Monday, August 29, 2016

How will the role of a successful #HealthIT #CIO change as we enter post-EHR era?

Image from
Last Friday the theme of the weekly #HITsm tweetchat was “The Future Skills of Health IT.” The chat was hosted by Rachel Macklin, Director of Talent Acquisition & Brand Strategy in Health IT for Jackson Health IT Staffing. Rachel can be found on Twitter as @rmacklinrecruit.

All of the topics elicited a lot of good comments and ideas. Since I was not able to hang around for the last question #5, I pulled the transcript from Twitter and have culled out interesting responses; here for viewing pleasure.

T5: How will the role of a successful #HealthIT #CIO change as we enter post-EHR era?  

Response to Topic #5
Think it will be quite a while before we can say we're "post -EHR"…
Many of the points distill down to maturation of the CIO role. Becoming key part of C-suite. 
Well, EHR's are not a total solution. So what else can be done to #Healthcare with #DigitalHealth ? Many avenues exist to improve 
No longer the "IT person." That's gone. Now a top-level resource stakeholder and facilitator, orchestrating improvement. 

Ability to Harness Info & Innovate Quickly

Response to Topic #5
Ability to harness different streams and sources of data. Filter the noise. Keep the engine running
CIOs should be judged on their ability to implement new innovations (cloud, #infosec, analytics) not on ability to install Epic. 
CIO evolves to be strategic about using information to drive patient engagement in value driven market 

Ability to Document ROI of Programs/Projects

Response to Topic #5
No more gold stars for EHR implementation; now need ROI with Analytics, Process Improvement, Security, #Telemedicine 
ROI, analytics w/ LEAN is the big picture

Cybersecurity, Workflow & Data Exchange

Response to Topic #5
Security will continue to grow in prominence. If data can't be protected, all will lose. 
IMO to Chief Process Officer/Chief Workflow Officer
What about #HIE? Move to #Interoperability #CareCoordination #HealthEquity Lots more a CIO can achieve to change #Healthcare 

But Wait! There's More!

One of the participants, Jared Johnson aka @jaredpiano reminded participants of two podcast interviews made with two healthcare CIO's on the evolving role of CIO. 

Sunday, August 28, 2016

Do Investors and Their Advisors Understand Basics of Healthcare Data & IT?

If you’re involved with healthcare information technology and read the industry postings, you’ve undoubtedly heard about Apple’s acquisition of a company called Gliimpse. Fast Company broke the story about a week ago in this post: Apple Acquires Personal Health Data Startup Gliimpse

What do Investors and PR People Know About Health IT?

I’ve seen several people quoted about what this means and how great it is for Apple. Greg Slabodkin wrote a post on Health Data Management titled “How Apple’s purchase of startup reveals health data strategy” in which the CEO of a 'capital group,' Raj Prabhu, stated: “Looks like Apple is beefing up its health tech ambitions with the purchase of Gliimpse

Really? How insightful! That quote from Raj Prabhu could have just as well came from Captain Obvious. What experience and expertise in healthcare data acquisition, normalization, storage and delivery does he have? I checked LinkedIn and don’t see any related experience.

It's Not So Easy to Do

I don’t think many people understand the technical difficulties and challenges in doing what Gliimpse is trying to do – at scale:

1. Physically accessing a wide range of EHR's securely and efficiently on behalf of specific individuals.

2. Locating data within the various nooks and crannies of that EHR (regardless of ‘standards’)

3. How much variability can exist within the common HL7 and other standards in which data is stored in an EHR

4. Converting/translating various structured and semi-structured data so it can be stored so as to lend itself to meaningful processing and display in any ‘dashboards’

5. Getting updates to patient data after the initial EHR access and updating the patient's source data.

6. The on-going support and maintenance required to maintain effective EHR data access and acquisition. Updates and upgrades can break even the most loosely-coupled integrations.

Let's Hear from Some Real 'Experts'

“Investors” and PR people rarely seem to have a good perspective on what’s really needed to implement what some people dream up. I’d like to hear what people like Fred Trotter, Jonathan Bush, Jerome Carter, John Moehrke and some others with real-world, hands-on experience working with EHR’s have to say about the Gliimpse purchase by Apple.

It's Happened Before and Will Happen Again

Over and over across the last two decades, I’ve seen VC investor-types ‘invest’ tens of millions of dollars in companies with flawed business models or good business models that are next to impossible to implement at scale. And it continues.

Wednesday, August 17, 2016

Acquiring, Managing & Disseminating Healthcare IT Knowledge

This Friday, 8/19/16 at 9:00am PT, I’ll be hosting the weekly #HITsm chat sponsored by @HealthStandards. The topic of the chat will be “Acquiring, Managing & Disseminating Health IT Knowledge.

Scientia potentia est

I’m particularly interested in this chat because I strongly believe that knowledge is power and that now, more than ever, there’s a huge amount of knowledge readily available to anyone with a browser; IF they know where and how to look for that knowledge.

In this chat we’ll toss out ideas about the following:

1. Tools & methods for finding, curating, storing and sharing information

2. Favorite ‘go to’ resources for health IT information

3. Preferred media, channels and formats for consuming and conveying information

4. Considerations to make when assessing validity, reliability and usefulness of information

5. Ways you organize and store the information you obtain

Some Additional Questions

In addition to the above, here are some other considerations related to acquiring, managing & disseminating health it knowledge.

