excessive data demands, poor usability or general app cussedness. There’s no end of studies that support this. For example, a recent study at the University of Wisconsin-Madison’s Department of Family Medicine and Community Health in the Annals of Family Medicine found that:

Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. The study broke out times spent on various tasks and found, unsurprisingly, that documentation and chart review took up almost half the time.

Figure 1. Percent Physician’s Time on EHR

This study is unique among those looking at practitioners and EHRs. They note:

Although others have suggested work task categories for primary care,13 ours is the first taxonomy proposed to capture routine clinical work in EHR systems. 

They also make the point that they captured physician EHR use not total time spent with patients. Other studies have reached similar EHR use conclusions. The consensus is there too much time keyboarding and not enough time spent one to one with the patient. So, what can be done? Here, I think, are the choices:

  1. Do Nothing. Assume that this is a new world and tough it out.
  2. Use Scribes. Hire scribes to do the keyboarding for physicians.
  3. Make EHRs Easier. Improve EHRs’ usability.
  4. Make EHRs Smarter. Adapt EHRs to physician’s needs through artificial intelligence (AI) solutions.
  5. Offload to Patients. Use patient apps to input data, rather than physician keyboarding.

Examining the Alternatives

 1. Do Nothing. Making no change in either the systems or practioners’ approach means accepting the current state as the new normal. It doesn’t mean that no changes will occur. Rather, that they will continue at an incremental, perhaps glacial, pace. What this says more broadly is that the focus on the keyboard, per se, is wrong. The question is not what’s going in so much as what is coming out compared to old, manual systems. For example, when PCs first became office standards, the amount of keyboarding vs. pen and paper notations went viral. PCs produced great increases in both the volume and quality of office work. This quickly became the new norm. That hasn’t happened with EHRs. There’s an assumption that the old days were better. Doing nothing acknowledges that you can’t go back. Instead, it takes a stoic approach and assumes things will get better eventually, so just hang in there.

2. Scribes. The idea of using a scribe is simple. As a doctor examines a patient, the scribe enters the details. Scribes allow the physician to offload the keyboarding to someone with medical knowledge who understands their documentation style. There is no question that scribes can decrease physician keyboarding. This approach is gaining in popularity and is marketed by various medical societies and scribe services companies.

However, using scribes brings a host of questions. How are the implemented? I think the most important question is how a scribe fits into a system’s workflow. For example, how does an attending review a scribe’s notes to determine they convey the attending’s clinical findings, etc. The attending is the responsible party and anything that degrades or muddies that oversight is a danger to patient safety. Then, there are questions about patient privacy and just how passive an actor is a scribe?

If you’re looking for dispositive answers, you’ll have to wait. There are many studies showing scribes improve physician productivity, but few about the quality of the product.

3. Make EHRs Easier. Improving EHR usability is the holy grail of health IT and about as hard to find. ONC’s usability failings are well known and ongoing, but it isn’t alone. Vendors know that usability is something they can claim without having to prove. That doesn’t mean that usability and its good friend productivity aren’t important and are grossly overdue. As AHRQ recently found:

In a review of EHR safety and usability, investigators found that the switch from paper records to EHRs led to decreases in medication errors, improved guideline adherence, and (after initial implementation) enhanced safety attitudes and job satisfaction among physicians. However, the investigators found a number of problems as well.

These included usability issues, such as poor information display, complicated screen sequences and navigation, and the mismatch between user workflow in the EHR and clinical workflow. The latter problems resulted in interruptions and distraction, which can contribute to medical error.

Additional safety hazards included data entry errors created by the use of copy-forward, copy-and-paste, and electronic signatures, lack of clarity in sources and date of information presented, alert fatigue, and other usability problems that can contribute to error. Similar findings were reported in a review of nurses’ experiences with EHR use, which highlighted the altered workflow and communication patterns created by the implementation of EHRs.

Improving EHR usability is not a metaphysical undertaking. What’s wrong and what works have been known for years. What’s lacking is both the regulatory and corporate will to do so. If all EHRs had to show their practical usability users would rejoice. Your best bet here may be to become active in your EHR vendor’s user group. You may not get direct relief, but you’ll have a place, albeit small, at the table. Otherwise, given vendor and regulatory resistance to usability improvements, you’re better off pushing for a new EHR or writing your own EHR front end.

4. Make EHRs Smarter. If Watson can outsmart Kent Jennings, can’t artificial Intelligence make EHRs smarter? As one of my old friends used to tell our city council, “The answer is a qualified yes and a qualified no.”

AI takes on many, many forms and EHRs can and do use it. Primarily, these are dictation – transcription assistant systems. They’re known as Natural Language Processing (NLP). Sort of scribes without bodies. NLP takes a text stream, either live or from a recording, parses it and puts it in the EHR in its proper place. These systems combine the freedom of dictation with AI’s ability to create clinical notes. That allows the theory maintains, a user to maintain patient contact while creating the note, thus solving the keyboarding dilemma.

