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Standardization vs. Personalization: Can Healthcare Do Both?

Standardization vs. Personalization: Can Healthcare Do Both? | EHR Success |

Can we standardize and personalize healthcare at the same time? James Dias, CEO and Founder of Wellbe shares how we can do both to improve patient care.


Usually when personalization is mentioned in the world of healthcare thoughts jump to genetics and personalized medicine with custom cancer drugs and medical devices. However, there is another type of personalization that can be applied to healthcare, to make each patient feel like an individual, rather than just “one of the masses.”

The world of ecommerce discovered the value of personalized online experiences a decade ago and the additional revenue/branding/loyalty that can be generated from it. For example, the NikeiD website offers customers the ability to customize their own shoes. Who can forget the “Elf Yourself” campaign from Office Depot, where you could stick your friends’ and family’s faces on to happy dancing elves? With the new year upon us, fewer people are opting to buy regular old glossy calendars when a dozen photo sites will let you make a custom one from your personal photos.

Personalization is all around us, from the recommendation engines of Netflix and Amazon, to the custom radio stations you can create on Pandora. Smart programs have figured out what’s relevant to each of us and help filter the signal from the noise in today’s massive universe of information. As consumers, we engage and respond much more positively to these personalized experiences, which encourages loyalty and repeat business.

The psychology of personalization shows that engaging the customer in the process helps build a psychological and emotional attachment to their purchase. In addition, increasing customer participation boosts feelings of control and ensures satisfaction at the point of sale.

Similarly, by offering a personalized digital healthcare experience, we can increase patients’ ownership of their health and outcomes. Often it seems that patients feel they have no control over their outcomes, when actually the opposite is true. When they feel like active participants in their health journeys, it is more likely they will achieve the outcomes they desire, and they will feel like they got better value for their dollar.

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Inforth Technologies's insight:

We have been preaching personalizing the NextGen EHR for years.  Not just personalization for patients, but for physicians and their practices.

AAAASF Marketing's curator insight, January 21, 2015 11:40 AM

"As consumers, we engage and respond much more positively to these personalized experiences, which encourages loyalty and repeat business."

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New approach to printing organs: How to 3-D print complex Kidney parts

New approach to printing organs: How to 3-D print complex Kidney parts | EHR Success |

A breakthrough in printing blood vessels is enabling a new approach to printing organs.


Earlier this year a group at Harvard solved one of the most difficult challenges involved in growing artificial human organs. The team used a 3-D printer to make human tissue that includes rudimentary blood vessels. Emboldened by that success, the researchers have started an ambitious project to make fully functioning printed kidneys.

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Can Fitbit Data Save Lives?

Can Fitbit Data Save Lives? | EHR Success |
Some docs are now claiming fitness tracker data holds no medical value. Meet the tech-savvy Kansas doctor who is proving them wrong.
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Google Smart Contact Lens Focuses On Healthcare Billions

Google Smart Contact Lens Focuses On Healthcare Billions | EHR Success |

Google is developing a smart contact lens, with pharmaceutical giant Novartis, to help patients manage diabetes – in one of a number of moves focused squarely on billions of dollars of  potential revenue available across the total digital healthcare market.


As technology moves further into treatment with remote consultations, monitoring and operations, robotic treatments, and advanced digital diagnosis, Google has seen the opportunity to apply its own eyewear technology (up until now limited as glasses called Google Glass) to the healthcare field.


Google’s 3D mobile technology and its offering around health record digitization form potential other strands of its expansion in the health market. Last month, it released the Google Fit platform to track exercise and sleep, among other health factors – but it is far from alone, as Apple and Samsung offer similar systems in that area.




Today, under a new development and licensing deal between Google and the Alcon eyewear division at Novartis, the two companies said they will create a smart contact lens that contains a low power microchip and an almost invisible, hair-thin electronic circuit. The lens can measure diabetics’ blood sugar levels directly from tear fluid on the surface of the eyeball. The system sends data to a mobile device to keep the individual informed.


Google co-founder Sergey Brin said  the company wanted to use “the latest technology in ‘minituarisation’ of electronics” in order to improve people’s “quality of life”.


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Jay Ostrowski's curator insight, July 16, 2014 7:52 AM

This is not directly related to mental health-yet, but shows how health technology is rapidly expanding.

jenii brain's curator insight, July 16, 2014 9:11 AM


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Why medical expertise is a must-have for mHealth tech development

Why medical expertise is a must-have for mHealth tech development | EHR Success |
When it comes to designing, developing and building new mobile healthcare tools, many of the most successful ventures typically have one factor in common: accredited healthcare expertise.


Proof is evident in the foray the Mayo Clinic has made with mHealth technology, as well as other pilots and deployments led by the healthcare institution and providers.



