< + > To Drive Value, EHRs Need to Actually be Usable

The following is a guest article by Khalid Al-Maskari, Founder and CEO of Health Information Management Systems (HiMS)

EHRs are ubiquitous because they’re useful – but how useful are they really, and to whom?

The truth is that an EHR by definition serves multiple masters, satisfying some more than others. For many clinicians, EHRs have actually been a disservice, a major factor in burnout. That’s because they weren’t invented to help clinicians in the first place.

“Many EHR products were designed with billing, payer requirements, and meaningful use criteria in mind rather than clinician use, resulting in a user experience laden with data entry that causes decreased productivity and efficiency, and a diminished patient-physician relationship,” researchers wrote in the Journal of the American Medical informatics Association in 2019. It still holds true.

If the patient-clinician relationship is diminished, outcomes will suffer.

Wanted: More Patient Face Time

When physicians, psychiatrists, psychologists, radiologists, nurses, case managers, peer supports, therapists, and others use an EHR, they commonly have trouble with nonlinear workflows, history lookups, information handoffs within teams, turning encounters into notes, turning notes into billing codes, prescribing meds, ordering labs, and marshaling data to prove value-based care. Users are doomed to excessive clicking, scrolling, page-switching, and toggling. The upshot? What should be patient face time becomes screen time.

It’s a shame, but EHR users aren’t finding EHRs usable.

I believe we can put that ignominious history in the past where it belongs. In 2023, six decades after the introduction of the EHR, I’m convinced the EHR can serve all masters – people as much as institutions. It can serve every user from the patient to the receptionist to nurses, doctors, counselors, billers, and the CFO. In fact, each professional can effectively have an EHR of their own with all of their priorities immediately at hand on their home page. Ideally, the EHR becomes a personalized hub of information, communication, productivity, revenue generation, patient satisfaction, and value-based care. It becomes usable, even enjoyable.

Getting to Usability

EHR usability starts with the user interface (UI), which should be 1) configured to each user and 2) customizable by each user. The interface should be streamlined and intuitive out of the box and, with modest tweaking, as personalized as a smartphone. All the functions that the user needs should be front and center. The rest of the functionality should be buried or hidden. Empower the user, simplify customization, and get out of the way. This is digital minimalism – eliminating clutter and designing with intent. 

Here are some other principles we’ve committed to: 

User Centricity

All of the user’s priorities should be executable from their start screen (regardless of device type) with little or no scrolling, switching, and toggling. For example, a physician should be able to see all of her appointments for the day at a glance in one panel. She should be able to hover her mouse over any thumbnail to see a capsule description of the patient and their reason for the encounter. Screens could easily be split to enable two functions to occur on one interface.

Patient Centricity

Any clinician, staffer, or group should be easily assigned to any patient’s care team, immediately creating an intimate information-sharing ecosystem (not unlike a social media chatroom) focused on the patient and the workflow.

Clinician-Driven Design

To maximize usability, we’ve spent thousands of hours watching integrated health professionals at every level work. We’ve tracked their workflows, analyzed their clicks, captured their feedback, removed obstacles, automated once-tedious processes, and capitalized on what makes people more effective and productive. 

Voice-Driven

Any EHR user should be able to issue any command or write any note by directing their voice toward any device. Clinician notes would be transcribed automatically, using artificial intelligence to suggest diagnoses and billing codes (as many as applicable) on the fly. Key terms would be normalized (e.g., revised to client, patient, or member as the organization prefers).

Click Relief

Multi-parameter searches should be stored as filters for future use. Multi-process operations should be saved as one-click macros. For example: Gather up patient summaries, codes, and claims, total them up, and send them to the CFO. 

Value-Based Care

A compliance dashboard should remind staff to do the things that improve outcomes, lower costs, and trigger maximum reimbursement, such as delivering preventive care, following up, referring patients to PCPs, and screening for cancer.

These are the features an EHR would have had from the beginning if the category had been created for the people who see patients. We’ve torn it down and built it back up to drive outcomes, value, and performance. We’ve made it useful for everyone – including, but absolutely not limited to – the back office. 

About Khalid Al-Maskari

Khalid Al-Maskari is the founder and CEO at Health Information Management Systems (HiMS), a Tucson, Arizona-based company that designs Electronic Health Records (EHR) software to transform the integrated healthcare experience. HiMS creates innovative solutions that lead to better outcomes, lower costs, and higher-quality care.

