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Healthcare IT Twitter Roundup

Posted on March 17, 2016 I Written By

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

I’m a huge fan of sucking the nectar out of Twitter and providing me own commentary on what people are sharing.


This would be a good step forward. Machine to machine communication can be a lot more accurate.


When you see some of the amazing things they’re starting to discover in genetics, you can see why many are focusing on genetics. However, Pat’s point is a good one that we should focus on other social determinants of health (SDOH) also since they can have a lot of impact.


This is where the cloud is so powerful. Cloud computing is going to be the solution to this problem.


I see more and more efforts to include the patient voice. Love this!

Verizon’s Take: How HIT Can Transform Healthcare

Posted on July 27, 2012 I Written By

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

Every day, readers here wrestle with how health IT can improve patient care and remove costs from our monstrously bloated system.  And even though we share many of the same conclusions, the struggle is likely to continue for quite some time.

That being said, it never hurts to find out what big, super-mega-deep-pocketed giants of IT and telecom have to say on HIT trends, if only as an exercise. Not only does it tip their hand a bit as to where they’re headed, it adds more fuel to the fire. Here’s some trends Verizon’s big thinkers see as leading to care transformation:

  • Telemedicine:  An also-ran for decades, has telemedicine finally come into its own with abundant cheap bandwidth and relatively cheap mobile devices available?  Verizon says yes. The big V says telemedicine can suck $31 billion in annual costs out of the system.
  • mHealth:  This is a obvious one. But for the record, Verizon agrees that mHealth’s flexibility — with 10K health apps in the iTunes store alone — can do much to manage chronic disease, monitor patients and suchlike.
  •  Fraud detection becomes fraud prevention:  Interesting. Verizon, which, naturally, has a fraud prevention solution, argues that today’s claim analysis can catch fraud and abuse well before the claims are paid. Is Verizon thumping its chest or can this realistically be done folks?
  • Cloud computing spreads patient information: Verizon’s honchos say cloud computing will not only make healthcare businesses more efficient, it will make sharing of patient EMRs easier. (Methinks there may be a technical problem there, though; don’t you still need to be using compatible subsets of, say, HL7 to communicate, cloud or no? And isn’t that the problem overall?)

The rest of their big 10, well, you read and tell me whether you think they’re worth noting. If this represents the cutting edge of Verizon’s thinking, I’m not impressed. But I’ll give a call to the Verizon press contact and see if I can get more info. I’ll keep you posted.

Pervasive Healthcare Technologies Continuum

Posted on March 20, 2012 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.

In my random visit to Twitter today, the master of healthcare Twitter usage, Gregg Masters (@2healthguru), posted a picture that really struck a chord with me. It’s embedded below for those who want to see it. In the picture it shows a number of core functionality and technology that’s needed to get a person’s healthcare data into their hands to become truly empowered patients. You might also call this the Quantified Self Continuum, but I also like the Pervasive Healthcare Technologies Continuum.

Here are the steps it displays: Ubiquitous Sensing -> Wireless Connectivity -> Cloud Computing -> Social Networks -> Empowered Patients

I think the one we’re missing the most right now is ubiquitous sensing. We’ve just started down this path and still have a long way to go to make this a reality. I’m also not sure about social networks being the way that the information is distributed. At least not the social networks they list. I think they might be healthcare specific networks that connect and share the data, but are lifted up and made more prominent using the major social networks.

Ok, here’s the tweet and picture. What are your thoughts on it?

NIST May Standardize The Cloud, Even If It’s Too Late For EMRs

Posted on March 5, 2012 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 at the august halls of the National Institute of Standards and Technology, researchers have been compiling data on what makes EMRs usable. A year ago, in April 2011, NIST presented a draft set of usability standards. At the same hearing, a wide range of academics and scholars got up to talk about what they saw as they key issues — including whether EMR workflow should be changed to make it cost-efficient.

