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Hospital Systems Look to Third Parties for EHR Interoperability & Care Coordination

Posted by Lawrence Kerr on Tue, Sep 12, 2017 @ 06:00 AM

daniel-wirtz-369020.jpgWhen it comes to housework, even though there are more time-saving tools than ever — dishwashers, washing machines, vacuum cleaners — families today spend about the same amount of time each week on housekeeping as they did in 1900. 

Similarly, I look at all the technological improvements we’ve made in medicine over the last 20 years and wonder whether care has improved or efficiencies have been made. And a recent article got me thinking about technology integration and interoperability challenges that hospital systems are facing -- that may need to be solved sooner rather than later.

At this point, EHR and EMR adoption is widespread. There are very few medical contexts in which technology isn’t a major component of our medical practice. But the ongoing problems (like interoperability and workflow issues) presented by many technologies may be more challenging to solve than the initial implementation was.

For instance, this article looks at several hospital systems that are struggling with interoperability. The University of Pittsburgh Medical Center uses three separate EHRs — one for oncology, one for ambulatory, and one for in-patient. Of course, up until recently, none of the systems talked to each other or were interoperable.

And as we move into a value-based era of medicine, the complications that present themselves in technology become even more challenging to manage.

The example of the University of Pittsburgh Medical Center using three different EHRs in a fee-for-service era may make sense. But when medicine is value-based, it simply won’t work. Chronic, complex conditions (those that tend to be most expensive for hospitals to deal with) are often the ones that bridge multiple areas of the hospital system. And having a separate EHR for each area, that doesn’t integrate or “talk to” the others, presents costs and care coordination problems that will be unmanageable, if they aren’t already.

That hospital’s solution was to develop interoperability software (developed in house) for one EHR to communicate with the others.

Ed Mcallister, CIO at University of Pittsburgh Medical Center says that “although EHRs took healthcare in the right direction by digitizing information that was once in a folder in a drawer, they are still lacking and not the right model for documenting patient information or for sharing it. More so than a vendor product that would tie [EHRs] together… [we need a technology that would] pull the information at the point of care into a layer that is more tied to patient care than what an EHR is today”

In other words — EHRs certainly do not meet hospital system needs for medical collaboration and care coordination. And interoperability problems aren’t just about transmitting information from one EHR to the other. The issue is facilitating care for patients, even in the complex context we find ourselves. What healthcare is seeking now is true care coordination, technological support for medical collaboration, and (certainly) interoperability, so that healthcare providers can access key information about their patients.

iClickCare plays a part in meeting the demands for a system that supports true medical collaboration -- but we can't do it alone.

If your hospital system struggles with Health IT interoperability or care coordination challenges, hybrid store-and-forward telemedicine may be one piece of the puzzle. Get our pictorial white paper report on it here:

ClickCare Quick Guide to Hybrid Store-and-Forward


Photo by Daniel Wirtz on Unsplash

Tags: medical collaboration, EMR, interoperability, healthcare IT,

4 Insights on Healthcare Collaboration from Execs at Huge Hospitals

Posted by Lawrence Kerr on Thu, Oct 22, 2015 @ 07:30 AM


Being a hospital administrator has never been easy. But the increasing rate of change in medicine (and in the world) has compounded both problems and opportunities. Plus, it's so easy for administrators and medical providers to feel like they're on opposite teams. But for medicine to really change, and for our patients to get excellent care, we need to be on the same page and learn from each other's insights.

Two articles in particular encapsulated some potent wisdom from two administrators facing volatile times in huge organizations: LaVerne Council, VA chief information officer and Albert Oriol, vice president of information management and CIO at Rady Children's Hospital in San Diego.

4 things I learned about medical collaboration from two hospital administrators:

  1. Looks for ways you're not speaking the same language.
    As Mr. Oriol shared, we can be communicating with people on a medical team, but if we're not speaking the same language, we're certainly not collaborating. This can mean aides using different words to describe a wound than a surgeon is using; or it can mean a CIO speaking differently about a telemedicine strategy than a doctor. Either way, it's crucial to try to cultivate a shared language so that we can effectively share our ideas.
  2. IT is a tool for all the things we want to do, not a separate objective altogether.
    Another important point Mr. Oriol had is that IT is often siloed (as so many things in medicine are.) The truth, though, is that medical providers can think about caring for the patient as the goal, and IT as one tool. So many times, medical providers think healthcare collaboration or telemedicine are things that "someone else" is in charge of, when really it's knitted into everyone's job.
  3. Transform or die.
    “External forces and the internal complexity demand change,” Ms. Council shared at one of her first public speeches as CIO at the VA. “It is not an option. When you have that many things changing on the outside, that many things changing and needing change on the inside, we have to transform.”
  4. Buy first.
    This may sound like a detail, but orienting an organization toward "buying first" (rather than building what the organization needs from scratch) is an important mental shift. As medical providers, we don't need to reinvent the wheel -- there are a lot of great tools out there for everything from telemedicine to taking notes. Ms. Council continued: “We’ve got to ask ourselves critical questions with the finite resources we have, how best to go forward, and what is the lifecycle that will enable the veteran experience to meet the needs that we have for the future.”

We appreciate these leaders big jobs and big visions. We'll look forward to cheering them on as they take on the future in their organizations. 

For more insights into healthcare collaboration, get our free guide:


ClickCare Quick Guide to Medical Collaboration

Tags: telemedicine, healthcare collaboration, healthcare IT,

Why We Make It (Almost) Impossible for Health IT Administrators to Innovate

Posted by Lawrence Kerr on Fri, Jul 10, 2015 @ 07:30 AM


We've worked with a lot of extraordinary healthcare CIOs and health IT administrators in our time. Both at our hospital, and at the hospital systems of iClickCare users, we see tireless, creative, passionate people working to ensure that IT supports excellent patient care.

And the field is growing: A Healthcare Information and Management Systems Society workforce survey found IT hiring "consistent" even with the economic downturns we've been facing. But that growth largely doesn't represent innovation, and with a fast-changing landscape, lack of innovation can actually mean getting farther behind.. According to the survey, "hospital CIOs spend little of their time innovating. 63% said they devote between 0 and 10 percent of their time to innovation. 

We have seen how much of an uphill battle it is for health IT folks to do a great job and innovate. Just a few of the challenges include: 

  • Failure is unacceptable in the work (while innovation requires acceptance of some level of failure as new ways of doing thins are found)
  • Most health IT departments are understaffed
  • There is not enough time for innovation built into the job.

How important is innovation to CIOs and hospitals? According to Gretchen Tegethoff, a member of College of Healthcare Information Management Executives's board of trustees, "Healthcare has been in the slow lane for years and it's time for us to catch up. [For instance, a doctor told us] 'I work in healthcare during the day, and then I go home to the 21st century.'"

It may not be reasonable to expect hospital IT departments to be innovating quite so much, though. Perhaps most CIOs and IT departments in hospital systems need to cultivate stability in the IT system as their primary job, and innovation needs to be outsourced (through savvy sourcing) to outside providers.

iClickCare is joined by many other innovative providers of products and services for the medical world. We're happy that there are CIOs and great hospital IT departments that can collaborate with us, be experts in their own patients, and leave (some of) the innovation to us. 


If you're interested in telemedicine innovation, we can help with that. Click to learn more:


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Tags: healthcare IT,, CIOs

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