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    As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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Five [5] Reasons to Govern Medical Provider Data

The Heart of the Health Care Enterprise

By http://www.MCOL.com

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Product DetailsProduct DetailsProduct Details

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A.I. Adoption and Perceptions in Healthcare

By http://www.MCOL.com

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Assessment: Your thoughts are appreciated.

BUSINESS, FINANCE, INVESTING & INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

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The 10 Worst Technologies of the 21st Century?

 MIT Technology Review

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 MIT Technology Review

The latest issue, MIT Technology Review revealed 10 breakthrough technologies, chosen by Bill Gates, that he thinks will change the world for the better. We thought it only fair (and fun) to come up with a corresponding list of 10 “bad” technologies.

A hard choice: What makes them bad? Well, it could be because they fail to achieve good aims, or succeed in wicked ones. They could be harmful, flawed, or ahead of their time.

Sad: The Segway turned out to be an expensive scooter that makes you look silly. Google Glass, on the other hand, makes the list as a decent technology that just lacked decent enough uses when it launched.

Bad: Electronic voting made the cut for making elections more vulnerable. The CRISPR babies born in November 2018 are on there too, because indiscriminate uses of the technology should worry us. Data trafficking, where our data is shared and used without our control, is undermining freedom and democracy—it had to be one there.

Mad: Of course, some inventions have no redeeming features whatsoever. May we present: selfie sticks.

AssessmentRead the full list here.

BEWARE THE IDES OF MARCH

Dictionary of Health Information Technology and Security

 [Foreword Dr.Mata MD CIS]

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What are the Most Impactful Technologies in Healthcare Today?

A Survey

By: http://www.MCOL.com

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Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

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***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 

On Health Economics; writ-large

A Big Data S.W.O.T Analysis

[By staff reporters]

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big data

[A Pharmaco-Economics Journal Report]

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MORE: Healthcare Economics

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

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Product Details

An EHR State of Mind [video]

Two Rap Videos

[By staff reporters]

Can you believe these videos are two years old?

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https://youtu.be/gaLi0ak5D-o

https://www.youtube.com/watch?v=3TveJLAi_y4

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Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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Product DetailsProduct Details

On Healthcare Data Aggregation

 Electronic “Disease” Registry Data Used to Identify Care Gaps

By http://www.MCOL.com

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Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

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Product DetailsProduct Details

 

Healthcare Technology in the News

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By Staff Reporters

Healthcare consumers show mounting interest in virtual, on-demand care
Fierce Healthcare, August 14, 2017

Transforming the mHealth Experience With Digital Health Assistants
HIT Consultant, August 14, 2017

Google buys smartphone health monitoring startup Senosis
Pharma Phorum, August 14, 2017

Could Trump’s Opioid Emergency Boost Telemedicine, mHealth Use?
mHealth Intelligence, August 11, 2017

Trump Administration Takes on VA Telehealth Opportunities
The Natonal Law Review, August 11, 2017

More and more businesses are offering telehealth services as an employee benefit
MedCity News, August 9, 2017

VR Glasses Give Doctors a New mHealth Tool to Treat Concussions
mHealth Intelligence, July 31, 2017

New Senate bill seeks to reduce restrictions on telemedicine use
MobiHealth News, July 31, 2017

The allure of health care for tech giants
Axios, July 20, 2017

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Health Information Technology [EMR] Update

2014 to 2017

 

 

 

 

 

 

By D. Kellus Pruitt DDS

Three years ago

“When Patients Fear EHR – When patients believe paper medical records are safer and more private than electronic ones, their health can suffer. Many members of the public mistakenly believe electronic health records (ehrs) are less secure than paper files. Magnified by misinformation and political distortion of facts, an unnecessary fear has taken root in the minds of many consumers — often with serious consequences.” 

-Mansur Hasib

Cybersecurity Professional – Author and Speaker in commentary for informationweek, July 28, 2014

Http://www.informationweek.com/healthcare/electronic-health-records/when-patients-fear-ehr/a/d-id/1297519

This week 

“Doctors claim medical records system puts patient safety at risk – PROBLEMS with Queensland Health’s electronic medical record system are angering health workers, with fed-up senior doctors circulating a document slamming the technology and those in charge of it.”

-Kara Vickery and Janelle Miles – The Courier-Mail, July 25, 2017.

Http://www.couriermail.com.au/news/queensland/doctors-claim-medical-records-system-puts-patient-safety-at-risk/news-story/dc18cb388552eb4d179629c298a28408

“300,000 records breached in ransomware attack on Pennsylvania health system – The breach on Women’s Health Care Group of Pennsylvania was discovered in May, but hackers had unauthorized access to the system as early as January.”

-Jessica Davis – Health Care IT News, July 26, 2017

Http://www.healthcareitnews.com/news/300000-records-breached-ransomware-attack-pennsylvania-health-system

“HIPAA Data Breaches, Cyber Attacks Reported by 47% of Orgs – KPMG found that there was a 10 percentage point increase in reported HIPAA data breaches or cyber attacks from 2015 to 2017.”

-Elizabeth Snell – Health IT Security, July 27, 2017

Https://healthitsecurity.com/news/hipaa-data-breaches-cyber-attacks-reported-by-47-of-orgs

“Doctors frustrated that electronic records steal time from patients – Dr. Rebekah Gardner has to make a choice each time she sees a patient in her Rhode Island office: she can scroll computer screens and click boxes, or she can focus on the patient and take home the computer work.”

-Ronnie Cohen – Reuters, July 28, 2017

Http://www.reuters.com/article/us-health-records-electronics-iduskbn1ad2gt

“Plastic Surgery Associates data breach: Patients’ records, payment card details possibly compromised – The company said it discovered that some of its systems were infected with ransomware in February.”

-Hyacinth Mascarenhas – International Business Times, July 29, 2017

Http://www.ibtimes.co.uk/plastic-surgery-associates-data-breach-patients-records-payment-card-details-possibly-compromised-1632555

Conclusion

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Update on Social Determinants of Health Data Usage

SDOH is “Hot” in  Healthcare Today

http://www.MCOL.com

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Conclusion

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The Top Medical Specialties with the Biggest Potential in the Future

The Medical Futurist

[By Bertalan Meskó, MD PhD]

Some say technology will replace 80% of doctors in the future. I disagree.

Instead, technology will finally allow doctors to focus on what makes them good physicians: treating patients and innovating, while automation does the repetitive part of the work.

While every specialty will benefit from digital health, some will especially thrive due to these innovations.

Here, I enlisted the medical fields with the biggest potential for development in the future. Read more.

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Conclusion

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One Man’s Quest to Hack His Own Genes

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A Repost by Antonio Regalado

When Brian Hanley set out to test a gene therapy, he started with himself

When Brian Hanley set out to test a new gene therapy, he needed a subject. So, he started with … himself.