"Our culture of learning, innovation, and the desire to find answers has allowed Mayo to remain at the forefront of health and wellness, and we want to extend this expertise to people anywhere," Paul Limburg, M.D., medical director of Mayo Clinic Global Business Solutions, said in an announcement. "We collaborated with and invested in Better to create a powerful way for people to connect with Mayo Clinic in their homes and communities, wherever they are."


Other top medical institutions are also finding success with mHealth initiatives. For instance, Steven J. Hardy, Ph.D., a pediatric psychologist at Children's National Health System in the District of Columbia, wants to engage families and patients in conversations about how they're managing illness and use mobile gaming as the tool to do so.


Speaking with FierceMobileHealthcare in an exclusive interview, Hardy discussed a pilot the hospital is conducting for children with sickle cell disease. The kids play a game on a mobile platform (in this case, an iPad) that helps them with an often-overlooked symptom of sickle cell disease--memory loss.


And a Harvard Innovation Lab startup aims to bolster patient treatment by enhancing coordination and communication among caregivers with an mHealth app that lets healthcare teams text, share images and videos and always have a patient list within reach.

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Vigisys's curator insight, June 15, 2014 4:25 AM

De la nécessité d'impliquer les médecins, et notamment ceux qui ont une double compétence médecine - technologies de l'information, dans le design de la santé mobile, applications pour smartphones et tablettes, objets connectés etc. Beaucoup de médecins sont prêts à jouer le jeu, je crois, mais il faut d'abord définir le marché et les filières d'usage.

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Case for dropping MU Stages 2 and 3 | Healthcare IT News

Case for dropping MU Stages 2 and 3 | Healthcare IT News | EHR Success |

Federal meaningful use requirements are well intentioned, but like a teacher who “teaches to the test,” the federal meaningful use program created a very complicated system that might pass the test of meaningful use stages, but is not producing meaningful results for patients and clinicians.

As reported on April 14, 2014 in MedScape (free log-in required), a formal study published in the April 2014 issue ofJAMA Internal Medicine shows no correlation between quality of care and meaningful use adherence. This study validates what common sense has told many of us for the last few years.

Meaningful Use Stage 1 was a jump-start for EMR adoption in the industry. That’s a good thing, I suppose, although meaningful use also created a false market for mediocre products. It’s time to put an end to the federal meaningful use program, eliminate the costly administrative overhead of meaningful use, remove the government subsidies that also create perverse incentives, and let “survival of the fittest” play a bigger part in the process. Let the fruits of EMR utilization go to the organizations that commit, on their own and without government incentives, to maximizing the value of their EMR investments toward quality improvement, cost reduction, and clinical efficiency.

When I arrived at Northwestern Medicine in 2005, it was clear very early that our EMRs (Epic and Cerner) were not being used in a meaningful way; this was several years before any broad discussion of meaningful use in the industry. Many Northwestern physicians were still using paper charts alongside the EMR, thus creating a fragmented and dangerous medical record for patients.

Using the log and audit files in Epic and Cerner, we created an “EMR Utilization Dashboard” for each physician that also rolled up to the organizational level. The data was revealing. Outside of General Internal Medicine and a few other spotty areas, the medication list was not being used. The problem list was not being used. Order entry (CPOE) for medications, prescriptions, and tests was not being used. Templates for documentation efficiency were not being used. Clinical alerts for best practices were not being used. Many patient encounters were not being documented in the EMR, indicating the continued use of paper records. In short, these very expensive EMRs were being used only occasionally as expensive word processors and dictation systems.

With input from all physicians, Drs. David Liebovitz, Phil Roemer, Gary Martin, and I decided to develop a simple document, describing the core principles of EMR utilization. Sarah Miller, the director of clinical applications, also played a huge part in this project. We declared that it had to be constrained to a single page, normal spacing and font, and that we had to be data driven. It was a big success. Over the next two years, our rudimentary EMR Utilization Dashboard showed steady and significant improvement.

I showed the dashboard and the core principles to John Glaser (then at Partners HealthCare) while we were both speaking at a conference in Victoria, British Columbia. A few years later, when John went to the Office to the National Coordinator (ONC) to support David Blumenthal, John took the influence of those core principles and dashboard with him. I’m not exactly sure what role the dashboard and those principles played in seeding the federal meaningful use program, but I suspect they had some degree of influence. By the way, we (Northwestern) offered to give the code and dashboard to the EMR vendors so that all clients could benefit, but the vendors declined. We shared them instead on the Users Groups’ web sites.

Below are the simple but effective Core Principles of EMR Utilization that we developed. These principles played a huge part in the progressive value of Cerner and Epic on the Northwestern campus and laid the foundation for a relatively easy qualification of Northwestern under the federal meaningful use program.

