As you probably know by now, we assist clients in developing strategic, sustainable social media campaigns that are meaningful to their target audiences. What you may not know is that before embarking on this project, we perform a full social media assessment because every company is different and not every social media platform is right for you.

To provide advice for effectively launching a social media campaign, we’ve invited John Lynn to discuss insight into his success with social media and the Healthcare Scene Blog Network.

John (or as many of you may know him on Twitter, @techguy) is a leading social media influencer in the healthcare space, managing 14 blogs and a Twitter account with nearly 4,000 followers.

Dodge: What made you decide to begin blogging about healthcare and ultimately launch the Healthcare Scene blog network?

Lynn: Initially I just started with one blog and was really just bored on a weekend. My day job was implementing an EMR in a health and counseling center along with providing top to bottom IT support. I did have the original goals of showing my knowledge of EMR for future jobs and getting to the top of Google for the search term EMR, but otherwise I was just playing around. I saw it as a great way to learn about EMR and to pass that knowledge forward.

A few years later, I heard about the EHR incentive money when it was just “money for EMR software.”  I wrote about it really early and thanks to those posts traffic to my site exploded. I then started posting to the website on average about once a day for the next couple years. Along the way I kept adding websites to the mix and eventually decided to brand the network of healthcare IT websites The Healthcare Scene Blog Network.

Dodge: The Healthcare Scene network, which now includes an impressive 14 blogs, pushes out an enormous amount of relevant, targeted content. What’s your secret for not only staying on top of the most relevant EHR/EMR news, but keeping it fresh?

Lynn: Luckily, I now have 7-10 writers helping me to create content on the network. It would be a real challenge to create content for 14 websites by myself. With that said, I still personally create between 10-15 posts per week.

I do think I’m blessed with some special gifts to be able to create so much content that’s usually fresh and relevant. Not the least of which is a good memory and an ability to connect different stories very quickly.

However, I also believe a number of other things really help me. First, is Twitter is a great resource to find stories when the well of ideas is dry. Do a search for a relevant keyword and you’re bound to find something interesting.  Second, I believe the best writers are the best readers. When I read stories throughout my week, I’ll often come up with a post I want to write. I store those post ideas as draft blog posts on my website. I probably have 200-300 draft ideas sitting there waiting for me to write the rest of the story. Third, I try not to constrain what I write. At the end of the day, I try to create something that provides value to the reader. Once I reach that bar I feel I’ve done my job with that post. Fourth, my domain expertise really helps when writing about EMR and EHR. If I hadn’t actually participated in the grind of multiple EHR implementations, it would be hard to write as much as I do. Fifth, I try to meet and surround myself with smart people at conferences, on social media, etc. I often take kernels of an idea from these smart people and turn it into a post.

Dodge: Adoption of social media by healthcare providers and vendors continues to grow. How do you envision social media evolving for these audiences going forward?

Lynn: My gut reaction is that healthcare providers and vendors will likely take very different approaches to social media. However, one thing every organization needs to understand is that one of social media’s strengths is connecting people. Behind every Twitter account is a person. Behind every visitor to your blog is a person. Behind every like on Facebook is a person. Behind every LinkedIn profile is a person.

For healthcare providers, I’d suggest that they test out the social media waters and see if they like it. While many are likely concerned about patient interactions on social media, they can still interact with other doctors, experts in the field and other people who can support their practice. Start where it’s comfortable and provides real value and expand your use of social media over time.

For vendors, it’s going to be increasingly important to have an online presence. My most important suggestion to vendors is to create an authentic voice. A number of vendors have asked me Healthcare Scene could do their social media for them. While there are certain aspects of social media you could outsource, I think you miss out on a lot of social media value if the company isn’t the main voice of the company. I think the better model is to have a social media expert help your company create a culture of social media use.

Both of these audiences will need to have some social media presence as more and more people look to social media as ways to understand and interact with businesses. You can learn a lot about a business through their social media presence.

Dodge: So, you’ve already grown from one blog to 14; what can your readers look forward to next?

Lynn: I don’t have any big expectations to keep growing the network larger and larger. I’m sure we’ll cautiously add blogs to the network if we can do so in a sustainable way. For example, we’re just launching a new EMR & EHR Asia blog. Instead, the plan is to focus our efforts on making the existing websites more and more useful to those who read them.

