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New Program Trains Physicians In Health Informatics Basics

Posted on January 18, 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 new program has emerged to help physicians make better use of the massive flow of health information they encounter on a day-to-day basis. With any luck, it will not only improve the skills of individual doctors but also seed institutions with clinicians who understand health IT in the practice of medicine.

The Indiana Training Program in Public and Population Health Informatics, which is supported by a five-year, $2.5 million award from the National Library of Medicine, focuses on public and population health issues. Launched in July 2017, it will support up to eight fellows annually.

The program is sponsored by Indiana University School of Medicine Richard M. Fairbanks School of Public Health at Indiana University-Purdue University Indianapolis and the Regenstrief Institute. Regenstrief, which is dedicated to healthcare quality improvement, supports healthcare research and works to bring scientific discoveries to bear on real-world problems.

For example, Regenstrief participates in the Healthcare Services Platform Consortium, which is addressing interoperability issues. There’s also the Regenstrief EHR Clinical Learning Platform, an AMA-backed program training medical student to cope with misidentified patient data, learn how different EHRs work and determine how to use them to coordinate care.

The Public and Population Health training, for its part, focuses on improving population health using advanced analytics, addressing public health problems such as opioid addiction, obesity and diabetes epidemics using health IT and supporting the implementation of ACOs.

According to Regenstrief, fellows who are accepted into the program will learn how to manage and analyze large data sets in healthcare public health organizations; use analytical methods to address population health management; translate basic and clinical research findings for use in population-based settings; creating health IT programs and tools for managing PHI; and using social and behavioral science approaches to solve PHI management problems.

Of course, training eight fellows per year is just a tiny drop in the bucket. Virtually all healthcare institutions need senior physician leaders to have some grasp of healthcare informatics or at least be capable of understanding data issues. Without having top clinical leaders who understand informatics principles, health data projects could end up at a standstill.

In addition, health systems need to train front-line IT staffers to better understand clinical issues — or hire them if necessary. That being said, finding healthcare data specialists is tricky at best, especially if you’re hoping to hire clinicians with this skill set.

Ultimately, it’s likely that health systems will need to train their own internal experts to lead health IT projects, ideally clinicians who have an aptitude for the subject. To do that, perhaps they can use the Regenstrief approach as a model.

An Example Of ACO Deals Going Small And Local

Posted on January 2, 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.

Until recently, ACOs have largely focused on creating large, sprawling structures linking giant providers together across multiple states. However, a news item that popped up on my radar screen reminded me that providers are quietly striking smaller local deals with hospitals and insurance companies as well.

In this case, cardiologists in Tupelo have begun to collaborate with Blue Cross & Blue Shield of Mississippi. Specifically, Cardiology Associates of North Mississippi will with Blue plan associate Magellan Health to create Accountable Cardiac Care of Mississippi.

It’s easy to see why the two agreed to the deal. The cardiology group has outpatient clinics across a wide region, including centers in Tupelo, Starkville, Columbus, Oxford and Corinth, along with a hospital practice at North Mississippi Medical Center-Tupelo. That offers a nice range of coverage for the health plan by a much sought-after specialty.

Meanwhile, the cardiology group should get a great deal of help with using data mining to deliver more cost-effective care. Its new partner, Magellan Health, specializes in managing complex conditions using data analytics. “We think we have been practicing this way all along, [but] this will allow us to confirm it,” said Dr. Roger Williams, Cardiology Associates’ president.

Williams told the News Leader that the deal will help his group improve its performance and manage costs. So far it’s been difficult to dig into data which he can use to support these goals. “It’s hard for us as physicians to monitor data,” he told the paper.

The goals of the collaboration with Blue Cross include early diagnosis of conditions and management of patient risk factors. The new payment model the ACO partners are using will offer the cardiology practices bonuses for keeping people healthy and out of expensive ED and hospital settings. Blue Cross and the Accountable Cardiac Care entity will share savings generated by the program.

To address key patient health concerns, Cardiology Associates plans to use both case managers and a Chronic Care program to monitor less stable patients more closely between doctor visits. This tracking program includes protocols which will send out text messages asking questions that detect early warning signs.  The group’s EMR then flags patients who need a case management check-in.

What makes this neat is that the cardiologists won’t be in the dark about how these strategies have worked. Magellan will analyze group data which will measure how effective these interventions have been for the Blue Cross population. Seems like a good idea. I’d suggest that more should follow this ACO’s lead.

