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Web Portal Use by the Numbers

Posted on October 7, 2013 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

With our first year of web portal use well behind us I started looking for practical ways to begin mining some data to get some basic statistical observations regarding patient use of web portal.  As with all new undertakings in health IT this was far more difficult and cumbersome than it should have been.  Nonetheless I got a few interesting observations documented over the past couple of days.  I did not do an exhausting review but I don’t think data like this exist anywhere else.

I was curious about what proportion of our network’s new patients have used the web portal over the past 6 months.  Overall 22% of our new patients used the web portal for clinical data entry.  This differs significantly from my subjective observation that about half of my new patients were using the portal; this data includes all 19 of our network physicians, not just my own.  I am in the process of looking at my patients only.

 

The breakdown by age is here – the first table  – web portal figure 1

 

Portal use is very steady at around 25% through age 65 years.  Use among pediatric patients shows parents are just as willing to use the portal for their children as they are for themselves.  It is reasonable to expect portal use to drop with increasing age but I didn’t expect 65 year olds to be using the portal as much as 25 year olds.  Portal use among patients in their 70’s and 80’s is quite respectable.  The bump in use in patients over 90 years of age is interesting but likely to be a statistical illusion due to the very small absolute numbers in those age brackets.

 

The second table shows the same data expressed as raw numbers rather than percentages.  All our new patients, regardless of portal use, tend to be from age 40 to 70 years.

 

 

Mulling Over EMR Market Consolidation

Posted on September 27, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I had the pleasure of attending a Technology Association of Georgia Health Society event last week on mobile health. It offered me a chance to chat with colleagues, and hear from a panel of payers, providers, startups and vendors on the current state of and predictions for mobile health. While networking beforehand, I found myself trying to succinctly answer a colleague’s question of, “Where do you see the EMR market heading in the next few years?”

My short answer was, “It is consolidating and will continue to consolidate.” I had more details and theories on the tip of my tongue, but didn’t get the chance to back up my statements before we were ushered in to the evening’s presentation. It was a big question – one that I think has only one correct answer, but also one that potentially has a variety of explanations behind that answer. Needless to say, I mulled it over that night and into the next day, when, coincidentally, I awoke to news of the Vitera/Greenway Medical deal.

If I had the chance to do it over again, I’d break my response down like this: Meaningful Use obviously provided incentive for businesses to get into the EMR game. Some were already in healthcare, while others were on the fringes. Combine those new industry entrants with companies that have provided EMRs since before HITECH, and you’re left with a crowded market.

Implementations and go lives coinciding with Stage 1 left many providers dissatisfied with the EMR experience thus far, but still willing to forge ahead. As they look to Stage 2, some realize their vendors – whom many are already disenchanted with – will not be up to the task of helping hospitals meet digital patient engagement quotas, among other Meaningful Use guidelines. And so began the rip and replace movement.

Vendors deemed not up to par looked at their options. Many took a step back and reassessed product development and strategy, deciding to either: get out of the healthcare game, close up shop altogether, merge with a competitor, or make themselves available for possible acquisition.

That’s one wave of consolidation. I’m fairly confident we’ll see another wave in the next 12 to 18 months, if it hasn’t already started. (I don’t think we’ll see too many Phoenix-type situations like Google.) As providers dive deeper into using technologies around Stage 2 engagement requirements, they’ll experience a second wave of acceptance or denial. At some point, the EMR replacement market will die down, providers will settle into the technology they’ve settled on, and purchases of new systems will stagnate. EMR sales will thus dry up a bit, forcing vendors to again look at their options. I would think that many will turn into consulting services once the demand for new software has died down.

Now that I’ve put pen to paper and laid out my thoughts, I wonder what readers predict. I encourage you to let me know whether I’m on the mark, totally off base, or somewhere in between.

Connecting the Dots Between S2MU and #HCSM

Posted on September 5, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I gave myself a pat on the back last week for attending Friday’s #HITsm chat. Moderator Brian Ahier (@ahier) and the usual suspects did a great job of zeroing in on the positives and negatives of what not only a delay to Stage 2 of Meaningful Use could look like, but what modifications to the requirements could look like as well.

As I mentioned during the chat, I feel that delaying it further would only delay the ultimate benefits we are all hoping healthcare IT like EMRs will bring to patient care. It will also add copious amounts of fuel to the already burning fire of provider discontent. Modification, however, might actually ease the burden on both providers and vendors. I’ll defer to the chat commentary, which you can view via the transcript.