Core Principles of EMR Utilization


·         All patient appointments/visits are to be documented in the EHR as an encounter.
·         Visit encounters should by closed by the attending physician within 48 hours of the patient visit.


·         All medication prescriptions and refills must be documented in the EHR, including those ordered in a telephone encounter.
·         Medications are to be reviewed at every patient encounter, in accordance with the individual specialty’s standard of care.
·         Every effort should be made to maintain a valid and complete list of patients’ current medications in the EHR, including end dates, discontinuing medications no longer being taken, and removing duplicate medication entries.

Problem Lists

·         All chronic, persistent patient diagnoses or complaints should be documented on the Problem List in the EHR, with the exception of highly sensitive diagnoses such as those associated with mental health care.
·         Problems should be documented using the most specific term applicable to the problem, ex: mild intermittent asthma vs. asthma.
·         The Problem List should be reviewed and updated at every patient encounter, in accordance with the individual specialty’s standard of care, and problems not currently clinically relevant should be filed to history and marked as resolved.


·         Allergy lists must be actively maintained for validity and completeness for all patients, including marking as reviewed when no new allergies are reported. The allergy list must be reviewed during any encounter in which a medication is ordered.


·         All patient orders must be documented in the EHR.

Progress Notes

·         All patient encounters should have an accompanied progress note that appropriately documents the history, physical, and decision-making in a way that is succinct and minimizes redundant content.
·         If dictating, notes must include the patient’s name and medical record number, the date of the encounter, and the attending physician’s name to ensure timely documentation.

In Basket

·         Patient results and messages should be reviewed within 72 hours of receipt, and In Basket coverage should be assigned when clinicians are unable to respond within that time frame.

In the early days of EMRs, the pioneers like Intermountain Healthcare, Vanderbilt, Duke, and Partners differentiated themselves by developing their own proprietary EMRs and then using them in a meaningful way, without any financial incentive except their own to do so. Meaningful Use Stage 1 served a valuable purpose — it jump-started the adoption of commercially supported EMRs in an industry that needed jump-starting. Maybe we should cancel Stage 2 and Stage 3, spend some of that money on seeds for true innovation (think DARPA for healthcare). And let survival of the fittest play a role in deciding which organizations will utilize their EMRs, and subsequent data, most effectively to improve healthcare.

Topics: Meaningful use, Electronic Medical Record (EMR), Epic, Computerized Physician Order Entry (CPOE), Glaser, John, The Office of the National Coordinator for Health Information Technology (ONC), Blumenthal, David, Cerner, Electronic Health Record (EHR), Intermountain Healthcare
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American Healthcare: The Emperor Is Naked

American Healthcare: The Emperor Is Naked | EHR Success |

So off went the Emperor in procession under his splendid canopy. Everyone in the streets and the windows said, “Oh, how fine are the Emperor’s new clothes! Don’t they fit him to perfection?…

“But he hasn’t got anything on,” a little child said.   - Hans Christian Anderson, The Emperor’s New Clothes, 1837


The overwhelming majority of healthcare providers and administrators I know are working hard to relieve suffering, and extend meaningful life.

That being said, I am going to let you in on a big secret: The American healthcare delivery structure, where these caring individuals work, is not what you think it is, and isn’t cloaked in the figurative garments that you think you see.

As in Hans Christian Anderson’s short story, you think you see a system that is focused on improving health, recovery from illness and the promotion of long, productive lives – because you desperately want and perhaps need to see those things. However, the primary goal of the health care delivery enterprise is the generation of revenue, not health. And so here’s the deal, the emperor isn’t wearing the clothes that you believe you see.

The emperor is naked.

English: Ilustration of “The Emperor’s New Clothes.” Español: Ilustración del cuento El traje nuevo del emperador. (Photo credit: Wikipedia)

In his 2013 TEDMED talk, entitled “What’s Wrong with Profit in Healthcare?” Jonathan Bush suggested that entrepreneurs can change health care. I fully agree, but he also said that it was possible, “by allowing the market to swirl out around us, to define a frontier that is quite beautiful,” and that is simply wrong.

The “open market” approach to health care among the incumbent providers, with revenue generation as its primary goal, has led to many consequences that are in fact fairly ugly.

An open-heart surgery program that performs around fifty cases per year can be profitable, and many programs in smaller hospitals around the country are working at these volumes. However, research suggests that the number of cases that an individual cardiac surgeon needs to perform yearly to be proficient is three times this.

In 2008, the city of Chicago had five heart transplant programs operating simultaneously – the results of which were discussed by the Chicago Tribune’s Judith Graham:

“Policy experts debate the value of competition in health care, and in this case competition appears to have backfired, leaving local heart transplant centers operating below capacity.”

