Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Nationwide Healthcare Interoperability Isn’t Happening

Posted on August 8, 2018 I Written By

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

I’ve got interoperability on the mind today. I think it’s probably because of all the tweets that are coming out on the #InteropForum hashtag from the ONC Interoperability Forum in DC. I would have liked to attend, but I’m grateful that so many people are sharing what’s happening. That said, I must admit that I’m tired of a lot of the tweets that aren’t grounded in reality and that call for things that are never going to happen or tweets that propose goals that aren’t meaningful (yes, I had to use that word).

The first reality that’s become clear to me is that nationwide interoperability of healthcare data isn’t going to happen.

It’s just not going to happen and in most cases it shouldn’t happen when you consider the costs and benefits. Sure, we are all traveling a lot more, but there are 45 or so states in the US where no healthcare organization has need for my health information. If they do, then there are ways they can get it, but they are rare. Even if I have a crazy medical incident in an unusual state, those care providers know how to take care of me even without all my health records. Doctors are always treating patients with limited information. If I’m a chronic patient where certain information would be important for me if I’m treated out of state by a doctor that doesn’t know me, there are hundreds of options for me to carry that information on my phone.

My point here is that there aren’t any massive economic incentives for there to nationwide sharing of health data. Don’t be confused though. I’m not saying that sharing health data is not beneficial. What I’m saying is that we don’t need to build a national framework of health data sharing. When people suggest we should make that a reality, they’re essentially dooming interoperability. Talk about biting off more than you can chew. It’s become quite clear to me that Nationwide Interoperability of health data isn’t going to happen.

I love this excerpt from Brian Mack’s blog post on the Great Lakes Health Connect (an HIE) blog:

The Trusted Exchange Framework and Common Agreement (TEFCA) released by the Office of the National Coordinator last January, was (it was thought) intended to bring clarity and define a path forward for national interoperability, but has instead just added more uncertainty and the promise of additional layers of bureaucracy.

Discussions around national healthcare interoperability just bring more uncertainty and more layers of bureaucracy. It’s a failed approach.

With that said, it’s also very clear that smaller scale interoperability is not only possible but a valuable thing for most in healthcare. This was highlighted by interoperability expert, Greg Meyer, when he tweeted:

It’s really great that Greg is trying to figure out how we can generalize these point to point interoperability solutions. That’s a smart approach. However, buried in this tweet in a way that most will miss is the fact that there are a lot of unique scenarios and solutions where healthcare interoperability has been successful. Healthcare interoperability is possible and many organizations are doing it. Just not on a national scale.

To continue Greg’s analogy, we need more of these interoperability “snowflakes” and we need those creating the snowflakes to share their successes. A blizzard of snowflakes is a powerful thing even though the individual snowflakes are small. As it stands today, a national approach to interoperability is more like spending millions and billions of dollars on a snow making machine and then never turning it on. I’d rather have a million snowflakes than a billion dollar machine that doesn’t produce any snow. </ end snowflake analogy>

Another example of healthcare interoperability in action was shared at the Healthcare IT Expo this year. Don Lee offered a great summary of UPMC’s success with interoperability and the parts of interoperability they have solved. There’s always still more work to do, but if every hospital was able to accomplish what UPMC has accomplished in regards to healthcare interoperability, then we could have a very different discussion around healthcare data sharing.

The only solution I see to healthcare interoperability is for healthcare organizations to make it a priority. As I said back in 2013, Interoperability Needs Action, Not Talk. The more small interoperability connections we make, the more we’ll understand our data, how to connect, and build relationships between organizations. All of that will be key to even starting to thinking about nationwide healthcare interoperability. Until then, let’s table the nationwide healthcare interoperability discussions.

An EHR Twitter Roundup

Posted on August 3, 2018 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 want to know how doctors feel about their EHR software, all you have to do is look at Twitter. There are doctors complaining all of the time about their EHR and the impact it’s having on their lives. I’m careful to not take their complaints too far. If Twitter was around 15 years ago, I’m 100% sure we’d have seen just as many doctors complaining about paper charts as we do about EHR software.

That said, it’s important to acknowledge the impact that EHR software and the policies and regulations it reflects has on doctors. Let me highlight some tweets that illustrate what I mean and add a little commentary and perspective.


