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!

Patient Directed Health Data Exchange on The Blockchain

Posted on September 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.

I’ve long been friends with Dr. Tom Giannulli who most of you will probably have known as the CMO of Kareo. I first met Dr. Tom back when he created what I would call the first iPad optimized EHR interface back when Dr. Tom was at Epocrates and before they sold that EHR to Kareo. Needless to say, Dr. Tom is the kind of guy that likes to sit on the cutting edge of technology and how it applies to healthcare. So, it was no surprise to me when he came to me with his patient directed health data exchange called PatientDirected.io which is built on the blockchain.

While a lot of people talk about blockchain and theories about how blockchain could help healthcare, a lot of what people were doing was just talk. What I like about Dr. Tom and PatientDirected.io is that they just put out a video demo of a patient chart being requested from Kareo by the patient and then the patient sending that chart to Epic. Check it out to see what I mean:

Many of you that watch this demo might be asking. How is this on the blockchain? That’s one of the things that many people don’t understand about blockchain. If it’s done right, you won’t know anything about the blockchain. However, the blockchain can do things like creating smart contracts with providers which can create trusted connections. The blockchain is distributed, so your data isn’t stored on a central server that’s owned and controlled by PatientDirected.io. Basically, blockchain has a number of benefits, but it’s the “Intel Inside” and so it’s not something you should see as an end user, but it could provide some great benefits.

I also like that PatientDirected.io isn’t trying to reinvent the wheel. They’re using trusted third party applications like Verato to handle their master patient index and for verifying patients identity. There’s a lot more to explore when it comes to identity management, but it’s smart to work with companies that are doing this all across healthcare.

I was also impressed with the detailed sharing permissions that were available in PatientDirected.io. At first glance, a part of me wonders if it’s too complex for most patients. However, as long as the options are there, the interface can adapt to allow for specific patient preferences when it comes to data sharing. Of course, it’s nice that all of the sharing of this data will be tracked on the blockchain.

The key to all of this working for me is the integration with the EHR vendor. It looks like it’s using Direct to handle the messaging to the EHR vendor and back. This is good because I believe all certified EHR (which is pretty much all of them) have direct messaging built in. Some have integrated it better than others, but they all have this capability. My big concern with it though is whether what’s being shared by EHR vendors using Direct is enough data. And will that data that gets sent from one EHR to another appear in a format that’s useful to the receiving physician? If it’s not, then it doesn’t solve much of anything. Plus, I wonder what happens when a doctor gets a record request and doesn’t respond. This is especially true for EHR vendors who haven’t integrated Direct into the core EHR workflow. Will this take a culture change to not leave patients waiting for records that will never come?

As you could imagine, PatientDirected.io has an ICO offering on StartEngine.com. Looks like it just got started, but there’s an opportunity to buy their tokens if you’re interested and believe they’re on to something special.

I think there is a space for a patient directed health information exchange assuming we can make the exchange of information between disparate providers very simple. There are still some challenges for patients when it comes to getting access to their health information, but the law is clear that patients should have access to their health information. Now we just need the user interfaces to be as simple as clicking a button like is demonstrated in the video above and we’ll see much more patient directed health information exchange.

The Ambulatory EHR Market with Raul Villar, Jr. CEO of AdvancedMD

Posted on September 5, 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.

The ambulatory EHR market is near to my heart since that’s where I started when I entered this world of healthcare IT. My first job was implementing an EHR in a small ambulatory practice. As regular readers know, I’ve commented on how the independent small practice is in trouble. I’m not suggesting this is what I’d like to happen or what should happen, but there are certainly a lot of challenging pressures on small practices.

Along with these pressures, the ambulatory EHR market is extremely different today than it was 5-10 years ago. The $36 billion funded meaningful use era of EHR adoption was what I call the golden age of EHR. We could argue whether it was a golden calf or not, but from a market standpoint, the meaningful use money fueled adoption of the EHR.

Today’s ambulatory EHR market is very different. That’s why we were excited to sit down with Raul Villar, Jr. CEO of AdvancedMD to talk about his perspective on the ambulatory EHR market. We also talk with him about the evolution of AdvancedMD as it went from ownership by ADP to now being owned by Marlin Equity Partners and what those changes mean for their customers. Plus, we go over AdvancedMD’s acquisition of NueMD and what their strategy is behind the acquisition. Finally, we talk about EHR vendors as a platform and where he sees AdvancedMD taking their platform in the future.