< + > Datavant Leads in Health Data Exchange: Surpasses Digital Connections to 70,000 Hospitals And Clinics, Acquires Healthjump​​

Datavant has now reached a milestone of more than 70,000 US hospitals and clinics in its digital network and enables the exchange of 60 million patient records per year. Datavant supports use cases ranging from continuity of care; to patient and attorney requests; to risk adjustment, to quality reporting and clinical research. Datavant also announces completing its acquisition of Healthjump, the leader in health data exchange for value-based care organizations, which has built connections to more than 1,500 healthcare organizations participating in risk-bearing arrangements.

“Together, Datavant and Healthjump will dramatically accelerate the process of controlled, compliant clinical data exchange for healthcare organizations across the country,” said Pete McCabe, Chief Executive Officer at Datavant. “This is the underlying infrastructure that is necessary to close millions of care gaps every day, to allow better and more rapid clinical and operational decision-making, and to enable the move to care arrangements designed around improved patient outcomes.”

Datavant is the largest provider of Release of Information services in the country, serving more than 65% of the top 200 US health systems when they have a need to provide patient medical records to authorized requesters, including patients, providers, researchers, attorneys, and health and life insurers. Since its merger with Ciox Health two years ago, Datavant has emerged as the leader in digitizing the process of patient data exchange, laying down hundreds of APIs in collaboration with its health system partners, and quickly moving towards the majority of patient information requests being fulfilled digitally with the entire process overseen by our expert managed services team.

Healthjump is the leader in health data exchange for value-based care organizations, enabling its customers to pull standardized electronic health record (EHR) data from participating practices and clinics regardless of which EHR systems they use. This information is used by value-based care organizations to assess the quality, cost, and outcomes of care being provided by those practices and clinics. “Healthjump has made it possible to get and use data that we otherwise would never have had. We’ve closed several thousand care gaps with that healthcare data and are looking forward to the future with Datavant” said Adam McClellan, Vice President, Strategic Development & Implementation at Community Care of North Carolina, Inc. Healthjump’s application is a guided thirty-minute installation that has been completed by more than 1500 practices and clinics, and is HITRUST certified. The combined company will operate under the name Datavant.

“We are thrilled to join the Datavant team,” said Cliff Cavanaugh, Chief Technology Officer at Healthjump. “We’ve been working in partnership for years in pursuit of parallel use cases, all limited by the same essential problems of health data liquidity. Healthjump has developed an elegant and scalable solution that can be implemented out of the box across Datavant’s customers and partners. Together, we can enable provider organizations to address their information release and exchange needs holistically, supporting the pursuit of high-quality, cost-effective care and improved patient outcomes.”

About Datavant

Datavant’s mission is to connect the world’s health data to improve patient outcomes. Datavant works to reduce the friction of data sharing across the healthcare industry by building technology that protects the privacy of patients while supporting the linkage of patient health records across datasets. Learn more about Datavant at datavant.com.

About Healthjump

Founded by Martin Aboitiz, Cliff Cavanaugh, and Jim Rowland, Healthjump is at the forefront of resolving the data liquidity challenges of traditional interoperability, serving over 1,500 clinical sites through its cloud-based platform. Healthjump revolutionizes the way EHR data is collected, standardized, and delivered, by eliminating the limitations and complexity of conventional interfaces. Our simple installation process alleviates the IT burden of complex EHR interface engines, empowering organizations to seamlessly transition to value-based care and leverage tools that enhance both patient and provider outcomes.

Originally announced September 26th, 2023

< + > Blackbaud settles ransomware data breach investigations for $49.5M

The software services provider to non-profits announced it has agreed to pay 49 states and the District of Columbia this month to resolve investigations into a 2020 cyber hack and misleading data breach statements made to patients and consumers.

< + > CIO and clinician alignment must improve, report finds

This is due in large part because provider organizations fear clinician burnout most of all concerns, a Symplr survey of CIOs says.

< + > Five Things Hospitals Should Do Immediately to Improve their Cybersecurity Posture

The following is a guest article by Jonathan Goldberger, Senior Vice President, Security Practices & Strategic Sales at TPx

Hospitals face the threat of cyberattacks daily and each attack threatens the hospital’s public brand and, worst of all, public health.

Because nearly every function at hospitals today is electronic, a cyberattack is crippling to the point where a provider can’t do anything. Even tasks such as sending a prescription to the pharmacy and ordering or reviewing X-rays are challenging amid a cyberattack.

It’s no secret that threat actors are targeting companies and organizations regardless of their size. However, hospitals are unique considering the reams of patient data entrusted to them.

As such, a hospital’s approach differs from that of a small or a mid-sized company.

Compounding the issue for most hospitals is that they operate on tight budgets and thin staff, and often, they don’t have everything they need. This causes key vulnerabilities in areas where the risk hasn’t been reduced.