 The best-known NLP system Nuance’s Dragon Medical One, etc. Several EHR vendors have integrated Dragon or similar systems into their offerings. As with most complex, technical systems, though, NLP implementation requires a full-scale tech effort. Potential barriers are implementation or training shortcuts, workflow integration, and staff commitment. NLP’s ability to quickly gather information and place it is a given. What’s not so certain is its cost-effectiveness or its product quality. In those respects, its quality and efficacy is similar to scribes and subject to much the same scrutiny.

One interesting and wholly unexpected NLP system result occurred in a study by the University of Washington Researchers. The study group used an Android app NLP dictation system, VGEENS, that captured notes at the bedside. Here’s what startled the researchers:

….Intern and resident physicians were averse to creating notes using VGEENS. When asked why this is, their answers were that they have not had experience with dictation and are reluctant to learn a new skill during their busy clinical rotations. They also commented that they are very familiar with creating notes using typing, templates, and copy paste.

The researchers forgot that medical dictation skills are just that, a skill and don’t come without training and practice. It’s a skill of older generations and that keyboarding is today’s given. 

5. Offload to Patients. I hadn’t thought of this one until I saw an article in the Harvard Business Review. In a wide-ranging review, the authors saw physicians as victims of medical overconsumption and information overload:

In our recent studies of how patients responded to the introduction of a portal allowing them to e-mail health concerns to their care team, we found that the e-mail system that was expected to substitute for face-to-face visits actually increased them. Once patients began using the portal, many started sharing health updates and personal news with their care teams.

One of their solutions is to offload data collection and monitoring to patient apps:

Mightn’t we delegate some of the screening work to patients themselves? Empowering customers with easy-to-use tools transformed the tax reporting and travel industries. While we don’t expect patients to select what blood-pressure medications to be on, we probably can offload considerable amounts of the monitoring and perhaps even some of the treatment adjustment to them. Diabetes has long been managed this way, using forms of self-care that have advanced as self-monitoring technology has improved.

This may be where we are going; however, it ignores the already crowded app field. Moreover, every app seems to have its own data protocol. Health apps are a good way to capture and incorporate health data. They may be a good way to offload physicians’ keyboarding, but health apps are a tower of protocol Babel right now. This solution is as practical as saying that the way to curb double entering data in EHRs is to just make them interoperable.

What’s an EHR User to Do?

If each current approach to reducing keyboarding has problems, they are not fatal. I think that physician keyboarding is a problem and that it is subject to amelioration, if not solution.

For example, here’s Nordic’s Joel Martin on EHR usability:

… In reality, much of this extra work is a result of expanded documentation and quality measure requirements, security needs, and staffing changes. As the healthcare industry shifts its focus to value-based reimbursement and doing more with less, physician work is increasing. That work often takes place in the EHR, but it isn’t caused by the EHR’s existence.

Blaming the EHR without optimizing its use won’t solve the problem. Instead, we should take a holistic view of the issues causing provider burnout and use the system to create efficiencies, as it’s designed to do.  

The good news is that optimizing the EHR is very doable. There are many things that can be done to make it easier for providers to complete tasks in the EHR, and thereby lower the time spent in the system.

Broadly speaking, these opportunities fall into two categories.

First, many organizations have not implemented all the time-saving features that EHR vendors have created. There are features that dramatically lower the time required to complete EHR tasks for common, simple visits (for instance, upper respiratory infections). We rarely see organizations that have implemented these features at the time of our assessments, and we’re now working with many to implement them.

In addition, individual providers are often not taking advantage of features that could save them time. When we look at provider-level data, we typically see fewer than half of providers using speed and personalization features, such as features that let them rapidly reply to messages. These features could save 20 to 30 minutes a day on their own, but we see fewer than 50 percent of providers using them.

Optimization helps physicians use the EHR the way it was intended – in real-time, alongside patient care, to drive better care, fewer mistakes, and higher engagement. Ultimately, we envision a care environment where the EHR isn’t separate from patient care, but rather another tool to provide it. 

What does that mean for scribes or NLP? Recognize they are not panaceas, but tools. The field is constantly changing. Any effort to address keyboarding should look at a range of independent studies to identify their strengths and pitfalls. Note not only the major findings but also what skills, apps, etc., they required. Then, recognize the level of effort a good implementation always requires. Finally, as UW’s researchers found, surprises are always lurking in major shake-ups.

Join us for this week’s #HITsm chat on Using Technology to Fight EHR Burnout to discuss this topic more.

In The Hot Seat Again: eClinicalWorks Faces Billion-Dollar Suit Over Alleged Software Problems

Posted on November 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.

Earlier this year, eClinicalWorks agreed to pay $155 million to the U.S. Department of Justice to resolve allegations that it had faked its conformance with Meaningful Use criteria. The DoJ suit alleged that by withholding information needed for certification, eCW violated the False Claims Act.

Now, the vendor is facing what could be an even more serious legal threat, according to a news report appearing in Becker’s Hospital Review. BHR is reporting administrator of the estate of a deceased cancer patient is suing the vendor over data display errors that may have affected the patient’s care.

What makes the stakes so high in this case is that the complaint is asking the court to certify the case as class action, with members to include “all persons residing in the United States whose physicians used eCW to record and store their medical records at all dates relevant.” The suit is asking the court to award plaintiffs $999 million in damages, Becker’s Hospital Review reports.

According to the complaint, which was filed by Kristina Tot, administrator of the estate of the deceased Stjepan Tot, errors with eCW software began to appear before the cancer patient’s death. For example, “he was unable to display his medical history or progress notes,” the complaint reportedly states.

The cancer patient’s problems were far from unique, however, the suit asserts. According to the complaint, important eCW software functions didn’t work or violated regulatory guidelines. The filing claims the vendor didn’t provide accurate and reliable health information, displayed incorrect panels and didn’t record EHR user actions in audit logs.

The bottom line, the suit claims, is that millions of patient records were compromised, leaving patients and physicians unable to rely on the eCW platform.

I am not qualified to speak on whether there’s any merit to the latest suit against eCW, though I think it’s reasonable to assume that the company may not have its act together. (You might also want to check out the angry eCW critiques on this site — whose publisher, like our fearless leader John Lynn, I know to have an impeccable reputation for honesty.)

Ultimately, it’s hard to say whether this latest suit is largely blowback from the previous certification problem or yet another (extremely) costly headache. Either way, if I were part of its leadership team I’d be more than a little shaken by recent events even if the recent complaint gets dismissed.

Thanksgiving Medical Humor

Posted on November 23, 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.

Happy Thanksgiving to all our Healthcare Scene subscribers. We are so thankful for your engagement and readership. We are also thankful to all our wonderful sponsors. Without your support and belief in us, we wouldn’t be here. Thank you for helping us bring the Healthcare Scene community together.

Stay safe. Smooth travels. Happy Thanksgiving!

Here is a little Thanksgiving humor to get you into the holiday mood.

A Look at the Future of Healthcare

Posted on November 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.

I saw this tweet from David Chou and thought that it was a good predictor of where healthcare is heading as we move to a value based care world. Check it out below:

When people see this graphic, they always point out how small of an impact healthcare delivery has on your health. That’s an important point, but I’m more interested in knowing how the other 90% impact health and the innovations in healthcare that are embracing these areas.

This graphic seems like a great indicator of where healthcare needs to head and where I believe it will head. The best innovations in health will be around influencing behavioral factors and genetics. What do you think? What companies do you know that work in these areas that we should be watching more closely?

EMR Twitter Roundup

Posted on November 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.

Always fun to do some searches on Twitter and find some interesting content. In this roundup, we cover a lot of ground starting with a lawsuit that could be the first crack in breaking the damn wide open.


This picture is hilarious for this story. That part aside, I’ll be personally surprised if this case is successful. However, you can be sure that every EHR vendor out there is watching this case careful. It would be a big deal if eCW does lose.


This is a huge problem. However, it’s not a problem with the EHR. In fact, the EHR could be the solution to the problem as it creates a usable clinical display while still satisfying the billing requirements. Even better would be for us to streamline our billing requirements so that EHR vendors didn’t have to produce these thousands of pages of documentation in order to bill and get paid by insurance companies.


We all know about this challenge. In fact, I’ve heard this used as the rationale for why some people used the term EMR instead of EHR. However, more disturbing is that Matthew doesn’t know that you can remove EHR from the autocorrect table in Word and not have that problem. Kind of reminds me of a lot of EHR complaints. EHR users complain about things that have solutions if they just knew how to use the EHR properly.

5 Tips for HIPAA Compliance

Posted on November 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.

Planet HIPAA had this great article that shared 5 tips to ensure an effective HIPAA program. The reality is that HIPAA is a pretty flexible program that in many cases is open to some interpretation by the medical practice. There are exceptions, but HIPAA is generally about reducing risk as opposed to strict compliance. That’s reflected in this list of 5 tips from Planet HIPAA:

1. Conduct a Risk Assessment/Analysis

2. Create, Review and/or Update all HIPAA policies and procedures

3. Provide Workforce HIPAA Education

4. Conduct regular HIPAA Audits

5. Use Security Technologies

Most of the items on the list aren’t rocket science. However, my guess is that most medical practices will go through this list and realize that they have work to do. Whether it’s not doing a HIPAA risk assessment regularly (yes, sadly this still happens), or whether it’s not documenting or training, most practices will have something they could improve when it comes to HIPAA compliance. How’s your practice doing? My guess is you know where you’re lacking.

