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Voice Technology: A Disruptive Force in Healthcare

Posted on November 19, 2018 I Written By

The following is a guest blog post by Adam Sabloff, CEO of VirtualHealth.

Voice technology is a disruptive force across many industries, and healthcare is no exception. In sync with tools like Amazon Alexa and Echo, voice-user interfaces (VUI) have the potential to take care management to the next level, and the advantages extend far beyond simple conveniences for patients. 

The world of healthcare lives in siloes: patients, family members, doctors, care managers, and health aides, just to name a few. All are inputting valuable health information from disparate systems, devices, and other sources—resulting in a fragmented view of the patient’s health.

A growing number of healthcare innovators, myself included, believe that voice technology is one solution that can help bring all the pieces together.

I joked during a presentation at Amazon’s VOICE Summit, where I addressed the use of voice technology as a patient engagement tool, that I had received a late-night text from my sister-in-law that four flavors of Goldfish crackers – which she knows I love – were being recalled due to salmonella. Imagine if Alexa knew my ordering behavior, understood what I had in my pantry and alerted me immediately to the recall. Now imagine if Alexa also automatically sent me a box to return the bags in question or merely alerted me to throw out my Goldfish stash and arranged for my refund.

When you apply those “what ifs” to healthcare, they take on new, more significant meaning.

Transforming Care Delivery with Greater Insights

Driven by the massive popularity of Alexa and Google Home, VUI is transforming care delivery by empowering providers with greater insights like these and better engaging patients in behavior change that leads to overall better health and outcomes. Implementation of VUI can enhance process across a variety of use cases such as:

  • Prompting patients to schedule appointments and follow through with care plans
  • Reminding patients about medications
  • Guiding patients through procedure preparations
  • Standardizing care information provided before or after treatment.
  • Enable interaction to complete assessments

The sky is the limit when it comes to implementing VUI, but the immediate goal is identifying medium-risk individuals before they become high-risk. What if Jane just had knee surgery but lives in a 4th floor walk-up? Her care team knows that compliance with her discharge plan may prove difficult. Voice technology can be the intuitive, patient-friendly layer that allows data to flow into healthcare systems faster.

Aging at Home

One of the biggest topics being addressed these days is Medicare’s unprecedented push into the home—a shift driven by an aging population that is outgrowing the amount of available senior living beds.

By weaving VUI-based smart home products like Amazon Alexa and Google Home into the fabric of healthcare technology, we can provide a better quality of life to seniors while allowing them to age gracefully in the comfort of their own homes.

Last month,, an Amazon spokesperson told a reporter that the company frequently receives positive feedback from “aging-in-place” customers who use Alexa’s smart-home features as an alternative to going up and down stairs. Amazon’s Echo Show is another product that offers users Tap to Alexa, a screen interface that lets users who are deaf and hard of hearing tap common commands. Microsoft, for its part, recently launched an A.I. for an accessibility program to create inclusive, affordable technology.

While a number of aging in place-focused technologies like these are already available, more still are being explored. We are seeing seniors embrace today’s connected devices to stay safely independent. Everything from blood pressure and glucose monitors to motion sensors are making seniors’ homes safer and smarter. Furthermore, voice devices can serve as the central data hub for all the connected devices in a person’s home. 10 years from now, I anticipate that most seniors who live independently will do so in smart homes equipped with passive devices that continuously monitor vital signs and activities of daily living. I also foresee the use of other monitoring devices, such as food trackers that monitor inventories and replenish when needed.

Addressing Social Determinants

Social factors such as lower income, education level, or high-crime area have been shown to significantly affect health outcomes. Subsequently, social determinants can cause care gaps such as difficulties with transportation, proper nutrition, understanding educational materials on a specific condition, or lack of a support network to help ensure compliance.

According to Lyft, 3.6 million Americans have transportation issues that prevent them from getting to or from doctors’ appointments, and 25% of lower-income patients have missed or rescheduled their appointments due to lack of transportation.

That’s where voice technology can help.

If John Smith needs to go to the doctor and Medicaid will pay for the appointment, John can say, “Alexa, I need to go to the doctor next week.” Alexa might respond, “Your doctor is available at 10 am on Tuesday. I’ll arrange for a Lyft to pick you up.”