In both of these cases, cost-effectiveness and outcomes are compromised, because there is a strong relationship between volume, better quality and lower cost in complex care. In addition, every one of these programs has millions of dollars in overhead costs (doctors, support personnel, technology). The added financial burden of redundant health care overheads in this country has never been fully calculated, but it is big, and passed on to you. As a conservative estimate, we could use the numbers from a 2012 Institutes of Medicine study that estimates $400 billion in unnecessary services, combined with excess administrative costs.

Do you believe that decisions made every day to develop programs such as these, or comparable ones in other specialty areas (stroke, bariatric surgery, imaging, etc.) are made because the organizers feel they will be doing it better than – or even as well as others – in regard to clinical outcomes?  No – it is because there is money to be made.

Conversely, revenue as the primary driver of the health care market has also led to a lack of adequate care in rural and less affluent urban areas of our country where the opportunity for profit is lower.

I agree with Nobel Laureate economist Paul Krugman, when he said, “…health care just doesn’t work as a standard market story.” When market forces are in play, and the goal is the generation of revenue, you don’t get more health – you get more overall system cost, lower quality and less equity.

Competition is one of the things that makes this country great, and I have nothing against profit or merit-based rewards. However, revenue is not our product in health care – health is our product.

Accordingly, I believe we can harness the power of the market, but clinical outcomes need to be the things for which we compete.  Perhaps then you will see innovation, but innovation directed at outcomes, not revenue generation.  You may then see fewer billboards promoting surgical robots, open MRI scanners and other bright shiny objects, and perhaps more that say things such as, “come here and you will objectively have a better chance of living longer, and healthier.”

Like many, I have been trying for years to conjure up the best alchemy to transform the base metal of American health care.  What dawned on me recently is that no matter what people like me do or write, nothing is going to happen until the general public sees the emperor literally “exposed,” and thusly reacts.

At the end of Anderson’s story, once the child speaks the truth, the others around him begin to whisper to one another his words, and eventually the “whole town cried out at last… But he hasn’t got anything on!”

Please, start whispering.



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Home | County Health Rankings Interactive Application

Home | County Health Rankings Interactive Application | EHR Success |

The County Health Rankings...

Inforth Technologies's insight:

It is interesting to see how the county you live in stacks up against neighboring counties.

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How do I Maximize the ROI on an EHR System? Hint: "Invest in training"

How do I Maximize the ROI on an EHR System? Hint: "Invest in training" | EHR Success |
One of the most important activities during implementation of your EHR system is training. Most vendors provide training on site, and the extent and amoun (How do I Maximize the ROI on an #EHR System?
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Training makes the difference between a failed attempt at using EHR's and successfully utilizing an EHR.

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Is Maryland's all-payer model a step toward European-style health care? - Al Jazeera America

Is Maryland's all-payer model a step toward European-style health care? - Al Jazeera America | EHR Success |
Al Jazeera America
Is Maryland's all-payer model a step toward European-style health care?
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Hospitals Use Tablets as Extension of EHRs

Hospitals Use Tablets as Extension of EHRs | EHR Success |

Some leading hospitals are increasingly turning to tablets -- iPads and iPad-like devices -- as a way to improve access to patient health records for providers walking the hospital halls.


Such devices are seen as a way to work around clunky desktops and make greater use of an electronic medical record's (EMR) capabilities.

"Tablets, in our experience, are very effective if you need not the entire EMR, but a slice of information," Will Morris, MD, associate chief medical information officer at the Cleveland Clinic, told MedPage Today.


The hospital is piloting the use of tablets with a few sectors of its workforce, such as its rapid response teams. Clinicians can look up patient information on their way to a patient who is crashing and better know how to treat the patient when they arrive at their room.

Other hospital staff use them on rounds; data entered is synced with the hospital's full EMR.


"The more we can assist our providers in being more efficient, the better the value proposition," Morris said.


Hospitals are increasingly turning to mobile devices as a cost-effective extension of their EMRs, making them more usable and friendly, David Collins, senior director of mHIMSS, the mobile wing of the Healthcare Information and Management Systems Society (HIMSS), in Chicago, said.


"You spend millions of dollars for EHR [electronic health record] implementation," Collins toldMedPage Today in a phone interview. "But if you can spend $300 on a tablet and issue these to providers so they're more mobile, it's really a minimal cost for the payoff."


At the Cleveland Clinic, officials don't have data on quality improvement just yet, but Morris said they have seen an improvement in how long it takes nurses to enter vital signs.


"It's not going to be the tablet that transforms practice," he said. "It's going to be 'How do you use the data coming out of your EMR, applied with clinical rules, to empower the clinical practice?' "



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We have had great success using the Microsoft Surface Tablets to access the EHR.

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Intel Launches SD Card-Sized Computer [CES 2014] - PSFK

Intel Launches SD Card-Sized Computer [CES 2014] - PSFK | EHR Success |
A tiny computer called Edison opens doors to new categories of computing.
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Wow, wearable tech is really starting to gain some traction!

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Sniffley tweeters help researchers locate flu outbreaks

Sniffley tweeters help researchers locate flu outbreaks | EHR Success |

Twitter has become the latest online tool to be used to monitor the spread of disease.


Researchers are looking at whether health providers can identify the locale of a disease outbreak by monitoring the social media network for complaints of illness.


Google is already working to gather data about illness through its flu trends project, by noting when users search for terms related to being unwell, although questions have been raised about how effective it can be.


Now Ming-Hsiang Tsou, a geography professor at San Diego State University, is exploring the use of Twitter to predict the spread of infection, such as influenza, by checking tweets across 11 US cities for signs of an outbreak.


Tweets mentioning keywords such as “flu” or “influenza” were logged when sent from within a 17-mile radius of the cities, which included San Diego, Denver, Jacksonville, Seattle and Fort Worth.

“There is the potential to use social media to really improve the way we monitor the flu and other public health concerns,” said Tsou. At the moment, outbreaks are monitored by hospitals and traditional health services but that leaves a long delay between reporting and issuing a public health warning.


If flu sufferers can be located through their social media use, the authorities could, in theory, issue warnings more quickly and channel resources into the areas that need them more efficiently.

Having identified tweets featuring keywords, Tsou’s programme records specific data, such as username; GPS location; and whether the tweet was sent via a mobile phone or a computer.


To test how effective this method was, his team compared the data against original reports on flu outbreaks that were produced by city and county health agencies. Of the 11 cities, nine showed a statistically significant correlation between locally reported outbreaks and the outbreaks identified on Twitter. Among these, five were detected more quickly by Twitter than the local reports.


Traditional procedures take at least two weeks to detect an outbreak,” said Tsou. “With our method, we’re detecting daily.” This digital “infoveillance, as Tsou terms it, could be applied across a range of public health issues, such as mapping local incidences of heart attack or diabetes.


“Mining data from online social media to gain useful knowledge is both a challenge and an exciting opportunity for health researchers and public health practitioners,” said John Powell, a senior clinical researcher from the Department of Primary Health Care Sciences at the University of Oxford.


Vasileios Lampos, a research associate at the Department of Computer Sciences, University College London, agrees that machine learning techniques like these produce high levels of predictive accuracy. However, he warns that we shouldn’t get carried away with hopes for its potential. “We are not there yet,“ he said. "Occasionally those models produce mistakes by being prone to hype or by not being able to adjust to a change in a seasonal pattern.”


One difficulty is separating out messages by a flu sufferer from those posted by users just talking about flu. It is difficult to differentiate between and “I’ve got the flu” tweet and a tweet about a friend who has the flu, possibly in a different city or even country. Nevertheless, researchers are making progress towards being able to do this, adds Lampos.


As a next step, Tsou plans to look into monitoring tweets that might be less obvious indicators of illness, such as those containing words like “cough” and “sneeze”.

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Patient portals and EMRs: Each requires a different skillset

Patient portals and EMRs: Each requires a different skillset | EHR Success |

Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information.


I’ve written at length about the differences between B2B software and B2C software and how B2B software is generally not very good (particularly from a usability perspective). And it’s not very good simply because it can get away with not being very good. B2B companies often just need a good salesperson that can lock-in long-term contracts to be successful. Once the software is purchased, it’s not easy for users to switch.

B2C companies, on the other hand, need an incredible product to be successful. If your user experience isn’t flawless, you cannot survive in the B2C space. The switching costs for consumers are near zero — the user experience must be incredible. Product is much more important than distribution. B2C user satisfaction scores are significantly higher than B2C scores.

Applying this to health care, if you’re a hospital and your EMR is hard to use, your employees will still use it because they have to — they can’t easily switch to a competitor.

But if your patient portal is bad you will lose patients instantly. It’s too easy for patients to switch to something else.

The Healthcare Information and Management Systems Society (HIMSS) published a good report talking about patient portals.  They noted that despite the difficulty of building a wonderful online consumer experience and the totally different skill set required to execute on it, 80 percent of hospitals surveyed chose their patient portal vendor simply because it was the same vendor that provides their EMR (the top three portals were made by Epic, Cerner and McKesson). All of these vendors have been building B2B enterprise software systems for more than 30 years. They’re all wonderful companies. But they have no idea how to build a patient facing product. Their management, engineering talent, sales force, culture and DNA is all about B2B. They have almost no chance of building a world class consumer product. That’s not a knock on these companies; it’s just reality. You can’t be good at both.