The concept of cognitive bandwidth is an important one. We’ve all felt that burnt out feeling where some part of your job leaves you so burnt out that you can’t spend time on something else. I do find it interesting that this same doctor has still been able to tweet 6,660 times despite the cognitive burnout that Epic has offered him. Granted, tweeting doesn’t require the same cognitive load as other professional development tasks he could do. Twitter is much more bite-sized which makes us think that it doesn’t suck the life out of us as well. Maybe there’s a lesson here for us on how to better educate people. Regardless, I know this doctor is not alone in his feelings of an EHR making other things more difficult to accomplish.

Many replies to the tweet suggested that it would get better over time, but there was plenty of commiseration as well. There was also this reply:


To be honest, I hate this example. It usually leads to people saying that Apple could build a much better EHR than those out there today. Every day I’m more convinced that’s just not the case. Ok, maybe Apple’s EHR would be nominally better than what’s out there, but I’m quite confident that doctors would still hate it.

Here’s the problem. If your niece had to document 100 data points in an app with 10,000 possible variations, she’d hate it too. One day doctors will be able to walk into an exam room and microphones and video cameras will capture everything that happens with a patient, NLP will identify the various clinical elements, AI will know what it all means, and the visit will be documented automatically. Until that happens, many EHRs can improve what they’re doing, but it will all still feel “non-intuitive” compared to a simple app that your niece uses.


And EMR software wasn’t designed to improve care.


If you read through the full thread, you get more details about what’s really happening. Many of the complaints like this one are around poor configuration and implementation. There’s no doubt that every EMR can do what she’s asking. Someone in a reply acknowledges that they can do it. However, that doesn’t help the doctor when they’re frustrated in that moment. It’s amazing the impact poor configuration and implementation can have on morale.


A hopeful view, but a challenging one when you stack it up against even just the simple complaints above.

The reality is that EHRs aren’t going anywhere. So, Dr. Levi is right. Providers can’t be enslaved by the EHR. Easier blogged than done.

Looking Back: Facebook in Healthcare

Posted on August 1, 2018 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.

Today I decided that I’d start regularly doing a series of blog posts called Looking Back. In this blog post series I’ll look back at some of my popular (and maybe some not so popular) blog posts I’ve written and see how it holds up today. Have things changed? Were we totally wrong? Did we forget those lessons? I’ve done this on occasion, but with over 12,000 blog posts I think I want to make this a regular feature. There’s a lot of value in looking back at old posts and remembering where we came from and how things have changed.

Today’s “Looking Back” post was published in October 2014 and was titled Facebook in Healthcare. I’ll wait here while you go and read the post.

Now that you’ve read the post…

It’s fascinating for us to think about Facebook in healthcare. Especially with what we now know about people using Facebook to influence elections and other nefarious things. It’s sad, because those same people could have used Facebook to do some good things for healthcare, but they didn’t. That’s not to say that there aren’t some good Facebook healthcare groups that provide value for patients. There are, but they aren’t really stuff that Facebook has been working on as a specific product.

What’s crazy is that even back in 2014 when I wrote the previous post, I suggested that many people didn’t trust Facebook with our health info. Today that’s true times 10. That said there are still a lot of people that would have no problem sharing health info on Facebook as well. It’s amazing to think about the separation between the people who would still share pretty much anything on Facebook and those who don’t want to use Facebook for anything.

What’s surprising today is that the post didn’t even look at other big companies that are now becoming big players in healthcare. I mentioned Google which was just starting back into healthcare after the failure of Google Health. However, I don’t think even back then I would have been able to predict all of the healthcare things that Google is doing through Alphabet.

The other big company that wasn’t mentioned at all is Amazon. Back in 2014, I can’t even remember Amazon being mentioned in any healthcare conversations. That’s not true today where it seems like Amazon is mentioned in almost every healthcare conversation.

Looking at things as they are now, I think Amazon will be a big player in healthcare and will have a big impact on it. However, they’re going to do it in new ways. They’re going to create new opportunities and new gateways to healthcare and healthcare services. If we look back on this post 4 years from now I think we’ll have had no idea of the ways Amazon will impact healthcare. I think of all the big tech companies out there, Amazon will have a bigger impact on healthcare than others like Apple, Google, Samsung, etc.

What’s your take on these big companies impacting healthcare? Which ones do you think will be effective and in what ways? We’ll look back on this post in 4 years and see if we’re right.