If you’re interested in the ambulatory EHR market or in AdvancedMD, you’ll enjoy this interview with Raul Villar, Jr.

If you enjoyed this video interview, be sure to Subscribe to Healthcare Scene on YouTube and watch all of our healthcare IT interviews.

AI-Based Tech Could Speed Patient Documentation Process

Posted on August 27, 2018 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 researcher with a Google AI team, Google Brain, has published a paper describing how AI could help physicians complete patient documentation more quickly. The author, software engineer Peter Lui, contends that AI technology can speed up patient documentation considerably by predicting its content.

On my initial reading of the paper, it wasn’t clear to me what advantage this has over pre-filling templates or even allowing physicians to cut-and-paste text from previous patient encounters. Still, judge for yourself as I outline what author Liu has to say, and by all means, check out the write-up.

In its introduction, the paper notes that physicians spend a great deal of time and energy entering patient notes into EHRs, a process which is not only taxing but also demoralizing for many physicians. Choosing from just one of countless data points underscoring this conclusion, Liu cites a 2016 study noting that physicians spend almost 2 hours of administrative work for every hour of patient contact.

However, it might be possible to reduce the number of hours doctors spend on this dreary task. Google Brain has been working on technologies which can speed up the process of documentation, including a new medical language modeling approach. Liu and his colleagues are also looking at how to represent an EHR’s mix of structured and unstructured text data.

The net of all of this? Google Brain has been able to create a set of systems which, by drawing on previous patient records can predict most of the content a physician will use next time they see that patient.

The heart of this effort is the MIMIC-III dataset, which contains the de-identified electronic health records of 39,597 patients from the ICU of a large tertiary care hospital. The dataset includes patient demographic data, medications, lab results, and notes written by providers. The system includes AI capabilities which are “trained” to predict the text physicians will use in their latest patient note.

In addition to making predictions, the Google Brain AI seems to have been able to pick out some forms of errors in existing notes, including patient ages and drug names, as well as providing autocorrect options for corrupted words.

By way of caveats, the paper warns that the research used only data generated within 24 hours of the current note content. Liu points out that while this may be a wide enough range of information for ICU notes, as things happen fast there, it would be better to draw on data representing larger windows of time for non-ICU patients. In addition, Liu concedes that it won’t always be possible to predict the content of notes even if the system has absorbed all existing documentation.

However, none of these problems are insurmountable, and Liu understandably describes these results as “encouraging,” but that’s also a way of conceding that this is only an experimental conclusion. In other words, these predictive capabilities are not a done deal by any means. That being said, it seems likely that his approach could be valuable.

I am left with at least one question, though. If the Google Brain technology can predict physician notes with great fidelity, how does that differ than having the physician cut-and-paste previous notes on their own?  I may be missing something here, because I’m not a software engineer, but I’d still like to know how these predictions improve on existing workarounds.

HPV Surveillance Project Reminds Us Why HIEs Still Matter

Posted on August 24, 2018 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.

When healthcare organizations use EHR data to improve care or streamline processes, it seems like an obvious way to go. There are many benefits to doing so – certainly far more than I could cover in a single story—and odds of finding better ways to leverage such data further keep increasing over time.

Given the attention commercial EHR data use gets, it’s easy to forget the role of such data in improving public health. Yes, medical practices need to meet criteria that converge with public health objectives, such as managing diabetes and its side effects. And of course, population health management efforts directly mirror and sometimes overlap with public health goals. But it’s seldom the work of which rockstars are made.

However, given that the bulk of efforts have typically been spearheaded by government agencies or independent non-profits in the past, it’s a good idea to keep track of what they’re doing, especially if you’re wondering what else you can do with patient health data. It’s even more important to remember that even a cache of regional health data can be very valuable in supporting community health.

I was thinking about this recently when the following story turned up in my inbox.  On the surface, it’s not a big deal, but it’s the kind of cooperative effort that can improve community health in ways that work for everyone in healthcare.

This story looks at the kind of data harvesting exercise that flies under the radar of most providers. It describes an HPV surveillance effort, the HPV Vaccine Impact Monitoring Project (HPV-IMPACT), which is sponsored by the CDC and implemented by the Center for Community Health and Prevention at the University of Rochester.