It’s the same with nutritional needs. If John says, “I need meals,” Alexa might say, “You’re on a low sodium diet. Your choices for this shipment include asparagus or carrots.” By making solutions easier to reach, VUI can close the care gaps more efficiently and effectively than a care manager reaching out via email or phone.

To be sure, there are a lot of lofty ideas out there when it comes to VUI and healthcare, but it’s not practical to boil the ocean; instead, it’s important to hone in on those aspects of healthcare where it can have the greatest impact in the shortest amount of time.  By engaging patients in their homes – particularly those who make up the most high-risk, complex populations – VUI applications can keep patients out of the doctor’s office or hospital, while still providing strong outcomes.

About Adam Sabloff
Adam Sabloff, CEO and Founder of VirtualHealth, is a nationally recognized leader and executive in the healthcare industry. Adam’s impact in the field can be traced back to the mid-2000s, when he co-created the Ritz-Carlton Residences in Baltimore and discovered a significant gap leaving seniors and the chronically ill without access to essential care delivery and technology.

That insight, coupled with the loss of a loved one to a late-stage diagnosis, led Adam to develop VirtualHealth, the first comprehensive care management solution purpose-built for integrated value-based care. Designed for use by payers and providers, the platform aggregates and normalizes patient data from multiple sources effectively providing healthcare organizations with the tools to provide proactive, quality care.

Adam is a frequent speaker at healthcare and technology events, including the annual J.P. Morgan Healthcare Conference, Parks Associates’ Connected Health Summit, and the Amazon Voice Summit where he discusses topics including the need for advanced health IT solutions to achieve a true “whole-person” view of the patient.

Looking Back: Facebook in Healthcare

Posted on August 1, 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.

Today I decided that I’d start regularly doing a series of blog posts called Looking Back. In this blog post series I’ll look back at some of my popular (and maybe some not so popular) blog posts I’ve written and see how it holds up today. Have things changed? Were we totally wrong? Did we forget those lessons? I’ve done this on occasion, but with over 12,000 blog posts I think I want to make this a regular feature. There’s a lot of value in looking back at old posts and remembering where we came from and how things have changed.

Today’s “Looking Back” post was published in October 2014 and was titled Facebook in Healthcare. I’ll wait here while you go and read the post.

Now that you’ve read the post…

It’s fascinating for us to think about Facebook in healthcare. Especially with what we now know about people using Facebook to influence elections and other nefarious things. It’s sad, because those same people could have used Facebook to do some good things for healthcare, but they didn’t. That’s not to say that there aren’t some good Facebook healthcare groups that provide value for patients. There are, but they aren’t really stuff that Facebook has been working on as a specific product.

What’s crazy is that even back in 2014 when I wrote the previous post, I suggested that many people didn’t trust Facebook with our health info. Today that’s true times 10. That said there are still a lot of people that would have no problem sharing health info on Facebook as well. It’s amazing to think about the separation between the people who would still share pretty much anything on Facebook and those who don’t want to use Facebook for anything.

What’s surprising today is that the post didn’t even look at other big companies that are now becoming big players in healthcare. I mentioned Google which was just starting back into healthcare after the failure of Google Health. However, I don’t think even back then I would have been able to predict all of the healthcare things that Google is doing through Alphabet.

The other big company that wasn’t mentioned at all is Amazon. Back in 2014, I can’t even remember Amazon being mentioned in any healthcare conversations. That’s not true today where it seems like Amazon is mentioned in almost every healthcare conversation.

Looking at things as they are now, I think Amazon will be a big player in healthcare and will have a big impact on it. However, they’re going to do it in new ways. They’re going to create new opportunities and new gateways to healthcare and healthcare services. If we look back on this post 4 years from now I think we’ll have had no idea of the ways Amazon will impact healthcare. I think of all the big tech companies out there, Amazon will have a bigger impact on healthcare than others like Apple, Google, Samsung, etc.

What’s your take on these big companies impacting healthcare? Which ones do you think will be effective and in what ways? We’ll look back on this post in 4 years and see if we’re right.

Some Alexa Health “Skills” Don’t Comply With Amazon Medical Policies

Posted on July 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.

It’s becoming predictable: A company offering AI assistant for scheduling medical appointments thinks that consumers want to use Amazon’s Alexa to schedule appointments with their doctor. The company, Nimblr, is just one of an expanding number of developers that see Alexa integration as an opportunity for growth.

However, Nimblr and its peers have stepped into an environment where the standards for health applications are a bit slippery. That’s no fault of theirs, but it might affect the future of Amazon Alexa health applications, which can ultimately affect every developer that works with the Alexa interface.

Nimblr’s Holly AI has recently begun to let patients book and reschedule appointments using Alexa voice commands. According to its prepared statement, Nimblr expects to integrate with other voice command platforms as well, but Alexa is clearly an important first step.

The medical appointment service is integrated with a range of EHRs, including athenahealth, Care Cloud and DrChrono.  To use the service, doctors sign up and let Holly access their calendar and EHR.

Patients who choose to use the Amazon interface go through a scripted dialogue allowing them to set, change or cancel an appointment with their doctor. The patient uses Alexa to summon Holly, then tells Holly the doctor with whom they’d like to book an appointment. A few commands later, the patient has booked a visit. No need to sit at a computer or peer at a smartphone screen.

For Amazon, this kind of agreement is the culmination of a long-term strategy. According to an article featured in Quartz Alexa is now in roughly 20 million American homes and owns more than 70% of the US market for voice-driven assistants. Recently it’s made some power moves in healthcare — including the acquisition of online pharmacy PillPack. It’s has also worked to build connections with healthcare partners, including third-party developers that can enrich the healthcare options available to Alexa users.

Most of the activity that drives Alexa comes from “skills,” which resemble smartphone apps, made available on the Alexa store by independent developers. According to Quartz, the store hosted roughly 900 skills in its “health and fitness” category on the Alexa skills store as of mid-April.

In theory, externally-developed health skills must meet three criteria: they may not collect personal information from customers, cannot imply that they are life-saving by names and descriptions and must include a disclaimer stating that they are not medical devices — and that users should ask their providers if they believe they need medical attention.

However, according to Quartz, as of mid-April there were 65 skills in the store that didn’t provide the required disclaimer. If so, this raises questions as to how stringently Amazon supervises the skills uploaded by its third-party developers.

Let me be clear that I’m not criticizing Nimblr in any way. As far as I know, the company is doing everything the right way. My only critiques would be that it’s not clear to me why its Alexa tool is much more useful than a plain old portal, and that of the demo video is any indication, that the interactions between Alexa and the consumer are a trifle awkward. On the whole, it seems like a useful tool and will likely get better over time.

However, with a growing number of healthcare developers featuring apps Alexa’s skills store, it will be worth watching to see if Amazon enforces its own rules. If not, reputable developers like Nimblr might not want to go there.

#HIMSS18: AT&T Incubating Digital Health Startups

Posted on March 9, 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 recent times, some tech giants have started to think small. For example, companies like Microsoft and Google have been developing startup incubator programs capable of finding new niches, especially in AI. They’re also greedily eyeing healthcare; even Amazon has a hush-hush health IT working group in place.

This approach makes tremendous sense So much so that I’m surprised we haven’t heard more about it before. Even if it tries to foster an entrepreneurial culture, the sheer weight of a colossal bureaucracy is likely to crush most new ideas, and even if it doesn’t, very large companies are seldom agile enough to execute on these ideas quickly enough.

Given these experiments at Amazon, Microsoft, Google and other massive tech firms, I wasn’t surprised to learn that AT&T is taking a similar approach. At HIMSS18, I spoke with Judi Manis, regional vice president of business development and strategic relations at the company, about how it’s working with startups to commercialize new ideas in healthcare.

According to Manis, the telecom giant is focusing – unsurprisingly – on connected health solutions. In partnership with the sprawling Texas Medical Center, AT&T has created the Foundry for Connected Health. TMC also has a foot in the incubator business, its TMC Innovation Institute.

Working together, TMC and AT&T scour the world for startups generating innovative ideas in healthcare. They generally select 12 to 15 startups to participate in the program.

When they come on, TMC offers the founders a curriculum designed to help them thrive, including lessons on accounting, legal issues and how to pitch venture capitalists. AT&T, of course, offers startups all of the conductivity they could ever wish for, including mobile, terrestrial and land-based networks.

Once they find a viable idea, AT&T and TMC move at lightning speed. “The Foundry allows us to talk to companies of all sizes and bring the technology from discussion to pilot in weeks,” Manis says.

Though there may be some I don’t know about, I haven’t encountered any startup incubator partnerships between tech giants and hospitals.

However, it’s not surprising to see it happen. As readers may know, many sharp hospital organizations have already begun creating internal incubators and developing programs that seek out and reward employees that come up with innovative ideas. Maybe this is just the next phase in the process of digital health’s maturation process.

Supercharged Wearables Are On The Horizon

Posted on January 3, 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, the healthcare industry has been engaged in a rollicking debate over the value of patient-generated health data. Critics say that it’s too soon to decide whether such tools can really add value to medical care, while fans suggest it’s high time to make use of this information.

That’s all fine, but to me, this discussion no longer matters. We are past the question of whether consumer wearables data helps clinicians, which, in their current state, are under-regulated and underpowered. We’re moving on to profoundly more-capable devices that will make the current generation look like toys.

Today, tech giants are working on next-generation devices which will perform more sophisticated tracking and solve more targeted problems. Clinicians, take note of the following news items, which come from The New York Times:

  • Amazon recently invested in Grail, a cancer-detection start-up which raised more than $900 million
  • Apple acquired Beddit, which makes sleep-tracking technology
  • Alphabet acquired Senosis Health, which develops apps that use smartphone sensors to monitor health signals

And the action isn’t limited to acquisitions — tech giants are also getting serious about creating their own products internally. For example, Alphabet’s research unit, Verily Life Sciences, is developing new tools to collect and analyze health data.

Recently, it introduced a health research device, the Verily Study Watch, which has sensors that can collect data on heart rate, gait and skin temperature. That might not be so exciting on its own, but the associated research program is intriguing.

Verily is using the watch to conduct a study called Project Baseline. The study will follow about 10,000 volunteers, who will also be asked to use sleep sensors at night, and also agreed to blood, genetic and mental health tests. Verily will use data analytics and machine learning to gather a more-detailed picture of how cancer progresses.

I could go on, but I’m sure you get the point. We are not looking at your father’s wearables anymore — we’re looking at devices that can change how disease is detected and perhaps even treated dramatically.

Sure, the Fitbits of the world aren’t likely to go away, and some organizations will remain interested in integrating such data into the big data stores. But given what the tech giants are doing, the first generation of plain-vanilla devices will soon end up in the junk heap of medical history.

The Future of Small Medical Practices

Posted on December 27, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the questions I get most often relates to the future of small practices in healthcare. I’ve heard a lot of people make really great arguments for why small medical practices have an extremely challenging future in healthcare. We’ve all heard stories of large healthcare organizations eating up small medical practices left and right.

For the longest time, I’ve argued that this is all just part of a cycle of doctors selling to hospitals and then doctors hating life as an employed doctor and so they return to running their own practice. This cycle seems to be playing out and most doctors still hate being employees. However, there are a lot of other forces at play that makes it harder for doctors to go out and start their own independent medical practice again.

As I look at the biggest healthcare trends, none of them point to a brighter future for the small, independent medical practice. In fact, most of them make it even harder for small medical practices to survive.

For example, the shift to value based reimbursement is something that should be a great thing for small medical practices that have been known to provide the highest quality, personalized care. While this is true, must of value based reimbursement is as much about understanding and applying the data to a population in order to improve the overall health. How many small practices are going to be capable to do this type of data analysis?

If you extrapolate this further, it’s hard to imagine a future healthcare system that’s not built on the back of data. If that’s the case, he who holds the data holds the power. It’s worth asking if even the hospitals and health systems will be large enough to have the data they need on their patients. Or will even the largest hospitals and health systems need to work with massive companies like Google and Amazon who are currently collecting data at rates that no hospital could even consider?

This is a scary and exciting future that is a topic for another post. However, from a small practice perspective, this could be a good thing. If large corporations like Google and Amazon have the data needed to improve healthcare, then it’s possible that those corporations will enable small practices to survive. It could level the playing field for small practices that are trying to compete with large health systems.

What’s certain is that every healthcare organization is going to have to move beyond just the EHR. Sure, the EHR will be a requirement for every medical practice, but I believe it will only be the start. For small and large medical practices to survive, they’re going to have to start exploring what other technology they can implement to provide a better patient experience. The good thing is that small practices can be nimble and implement new technology quickly and without as much bureaucracy. The hard part is that they have to do so with a smaller budget.

What do you think about the future of small medical practices? Will they survive? Should we be making efforts to make sure they survive?

Will 2018 Be The Year Of The Health IT/Non-Health-IT Merger?

Posted on December 1, 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.