There Are No Simple Answers When You Try to Personalize Healthcare Communication

Posted on July 27, 2018 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.

Earlier this month, Brian Norris (@Geek_Nurse), a registered nurse and informaticist who also has an MBA (when has this mix ever occurred?) asked the question on Twitter “Which would you rather receive post having labs drawn as a patient?” His options were: A call, email, text, or Leave Me Alone. While not scientific in anyway, the poll did have a good response and the results below were quite interesting:

The results of this poll highlighted that everyone has different preferences. In fact, if you look over the comments in reply to the poll, you’ll realize that many hated the poll because they would want different modalities based on the specific situation. Personalizing healthcare communication gets really complex really quickly.

The good news is there are healthcare companies that are working towards this kind of personalization. My friends at CareCognitics (I’m an advisor to the company) are doing detailed tracking of each patient’s communication preferences so they can customize which communication platform is used, but also what time is best to communicate and much more.

Another great example of this is the ways Stericycle Communication Solutions allows patients to communicate across a wide variety of platforms from text to humans. That’s right, they have actual humans who talk to you. Eventually, our systems might get good enough that a human discussion isn’t needed, but as the poll above shows, there’s still a desire for phone discussions with patients. Depends on the situation of course since many would argue that a phone call is the worst experience when a text could have accomplished the same thing. Many long-time readers will remember a post by Jim Higgins from Solutionreach that highlights the gap between the communication patients want and what practices offer. A call when a text is sufficient is a bad patient experience. A text when a call is needed is a bad patient experience.

Of course, we also see outside of healthcare where we can experience communication overload. When I do a payment on Paypal, I get an email notification, a Paypal app notification, and a notification from my bank. Another example that might be more familiar to you is an Amazon shipment. They send me an email and a text and an app notice. That’s a bit of overkill no?

Over communication is generally better, but not always. When I’m receiving a package from Amazon, then a few extra messages might just get me more excited for the package to arrive. Even the extra notifications from Paypal are good since I’m afraid of some sort of identity theft. However, if it’s a bad lab result, do I want to be reminded of it 3 times? Definitely not.

What does all of this mean? Healthcare communication is hard work and it’s almost impossible to get perfect. However, we can do better than we do today. The key is to provide the patient multiple avenues of communication. Until the systems start learning about patient’s preferences, ask the patient and let them adjust their preferences over time as they learn what works for them and what doesn’t. Learn from communication mistakes that happen, but make sure you keep the mistakes in perspective. One bad communication doesn’t mean you should necessarily stop the thousands of good communications.

Stericycle Communication Solutions and Solutionreach are both Healthcare Scene sponsors.

QPP (Quality Payment Program) 2019 Changes, Medicare Telemedicine Reimbursement, and Physician Fee Schedule E&M Changes

Posted on July 12, 2018 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.

Today, CMS came out with some big changes as part of the 2019 Physician Fee Schedule and proposed rule for the QPP for 2019. These are some of the biggest efforts I’ve seen to try and change what Medicare has been doing for a while.

CMS has put together a fact sheet on the 2019 Physician Fee Schedule proposed rule. Plus, you can also view the fact sheet for the 2019 Quality Payment Program (QPP) proposed rule. If you like all the details, you can find the full rule for both the 2019 Physician Fee Schedule and QPP 2019 (1473 pages) on the Federal Register.

That’s a lot of information and changes to process, but here are some initial thoughts. While what CMS and HHS are saying in their announcement is directionally good, the devil is always in the details. Here are a few of the highlights that could have a big impact on the healthcare IT and EHR world.

E/M Documentation Requirement Changes
The biggest change in this announcement is the change in E/M coding requirements. As part of CMS’ goal to streamline E/M documentation requirements, they’ve proposed some of the biggest changes to E/M since 1997. The one that will likely be talked about most is the opportunity for providers to bill Medicare using “medical decision-making or time.” Here’s a description of the change:

To improve payment accuracy and simplify documentation, we propose new, single blended payment rates for new and established patients for office/outpatient E/M level 2 through 5 visits and a series of add-on codes to reflect resources involved in furnishing primary care and non-procedural specialty generally recognized services. As a corollary to this proposal, we propose to apply a minimum documentation standard where Medicare would require information to support a level 2 CPT visit code for history, exam and/or medical decision-making in cases where practitioners choose to use the current framework, or, as proposed, medical decision-making to document E/M level 2 through 5 visits. In cases where practitioners choose to use time to document E/M visits, we propose to require practitioners to document the medical necessity of the visit and show the total amount of time spent by the billing practitioner face-to-face with the patient. Practitioners could choose to document additional information for clinical, legal, operational or other purposes, and we anticipate that for those reasons, they would continue generally to document medical record information consistent with the level of care furnished. However, we would only require documentation to support the medical necessity of the visit and associated with the current level 2 CPT visit code.

