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!

Does HIMSS Serve Practicing Doctors Well?

Posted on March 5, 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 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.

Take a look around you at HIMSS18 and you will see a lot of different types. Of course, the biggest and flashiest presence will be the hordes of vendor marketing and salespeople. You’ll also run into C-suite and mid-level executives with health systems in hospitals or managing partners of large medical practices, along with a grab bag of consultants, researchers, attorneys and bloggers like myself.

What you seldom see, however — and this has been true for decades — are physicians active in day-to-day medical practice. I’m sure the reasons for this vary, including a reluctance to spend the time and money to attend and questions about the show’s immediate value, but regardless, practicing doctors are sorely underrepresented at the annual HIT blast.

In the past, I might’ve suggested that the reason they aren’t showing up was lack of interest. After all, in the past, most physicians had very little contact with their IT infrastructure. Sure, they interacted with billing and coding systems, and to a lesser extent practice management platforms, but that was about it.

That’s hardly the case today, though. For most doctors, it’s smartphones in the morning, tablets in the afternoon and EMRs all day. What’s more, some practices are integrating connected health monitoring and wearables data to the mix and some are rolling out telemedicine services.  While few doctors have to dig into the guts of these tools, they’re increasingly dependent upon them and in some cases, and hardly function without daily access.

Given the extent to which these tools are ultimately designed to serve clinicians at the point of care, it’s disconcerting how seldom HIMSS attendees seem to put clinicians’ IT challenges front and center.

Perhaps I’m being unfair, but my sense is that most of the show is designed to serve health systems CIOs, practice leaders with complex IT needs and to a lesser extent, the influencers that guide sales decisions (such as analyst firms). I’m not saying small-practice doctors get ignored, but from what I’ve seen they don’t get catered to either. In fact, many companies focused on small practices have stopped exhibiting at HIMSS because of this and instead focus on the various medical society conferences.

Sadly, this reflects the larger dynamic in which vendors work to strike deals with senior executives first, putting physician needs largely aside. Rather than seeing to it that the actual end users find the products to be workable, they accept the reality that most cases, non-physicians are calling the shots.

For the benefit of the entire health IT community, I hope that in successive years, HIMSS does far more to attract the 10-doctor and below practices that make up the backbone of the medical community. Letting the deepest pockets in health IT systems dictate everything is simply toxic.

How To Get Nothing Out Of #HIMSS18 And Go Home Empty

Posted on March 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 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.

Going to HIMSS can be a high-stakes game.  To get anything done at the show, it takes a pretty substantial investment of time, energy and if you’re a vendor, a huge marketing budget.  Unfortunately, though, some poor schmucks will end up squandering the great opportunities the show offers and go home with their tail between their legs.

If you want to be like them, and get nothing out of HIMSS18, here are a few ways to make it happen:

Spend all your time in chitchat

The show offers you a chance to meet amazing people accomplishing great things, and many are happy to talk about what they do. But you’re more comfortable sticking with your buddies from the home office who already know you. So why not talk about sports and office politics with the gang for most of the event? Learning about new things, meeting new people, and stretching yourself is scary and hard, right?

Confirm your prejudices

Shows like HIMSS18 offer fertile ground for creativity and collaboration. But that doesn’t work for everybody. If you’re a vendor, stick to your booth and your product as you know it. No need to check out anything new; your solution is obviously the best one. If you’re walking around the exhibit hall touring the scenery, assume you already have all the answers, and tune out anybody who challenges you. Tell yourself that this is not the time to rethink your strategy.

Be disorganized

If you make an effort, you can take in a ton of information and make a lot of contacts at HIMSS18. Want to be sure you don’t have to follow up? Stick people’s cards in your suit jacket pocket or the bottom of your purse then forget they’re there or forget to get the cards in the first place. Meanwhile, if absorbing new information isn’t your speed, be sure to leave your vendor fliers, e-books and white papers in your briefcase, unsorted and inaccessible. And by no means take notes!