As we transition to a world where the patient is in the driver’s seat, exposing patients to old-fashioned enterprise software code and interfaces is not a good idea. Hospitals shouldn’t let a piece of software touch their customers unless it’s been vetted and tested fully, and it’s clear that patients love it. If you check out the satisfaction scores for most patient portal apps, you’ll find that most patients despise them (one of them I looked at last week had 2,000 reviews in the iOS app store and more than 1,500 of them were only 1 star).

Patients are becoming consumers. They want slick, easy, mobile, beautiful, simple and seamless web experiences. If the software that touches patients doesn’t give them that they’re going to go somewhere that does.

Now, in defense of these hospitals let it be known that there aren’t a lot of great consumer-focused software companies building-out patient portals. So in the short term, they might have no choice. But I’d encourage CIOs that are making patient portal investments to consider the consumer and to cautiously enter into flexible and short term contracts with these patient portal vendors.

You should be careful about buying groceries from the company that fixes your car. And you should be careful about buying consumer-facing software from the company that built your EMR.


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After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know

After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know | EHR Success |
In a growing practice, medical assistants, consultants and other hospital staffers, often called in without patients’ knowledge, are charging hefty fees.
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What EHR/PM vendors should do as 63% of buyers look to replace existing PM solutions

What EHR/PM vendors should do as 63% of buyers look to replace existing PM solutions | EHR Success |

Melissa McCormack, a medical researcher with EHR consultancy group Software Advice, recently published their medical practice management BuyerView research, which found that 63% of the buyers were replacing existing PM solutions, rather than making a first-time purchase.  This mirrors the trend we’ve seen across medical software purchasing, where the HITECH Act may have prompted hasty first purchases of EHR solutions, followed by replacements 1-2 years later. For PM vendors, this means there’s a huge opportunity to market your products to practices as an upgrade, even if they’re already using PM software. I reached out to Melissa to ask her to elaborate on the implications of the trends she found in her recent research. Here’s some advice for vendors and solutions providers.

1. As EHR meaningful use requirements grow more involved, standalone billing or scheduling systems are becoming less viable. In fact, nearly 70 percent of the buyers we spoke with wanted integration between practice management and EHR. The trend of PM buyers looking for robust EHR integration grows more pronounced each year, and shows no signs of tapering off since EHR meaningful use requirements increasingly require physicians to utilize charting, billing and scheduling in tandem. Vendors who can offer seamless integration between these applications will have a clear advantage over those who cannot.

2. Another regulatory pressure influencing PM software replacement is ICD-10. Compliance with the new code set is a major driver not only of practice management purchases in general, but specifically of replacements—25% of buyers replacing an existing solution cite a concern that their current solution wouldn’t support the code set switch. Despite the implementation deadline having been extended to October 2015, we’re seeing practices give a lot of thought to preparation, and they’re realizing the software they use will play a major role in their own readiness. Vendors who are confident in their ICD-10 readiness should take care to communicate that confidence to their existing users, as well as marketing it to prospective customers.

3. The medical practice management software buyers we talk to clearly prefer cloud-based systems. Among buyers with a preference, 88% want cloud deployment. We’re hearing from smaller practices that they value the low up-front costs, as well as not needing to maintain servers and dedicated IT staff. Additionally, buyers appreciate the remote access options afforded by cloud solutions. Some buyers even seem to conflate “cloud” with “remote access” and “mobile access” (even though those features aren’t unique to cloud-based products), suggesting these are the features of cloud-based software they are most concerned with. In fact, almost 20% of buyers identified mobile access as a top priority. Vendors who offer mobile support are at an advantage and should highlight their capabilities prominently.

4.  Practice management software buyers come from diverse roles within practices. We saw clinicians and administrative staff represented almost equally—46% and 40%, respectively—among our buyer sample. Vendors should consider their audiences when marketing their products and tailor communication accordingly, giving equal weight to the unique benefits for clinicians and administrators.



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A Straightforward Method for Making Wearable Tech

A Straightforward Method for Making Wearable Tech | EHR Success |

Considering the pace of technological growth in recent decades, the convergence of humans and machines seems a foregone conclusion. Yet, unlike most machines, the body is far too flexible and squishy for modern advanced materials. So it falls on researchers to develop new stretchable technologies that are easily manufactured and relatively inexpensive.


Recently, a biomedical engineering team at Purdue University developed a methodology to generate zigzag patterns out of conventional wire that can extend up to five times in length. The wires can be utilized as conductive interconnects between sensors, allowing for flexible networks or meshes to be embedded or wrapped around 3D objects.


“This compares to only a few percent for an ordinary metal connection,” said Professor Barak Ziaie, leading the research in the press release. “The structures are also highly robust, capable of withstanding thousands of repeated stretch-and-release cycles.”


Even more intriguing, the approach utilizes a standard sewing machine to fabricate the system.