There are other changes to E/M that could be a big deal as well including having providers focus their documentation on what’s changed since the last visit as long as they review and update the previous information. Plus, providers can now just review and verify the information entered by ancillary staff or the patient rather than having to re-enter it.

The goal is quite clear. CMS is trying to battle against the bloated notes that are getting generated by EHRs today to justify a certain billing code level. Doctors will no doubt celebrate this as most doctors describe notes from their peers as awful and difficult to use because of all the note bloat. I don’t know how many times I heard from my medical billing friends at AHIMA that it doesn’t matter what’s actually done if it’s not documented. With the changes mentioned above, CMS is looking to change this.

Of course, EHRs aren’t going to be able to change their interfaces overnight. The new E/M changes are going to take a while to incorporate into EHR software. Plus, we’ll have to see how the non-Medicare payers react to these changes. If they don’t follow Medicare’s lead, that puts the EHR vendors in a tough position. We’ll have to see how that plays out.

Many doctors complain about hating their EHR software. I’ve long argued that the EHR is just the whipping boy for doctors’ ire. What doctors really hated was the crazy billing documentation requirements that were reflected in the EHR. If the changes above go far enough, maybe we’ll finally see if the EHR vendor really is to blame for provider burnout. However, as I mentioned, it will take some time for this to happen.

Medicare Telemedicine and Telehealth Reimbursement
The next biggest thing in today’s announcement was Medicare’s plans to reimbursement for what we would call Telemedicine or Telehealth services. 2 G codes (HCPCS code GVCI1 and GRAS1) were announced that seem like they could present a lot of opportunity for healthcare IT companies to finally get paid for the services they can provide:

Brief Communication Technology-based Service, e.g. Virtual Check-in (HCPCS code GVCI1)

Remote Evaluation of Recorded Video and/or Images Submitted by the Patient (HCPCS code GRAS1)

Practitioners could be separately paid for the Brief Communication Technology-based Service when they check in with beneficiaries via telephone or other telecommunications device to decide whether an office visit or other service is needed. This would increase efficiency for practitioners and convenience for beneficiaries. Similarly, the Remote Evaluation of Recorded Video and/or Images Submitted by the Patient would allow practitioners to be separately paid for reviewing patient-transmitted photo or video information conducted via pre-recorded “store and forward” video or image technology to assess whether a visit is needed.

Travie Broome offered some interesting insights into these codes:

CMS also proposed a number of CPT codes for “Chronic Care Remote Physiologic Monitoring” and “Interprofessional Internet Consultation” as follows:

We are also proposing to pay separately for new coding describing Chronic Care Remote Physiologic Monitoring (CPT codes 990X0, 990X1, and 994X9) and Interprofessional Internet Consultation (CPT codes 994X6, 994X0, 99446, 99447, 99448, and 99449).

The also proposed adding HCPCS codes G0513 and G0514 for Prolonged preventive service(s) which seems to include ESRD (end-stage renal disease) patients who receive dialysis at home and mobile stroke units.

QPP (Quality Payment Program, better known as MACRA and MIPS) Changes
I have to admit that the changes to the QPP program didn’t feel nearly as substantial. The QPP 2019 Fact Sheet seemed short on details and I haven’t had a chance to fully digest the full rule. A few highlights though:

  • 2019 QPP will remove the MIPS process-based quality measures
  • MIPS Expands to PTs, OTs, CSWs and clinical psychologists (which was required by law)
  • It will overhaul the “Promoting Interoperability” category (pretty generic and haven’t figured out what this really means, but they say it will focus on interoperability, imagine that!)
  • The Promoting Interoperability scoring has changed and so has some of the weighting, but nothing major
  • Many of those excluded from MIPS in 2018 can opt in to participate if they want in 2019
  • $500 million pool is available for exceptional performance (whith is now at 80 points vs 70 in 2017)
  • Must use a 2015 Certified EHR (officially a 2015 Edition CEHRT)

Those are some of the big changes I saw offhand.  I’d suggest that this is mostly business as usual for the most part.  Significant if you’re in the MACRA and MIPS weeds, but isn’t likely going to change your MACRA and MIPS strategy.