I’ve also started a related site called Influential Networks which in some ways is an extension of the Healthcare Scene network. Influential Networks embraces social media and the new world of integrated marketing in a way that’s never been done before in healthcare IT. It will be a lot of fun to see it evolve as new media continues to evolve.

In many ways, I’m still doing what I did when I started. I’m just having a good time doing something I love.

As they say, “the early bird gets the worm.” Healthcare providers who qualified for Stage 1 meaningful use this year got a bit of a reprieve on Stage 2 compliance when CMS announced late last month that they could take until 2014 to meet the requirements—a year later than previously planned. And those hospitals and doctors who are on the ball and attest to meaningful use Stage 1 requirements by year’s end can qualify for incentive payments in 2011 and 2012. Those who said they would attest for Stage 1 in 2012, and, thus, Stage 2 in 2014 will need to stick to the original schedule.

I applaud CMS for its decision to postpone the Stage 2 deadline given that a decision on the requirements, which are a work in progress, isn’t expected before next summer. I also appreciate their efforts to promote EHR adoption sooner rather than later, a message that has resonated with nearly 43 percent of physicians that are planning to apply for meaningful use incentives having computerized systems that would allow them to meet at least eight Stage 1 “core set” objectives, according to statistics from the Centers for Disease Control and Prevention (CDC).

However, I find the language in the CMS press release announcing the delay a bit curious: “Doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012.” This coming only 30 days before the deadline. Even for those technically adept providers with who have been in an EHR environment for some time, proving meaningful use is not a slam dunk. Among the more difficult requirements is ensuring that physicians—and the EHR—are collecting enough of the right quality measures and public health information to support CMS reporting requirements. It demands providers have a compatible technology and the appropriate user-training mechanisms in place.

I would hope that the proverbial carrot to entice providers into deploying an EHR doesn’t cause them to rush their EHR projects and risk a deployment error that sets them back with added costs and delays that could effectively negate the financial reward. Let’s remember what EHR utilization is really about: greater efficiencies and increased patient safety—two benefits with lasting and returns. Considering the host of other regulatory revamps demanding high technical compliance, including HIPAA 5010 and the ICD-10 conversion, healthcare organizations would be wise not to rush their EHR project just for the monetary incentive.

HealthTECH Live: HealthTECH Live is a news aggregator focused specifically on news relating to health reform and health technology. The site is regularly updated with news around the Web that is of interest to anyone in healthcare or anyone involved in marketing or PR for healthcare. The site is divided into a few basic categories, including Health TECH, Healthcare Reform, EHR and EMR, and HITECH/HIPAA. Each category contains the most recent developments from a wide variety of news outlets, both traditional and online.  There is also an option for registered users with a free login to submit a story that is not already on the site

Past Words of the Week

Revolution Health, Buffer, Twilert, nptech, Taweet, MedicalCavity, DoAT, Turntable.fm, iMedix, Twylah, Masher, Proxlet, Geeje, Google+, SocialVisor, Scribd, Pinterest, Graspr, White hat, Screenr, dushare, MEDgle, PostPost, Deals, SPOT Healthcare, Evernote, dlvr.it, Bounce, iTriage, popurls, Trunk.ly, Dropbox, Storify, Newsvine, Layers, Thsrs, #tagdef, Check-in, MDJunction, Blekko, Healthline, Spindex, Vanilla, Twingr, Tweetbeat, Social Media Policy, infoMedMD, Health Care 3.0, Groupon, icyou, #MDchat, Quality 101, MedlinePlus, HITSphere, URL X-ray, Mashup, Blog Talk Radio, TweetedRanks, Ping.fm, Digsby, Qik, Posterous, Ning, API, Lifecasting, Crowdsourcing, Meme, Social bookmarking, Trackback, Twitter Grader, Authority, TweetBeep, Compete, Astroturfing, WEGO Health, BackTweets, PDR.net, socialmention, Twazzup, Health Exchange, Health Tweeder, DIDGET, Thoora, Google Buzz, bit.ly, E-patient, Alltop, mHealth, Augmented reality, OpenID, ROI, #hcsm, Medpedia, Almost.at, Hashtag, FollowFriday, Beta, Microblogging, Sidewiki, Meta tags

Two years ago, many of us in healthcare IT were wowed by the creativity found in Ross Martin’s three part “interoperetta.” The video summed up the complexities of the Health Information Technology for Economic and Clinical Health (HITECH) Act in just under four minutes through the lyrical mastermix. Check out our blog post “Singing the praises of the HITECH Act” to see the video if you happened to miss it.

