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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

Take Part in Practical Health Innovation Think Tank – #HITExpo

Posted on May 28, 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’m certain that most of you know about the Health IT conference that Healthcare Scene is organizing called Health IT Expo. We’re thankful for hundreds of you who will be joining us in New Orleans for the conference. However, we understand that many of you couldn’t make it to HITExpo this year and so we wanted to find a way to share some of the practical innovations that will be shared at the conference.

With this goal in mind, we’ve brought together a number of the Health IT expo speakers, thought leaders, and experts in a Think Tank event that we’re making available in a free live stream event. As part of the Think Tank, we’ll be discussing the following three topics:

  • Going Beyond the EHR
  • Practical Health Innovation
  • Communication and Patient Experience

In order to join the live stream, you’ll need to visit the Healthcare Scene YouTube, Facebook, or Twitter accounts on Wednesday, May 30th from 9-2:30 PM CT. We’ll also embedding the live stream in this blog post on the day of the event. You can also follow along and join in on the conversation using the #HITExpo hashtag on Twitter. We’ll be watching the hashtag for questions and comments which we’ll try to incorporate in the conversation as much as possible.

We’re thankful for each of you that are part of the health IT community. Please carve out time to join the community to share practical innovations that can help move healthcare forward. Check out the Health IT Expo website to learn the group of experts that will be participating in person at the Think Tank.

Doc Vader on Integrative Medicine – Fun Friday

Posted on May 11, 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.

Time again for another Fun Friday entry as we head into the weekend. This week we tapped into the most comedic doctor out there, ZDoggMD. Well, I guess it’s actually his alter ego Doc Vader, but you get the idea (and if you don’t get the idea, you should find ZDoggMD’s parody videos and watch them).

For this week’s Fun Friday video check out this video with Doc Vader talking about Integrative Medicine (not to be confused with integrated medicine or collaborative medicine with your doctor):

Meaningful Use Becomes Advancing Care Information Becomes Promoting Interoperability – MACRA Monday

Posted on May 7, 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.

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.

I’m quite sure you’ve all seen the news coming out from CMS about the name change for the various Medicare EHR Incentive and MACRA programs. I decided to not dive into it in depth here since so many organizations are already doing it. Plus, this is just the proposed rule. However, if you want some light reading, here’s all 1883 pages of the Promoting Interoperability proposed rule.

The name change of Meaningful Use/Advancing Care Information to Promoting Interoperability is an interesting way for CMS to signal what they want these programs to accomplish. It’s always been clear that ONC has wanted to find a way to promote interoperability. Now they literally have a program that will work to drive that goal.

I’ll admit that I’ve been a fan of this idea since May 15, 2014 when I suggested that ONC and CMS blow up meaningful use and just focus it on interoperability. It only took 4 years for them to figure this out.

While I still think this is directionally an interesting way to go, I’m afraid that the current programs aren’t a big enough incentive for CMS to really move the needle on interoperability. Plus, can CMS really create a rule that would push effect interoperability? I’m skeptical on both counts.

What’s interesting is that CMS could really push interoperability if it wanted. It could just say, if you want to get paid for Medicare, then you have to start sharing data. No doubt there are some complexities to this idea, but if CMS is really serious about promoting interoperability, that’s what they’d really do. That would move the needle much better than thousands of pages of rule making that won’t cause doctors and healthcare organizations to change.

What are your thoughts on the proposed rule? Were there big pieces of it that you saw and you think others should be watching? Are these changes going to relieve doctors of the massive reporting burden they should today? Please share your thoughts in the comments or on Twitter with @HealthcareScene

Medical Billing Cartoons – Fun Friday

Posted on May 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.

I shouldn’t share jokes about healthcare billing because it impacts so many patients. However, sometimes it takes illustrating how ridiculous something has become to help people understand that something needs to change. I think this is particularly true with medical billing. The hard part is that I don’t see any of it getting much better. Are there any initiatives out there to make medical billing easier and less onerous? I haven’t seen them.

Maybe I should have called this the not so Fun Friday. Hopefully, the cartoons at least give you a laugh.

Setting Work Limits, Slow EMR Access, and Good, Better, and Best Data

Posted on April 30, 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.

It’s that time once again for a roundup of interesting tweets. There are always thousands more that we could highlight, so if you’re not on Twitter, why not? It takes some investment to get the best feed possible, but once you do it’s invaluable. Of course, we do our best here at Healthcare Scene to read everything so you don’t have to. So, at least we have you covered there.

Now on to the fun…


This is a fine point that is worthy of more discussion. Of course, it’s a universal problem that doesn’t just apply to healthcare. It’s worth noting that this doctor didn’t comment about the times she had to race into the office to look up a paper chart either because she got a call about a patient that was in the ER. As in most things in life, there’s a lot of give and take. Setting limits is really the key because the accessibility of records can save a lot of time too.


This is an interesting one for me. There are some real red flags here. First, if they’re using Citrix, then it’s likely not a true cloud implementation and likely means it’s an older EMR software. Not always true, but quite possible. Second, if the workflow is to print a list so they can write notes with a pencil, then they have some serious EHR implementation, adoption, and optimization problems. Is the optimal workflow a pencil and paper? My guess is not. However, the fact that the machine boots up slow probably indicates that this user doesn’t have great tech support that can show them a better way. Unfortunately, I think that this is probably all too common too.


Rasu offered some great insights into data at Health Datapalooza. This was a golden one that I could tell he’d shared quite a bit. How many of you work in organizations that turn data into action?

Making EHRs Easier to Use and Safer

Posted on April 23, 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.

Most people know that I’m a sucker for a well done infographic. Of course, there are a lot of crappy infographics out there, but a well done one is easy to read, educates, and informs in a really nice way. That’s why I enjoyed this infographic from The PEW Charitable Trusts embedded below.

Some of the EHR usability it issues are well known things like alert fatigue and incomplete lab results. However, I was impressed that this list included things that are often hidden from many’s view like the unintended consequences of customization and autorefresh mix-ups. Of course, the infographic doesn’t talk about how to fix them, but in many of these cases awareness is what’s most needed to fix the problem.

What do you think of the infographic below? What stands out to you?

Pace of Technological Innovation

Posted on April 18, 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.

Sometimes you come across a chart that blows your mind and causes you to step back and reconsider your perspective. That’s what happened to me when I saw this chart shared by Sandeep Plum MD. The chart shows every major technological innovation in the last 150 years and how they have changed the way we work. More specifically, I think it shows how technology has improved the output we’re able to create.

This chart is pretty astonishing to consider. I’d like to dig into the data some more, but no doubt the concept of technology allowing us to produce more is something we’ve all experienced. The amount of leisure time we have compared to farmers even 150 years ago is astonishing to consider.

The problem in healthcare is that many people will wonder why healthcare hasn’t seen the same increase in output. The reality is that we have seen an improvement. The challenge in healthcare is the care we provide has become much more complex and the regulations around that care have become more complex as well. So, the increased output doesn’t feel the same because of these added complexities.

When thinking about healthcare complexity I always like to think about the country doctor back in the day that had the famous black bag and would visit you in your home. What diagnostic tools did he have? Not very much. What treatment options were available to him? Not very many (and a lot of them were very questionable). Compare that to today’s healthcare which has extremely sophisticated diagnostic tools and treatment options. Much of our increased output goes into navigating these tools and options.

The same is true for the increased regulation and reimbursement requirements. How did the country doc handle documentation and reimbursement? He might have written a few notes on a sheet of paper. Underscore the might. The country doc didn’t have to worry about insurance requirements, prior authorizations, CPT codes, or other complexities that make medical billing so time-consuming. He just asked the patient if they could pay. Sometimes that meant he was taking a pig home with him as payment, but he didn’t have to worry about insurance claims denials or sending out patient bills.

This is why I think so many doctors are frustrated by technology. The technology has improved their output, but in many ways that improved output has just been pushed to satisfy bureaucratic requirements as opposed to improving care and making the doctor more efficient.

The good news is that the pace of technological change will continue. It’s not too hard to see the day when a doctor goes into an exam room and the documentation that’s required for reimbursement and continuity of care just happens automatically. We’re not there yet, but the technology to make that a reality is. The only question is whether we can stem the increase in regulations that are eating away all that increased output that technology provides.

Self-Learning Analytics and Making Analytics Useful

Posted on April 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.

One of the shocks to me at HIMSS 2018 was that there wasn’t nearly as much discussion around healthcare analytics as I thought there would be. I thought for sure we’d see an explosion of proven analytics that healthcare organizations could start to take advantage of. Maybe I just missed it, but I certainly didn’t see anything all that new.

It’s too bad because that’s one of the huge opportunities I see for healthcare. I was looking through some old notes from conferences and saw a note where I wrote: “What you do with the data is the competitive differentiator, not the data.

Certainly, you need access to the data to be successful, but there are a lot of organizations out there which have access to health data and they’re not making any sort of dent. Many of the now defunct HIEs had access to the data, but they didn’t know what to do with all that data. I’m still on the search for more analytics which are useful.

One other idea I found in my notes was the concept of a self-learning analytic. Related to this was the discussion we had about black box analytics in a recent #HITsm Twitter chat. I don’t think they have to be the same, but I do think that the key to successful healthcare analytics is going to require some component of self-learning.

The concept is simple. The analytic should look at its past recommendations and then based on the results of past recommendations, the analytic should adjust future recommendations. Notice that I still call it recommendations which I think is still the right approach for most analytics. This approach to constantly learning and evolving analytics is why it’s so hard to regulate healthcare analytics. It’s hard to regulate moving targets and a self-learning analytic needs to be moving to be most effective.

This is possibly why we haven’t seen an explosion of healthcare analytics. It’s hard to get them right and to prove their effectiveness. Plus, they need to continually evolve and improve. That’s the opposite of what researchers want to hear.

This is why the future of healthcare analytics is going to require deep collaboration between healthcare analytics vendors and provider organizations. It’s not a black box that you can buy and implement. At least not yet.

What’s been your experience with healthcare analytics? Where are you seeing success? We’d love to hear your thoughts in the comments.

Potential 2015 Edition EHR Certification Logjam

Posted on March 23, 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’ve read these blogs for any amount of time, you know how I feel about EHR certification (Not a fan!). I think EHR certification has wasted a lot of EHR programming cycles and in many ways killed EHR innovation that would have occurred without it. That said, EHR certification is still a cost of doing business given the current regulations.

My friend Jim Tate from EMR Advocate described it even better:

Certification has become embedded in the evolving field of healthcare technology. Whether it is MACRA/MIPS, recognition of Medical Home status, or the requirements of a Request for Proposal (RFP), there is an ongoing need for vendors to achieve and maintain certification of their products. The ONC certification system may contain some flaws, but it is the cost of doing business in this domain. If a vendor does not achieve ONC Certification their business model is at great risk.

Jim and I have had many conversations about EHR certification. While we might disagree on the value of EHR certification (or lack therof), we both agree that EHR certification is embedded in the EHR market and every EHR vendor has to do it (Yes, I know about DPC and a few other elective practices that don’t have to worry about it). Do I see it going away? Not in the near future, so we just have to grin and bear for now.

That said, Jim Tate also made a really strong prediction about what EHR vendors can expect in the 2nd half of 2018 in regards to EHR certification. Let’s just say that a number of EHR vendors aren’t likely to be grinning if they’ve put off 2018 Edition EHR certification. Here’s how Jim describes it:

ONC has rolled out three editions of CEHRT. The first, the 2011 Edition, has long gone into the history books. The 2014 Edition can still be used throughout 2018. 2019 is altogether another story. Originally 2018 was the year that vendors had to roll out their certified 2015 software editions. A one-year grace period was thrown into the mix and vendors were given an extra year to achieve the 2015 Edition certification and roll out their products to providers. With only 9 months left to accomplish that task, they may be running out of time.

The Certified Health IT Products List (CHPL) maintains the ledger of all active and withdrawn certifications. There is some fascinating data there to review. There are over 4000 entries for active 2014 Edition Certification. For the 2015 Edition there are less than 300 active certifications. Now I admit there is a bit of an apples to oranges comparison here. For 2014 many vendors active certification is shown for different versions of the same product. Nonetheless it is apparent to me that many vendors have yet to achieve certification even with a deadline staring them in the face.

If that’s not a definition of a logjam, then I don’t know what is. Plus, Jim notes that there’s been some contraction of the EHR certification bodies as well. There just aren’t as many out there to get your EHR product certified. Jim would know since he’s helped over 300 health IT systems get certified. Do you see the problem that’s coming?

What can you do?
The first thing you can do is to go to the Certified Health IT Products List (CHPL) and see if your EHR vendor is 2015 Certified. If it’s not, then you may want to ask your EHR vendor what their plan is to become certified. Knowing the answer to that question will be important to your organization. If it’s not 2015 Certified, then you’ll have issues with MACRA and MIPS in 2019.

Thanks Jim Tate for always staying on top of this stuff and being the wise words of warning about impending issues.