Be jaded

At any HIT show, some of what you see won’t be completely new, but it’s pretty much a guarantee that you’ll be exposed to exciting proposals. But you can avoid being stimulated or bringing valuable ideas home.  It’s easy – just assume that you’ve seen it all before. Startups are run by silly dreamers and big companies are clumsy and slow, so why believe that anything in HIT will really change?

Of course, most people who go to HIMSS18 are there to learn, connect with their peers, talk about big ideas and go back to their jobs refreshed and inspired. Despite the investment required, going to shows like HIMSS18 can be immensely valuable. Just go with an open mind and you’ll be glad you were there.

10 Things I Look Forward to at HIMSS 2018 #HIMSS18

Posted on March 1, 2018 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 are you looking forward to this year for HIMSS18? Since last year I won the award for best shoes, I’m not sure how this year could be better than last. However, here are 10 reasons this year might beat the year where I won “best shoes.”

Women in Health IT Mentor Meetup

Each year HIMSS releases a report on women in healthIT included wage disparities. The release of this report and support of women in healthIT has gained traction this year. There is a HIMSS Meetup Thursday morning addressing the challenges of women in Health IT. You can register for the event and be matched with leaders. Doyenne Connections is also having a meet up before the Monday Keynote from 3- 4:30 PM at Yardbirth Southern Table & Bar. Doyenne Connections is a group dedicated to creating opportunities for women in HealthIT to make meaningful connections and networking. I really enjoy the Women in Health IT events at HIMSS.


Catching up with friends and making new friends. I’m looking forward to seeing amazing thought leaders and finding out what they have been up to. I was going to put swag here (I actually really appreciate great swag) but really- the people I’ve met at HIMSS have been some of the best career inspirations and allies and I consider many close friends. It is also inspiring to see progress with increased access to mental healthcare and better patient communication through health IT.

I am lucky to have friends that are brilliant data scientists and working to provide better health. There is also a meetup at HIMSS for people who like #SciFi. With HealthTech Bookclub chats online we discovered that a LOT of people in HealthIT like scifi. Some of the predictions from older books that seemed to paint an impossible future now have prophetic impact from self driving cars to surgical robots. I am looking forward to meeting new friends who love data science and reading (and also swag).

Series A Pitch Competition Presentations

There is a contest at HIMSS! HIMSS VentureConnect has a pitch competition and I love contests and games. I am looking forward to the presentations and hearing more from investors about what they see as a great value proposition in HealthIT. I have seen Wellpepper for several years in the Patient Engagement space and admire Anne Weiler’s leadership as a female CEO and leader in business excellence. The pitch competition is Wednesday March 7 from 10:45 AM to 12:00 PM in Lido 3104.

Best in Klas Vendors

I have a lot of respect for the KLAS research team and I’m looking forward to meeting the vendors that are voted best in KLAS for 2018. I am planning to check out Lightning Bolt and their physician scheduling tools. Lightning Bolt helps manage physician scheduling and improve workflow. Who would you vote best in KLAS? Klas research has also started a cooperative that I am thrilled about, the arch collaborative. This group is working to improve physician satisfaction with their EMR and EHR experience.


I get to speak!  I was lucky enough to have the opportunity to speak at HIMSS18 about physician suicide and burnout with Melissa McCool, CEO and Founder of Stellicare. I am fortunate to have the opportunity to share some of the work we’ve done in memory of my late husband. John Madsen died of suicide in 2015 and I noticed a lack of resources for our three children. Most physicians know someone that has died and there aren’t really easy ways to talk about the loss.

Please share your stories at Yesterday we launched, collecting more information about burnout, including providing community support tools. The mission of providing a memory honoring such a personal loss is hard to talk about. I am hoping our newly forming non profit has more partners and sponsors for increasing care for physicians after HIMSS. Our session, “Physician Suicide and Clinician Engagement Tools,” takes place on March 8 at 4 p.m. PST at the Venetian Convention Center, Palazzo L.