Within the last several days, the news broke that Amazon Web Services would probably be doing some sort of far-reaching cloud deal with Cerner. Given that AWS is a nearly $20 billion cloud organization, and Cerner one of the largest health IT players in the game, a lot could happen here.

My guess, not that it’s any leap of imaginative genius, is that if the currently-rumored deal between the two partners works, Amazon will make a serious bid to buy out Cerner as a whole. Given the massive profits potentially at stake in health IT, the idea of such an acquisition seems credible to me, at least if Cerner’s stockholders approve. After all, isn’t Amazon the company that just did a multibillion-dollar buyout of Whole Foods to fuel its growing (but still relatively small-scale) efforts in food retailing?

Not only is this particular deal interesting, I think it may portend some major structural changes in the health IT business as a whole. Specifically, I think we’re reaching a point where there will be a lot of pressure on companies with adequate cash and compatible goals to target HIT organizations, particularly if they need to scale up quickly and don’t have much internal knowledge on the subject.

And there’s no question that as healthcare settles into being a digital business, a range of digital businesses outside of healthcare will see that as an opportunity to step into such an important market. After all, how could they not want to be part of any organization that’s competing effectively in an industry that consumes a double-digit portion of the US GDP?

Over this period, many small internal workgroups outside healthcare will be transformed into scouting units seeking the next big digital healthcare deal. At the same time, these divisions will start forming quiet alliances strategic to their business, not only with giants like Cerner and Epic but also well-positioned startups in hot areas such as, say, blockchain security or supply chain management. (How could an ERP vendor not wonder how a healthcare supply chain management company running over blockchain could enhance their business?)

Then, of course, there are the more obvious moves which will bring a new critical mass of health IT customers, knowledge and talent to companies with a giant market presence already, such as Apple and Samsung.

Such M&A efforts won’t be optional. As Microsoft’s experience has proven in the past, and Amazon has apparently found more recently, you can’t just storm into the enterprise healthcare world and demand your cut, no matter how big a player you are. Getting there will take a well-finessed, mutually-fruitful agreement, if not an acquisition, even for a mega-company like Google/Alphabet.

Now, can I tell you which companies will be executing on such deals next year? I have a few theories, but no specific intelligence to share that you couldn’t pick up on your own by skimming industry headlines. But I do stand by my prediction that by the end of 2018, we’ll have seen a few spectacular deals between HIT vendors and digital companies outside the industry that will have a major influence for years to come.

Amazon Attacking Health IT Opportunities

Posted on August 17, 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.

Getting a footing in the health IT industry is more challenging than it looks. After all, even tech giants like Microsoft, Apple, and Google haven’t managed to take over despite their evident interest in the field.

Apparently, that hasn’t daunted Amazon. The retail giant has pulled together a secret team dedicated to exploring new healthcare technology opportunities, according to a CNBC report. And unlike other companies attacking the space from outside, Amazon has a history of sliding its way into unexpected markets successfully.

According to CNBC the new team, which is named 1492, is working to find an easier way to extract data from EMRs as well as push data into them. In doing so, Amazon is going up against a very wide field of competitors ranging from small startups to the healthcare arms of giant tech vendors and consulting firms.

What distinguishes Amazon’s approach from its competitors is that the online retailer hopes to aggregate that data and make it available to consumers and their doctors, sources told CNBC. The story doesn’t say whether Amazon plans to sell this data, and I don’t know what’s legal and what isn’t here, but my bet is that if it can, Amazon will pitch the data to pharmaceutical companies. And where there’s a will there’s a way.

In addition to looking at data management opportunities, 1492 members are scouting out ways of repurposing Amazon’s existing technology for use in healthcare. As another article notes, some healthcare organizations have already begun experimenting with delivering routine medical information and even coaching surgeons on safety protocols using Amazon voice-based assistant Alexa.  The new group, for its part, will be looking for healthcare applications for existing Amazon products like the Echo and Dash Wand.

The 1492 group is also preparing to build a telemedicine platform. Your first thought might be that the industry doesn’t need another telemedicine platform, and generally speaking, you would probably be right.  But if Amazon can get its healthcare IT bona fides in order, and manages to attract enough doctors to its platform, it could be in a strong position to market those services to consumers.

Make no mistake: We should take Amazon’s health IT effort seriously. At first glance, healthcare may seem like an odd arena for a company best known for selling frying pans and socks and discount beauty supplies. But Amazon has expanded its focus many times over the years and has typically done better than people expected. It may do so this time as well.

