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Want a Connected Healthcare System? You Are the Missing Key

by System Administrator - Thursday, 23 April 2015, 7:36 PM

Want a Connected Healthcare System? You Are the Missing Key


by John Hammergren | CEO at McKesson

Editor’s Note: John H. Hammergren is chairman, president and chief executive officer of McKesson Corporation.

How often do we visit the doctor’s office and think, “This again?” when handed a long medical form to fill out? Don’t we all wonder why our medical information can’t be automatically transferred from our primary care physician to the specialist? Or to the hospital or outpatient surgery center? 

The answer is this: we don’t currently have a national network of connectivity that allows for the safe and secure sharing of health information between all locations of care or with patients. The good news is that such a system is possible and, with the right industry and political leadership, could be in place in the next few years. But it won’t happen without consumer engagement.

Why should consumers care about sharing their health information – aside from the aggravation of repeatedly filling out the same forms?

We should care because we are all patients and currently we are at the mercy of a disconnected healthcare system. The status quo leads to fragmented and lower quality patient care. Wouldn’t it be better for patients if emergency department staff had immediate access to a patient’s medical history and medications? Wouldn’t it be better for the patient if, when filling a prescription, their pharmacist could see all prescribed medicines to check for drug interactions? And wouldn’t it be better if we could view our health information in the comfort of our home any time, day or night?

There are hurdles to overcome before a national system to share medical information becomes a reality. Today, many in the healthcare industry have been narrow in their approach to supporting a robust network of connectivity. Some healthcare IT vendors and even some providers focus exclusively on the patient’s electronic health record (EHR), arguing that if it’s technically possible to share a patient’s information from point A to point B or from EHR to EHR (often for a fee), then they’ve “checked the box” and achieved connectivity.

But this is a shortsighted view – and puts the needs of the patient last. If it is acceptable to claim success when two healthcare IT systems can technically communicate – but are not actively sharing information – then the bar is set far too low. Patients deserve better; we all deserve better. Our nation needs a broader, seamless system of interconnectivity that allows providers and patients to have the right information for the right patient at the right time, regardless of the technology platform used or the location of care. 

As healthcare reform continues to evolve, the care choices that consumers have will also evolve. Patients are already receiving care in a variety of new settings and monitoring their care with an array of tools. The rapid proliferation of mobile applications and the increasing adoption of telehealth services will also give healthcare providers additional patient information—often in real-time.  These new tools will also allow for the creation of personalized health and treatment plans for individual patients.

True connectivity will allow the patient, their providers and a patient’s designated caregivers to see a complete view of their health record, creating more engaged, informed patients and caregivers. A successful network also will put the needs of the patient first to ensure that the patient’s entire care team has 24/7 access to all of the information necessary to select the most effective care plan and support services. 

The benefits of real healthcare connectivity are numerous—but how will such a system be achieved?

Fortunately, the healthcare technology industry is already at work creating the infrastructure framework needed for a truly connected system. Trade alliances such as the CommonWell Health Alliance, comprised of competitors, providers and patient groups, are creating a seamless flow of patient health information between hospitals, doctor’s offices, labs, pharmacies and nursing homes—regardless of the technology platform used at each location of care. In Chicago this week, stakeholders are gathering at HIMSS, a major health IT conference, and healthcare connectivity will be a major point of discussion. Through sustained collaboration and ongoing dialogue, industry partnerships are making the safe and secure sharing of health information a reality.

What role can consumers play in moving the ball down the field? As patients and consumers, we play the most important role. We should insist on the same level of connectivity in healthcare that we have come to expect in so many areas of our connected lives. We should refuse to settle for paper forms and incomplete information. Instead, we should demand a seamless, interconnected system that provides access to the right health information regardless of where we receive care.

If you are interested in participating in the dialogue about creating a national system to safely and securely share patient data, I encourage you to share your thoughts with your federal representative. There is a strong interest in Congress to address this issue in the current legislative session.

But you should also talk with your physician about your desire to have online access to your complete medical records. At your next medical appointment, when you’re handed a piece of paper to fill out, ask whether the information will be available for use by other medical professionals who may be involved in your care—specialists, labs, pharmacists, etc. A vocal consumer population is a critical ingredient to make the patient’s needs and wants heard as we build out a truly connected healthcare system.

