A collection of 21  Posts

Join me and other cheerleaders at the “Driving demand for Healthcare Interoperability” Pep Rally this Thursday in DC

When I was growing up in Texas I remember that we used to have Pep Rallies before our major sporting events. The idea behind a pep rally is to get the juices flowing and get fans engaged and cheering for the home team. On Thursday this week the West Health Institute and the ONC are hosting “Health care Innovation Day, HCI-DC 2014: Igniting an Interoperable Health Care System” where the purpose is to get people cheering for interoperability between EHRs, health IT systems, medical devices, and related technologies.

I’ve often said that Meaningful Use and the HITECH Act created false demand for EHRs and has (perhaps irrevocably) harmed innovation in the EHR space by standardizing features and function rather than outcomes and expectations. It’s a false demand because it concentrated too much on prescriptive, sometimes useless, and in many cases productivity-killing, functionality instead of focusing on what’s really needed — data interoperability and fostering innovation. John Halamka wrote something similar recently in his Advice to the new ONC chief (highlights in red below are mine, not John’s):

“Digital Health” is often centered on EHRs and Meaningful Use to the detriment of many other technologies that can help improve patient satisfaction. To help make sure that we don’t forget how useful modern technologies are to actually getting paid for medical services, I invited Jay Fulkerson, president and CEO of Health Payment Systems (HPS), to take us through the most important issues surrounding claims and payment tech. Prior to his role at HPS, Fulkerson served as chief executive officer of Touchpoint Health Plan (which was acquired by United Healthcare) so he knows the payment space pretty well.

As I travel and speak with physician practices and hospital execs about health IT, I often hear questions about how practices can become paperless as they transition from manual to electronic processes. For those of you that have installed EHRs, you know that going digital does not mean that you’ll be paperless and you’ve probably had to buy more scanners and printers than you originally planned. For those of you that haven’t installed your EHR you’re probably puzzled so let me take a moment to explain why you shouldn’t believe vendors that tell you that you can be completely document-free or paperless in your environment.

Earlier this week I spoke at Atlanta Healthcare IT Leadership Summit on Accountable Care Organizations (ACOs) and what I call “accountable tech“. I was pleasantly surprised to learn most of the audience agreed that ACOs can’t succeed without the right technology but am continuously disappointed as to how little we as an industry are doing about it. Accountable tech is health IT that truly enables the slow but emerging move from fee for service (FFS) based payments to value-driven and outcomes based payments.

Carl Bergman, a seasoned systems analyst and project manager, is Managing Partner of and has been sharing a number of ideas for improving EHR usability with me via email. Since I loved his enthusiasm and agreed with his ideas, I invited Carl to share with us some more detail around how to improve the EHR user experience. Here’s what Carl had to say: Earlier this year, we went to an outdoor wedding.

A few days ago Harvard Business Review’s Blog Network published “You Can Win Without Differentiation” and it reminded me of the many lectures I’ve given over the past few years on why the health IT industry tolerates hundreds of EHR and EMR companies that don’t really differ much from each other. A key point made in the article was: The trick is that when there is uncertainty about the quality of a product or service, firms do not have to rely on differentiation in order to obtain a competitive advantage.

It is general knowledge among seasoned EHR implementers that EHR technology is not the primary concern when promoting EHR adoption (while there are many areas of potential improvements, the tech is generally “good enough” in most cases). There are, however, many challenges surrounding the deployments EHRs and one of the biggest is that not enough training or pre work done to prepare staff and resources. A great way to ensure EHR success is by creating a “Culture of Adoption,” which is something I discussed at length with my friend John Lynn after he attended a recent “think tank” style event hosted at TEDMED by the Breakaway Group (a Xerox Company).

Today’s reality of patient management is “disjointed care” and most of the collaborators in a patient’s care team don’t know what each other is doing for the patient in real time. Knowing all the different participants in the patient’s care team (providers, payers, family members, etc.) and coordinating and integrating their electronic activities is what successful EHRs must handle with ease as they look to graduate from basic retrospective documentation systems to modern patient collaboration platforms.

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