Monday, January 30, 2017

App, Snap, what are we doing with all this crap: Why buy-in may be the missing part of the HealthIt equation

I rarely associate the term "layoffs" with the healthcare IT sector. In fact, it could be argued that jobs in the HIT sector are plentiful, with many companies reporting a shortage of workforce. I'm not sure if others share my reaction to layoffs in the healthcare sector but when I read that Fitbit, a company I really respect, was laying off ten percent of its workforce due to lapsing revenues, I felt a twinge of responsibility. 
In an average week, I typically meet or meet with over a hundred healthIT experts or thought leaders. Add to this my on-line engagement and project collaborations and what you have is a lot of brain power and a lot of possible solutions to complex problems. So, when I read of the issues with Fitbit, I posed the question to the healthIT community; are we partly to blame?
Not all healthIT leaders consider themselves disruptors but I believe we all consider ourselves problem solvers. We like to question what's right and wrong in healthcare delivery. We like to offer possible solutions. But more importantly, we like to make others aware that there are solutions and that care doesn't have to hurt. And yet, with all the content we publish, the conferences we attend, and the consulting we do, as a collective sector, we have not been able to create sustained buy-in from either patient populations or physician communities. Buy-in, being the one ingredient needed for sustained growth has eluded even the most heavily funded of healthcare organizations. Consumers aren't flocking to portals, millennials are losing interest in the limited abilities of wearables, and physicians have abandoned hope of finding the patient-focused EHR and have instead opted for minimum met standards of compliance.  And here we sit; the disruptors, designers, the dreamers, all with the talent and savvy to get things done but doing nothing substantive. Why can't we create buy-in?


I've heard a lot of people and organizations refer to themselves as a disruptor or disruptive. While this may look good in a prospectus or on social media, very few meet the historic meaning of the word. For the sake of argument maybe we can agree; in the healthcare sector, disruption is the use of healthIT innovation to create better ways to deliver care, improve outcomes, and engage with patients, at a cost-savings. In my opinion, if a solution fails any one of the aforementioned tests, it's not disruptive.  
Patients are becoming more empowered than ever in our history. They are more resilient to changing care delivery methods and they know, more than practice leaders, how consumerism is affecting the care they receive. They're driving change. To that end. healthcare organizations have to innovate in a way that listens to patients as consumers of healthcare services.  Listening to patients does not signify a loss of control for practice managers; it's a signal that leaders are including patients in care decisions. This small action creates a vested interest for patients, creating buy-in.


LaRusso, Spurrier, and Farrugia (2015) wrote that healthcare delivery is better left to non-disruptive solutions. They concluded, "Tearing down everything and starting over is not an option in health care." While I respect the opinion of these Mayo researchers, I question their approach to the design question. In my opinion, it is not always necessary to destroy current systems in order to improve a design. Furthermore, in the healthcare sector, systems design is still in infancy. Many organizations are still moving from paper application and other outdated forms into innovative solutions, giving designers ample time to design from a foundation of interoperability and patient-centered approaches. Design can meet disruption when it is approached with the user and consumers or patients in mind. Designers need to stop designing for regulators and the c-suite, as their interests are flawed. Even CIOs are losing focus, content to chase revenues instead of changing outcomes. Regulatory compliance is a by-product or bonus of design, not the primary focus. Designing innovative healthcare solutions that are focused on the physician as the deliverer of care and the patient as the consumer of that same care creates buy-in.


And what of the dreamers? Dreamers are those empowered patients, curious clinicians, and other stakeholders who remain the silent majority while others make decisions about innovation used to deliver care and care-associated products and services. Often the most useful solutions come from a hundred crazy ideas from stakeholders. Patients should discuss with brands like Fitbit what makes a product attractive, what features are important, and what healthcare information is vital to keep their care personal.  Healthcare providers should also lend their expertise to product design and publish content designers would find useful when creating solutions. Stakeholders should ensure their voices are heard through social media platforms, focus groups, and direct contact. What can it hurt? Remaining silent about products or services designed around your health definitely hurts. Including the patient, provider, and stakeholder voice in design creates buy-in.


Finally, data is a peculiar thing. We all think we know how to use it until we don't. Data needs to be used as a learning tool. Using patient data as a segmentation tool or to tailor innovation to certain populations makes far better sense than using it to meet quality markers. That is to say, use data to measure what matters to patients and consumers. Meeting quality markers will be the result of that focus. Knowing what matters most creates buy-in.
We all want to believe the right solution will solve all the woes we face in healthcare. We'd like to believe interoperability will save the wearables industry. We'd like to believe the answer to the perfect EHR lies in getting the Dr's head out of the EHR and onto the patient. But at the end of the day, no matter where you fit into the healthcare landscape, disruptor, designer, or dreamer, buy-in is created when health becomes personal. The ultimate solution is not some shiny thing; it's a collaborative approach. How will this approach optimize my health or the health of someone I love? Perhaps failing to ask this question is why we owe soon-to-be former Fitbit employees an huge apology.

Wednesday, June 8, 2016

Response from Infoway Regarding Patient Inclusion in Partner Conference

Per our recent #hcsm chat and the info I shared regarding Infoway, I am posting the response I received. I believe this is a positive path and I hope all will see this as an opportunity to affect change.

From Infoway . . .

Hello Shereese,

Thank you for the inquiry. The Infoway Partnership Conference is open to the public. Anyone can attend and here is more information about registration:

We also have another pre-conference event happening on November 15th that is exactly geared toward patients. The information has not been posted yet but I am going to pass your information along to my colleague Christina Wong who will follow-up with you about the event with more information.

Wednesday, May 25, 2016

Speaking with Authority: 10 Behaviors HealthIT Speakers Should Adopt to Own the Room

Imagine being asked to deliver a speech on HealthIT. As a professional, the next common sense question would be, "In which area of IT would you like me to concentrate?" Now imagine the conference promoter answers, "Whatever you think our audience would like." That very scenario happened to me recently but instead of panicking, not sure whether I could produce a speech within the time frame given, I decided to take it on as a challenge. Achieving that goal also gave me an opportunity to query: What does resonate with HIT audiences and are there universal standards speakers can use to own the room on any HIT subject? I decided all speeches needed to address two areas: the subject and the visual. The following outlines behaviors I feel will work for all speakers, while being flexible on time constraints.

Subject: The three Ps
  1. Passion: Are you passionate about a particular HIT subject? It is easier to deliver on a subject you actually like.
  2. Popularity: Will your audience like the subject? All HIT subject-matter is not created equal. Try to stick with subjects that are popular or are currently affecting the industry. For example, more people will show up to hear a speech on how to protect systems from ransomware than will show up for how to install billing software.
  3. Profession: Are you an expert on the subject? You can't sell what you don't know. Your audience will more than likely have knowledge of the subject already and trying to deliver information on which you are not truly familiar could damage you credibility. 
The objectives of selecting a topic should meet at the intersection of the three Ps.
Visual: The number one thing you need to remember; you are part of the visual! Don't be a distraction from your own content. Dress appropriately.
  1. Don't start the presentation by apologizing to your audience. Don't apologize that the topic isn't sexy. Don't apologize that you're feeling a little under the weather. Don't apologize that they have to be there. Just don't apologize!
  2. Don't ask your audience if they can hear you. If they can't hear you, they will let you know.
  3. If you use PowerPoint, don't use fonts that are too small to be viewed by the whole audience and don't say things like, "I don't know if you guys in the back can see this . . .," 
  4. Don't constantly say, "I'll come back to that later. Make your point in the moment. Your audience won't remember the reference later and you'll lose the room.
  5. Don't promise to keep things short. This is impossible. You were give an allotted time to speak. Speak!
  6. Try to keep words like, "um" and "so" to a minimum or try not to say them at all. They create a distraction & eventually that's all your audience will hear.
Last, save some time for Q & A. Your audience will want to clarify information received. And there you have it; universal rules we can all use to give amazing presentations and get the next invite.

Thursday, May 12, 2016

HIT Crush Thursday: Finding Solutions that actually solve problems for independent practices

If you've been following along, you know I've been obsessively searching for health IT solutions for my behavioral health and small provider practice clients. This is no easy task. First, small practices generally lack the resources to invest in comprehensive IT solutions. Second the notion of adopting new technology and having the talent to manage it can seem daunting to a provider. Last, providers aren't marketing professionals; they're clinicians for the most part. They need simple solutions and someone to bottom-line ROI expectations for them. Add to this the need for ongoing support and continued learning options and what you have is an enormous mountain to climb. That being the case, I've been reviewing small practice solutions and I think I've identified one I can endorse.
Kareo is a provider of tech-enabled practice solutions for small providers. Being from the west coast, Kareo has their head in the clouds. Cloud-based and optimized for mobile practice management, Kareo is proving to be a credible player in the provider solution field. Not a company to rest on their growing reputation, Kareo recently announced the launch of what they claim is the first and only complete, seamlessly integrated tech platform, built for the specific needs of independent provider practices. Oh really, I said, "I'll be the judge of that!" And so off I went to YouTube and what I found had me not only glued to my screen, but also to my tablet, researching everything about Kareo's Go solutions. Having spent the last couple of days testing and stalking, I'm going to go ahead and call it; "I've got a crush on you, Sweetie Pie".
I won't go into a full review of the product; there's an excellent demo option by way of Kareo's website. You can find it here: Just click on the link to schedule a demo. That being said, here's what I like about Kareo's solution that will resonate with small and independent practices:
  1. Use-friendly website: Kareo's landing page is designed for ease of poking around and finding the right information for the right provider type. There's little guess work in finding what you need. Also, users have a chat option on every page. The layout and ease of navigation is as comfortable as a couch your favorite coffee shop. 
  2. Billing Analytics: A lot of solution providers offer analysis but what make Kareo's different is the ability to look at "How much did I bill" and "How much did I collect" with custom time periods. Why is this important? Independent providers have non-traditional growth periods. For example: community practices should see an increase in patient traffic from March to May of their fiscal year. "Why is that," you might ask. I'd tell you but that's not the focus of this post so pay attention! The ability to isolate time periods lets providers target the right information and not spend unnecessary time that could otherwise be spent taking care of patients. This is a great feature.
  3. Marketing option: Kareo's model offers a way for patient contact to be noninvasive post visit, at which time all critical physician scoring is done. That is to say, the patient can provide
    feedback, can post to social media, can get feedback, and can make additional appointments. Score! What's different about Kareo? The coaching offered by Kareo's team explains the importance of this function in a way providers can easily understand and I believe it will aid in employee and provider buy-in. 
  4. Price point: The Kareo solution offers discounts for multi-user engagement and for non-physician stakeholders. This is very important for diverse provider-types. It’s rare that everyone involved in management practice is a physician. Offering plans for non-physician providers makes this solution a smart and economical choice for independent practices. What’s different about Kareo? The prices are very indicative of Kareo's mission to bring tech within reach of independent practices and "to free doctors' hands for the important work of patient care"(Kareo, 2015).

So that's it; give me a simple solution that's packed with value and a hint of ongoing support and I'm on board.  You can visit Kareo's website here: and look for my follow-up on this post. I'm having my providers tell me what they think. Go forth and care!