Power Press Party

I love meeting press leaders in Health IT. On the eve of HIMSS I am looking forward to the Power Press Party. Every year we have a party celebrating great healthIT accomplishments in Media and have early meetings with vendors. If you are in the media and will be there Sunday Night- make sure you register HERE. This year it is at the Hyde Bellagio and celebrates Momcology as a charity partner. We get to celebrate the good news of HealthIT and support pediatric cancer.  The Power Press Party is Sunday, March 4 from 5:30 to 8:15 PM PST.

Telehealth Presentations

I am interested in a few presentations about Telehealth, One of them is A Framework to Support Measure Development for Telehealth with Jason Goldwater and Judd Hollander on Wednesday from 8:30-9:30 AM. The other is Behavioral Health: A Launchpad for Enterprise Telehealth with Nathaniel Lacktman and Sarah Sossong Tuesday from 4 PM to 5 PM. There are great possibilities for telehealth increasing access to providers and allowing better access to specialists. From rural populations with little access to specialists to underserved populations who need better behavioral health support, telehealth has increased access to care and will get bigger.  

Artificial Intelligence and Data Systems

Intersystems is a unified data platform for building scalable analytics platforms. They are also hosting workshops for FHIR and keynote speakers at their booth. I want to go see the presentation from Erid Widen, CEO of HBI solutions, about Predicting suicide and Opioid Abuse Using Clinical and Social Determinant Data. They are hosting this in their booth #4444 March 6 from 1 PM to 1:30 PM PST.  Innovation in Algorithms and data management is a key imperative to improving Health IT and HBI solutions has great innovations in data. If you know about companies that have great analytics I want to see what they are doing.  I will also go see CrossChx and meet their AI agent, Olive.

New Media Meetup

Some of my favorite people in HealthIT are the people who understand communication and marketing. They can translate a great algorithm to a message people understand. I call them the matchmakers, facilitating great solutions through faster connections. I’m looking forward to the New Media Meetup hosted by Care Cognitics. It is Wednesday from 6 PM to 8 PM at Senor Frogs. Register here. Communication is important in healthIT and @techguy hosts several meetups during HIMSS about the power of social media in healthcare, both to improve patient care and improve business. I go to as many of the Healthcarescene meetups as possible.


Wednesday at 4:30 Michael Joseph and Rasu Shrestha will launch Empathy.Health. Healthcare and patient leaders have observed an empathy gap, especially in the digital health arena, and believe that empathy must be a strategic and humane imperative and a core value for every health care delivery system. Physicians lose empathy during their training and frequently have a difficult time regaining that ability to relate. They will launch their work developing an increase in empathy and how to spread empathy in digital health. I am looking forward to being part of a group that recognizes the importance of healthy connections and understanding.

Those are a number of the things I’m most looking forward to at HIMSS18. What did I miss? What are you most excited to experience, see, or do at HIMSS? Let us know in the comments.

It’s Time to Rethink Patient Matching

Posted on February 28, 2018 I Written By

The following is a guest blog post by Wes Rishel in partnership with Verato.

Henry Ford famously said, “If I’d asked them what they wanted, they would have said ‘faster horses.'” When it comes to patient matching – the cornerstone of health information interoperability – we seem to be asking for faster horses. But what we need is a totally new approach.

The “horse” here is probabilistic patient matching. Probabilistic algorithms match two patient records by comparing them directly to each other and determining the probability that the two records belong to the same patient. Basically, if the demographic data (like name, address, and birthdate) looks very similar across the two records, then a match is made.

These algorithms have been the preferred approach to resolving and matching patient identities since the 1980s. But today’s healthcare landscape is very different from that of the 1980s. Healthcare organizations are no longer simply providers or payers – there are now Health Information Exchanges (HIEs), Accountable Care Organizations (ACOs), care management companies, and even health systems with their own insurance plans.