Since then, from what I can tell, there’s been a lot of noise but little light shed on the design specs a truly usable EMR should adhere to.  There’s been some progress in the development of HIE connections between EMRs, some worthwhile work EMR return on investment and even some improvements that might leverage EMRs to help doctors collect more from patients.

Talk to many doctors, and they’ll tell you their EMR stinks. Why? Largely because workflow is still inefficient and the “click burden,” which can drive doctors through a dozen steps to get tasks handled, hasn’t been reduced any too much. Some older docs I’ve spoken with even pine for the rough-hewn EMRs of 20 to 30 years ago more, which were at least built by their colleagues.

Honestly, I don’t expect the “awkward interface” problem to go away anytime soon. But while we stew on this issue, you might be interested to learn that NIST is taking over a few related problems in which it could conceivably make a real difference.

A few months ago, NIST released the 16th and final draft of its recommendations on definition of cloud computing. (Talk about insisting on getting it right!)  Not everyone in the health IT industry is even aware that NIST has kicked out a cloud standards document, which our friend Shahid Shah, “The Healthcare Guy,” is urging people to get onto their radar.  Maybe this time, NIST has a chance to actually standardize before an industry runs while with its own implementations of key technology.

I think I’ll finish with Shahid’s comments on the subject, as I think he’s pretty clearly got it right:

My strong recommendation to all senior healthcare executives is that we not come up with our own definitions for cloud components – instead, when communicating anything about the cloud we should instruct our customers about NIST’s definition and then tie our product offerings to those definitions. The essential characteristics, deployment models, and service models have already been established and we should use them. When we do that, customers know that we’re not trying to confuse them and that they have an independent way of verifying our cloud offerings as real or vapor.

Electronic Medical Records Lost Using External Hard Drive

Posted on August 16, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

I hate to call anyone stupid, but reading stories like Hospital Reports a Possible Data Loss really steams my Chinese dumplings.  According to the post, a doctor who works at two facilities, including the famous Harvard’s Brigham and Women’s hospital (of NOVA fame) walked out carrying a hard drive with over 600 patients’ personal, private medical records and then “lost” it on a trip to Mexico.  How could anyone commit or sanction such a risky action as walking out of a medical facility while hand-carrying an unprotected copy of so many people’s medical records in electronic form?!  And you gotta love that the records ended up in freakin’ Mexico of all places.  Whoever the legendary doctor was — who remains nameless — couldn’t have done a better job, short of sending the records to Al-Qaeda.  Can you imagine?!  Ugh…

You know what the answer to this is?  It’s quite simple — don’t store records on removable hardware. With the Cloud in place, I dream of the day when it’s mandated by law that health records cannot be stored on portable hardware.  We have so many brilliant companies using the latest SaaS technology that I really scratch my head wondering why this isn’t the default choice for all EMR and EHR systems.  There is little reason that the above disaster should still be allowed to happen in 2011.

Rather interestingly, and yet again, this is another example of data theft of patient records that was NOT electronic theft.  No usernames and passwords were hacked to get at the information.  It’s was just a plain, simple (at least as far as anyone knows) dumb-luck loss.  Another shining and yet pitiful  example of why I believe that records are far safer on the web and in the Cloud than in someone’s portable hard drive or laptop.  Do we really need to start anti-theft pad-locking and chaining hardware in place at medical facilities?

On another note, I’d love to have been the fly on the wall when the doctor was asked what happened that encouraged him or her to walk out with it.  Just how common is it?

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Tornadoes and HIPAA

Posted on June 16, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

[Note:  Since this post was published, I found an excellent post over at EMRandHIPAA.com.]

My friend John Lynn over at EMRandHIPAA.com posted an interesting piece discussing hospital liability when health information is literally strewn around town after a tornado hits.  With all of the recent tornado activity and tragedy occurring in the U.S., it seems likely to happen again and again.