1. What are some considerations for sharing information with different end-users? Ex. Execs vs. managers vs. co-workers vs. customers?

2. How is the manner in which you disseminate information influenced by the geographic location of the end user?

3. What are your preferred sources of healthcare taxonomies, controlled vocabularies, and thesauri ? (What’s another word for more than one thesaurus?) 

4. What are some of the benchmarks for evaluating the effectiveness of knowledge exchange between individuals, teams, and groups across various collaboration activities?

5. What special considerations, if any, does content organization and management of healthcare information present?

Background Material

To help those that will or won’t attend this tweetchat I’d like to offer the following background material:

Communication and Dissemination Strategies to Facilitate Use of Health Care Evidence

Evaluating Internet Resources

Criteria for Assessing the Accuracy/Validity of a Website

Finding and Evaluating Online Resources

Evaluating Internet Health Information: A Tutorial from the National Library of Medicine

How (and Why) to Better Organize Your Content Marketing Ideas

Show up or Check Back for Some Freebies

During the #HITsm tweetchat, I’ll provide special tips, handouts and other materials I’ve developed over the years including

1. A file containing bookmarks to a number of what I consider good healthcare-related resources – particularly information technology related resources.

2. A file (OPML) containing all the RSS feeds I have collected over the years and which I use to locate good information on a daily basis.

Hope to see you there!

Tuesday, August 16, 2016

Communication Techniques for Health Plans & Healthcare Providers

Health plans and healthcare providers must communicate with their members and patients using messages that are easily interpreted, persuasive, and actionable. Key communication techniques that health plans and healthcare providers should consider using include tailoring, targeting, framing and using narratives.

Tailoring the Message
Tailoring involves creating a message for the member or patient recipient based on information known about the recipient.

Approaches to Tailoring Messages
1. Prepare a categorized list of messages that can be programmatically matched to inquiries made by patients based on the patient’s socio-economic status and key social determinants.

2. Implicitly or explicitly craft the message so the recipient understands it was meant for them and not just a generic message delivered to a group of individuals. i.e. go beyond simple personalization like “Dear Jane.”

3. Deliver messages to patients that incorporate aspects of their recent psychological or behavioral state(s) gleaned from previous exchanges with the patient.

Targeting the Message

Targeting involves designing a message based on recipient characteristics such as age, gender or sex, race, cultural background, language, and other “psychographic” characteristics such as a person’s attitudes about particular subject matter.

Approach to Targeting Messages:
1. Alter the verbiage, graphics, topical theme and other aspects of the message to make it more interesting, relevant, or appealing to specific subgroups.

Framing the Message
Framing is presenting information in a way that emphasizes recipient gain or loss based on how they respond to the message content.

Consideration for Framing Messages:
1. Ensure your message is associated with either an explicit positive consequence (gain) or an explicit negative consequence (loss) for patient/member non-compliance.

Positive (gain) frame: “Get active! Enhance your health!” vs. “A lack of activity increases risk for diabetes.

Negative (loss) frame: “With drug X, you have a 5% chance   of dying” vs. “With drug X, you have a 95% chance of surviving.”

Using Narratives
A narrative message elaborates on a series of connected events – one that includes specific details, characters, and a plot – and can serve to transport the recipient into a situation that can enhance their emotions, attitudes, and behaviors.

Considerations for Using Narratives:
1. Incorporate personal stories, anecdotes, and testimonials in the message.

2. Use ‘entertainment education’ (e.g., talking about an issue in a soap opera storyline) and photo novellas

Use More Than One Technique
Combining two or more of the above communication techniques into a message may be more effective than using just a single technique and increase member/patient comprehension and understanding of the message.

Other Communication Techniques
Other communication techniques such as applying plain language principles, varying the source of the evidence, and using theoretically driven messages can be considered best practices and are not included in summary.

Note: The above information was gleaned and summarized from “Communication and Dissemination Strategies To Facilitate the Use of Health-Related Evidence” published by the Agency for Healthcare Research and Quality on 7/31/12.

Saturday, August 13, 2016

Healthcare's Unsung Among the #HIT100 - Introduction

The HIT100 is a yearly event where individuals who participate on twitter recognize others for their social media contributions relative to health care. Besides the many well-qualified names that dominated the top-ranking positions, there were many equally worthy individuals that weren't so highly ranked. So...

Shortly after the 2016 HIT100 event was finished, I reached out to about 100 individuals 
that received at least one nomination to the 2016 HIT100 list, who I consider to be knowledgeable healthcare resources, and who I've known to be active on social media. My purpose was to survey them about their social media presence and habits. I received 80 responses. While I'm currently in the process of reviewing and curating their responses into a format that I can share with others, I thought I'd share some high-level results from the survey. 

Question #1

Question #2
Question #3

Question #4

Question #5
Question #6
Question #7
Question #8

I future blog posts I'll share more results of the survey including specific details about the social media presence and activities of respondents who gave me permission to share their details. I'll also provide some analysis as to how I see social media being used by those that were surveyed.

In the meantime, you may want to consider following me on Twitter for more information on Healthcare Data, Technology and Services.