There is now a larger push to share and exchange patient data between all of these organizations and with state and federal agencies and do analytics on a massive scale for research and population health. And we can anticipate an explosion of patient data coming from many new sources, including patient portals, patient engagement applications, telemedicine applications, personal health records, and Internet of Things (IoT) medical devices.

All of these factors make today’s patient matching challenges much more difficult than those of the 1980s, and yet we’re applying the same matching approach we used three decades ago. The consequences are drastic: up to one in five patient records are not accurately matched within the same health care system according to CHIME, and as many as half of patient records are mismatched when data is transferred between health care systems according to the ONC.

As a technology adviser over the years, I frequently advised governmental and private entities with over a million patient records that, as flawed as it was, probabilistic matching was their only choice. But probabilistic matching has clearly reached its limits. Even large and expensive efforts within healthcare organizations to improve and tune probabilistic algorithms achieve only incrementally better results. It is time to move on from the “horse.” We need a totally new approach.

A completely new approach in healthcare is a familiar approach elsewhere

It is time to emulate Henry Ford and find a completely new approach to patient matching. But it is also important to recognize that Ford didn’t actually invent the car. He didn’t even invent mass production, which had already been applied in other industries. His contribution was the vision that applying mass production to automobiles would open up a whole market, the gumption to gather the investment and execute, and the stubbornness to ignore naysayers.

So it is with patient matching. We simply need innovators that have the vision to apply proven identity matching approaches to the healthcare industry – as well as the gumption and stubbornness necessary to thrive in a crowded and often slow-moving healthcare IT market.

Many industries – including retail and financial services – already have viable and proven solutions to match and link their customer records, and these are the solutions we should look to as an industry to solve our own patient matching challenges.

Most proven solutions hinge on cross-correlating the demographic data from customer records with demographic data from third-party sources, including public records, credit agencies, or telephone companies. Importantly, this third-party demographic data includes not just current and correct attributes for a person, but also out-of-date and incorrect attributes – like previous addresses, maiden names, and common typing errors for birthdates or phone numbers.

By referencing these comprehensive sets of third-party demographic data during the matching process, these “Referential Matching” approaches can significantly outperform probabilistic matching algorithms. For example, Referential Matching can match one record that contains a maiden name, old address, and birthdate with another that contains a married name, new address, and phone number. Both of these records match to the same person in the third-party reference database, which has the entire set of demographic attributes for that person. In essence, this third-party reference database acts as an “answer key” for demographic data.

Results from this approach were recently published in Journal of AHIMA 88, “Applying Innovation to the Patient Identification Challenge” by Lorraine Fernandes, RHIA, Jim Burke, and Michele O’Connor, MPA, RHIA, FAHIMA. This article reviewed how Healthix, the largest public health information exchange (HIE) in the nation, used a vendor built on referential matching architecture to resolve 54.1 million MRNs down to 21.9 million unique identities. These 21.9 million unique individual records are now clear and available to meet key clinical and operational needs.

Referential Matching needs to make its way to the healthcare industry, and luckily it is already being used by many of the largest health systems, payers, and HIEs. But this is not enough. The costs of poor patient matching are too dramatic to keep pushing for faster horses: inaccurate matching decreases quality of care, has drastic implications for patient safety and privacy, costs millions of dollars of lost revenue each year to denied claims, and increases costs to our healthcare system due to systemic inefficiencies, redundant tests and procedures, and unnecessary IT and labor expenditures.

The healthcare industry should take a lesson from Henry Ford. The winning disruptive patient matching solution need not be created, but only adapted from other industries. As another wise man said, “discovery consists of seeing what everybody has seen, and thinking what nobody has thought.”

Conquering Medication Errors: Better Tools, Better Reconciliation

Posted on February 27, 2018 I Written By

The following is a guest blog post by Greg Anderson, Senior Business Advisor, Surescripts.

For years now, prescribing has been growing more complex. Between 1994 and 2014, the percentage of the U.S. population taking three or more prescription drugs nearly doubled, and as of 2014, nearly 11 percent had taken at least five prescription drugs within a 30-day period.