Recognize that the Risk is Real

Before hospitals can act on the threat, they must accept that it is real and understand their organization’s shortcomings. An annual gap assessment is the best way to understand those areas where improvement is needed.

The pace of technology and regulations is changing rapidly, and a gap assessment can give an organization a frame of mind to mark where they are while also recognizing the needs they must bridge for everyone who connects to the network.

Consider the Federal Trade Commission’s (FTC) Safeguards Rule, which requires companies with significant financial transactions to protect customer information in specific ways. It states that organizations must write into vendor contracts that they will meet the requirements from a security program perspective. These requirements must be clearly defined to ensure both the organization and its vendors comply.

Prepare to Tackle Ransomware

Ransomware often happens through three well-established and known vectors: phishing, remote desktop protocols (RDP) or remote administration of routers, firewalls, and other network systems, and misconfigured web applications.

Hospitals are no exception, an overwhelming number of hospital ransomware attacks come through these vectors. They must be diligent and go beyond what other organizations must do to protect those vectors.

Hospitals have an increasing number of web applications that patients use to schedule visits or pay bills. While providing patients with convenience, these web applications are another point of risk to consider.

The good news is the solutions exist. And the means of reducing the risk from those threat actors is well established. But it’s about doing more than the minimum.

Deploy Inbox Detection and Multi-Factor Authentication

Relying on recipients to validate an email’s authenticity is challenging. When it comes to phishing, a recipient sees an authentic-looking email, so they click on it.

Inbox detection and response can be one of an organization’s most valuable investment returns. It is an inexpensive solution that companies can use all the time and helps significantly reduce the risk.

What is ideal about an inbox detection and response solution is that instead of clicking on the email, recipients click a button to submit the email for validation. Essentially, recipients can get a certification of authenticity for each email that comes in. That goes beyond just simply conducting training.

This type of tool is a better means to protect against phishing. But there is another that mitigates two of the three vectors: multi-factor authentication.

Multi-factor authentication helps like a safety net. It can save organizations from more serious phishing attacks because, in many cases, they capture credential pools from the network and relay the credentials to the key systems someone is trying to access.

MFA protects against bad actors gaining network access for administrators and users. Many organizations rely on MFA for administrators, but MFA for users is another key tool in protecting a network.

Conduct Regular Security Awareness Training

The best way for hospitals to combat threats like phishing is to bring their team members into the fight. Security awareness training will have the most significant impact on an organization, but it’s not about doing it once a year but every month.

Pushing phishing exercises to team members every month empowers them to apply what they’ve learned and ensure they don’t make mistakes. When mistakes happen in these exercises, they occur in a controlled environment where the risk is low, and the results can be used to inform future plans.

Mitigate the Greatest Risk: The Human Factor

The difficult part in cybersecurity is it only takes one person to click. An organization can have the best technologies, hardened servers, vigorous security training and policies, but if one user clicks on a phishing email, all those efforts are for naught.

They might download malware and log into a bogus authentication-capturing site, giving bad actors access to a company’s networks.

Measuring the return on investment is an age-old question. Cybersecurity tools don’t have to be expensive to be effective.

An organization should consider that an average ransomware attack could cost roughly $200,000 — and larger institutions might be on the hook for more. Additionally, offerings like cyber insurance can help offset some of the cost to companies in the event of an attack, but like any insurance, the best policy is the one an organization doesn’t need to fall back on.

If the dollar amount isn’t enough to convince the organization, focus on downtime costs for booking, billing, and other systems, a statistic every CIO knows. Based on those, the team can evaluate the cost of a solution against the potential cost of the threat it remediates.

Security teams have found that these solutions reduce the phishing rate alone by over 80%. That’s a tangible number and a significant return on investment.

With the multitude of threats facing hospitals, providers must critically assess their security posture and take action to bolster their efforts. It’s always easier to proactively prepare for a cyberattack than it is to retroactively respond to one.

About Jonathan Goldberger

Jonathan Goldberger is an accomplished Senior Executive at TPx with 26 years of success spanning cybersecurity and information technology roles. He has a diverse cybersecurity experience leading security consultancies at TPx, Cisco, Sourcefire, and Cybertrust. He led Sales Engineering at Venafi and was the General Manager of Security Solutions at Unisys. Jonathan’s expertise extends across all aspects of cyber security: professional services, managed services, sales, and go-to-market. As an entrepreneur himself, Jonathan is keenly aware of small business challenges and the need for cost-effective security solutions that protect against the most relevant risks.