The HPV-IMPACT project is relying in part on data by the Rochester RHIO, which is sharing anonymized patient health information collected between 2008 to 2014. The researchers are also using data from California, Connecticut, Oregon and Tennessee.

The goal of HPV-IMPACT is to identify trends such as changes in the percentage of women screened for HPV, the implications for different age groups and overall test outcomes. Once they complete this analysis, research will use it to determine whether HPV incidence rates can be attributed to vaccine use or alternatively, decreases in detection.

While this kind of project is bread-and-butter research, something that won’t ever make headlines in medical journals, it deserves some thought.

With things being as they are, it’s easy to dismiss HIEs as parts of a broken national interoperability effort. Hey, I’ve been as guilty of this as anyone. For many years, I waited for the HIE model today, in part because it just didn’t seem to be a sustainable business model, but at least some just kept on chuggin’.

As it turns out, regional HIEs aren’t abandonware — they just have their own niche. This kind of story reminds me that even limited health data collection efforts can make a difference. Keep up the good work, folks.

The Latest Look At How Physicians Share PHI Electronically

Posted on August 22, 2018 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.

Over the last several years, I’ve read many a report on physicians’ sharing of health data. The key metrics most observers use to measure these efforts are how often physicians send and receive data and what type of data they’re sending.

I’m not so sure that this measurement offers the best look at health data sharing. I’m more interested in what doctors do with the information than what they shared and received. My guess is that these reports measure PHI coming and going because it’s simply more practical and does offer at least some insight.

In that spirit, I present to you some numbers from the CDC’s National Health Statistics Reports. That data comes from the 2015 National Electronic Health Records Survey, a nationally-representative survey of nonfederal office-based physicians. The study estimates the types PHI doctors electronically sent, searched for, received and integrated.

Survey results included the following:

  • Among physicians who sent PHI electronically, the most common types of data sent were referrals (67.9%), laboratory results (67.2%) and medication lists (65.1%). The least commonly observed types were summary of care records (51.5%), registry data (55.9%) and imaging reports (56.6%).
  • When these physicians received PHI, the most common types the study found were laboratory results (78.8%), imaging (60.8%) and medication lists (54.4%). The types seen least often included ED notifications (34.5%), hospital discharge summaries (42.5%) and registry data (43.2%).
  • For physicians who integrated PHI electronically, the most commonly observed types were laboratory results (73.2%), imaging reports (49.8%) and hospital discharge summaries (48.7%). PHI least commonly integrated included registry data (30.9%), problem lists (32.7%) and medication allergy lists (36.1%).
  • The most common reasons physicians searched for PHI electronically were to find medication lists (90.2%), medication allergy lists (88.2%) and hospital discharge summaries (80.4%), followed by imaging reports (58.9%), laboratory results (48.5%) and problem lists (41.2%).

The CDC analysis of this data notes that it might be smart to articulate the differences between primary care PHI exchange and specialist PHI exchange. It rightfully points out that research which breaks down such data not only by specialty, but also office setting, practice size and EHR vendor would be a good idea.

These aren’t the only issues left unaddressed, though. What strikes me about this data is that there’s little symmetry between what doctors send and what they receive. There’s also little overlap between the sharing stats and those regarding what they integrate. Their priorities when searching for information seem to be on their own track as well.

What does this mean? It’s hard to tell. But I think someone should look at the differences in how doctors participate in various forms of electronic exchange of PHI. These differences probably say something, and it would be nice to know what it is.

 

 

Physician Revolt Against EHRs – Unlikely to Happen

Posted on August 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.

Physicians hate EHRs.

Yes, there are a few exceptions, but it’s pretty rare to find a physician that loves their EHR. There are a fair number of them that are apathetic towards their EHR, but there are a lot of doctors who hate them.

How much do they hate them? That’s hard to say, but it seems clear that they don’t hate them enough to really change things. Sure, they’ll leave some comments on message boards, send out some tweets or write some blogs, but they don’t seem ready to take it to the board (even when they’re the board). The most common path is doctors hate the EHR when it’s first implemented and then they learn the EHR software and become apathetic.

Clay Forsberg recently laid out the strategy for doctors who hate their EHR and want change:

Clay makes a great point. He then extends the discussion with these tweets:

The real problem here is that EHRs are the epitome of “meh.” They get in the way, but it’s hard to draw a specific line between EHR software and deaths or really poor quality care. They cause some time issues with multiple logins and lots of clicks, but they also save time in other ways. They have some bad workflows, but they make some workflows better.