Should Doctors Offer Concierge IT Security Services?

Posted on December 20, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today, just for fun, I’m gonna start with a thesis and work my way back to see if you agree with its foundations. My conclusion: With the cost of IT security services climbing, the cost of care coordination rising and practice income in many cases remaining relatively level, group practices will have to change their business model substantially.

Specifically, though this may sound insane, I’m suggesting that they may have to begin charging patients for beyond-the-call-of-duty security efforts.

Of course, as we all know, practices are required to offer at least a minimal level of security protection as specified in rules like those in HIPAA. Necessary though it is, it’s a pricey exercise for many groups.

Even so, cold economics may push them to cut data protection further. Given that care coordination will be necessary to meet population health goals, and that quality monitoring and management are indispensable, they may see security as the most dispensable of these spending options.

As the need for care coordination staff, quality management and other necessities of value-based care rise, paying for IT security services will become almost impossible to pay for without borrowing from another source.

That source can come from an internal budgetary resource, such as money allocated for routine general expenses, or other overhead, such as salaries for existing staff members, neither of which is desirable. Of course, there’s also the possibility of obtaining a line of credit, but that’s arguably even worse for the future of the company.

But since no medical organization can go entirely without IT security protection, it will have to find the funds to pay for it somehow. Given that any of the possibilities discussed above will drain the practice and possibly cut its finances to the bone, but something will have to give.

At this point, many practices decide to sell their group to a hospital or health system. That’s certainly a legitimate way of taking on unmanageable levels of overhead and getting access to far more infrastructure options and financial resources.

But if that’s not the direction you want to take, here’s off-ball idea for recapturing some IT security revenue: concierge security services.

While every patient’s data needs to be protected, obviously, you could offer concierge security patients access to extra layers of security attentiveness, such as a private IT staff or to answer any data privacy and security questions they might have about the practice, hospital where they are seen or other entity.

Toss in a special “security report” (in all candor, probably info they could’ve read in any trade magazine), personalized to patient needs, and a free zip drive with secured copies of their data and you’ll have them hooked.

If this worked, and I’m not suggesting that it necessarily would, it could help carry the cost of mundane IT security services. What do you think? Would this model have a chance?

Telemedicine Becoming Popular, But Seldom Profitable

Posted on October 18, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

New research suggests that while most physicians are supportive of telemedicine, others have grave reservations about providing this type of care, and that more than half of organizations aren’t making money delivering telemedicine services.

In an effort to learn more about attitudes toward telemedicine, Reaction Data surveyed 386 physicians, physician leaders, IT leaders and nurse leaders as well as differences in adoption levels between different types of organizations.,

Some of the top benefits of telemedicine cited by respondents included that it helped providers to meet demand for simpler and more cost-effective care delivery (28%), allowed them to treat more patients (23%) and that it was easing demands on staff (19%). Interestingly, just 10% said that telemedicine was proving to be a viable source of revenue, and elsewhere in the survey, 14% reported that telemedicine was revenue-negative.

The majority of physicians (68%) reported that they were in favor of telemedicine, while another 15% took a neutral position. Only 17% didn’t support widespread telemedicine use.

Their responses varied more, however, when it came to how much of care could be effectively delivered via telemedicine.

Thirty-two percent felt that 0 to 20% of care could be delivered this way; 33% of physician respondents felt that 30 to 40% care could be delivered digitally; 19% of respondents said 50 to 60% of care could be provided via telemedicine; 14% felt that 70 to 80% of care could be provided digitally. Just 2% felt that 90 to 100% of care could be delivered via this channel.

When it came to actually delivering the care themselves — rather than a hypothetical situation — respondents seemed less flexible. For example, 33% said that they would never contract with an outsourced telemedicine company to provide patient consults.

On the other hand, 50% said they’d considered moonlighting as a telemedicine consultant, 7% said they’d already done so frequently, 8% said they delivered such consults occasionally 2% said that was all they did for a living.

Regardless, many healthcare organizations are adopting this approach on a corporate level. Sixty-one percent of hospitals in a health system said they adopted telemedicine: 40% of standalone hospitals had done so; 58% practices owned by a health system has that this technology. Only 17% of physician-owned practices had done so, which could reflect cultural issues, costs or technology adoption concerns.

Physicians that were delivering telemedicine services most often used them to reach patients in rural areas (24%), provide follow-up care (24%) and manage specific patient populations (23%).

Among organizations that haven’t adopted telemedicine, many are scarcely getting their feet wet. While one in three providers are evaluating telemedicine options currently, 20% are two years or more away from adoption and 26% said they would never move in this direction.

Meanwhile, roughly one-third of physician-owned practices reported that they would never adopt telemedicine. One responding physician called it “inherent malpractice,” and another called it a “blatant attempt to circumvent the physical examination.” It seems unlikely that these clinicians will change their views on this topic.

Getting Buy-in For Your Second (Or More) EMR Purchase

Posted on August 15, 2017 I Written By

The following is a guest blog post by Michael Shearer is VP of Marketing for SelectHub.

Remember when you rolled out your first EMR?  Many of your doctors were uncertain, frustrated or angry, insurers were rejecting claims left and right and revenue fell as providers struggled to use the new system. Ah, those were lovely days.

Thankfully, in time everyone finally adapted. Through a combination of one-on-one coaching, group training, peer-to-peer mentoring and daily practice, clinicians got used to the system. Your patient volumes returned to normal. Some, though probably not all, of them got comfortable with the EMR, and a few even developed an interest in the technology itself.

Unfortunately, over time you’ve realized that your existing EMR isn’t cutting it. Maybe you want a system with an integrated practice management system. Perhaps your vendor isn’t giving you enough support or plans to jack up prices for future upgrades.  It could be that after working with it for a year or two, your EMR still doesn’t do what you wanted it to do. Whatever your reasons, it’s time to move on and find a system that fits better.

Given how painful the previous rollout was, buying a new EMR could be pretty disruptive and could easily stir up resentments and fears that had previously been laid to rest. But if you handle the process well, you might find that getting EMR buy-in is easier the second (or more) time around. Below are some strategies for getting clinicians on board.

Learn from your mistakes

Before you begin searching for an EMR, make sure that you’ve learned from your past mistakes. Consider taking the following steps:

  • Conduct thorough research on how clinicians (and staff if relevant) see your existing system. This could include a survey posing questions such as:
    • How usable is the EMR?
    • What impact does the EMR have on patient care, and why?
    • Does the EMR meet the needs of their specialty?
    • What features does the existing EMR lack?
    • Are EMR templates helping with documentation?
    • What are the great features of your existing EHR?
  • Compile a list of technical problems you’ve experienced with the system
  • Evaluate your relationship with the EMR vendor, and make note of any problems you’ve experienced
  • Consider whether your purchasing model (perpetual license vs. online subscription) is a good fit

Put clinicians in charge

When you bought your first EMR, you may have been on uncharted ground. You weren’t sure what you wanted to buy or how much to spend, and clinicians were at a loss as well.  Perhaps in the absence of detailed clinical feedback, you moved ahead on your own in an effort to keep the buying process moving.

This time around, though, clinicians will have plenty to say, and you should take their input very seriously. If they’re like their peers, their critiques of the existing EMR may include that:

  • It made documentation harder and/or more time-consuming
  • It wasn’t intuitive to use
  • It got in the way of their relationship with patients
  • It forced them to change their workflow
  • It didn’t present information effectively

These are just a few examples of the problems clinicians have had with their first EMR – you’ll probably hear a lot more. Ignoring these concerns could doom your next EMR rollout.

To avoid such problems, put clinicians in charge of the EMR purchasing process. By this point, they probably know what features they want, how documentation should work, what breaks their workflow, what supports their process and how the system should present patient data.

This will only work if you take your hands off of the wheel and let them drive the EMR selection process. Giving them a chance for token input but buying whatever administrators choose can only breed hostility and distrust.

Look to the future

When EMRs first showed up in medical practice, no one was sure what impact they’d have on patient care. Administrators knew that digitizing medical records would help them produce cleaner claims and shoot down denials, but few if any could explain why that would help their providers offer better care. In some cases, these first-line systems did nothing whatsoever for clinicians while weighing them down with extra work.

Over time, however, providers have begun using pooled EMR data to make good things happen, such as improving the health of entire populations, identifying how genetics can dictate responses to medication and predicting whether a patient is likely to develop a specific health condition. These are goals that will inspire most clinicians. While they may not care what happens in the business office, they care what happens to patients.

These days, in fact, using EMR data to improve care has become almost mandatory. Even if they didn’t bother before, practices are now buying systems better designed to help providers deliver care and improve outcomes. If your clinicians are still unhappy about their first experience, they may have trouble believing this. But make sure that they do.

The truth is, there will always be someone who doesn’t like technology, or refuses to take part in the buying process, and it’s unlikely you’ll win them over. But if your EMR actually enhances their ability to provide care, most will be happy to use it, and even evangelize the system to their colleagues. That’s the kind of buy-in you can expect if you deliver a system that meets their needs.

Michael Shearer is VP of Marketing for SelectHub, which offers selection tools for EMRs and practice management systems.

 

Should EMR Vendors Care If Patients Get Their Records?

Posted on August 11, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, Epic CEO Judy Faulkner and former Vice President Joe Biden reportedly butted heads over whether patients need and can understand their full medical records. The alleged conversation took place at a private meeting for Cancer Moonshot, a program with which Biden has been associated since his son died of cancer.

According to a piece in Becker’s Health IT & CIO Review, Faulkner asked Biden why patients actually needed their full medical records. “Why do you want your medical records? They’re a thousand pages of which you understand 10,” she is said to have told Biden.

Epic responded to the widely-reported conversation with a statement arguing that Faulkner had been quoted out of context, and that the vendor supported patients’ rights to having their entire record. Given that Becker’s had the story third-hand (it drew on a Politico column which itself was based on the remarks of someone who had been present at the meeting) I have little difficulty believing that something was lost in translation.

Still, I am left wondering whether this piece had touched on something important nonetheless. It raises the question of whether EMR vendor CEOs have the attitude towards patient medical record access Faulkner is portrayed as having.

Yes, I suspect virtually every EMR vendor CEO agrees in principle that patients are entitled to access their complete records. Of course, the law recognizes this right as well. However, do they, personally, feel strongly about providing such access? Is making patient access to records easy a priority for them? My guess is “no” and “no.”

The truth is, EMR vendors — like every other business — deliver what their customers want. Their customers, providers, may talk a good game when it comes to patient record access, but only a few seem to have made improving access a central part of their culture. In my experience, at least, most do what medical records laws require and little else. It’s hard to imagine that vendors spend any energy trying to change customers’ records practices for the better.

Besides, both vendors and providers are used to thinking about medical record data as a proprietary asset. Even if they see the necessity of sharing this information, it probably rubs at least some the wrong way to ladle it out at minimal cost to patients.

Given all this background, it’s easy to understand why health IT editors jumped on the story. While she may have been misrepresented this time, it’s not hard to imagine the famously blunt Faulkner confronting Biden, especially if she thought he didn’t have a leg to stand on.

Even if she never spoke the words in question, or her comments were taken out of context, I have the feeling that at least some of her peers would’ve spoken them unashamedly, and if so, people need to call them out. If we’re going to achieve the ambitious goals we’ve set for value-based care, every player needs to be on board with empowering patients.

Bringing Zen To Healthcare:  Transformation Through The N of 1

Posted on July 21, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The following essay wasn’t easy to understand. I had trouble taking it in at first. But the beauty of these ideas began to shine through for me when I took time to absorb them. Maybe you will struggle with them a bit yourself.

In his essay, the author argues that if providers focus on “N of 1” it could change healthcare permanently. I think he might be right, or at least makes a good case.  It’s a complex argument but worth following to the end. Trust me, the journey is worth taking.

The mysterious @CancerGeek

Before I share his ideas, I’ll start with an introduction to @CancerGeek, the essay’s author. Other than providing a photo as part of his Twitter home page, he’s chosen to be invisible. Despite doing a bunch of skillful GoogleFu, I couldn’t track him down.

@CancerGeek posted a cloud of interests on the Twitter page, including a reference to being global product manager PET-CT; says he develops hospital and cancer centers in the US and China; and describes himself as an associate editor with DesignPatient-MD.

In the essay, he says that he did clinical rotations from 1998 to 1999 while at the University of Wisconsin-Madison Carbone Comprehensive Cancer Center, working with Dr. Minesh Mehta.

He wears a bow tie.

And that’s all I’ve got. He could be anybody or nobody. All we have is his voice. John assures me he’s a real person that works at a company that everyone knows. He’s just chosen to remain relatively anonymous in his social profiles to separate his social profiles from his day job.

The N of 1 concept

Though we don’t know who @CancerGeek is, or why he is hiding, his ideas matter. Let’s take a closer look at the mysterious author’s N of 1, and decide for ourselves what it means. (To play along, you might want to search Twitter for the #Nof1 hashtag.)

To set the stage, @CancerGeek describes a conversation with Dr. Mehta, a radiation oncologist who served as chair of the department where @CancerGeek got his training. During this encounter, he had an insight which helped to make him who he would be — perhaps a moment of satori.

As the story goes, someone called Dr. Mehta to help set up a patient in radiation oncology, needing help but worried about disturbing the important doctor.

Apparently, when Dr. Mehta arrived, he calmly helped the patient, cheerfully introducing himself to their family and addressing all of their questions despite the fact that others were waiting.

When Dr. Mehta asked @CancerGeek why everyone around him was tense, our author told him that they were worried because patients were waiting, they were behind schedule and they knew that he was busy. In response, Dr. Mehta shared the following words:

No matter what else is going on, the world stops once you enter a room and are face to face with a patient and their family. You can only care for one patient at a time. That patient, in that room, at that moment is the only patient that matters. That is the secret to healthcare.

Apparently, this advice changed @CancerGeek on the spot. From that moment on, he would work to focus exclusively on the patient and tune out all distractions.

His ideas crystallized further when he read an article in the New England Journal of Medicine that gave a name to his approach to medicine. The article introduced him to the concept of N of 1.  All of the pieces began to began to fit together.

The NEJM article was singing his song. It said that no matter what physicians do, nothing else counts when they’re with the patient. Without the patient, it said, little else matters.

Yes, the author conceded, big projects and big processes matter still matter. Creating care models, developing clinical pathways and clinical service lines, building cancer centers, running hospitals, and offering outpatient imaging, radiology and pathology services are still worthwhile. But to practice well, the author said, dedicate yourself to caring for patients at the N of 1. Our author’s fate was sealed.

Why is N of 1 important to healthcare?

Having told his story, @CancerGeek shifts to the present. He begins by noting that at present, the healthcare industry is focused on delivering care at the “we” level. He describes this concept this way:

“The “We” level means that when you go to see a physician today, that the medical care they recommend to you is based on people similar to you…care based on research of populations on the 100,000+ (foot) level.”

But this approach is going to be scrapped over the next 8 to 10 years, @CancerGeek argues. (Actually, he predicts that the process will take exactly eight years.)

Over time, he sees care moving gradually from the managing groups to delivering personalized care through one-to-one interactions. He believes the process will proceed as follows:

  • First, sciences like genomics, proteomics, radionomics, functional imaging and immunotherapies will push the industry into delivering care at a 10,000-foot population level.
  • Next, as ecosystems are built out that support seamless sharing of digital footprints, care will move down to the 1,000-foot level.
  • Eventually, the system will alight at patient level. On that day, the transition will be complete. Healthcare will no longer be driven by hospitals, healthcare systems or insurance companies. Its sole focus will be on people and communities — and what the patient will become over time.

When this era arrives, doctors will know patients far more deeply, he says.

He predicts that by leveraging all of the data available in the digital world, physicians will know the truth of their experiences, including the food they eat, the air they breathe, how much sleep they get, where they work, how they commute to and from work and whether they care for a family member or friend, doctors will finally be able to offer truly personalized care. They’ll focus on the N of 1, the single patient they’re encountering at that moment.

The death of what we know

But we’re still left with questions about the heart of this idea. What, truly, is the N of 1? Perhaps it is the sound of one hand clapping. Or maybe it springs from an often-cited Zen proverb: “When walking, walk. When eating, eat.” Do what you’re doing right now – focus and stay in the present moment. This is treating patients at the N of 1 level, it seems to me.

Like Zen, the N of 1 concept may sound mystical, but it’s entirely practical. As he points out, patients truly want to be treated at the N of 1 – they don’t care about the paint on the walls or Press Ganey scores, they care about being treated as individuals. And providers need to make this happen.

But to meet this challenge, healthcare as we know it must die, he says. I’ll leave you with his conclusion:

“Within the next eight years, healthcare as we know it will end. The new healthcare will begin. Healthcare delivered at the N of 1.”  And those who seek will find.

The EMR Vendor’s Dilemma

Posted on June 6, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Yesterday, I had a great conversation with an executive at one of the leading EMR vendors. During our conversation, she stressed that her company was focused on the future – not on shoring up its existing infrastructure, but rather, rebuilding its code into something “transformational.”