One change I’m still processing is this one:

Changing the application of MIPS payment adjustments, so that the adjustments will not apply to all items and services under Medicare Part B, but will now apply only to covered professional services paid under or based on the Physician Fee Schedule beginning with 2019, which is the first payment year of the program.

Does this change the analysis that Jim Tate did previously that MIPS Penalties (and incentives for that matter) included Medicare Part B drugs? Sounds like it to me. If I’m reading it right, this change means that the penalties will be less for those getting penalized, but the payments will be less for those participating in the program as well. Not a good thing for a program that already has incentive problems. Is that right or am I reading it wrong?

On that note, this explains why the final rule is 1473 pages long. Time to do some reading of the final rule and see what all the experts find as they analyze it. Let us know what we missed in the comments or any analysis of this that we got wrong. We can all learn what this means together.

Plus, remember that this is just the proposed rule and CMS even asked for comment on if it should go into effect in 2019 or 2020. I encourage you all to provide your feedback on the proposed rule so it can be improved when it goes final.

How Are Ambulatory Practices Going to Compete with Health Systems?

Posted on July 9, 2018 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.

We’ve all seen the stories about the explosion of data and the way healthcare is getting more personalized. However, David Chou recently pointed out how the data is one thing, but figuring out the role everyone plays in your healthcare organization is just as important as the data itself. It gets complex quickly as this graphic David shared shows:

This is a great graphic of the healthcare analytics roles and responsibilities that will be needed to make the personalized medicine future a reality. Plus, it will be key to getting a lot of the value out of our past EHR investments. Many hospitals and health systems already have these roles filled or are working to have them filled. We’ve seen this first hand when we see data jobs being posted to our healthcare IT job board.

While this work is extremely exciting and shows a lot of promise, I imagine a graphic like the one above is just completely overwhelming to consider for a small ambulatory practice. Even a large group practice would likely find the above graphic challenging to consider in their relatively small healthcare organization. How can they compete with a large health system with that kind of complexity? Do graphics like the one above just provide one other illustration of why small practices are going to soon be extinct?

I don’t think so and I hope not. However, graphics like the one above do illustrate the tremendous challenges that ambulatory practices face when they don’t have a massive health system behind them. What’s the path forward for smaller practices then?

The first thing to remember is that even though a health system is large, it doesn’t mean it’s going to do things well. In fact, it’s easy to argue how large organizations are much less efficient. It’s not hard to see how a large health system will focus all of their analytics work on the acute care environment and leaves out ambulatory practices. Smaller healthcare organizations are going to have to use this to their advantage.

While it’s unlikely that ambulatory practices will do all of the healthcare analytics work on their own, it is possible for ambulatory practices to tap into third party vendors that do the work for them and hundreds of other ambulatory practices. Smaller healthcare organizations partnering with corporate and entrepreneurial vendors is going to be the best way for these healthcare organizations to compete with the large health system. In fact, it’s a huge opportunity for them to show why patients should visit their practice instead of the large health system.

One thing that’s holding these efforts back is EHR vendors’ decision to close the doors to outside vendors. There are a few EHR vendor exceptions and areas where every EHR vendor is more open (ie. labs, pharmacy, etc), but it won’t be enough going forward. My friend Jeremy Coleman recently described why in this series of tweets:

I don’t see any healthcare future where centralization will survive. Sure, it will put up a good fight for a while, but the number and variety of applications that are coming out in healthcare are going to be so varied and dramatically important for doctors to incorporate into the care they provide that EHR vendors won’t have a choice but to create APIs that facilitate all of these applications.

An EHR vendor that embraces this approach is going to be essential for every ambulatory practice. Eventually, ambulatory practices will be stuck with the need to switch EHR systems or sell to the health system (which generally means switching EHR systems too). However, an ambulatory EHR that provides an open ecosystem for the latest and greatest in health IT will allow ambulatory practices to thrive even against the much larger health systems.

Happy 4th of July

Posted on July 4, 2018 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.