This article was originally published on LinkedIn and has been republished with permission by the author. 


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Watch Surgical Robot Deftly Suture a Grape

by System Administrator - Monday, 18 May 2015, 8:44 PM

Watch Surgical Robot Deftly Suture a Grape

By Jason Dorrier

We've covered Intuitive Surgical's da Vinci surgical robot for years. In fact, to some, the system's long history—1.5 million surgeries dating back to 2000—may be one of its most surprising attributes. But this video really drives home the system's dexterity. Using a new tool, the FDA-approved Single-Site Wristed Needle Driver, a surgeon guides the bot to gently stitch the skin back onto a grape. Inside a glass bottle.

If you aren't familiar with the da Vinci surgical robot—it's not a robot in the sense you might imagine. This isn't Prometheus. The da Vinci's robotic arms still require a human operator to perform surgery.

The surgeon sits across the room from the robotic arms and, looking through a viewfinder, manipulates a pair of controls. As the surgeon works, his or her movements are translated to the arms, onto which a range of end effectors (or tools) can be attached. Using a surgical robot requires long training and practice.

The idea is simple though. The robot is said to enable less invasive surgery by way of smaller incisions. This, in turn, means less scarring, shorter recovery times, and a lower probability of complications.

As far back as 2010, surgeons were using the robot to perform some 86% of prostate surgeries and 10% of hysterectomies (up from less than 1% in 2007) in the US. Whether its professed benefits play out in practice, however, has been a matter of debate. At least one study, out of Johns Hopkins, called into question the benefits of robotic surgery as compared to human surgery and noted its greater cost.

In either case, the system's popularity is hard to deny.

Dreams for the future include telesurgery—where we might install a surgical robot in a field hospital thousands of miles away, and operated by a top surgeon, it would (securely) transport his or her skills around the globe to where they're most needed—and maybe, much further on, some degree of autonomy.

But such capabilities are still ahead of us. For now, we can marvel at the dexterity with which this surgeon handles their robotic tools. And no doubt, grapes everywhere can feel more secure such tech exists.

Related topics:

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Wearable App for ALS Patients

by System Administrator - Tuesday, 16 September 2014, 12:44 PM

Phillips and Accenture Develop Brain Controlled Wearable App for ALS Patients (Amyotrophic lateral sclerosis)

Phillips and Accenture today announced that they have developed proof of concept software connecting a wearable display to Emotiv Insight Brainware that could ultimately give more independence to patients with amyotrophic lateral sclerosis (ALS) and other neurodegenerative diseases. Affecting more than 400,000 people per year*, ALS, also known as Lou Gehrig’s Disease, impairs brain and spinal cord nerve cells, gradually diminishing voluntary muscle action. Late-stage patients often become totally paralyzed while retaining brain functions.

How It Works

When a wearable display and the Emotiv Insight Brainware, which scans EEG brainwaves, are connected to a tablet, users can issue brain commands to control Philips products including Philips Lifeline Medical Alert Service, Philips SmartTV (with TP Vision), and Philips Hue personal wireless lighting. The tablet also allows control of these products using eye and voice commands. In both cases, a patient could communicate preconfigured messages, request medical assistance, and control TVs and lights. Accenture and Philips developed the software that enables the integration and interaction between these multiple technologies.

The proof of concept application demonstrates how existing technology could be used to transform the quality of life for ALS patients. When patients lose muscle control and eye tracking ability, they can still potentially operate the Philips suite of connected products in their home environment through brain commands. The Emotiv technology uses sensors to tune in to electric signals produced by the wearer’s brain to detect, in real-time, their thoughts, feelings and expressions. The wearable display provides visual feedback that allows the wearer to navigate through the application menu.

The Accenture Technology Labs in San Jose, California collaborated with the Philips Digital Accelerator Lab in the Netherlands to create the software to interact with the Emotiv Insight Brainware and the wearable display. Fjord, a design consultancy owned by Accenture Interactive, designed the display’s user interface.

“This proof of concept shows the potential of wearable technology in a powerful new way —helping people with serious diseases and mobility issues take back some control of their lives through digital innovation,” said Paul Daugherty, Accenture’s chief technology officer. “It is another demonstration of how Accenture and Philips, collaborating with other technology innovators, seek to improve the lives of people with healthcare challenges.”