In a plastic surgeon’s office in Davis, California, Hanley had genes, which he had designed himself, injected into his thigh. The hope: they would make his body produce more of a potent hormone that would hopefully increase his strength, stamina, and life span.

Hanley has a PhD in microbiology, but his experiment is independent, unapproved by the FDA, and funded by savings. He claims to be “informed consent personified,” while ethicists argue that “experimenting with yourself is a very, very deep conflict of interest.”

Our own Antonio Regalado met Hanley to find out why he did it, what he thinks his project could prove—and how he prepared for the possibility of something going wrong.

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Conclusion

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Cyber-Risks in Banking

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By Ibrahim Jaafaru

This is a review of a white paper by Longitude Research that talks about Cyber-Risks in Banking.

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346_1

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Cyberrisk in Banking

Cyber security is a complex and multifaceted challenge that is growing in importance.

Conclusion

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Generational Attitudes Toward HIT

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By http://www.MCOL.com

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graphoid101916

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MORE: foreword-mata-2

MORE: Glossary IT Terms

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Navigating Health Care Integrated Delivery Networks

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It’s Complicated

http://www.MCOL.com

*** infographic100516

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Conclusion

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10 Reasons Why People Should Not Fear Digital Health Technologies

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Fear NOT!

By  Bertalan Mesko, MD PhD 

10 Reasons Why People Should Not Fear Digital Health Technologies

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e061d80a-6884-4496-b9a9-d910c7d54f15

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Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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HDS

HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET

      Product DetailsProduct DetailsProduct Details

 

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Are Paper MRs Safer than EMRs?

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Paper is Safer!

1-darrellpruitt[By Darrell K. Puitt DDS]

“Ransomware Attacks Can’t Hide from HIPAA Anymore – Hospital and health system executives are on notice: Come clean about ransomware attacks as early as possible or be prepared to face sanctions.”

By Scott Mace, for HealthLeaders Media, July 19, 2016.

http://www.healthleadersmedia.com/technology/ransomware-attacks-cant-hide-hipaa-anymore#

Dean Sittig, a clinical informatics professor at University of Texas Health Science Center and the Houston UT-Memorial Hermann Center for Health Care Quality and Safety, tells HealthLeaders,

The new HHS guidance is going to really ratchet up people’s attention, because now you’re also talking about big fines from the government, as well as the effects of the ransomware.”

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Show Me the Money?

“Survey: Nearly Three Quarters of Physicians Say They Haven’t Seen ROI From Electronic Records.”

By Matt Goodman: [Dallas/Fort Worth Healthcare Daily, July 21, 2016]

http://healthcare.dmagazine.com/2016/07/21/survey-nearly-three-quarters-of-physicians-say-they-havent-seen-roi-from-electronic-records/

Conclusion

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Product Details

http://www.BusinessofMedicalPractice.com

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Top 40 Medical Technology Trends

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Changing Technology Trends

Bertalan Meskó, MD, PhD

By Bertalan Meskó MD PhD

How The Top 40 Medical Technology Trends Changed In 3 Years

Free Guide And Infographic http://bit.ly/1XxSA3g

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26a6e234-8f5a-4a9b-87fc-5ce6168c0d30-original

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Conclusion

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Healthcare Technology Purchasing in 2015

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By Peer 60 and eVisit

Amount of Dollars Invested

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hitn_marketshare_infographic

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Conclusion

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EMR Security Risk [No protocol for physical emergencies]

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BEWARE “OLD-FASHIONED” CYBER SECURITY PHYSICAL RISKS

By Shahid N. Shah MS]

Shahid N. Shah MS

In the event of an emergency [likes now storm Jonas last week], a well defined contingency plan helps the team to allow for data restoration in addition to providing physical security. A contingency plan is usually used when there is an emergency, for example when there is an outage. During the crisis it is important that the doctors still have access to EMRs/ePHI so that the quality of care is not compromised.

Major Mitigation:

Based on the size of the physician’s practice, the contingency plans in place may vary. For small doctor’s offices, the whole staff may need to be involved in restoration. In the case of large physician practices, authorized personnel may need to be accompanied into the buildings by guards.

A contingency plan should be in place that ensures the right people have access to where the PHI is physically housed. This would mean that there needs to be procedures and processes that are well established so that in the case of an emergency, authorized people that have access can retrieve the PHI or even make a back up copy of the PHI data.

For example, this can mean bringing up the application in another data center if the primary data center housing the application becomes inaccessible. This should be done so that the physician’s have uninterrupted access to their patient’s PHI even in the event of an emergency.

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winter solstice

http://www.BusinessofMedicalPractice.com

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Assessment

Periodic third party audits of contingency plans and mock emergency drills can help ensure that this risk has been taken care of and mitigated.

Conclusion

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Emerging PATIENT Collaborative Medical Marketing Trends

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Seeking End-to-End Solutions?

DEM blue

[By Dr. David Edward Marcinko CMP® MBA]

http://www.BusinessofMedicalPractice.com

Given today’s economic and political environment, with its’ increasing competitive pressures, medical practices are focused more-than-ever on patient acquisition and patient retention. Modern medical practices are teaming together to offer comprehensive end-to-end solutions.

If you are partnering with other healthcare organizations to pool in your expertise, offer joint solutions and take up joint medical marketing and patient communications programs, be careful how you execute and about what you agree with your partners on sharing patient databases.

Policy

It is advisable to formulate a simple and clear privacy policy and adhere to that in the partnership agreements. Comply with the policy at all patient touch points. Communicate this very clearly with your partners and patients prominently in all your channels of communication. Inventory your data collection processes and gateways. Select appropriate projects to add security to your data across extended networks and partners.

Note there is no silver bullet to protect the privacy. Privacy compliance is as much a business issue as it is a technical issue, sometimes more so.

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value

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Implications for Patient Strategies

While you are formulating and implementing privacy policies; you need to address the following questions:

  • Do your patients respond to your practice’s privacy strategy? It is not enough to have a privacy policy that is so confidential no one is aware of that. It is imperative for practices, once they implement their privacy strategies, to understand how patients are responding and loop the feedback to fine-tune policies accordingly.
  •  How do you consider the impact on the patient from every privacy decision you make? Every privacy decision made will impact the patient and your practice; but to what extent? How do you determine this impact? Some of them will be patient-facing and some will be in the back–end. This step is essential so that you can make appropriate decisions and make optimum usage of resources.
  • Will your medical practice operations support the privacy initiative? Privacy enablement requires resources and training with perhaps no immediate, apparent short-term value-add to the top-line or bottom-line. Medical practices that take a proactive view of privacy enablement as cost of doing business in the 21st century will benefit. Practices still need to adopt critical processes and technology that agree with their resources and gradually privacy enable in an incremental way.

Role of Technology

There is no technology silver bullet. Privacy enabling a practice is composed of elements of company loyalty towards patients, commitment to build long lasting and profitable patient management by building trust, and engaging cross-functional teams that can pick and deploy suitable data security across the network.