EHRs are just good enough to avoid a revolt.

Plus, a doctor replying to Clay Forsberg’s tweet above identified another issue:

Doctors definitely don’t want to risk their livelihood, but I think even more than that they don’t think that complaints about the EHR are going to have any impact. This is particularly true in large health systems. As Clay Forsberg points out, one voice will likely fall on deaf ears. It would take a coordinated effort to really effect change.

I’d also add that the problem I’ve seen with those doctors that are complaining about EHR software aren’t doing it in a productive manner. It’s almost like these people are arguing that we should go back to paper. Let’s be honest. That’s not going to happen. Plus, they don’t acknowledge how much they hated paper either. Think about something as simple as a missing chart and that usually refreshes some of the memories. Let alone the stacks of paper charts on physician’s desks that still needed to be completed.

Don’t get me wrong. I’m not suggesting that EHRs couldn’t do a lot more to make physicians’ lives easier. There’s also a ton of poorly optimized EHR implementations that are driving doctors crazy. Those are fixable even if many doctors don’t realize that there are solutions out there. It’s important to realize that both are issues, but are addressed very differently.

At the end of the day, doctors can complain about EHR software until their blue in the face, but EHRs aren’t going anywhere. We’re not going back to paper and I don’t see an alternative to them coming soon. That said, a physician revolt against EHRs would make them better and that would be a great thing for everyone involved. I just don’t see enough doctors ready to revolt. Do you? If so, I’d love to hear what they’re doing.

Let Vendors Lead The Way? Are You Nuts?

Posted on August 13, 2018 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.

Every now and then, a vendor pops up and explains how the next-gen EHR should work. It’s easy to ask yourself why anyone should listen, given that you’re the one dishing out the care. But bear with me. I’ve got a theory working here.

First of all, let’s start with a basic assumption, that EHRs aren’t going to stay in their current form much longer. We’re seeing them grow to encompass virtually every form of medical data and just about every transaction, and nobody’s sure where this crazy process is going to end.

Who’s going to be our guide to this world? Vendors. Yup, the people who want to sell you stuff. I will go out on a limb and suggest that at this point in the health data revolution, they’re in a better position to predict the future.

Sure, that probably sounds obnoxious. While vendors may employ reputable, well-intended physicians, the vast majority of those physicians don’t provide care themselves anymore. They’re rusty. And unless they’re in charge of the company they serve, their recommendations may be overruled by people who have never touched a patient.

On the flip side, though, vendor teams have the time and money to explore emerging technologies, not just the hip stuff but the ones that will almost certainly be part of medical practice in the future. The reality is that few practicing physicians have time to keep up with their progress. Heck, I spend all day researching these things, and I’m going nuts trying to figure out which tech has gone from a nifty idea to a practical one.

Given that vendors have the research in hand, it may actually make sense to let them drive the car for a while. Honestly, they’re doing a decent job of riding the waves.

In fact, it seems to me that the current generation of health data management systems are coming closer to where they should be.  For example, far more of what I’d call “enhanced EHR” systems include care management tools, integrating support for virtual visits and modules that help practices pull together MIPS data. As always, they aren’t perfect – for example, few ambulatory EHRs are flexible enough to add new functions easily — but they’re getting better.

I guess what I’m saying is that even if you have no intention of investing in a given product, you might want to see where developers’ ideas are headed. Health data platforms are at an especially fluid stage right now, tossing blockchain, big data analytics, AI and genomic data together and creating new things. Let’s give developers a bit of slack and see what they can do to tame these beasts.

eClinicalWorks Faces Additional Fine For Violating Terms Of Fraud Settlement

Posted on August 10, 2018 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.

In mid-2017, the news broke that EHR vendor eClinicalWorks had agreed to pay $155 million to settle a whistleblower lawsuit brought by a former employee. The government had accused the company of doctoring its code to cover the fact that its platform couldn’t pass certification testing,

Following the agreement with the government, eCW was hit with two class-action lawsuits related to the certification fraud, one filed by a group of clinicians over funds lost due to the certification and another by patients who say that data display errors may have affected their care.