For more information on the proof of concept application for controlling Philips connected technologies with brain commands, see the infographic visualization below: 

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Web-based mHealth tools can drive patient engagement, care satisfaction

by System Administrator - Tuesday, 11 August 2015, 3:15 PM

Web-based mHealth tools can drive patient engagement, care satisfaction

By Judy Mottl

Access to online educational content specific to medical issues and Web-based tools that enhance communication between patients and providers can help users gain a deeper understanding of care and boost patient satisfaction, reveals a new Brigham and Women's Hospital study.

The use of an online patient-centered toolkit (PCTK) also facilitates patient involvement and input into the plan of care, states the study published in the Journal of the American Medical Informatics Association.

"Doctors and nurses oversee the plan of care, but the patients' goals, priorities and preferences may not always be effectively conveyed to the clinical care team," lead study author Anuj Dalal, and a hospitalist in Brigham and Women's division of general medicine and primary care, said in an announcement. "Decision-making should be shared among patients, families and healthcare providers."

The study aligns with recent research and efforts investigating how consumers view mHealth tools. For instance, a research team featuring physicians from the departments of emergency medicine at Yale School of Medicine and Beth Israel Deaconess Medical Center recently reported a large number of emergency department patients are embracing smartphones, tablets and apps to assist in their care. Another effort, a wearable monitor pilot launched by the University of Pennsylvania Health System, is aimed at determining how patients and clinicians view mHealth technology.

The Brigham and Women's study provided iPads to patients and caregivers in the intensive and oncology units at the hospital, which enabled them to access online content specific to the patient's condition. The researchers evaluated enrollment strategies, the use and usability of patient tools and the content of patient-generated messages.

The study revealed non-critically ill patients were more inclined to engage with the tools compared to those who were critically ill. The majority of patients who used PCTK features were those helping patients establish goals, access test results and medications and identify care team members.

For more information:
- read the announcement
- here's the abstract

Related Articles:


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Where do health IT investments and improved outcomes intersect?

by System Administrator - Sunday, 20 September 2015, 7:38 PM

Where do health IT investments and improved outcomes intersect?

Love it or hate it, the HITECH Act has reshaped the hospital IT market and encouraged a rapid increase in the use of EMRs. In 2006, HIMSS Analytics EMR Adoption Model Data showed 62% of hospitals had only some EMR functionality. Today that number is north of 90% >>
Now that you have all this data, what do you do with it? What’s next?

We’d love to hear what you think. HIMSS Analytics sees the following priorities driving hospital purchase activity in the near term:

1. Optimization

2. Improved workflows

3. Better revenue capture

4. Patient & provider engagement

There’s no shortage of technologies out there to help hospitals improve these core operations. But according to HIMSS Analytics the following 18 technologies are poised for the biggest growth >>

These technologies focus on capturing, understanding and utilizing data to drive improved outcomes and lower costs. Over the last four years we’ve seen adoption of some of these technologies increase by 25% but there are still more than 1,600 hospitals that have yet to adopt.
Examining the technologies we’ve identified (or perhaps some that we haven’t), what areas will or should flourish in a post-EMR world?


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by System Administrator - Tuesday, 10 March 2015, 9:49 PM



With the prevalence of smartphones and pagers, reaching the right doctor for consultations and questions ought to be easy.

In fact, ninety-six percent of physicians use smartphones to support patient care. But the reality is that finding the right clinician, especially one on call, is still a challenge. Sixty-one percent of physicians express concerns about having access to colleagues and specialists, and 53 percent of nurses cite difficulties determining which physician is available.

In a two-month study at academic medical centers in Toronto, Canada, Dr. Brian Wong found that 14 percent of pages were sent to a provider who was not on duty. Further investigation revealed that 15 percent of the pages sent to the wrong clinician were for emergencies that required immediate attention—that’s 211 pages in just two months.

Another 32 percent of pages sent to the wrong provider were urgent. Why were so many important messages sent to off-duty doctors?

According to the author, many of these errors resulted from numbers being written incorrectly on paper (so the wrong number was dialed), or information was pulled from a schedule that had not been updated.

Please read the attached whitepaper.