By the way, the retailer is apparently still hiring people for the 1492 initiative. I doubt it’s easy to find the hiring manager in question, but if I were you I’d inquire. These jobs could pose some interesting challenges.

ZocDoc’s Company Culture – What’s Been Your Experience?

Posted on August 17, 2015 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.

Company culture has been in the tech news lately after this lengthy article looking at Amazon’s company culture. However, in the healthcare IT world, I was more interested in this recent article by Business Insider looking at ZocDoc’s company culture. The article paints a brutal picture of a “frat house” mentality together with sexism and drugs. Not a pretty picture and it pains me to even read stories like this. However, this part of the article really stuck out for me:

On the sales floor at ZocDoc, employees say there’s a phrase used over and over again: “churn and burn.” Former employees say this phrase indicates the competitive, often stressful nature of work in ZocDoc’s sales division.

“They are full steam ahead,” one former salesperson told Business Insider. “They have this arrogance in the company where the human capital is of zero value.”

A former employee at ZocDoc told Business Insider that employee turnover at the company is high. The company recruits and brings in batches of new employees regularly because so many end up leaving or quitting, the employee alleges.

I definitely know very little about ZocDoc’s company culture. I do know that they raised a lot of money, very quickly. That puts a lot of pressure on your company. First, you have to hire a lot of people over a very short period of time. That doesn’t leave much time to develop a quality company culture. Second, when you raise that much money, you face enormous pressure to scale the company and deliver results. That’s not an excuse for bad behavior (assuming the Business Insider report is accurate), but it could explain how their company culture got out of control.

Company culture aside, their description of their sales organization mimics what I’ve heard from a number of doctors about ZocDoc. I’ve only ever met one doctor who liked ZocDoc. That doctor felt that he got patients he wouldn’t have otherwise gotten and so it was worth it. Every other doctor I’ve talked to said that ZocDoc charged way too much for new patient referrals and so they didn’t use them.

Outside of doctors’ views on ZocDoc’s pricing model, some doctors told me how aggressive the ZocDoc sales people were with them. They’d tell me about being contacted all the time by their sales people. I remember one practice manager telling me that they would never do business with ZocDoc since they hated their sales approach. The practice manager didn’t talk about the ZocDoc product or service at all. The sales person had ruined ZocDoc with that practice.

After hearing so many practices talk about ZocDoc over the years, it resonated with me when the former salesperson described the “arrogance in the company.” That’s the impression I’d been given by the many practices I’d talk to myself. I’m sure the $97.9 million they’d raised in funding (and reports said they’re raising another $152 million) helped perpetuate that culture.

What’s been your experience working with ZocDoc? I’d love to hear from more doctors and practice managers.

Could Amazon or Facebook Build A Better EMR?

Posted on February 18, 2011 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.

As we all know, few EMRs are a breeze to use.  In fact, many have such awkward, counterintuitive UIs that they ought to be thrown back into the pond.

On the other hand, superstar consumer apps like Facebook and Amazon have hooked people by the millions with intuitive, logical interface designs that simply addict users.  (And let’s not forget Apple, whose gift for consumer design has vaulted it from has-been to trend setter for the world.)

One CIO, Dale Sanders of the Cayman Island Health Authority, has taken these  examples and run with them, making what seems like a very strong argument in favor of the these giants’ approach:

In Facebook, we have a perfect framework for longitudinal documentation, collaboration, messaging, and scheduling between a patient and members of their entire care team, including family and friends.

We also have a framework for easily integrating data from other sources to enhance the value to the patient’s healthcare – there’s no equivalent of HL7 interchange going on in Facebook.  It references data located in other sources and systems. Can you imagine Facebook surviving if it required itself to house all the data that it presents?  Facebook takes great advantage of referencing and pointing to data in the source systems.

In Amazon, we have a perfect and familiar metaphor for ordering tests and procedures; tracking them; assessing their costs; rating them and seeing how other clinicians rated those orderables and referrals; and adjusting orders based on the behaviors and ratings of other clinicians, etc.

What makes his thoughts more interesting is that he actually marks up screenshots of key Amazon and Facebook pages, commenting directly on aspects he thinks EMR vendors could adopt.  It’s a thought-provoking exercise:  I recommend you check it out.