If a recent CMS presentation on providers likely to incur Meaningful Use penalties is any indication, modifications might just let them breathe a small sigh of relief and focus a bit more on their patients, rather than hurriedly struggling to meet IT deadlines with ill-fitting or non-certified products.

Concurrently with all of this Stage 2 coverage has been a rise in commentary on providers’ use of social media. I have to assume that physicians and hospitals are becoming more attuned to the benefits of social networking in light of the industry’s push towards more patient engagement. While hospital social media strategies may be considered an offshoot of engagement initiatives tied to Stage 2, I have a feeling providers are beginning to realize such strategies are a valuable means of marketing and education outreach in their own right.

It would be interesting to see if there is a correlation between the types of doctors and hospitals CMS has identified as being most likely to incur Meaningful Use penalties and the social networking activity of that same group. I’d venture to say that providers at penalty risk don’t have social strategies in place, and face more systemic problems related to lower reimbursements, fewer resources, not enough qualified IT staff available, too many patients and not enough physicians, etc. It’s also probably safe to assume that providers that do have a social networking strategy have more resources, and have been able to devote those resources to preparation for Meaningful Use well before their less fortunate colleagues.

What do you think? Feel free to play devil’s advocate by leaving a comment below.

The Doctor’s Best Use of the Tablet

Posted on August 27, 2013 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

I recently reviewed the Epocrates 2013 Mobile Trends report.  The study has a somewhat unusual participant profile, consisting only of primary care, 3 medical specialties and no surgical specialties; nonetheless the observations are probably close to the mark and are consistent with my experience with my first tablet a couple of years ago.

I purchased an iPad within a couple of months of the introduction of the first model thinking it was perfect for EMR use in my office.  I abandoned it after a couple of months when I discovered several shortcomings.  First, the first iPad was too heavy to hold by the edge and had to be held by a fully supinated hand (totally flat palm facing up).  Try that for 5 minutes and see how your forearm feels.  The first iPad was also too big to put in a physician’s white coat pocket.  And the screen resolution of the first iPad models was not good enough to display a busy EMR screen.   But the biggest drawback was that the early remote desktop apps did not work very well.

The iPad mini addresses all four of these issues.   The Mini is small enough to fit in a white coat pocket with the standard magnetic cover in place.  It is easily and comfortably held by its edge.  It needs a Retina screen badly but the display is better than the original iPad and is (barely) adequate for my 50-year-old eyes to see.   And remote desktop apps have come a long way.  It appears that similar advances have been made in tablets from other manufacturers as well.

I was therefore surprised to learn from the Epocrates study that although a majority of providers (53%) use tablets for patient care related activities, only a small portion (2%) use tablets for actual patient care record keeping in an EMR.  So I thought it would be interesting to outline my current methods of using a tablet that put me in the 2% category as well as the 53%:

 

  • Entering data into my EMR via a Remote Desktop app.  There are important lessons here.  Don’t expect to stick a tablet in the physician’s hand and have it work like magic.  Our office workflow is designed to optimize the physician / tablet combination.  I use the tablet for only 2 data fields in EMR:  assessment and coding (CPT and ICD).  The office staff enters all the other parts of the note and initiates treatment workflow through the EMR at the physician’s direction.  After the patient is seen I review all parts of the note (on a laptop or desktop), make additions / corrections, and sign it.
  • Cloud based voice-to-text.  This takes the tablet from merely useful to spectacular. There are 3 characteristics of Apple’s built-in cloud-based speech recognition that make it comparable to the Dragon software I have used in various forms for over 10 years:  1.  It is embedded seamlessly into the soft keyboard, 2.  An inexpensive external microphone plugged into the headphone /microphone jack raises transcription accuracy tremendously, and 3.  It works well with Remote Desktop, eliminating the need for a “dictation box” or other similar workaround.  These attributes make up for its most serious drawback, the lack of a medical (or at least customizable) vocabulary.  At the moment I have the right people talking to each other to address that problem.
  • Hospital EMR.  Our hospital is still in the implementation phase of a new Cerner system.  I am still learning the system myself but my initial experience using the system on my tablet using Citrix Receiver has been very positive.
  • Patient education.  LUMA, a product of Eyemaginations, is a very nice product for showing surgical patients the complex head and neck anatomy of their diagnosis and/or proposed surgical procedure.  There are both online and iPad versions available.  I can switch back and forth between EMR and LUMA without losing the Remote Desktop connection.
  • Medical imaging.  I can’t load an image disk directly onto my tablet but I can load it onto my desktop and take a photo with my tablet to review relevant images with patients.  I have tinkered with some apps that allow me to draw on the image to help educate patients.  Still looking for a way to conveniently reduce the file size to facilitate copy-pasting into EMR notes.
  • Literature searches in the exam room.  Not glamorous but helpful, most commonly to review medication side effects.