This also highlights another reason I love my web-based, redundantly backed-up EMR system.  You can’t lose any protected health information unless the locked-up primary server farm and the locked-up secondary backup server farm, which are typically geographically isolated from each other, are both destroyed .  You can’t blow paper chart notes out windows or plastic x-ray films into tree tops when they don’t exist.

Inadvertent exposure of PHI?  Think again.  Web-based records require the person to login remotely to access them, so you can’t just lose a laptop on the train or in a cab and be at risk of data breach.

I feel bad for all the patients who lost, or will lose, their records because they were kept on paper, since it probably means they’re at high risk of having a less informed doctor treating them in the future.  Don’t fight future tornadoes… embrace the cloud today!

 

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at doctorwestindc@gmail.com.

Health IT And Cloud Computing: A Promising Start

Posted on January 28, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Note: This piece was written by Priya Ramachandran, a former IT auditor and freelance writer who blogs at www.pramwriter.com. We’d like to welcome her to EMRandEHR.com.

You gotta hand it to the IT folks.    Once they come up with a catchy phrase like cloud computing, it spreads like crazy, and now it’s come to mean just about any architecture you can imagine. This Wikipedia entry explains how “cloud” might mean anything from software and services available on the web, to virtual servers created off of physical servers. Adding to the confusion, some leading names in IT willfully obfuscate the terms.

I really like Rob Pegoraro’s definition of the term and that’s all cloud computing is going to mean for the purposes of this post:  cloud computing is “having an Internet site host your data and the programs you use instead of keeping them on your computer.”

Some benefits to putting health data in the cloud:

Now in the case of health IT, there are compelling reasons why a cloud may benefit your organization:

— Increased processing power:  If you leave it to the folks who provide these services, you won’t have to administer/upgrade your own hardware

— Pay as you go:  Pay for only those services that you end up using

— Data portability:  If you keep your customers’ health IT records online, it’s a lot easier for you and your customers to access said data

— Freedom from the IT department guys:  Yeah, it might be a pipe dream, but when you’re with a good cloud service, IT is really your vendor’s headache

— Security:  Which, as we will see later, can be something of a double edged sword

Some models of cloud computing have evolved to better address data integrity. The costlier and most robust solution would be to create a private cloud. Open source cloud solutions such as osCloud allow healthcare organizations with some IT muscle to design their own.

Third party vendors often work with healthcare providers to create a secure version of the cloud for private use. The costs of this approach are significantly higher than investing in a public solution, where all your patient data is on a nebulous cloud. Pragmatic hybrid cloud solutions abound too, fixing the security concerns of a public cloud, and with costs cheaper than a private cloud solution.

Use cases in healthcare:

For health IT, there are several uses cases where cloud computing is probably a great option. Some of the more interesting ones I’ve come across:

— For hospital surveillance and security – Awarepoint, a fully managed service, provides GPS style RTLS (Real Time Location Systems) tracking of patients, personnel, equipment for reducing hospital theft prevention; Denver Children’s Specialists is utilizing ControlByNet’s cloud-based, hosted video security surveillance solutions, to monitor six locations on the cloud. The group moved from separate DVRs to ControlByNet’s solution to monitor its six locations throughout Colorado.

— Cheaper and better transcription services –  Details courtesy of Lauren Richman, healthcare marketing director at Nuance Healthcare: “The doctor dictates a patient record (via phone or into an electronic health record system), the voice file is sent to the cloud where it runs through a speech recognition engine, a draft medical record is created and sent to a transcriptionist for review/editing and then sent back to the doctor for final sign off. Leveraging this cloud-based technology saves time on documentation for doctors and transcriptionists, which speeds efficiency and significantly reduces costs.” A whitepaper published by Nuance shows that 39 customers saved over a million dollar each for a total savings of 93 million dollars.

— Access and collaboration between specialists: ClickCare, a HIPAA compliant SaaS and iPhone application combines pictures, text, sounds, and videos to improve collaboration between healthcare providers. In one instance, at the Wound Institute in PA, 70 patients were treated solely over ClickCare with an overall healing rate of 93% and an estimated savings of $24,000 in transportation costs.