While HITECH was the word on the street in 2009, Ross Martin is back again with yet another entertaining and creative video… this time with an edge! For 2011, Martin has taken on Meaningful Use, through his “Meaningful Yoose Rap” and we certainly couldn’t pass up the opportunity to share his unique lessons on how physicians can get yo’ 44 g’s for doing meaning yoose!

Ted Wojno, MD is director of Oculoplastic and Orbital Surgery at the Emory Clinic. In the following entry, he weighs in on how healthcare reform is impacting the physician.

1. What impact have recent healthcare reform initiatives, such as the HITECH act, had on your organization?
In keeping with the HITECH Act, Emory Healthcare (Atlanta, Ga.) has adopted an electronic medical record (EMR) and has begun phasing it in over the last year.  As with any major change in a large organization, the conversion has been painful.  From my personal perspective, the losses have outweighed the gains to date. 

• We adopted a “one size fits all” approach.  The EMR system we purchased from Cerner is more of a hospital-based system and more amenable to use by a physician who spends 30-60 minutes with each individual patient such as an internist.  It is not user-friendly to a physician like myself who sees 25+ patients on a Tuesday morning and 50+ patients all day Wednesday and spends the rest of the time in surgery.  The use of the EMR adds one to two minutes to each visit.  This is not significant for someone who spends 30 minutes on a patient encounter but adds one to two extra hours to my day greatly decreasing my efficiency and making my patients wait longer.  The extra time is taken up by the painfully slow “mouse clicking” between pages in the EMR representing previous visits, labs, MRI’s, etc.  Normally this would take only a few seconds in reviewing a paper chart.  Also, one needs to continually keep logging in from patient to patient.
•  In ophthalmology, we draw pictures in the patient chart.  Our EMR does not have this capability so we continue to use paper in the office visit and then have a clerical person scan the visit into the computer.  This has of course, turned out to be very expensive.
• In an effort to speed up the patient flow, the technician now photocopies the last encounter for each patient (office visit, surgery, etc.) and places it in the room for the doctor to see.  This too, has greatly increased our expenses and is a poor use of technician time.
• Prescription writing takes longer on the computer than it does by hand.

In short, since high volume physicians = high profitability, anything that decreases physician productivity will decrease profits (and physician satisfaction).

2.  How is your organization moving towards meeting meaningful use criteria? What future impact do you feel the new initiatives will bring?
We are currently “reporting clinical quality measures and public health data” on all Medicare patients.  The physician asks if the patient is a smoker and if so offers referral for smoking intervention and then documents this in the record in a check box.  We must also check a box that documents that we used the EMR. 

At this point we do not “submit orders” in the Emory Clinic electronically but almost all orders are done electronically at Emory University Hospital.  Again, orders submitted by the physician in the EMR take much longer than writing them out by hand.  This has been a source of great dissatisfaction for many of us.

3.  What is your outlook on the future of healthcare technology?
Clearly the electronic medical record is here to stay.  To date there have been woefully few (if any) good studies that have shown that the EMR has improved physician productivity, decreased overall costs, and decreased medical errors despite glowing reports by the companies that make the software.  Personally, I have erroneously entered more improper medication orders over the last year than in my entire career.  This is simply because it is easier to “point and click” wrong than to accidentally write the incorrect dose for a medication.  I have had several instances where even the drug that showed up on the order was completely different from what I “clicked” on.  Fortunately, all of these errors were picked up by nursing or pharmacy staff.  Often, it has been impossible to understand how the error happened.  It is my impression from speaking with other physicians and nursing staff that medication errors have increased overall.  We would all like to believe that this represents a “learning curve” with the new technology but only time will tell.

On the positive side, it is easier to obtain a complete record of the patient’s history by opening the EMR when I need it.  It has been easier to view radiologic studies on my patients since I can pull them up on the computer and no longer need to walk over to the radiology department.  Again however, for some inexplicable reason, it now takes longer to get some reports logged into the computer and visible on the EMR than it did to receive a paper copy of the report.

Patients now come to the office with their radiologic studies on a CD instead of a folder of films.  It takes longer to “load up” the CD than it did to leaf through the standard type “xray”.  Additionally, there appears to be an unlimited number of software programs in use so the physician must often “learn” how to access the information on the CD.  This is frequently very time consuming and frustrating in the middle of a busy office day.

4.  Are your patients able to communicate with you via email, and how do you see electronic doctor-patient communications evolving in the future?
I do not encourage most of my patients to email me but continue to ask them to call me. It takes much longer to type a response to patient’s questions than to speak the answer over the phone. Often a typed answer from me generates more questions from the patient and we end up with multiple back and forth emails that could have been solved by a very short phone call.

On the positive side, the occasional patient who lives far away can email a picture of “the problem” to me that is better than a verbal description. This is a very small subset of patients. Clearly some of my patients use email to substitute for an office visit (multiple page letters).  If this becomes more routine then we feel that we should be able to render a charge for the time spent responding to them.

My overall feeling at this point in time is that the electronic health record has decreased the time that our ancillary staff spends on issues that used to involve paper and increased the time that the physician spends on those same issues. Since time spent by secretarial and clerical staff is relatively low cost compared to the physician’s time it is so far a money losing proposition. Given the large number of software programs (I use four different programs that have nothing in common at the various hospitals I work at) uniformity would be helpful. For physicians to enthusiastically adopt the technology it must save time and not waste time. That has not yet happened. Big business has done a much better job of selling the government on the technology than providing the physician with something that really works.  All this will of course be meaningless even if the technology does not improve. This is simply because the current generation of physicians in training will never know anything but the EMR and will have nothing to compare it to. They will accept it as “the norm”. 

Ted Wojno, MD is director of Oculoplastic and Orbital Surgery at the Emory Clinic and holds an endowed chair in the department of Ophthalmology at the Emory University School of Medicine.  He has written over 80 papers and book chapters in the field of ophthalmology and given over 100 lectures at local, national and international meetings.

Quality 101: Quality 101 is a new site developed by the HIMSS Patient Safety & Quality Outcomes Committee to help healthcare vendors and providers understand the details of quality measurement and improvement as it relates to EHRs and meaningful use incentives. The site is divided into several sections, such as The Basics, Key Industry Players and Public Reporting, and it serves as an aggregator, providing updated information and data from several resources. New phases of the site will be rolled out each quarter.

Past Words of the Week
MedlinePlus, HITSphere, URL X-ray, Mashup, Blog Talk Radio, TweetedRanks, Ping.fm, Digsby, Qik, Posterous, Ning, API, Lifecasting, Crowdsourcing, Meme, Social bookmarking, Trackback, Twitter Grader, Authority, TweetBeep, Compete, Astroturfing, WEGO Health, BackTweets, PDR.net, socialmention, Twazzup, Health Exchange, Health Tweeder, DIDGET, Thoora, Google Buzz, bit.ly, E-patient, Alltop, mHealth, Augmented reality, OpenID, ROI, #hcsm, Medpedia, Almost.at, Hashtag, FollowFriday, Beta, Microblogging, Sidewiki, Meta tags

As marketers, we try our best to stay ahead of the curve when it comes to social media, its tools and its practices, and we do our best to communicate the advantages of a strong online presence to our clients and our bosses. In healthcare, we often take for granted how the Web is being used by consumers. Sixty-one percent of American adults use sites such as WebMD to find healthcare information, surgeons tweet from the OR to update concerned family members, and “e-patient” is a term with its own Wikipedia entry.

So imagine my surprise when I came across this article from Healthcare IT News on “ePediatrics.” This article references two surveys, each concerning trends in the desire and ability of parents to communicate electronically with their children’s doctors. The first poll, conducted by C.S. Mott Children’s Hospital in Ann Arbor, Mich., and Knowledge Networks, reports that approximately 50 percent of parents believe e-mail or online communication would be useful for tasks such as requesting prescription refills or medical records. However, the same poll reports that less than 15 percent of parents are currently able to communicate online with their children’s healthcare providers. In a similar study by Johns Hopkins Children’s Center, 90 percent of parents said they would like to be able to e-mail their pediatrician, but only 11 percent can currently do so.

Healthcare providers have two main concerns when it comes to electronic communication. The first is reimbursement for electronic services that require staff time. A doctor’s office, after all, is a business. While e-mail seems quick and easy, from the doctor’s perspective, it can be tantamount to a free consultation, as many insurers will not pay a doctor for these virtual visits. This trend is beginning to be reversed, however, led by Aetna and Cigna, who in 2008 began reimbursing doctors for online consultations. As a result of this, services have been developed to help the doctor manage the virtual appointment process, and the fees charged by these companies are paid for by the patient. 