 

I think that is a pretty complete use of the tablet for the physician.  No doubt new uses will appear before long.

 

Our First Year with a Patient Portal

Posted on August 11, 2013 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

Last month marked the end of our first year with our web portal.  It has been a steep but worthwhile learning curve.  Similar to every other component of our IT system there were many bumps along the way.  Here are some observations worth sharing:

  1. If you build it – and promote it – they will come.  There is no question that patients in our North Atlanta market like the portal.  Over the first 12 months 12,518 patients have signed up and completed over 130,000 health, demographic and general consent forms.  Participation has increased steadily as we have refined web page usability and improved the reliability of the system.  Subjectively I think about 2/3 of my new patients are using the portal to enter their demographic and personal health information prior to their initial appointment.
  2. Overpromotion backfires.  Our telephone-greeting message says, “To schedule an appointment, dial 0 or go to www.entofga.com.”  Sounds reasonable enough, but patients have misinterpreted this message as meaning that we don’t want to talk to them.
  3. If it doesn’t work, patients get angry – with good reason.  Nothing is more frustrating than spending 45 minutes filling out all your information at home and then getting handed the same forms on paper at the office because your online data was lost.  The IT folks seem to think if the explanation for the failure is fancy enough that will make everything OK.  It doesn’t.
  4. Patients who choose not to use the portal at home don’t want to use it in the waiting room, either.  We have tried iPads, laptops and desktop kiosks.  We have trained our front office folks to promote it and even “walk patients through” the portal.  Nothing has worked.  We have considered recruiting those patients with a different technology such as scanned #2 lead pencil bubble forms, at least for the discrete data.
  5. Patients have little interest in using the portal as an ongoing tool.  After the initial creation of the account, data entry and first appointment, they rarely use the portal again.  Last month with over 12,000 patients enrolled we got only 6 prescription refill requests and 24 “ask the doctor” questions.   Appointment requests were slightly better at 134.  Our telephone appointment schedulers tell me they frequently get calls from folks who made an appointment request online but then immediately call for the same appointment because they were not comfortable with the online appointment concept.  One could argue that this is unique to our specialty practice or that the online forms and workflow need improving.  That may be true, but I am convinced that at least a part of this phenomenon represents cultural pushback from patients.
  6. The ROI on the web portal is in some ways an all-or-nothing situation.  For a while the portal was passing to EMR only about 15 of the 20 data fields required to complete our demographic database.  Intuitively one would think the portal was therefore “75% useful”.  The problem is if I have to pay staff to open the patient’s file to manually enter the 5 remaining fields, I may as well have them manually enter all 20 fields.  That makes the portal 0% useful.  I can’t reassign staff to better things until the portal passes 100% of the data to the EMR.  This also relates to the reliability issues described above.  Until we reach near 100% reliability the return on investment is limited.
  7. As with every health IT product we have ever tried, it doesn’t work completely as advertised.  Although the new patient workflow is going fairly well other features remain severely compromised.  In our vendor’s defense this is partly because our parent EMR has had some upgrades which in turn requires our vendor to update the portal to adapt to the EMR changes.  The point is that none of these products is “plug and play” and the industry has a long way to go before these products become easy to use and practical for everyone.
  8. There are unintended consequences of a web portal.  Unbeknownst to us our portal was directing patients to the vendor’s personal health record product.  The transition is apparently pretty seamless so patients often still thought they were still inside our portal when they encountered very personal questions (i.e., sexual history) that had no relevance to their ear / nose  / throat appointment.

As an “early adopter” practice we are pleased overall with the portal but I’m not sure how a more typical practice would feel.

Bill Gates Puts a New Spin on the Great EMR Debate

Posted on May 13, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I heard an interesting interview on NPR the other day with Bill Gates on the subject of polio eradication. The Bill & Melinda Gates Foundation has been working for a number of years now on the effort, and are intent on seeing that no child ever becomes paralyzed as a result of the disease. The interview got me thinking about money, as NPR host Robert Siegel grilled Gates about the cost of this hopefully final vaccination push in the three countries that still show cases of it each year – Afghanistan, Pakistan and Nigeria.

According to Gates, a nice tidy sum of $5.5 billion will be necessary to vaccinate enough children to finally push out the disease. The question arose as to whether or not this money will be spent wisely. Could it be put to better, more effective use fighting other healthcare conditions, such as malaria, that affect greater numbers of people? Gates made the point that once polio is eradicated, the enormous amount of money already being spent on fighting it can then be spent on these other issues – a statement that to me didn’t seem to sit well with Siegel.

Now, if you’re in healthcare, chances are money crosses your mind a few times a day. And if you use an EMR, you’ve likely voiced an opinion or two on whether it has lived up to its promised value. I think Gates’ point above on cost effectiveness of disease eradication – the most expensive disease gets eradicated first to free up its funds for other healthcare causes – can be applied to the EMR ROI debate.

Yes, healthcare is expensive. Yes, current and possibly future EMRs may not have the best interfaces or give the ideal user experience. But, given time (perhaps a lot of time), they will ultimately help springboard immense cost savings throughout the industry. I consider them the backbone of interoperability, especially when it comes to health information exchange and accountable care – two notions that might just become the norm once EMR utilization finally reaches critical mass.

Stage 2 Meaningful Use will likely see a shift in the market, and from what I’ve read thus far, is causing providers to think about Meaningful Use in a new way. It might be a hiccup in this journey to cost savings, but it will likely separate the wheat from the chaff as far as vendors go. Hopefully, only effective products will be left standing, which will in turn make it easier for providers to use EMRs in the most effective way.

Money will of course be on everyone’s minds at the upcoming HFMA ANI show in Orlando. This has got to be one of my favorite events as it is smaller than HIMSS but still has that bustling, breaking news vibe. I’ll be interested to hear from providers their opinions on the recent push for greater price transparency when it comes to hospital costs, and how they are feeling about EMRs as of late. It will also be interesting to see how vendors are helping these providers meet Stage 2 and patient engagement head on.

Will you be at the ANI show? Drop me a line in the comments below and let me know what you’re looking forward to learning about or seeing the most.

HIPAA Puts Innovation and the Cloud Into Perspective for Providers

Posted on April 25, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I had the pleasure of attending the iHT2 conference in Atlanta for the second year in a row and was once again pleased with the opportunity to interact with providers in such an intimate setting. A far cry from the chaos and showmanship of HIMSS, to be sure. No matter what session I attended throughout the two-day event, I heard consistent mumblings of discontent around HIPAA, especially in the context of being a barrier to innovation in the mobile health space.

My Twitter friends have a habit of putting things into perspective for me, and Susana Vallelonga, aka @sgcalderoni, didn’t disappoint:

twitter

She makes a good point – one that ties into a recent discussion I had with Frankie Rios, the new Vice President of Information Security at GNAX Health. He is facing a similar challenge when it comes to convincing providers of the benefits of the cloud in the face of new HIPAA rules. He is no stranger to challenges, though, having spent 16 years in the US Marine Corps as a Senior Network Engineer, Trainer and Supervisor. I had the chance to chat with him recently about the state of cloud computing in the wake of the recently enacted Omnibus Rule.

Do you think the newly enacted HIPAA rules will scare providers away from migrating to the cloud?
Actually, the new HIPAA rules protect providers as they migrate data and applications to the cloud. Whether it is cloud computing or cloud storage, the new rules provide a stronger framework. The technology continues to mature and as it does so, I believe we will continue to see a growing acceptance of cloud services from providers.

How are you working to combat these fears?
We are educating providers from both a technology and policy perspective. Technologically speaking, there is no reason why the cloud cannot be as (or more) secure than an on-premise solution. We are also providing information on implemented controls to secure patient data within the cloud.

You recently created a set of criteria to help providers evaluate potential cloud providers and their compliance with HIPAA requirements. How would you say this list has changed in the last five years? What should providers be aware of now that they may not have even considered a few years ago?

The list has really not changed much in the last five years. All of the controls are based on information management security best practices that have been around much longer. What has changed are the security technologies and cost of implementing the controls. For some, the costs have gone down and for some the costs have increased.

A few years ago it was difficult to ensure that vendors had the proper controls in place. There were no instruments to hold vendors accountable other than extra contract language or business associate agreements. The responsibility was on the provider to implement security controls and ensure HIPAA compliance. In the case of a breach, the provider (not the vendor) was liable.

With the new rule, business associates are also liable in the event of a breach, and must ensure that the same security controls are in place.

Along those same lines, how do maturing EMR technologies play into a provider’s decision to move to the cloud?
Most EMRs already have the ability to deliver their application in a cloud-based environment, or their solution is offered as an ASP model. This makes it very easy for providers to migrate their EMR technologies to the cloud.

The cloud is really just the “next step” from virtualization of current assets. It is not maturity of the EMR itself, but simply an enhanced infrastructure and platform functionality.

However, providers should ask how cloud options for their EMR impact clinician workflow. Changes should be clinician-centric; not technology-centric. All the technology in the world is meaningless if it doesn’t improve the workflow or functionality of the clinician.

It seems you are well versed in risk analysis, coming from a military background and then moving into healthcare IT. How has that first career prepared for you this new age of digital breaches in healthcare environments?
My first career in the military greatly improved my ability to act quickly on new situations or regulations. In addition, the emphasis on planning is an important part of the process along with communication.

Risk analysis is an ongoing process. Most implementation mistakes are around performing risk analysis and then doing nothing for the rest of the year. Risk analysis must be part of all aspects of information management in healthcare: especially, strategic and budget planning.

Simply checking the box off that the risk analysis is complete is wrong! As business processes and technology changes, so will the risks that have been introduced. Risk analysis is an ongoing process – not a once and done.

User Experience is Hot HIT Topic with Good Reason

Posted on April 18, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

User experience in the world of healthcare IT has never been a hotter topic. It seems not a day goes by that I don’t come across an article, blog, tweet, or outright rant regarding the state of user friendliness, especially with regard to EMRs. (Who can forget the American Medical Association’s note earlier this year to Farzad Mostashari, peppered with complaints about physician usability of EMRs?) I see plenty of negative coverage around the topic – plenty of folks like to have a soapbox to stand on, after all.

I don’t, however, see enough coverage devoted to businesses and providers working to make the backlash better. Surely there are unsung heroes out there in the world of HIT UX that are at their drawing boards right now, attempting to take the sting out of those extra clicks, and listening with bated breath to providers’ complaints and praises.

I came across one such story in New Orleans a few months ago, where, like many of you, I tried to successfully drink from the fire hose (bottled water, actually) that was HIMSS13. I was able to sate my thirst for good UX news at the PointClear Innovation Awards breakfast, which honored a select group of the company’s clients for their work in the realm of user experience.

McKesson took home top honors this year, and while I had some knowledge of their work in the area, I didn’t realize how great of an emphasis they have placed on making sure their healthcare IT solutions are used in the most optimal way for the best possible patient outcomes.

“The big dynamic we are trying to tackle is around critical decision makers,” explains Bobby Middleton, Executive Director, Enterprise Intelligence Product Management at McKesson. “Through experience with our customers and continued research, it is becoming very obvious that our healthcare leaders are often put in a position to make critical decisions without pertinent, relevant and timely information.

“Our Enterprise Intelligence solutions are all geared around providing the right information to the right person at the right time,” he adds. “Our User Experience research is being used to make sure the targeted offering we are delivering via these solutions help a specific set of critical decision makers make the right decision. It is going great so far, and really allowing our technology teams to connect with their end consumers.”

I wonder if we’ll start to see more positive publicity of efforts like McKesson’s, especially as Stage 2 draws closer, more and more providers consider switching to more mature EMRs, and next year’s predicted influx of the newly insured start to clamor for greater digital engagement options and price transparency. One less click or toggle may just make all the difference when it comes to quality patient care.

Secure Text and Email, Smartphone Physicals, and EMR Documentation – Around Healthcare Scene

Posted on April 14, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

There are so many types of mHealth apps and devices out there, it was inevitable that someone would try to have them work together. At TEDMED 2013, Shiv Gaglani and a team of physicians-to-be will be presenting the “smartphone physical.” Are these types of visits closer to becoming a reality than we may have realized?

One of the amazing technologies that have been developed is a smartphone that measures vitals — maybe this will be used in smartphone physicals someday! The Fujitsu Smartphone analyzes subtle changes in blood flow and determines vital signs, all by the user taking their photo with the phone’s camera. It goes to show that you don’t necessarily need fancy equipment to have incredible mHealth technology.