Unfortunately for eCW, its legal troubles aren’t over. The vendor is now on the hook for a fine it incurred for failing to comply with the Corporate Integrity Agreement it signed as part of its settlement deal. The $132,500 fine probably won’t have a massive impact on the company, but it’s a reminder of how much trouble the certification problem continues to cause.

In signing the CIA, which will be in place for five years, eCW agreed to a number of things, including that it would adhere to software standards and practices, identify and address patient safety and certification issues and meet obligations to existing and future customers. eCW also promised to report patient safety issues in a timely manner.

Apparently, it didn’t do so, and that triggered the penalty stipulated in the CIA. Among the terms buried in the hefty CIA document is that the vendor would be fined $2,500 for each day eCW failed to establish and implement patient safety issues as reportable events. Somehow, the vendor let this go for almost two months. Bummer.

Of course, eCW leaders must be reeling. This has to have been the most painful year in the company’s history, without a doubt. Customers are understandably quite angry with eCW, and some of them are suing. Patients are suing. Its reputation has taken a major hit.

The financial implications of the settlement are staggering too. Very few companies could cover a $155 million payout without a struggle, and even if a business liability insurer is covering the loss, the settlement can’t be good for its relationships with financial institutions. It’s a mess I’d wish on no one.

On the other hand, am I being too harsh when I suggest that under the circumstances, letting a reporting problem go for 53 days doesn’t speak well of eCW’s recovery? Yes, I’m sure that keeping up with CIA requirements has been pretty burdensome, but we’re talking about survival here.

I’m not going to hazard a guess as to whether eCW is on the skids or just struggling to recover from a massive blow to its fundament. But geez, folks. Let’s hope you get on top of these issues soon. Violating the terms of the CIA within year two of the five-year agreement doesn’t exactly inspire confidence.

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.

Physicians Are (Justfiably) Ambivalent About Virtual Care

Posted on July 30, 2018 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.

It’s easy for pundits like myself to support virtual care. From my standpoint, it’s obvious that virtual care is the easiest and most effective way to handle many health conditions, from handling one-off issues like sore throats and sinusitis to managing long-term chronic conditions.

Not only that, emerging devices will allow patients to test their own blood, urine, heart rhythm and more. When these devices are perfected and put into common use, virtual care will become even more useful and appropriate.

Despite all of these signs of progress, though, physicians aren’t all in with virtual care just yet. According to a study by consulting firm Deloitte, doctors think virtual care might help with patient engagement and support. However, doctors said they would need to overcome several obstacles to virtual care use before they get involved.

Generally speaking, survey respondents seem to “get it” about telemedicine. In fact, according to the survey nine in 10 physicians understand the benefits of virtual care, particularly when it came to connecting with patients. They reported that these benefits include improved patient access to care (66%), increased patient satisfaction (52%) and staying connected with patients and their caregivers (45%).

They also said virtual care could improve patient care coordination (42%), boost the cost-effectiveness of care (42%), offer increased flexibility to clinician schedules (41%), streamline workflow (32%) and help them stay connected with peers and other clinicians (28%). Only 11% said they didn’t see any benefits to virtual care.

Given these advantages, you might think that physicians were gung-ho about virtual care adoption – but you’d be wrong. Just over a third (38%) have rolled out email/patient portal consultations, and 17% are conducting physician-to-physician electronic consultations. Only 14% are conducting virtual/video visits.

On a side note, I was interested to learn adoption of such technologies is higher among primary care physicians than specialists. The survey found that 48% of primary care physicians have implemented portals, compared with 34% of specialists, and that 17% of PCPs were offering video visits versus 13% of specialists.

Meanwhile, I was interested to learn that 43% of respondents who had electronic consultation tools at their disposal connected with colleagues at least once a week. In fact, I’m surprised to learn that this is even happening– electronic consults with between doctors and their peers was not on my radar.

But I wasn’t taken aback to learn that physicians employed or affiliated with hospitals and health systems (62%) made regular use of at least one virtual care technology. After all, hospitals are generally ahead of other providers when it comes to telemedicine. (For example, check out Intermountain’s virtual hospital program.)

Bottom line, physicians still face big obstacles to rolling out virtual care, including a need for training (51%), a lack of access to this technology (35%) and worries about security and privacy of patient data (33%).

All told, when I read about their reasonable objections, low physician adoption of virtual care makes a whole lot more sense. Until these concerns are addressed little is likely to change.