— Other business activities: SuccessFactors is a vendor that works with several hospitals to streamline their HR processes. Presidio Health, a service created by a former ER physician, helps hospitals enables hospitals, health systems and urgent care centers to efficiently collect patient payments at the point of service. (Interesting statistic provided by Presidio: once a patient leaves the ER, the facility only has a 20% chance of collecting any amounts due from the patients)

If you live next door to a mafia don, you’re more likely to get shot:

All these success stories in the media must make everyone else in the healthcare field salivate. But, moving to the cloud shouldn’t cloud one’s judgment about this relatively new IT paradigm. When you’re housed in some cloudy barracks, you have little say over what services you receive, as pharmaceutical giant Eli Lilly found in its experience with Amazon web services. Eli Lilly had long been promoted by Amazon as its poster (client) child, but found that it could ask (and receive) few guarantees from Amazon about power outages, security breaches and other unsavory aspects.

Also as in real life, the ‘hood you decide to live in might very well affect how secure your data is. Amazon Web Services found itself having to boot Wikileaks after it (Amazon) was targeted by groups intent on bringing Wikileaks down. Even though Amazon might be better able to protect itself against a DOS (Denial of Service) attack, its visibility might mean it is attacked more than an average client.

Bottom line:

I’m excited by the services that are now available on the cloud, and even more excited about how much they can revolutionize healthcare. But given my background as an IT auditor, I’m wary of getting too excited about cloud computing just yet.  Let’s see what the next year or two brings.

Halamka’s Top 10 Healthcare IT Takeaways from HIMSS10

Posted on March 4, 2010 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.

Anyone that works in Healthcare IT knows who John Halamka is and so of course I was interested in his post of his top 10 impressions after HIMSS. It’s an interesting list and I think he does a pretty good job of looking at things from a very high level. Here they are as posted on his blog:

1. Meaningful Use is everywhere. Vendors are promising EHRs, modules, appliances, and services to help clinicians achieve it. I had dinner on Monday night in a small Indian vegetarian restaurant. Sitting next to me were 3 engineers from Bangalore who were arguing about the details of Meaningful Use in between bites of vegetable curry. I could not escape Meaningful Use anywhere!

2. Certification is everywhere. It’s particularly ironic that many vendors claimed their systems were certified, even though the certification NPRM was just released today, making compliance with the new certification process in time for HIMSS impossible.

3. Cloud computing, Software as a Service and ASP models are popular tactics to accelerate EHR rollouts. There are still lingering concerns about how to ensure privacy in a cloud environment.

4. Several firms such as Intersystems, Axolotol, and Medicity are offering HIE platforms that include many of the standards noted in the IFR. The marketplace for HIE products is just emerging and it’s hard to predict who will become the market leader.

5. The Continuity of Care Document is gaining traction. I found many vendors supporting CCD exports from their EHRs. A company called M*Modal , has developed natural language processing technology that captures dictated content in its original context (ontology-driven
rules) as a CDA document.

6. Consultants abound. It’s clear that Regional Extension Centers and Health Information Exchanges will require expertise and staffing from professional firms. They all had large booths at HIMSS.

7. 30,000 people attended, including 10,000 I did not recognize (just kidding). It’s clear to me that many IT professionals, even those with limited healthcare domain expertise, attended HIMSS to better understand how they could participate in the euphoria of HITECH stimulus dollars.

8. Self service kiosks for patient identification and self-registration are now mainstream. Just as we print our airline boarding passes, we can now use credit cards or biometrics to check into ambulatory care appointments and automatically settle all co-pay balances.

9. Image exchange in the cloud is being offered by several vendors. As I mentioned in Monday’s blog, Symantec announced an appliance for small clinician offices that cloud enables all imaging modalities using a facebook-like social networking invitation to share/view images.

10. PHRs and patient engagement are becoming more mainstream. Google and Microsoft continue to innovate in the non-tethered PHR marketplace.