While some are concerned about the safety of email and texting for healthcare communication, it’s becoming a way of the future. Companies such as Physia and docBEAT are working specifically to make email and texts more secure. So which one is better? Both have their pros and cons – texting is quick and to the point, while email can take more time. Which would you rather receive?

Most doctors will agree, the current documentation options that EMRs offer are frustrating. There’s just too much clicking. However, the tide is shifting and it is very possible full keyboards will be needed. And the need for point of care EMR documentation will be more necessary than ever before.

With the current budget proposal by President Obama, EMR vendors might be impacted significantly. The ONC is suggesting that health IT vendors pay up to $1 million in fees. With the upcoming expiration of the ONC’s $2 billion appropriation from ARRA, the agency is needing some new funds. It also would help maintain ONC’s Certified Health IT Product List. Of course, vendors will not be happy to hear this news.

Cash for Care a Trickle-Down Effect of EMR Dissatisfaction?

Posted on April 5, 2013 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

By now we’ve all heard about or read of the group of dissatisfied EMR users – hospitals and small-practice physicians who bought into the notion of government incentives – and a better way to deliver healthcare with the added benefit of more efficient processing and payment collection from patients and payers – but aren’t seeing the ROI they initially anticipated. Say what you will about this group, but one thing is for sure: Investment in healthcare IT systems like EMRs have led some physicians to turn to hospital employment, others to close up shop, and yet others to turn to more unique business models such as concierge or cash-only practices.

On the flip side of this change in healthcare delivery is an increasing demand from patients to know just what their dollars are paying for, no matter whether those dollars pay into a monthly insurance premium or directly for services rendered. I wouldn’t say we’re yet at the point where this demand is a trend, but I do believe that as more and more mainstream media outlets cover the debate over healthcare costs and price transparency, more patients like you and me will learn how to ask for costs up front, how to shop around, and most importantly, how to determine if what we’re paying for is worth it.

Entrepreneurs didn’t take long to catch wind of this, and as a result we’re seeing a number of consumer-friendly healthcare businesses pop up. Take Healthpons, for instance. I came across mention of this company a few weeks ago, and was intrigued by its Groupon model for healthcare services. The company offers one line of service for providers, and another for patients. According to its website, Healthpons offers a free portal that allows physicians to market their services at a cash price so that patients can quickly search for said practice and service by city, state, zip, specialty or symptom checker; purchase services and set appointments online. Patients, in turn, can use the portal to search for providers, find the one with the best price, and use a Healthpons discount to pay in advance and make an appointment at the same time.

I chatted with Healthpons co-founder Patty Everette, to learn more about the business:

How do you qualify providers to participate in the program?
We have a system, similar to an insurance company, to review and verify credentials of all providers. This is why we are in a pre-launch phase to validate providers prior to posting their information.

How many providers have signed up?
We have validated about 6,000 providers and many more have enrolled.

The website mentions the patient portal will go live in all 50 states in 2013 – can you give us a more exact timeline?
June 2013 is our target launch. All validated providers will be posted, however, there are certain geographic areas that have a higher concentration of providers, such as the Southeast, Northeast and California. Each month we will continue to add providers as they enroll and are verified.

What types of providers is healthpons best suited to (primary care docs, dermatologists, cosmetic surgeons, etc.)?
The first provider registered was an ENT. We have pediatricians, surgeons, primary care, orthopedic, ENTs, family medicine and more. It is best suited to any provider willing to provide reasonable cash prices, willing to share content and to help people become more informed about what they do and how they are qualified to do it. Our focus is on transparency – and developing relationships.

How are you going to avoid the Groupon problem of too many vouchers sold, and providers subsequently becoming overrun with customers they are inadequately staffed to handle (typically resulting in poor customer service and no repeat patients)?
Our business model is not like Groupon. We make money primarily from any upgraded, subscription-based services or advertising.

All providers control the number of visits they can sell per service. We provide a guide to each provider as to what is recommended to sell. The consumer can see the provider’s availability prior to purchasing a visit. Also, we will monitor their sales and service comments to ensure quality and service is maintained.

I know there is more to share as Healthpons is developed with great depth. We have used multiple panels of providers and their office managers to preview our systems as we have developed. We took an idea we had and asked providers what they thought – what they wanted – then we asked our customers (patients) what they would like to get out of our platform. We bridged the concepts to bring doctors and patients together for an online network marketing experience to de-mystify medical services and pricing.