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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.

EMR and EHR Angst

Posted on March 21, 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 thought it was time to do another Twitter roundup and as I started searching for interesting tweets I came up with a theme: EMR and EHR angst. I’m sure if you use an EHR in your practice, then you’re familiar with this subject. The following tweets illustrated some of the angst that exists out there.


I love the term algorithm monster that we get from John. I wonder if he’d feel different if the algorithm monster was able to improve patient care and not just maximize reimbursement.


Jeremy offers a more rosy view of EMR. Although he still has angst that many people are treating the EHR as the end game as opposed to a foundational piece that’s required to get to the benefits that so many desire. I think many are just tired of the promises that never materialized.


Leave it to the Gomer blog to add some humor to the situtation. Unless you’re the one that far behind on your charts. Then, it’s not quite so funny.

Blockchain and Tokens

Posted on March 20, 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’ll admit that I’m still trying to really understand blockchain and tokens. I can see elements of potential, but I think everyone would agree that we’re still very early in the development of blockchain and tokens. I’ll avoid comparison to the early internet days, but no doubt there’s a lot to be learned from those comparisons.

A VC blogger I read who invests in the blockchain space shared this really great presentation on cryptotokens and a look at the various players in a blockchain community. If you’re trying to understand blockchain and tokens in particular, read the following presentation in full screen mode and you’ll have a better understanding of it.

No doubt this cryptotoken presentation was skewed towards how regulators should approach regulating the space. However, it helped me understand some of the ways tokens are used in blockchain. Do I understand it fully? Not yet, but this is getting me closer.

What’s not clear to me is how much we will really need to know to benefit from blockchain. It seems to me like the answer is not much. When I use Amazon I don’t need to know what database they use or what programming language their website uses. The same is true for a laptop. I don’t really need to know the details of how an Intel processor works, but I do like to see the Intel Inside sticker on the outside and some of the specs.

I have a feeling blockchain will evolve to be something similar. A few very technical people will need to know more about the details and they’ll build the infrastructure. However, most people will just use a service and not know any of the technical details. However, if blockchain is successful, then people will want to choose a service that’s built on blockchain because of some of the characteristics that make it better than one centralized system. We’re certainly not there yet in healthcare.

Are You Ready for IoT in Healthcare?

Posted on March 19, 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.

Are you worried about how to leverage IoT in your healthcare organization? Do you know what IoT even is?

You may or may not know what it is, but no doubt IoT is part of your life. Here’s the wikipedia definition of IoT or Internet of Things:

The Internet of things (IoT) is the network of physical devices, vehicles, home appliances and other items embedded with electronics, software, sensors, actuators, and connectivity which enables these objects to connect and exchange data. Each thing is uniquely identifiable through its embedded computing system but is able to inter-operate within the existing Internet infrastructure.

It’s easy to see how much IoT is impacting our lives. Is there any reason to think that IoT won’t make its way into our healthcare lives as well?

David Chou recently shared an example IoT ecosystem that’s being built along with a number of the players in the space:

To me, this graphic illustrates two important truths about the future of IoT.

First, IoT is happening in a really big way with some really enormous companies driving it forward. Plus, the infrastructure to make it a reality is being built out and it’s going to impact all of our lives even more than it does today.

Second, IoT is a complex beast and so don’t be surprised if it takes healthcare a little while to fully embrace everything that’s possible with IoT. Healthcare is so risk averse that it will wade into the IoT waters very slowly. IoT won’t be disrupting healthcare tomorrow, but it will disrupt healthcare in new and interesting ways.

What do you think of the potential for IoT in healthcare? Do you see any companies bucking the above two observations? Where are you starting to see IoT get implemented today?

Learn the Latest ACI (Advancing Care Information) Details as Required in MACRA-MIPS

Posted on March 16, 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 been partners with 4Med for a long time and offered a wide variety of courses over the years. Many of you reading this have probably taken their HIPAA security courses or possibly one of their previous PQRS and meaningful use courses.

Of course, the meaningful use and PQRS courses have now evolved into training around MIPS and MACRA. You know how complex these can be and that’s why I’m grateful that 4Med has put together these concise courses to teach you and your practice what you need to know. Plus, as part of these courses you also get a certification and possibly CEUs (depending on which CEUs you need).

With this in mind, 4Med recently announced their next ACI (Advancing Care Information, formerly known as Meaningful Use) course along with the CMAP (Certified MACRA-MIPS ACI Professional) Certification. This is a great course for those wanting to hear the latest info from the 2018 final rule.