Using water-soluble thread, the technique involves stitching wire in zigzags onto standard transparencies used with overhead projectors.


A commercially available elastomer called Ecoflex is poured over the sheet and allowed to solidify. The thread is dissolved with warm water, allowing the flexible polymer with the embedded wires to be separated from the transparencies.

To demonstrate how their approach could be used for medical devices, the team generated a sensor system that wraps around a urinary catheter balloon - as the balloon inflates, the sensor gauges the strain.

This flexible system can measure much greater expansion than conventional approaches that employ rigid metal films that permit only small percentages of stretching before breaking.

The findings, to be published in a forthcoming paper, were reported at the Solid-State Sensors, Actuators and Microsystems Workshop.


more at


Via nrip
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10 Mistakes to Avoid When Using EHRs

10 Mistakes to Avoid When Using EHRs | EHR Success |


While electronic health record design flaws exist, individual physicians and their practices also often make mistakes that can add to the frustration of working with EHRs, according to a Medscape Business of Medicine report. 

Here are the 10 biggest mistakes that physicians make when using EHRs:

1. Purchasing an EHR without making a site visit to a similar practice using the same EHR. 
2. Signing an unvetted contract. 
3. Neglecting to perform a workflow analysis.
4. Under-training physicians and staff on EHR use. 
5. Refusing to purchase a laboratory or device interface.
6. Entering too much data into the EHR. 
7. Doing EHR-related work your staffers should do. 
8. Using shortcuts and workarounds. 
9. Creating "shadow" paper documents. 
10. Accepting inefficiency as the new status quo.

Via Technical Dr. Inc.
Inforth Technologies's insight:

The EHR vendor or EHR specialists can help ensure EHR success.  

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Do medical scribes threaten patient privacy? -

Do medical scribes threaten patient privacy? - | EHR Success |
Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance.

Via Linda G. Brady, CAE
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Obama and Congressional Leaders Can’t Overlook EMR Failure Rates | EMR and HIPAA

Obama and Congressional Leaders Can’t Overlook EMR Failure Rates | EMR and HIPAA | EHR Success |

“If it’s [EMR investment and implementation] too hasty, you can create so many bad experiences that people say…’My data’s a mess and my patients are angry,’” Mr. Glaser said in a recent Wall Street Journal article on the possible wasted investment in EMR. 


The scary thing is that John Glaser, chief information officer for Partners Healthcare, is probably right.  I know that President Barack Obama wants to “wield technology’s wonders to raise health care’s quality and lower its costs.”  I want to do that too.  In fact, I think we’d all like for that to happen.  Unfortunately, I think we have to seriously ask ourselves if the current electronic medical records offerings can raise health care’s quality and lower its costs.


I think there are two points that have been proven time and time again in implementing an electronic medical record in a doctor’s office.


Point 1: A Well Implemented EMR Yields Great Results – Hundreds (possibly thousands) of doctors can attest to how happy they are using an EMR.  My personal finding is that the key to a successful EMR implementation is deeply related to how well a clinical practice is run before implementing an EMR.  In fact, I believe an EMR will exacerbate any problems a clinic may have been experiencing pre-EMR.  However, many clinics have shown that when done right there are tremendous benefits associated with an EMR.


Point 2: A Poorly Implemented EMR Causes More Harm Than Good – Blame it on the software.  Blame it on the clinic.  Blame it on the technology.  Blame it on the health care culture.  It’s probably a mixture of all of these things that has caused so many EMR implementations to fail.  Regardless of the reason, all of these failed EMR implementations have shown the damage that can be done to a practice that fails in their implementation.  Unhappy patients.  Unhappy and frustrated doctors.  Thousands of hours evaluating, learning, training, testing and implementing down the drain.


It’s no wonder that the New England Journal of Medicine found that only 4% of U.S. physicians were using a “fully functional” electronic health record system.  The huge failure rate among physicians has created a fear in doctors that’s difficult to overcome.  Sadly I think it might take a generation for doctors to overcome this bias.


The reality is that implementation of an EMR CAN increase health care’s quality and lower its costs.  The problem is that most clinics haven’t yielded these promised benefits and most are living with failed EMR implementations.  The huge numbers of failed implementations can not be ignored.  Ignoring this will lead to even more failed implementations which could set the movement to digitizing patient records back years.

It’s not enough to poor money onto something without looking at and solving the reasons why so many people have failed in their implementation of electronic medical records.