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Why dual ICD-9, ICD-10 coding is equivalent to another delay

by System Administrator - Monday, 9 March 2015, 9:48 PM

Hospital execs: Why dual ICD-9, ICD-10 coding is equivalent to another delay

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Why healthcare info governance must be 'proactively managed'

by System Administrator - Saturday, 9 August 2014, 2:15 AM

Why healthcare info governance must be 'proactively managed'

By Katie Dvorak

While working on Wall Street, Laura Zubulake dealt with information convergence and governance, later becoming a key player in landmark opinions on preservation of electronically stored information. In an interview published this week in the Journal of the American Health Information Management Association, Zubulake spoke about her experiences and how they translate to healthcare.


The patient care industry shares many similarities with both the finance and banking industries, Zubulake told the Journal of AHIMA. Much of her work on Wall Street likely mirrored that of health information management professionals, Zubulake said, particularly when it comes to electronic health records.

"It is important for HIM professionals to become knowledgeable about all technology at their disposal, how to use it, communicate feedback, demand accuracy, and have patience," she told the Journal of AHIMA.

She also said that information for healthcare organizations is a strategic asset that greatly impacts their ability to advance goals and outcomes. It requires more than just the addition of CIOs, whom she said should not hold sole responsibility of information.

AHIMA CEO Lynne Thomas Gordon has also remarked on the importance of the C-suite ensuring information governance at healthcare facilities.


To that end, in AHIMA's fist study on information governance, it found 35 percent of the 1,000 respondents didn't know if their healthcare organization had any information governance efforts underway or did not recognize a need for it.  

All levels of management need to endorse that information is as important as other assets, Zubulake said. It must be proactively managed, assembled and secured.

"It should be natural and intrinsic to employee's roles and responsibilities and the organization as a whole," Zubulake told the Journal. "Failure to instill this thinking exposes organizations to significant risks."


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Why hospital CIOs must carve out time for innovation

by System Administrator - Friday, 27 February 2015, 7:36 PM

Why hospital CIOs must carve out time for innovation

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Why Hospitals Must Help Physician Practices Move to ICD-10

by System Administrator - Tuesday, 17 March 2015, 3:21 PM

Why Hospitals Must Help Physician Practices Move to ICD-10


Written by  D’Arcy Guerin Gue with Tom Grove

When it comes to ICD-10, physicians, as a group, are much farther behind the curve than their hospital counterparts. The claims clearinghouse Navicure recently polled 350 physician practice administrators, office staffers, and coders about readiness for ICD-10. While the survey found that 82 percent of respondents are optimistic about being ready by Oct. 1, 2015, only 21 percent reported that they believe their practice is actually on track to meet the implementation deadline. One reason is that almost two-thirds of the respondents indicated that they put a hold on their conversion efforts after last year’s congressional extension of the compliance deadline to this year.

The larger concern should be the many physician practices that have not started to prepare for ICD-10. Fifteen percent of the survey respondents reported that their practice has done nothing to prepare for ICD-10, and another 18 percent reported that their progress has not developed beyond the planning and responsibility assignment stages. Reasons given for this include:

  • Time or resource constraints (29 percent)
  • Waiting on software updates (25 percent)
  • Belief that implementation won’t take long (15 percent)
  • Belief that the deadline will change again (15 percent)
  • They don’t know where to start (13 percent)
  • Belief that ICD-10 won’t have a big impact (2 percent)

Hospitals should be especially concerned about this lack of physician responsiveness to the ICD-10 mandate, as most are highly dependent on community physicians. Those of us who work with ICD-10 on a daily basis have long realized that ICD-10 readiness and organization size are closely correlated. The larger organizations are more likely to have made significant progress, and the smallest hospitals and physician groups are more likely to be behind the curve. Regardless, in the end, organizations large and small that have business relationships will have to continue being able to operate using ICD-10 coding. The unavoidable truth is that hospitals need their community’s physician practices to get on board with ICD-10, as they will be financially and operationally vulnerable if they don’t.

Hospitals should consider how to make ICD-10 assistance part of their larger physician engagement strategy. The fact that hospitals must work to bring their own internal physician staffs into the ICD-10 fold means that there are various options for supporting external physician practices at little additional expense:

  • Hospitals can broaden the reach of their internal ICD-10 educational resources to support ICD-10 learning within associated physician practices. Because hospitals are already making significant commitments to education for ICD-10, extending those training resources to cover community physicians and their key office staffs is a relatively small investment. This will help to yield a more stable physician practice community and further physician engagement with the hospital, both overall and with the hospital’s own ICD-10 efforts.