Here’s a full summary of topics the ACI course will cover:
* Introduction to ACI for MIPS ECs
* ACI Reporting 2018
* ACI Reporting Options for 2017
* Required Objectives for the ACI Category
* Optional ACI Objectives for ECs Using a 2015 CEHRT
* Optional ACI Objectives for ECs Using a 2014 CEHRT
* Focus on Protecting Patient Health Info
* Patient Electronic Access
* Coordination of Care Through Patient Engagement
* Health Information Exchange
* ACI Scoring

This course is a live online workshop held on April 18, 19, 25, and 26 and are led by Trisha Conway, RN, BSN, CEO and Principal Consultant at eHealth Consulting. Of course, if you can’t attend the live sessions, then they’ll be recorded and available to you after the live event as well.

If this course interests you, you can register now and save $150 off your registration thanks to Healthcare Scene’s partnership with 4Med. The promo code to get the discount is HCSEARLYBIRD150, but if you click this link the discount will be applied automatically.

Meet the #HIMSS18 Press – A Wrapup Discussion of the Conference

Posted on March 13, 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 week most in the healthcare IT community are recovering from the massive healthcare IT conference we know as HIMSS. The conference brings together a wide variety of people from the healthcare IT community and everyone is guaranteed to miss something that they’d find interesting and valuable. With that in mind, we’re hosting this week’s #HITsm chat to talk about what we saw and heard at #HIMSS18. Be sure to join us and share your insights and perspectives since we all no doubt had unique experiences.

As I’d done once previously, on the last day of HIMSS I hopped on video with my friend and colleague, Neil Versel who now writes at Genome Web, to talk about what we saw at HIMSS 2018. While I’m attending my 9th HIMSS, this was Neil’s 17th. So, we have some experience and perspective to offer having attended HIMSS for a combined 26 years. Enjoy our wrap up discussion on the final day of HIMSS:

What was your experience at HIMSS18? If you didn’t attend, what would you have liked to see? Did you follow along on Twitter? What do you think of the trending topics we discussed. How will they impact your business? Let us know in the comments.

Changes Coming to MACRA Announced at #HIMSS18

Posted on March 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.

At the HIMSS18 Annual Conference in Las Vegas, Seema Verma announced a new HHS initiative called MyHealthEData. It’s not actually clear to me how this initiative works. It says that it will make clear that “patients deserve to not only electronically receive a copy of their entire health record, but also to be able to share their data with whomever they way, making the patient the center of the healthcare system.”

All of us as patients love this idea. What’s not clear to me from this announcement is what HHS and Seema Verma are going to do to make this a reality. It’s nice that they’re pushing it, but will they use something that will really motivate healthcare organizations to change?

As an almost afterthought in the press release for the MyHealthEData initiative was this section on MACRA:

Additionally, CMS intends to overhaul its Electronic Health Record (EHR) Incentive Programs to refocus the programs on interoperability and to reduce the time and cost required of providers to comply with the programs’ requirements. CMS will continue to collaborate with ONC to improve the clinician experience with their EHRs.

Administrator Verma said CMS has implemented laws regarding information blocking – a practice in which providers prevent patients from getting their data. Under some CMS programs, hospitals and clinicians must show they have not engaged in information blocking activities.

The Administrator also highlighted other CMS plans to empower patients with data:

  • CMS is requiring providers to update their systems to ensure data sharing.
  • CMS intends to require that a patient’s data follow them after they are discharged from the hospital.
  • CMS is working to streamline documentation and billing requirements for providers to allow doctors to spend more time with their patients.
  • CMS is working to reduce the incidence of unnecessary and duplicative testing which occurs as a result of providers not sharing data.

This definitely isn’t clear what changes are coming to MACRA (or Electronic Health Record (EHR) incentive programs as she calls it), but it is clear that CMS is going to work to simplify the requirements for MACRA. We’ll all be watching this with a keen eye. I also found the push for interoperability fascinating since it’s what I’ve suggested would be a much narrower goal that could be achievable with the right incentives.

I was also interested with the bullet point about streamlining documentation and billing requirements. We all can’t wait for this, but I think it’s much harder to change than I think most of us think.

Change is coming to MACRA. What’s your prediction on the changes that will be made to MACRA?

Healthcare IT Job Satisfaction – Fun Friday

Posted on February 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.

It’s Friday and so as we head into the weekend it’s time for some fun. This is especially needed with HIMSS only 10 days away. This first cartoon hits on the impact of technology on our health, but also on the impact of EHR and technology on doctors. Especially healthcare IT software with really bad UIs. You know what I’m talking about.

And this one for my coffee loving friends: