Latest Posts


Clinical data aggregation

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As co-founder and Chief Medical Officer of Flow Health, a collaboration platform for transitions of care, I will continue to contribute new content on the Flow Health blog.

The most recent article, Aggregating Clinical Data – Beyond Interoperability, describes in more detail the notion of aggregated patient-centric data, de-coupled from the EHRs and other technologies that created them. Such an approach can bridge across the institutional silos that has resulted in the data fragmentation we see today.  Further, this universal data layer for all of health IT, which can be accessed via API linkages by new technologies of the future, is a new paradigm. It can radically change the nature of EHRs in the next generation of products, allowing them to be UI-only lightweight products that interact with the universal cloud-based data layer in the background. It can (finally) allow UI-only EHRs the ability to compete with each other based on usability.

Further articles will be featured on the Flow Health blog, and only referenced in a summary fashion here.

More Latest Posts

EHRs as platforms

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Some very interesting trends are occurring in the health IT arena, which raise the question of what role Electronic Health Records (EHR) systems will have in the future. A few years ago, the focus for health care professionals and hospitals was EHR acquisition and implementation, as well as qualification and access to federal incentive money   …Continue Reading


When do physicians behave like consumers?

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We are seeing a flood of health IT tools come in to the market, some simple and some highly complex. The way that physicians approach the adoption of these tools has major implications for vendors. Electronic Health Records (EHR) systems have been the centerpiece of health IT for a number of years, and now a   …Continue Reading


What is the future of EHRs?

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Electronic Health Records (EHRs) have come a long way in moving U.S. healthcare onto an electronic platform in the past few years. As of 2013, the majority of practicing community physicians, as well as most hospitals, have adopted an EHR system in their practices. Like was the case with paper beforehand, EHRs have maintained the   …Continue Reading


Value based healthcare payments – what kind of IT is needed?

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The trend toward value based payment for healthcare services is gaining momentum. For better or for worse, we have paid for health care in the U.S. on a fee-for-service basis – from the perspective of providers (doctors, hospitals, etc.), that means that the more you do, the more you make. Except for efforts around managed   …Continue Reading


Patient centered data is the best solution for “meaningful consent”

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The Office of the National Coordinator for Health IT (ONC) recently released guidelines to address the question of consent when it comes to electronic health information exchange (eHIE) – “meaningful consent.” This is a helpful effort, and underscores the difficulty of obtaining, documenting, and implementing consent in the modern ever-more-complex world of electronic health information.   …Continue Reading


Rethinking health information exchange

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We have come a long way, in the past several years, in our efforts to bring health care data into the modern era of electronic connectivity. Yet, the entirety of one’s health story is still fragmented into a variety of data silos that are largely organization-centric. Through the efforts of many very talented people, spurred   …Continue Reading


Patient centered health IT as the solution to universal health identifiers

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The effort to build health IT products that are patient-facing, and able to pull together all the health information about oneself into one unified dashboard, is well underway. It is the inevitable next step in the evolution of health care data – putting patients at the center of their own data, and having them be   …Continue Reading


Patient-generated health information is the future of healthcare

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“Patient engagement” has certainly become a buzz-word in the realm of modern health IT. Medical practitioners as well as hospitals hope to encourage patients to interact with them using on-line tools, and Stage 2 Meaningful Use criteria (which go into effect beginning in 2014) require that at least 5% of a clinical practice’s patients actually   …Continue Reading


Identity verification is key for successful implementation of Direct

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Health Information Technology is on the threshold of a significant step forward. Up until now, most of the emphasis in health IT was encouraging physicians and other ambulatory providers, as well as hospitals, to move off paper and onto an electronic platform. EHR adoption has increased significantly from 2008, where only about 4% of physicians   …Continue Reading


Can patient engagement be achieved from a clinician messaging system?

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For clinicians participating in the federal EHR Incentive Program (Meaningful Use), Stage 2 of Meaningful Use (MU2) is right around the corner (2014). No one yet has EHR software that is certified for MU2, given that vendors are just becoming certified this year. So, from a clinician perspective, it is hard to imagine how using   …Continue Reading


Two-year EHR analysis now available

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Newly released federal data has allowed analysis of the EHR Incentive Program (Meaningful Use) based on two years of data. First-year users, both from 2011 and 2012, as well as second-year users (who started in 2011) can now be studied. A new comprehensive analysis is now available, and can be downloaded for review. This document   …Continue Reading


Trends in EHR vendor strength

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New data from CMS allows comparison of EHRs used for Meaningful Use. Shifts in market footprint by EHR vendors from 2011 to 2012 can now be analyzed.


The riddle of adoption of consumer PHRs

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Next-generation Personal Health Records (PHRs) are starting to emerge. We review the evolution of these and look at different ways to build PHR adoption.


Paperwork in an EHR-enabled medical office

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Electronic Health Records (EHR) systems come with the vision of eliminating paper in a medical practice. “No more paper” is the rallying cry of many an EHR company. But is this the case? As it turns out, not really. Stacks of legible, computer-generated paper still pile up on a medical practitioner’s desk, despite having an   …Continue Reading


The art of population management

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The term “population management” has become one of the buzzwords of modern health care. Medical practices as well as larger delivery organizations, such as medical groups, IPAs, ACOs, and PCMHs, are being asked to report on their performance around managing the health of assigned populations. Performance-based compensation, in fact, hinges on measuring and comparing groups   …Continue Reading


Healthcare collaboration and PHRs in 2013

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With the beginning of 2013, health IT is facing a new set of challenges. Electronic Health Record (EHR) vendors are gearing up for Stage 2 Meaningful Use certification, which includes more emphasis on interoperability – the sharing of health data about a patient across different health settings – and on patient engagement. Health care is   …Continue Reading


The role of PHRs in Medication Reconciliation

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Medication Reconciliation, keeping track of all a patient’s medications from all soruces, is a big challenge. Universal PHRs can be very significant here.


Free-standing PHRs and Stage 2 Meaningful Use

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In the upcoming year, Electronic Health Record companies will be challenged to enhance their products in anticipation of Stage 2 Meaningful Use. Stage 2 is right around the corner, and will begin in 2014 for those who have already started their EHR usage in 2011 or 2012 (for those who start Meaningful Use later, Stage   …Continue Reading


Do doctors resist health information exchange with patients?

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Health technology tools are rapidly emerging, a swirling rising tide of products (web and mobile applications) addressing countless niche issues in the very complex healthcare ecosystem. Two countervailing sources of such efforts characterize the modern landscape – products that come from the consumer Internet side, and products that come from the healthcare provider (and payer)   …Continue Reading


PHRs: what problem are we trying to solve?

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“Patient engagement” is one of the buzzwords in health policy these days, and substantial data exist to show that when patients are actively engaged with the health care system, particularly if they have a chronic medical condition, their resulting health outcomes are better. Clearly, it’s a good thing for people to be involved in their   …Continue Reading


HIEs are not just for EHRs anymore

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Health Information Exchanges (HIEs) are hubs where different parts of the healthcare system can exchange information with each other. Doctors can communicate with other doctors, with hospitals, with labs, etc. Funding that encouraged the creation and maturation of HIEs were part of the 2009 American Reinvestment and Recovery Act (ARRA), just like Meaningful Use was   …Continue Reading


Modern PHRs beyond Meaningful Use

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Patient-facing health IT has come a long way, but is also poised to make another significant leap forward. Last week, the final rules for Stage 2 Meaningful Use were released, and even though these rules address what physicians and hospitals must do to receive incentive payments for demonstrating “meaningful use of certified healthcare technology,” some   …Continue Reading


The changing health care environment, and what it means for health IT

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Health care is changing. It is doing so in a profound, organizational way. I’m not talking about the advent of new technologies – diagnostics, therapeutics and information technology – I’m talking about how doctors and hospitals are organized. The tradition in this country is that health care has been delivered mainly by individual, self-employed physicians   …Continue Reading


The looming policy struggle for Meaningful Use

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The federal EHR Incentive Program (Meaningful Use) is based on the presumption that once a medical practitioner has adopted an Electronic Health Record (EHR) system, that system will remain in use for subsequent years. More specifically, the presumption is that once a clinician attests to Meaningful Use (the first year of attestation only needs a   …Continue Reading


Meaningful Use 2012 mid-year report card

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The mid-year data on the Electronic Health Record (EHR) Incentive Program (Meaningful Use) has been released, allowing further insight into adoption of EHRs. The current year-to-date Meaningful Use attestation figures can be compared to 2011 data, and can illustrate vendor-specific trends in adoption. A few points about Meaningful Use need to be made here. All   …Continue Reading


The three legs of health IT

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Health Information Technology (health IT) has been a burgeoning space in the past several years. Partly spurred by federal incentives to clinicians to adopt Electronic Health Records (EHR), investment in companies in this field has flourished. In addition to EHR companies, which are numerous, and which will very likely experience significant shake-out over the next   …Continue Reading


An ACO “heat map”

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Accountable Care Organizations (ACOs) are gaining momentum. These efforts, part of the 2010 Affordable Care Act (recently upheld by the Supreme Court), aim at building voluntary groups of doctors, hospitals and other healthcare providers in order to improve the quality and reduce the cost of health care (at least, to Medicare fee-for-service beneficiaries). In December,   …Continue Reading


The biggest challenge for HIE is not technical

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We are at a time of dramatic change in health care. Not only is the question of health care finance on the table as a hot area of debate, but also the issue of health care delivery is (perhaps more quietly) undergoing big change. And the kinds of health Information Technology needed by the delivery   …Continue Reading


Will there be mass consolidation among EHRs?

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The number of vendors of Electronic Health Records products seems unsustainable. Stimulated by federal Meaningful Use incentives, plus the irresistible tide of pressures and encouragement from all sides (specialty societies, peers, licensing boards, insurance payers), the uptake of EHRs has been steadily increasing. As a result, large established EHR companies, some of whom have been   …Continue Reading


Comprehensive EHR market analysis now available

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In response to requests for a thorough analysis of the Electronic Health Record industry, I have spent some time putting together a comprehensive EHR market analysis reference document, based on actual Meaningful Use experience in 2011. This document is now available for purchase and download in a newly-created bookstore. This document is designed to be   …Continue Reading