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cyber

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Steps

Here are some salient steps for secure data management that affect technology choices of any medical practice:

  • Privacy-compliant database development – healthcare organizations have to “listen” and record what patients are saying, and if and how they prefer to be contacted, or not at all. All these details will have to be stored in a secure database, which is regularly refreshed with the outcome of practice communications with patient. This will be the central repository that the office draws upon to design and execute consistent and privacy enabled patient communications.
  • Protect the data across the practice, from group to group, area to area, or from network to network. It is not enough for a medical practice to protect data from external intruders, but also from internal data abusers. It is not enough that patient data is secure during transmission at the patient touch point. It also needs to be safe where it is stored. It is not unusual to have patient data stored or lying around where it is accessible by internal intruders. Therefore it is imperative for medical practices to go beyond traditional firewalls to have multi-layered security at the data level.

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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***

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About the lack of ePHI encryption in transmission and at rest?

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 e-Patient Health Information is Vulnerable!

Shahid N. Shah MS[By Shahid N. Shah MS]

ePHI is vulnerable to be compromised in all the states it is in. Whether it is at rest (in databases and files), or in motion (being transmitted through networks), or in use (being updated, or read), or is disposed (discarded paper files or electronic storage media).

An extra layer of security

Using encryption puts an extra layer of security to ePHI because even if someone gains access or reads ePHI, if it is encrypted then the chances of ePHI getting compromised diminishes. It makes the data unreadable and unusable by unauthorized persons. When ePHI is transmitted through networks, it is possible that it will be accessed by unauthorized persons, thus compromising ePHI. These type of unauthorized access hacking may not be immediately known, but can cause many damages.

Major Mitigation

ePHI should be encrypted and there must also be reasonable and appropriate mechanisms in place to prevent access to ePHI so that it is not accessed by persons or software programs that have not been granted access rights.

There are many different encryption methods and technologies to encrypt data in motion (SSL, VPN) or at rest.

So, choose the methods and technologies that best meet the physician’s office requirements.

***

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Success criteria

A risk analysis/assessment reports will provide a clear indication of whether these type of risks exists or has been mitigated with appropriate controls.

Assessment

Auditing logs that track access to ePHI can be verified periodically to check if there has been unauthorized access by persons or software programs that have not been granted access rights.

More:

About: Meet Shahid N. Shah MS [Our Newest IT Thought-Leader]

Conclusion

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

***

On the lack of encryption of ePHI in transmission and at rest

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Shahid N. Shah MS[By Shahid N. Shah MS]

ePHI is vulnerable to be compromised in all the states it is in. Whether it is at rest (in databases and files), or in motion (being transmitted through networks), or in use (being updated, or read), or is disposed (discarded paper files or electronic storage media).

Using encryption puts an extra layer of security to ePHI because even if someone gains access or reads ePHI, if it is encrypted then the chances of ePHI getting compromised diminishes. It makes the data unreadable and unusable by unauthorized persons. When ePHI is transmitted through networks, it is possible that it will be accessed by unauthorized persons, thus compromising ePHI. These type of unauthorized access hacking may not be immediately known, but can cause many damages.

Major Mitigation

ePHI should be encrypted and there must also be reasonable and appropriate mechanisms in place to prevent access to ePHI so that it is not accessed by persons or software programs that have not been granted access rights.

There are many different encryption methods and technologies to encrypt data in motion (SSL, VPN) or at rest. Choose the methods and technologies that best meet the physician’s office requirements.

Success criteria

The risk analysis/assessment reports will provide a clear indication of whether these type of risks exists or has been mitigated with appropriate controls.

***

secret

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Assessment

Auditing logs that track access to ePHI can be verified periodically to check if there has been unauthorized access by persons or software programs that have not been granted access rights.

More

ABOUT 

Mr. Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100″ Award, in 2009. Over a twenty year career, he built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications. He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator. Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland. 

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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An MD’s Venture Back to Microsoft Windows 10

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A Review

By Robert E.H. Khoo MD FRCS(C) FACS

http://www.colondoc.com.

***

disruptive

***

My Venture Back to Microsoft – a Review of Windows 10

Conclusion

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***

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

***

The Economic Impact of UnHealthy Bio-Metrics

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For 20102 – 2014

http://www.MCOL.com

***

ImageProxy

***

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***

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

***

Got a Beef With Your EHR?

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So – Go Tell the Feds; Already!

[Staff reporters]

Are you a doctor or medical provider unhappy with your electronic health records system, or unable to share health data because of the actions of other organizations?

Or, are you a healthcare consumer who can’t access your EHRs? The feds want to hear from you.

The Office of the National Coordinator for Health Information Technology has a new online complaint website, healthit.gov/healthitcomplaints. It is the first formal complaint process that ONC has had throughout the journey to EHR meaningful use.

***

Source: Joseph Goedert, Health Data Management [9/18/15]

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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd.  Edition]

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  [Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]

***

Health Organizations Slammed by Cyber Breaches

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Top TEN Health Organizations Slammed by Cyber Breaches

Last year, the FBI released a private notice to the healthcare industry warning providers that their cybersecurity systems are lax compared to other industries, according to Reuters.

The notice reportedly stated, “The healthcare industry is not as resilient to cyber intrusions compared to financial and retail sectors, therefore the possibilities of increased cyber intrusions is likely.”

More: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/ten-health-organizations-slammed-cyber-breaches?page=0,1

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lock

READ: Under Attack: Executives Face Rising Cybersecurity Risks

***

Considering the recent outbreak of major breaches affecting the industry, it appears that those concerns were warranted. The healthcare industry accounted for 43% of major data breaches reported in 2014, according to the Identity Theft Resource Center.

While 2015 data are not yet available, the steady stream of cybersecurity breaches has continued, and many organizations have already reported major breaches. Here are 10 recent victims.

Conclusion

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***

[Foreword Dr.Mata MD CIS]

***

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

“Physicians have more complex liability challenges to overcome in their lifetime, and less time to do it, than other professionals. Combined with a focus on practicing their discipline, many sadly fail to plan for their own future. They need trustworthy advice on how to effectively protect themselves, families and practice, from the many overt and covert risks that could potentially disrupt years of hard work. Fortunately, this advice is contained within Risk Management, Liability Insurance, And Asset Protection Strategies For Doctors And Advisors [Best Practices From Leading Consultants And Certified Medical Planners™].

Written by Dr. David Edward Marcinko, Nurse Hope Rachel Hetico and their team of risk managers, accountants, insurance agents, attorneys and physicians, it is uniquely positioned as an integration of applied, academic and peer-reviewed strategies and research, with case studies, from top consultants and Certified Medical Planners™. It contains the latest principles of risk management and asset protection strategies for the specific challenges of modern physicians. My belief is that any doctor who reads and applies even just a portion of this collective wisdom will be fiscally rewarded. The Institute of Medical Business Advisors has produced another outstanding reference for physicians that provide peace of mind in this unique marketplace! In my opinion, it is a mandatory read for all medical professionals.”

David K. Luke MS-PFP, MIM, CMP™ [Net Worth Advisory Group, Inc., Sandy, Utah, USA

http://www.CertifiedMedicalPlanner.org

Cyber-Security Considerations for “Mission-Critical” Medical Devices

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Understanding the balance between new regulations (almost none) and guidance (in the form of non-binding recommendations)

By Shahid N. Shah MS

Shahid N. ShahTHEN …

In 2013, the Food and Drug Administration (FDA) issued its first cybersecurity safety communication, followed in 2014 by final guidance.

It struck a reasonable balance between new regulations (almost none) and guidance (in the form of non-binding recommendations).

NOW …

In 2015, the Federal Trade Commission (FTC) released a staff report entitled Internet of Things: Privacy & Security in a Connected World, in which it recommend that Internet of Things (IoT) style devices, which of course include medical and clinical devices, need to maintain a good security posture. It’s worth noting that the FDA, FTC, and other government regulators are centering on a few key guidelines.

Six Recommendations

The following six recommendations come directly from the FTC report:

  1. Companies should build security into their devices at the outset, rather than as an afterthought. As part of the security by design process, companies should consider:
  • Conducting a privacy or security risk assessment
  • Minimizing the data they collect and retain
  • Testing their security measures before launching their products
  1. Companies should train all employees about good security, and ensure that security issues are addressed at the appropriate level of responsibility within the organization
  2. Companies should retain service providers that are capable of maintaining reasonable security and provide reasonable oversight for these service providers.
  3. When companies identify significant risks within their systems, they should implement a defense-in-depth approach, in which they consider implementing security measures at several levels.
  4. Companies should consider implementing reasonable access control measures to limit the ability of an unauthorized person to access a consumer’s device, data, or even the consumer’s network.
  5. Companies should continue to monitor products throughout the life cycle and, to the extent feasible, patch known vulnerabilities

The FTC report and FDA guidelines are remarkably consistent. When thinking of cybersecurity and data privacy, engineers tend to think about authentication, authorization, and encryption. Those are the relatively easy topics.

*** circuit***

Mission Critical Medical Devices

For “mission-critical” medical safety devices, however, things are much more difficult and need to encompass a larger surface of questions, including but not limited to:

  • Asset Inventory: Is the device discoverable, and can it associate itself with standard IT inventory systems so that revision management, software updates, and monitoring can be automated?
  • Cyber Insurance: Does the device have enough security documentation to allow it to be insured by standard cyber insurance riders?
  • Patching: How is the firmware, operating system (OS), or application going to be patched by IT staff within hospitals (or the home for remote devices)?
  • Internal Threats: Has the device been designed to circumvent insider (hospital staff, network participants, etc.) threats?
  • External Threats: Has the device been designed to lock down the device from external threats?
  • Embedded OS Security: Is the device sufficiently hardened at the operating system level, such that no extraneous software components, which increase the attack surface, are present?
  • Firmware and Hardware Security: Are the firmware and hardware components sourced from reputable suppliers and free of state-sponsored spying?
  • Application Security: Is the Microsoft Security Development Lifecycle (SDL) or similar software security assurance process integrated into the engineering process?
  • Network Security: Have all network protocols not in use by the device been turned off so that they are not broadcasting?
  • Data Privacy: What data segmentation, logging, and auditing is being done to ensure appropriate data privacy?
  • HIPAA Compliance: Have proper steps been followed to ensure Health Insurance Portability and Accountability Act (HIPAA) compliance?
  • FISMA Compliance: If you’re selling to the federal government, have proper steps, such as use of Federal Information Processing Standard (FIPS) certified encryption, been followed to ensure Federal Information Security Management Act (FISMA) compliance?
  • Data Loss Prevention (DLP): Is there monitoring in place to ensure data leakage outside of the device doesn’t occur?
  • Vulnerabilities: Have common vulnerabilities such as the Open Web Application Security Project (OWASP) Top 10 been reviewed?
  • Data Sharing: Are proper data sharing agreements in place to allow sharing of data across devices and networks?
  • Password Management: Are passwords hardcoded into the device or made configurable?
  • Configuration Protection: Are configuration files properly check-summed and protected against malicious changes?

Conclusion

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ABOUT

Mr. Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100″ Award, in 2009. Over a twenty year career, he built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications. He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator. Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland. 

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Overview of Hospital Information Systems Architecture

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On Configurations and Varieties

[By Brent Metfessel MD MIS]

Dr. Metfessel

Hospitals can use a variety of configurations for HIS implementation depending on business needs and budgetary constraints.

Staffing needed for these systems can range from a few full-time equivalents (FTEs) per 100 beds for very basic off-site processing systems to 15 or more FTEs per 100 beds for sophisticated systems that attempt to combine several architectures into one system (e.g., combination of client-server systems with mainframe processing). Resource use and customizability tend to vary in tandem; the greater the flexibility of the system to meet unique user needs, the greater the cost outlay for capital and/or additional FTEs.

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Relationship of Resource Use and Customizability Based on System Architecture Selected

Values range from one (low) to four (high) stars
Architecture Hospital resource use Customizability
Off-site processing * *
Turnkey systems ** **
Mainframe systems *** ***
Client-server *** ****

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The Possibilities

The basic system architecture possibilities are as follows:

Off-site (remote) processing: In this case the hospital contracts with a vendor external to the hospital. The hospital sends data over to the vendor site where the actual processing takes place. When processing is complete, the vendor sends the data back to the hospital, usually in electronic form.

Turnkey systems: A vendor provides the hospital with systems that are “pre-packaged” so that hospital-based system development is minimal. Limited customization of the system is possible using systems analysts or programmers.

Mainframe systems: Most applicable to large hospitals, this configuration is highly centralized. A large and powerful computer performs basically all the information processing for the institution and connects to multiple terminals that communicate with the mainframe to display the information at the user sites. Hospital IT departments usually use in-house programmers to modify the core operating systems or applications programs such as billing and scheduling programs.

eHR diagram

Client-server systems: In this configuration one or more “repository” computers exist, known as “servers,” that store large amounts of data and perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use. Both customizability and resource use is high, depending on the desired sophistication.

Many clinical information systems that process data directly related to patient care use this configuration.  For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture.  Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers.  VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.

Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.

Broad Categories

The above architectures are broad categories.  Modifications and combinations of the above also exist, such as the use of client-server technology with mainframe systems and the addition of wireless technology, smart phones, laptop PCs and tablets,  and various personal digital assistants (PDAs) to supplement the core computing functionality.