Happy 4th of July to all of you! I’m grateful this day for the opportunity to be a blogger and be able to share all of the things we do with you. I know that freedom of the press isn’t available everywhere in the world. I hope everyone is enjoying this day with family and friends and taking time to enjoy the little things in life.

Happy 4th of July!

EHR Passwords

Posted on July 2, 2018 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.

Everyone has issues with passwords in their lives. I once saw a startup company who’s entire advertising at an event was a big screen that said “Kill Passwords.” They were mobbed by people that stopped to hear what they were doing (Sadly, they haven’t killed passwords yet).

Turns out that EHR users hate passwords too:

The responses to this thread are pretty epic. Here are a few of them that stood out to me:


Many doctors have felt like doing this…and a few have done it.


Sad, but true in some places.


Been there. In fact, I’m always there since some password I use reguarly is always changing on me.


This is what annoys me most. Many of these password policies aren’t based on security or they’re based on outdated security.


The best reason why IT professionals should get to know more reasonable password policies that are just as or even more secure.

2017 MIPS Final Score and Performance Feedback Is Out

Posted on June 29, 2018 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.

Big news just came out for those that are participating in MACRA and MIPS. CMS Announced it on Twitter:

That’s right, you can now visit the QPP website and login to see and verify your 2017 MIPS final score and performance feedback. Interesting that they would choose to push this out late on a Friday. You’ll want to verify this information to make sure you’re paid correctly and to make sure they have the right data for you before they make all the MIPS scores public.

I looked at the Physician Compare website and unless I just didn’t look in the right places, I don’t see the MIPS Quality scores available on the website yet, but I expect they will be soon. Plus, they’re likely going to make the data available for download as a dataset. Once they do, websites like ZocDoc, Vitals, HealthGrades and the rest of the physician ratings and review websites will pull the data and incorporate it into their physician profiles. So, you’ll want to make sure your data is accurate.

I will say that when I was looking at physicians on the Physician Compare website, I was fascinated by the note they put as a popup for someone who had “Used electronic health record”:

To be fair, they did use the word “may”, but I think most doctors would say this is a far cry from what EHR software has accomplished. However, it’s clear what the intent of the legislation and CMS was when it came to adoption of EHR software.

Have you had a chance to look at your MIPS score and performance feedback? We’d love to hear about your experiences. We’ll be interested to see how these MIPS quality scores are used by doctors and patients.

The Importance of Patient Experience for Small Practices

Posted on June 8, 2018 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.

Small practices are in a really interesting and challenging place right now. Every doctor I know wants to practice medicine in a small practice, but they’re increasingly getting squeezed out of the equation. Most are succumbing to large health systems or migrating to larger group practices that can leverage their power against the larger health system. History shows that this ebbs and flows, but my gut tells me that this time it’s a bit different because of technology.

Without going to deep into the dynamics of small practices, I want to highlight how a unique patient experience is one place where a smaller practice or even group practices can differentiate themselves. At large health systems, there are very different dynamics when it comes to patient experience, but there are also a lot of barriers to creating a great experience for patients. This is where smaller practices should take advantage.

The reality is that small practices have a tremendous opportunity to offer a unique experience because of their lack of scale.

As I’ve seen recently with a company I advise, CareCognitics, there’s a great opportunity with chronic care management to create a unique patient experience. Initially this can be funded with the chronic care management CPT code, but it’s just the start of building the deep relationship with your patients that I’ve written about many times previously.

One doctor I talked to about chronic care management pretty bluntly said “When a patient walks out that door, I’m not going to think about them again until they come back into my office.”

While this hurts to write and even more to say, it’s the reality for most doctors. They don’t have the time to think about all their patients once their out of the office. In fact, with all the reimbusement and regulatory requirements heaped on them, they can barely think about the patient while their in the office (but that’s a story for another day).

We need to shift this paradigm and I think practices that don’t are going to have real issues in the future. Certainly your doctor isn’t going to be thinking about you much outside of the office. However, our systems can think about you all the time. Our health data can be there and available and queue the physician in when there is something that needs addressing. The technology to do this is basically here and ready. What’s holding it back?

The real challenge we face is accepting that these systems won’t be perfect. At Health IT Expo, we had a great discussion about perfect being the enemy to good and that doing nothing can cause a lot of harm. I think this is the route we’re