In describing her company’s next steps, she touched on many familiar bases, including population health, patient registries and mobile- first deployment to support clinicians. She told me that after several years of development, she felt her company was truly ready to take on operational challenges like delivering value-based care and conducting disease surveillance.

All that being said – with all due respect to the gracious exec with whom I spoke – I wouldn’t want to be a vendor trying to be transformed at the moment. As I see it, vendors who want to keep up with current EMR trends are stuck between a rock and a hard place.

On the one hand, such vendors need to support providers’ evolving health IT needs, which are changing rapidly as new models of care delivery are emerging. Not only do they need to provide the powerhouse infrastructure necessary to handle and route massive floods of data, they also need to help their customers reach and engage consumers in new ways.

To do so, however, they need to shoot at moving targets, or they won’t meet provider demand. Providers may not be sure what shape certain processes will take, but they still expect EMR vendors to keep up with their needs nonetheless. And that can certainly be tricky these days.

For example, while everybody is talking about population health management, as far as I know we still haven’t adopted a widely-accepted model for adopting it. Sure, people are arriving at many of the same conclusions about pop health, but their approach to rolling it out varies widely.  And that makes things very tough for vendors to create pop health technology.

And what about patient engagement solutions? At present, the tools providers use to engage patients with their care are all over the map, from portals to mobile apps to back-end systems using predictive analytics. Synchronizing and storing the data generated by these solutions is challenging enough. Figuring out what configuration of options actually produces results is even harder, and nobody, including the savviest EMR vendors, can be sure what the consensus model will be in the future.

Look, I’m aware that virtually all software vendors face this problem. It’s difficult as heck to decide when to lead the industry you serve and when to let the industry lead you. Straddling these two approaches successfully is what separates the men from the boys — or the girls from the women — and dictates who the winners and losers are in any technology market.

But arguably, health IT vendors face a particularly difficult challenge when it comes to keeping up with the times. There’s certainly few industries are in a greater state of flux, and that’s not likely to change anytime soon.

It will take some very fancy footwork to dance gracefully with providers. Within a few years, we’ll look back and know vendors adapted just enough.

Clinical Insights from Social Media Data: Amplifying Patient Voice with Symplur

Posted on May 31, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

What data from social media can help healthcare organizations?

One of the biggest challenges of online and social data is the sheer volume of unstructured data. Can your physician read all your tweets and postings? Hopefully not. Physicians have data and work overload, a daily report of steps taken from activity trackers or online social media use hurts their ability to treat patients. HealthIT solutions can help process this data and find patterns and changes.

I had a conversation with Audun Utengen about actionable insights into healthcare from his company, Symplur. At Datapalooza he participated in a panel and mentioned the rich amount of patient data that can be found on twitter (shocked gasp followed by a furrowed brow). Symplur signals tracks online engagement.  You can find healthcare insights from conversations really quickly. They provide tools that help healthcare providers get patient insights where they are naturally interacting. There is value in meeting patients where they are, and patients are discussing their healthcare online.

Originally, the assumption was that patients would not say things online. Sensitive topics do not naturally show up in social media use- fewer people are discussing gonorrhea online than receive treatment for gonorrhea. Providers assumed that things which are protected patient information would not show up on twitter. They were wrong. As most social media users know- it’s shocking what people will post online. Not every aspect of health is on twitter but patients want to engage online.  They go to twitter because they want their voices to be heard. They want things to change. They can’t be ignored on twitter. They want their voices to be heard by people in decision-making positions.

Patient’s online discussion have positive impacts on organizations. The key is to be proactive about patient engagement online. Stanford did a study looking about patients’ engagement at conferences. Typically, you will find 1 patient in the top 1 percent of influencers. While this number is low, conferences which have a higher percentage of patients active as top influencers have a greater reach. Want to increase your Healthcare voice and conference audience? Engage patient advocates online. Engaging patients is commercially valuable in amplification. Future patients get more insight as well.  Audun Utengen and I looked at the data from Datapalooza and found that 11 of the top 100 influencers were patients.  That is way ahead of the median number for all healthcare conferences- in 2016 the average number of top influencers that were patients at a conference was one.

“They did a great job giving patients a voice at the conference. I am impressed.”

-Audun Utengen, Co-Founder of Symplur

Healthcare Stakeholder breakdown of the top 100 influencers ranked by the Healthcare Social Graph Score.