< + > ShowdMe Announces Partnership with Spring Mountain Capital and Blue Heron Capital for Series A Funding Round and Expansion

ShowdMe, the premier compliance training partner for home care agencies and skilled nursing facilities, announces today a Series A investment led by Spring Mountain Capital and Blue Heron Capital. The funding will drive expansion for the Company, allowing for the hiring of new employees and continued growth of its products and services. ShowdMe chose to engage with the two firms after growing 90% year over year in 2022, obtaining over 100 new clients in the past 12 months, and achieving 98% logo retention.

Healthcare professionals are required to complete compliance training on an annual basis, as well as during the hiring process. ShowdMe’s software and “Compliance-as-a-Service” offering simplifies the training experience for users by providing the platform and full-service support to help users complete training remotely. By incorporating ShowdMe’s platform into their training process, organizations have seen compliance rates increase, on average, to 92%– in addition to a significant reduction in operational costs.

“ShowdMe is a leader in the digital transformation of compliance and training solutions for healthcare organizations and we are proud to partner with them. Impressively, the Company has reduced in-service costs by as much as 80% while achieving 93% satisfaction rates, and we are committed to helping ShowdMe accelerate its growth initiatives to broaden its platform and course offerings. We look forward to a partnership with ShowdMe to expand its solutions so more healthcare organizations can focus on their primary objective of delivering quality patient care,” said Kenny Soll at Spring Mountain Capital.

“We’re excited to be working with Avi and the entire ShowdMe team to advance their goal of making healthcare compliance easy. The Company’s easy-to-use platform provides the right training, to the right employee, at the right time to ultimately help get more healthcare professionals doing what they do best, helping patients. That’s a mission we are excited to support,” said Gordon Crenshaw at Blue Heron Capital.

“With the recent success of our platform, the timing was right to partner with Spring Mountain Capital and Blue Heron Capital. The funding will allow us to accelerate growth and meet the compliance needs of health organizations without sacrificing the service our customers expect. In today’s age of employee burnout and high turnover rates, streamlining compliance training can make all the difference in employee retention,” said Avi Singer, Founder and CEO at ShowdMe.

About ShowdMe

ShowdMe is the premier partner for healthcare organizations, providing simple and effective solutions for hiring, developing, and retaining employees while staying fully compliant. ShowdMe was founded in 2014 by Avi Singer. More information can be found at ShowdMe’s website: showd.me.

About Spring Mountain Capital

Spring Mountain Capital is an investment management firm that focuses on alternative asset investing. The SMC Growth equity team focuses on providing expansion capital to companies capitalizing on breakthrough innovations, paradigm shifts, or fundamental market or behavioral changes. SMC invests in two sectors of the U.S. economy undergoing the most change and with the highest growth potential: enterprise technology and healthcare companies. For more information, visit smcgrowthcapital.com.

About Blue Heron Capital

Blue Heron Capital is an early-stage growth equity firm funding big ideas in enterprise and healthcare technology. Using the powerful combination of financial capital and the human capital of its OA Collaborative, Blue Heron helps build businesses that make big impact. For more information, please visit blueheroncap.com.

Originally announced September 27th, 2023

< + > Bonus Features – October 8, 2023 – 67% of Women are Having Issues with Getting a Clear Diagnosis – of which 25% are Still Waiting for Diagnosis or Gave up Entirely, Health Gorilla has 17 Healthcare Organizations Commit to Joining their QHIN, and More!

Welcome to the weekly edition of Healthcare IT Today Bonus Features. This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.

News

This year’s Customer Forum and Innovation Summit from Avel eCare will double as a celebration of their 30th anniversary!

PEP Health’s AI-powered Patient Experience Platform releases its first report offering quantitative and qualitative insights on the patient experience.

Claims on the community care program, Connect for Life (CFL), from Wider Circle preventing 8 ED visits per 1,000 members, saving $103 Per Engaged Member Per Month net savings for Medicare Advantage members, and more have been validated in a recent review from Milliman.

Medicomp Systems hits a milestone of directly mapping over 10 million clinical codes and concepts across more than 12 terminologies to its MEDCIN clinical relevancy engine!

Studies

The State of Health of Women in the Workforce, a study from Parsley Health finds 80% of women report delaying care until symptoms worsen or begin to affect their life before seeking care and 67% of women are having issues with getting a clear diagnosis – of which 25% are still waiting for diagnosis or gave up entirely, painting a bleak picture of the struggles women go through.