In considering the optimal architecture for a hospital, management needs to take into account factors such as size of the institution, desired sophistication of the application, IT budget, and anticipated level of user community involvement.

Assessment

EHR

Another important aspect of HIS is the need for integration.  Often, different hospital departments have their own stand-alone systems — such as a Laboratory Information System (LIS) and pharmacy systems — that do not communicate with each other.  Duplicate data may be kept in separate systems, creating additional work to enter the data multiple times.

In an integrated system, each departmental system communicates with the other systems through either a centralized or decentralized. A computerized physician order entry (CPOE) system, for example, would be much less effective if it did not communicate electronically with the pharmacy system that would process the medication orders.

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Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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NOTES: Resource use refers to the need for FTEs and hospital capital expenditure. Customizability refers to the ability for users to alter the system structure or function to meet the unique needs of the institution.

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Understanding “Meaningful Use” Attestation Numbers for 2014

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Providers versus Hospitals

By CMS

ME121014_PAGE_16

Assessment

So, what do the hospitals know –  that the doctors do not?

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Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Why Your Medical Internet Marketing Campaign Isn’t as Effective as It Used to Be

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On the Crucial Online Presence

[By John Deutsch]

John DeutschA strong online presence is crucial to running a successful business, and healthcare is no exception.

However with constant change, especially in the past two years, many businesses are experiencing underperforming campaigns and struggling to figure out where to spend their marketing dollars. Should you invest heavily in pay-per-click (PPC) advertising, focus your efforts on search engine optimization (SEO) or hit the ground running with social media?

The answer is that you should never focus solely on one marketing channel, as it could take months or even years to recover when changes in the marketing industry occur – and they inevitably will occur. Another reason to diversify your efforts is that the success of some channels depends on the success of others – for example, social media influences your search rankings and display advertising heavily influences your brand recognition.

As a healthcare marketing company with over ten years of experience in internet marketing, we have seen the industry get flipped upside down more than once and have seen it affect organizations that have weak marketing campaigns with little to no diversification. A good mix of tactics is the best way to reach your target audience while allowing you to adapt quickly in the face of changes.

 cell

Three Elements Crucial to Any Marketing Campaign

Search marketing, direct marketing and social media are three components that healthcare organizations should incorporate for a healthy marketing campaign. Here’s what you need to know about these marketing elements, including the changes each channel has gone through in the last few years and what we could expect to see in the future.

  1. Search Marketing

Search marketing typically refers to PPC and SEO, the paid and unpaid efforts used to increase online visibility in search engine results. Early marketers were able to easily leverage SEO to gain top search engine rankings and also invest minimally in PPC for quick leads, but the search marketing landscape has changed significantly in the last three to four years, altering the online marketing game.

We might say it all started when Google modified its PageRank algorithm in 2011 and then again in 2012 (the update often referred to as “the death of SEO”), causing many organizations’ rankings to plummet. Marketers were forced to rethink their organic SEO efforts to stay in Google’s good graces. Instead of relying heavily on getting backlinks (even from low-quality websites) and stuffing content with keywords, the focus switched to creating quality content in order to get real clicks and page views.

Meanwhile, companies like Google started trying harder than ever to monetize their services. The highly saturated market contributed to driving advertising costs up – and beyond that, the actual efficacy of online ads went down. In some of our own campaigns, we have seen over 30% inflation in ad prices per year and a loss of efficacy (decreased traffic and leads) despite increasing ad spend to match inflation – and this isn’t just a result of market saturation. It also has to do with the fact that consumers are less and less receptive to online advertising due to the over publicizing of ads.

As a result of this, organizations have to constantly innovate so that their ads are seen among all the online advertising noise. This, in addition to rising ad prices means that a return on investment can be difficult to realize. Working with a true PPC expert who knows your industry well is the only way to make your budget go a long way.

The bottom line: SEO and PPC are still the number one ways to draw leads online, but they have both seen significant change in the past years and are likely to keep changing, so your marketing strategy should not depend on either channel alone.

  1. Direct Marketing

With SEO having lost some importance and PPC advertising requiring a skill set that many health organizations lack, we are seeing trends shifting towards a more direct form of marketing. This is evident by the number of lead generation companies that have cropped up in the last few years, such as Healthgrades and Vitals, which allow providers to attract more patients and referrals, often for a nominal fee. Similarly, in the medical software industry, SoftwareAdvice dominates the SEO/PPC channels.

Organizations are also increasingly employing alternative marketing channels like email newsletters and direct email marketing to reach out to clients and potential opportunities. This starts with a simply crafted email addressing a very specific issue to a specific audience. It is an extremely effective and budget-friendly tactic to diversify a marketing strategy.

  1. Social Media

Just like other marketing channels, social media is constantly evolving and also increasing in price. This is due, in large part, to major social media companies becoming publicly traded companies in recent years (i.e. Facebook in 2012 and Twitter in 2013), but also to market saturation.

According to a LinkedIn study, 81 percent of small- and medium-sized businesses are using social media and, of those, 94 percent do so for marketing purposes. While networks like Facebook and Twitter remain free to use, they have started trying to capitalize on their popularity by pushing paid advertisement, often to the point of risking the integrity of their sites.

Whereas prior to companies like Facebook and Twitter having gone public, a well-crafted social media post (text, video or image) could go “viral” naturally, we are now seeing this happen less and less, often requiring an initial advertising spend to get the ball rolling. Facebook is a good example of this. In December 2013, Facebook changed the algorithm that determines what stories and updates users see in their News Feeds. This resulted in business pages losing viewership of their posts, as Facebook decided that brands would have to “pay to play.”

Stethoscope on a laptop keyboard

Assessment

While we don’t recommend social media being the focal point of any healthcare organization’s marketing campaign, much less the only element, it is an integral component – and definitely one you should stay on top of if you want to remain competitive. Social media is also a major factor in Google’s algorithm for organic search engine rankings, so there is some added value to having a strong social media presence.

More:

About the Author

John is the President and CEO of Medical Web Experts, developer of Bridge Patient Portal, the leading 2014 ONC certified solution for patient engagement and improved practice profitability. A vital component in the exponential growth of numerous healthcare IT and Internet companies over the last ten years, John has benefited immensely from a unique mix of professional experiences, boasting a strong background in both marketing and technology.

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Divorcing your EHR Sytem [A How to Approach]

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Planning for an Escape Hatch

[By Shahid N. Shah MS]

Shahid N. ShahAs a doctor, or physician executive, you will spend weeks or months in the “sales and demo cycle” for selecting an EMR. If you’re lucky you will have time to consider all workflows; if you’re even luckier you will test drive the UI and make sure training goes smoothly.

You will also try to ensure that deployment will be easy.

However, another thing not to forget is to plan how to get out of an application or system after it’s been installed for a while.