As important as these medications may be, every new drug prescribed introduces a new possibility for error. And this increased complexity is indeed having dangerous effects. Medication errors made by patients and their caregivers outside healthcare facilities doubled between 2000 and 2012, according to a 2017 study. That’s not even counting the estimated 40 percent of medication errors that spring from another source: inadequate reconciliation.

Accurate Reconciliation: High Barriers, High Stakes

Medication reconciliation can be a frustrating task in any setting. Compiling an accurate medication list can easily take 45 minutes when care providers need to not only consult with the patient, but also reach out to pharmacies, pharmacy benefit managers, other physician offices and family members to get the full story. Achieving accuracy is especially daunting in acute care settings, when time is of the essence and memory-impeding stress is heightened. Records of medications prescribed and taken are often far from complete, leaving care teams reliant on whatever history patients and their families can patch together.

A lot can go wrong when medications fall into the gaps. One study of hospital patients taking at least four prescription medications found that a majority of patients had at least one medication not identified upon admission, and 38.6 percent of these reconciliation errors had the potential to cause significant discomfort or adverse health outcomes. A recent study of 306 medically complex patients found up to seven errors per patient in medication histories.

When a healthcare provider misses a drug, consequences can range from treatment interruptions to incorrect treatment decisions. Inevitably, some of these medication errors lead to the most common cause of iatrogenic harm: adverse drug events (ADEs), which send nearly 700,000 people to emergency departments each year.

The Best Defense Against ADEs

Not all medication errors can be foreseen and eliminated, but there’s reason to believe we can greatly reduce the 10 percent of ADE-related emergency department visits that stem from medication errors. Researchers estimate that 50 to 70 percent of ADEs that lead to hospital admissions are preventable.  And there’s one tactic in particular that’s been shown to make a serious difference: consistent medication reconciliation, aided by access to electronic medication history. More than half of the medication errors in one 2008 study of primary care clinics could have been prevented with the help of electronic tools. That’s in line with the Agency for Healthcare Research and Quality’s findings that “anywhere from 28 to 95 percent of ADEs can be prevented by reducing medication errors through computerized monitoring systems.”

Recent studies in clinical settings have borne out insights like these. In 2016, the Cedars-Sinai Health System performed a study assessing medication history errors among older adults on complex medication regimens. Researchers determined that accessing pharmacy fill and PBM claims data for those patients via Surescripts Medication History for Reconciliation would likely have prevented 35 percent of admission medication history errors and 31 percent of resultant inpatient order errors. Those percentages rise when considering only severe errors.

By helping doctors avoid prescribing errors, effective medication history solutions can also help patients make fewer medication mistakes at home. Eliminate redundant or conflicting prescriptions, and you also eliminate opportunities for patients and their caregivers to become confused. Even in a world of increasing prescription complexity, we can work as an industry to reduce many types of medication errors. We just need the right tools to collaborate and to make informed care decisions together.

Practice Fusion Drops Free Software Model

Posted on February 26, 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 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.

More than a decade ago, an upstart company grabbed the health IT world’s attention when it rolled out a free advertising-based EMR. The company, Practice Fusion, wasn’t the only venture offering free EMR access. But its brash attitude and unapologetic defense of its business model won the industry’s grudging acceptance, and its occasional bouts of hyper-aggressive sales tactics actually made its story more interesting.

Now, in the wake of its $100 million agreement to sell out to Allscripts, the end of an era has arrived. The company has announced that it’s now switching to a paid subscription model, priced at $100 per physician per month, according to CNBC.

Prior to his 2015 ouster from the company, founder and then-CEO Ryan Howard had continued to insist that Practice Fusion software would always be free. Apparently, over the long run, this didn’t work out. (No need to shed any tears for Howard, by the way. He’s comfortably ensconced in a new venture called iBeat. The company is building a cellular smartwatch that monitors heart rhythms and calls emergency responders in a crisis.)

Most observers see the $100 million sale to Allscripts as a bad deal for Practice Fusion which, as my colleague John Lynn notes, had raised more than $157 million over its lifespan.

It seems fair to say that if the free EMR model was still working, Allscripts wouldn’t have been able to pick up Practice Fusion so cheaply.Its increasingly tarnished reputation can’t have helped either. The company has always pushed the envelope with its aggressive marketing strategies, but in recent years it pretty much burst the envelope open.

Two years ago, Practice Fusion got slapped by the FTC for engaging in deceptive consumer marketing practices. Its problems began in 2012 when it began to send out email messages to patients of providers who used its EMR. According to the agency, Practice Fusion never told consumers that the doctors didn’t send the email messages, nor informed them that their responses to the emails would be made public. It’s hard to tell whether this played a role in the firm’s seeming decline, but it certainly didn’t help.

In all fairness, Howard and his team deserve a great deal of credit for breaking ground in HIT. Offering doctors an alternative to the hugely expensive, doctor-hostile EMRs available to medical practices at the time was a big accomplishment and provided a lifeline for many medical practices. Unlike many of its old-school competitors, Practice Fusion was physician-centric and affordable, and that was no small feat either. But over time, its big idea didn’t prove out. Practice Fusion has been forced to admit that there’s no (even ad-based) lunch.

Let’s see what Allscripts does with Practice Fusion’s assets and whether it invests in its latest addition to the corporate family. My guess is that Allscripts will let its latest toy languish and eventually die, but you never know. Maybe Practice Fusion will be reborn.

Healthcare IT Job Satisfaction – Fun Friday

Posted on February 23, 2018 I Written By

John Lynn is the Founder of the 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 and 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:

When It Comes To Security Threats, Doctors Are Less Aware

Posted on February 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 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 study suggests that while most healthcare employees aren’t very aware of privacy and security threats, doctors may be further behind.

According to the Verizon Enterprises Data Breach Investigations Report, 78% of healthcare employees were less than prepared for such risks. Given the threat environment out there, that’s bad enough. Other aspects of the survey found that 24% of healthcare employees had trouble identifying some common signs of malware, as compared with 12% of respondents in the general population.

However, physicians appear to be even less prepared than their healthcare peers. For example, 24% of physicians and other types of direct healthcare providers showed a lack of awareness of phishing emails, a deficit which could cause big problems. (Their rate of identifying phishing emails was three times worse than their non-physician counterparts.) Half of the physicians studied scored in the overall “risk” category, which meant that their actions could impose a privacy or security threat.

Looking again at the healthcare industry as a whole, 23% of respondents failed to report a variety of potential security or privacy incidents such as unsecured personnel files and potentially malware-infected computers. Twenty-one percent of survey respondents didn’t recognize some forms of personally identifiable information, but perhaps more alarmingly, more clinicians exhibited risky behaviors in this category than their non-clinician peers.

In wrapping up the report, the authors make the important point that educating healthcare workers and clinicians on HIPAA rules is far from enough to help organizations protect themselves cyberattackers. “Keeping within HIPAA regulations, while vital, does not educate users on how to spot a phishing attack,” they wrote. “[And] mere compliance does not equate to a fully security-aware culture.”

Ultimately, the study makes a point that can’t be made too often. When security education occurs in silos, be they HIPAA compliance, abating risks of internal malfeasance and errors or training employees to catch sneak attacks such as phishing emails, no one of these strategies is enough to protect organizations from cyber-intrusions.

The key, as the authors rightly point out, is to cultivate a risk-aware culture across the healthcare organization’s entire population, including (perhaps most particularly) clinicians who make the closest use of the data.

EMR-Based Alert System Can Identify Possible Child Abuse Victims

Posted on February 21, 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 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.

Sometimes, it’s pretty easy for a physician to tell that a child might be experiencing physical abuse at home. However, sometimes physicians are rushed and may not do an adequate screening for abuse, the signs of which aren’t always available at first glance.