A recent study by Surescripts on prescribing trends found that non-physicians working outside of primary care prescribed nearly 20% more diabetes, high cholesterol, and hypertension medicines than they did in 2019. Meanwhile, primary care physicians prescribed these same medications 3.5% less than they did in 2019, suggesting that pharmacists could lead the way in filling the primary care gap.

In a time of high burnout levels, every decision can be critical to your organization – such as your healthcare operations software being on a single platform. symplr’s second annual Compass Survey report found that on average respondents said that single platform operations would let them redirect 20% more time to patient care – the equivalent of one full workday.

Particle Health and LifeMD teamed up to do a study on triaging patients for GLP-1 Treatment using clinical data. From the screening criteria, they were able to rule out 61 patients as potential candidates and determine 32 patients as a good fit out of their sample of 200 patients – proving that this will save a significant amount of time for physicians.

Ronin, the University of Texas, and MD Anderson Cancer Center had a study published recently detailing a model that predicts emergency room visits for cancer patients in a 30-day window, 41% to 64% of these visits could potentially be avoidable.

Provider Density Data from LexisNexis Risk Solutions finds the Vallejo-Fairfield, CA area had the largest net increase of primary care physicians (PCPs) clocking in at a 38.9% increase. On the flip side, the largest net decrease in PCPs was the Fayetteville, NC area – losing nearly 12% of their PCPs.

Essentia Health conducted a study by implementing their Telestroke program at several hospitals in the Midwest and found Telestroke drastically decreased the door-to-needle time from 61 minutes on average to 38 minutes on average.

Partnerships

• SmithRx and 9amHealth team up to offer SmithRx’s ecosystem of clients an affordable solution for their most prevalent conditions such as diabetes and obesity.
• Hyro and UST partner to get Hyro’s conversational AI assistants integrated into UST ContineoHealth’s hospital and health system clients.
• Seeking to improve the patient paying experience, TrustCommerce combines their TrustCommerce patient payments platform with athenahealth’s athenaIDX revenue cycle management (RCM) solution.
• Medisafe and Amazon Web Services (AWS) join forces to create Medisafe’s Digital Companion, powered by AWS, to support patients and caregivers throughout their entire treatment journey.

Products

• Zencape Health launches new subscription service for people with pelvic health conditions, offering members unlimited virtual access to a team of specialty physicians and support from a Care Coordinator.
• WellTheory tackles the hidden costs and productivity impacts of untreated autoimmune diseases with their new enterprise solution.
• DrFirst rolls out new medication management platform, Fuzion, reducing staff burden and increasing patient safety.
• Data creation can now be streamlined with Integral’s Privacy Workbench. This privacy analytics suite automates de-identification and compliance reports, ensuring the protection of this sensitive information.
• Ricoh USA, Inc. launches new end-to-end managed service, RICOH Remote Patient Monitoring (RPM) Enablement, designed to fuel more efficient and sustainable RPM workflows
• H1 announces the launch of GenosAI, a new generative AI tool that they are embedding into their clinical trial intelligence platform, Trial Landscape.
• Atropos Health launched two new products this week geared towards advancing evidence generation, Geneva OS™ (Generative Evidence Acceleration Operating System) and ChatRWD™ (Real World Data).

Sales

• Health Gorilla gets 17 healthcare organizations to commit to joining their QHIN once designated!
• Banner Health, BJC Healthcare, Boston Children’s Hospital, Children’s Mercy Kansas City, Cottage Health, Novant Health, OSF Healthcare, and UVA Health join AVIA’s Generative AI Collaborative – making almost a total of 30 major health systems.
• Kaiser Permanente buys Nabla Copilot, a clinical AI scribe from Nabla, for 10,000 of the doctors in North Carolina.
• WellSpan Health utilizes Artisight’s Smart Hospital Platform in their Surgery and Rehabilitation Hospital in York, PA, with plans to expand the platform to their other hospitals in the future if all goes well.
• Accelecom was chosen as the provider of high-speed internet solutions in Horizon Adult Health Care’s 17 locations across the Commonwealth of Kentucky.
• Veradigm joins the FDB Vela™ ePrescribing network, officially being the first major EHR network to do so.

People

• Laudio hired two new people this week! Emma Smith has been hired as their very first Chief Marketing Officer and Michael Vipond as Executive Vice President of Sales.
• Monica Cepak was named Interim CEO at Wisp, making her their very first female CEO.
• Jennifer J. Canfield was appointed Executive Vice President of Sales at emtelligent.

If you have news that you’d like us to consider for a future edition of Healthcare IT Today Bonus Features, please submit them on this page. Please include any relevant links and let us know if news is under embargo. Note that submissions received after the close of business on Thursday may not be included in Bonus Features until the following week.