It’s Harder to Get Out – Than Get in

Why is getting out important? Every application looks better in a demo than in a working environment and every solution becomes “legacy” sooner or later. Every system will be replaced or augmented at some point in time. The cost of acquisition (“barrier to entry”) is well understood now as something we need to calculate. But the “barrier to exit” or switching cost is something you must calculate at the time you decide what systems to purchase.

If you can’t answer the “how, in 6, 18, or 24 months, will I be able to move on to the next-better technology or system?” question then you’ve not completed your due diligence in the sales cycle. Vendor sales staff are quite reticent to answer the “how do I leave your system” question; you will need to press hard and ask for a plan before signing any contracts.

Some Vendor Queries

When preparing an RFI or RFP, ask vendors specific questions about how easy it is to get out of their technology (rather than just how easy to it is to deploy and interoperate). Put in specific test cases and have your folks consider this fact when they are looking at all new purchases.

Here are some specific factors to consider:

  • Do you own your data or does the vendor? If you don’t have crystal clear statements in writing that the data is yours and that you can do whatever you want with it, don’t sign the contract. Look for a new vendor.
  • Is the database structure and all data easily accessible to you without involving the vendor? If only your vendor can see the data, you’re locked in so be very wary. Find out what database the vendor is using and make sure you can get to the database directly without needing their permission.
  • Are the data formats that the system uses to communicate with other vendors open? If not, you don’t own your data. Be sure that at least CCR and CCD formats are available and that all document data is accessible in standard PDF or MS Office friendly formats. Discrete data should be extractable in XML or HL7.
  • How much of the technology stack is based on industry standards? The more proprietary the tech, the more you’re locked in.
  • Are all the programming APIs open, documented, and available without paying royalties or license costs? If not, when you try to get out you’ll pay dearly.

***

EHRs

***

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Chapter 13: IT, eMRs & GroupWare

On Healthcare Provider’s Use of Technology

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Most Important Tool for Effective Communications in ACO

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MD Technology

 

Assessment

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Common Daily Clinician Health Technologies

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Do Medical Practices Really Like EHRs?

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  1. The Percentage of Office-Based Doctors with EHRs
  2. Do Nurses like EHRs?
  3. EHRs – Still Not Ready For Prime Time
  4. The “Price” of eHRs

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The Percentage of Office-Based Doctors with EHRs

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US 2001-2013

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EHR

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On Health Websites and “Apps”

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Not Just a Fad – Anymore

By Jennifer Tomasik, Carey Huntington and Fabian Poliak

http://www.CFAR.com

Jennifer Tomasik

Health Information Technology [HIT] may have arrived slowly into clinics and insurance companies, but the pace of innovation and adoption in consumer electronics today is astounding (and accelerating).

Devices are quickly penetrating every facet of our lives in the form of laptops, smartphones, tablets, and beyond. Thousands of health and wellness websites and software applications (“apps”) already exist, and we believe their role in healthcare will be increasingly a central one. Some are crucial elements of health organizations’ programming, such as the online platform that ShapeUp is built on: www.ShapeUp.com

Are they Effective?

Many are stand-alone tools without an organization or programming per se—i.e. apps for counting calories, monitoring glucose levels, or tracking sleep. But are websites and applications effective means of engaging individuals in their own health? And if so, what separates the good ones from the bad ones?

The Data

A 2009 meta-analysis of web-based smoking cessation programs found the pooled quit rate for participants to be 14.8% after follow-up conducted three months out, and 11.7% after six months out. [i] These figures are an improvement over the rate of people attempting to quit without any help or resources, as previously cited.

Internal Studies

From our own study of health websites and applications, we are beginning to see that high-quality digital resources share many of the same characteristics as great products and services do in the physical world. They create pull by engaging users via explicit reward structures. They enable teamwork and foster social accountability. Their content is interactive, informative, and often individualized. Their use is intuitive, convenient (e.g. accessible by web on a laptop or tablet and by smartphone “mobile apps”), and even effortless to the user (e.g. automatically collecting, synchronizing, and analyzing information).

Apps

Fragmentation

The fragmented world of websites and applications is not without its problems.

In today’s “app market,” the void that many websites and applications fill is not necessarily in the best interest of “health consumers,” and the quality of their products or services is often questionable. We see such issues as a reality of any market in its early stages.

Assessment

However, we are optimistic that greater consultation with medical professionals, greater investment and competition among health organizations, and improved regulation can help this new market mature into an indispensable virtual ecosystem of resources for health-seeking individuals.

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[i] Myung SK, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. “Effects of Web- and computer-based smoking cessation programs: meta-analysis of randomized controlled trials.” Arch Intern Med 2009;169(10):929-37.

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Pennsylvania dental patients’ stolen social security numbers posted online

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EDR Data breach in Williamsport, Pennsylvania

By D. Kellus Pruitt DDS

1-darrellpruittOver the last 7 years, I have absorbed a surprising amount of criticism for warning my community that electronic dental records continue to grow both more expensive and more dangerous than paper dental records. That chunk of bad news which not one dental leader is ready to acknowledge is becoming increasingly difficult for even the most popular practice management consultants and other 3rd parties to hide. Unresponsiveness from those who profit from EDR sales is unethical and has already harmed dental patients.

Vulnerability Notes

In the Vulnerability Notes that have been issued by the US Department of Homeland Security to dental software giant Dentrix in the last year, security expert Justin Shafer was thanked in both for alerting authorities to Dentrix’s weaknesses.

Though evasive EDR stakeholders were able to fend off transparency far too long, it is fast becoming obvious to the world that their free ride with no accountability has always been destined to end ugly, and greed is to blame. Unforgiving media coverage of the nation’s loss of confidence in EDRs just might start in day or so in the parking lot of dentist’s office near Williamsport, Pennsylvania. Take cover, Dentrix

Eyeing Dentrix 

In the last two years, Justin Shafer’s uninvited watchful eye over Dentrix’s vulnerabilities may have already helped protect millions of dental patients from identity theft. Nevertheless, Dentrix’s security problems which company officials apparently hide, continue to endanger the welfare of uninformed Americans. I have learned that Shafer doesn’t give up easily. He’s in HIT for the long haul.

Yesterday morning, he posted a heads-up on the City of Williamsport’s Facebook, as well four other local Facebooks, warning of the results of a dental office data breach of Dentrix software: Dental patients’ social security numbers have become available on a zip file from Piratebay.

Shafer: “I am willing to bet there are a lot of your citizens SSN’s in this database. Look at rsc_dat.dat and patient.dat… Seems a dental database ended up on piratebay. You may already know.. you may not.”

He explained it to me this way: “the practice info is in rsc_dat.dat, patient info is in pat_dat.dat. It’s a nightmare, and I told dentrix and the doctor a full year ago.”

Insightful or clueless dentist?

Assessment 

Did your opinion of censorship in dental care recently undergo change?