The second concern shared by many healthcare providers is that an online consultation or e-mail response is not an adequate substitution for a doctor examining a patient in person. This concern extends to the possibility that doctors who provide advice through e-mail could face medical liability if that information is inaccurate or lacks the standard of quality that their patients have come to expect.

While I am sensitive to these concerns, I believe that there can be compromise when it comes to a patient or a parent being able to communicate with a doctor over the Internet. If policies are put into place with strict guidelines for what activities may take place via e-mail and other electronic communication, providers can work to alleviate these concerns, instead of feeling pressured to engage in an activity that they aren’t comfortable with. As consumers, we need to demand the ability to communicate electronically with our doctors, and the insurance industry needs to recognize the importance of this in improving healthcare delivery, maintaining accountability and controlling costs. Personally, I would love to see a deadline for the meaningful use of e-mail, to go along with the deadline for EHR’s.

As I near the end of my pregnancy, I’m holding down my daytime gig of being a PR/marketing professional in HIT, but I’m also moonlighting as a professional patient. And, at the same time this is happening, the rollout of the ARRA incentives for meaningful EHR use draws closer. We’ve seen the articles lamenting the barriers, others singing the program’s praise and some recently on the impact this will have on vendors and its potential “for bringing measurement, data-based decision-making and accountability to the practice of medicine,” according to Dr. David Blumenthal in a New York Times post.

Before starting this pregnancy adventure, I didn’t have an intimate understanding of my providers’ use of technology. Now, almost 40 weeks later and immersed in a myriad of visits, I’ve been granted a peek into the world and opinions of my medical team as I often couldn’t avoid my curiosity about their use of EHRs or lack thereof, and their feelings about ARRA and meaningful use. Do they think that utilizing an EHR in accordance with the terms set forth by meaningful use will bring better measurement and clinical support into their practices? Are they already using a system of some sort on its most basic level? With so many test results and forms needed by OB patients, why isn’t there a PHR used to create greater efficiencies?

My primary OB for example, a group of savvy, younger physicians from a variety of backgrounds, has taken a hybrid approach. None of the nurses taking vitals can tell me what EHR they are using, just that it makes entering weight and blood pressure easy. And what about the physicians? After numerous appointments and regularly seeing only paper charts, one OB recently showed up with a tablet PC to my visit. A previous user of a full-fledged EHR at another job, Dr. A—to protect her identity—felt that using an EHR as fully intended was not only cumbersome, but really generated more billings and did not necessarily lead to better clinical care. When using the system and entering all the notes and fields required, the previous EHR still took Dr. A more time to use per patient than traditional charting despite being well beyond the implementation phase. Much happier with the approach she currently uses, my OBGYN practice now uses an EHR to track some basics and have paired it with a document management system for electronic scans of certain paper forms, resulting in a somewhat comprehensive patient view.

Shifting to the search for our pediatrician, one of my primary questions was centered on whether or not an EHR was used in the practice. Yet again, the group we selected ultimately plans to adopt an EHR to avoid penalties, but not any time soon. In searches thus far none of the existing EHRs provide what the group considers to be adequate reporting capabilities or tracking for a pediatric setting.

In our world we talk about EHRs saving time and costs, allowing the providers to see more patients and improving clinical care. They most certainly do for some, but not for others it seems. What’s more, despite the technology, the paper-based forms and hard copies of patient charts are abundant. One step at a time is certainly necessary, but what will it take beyond the ARRA incentives and eventual penalties to move physicians to fully implement and use EHRs, make them feel comfortable with the technology and eventually create the efficient, “data-based decision-making” setting we’re striving for? Between these specialty healthcare settings I’ve encountered in my recent experiences, it’s easy to see firsthand the industry adoption issues that we face. Clearly the topic is top of mind in these practices. While we have numerous examples of success stories, I can only imagine there are more practices in situations like mine than adopters out ahead of the curve. What have your experiences been, how does your background impact the way you look at the rapidly changing face of healthcare when you have to play the patient?

As the healthcare industry discussions continue surrounding the definition of meaningful use for electronic health records (EHRs), others have been seeking to define meaningful use as it relates to more appealing concepts.

Photo credited to Neil Versel’s blog with the original source as Pat Wise of HIMSS.