However, a group of researchers has developed an algorithm, drawing on patient records in the EMR, which it says can improve screening rates for physical abuse and identify such cases earlier.

The project, the write-up of which appears in the Journal of the American Medical Informatics Association, coded triggers to identify children less than two years old at risk for physical abuse into the EMR using a freestanding pediatric hospital with a level 1 trauma center. The researchers embedded 30 age-specific triggers in the EMR.

During the test, the system ran a “silent mode,” in which study personnel saw data on children whose clinical symptoms triggered the alert system but physicians did not. During the period between October 21, 2014 through April 6, 2015, 226 children triggered the alert, the mean age of whom was 6.5 months.

During the pilot the system detected 98.5% of children less than two years of age with signs of probable or definite child abuse, according to the study authors.

If these algorithms are that successful in identifying at-risk children, one would hope that the system moves from pilot to widespread rollout fairly soon. In theory, the system should help clinicians who encounter children in potential danger, especially ones presenting with serious injuries in the emergency department, be better prepared to identify these children and take appropriate action.

Ultimately, this study suggests that even if such clinicians are alert and careful, triggers generated by an EMR might be more effective at detecting these cases. After all, while clinicians must juggle multiple patients in an extremely hectic environment, especially in the ED, EMRs don’t get tired and they don’t need to check a signs and symptoms list manually to detect signs of trouble.

Of course, while these triggers can be very helpful in investigating signs of abuse, clinicians would be ill-advised to rely on them entirely, as there’s no substitute for experience and medical judgment. Also, there’s always a risk that adding another alert to the cacophony of existing alerts could lead to it going unnoticed. Still, it seems certain that if nothing else, this is a promising approach to protecting children from harm.

Most Health Organizations Now Integrating SDOH Into Pop Health Management Programs

Posted on February 20, 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 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 has found that healthcare organizations have begun to actively integrate social determinants of health into the population health management strategies.

The research, conducted by Change Healthcare and the HealthCare Executive Group, found that 80% of organizations had begun to track and use data on social determinants. This is a huge step up from just a few years ago, when discussions around SDOH and their use in population health management were more speculative than practical.

Perhaps the most interesting technique organizations are using is enlisting doctors in this effort. About 21% are training doctors to identify social determinants, a step which, in my opinion, is long overdue. Given how taxing this might be for physicians at first, it’s good to see that just a hair under 21% have also rolled out point-of-care checklists designed to help clinicians identify potential social determinants.

Other strategies respondents are using to leverage SDOH info include integrating community programs and resources into their population health management programs (42%), integrating medical data with financial, census and geographic data (34%), offering social assessment tools with health risk assessments (33%), incorporating social determinants into the clinical workflow (27 percent) and using third-party software, data and/or services (19%).

On a side note, the research data also suggests that another set of tools in PHM — mobile and digital health technologies — haven’t found their footing. When asked what’s limiting widespread consumer adoption of these tools, top reasons respondents cited included security and privacy concerns (49%), limited functionality (35%), a duplicative, redundant and confusing app environment (34%), problems with system interoperability (33%), a lack of healthcare literacy (33%) and poor user interface design (32%).

The latter data pointing to low mobile/digital health adoption came as a surprise to me. I like to think I can see through health IT industry hype, but maybe I’ve been fooled somehow. The data I’ve seen to date (some of it, admittedly, collected by vendors) has suggested for years that mobile healthcare adoption was climbing dramatically and that more recently, other digital health tools have begun to follow suit. I guess I missed something.

Given this lag, I’m glad to see that healthcare organizations are enlisting physicians, point-of-care checklists, clinical integration and other tactics to make use of SDOH data. We all know on a gut level that if the patient can’t get to the doctor, lacks social support or lives in a “food desert” where finding unprocessed foods and healthy produce may be quite difficult, preaching at them about their health concerns isn’t going to help. It’s high time we help physicians collect this information and find ways to close some of these gaps.