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The RAND Corporation’s Health IT Legacy‏

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Understanding ObamaCare and HIT Data Breaches

[By Darrell K. Pruitt DDS]

1-darrellpruittTwo current topics in the HIT industry: (1) A dishonest 2005 RAND study set up lawmakers for disappointment in electronic health records, which are essential to Obamacare, and (2) I told you so.

The Reports

Just the other day, there were reports of two data breaches of EHRs involving over 734,000 patients in Texas and California.

http://www.ihealthbeat.org/articles/2013/10/23/health-facilities-in-california-texas-report-health-data-breaches

For reasons like this, the wisdom of an ambitious mandate for paperless healthcare by 2014 is beginning to be questioned by the same lawmakers who were sucked in years ago by RAND’s tainted 2005 study.

According to the vendor-friendly results gleaned from vendor-friendly data supplied by vendors, EHRs should have started saving 100,000 lives and $77 billion a year, years ago. Predictably, that has not happened. Far from it!

The Findings 

The happy findings – discredited even by RAND in January of this year – were paid for by Cerner and GE, who profited immensely from their RAND investment. Since nationwide adoption of EHRs became a bi-partisan goal with bubbly beginnings and millions of campaign dollars, the costs and danger of healthcare IT didn’t appear to bother conservatives until three months after RAND admitted the study was garbage.

In April, six GOP senators, led by Sen. John Thune (R-S.D.), released a detailed report criticizing HHS Secretary Kathleen Sebelius’ execution of a $35 billion initiative to promote EHRs as part of the ARRA stimulus package. (See: “GOP senators raise concerns with push for electronic medical records,” by Sam Baker, April 16, 2013, The Hill).

http://thehill.com/blogs/healthwatch/medicare/294273-gop-senators-raise-concerns-with-push-for-electronic-medical-records

Wither ARRA?

Have you ever wondered why ARRA was passed as a jobs bill rather than as part of healthcare reform? Any ideas?

More recently, with the conservatives’ failure to stop Obamacare even by shutting down government, EHRs have become recognized as the ACA’s next best weakness. Yesterday, Greg Scandlen, writing for RightSideNews.com, posted “The Tyranny of Electronic Systems.” It goes downhill from there.

http://www.rightsidenews.com/2013102333379/life-and-science/health-and-education/the-tyranny-of-electronic-systems.html

Even More

Also yesterday, Michelle Mailkin writing for Townhall.com, an ultra-conservative website similar to RightSideNews, posted, “Don’t Forget Obamacare’s Electronic Medical Records Wreck.

http://townhall.com/columnists/michellemalkin/2013/10/23/dont-forget-obamacares-electronic-medical-records-wreck-n1730172?utm_source=TopBreakingNewsCarousel&utm_medium=story&utm_campaign=BreakingNewsCarousel

Assessment 

Conservatives found traction: Without the anticipated healthcare savings from EHRs, Obamacare will not survive. These times are not as happy for EHR stake-holders as RAND led them to expect.

Conclusion

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Marketplace HIE Enrollment Update

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[By www.MCOL.com]

###

enrollment

###

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The Danger of Used Health Information Technology

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Remember to destroy that hard drive!

By D. Kellus Pruitt DDS

1-darrellpruittNEWS FLASH!

Affinity Health Plan to Pay $1.2 Million+ for HIPAA Violations -The HHS Office for Civil Rights on August 14 sent the industry a message on the importance of erasing protected health information on hardware being sold, recycled or returned,” by Joseph Goedert, HealthDataManagement.

http://www.healthdatamanagement.com/news/breach-notification-hipaa-privacy-security-affinity-46483-1.html

Talk about bad luck

A photocopier once leased by Affinity Health was purchased by CBS Evening News – which discovered that the copier’s hard drive contains 344,579 individuals’ unencrypted Protected Health Information.

The Response

In response to the federal investigation triggered by the CBS discovery, the Office of Civil Rights announced: “OCR’s investigation indicated that Affinity impermissibly disclosed the protected health information of these affected individuals when it returned multiple photocopiers to leasing agents without erasing the data contained on the copier hard drives.

Moreover ….

In addition, the investigation revealed that Affinity failed to incorporate the electronic protected information stored on photocopier hard drives in its analysis of risks and vulnerabilities as required by the Security Rule, and failed to implement policies and procedures when returning the photocopiers to its leasing agents.”

Assessment

Before disposing of used technology, remember to destroy the hard drive.

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What’s Next for Healthcare Information Technology Innovation?

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A Video Panel Discussion

By Shahid N. Shah MS

http://www.healthcareguy.com/

Shahid N. Shah MSIn Nashville a few weeks ago, at the Vanderbilt Healthcare Conference, I gave a short talk on a panel focused on the question “What’s next for healthcare information technology innovation?”

The Key Questions

The talk focused on answering a couple of key questions:

  • What does innovation in healthcare mean?
  • Where are the major areas in healthcare where innovation is required?

The Take-Aways

And it had a few key takeaways:

  • Understand health tech buyer fallacies
  • Understand PBU: Payer vs. Benefiter vs. User
  • Understand why healthcare businesses buy stuff so you can build the right thing

Assessment

My speaker deck is found below (if you’re reading this through a feed reader you should click into the blog so that it is visible). You can download the PDF here. After you’ve flipped through it, let me know what you think by dropping some comments below.

Editor’s Note: Mr. Shah is a ME-P thought-leader and an internationally recognized enterprise software analyst that specializes in healthcare IT with an emphasis on e-health, EHR/EMR, Meaningful Use, data integration, medical device connectivity, health informatics, and legacy modernization. He contributed CH 13 to: www.BusinessofMedicalPractice.com and Chapter 13: IT, eMRs & GroupWare

Conclusion

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Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

 

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The “Price” of eHRs

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Race to electronic health records may come with a price

By Fred Schulte

Amid all the enthusiasm over increasing the use of information technology in health, politicians and policy makers paid little attention to the implications of a gold rush sparked when billions of taxpayers’ dollars suddenly came up for grabs. Hundreds of medical technology companies scrambled to sell digital systems — often by promising doctors and hospitals they could boost revenues by billing higher rates to Medicare and other health insurers.

The fallout from those early decisions could be coming back to haunt taxpayers, according to a three-part investigative series from the Center for Public Integrity. The series documented that thousands of medical professionals steadily billed Medicare for more complex and costly health care over the past decade — adding $11 billion or more to their fees — despite little evidence elderly patients required more treatment.

In this essay, reporter Fred Schulte explains how the project came about, how the Center did its reporting and provides plenty of background on medical coding, Medicare billing and the potential fallout as health care providers install and use electronic systems.