I don’t want to give the impression that I’m not for investment in EMR and health care IT.  I think that help is needed and could be beneficial to the future of health care in the US.  I also really believe that EMR does open up a whole world of opportunities that we couldn’t consider without broad adoption of electronic medical records.  However, I don’t think enough attention is being paid to understanding what factors are important to implementing an EMR successfully.  By understanding these facets of implementation we can invest in electronic medical records that are actually being used and effective.  Otherwise, we’re just lining the pockets of the EMR vendors without any benefits



Via Technical Dr. Inc.
Inforth Technologies's insight:

I cannot stress enough about training clinical staff to utilize the EHRs.  Paper workflows rarely lead to efficient electronic documentation.

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Senate passes one-year SGR patch, ICD-10 delay bill |

Senate passes one-year SGR patch, ICD-10 delay bill | | EHR Success |
Without a single mention of ICD-10, the Senate has pushed back the compliance date for the next code set by a full year with the passing of one-year SGR patch.
Inforth Technologies's insight:

NextGen still needs to be updated for Meaningful Use Stage 2, but the ICD-10 delay will temporarily ease some providers woes.

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Setting Healthcare Interop On Fire - Forbes

Setting Healthcare Interop On Fire - Forbes | EHR Success |
Setting Healthcare Interop On Fire
FHIR is the “HTML” of healthcare. It's based on clinical modeling by experts but does not require implementer's to understand those details.
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Online community connects 3D printer owners with people who need prosthetic hands

Online community connects 3D printer owners with people who need prosthetic hands | EHR Success |

A chance connection over the internet has spawned multiple efforts to provide 3D printed hands at an extremely low cost.


Around the world, there are people who have lost all or part of their hand, or were born without one. There are also people and institutions with 3D printers. Pair the two, and you can print a custom mechanical hand for $20-150 — thousands less than the typical prosthetic.


e-NABLE, which functions through a website, Facebook page and Google+ page, stepped up to connect the two after site founder Jon Schull came across work by American prop maker Ivan Owen, who made a metal mechanical hand for South African carpenter Richard Van As. Van As had lost four of his fingers in a carpentry accident.


Owen was then contacted by a mother whose 5-year-old son needed a hand. He again made a metal hand for the boy. But then he turned to 3D printing. MakerBot gave both Owen and Van As a 3D printer.


The pair developed a 3D printed hand for the boy and then posted the design to Thingiverse, where anyone could download and print it.

Van As and Owen’s efforts toward developing 3D printed hands live on via the Roboand project, which has created more than 200 hands and now branched into prosthetic fingers and arms. But Schull was interested in connecting people who needed hands with individual makers and institutions that had 3D printing skills, but potentially idle printers.


He started a Google+ page, and then a Facebook page and website. More than 300 makers make their services available to people who contact e-NABLE about a hand. Just a quick scroll through posts on the Facebook page reveals many, many people who have a use for a hand.


“I see e-NABLE as a crowd-sourced pay-it-forward network for design, customization and fabrication of all sorts of assistive technologies,” Schull told Rochester Institute of Technology, where he is a researcher. “This is a scalable model that could go way beyond 3D printed prosthetic hands.”


  more at   ;
Via nrip
Inforth Technologies's insight:

Such a great idea.  3D printed prosthetics can be custom fit to the owner.

Andreas Eriksen's curator insight, February 26, 2014 1:23 PM

Awesome Samsung phones/accessories on

petabush's curator insight, February 27, 2014 4:05 AM

Interesting model for 'crowd sourced pay-it-forward network' 

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Can sharing patient records among hospitals eliminate duplicate tests and cut costs?

Can sharing patient records among hospitals eliminate duplicate tests and cut costs? | EHR Success |

A recent analysis of the impact of health information exchanges, which allow health-care providers to share patient records electronically and securely, shows the systems hold promise for reducing health costs and unnecessary care in emergency departments.


For the study (subscription required), University of Michigan researchers examined information on hospital health information exchange participation and affiliation from the Health Information Management Systems Society’s annual survey as well as data the  California and Florida state emergency department databases from 2007 through 2010. Both states were early adopters of health information exchanges. According to a university release:

The findings show that the use of repeat CT scans, chest X-rays and ultrasound scans was significantly lower when patients had both their emergency visits at two unaffiliated hospitals that took part in a [health information exchange]. The data come from two large states that were among the early adopters of [health information exchanges]: California and Florida.


Patients were 59 percent less likely to have a redundant CT scan, 44 percent less likely to get a duplicate ultrasound, and 67 percent less likely to have a repeated chest X-ray when both their emergency visits were at hospitals that shared information across an [health information exchange].


- See more at:


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NextGen Claims Scrubbing Processing Services | CA - BillingParadise

NextGen Claims Scrubbing Processing Services | CA - BillingParadise | EHR Success |
BillingParadise provides NextGen EHR based thorough claims scrubbing Services to improve your medical practice revenue. Call @ 1-888-571-9069 (@Fertility_PFC In claim scrubbing, only medical necessity edits are adequate?
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