Datapalooza had a higher than average reach and a unique blend of participants. Audun Utengen described some of the unique features of the conference:

“The social conversation from the conference was very dynamic. From the 9,366 tweets, 80% included at least one mention. Lot’s of connections were made and we witnessed the typical “flattening of healthcare” that social media is known for by breaking down the barriers between the stakeholder groups. Below is a network analysis graph showing the flattening and the conversational patterns between Twitter account and their healthcare stakeholder groupings.”

Conversations blend between different stakeholders in the healthcare conversation at Datapalooza

The ability for many stakeholders to access information and interact with each other in one place is one of the advantages of twitter. Using hashtags can help stakeholders learn about content about a specific topic quickly. One of the things Symplur is allows is the visualization of keywords surrounding conversations on twitter. When looking at the conversations from Datapalooza the topic of “patients” was very high. Unsurprisingly, “data” is the topic of focus. Patient, Health and Patients rounded out the top conversation topics.

Keyword Frequency Analysis Graph

Symplur Signals have been used for over 200 healthcare studies. They partner with academic research centers seeking more information from online conversations. Companies can also look at competitors in their area and see how they compare. Does a nearby provider have more positive mentions on social media?

Data from online interactions can also give insights into patient health. Social usage has unique implications for mental health. Frequently, online behavior change can predict mental health change. Pediatricians and Providers are in a position to see online behavior in their area and help families understand the implications. If bullying is a problem in your area providers can know their patients will have higher stress levels and provide resources and support. Certain behaviors and even emojis indicate a higher risk of depression. A suicide that will predictably happen based on social data will not show up in clinical records. Listening to what patients want us to hear will help provide greater support.

The sheer volume of social data can mask its usefulness. Online activity and data can be difficult to process for many clinicians. In a world of ever-increasing data and patients reporting everything from steps taken a day to now online behavior many providers have data overload. Data insight tools such as Symplur filter data into a format that allows physicians and systems to use it to improve patient outcomes.

Few Practices Rely Solely On EMR Analytics Tools To Wrangle Data

Posted on May 23, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new survey done by a trade group representing medical practices has concluded that only a minority of practices are getting full use of their EMR’s analytics tools.

The survey, which was reported on by Becker’s Hospital Review, was conducted by the Medical Group Management Association.  The MGMA’s survey called on about 900 of its members to ask how their practices used EMRs for analytics.

First, and most unexpectedly in today’s data-driven world, 11 percent of respondents said that they don’t analyze their EMR data at all.

Thirty-one percent of respondents told MGMA that they use all of their EMR’s analytical capabilities, and 22 percent of respondents said they used some of their EMR’s analytics capabilities.

Another 31 percent reported that they were using both their EMR’s analytics tools and tools from an external vendor. Meanwhile, 5 percent said they used only an external vendor for data analytics.

According to Derek Kosiorek, CPEHR, CPHIT, principal consultant with MGMA’s Health Care Consulting Group, the survey results aren’t as surprising as they may seem. In fact, few groups are likely to get  everything they need from EMR data, he notes.

“Many practices do not have the resources to mine the data and organize it in ways to create new insights from the clinical, administrative and financial information being captured daily,” said Kosiorek in a related blog post. “Even if your practice has the staff with the knowledge and time to create reports, the system often requires an add-on product sold by the vendor or an outside product or service to analyze the data.”

However, he predicts that this will change in the near future. Not only will EMR analytics help groups to tame their internal data, it will also aggregate data from varied community settings such as the emergency department, outpatient care and nursing homes, he suggests. He also expects to see analytics tools offer a perspective on care issues brought by regional data for similar patients.

At this point I’m going to jump in and pick up the mic. While I haven’t seen anyone from MGMA comment on this, I think this data – and Kosiorek’s comments in particular – underscore the tension between population health models and day-to-day medical practice. Specifically, they remind us that doctors and regional health systems naturally have different perspectives on why and how they use data.

On the one hand there’s medical practices which, from what I’ve seen, are of necessity practical. These providers want first and foremost to make individual patients feel good and if sick get better. If that can be done safely and effectively I doubt most care about how they do it. Sure, doctors are aware of pop health issues, but those aren’t and can’t be their priority in most cases.

Then, you have hospitals, health systems and ACOs, which are already at the forefront of population health management. For them, having a consistent and comprehensive set of tools for analyzing clinical data across their network is becoming job one. That’s far removed from focusing on day-to-day patient care.

It’s all well and good to measure whether physicians use EMR analytics tools or not. The real issue is whether large health organizations and practices can develop compatible analytics goals.