One hospital we’ve worked with has chosen to give practice staff members access to formal online training and hospital coders who can help answer ICD-10 questions. Their charter for this process anticipates at least two benefits: the hospital will be demonstrating the overall importance of the physicians to the hospital, while at the same time, the hospital will increase the odds that incoming documentation (like lab orders and prescriptions) will be ICD-10-compliant.
Another hospital, which has created a formal ICD-10 help desk to provide certified coding assistance to their internal coding teams, has also decided to give access to the physician offices in their own community. 

Another organization is creating versions of both of the above training programs, and adding a twist. This organization is planning to bring in a physician–turned– ICD-10 consultant to provide in-person, on-site education that will support the broader training programs. While such a measure may not be practical for many hospitals, the concept of offering an ICD-10 “superuser” to offer direct educational support is one to consider.

  • Hospitals can provide IT or billing services to the community practices. As many IT and billing shops already provide services to groups of hospital-employed physicians, expanding those services as a commercial endeavor to physician practices is not a complicated operation. Doing so will allow practices access to services and expertise for ICD-10, as well as everyday operations that they could not afford on their own. A shared electronic health record platform would have particular additional benefits, as it would expand data sharing in the community to advance population health.
  • Hospitals can name an ICD-10 project manager to coordinate implementation work for community physician practices. While much of ICD-10 involves knowledge and capabilities that every practice will need to become familiar with, there are many transition activities that are one-time events. Providing a coordinator to help guide the transition and share best practices with other physician groups in the community is an efficient way to help advance readiness in the physician practice community.
  • Another area where hospitals can provide a common resource to support physician practices’ transitions to ICD-10 is in data analysis after the actual conversion. It will be critical for every provider to have the capability to analyze revenue effects and denial patterns for unexpected ICD-10 impacts. A shared community resource could not only provide this assistance to the practices, but also offer information on critical issues affecting other practice groups, to ensure that they are not having the same issue.
  • Finally, hospitals might consider the combination of ICD-10 and meaningful use initiatives as an opportunity to move toward purchasing physician practices, and then quickly converting them to a compliant billing and electronic health records system. This is consistent with the trend in the physician practice world in which few physicians are remaining in solo practice because the business office overhead for a single provider is unaffordable.  

It is evident that many larger hospitals are following similar thinking with regard to smaller hospitals. A recent analysis of HIMSS analytics data shows that EPIC holds the No. 2 slot in number of installs (almost 16 percent) in electronic health records (EHRs) in hospitals under 100 beds, even though EPIC doesn’t focus selling efforts on that market. These small hospitals are obtaining access to EPIC through direct ownership by a larger health system or some other formal affiliation.

By utilizing one or more of the above strategies to enhance physician engagement in ICD-10, hospitals can achieve several long-term benefits:

  • Stronger ties with community physician practices, which can lead to increased referrals and referral revenue.
  • Better relationships with the physicians themselves. There is ample evidence that hospitals with positive physician relationships have a much easier time of implementing major initiatives such as ICD-10 or meaningful use.
  • A more stable physician community that will find itself in a better position to remain in business and meet the larger community’s healthcare needs.
  • Direct revenue enhancement through the purchase of physician practices or selling of IT and billing services to affiliated practices.

Finally, and to the original point of this article, hospitals that have spent millions to convert to ICD-10 risk an unsuccessful transition if they haven’t also supported the physician practices in their communities. Hospitals will need these practices to send properly coded diagnoses and orders, at the very least to save time and effort on getting them corrected. Most importantly, without making sure their associated physician practices can transition, on time, into the ICD-10 world, hospitals risk disruption and errors in patient care – and non-payment of their claims.

About the Authors

As a co-founder of Phoenix Health Systems, D’Arcy Gue has had leadership roles in the growth of the company. Currently, she leads overall corporate administration, marketing and industry relations, services development, human resources, and knowledge management. She has led various strategic initiatives, including the development of ICD-10 services, HIPAA-based security and privacy compliance tools, and online education programs.

Thomas Grove has more than 16 years of experience in healthcare IT. As a principal at Phoenix Health Systems, he provides IT project leadership and consulting services with a focus on ICD-10, meaningful use, and privacy and security.

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