My favorite tip on this list was to use security technologies. HIPAA has some really good elements that help a practice protect PHI, but HIPAA does not equal secure. There is plenty more that a medical practice needs to do to ensure that their practice is secure and protected against the malware, ransomware, viruses, and other online threats that exist and are bombarding their IT infrastructure from every angle. HIPAA is required by law, but security beyond HIPAA is required to avoid a cybersecurity disaster in your organization.

The sad reality for many small practices is that they aren’t keeping up with the HIPAA requirements. This was illustrated by this story from Dr. Jayne:

One of my friends admitted that she had her work laptop stolen and didn’t report it to anyone despite it containing protected health information. That sort of thing is one of the perks (or hazards, depending on how you look at it) of owning your own practice and not fully understanding the huge number of laws that impact our practices. At least she realized after attending the conference that she should have taken additional action.

Dr. Jayne described most small medical practices’ feelings perfectly when she said the “perks (or hazards, depending on how you look at it)” of owning your own practice. Ignorance is bliss until you’re stuck on the front page of the paper or in some lawsuit. I’ll never forget the doctor who told me “They won’t throw us all in jail.” Maybe not, but they won’t be afraid to send you all fines.

An ounce of prevention is worth a pound of cure. This seems quite appropriate when it comes to HIPAA and security in a medical practice.

Technology and Health – Fun Friday

Posted on November 17, 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 Friday. Time for a break from the minutiae of government regulations and other fun topics like MACRA and MIPS. We’re doing our part to help with physician burnout…or at least that should be the goal of the relatively off topic Fun Friday blog posts we do.

This week we have two cartoons for your viewing pleasure. The first one is one that many of us have experienced. I wonder how much this type of thing really comes up in a doctor’s office (ie. too much social media). I’m sure it’s an issue in mental health.

This second cartoon hits a little close to home as a professional blogger.

For the record, I don’t drink caffeine and I couldn’t be at my computer more than 12-14 hours a day. I also may or may not have an addiction to ultimate frisbee (ie. exercise).

Happy Friday!

Patients Showing Positive Interest In NY-Based HIE

Posted on November 16, 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 few months ago, I shared the story of HEALTHeLINK, an HIE serving Western New York. At the time, HEALTHeLINK was announcing that it had managed to obtain 1 million patient consents to share PHI. The HIE network includes 4,600 physicians, in addition to hospitals, health plans and other providers.

This month, HEALTHeLINK has followed up with another announcement suggesting that it’s making significant progress in getting patients and physicians connected and perhaps more importantly, interested in what it can do for them. In particular, the study suggested that consumers were far more aware of the HIE’s existence, function and benefits than one might’ve assumed.

The study found that 90% of respondents said they knew their doctors use EHRs, a percentage which differed but remained high across all demographic groups study. Respondents also knew that their doctor could send and receive medical information back and forth with other healthcare providers involved in their care using EHRs.

Not only that, 51% of respondents felt that the use of EHRs by doctors and hospitals made healthcare “more safe,” though 24% said EHRs made no impact on their care and 18% said EHRs made care “less safe.” Fifty-eight percent of respondents said that electronic access is good for healthcare, and 24% answered “strongly yes” when asked whether electronic access was beneficial.

When asked whether electronic access is good for healthcare, 24% of respondents said “strongly yes” and 58% said “yes.” Things looked even more positive for the future of the HIE when patients were specifically aware of HEALTHeLINK, with 57% of this group of patients rating care as “more safe.”

Those who rated care as “more safe” using HEALTHeLINK also included respondents with a two-year degree, those who visited Dr. more than 15 times a year and those who fell into 35 to 44-year-old age bracket.(However, it is worth noting that 41% to respondents said they weren’t aware of the name HEALTHeLINK.)

The only significant downside mentioned by HEALTHeLINK users was a lack of face time, with 37% reporting that their doctor or healthcare professional was spending too much time on a laptop or computer, and another 11% saying that this was a significant problem. (Another 60% had no issue with this aspect of the electronic medical records use process.)

Despite those reservations, when asked if they were willing to cut their doctor to use the HIE to give the other providers instant access to medical records, 57 percent said “yes” and 24% said their answer was “strongly yes.”

Lest this begin to sound like a press release for HEALTHeLINK, let me stop you right there. I am in no way suggesting that these folks are doing a better overall job of running its business than those in other parts of the country. However, I do think it’s worth noting that HEALTHeLINK’s management is building awareness of its benefits more effectively than many others.

As obvious as the benefits of health information sharing may seem to folks like us, it never hurts to remind end users that they’re getting something good out of it — and if they’re not, to find out quickly and address the problem.