Assessment

Full link: Race to electronic health records may come with a price

Publisher’s Note: Fred Schulte is a four-time Pulitzer Prize finalist, most recently in 2007 for a series on Baltimore’s arcane ground rent system. Schulte’s other projects exposed excessive heart surgery death rates in veterans’ hospitals, substandard care by health insurance plans treating low-income people and the hidden dangers of cosmetic surgery in medical offices. He spent much of his career at The Baltimore Sun in Maryland, where I first noted his work, and then the South Florida Sun-Sentinel. Schulte has received the George Polk Award, two Investigative Reporters and Editors awards, three Gerald Loeb Awards for business writing and two Worth Bingham Prizes for investigative reporting. The University of Virginia graduate is the author of Fleeced!, an exposé of telemarketing scams. Schulte can be reached at fschulte@publicintegrity.org or 202-481-1210.

eHRs

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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The Build or Buy HIT Decision

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Best of Both Worlds for Healthcare IT Systems?

By Brent Metfessel MD

An important consideration when looking at the development of new technological functionality is whether to obtain an HIT system from an outside vendor or build the system using primarily internal staff.

Three Parameters

Basically, such a build or buy decision depends on the following aspects:

  • availability of internal resources to hire the highly skilled staff needed to create a new system;
  • availability of vendors with proven expertise in the area of technology relevant to the new project; and
  • flexibility of the vendors to customize their products for hospitals with unique needs.

The temptation to use consultants rather than FTEs to develop and implement the new system needs exploring.

Both Sides and the Consultants

On the positive side, finding consultants that have highly specialized expertise relevant to the project is often less difficult than finding such expertise in people willing to come on board as FTEs.  Such expertise in clinical informatics may be critical to the success of the project.

On the negative side, the cash outlay for multiple consultants can be staggering, especially if multiple consultants come on board with long-term contracts and retainers. Specialized consultants may charge up to $150 to $200 dollars per hour, quickly draining the most robust of IT budgets. Consultants should be used for just that — consulting. They exist on the project for their expertise and transfer of knowledge to the rest of the staff. To use consultants to do the hands-on tasks of actually building the system is generally not an optimal use of the consultant’s time.

Consultants, if used at all, should typically be used on a temporary basis to share their expertise and advice during critical parts of the project.

Buy Off the Shelf

Overall, buying an application off the shelf may be favored for more sophisticated applications. For example, computerized order entry [CPOE] and EMR systems have a number of dedicated vendors that are vying to achieve market share.

For major projects, distributing request for information (RFI) packages to selected vendors enables senior management to critically evaluate the different vendors in parallel, in the end selecting finalists and ultimately the vendor of choice. A critical requirement when evaluating vendors is a strong client reference base. The best predictor of future success is past success, and thus multiple existing satisfied clients are essential for the chosen vendor. Larger academic or tertiary care systems, however, tend to have more access to expertise and more significant customization requirements. Consequently, building a home-grown system rather than outsourcing the work to a vendor may be the best strategy for such institutions.

Vendors

When working with vendors, one should be strategic in price negotiations. One suggestion is to link part of the vendor compensation to the success of the implementation. This puts the vendor partially “at risk” for project success and thus provides additional incentive for vendor cooperation. Additionally, one should not purchase a system or services from the initial bid. It is critical that more than one vendor bids for the project to provide a pricing and negotiation advantage.

There is nothing that states only one vendor can be chosen for a project. Although obtaining everything from one vendor can lead to a more seamless integration and prevent the juggling of multiple vendor relationships, using more than one vendor may in some cases lead to a higher quality end product. This is known as the “best of breed” approach and is a viable option, in particular for complex projects where a single vendor does not adequately meet user needs.

Assessment

For more basic administrative systems, there are also off-the-shelf products from vendors that may be applicable. Where there is less need for customization, a single vendor may work out very well. Where there are significant unique needs that require customization, once again it may be best to develop the system internally or outsource the work to multiple vendors.

There is also the issue of small or rural hospitals that have limited resources. For such institutions, investments in more complex information systems may be difficult. Consequently, many vendors offer “stripped down” versions of their systems at a more affordable price, specifically tailored to the small hospital. The ability to customize the system for unique needs, however, is significantly more limited.

More info: http://www.hitconsultant.net/2012/10/01/healthcare-it-systems-buy-vs-build-or-best-of-both

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Doctors’ Use of For-Profit Algorithms Considered UnSportsManLike Conduct

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On Protecting Medical Coding Jobs

By Darrell K. Pruitt DDS

The US government moves quickly to protect tedious upcoding jobs from being taken over by upcoding software.

Medical Billing and Coding for Dummies

In coding expert Karen Smiley’s July 2012 book, “Medical Billing and Coding for Dummies,” she writes: “It really does pay to be a certified medical biller/coder, no matter what designation you choose to pursue. Surveys conducted by the AAPC [American Academy of Professional Coders] indicate that coder salaries have continued to increase despite economic downturns. One possible reason for this is that getting payers to pay claims is becoming increasingly difficult.”

Call me cynical, but to me, her defense of the coding profession confirms that healthcare’s increasing demand for highly-paid coders (who have nothing to do with directly providing care to patients) is artificial, and originates with an administration which complicates providers’ payments in order to create new, high-paying jobs in the HIT industry – quietly adding to the cost of healthcare to cosmetically boost employment figures before an election. Who ultimately pays the bill for all non-productive healthcare costs?

Amazon Morphs

Less than 3 months following the appearance of “Medical Billing and Coding for Dummies” on Amazon for under $25 (paperback), EMR software suddenly changed or morphed the entire game, and the administration reacts by changing the rules to protect political investments.

Similar to algorithmic trading’s proven advantage over low-tech investors on Wall Street, the computation capabilities of modern EMRs allegedly provide an unfair advantage to doctors and hospitals, and at taxpayers’ expense – according to HHS and Justice Department officials.

Enter Eric Holder and Kathleen Sebelius

“On Monday [September 24], Attorney General Eric Holder and HHS Secretary Kathleen Sebelius sent a strongly worded letter warning that the Obama administration will not tolerate hospitals’ attempts to ‘game the system’ by using EHR systems to boost Medicare and Medicaid payments.” – iHealthBeat, September 26, 2012.

http://www.ihealthbeat.org/articles/2012/9/26/stakeholders-react-to-warning-on-use-of-ehrs-for-upcoding.aspx#ixzz29fYzjPUH

This was followed by an article posted yesterday, also on iHealthBeat titled, “Mostashari To Launch Review of Using EHRs for ‘Upcoding,’”

http://www.ihealthbeat.org/articles/2012/10/17/mostashari-to-launch-review-of-using-ehrs-for-upcoding.aspx#ixzz29fDElIKL

Enter the NCHIT

“National Coordinator for Health IT Farzad Mostashari MD plans to launch an internal review to determine whether electronic health record systems are prompting some health care providers to overbill Medicare by selecting higher-paying treatment codes, a process known as ‘upcoding,’ the Center for Public Integrity reports.”

Apparently, it only recently occurred to lawmakers that the EMRs they promote greatly simplify Medicare’s intentionally tedious and time-consuming reimbursement requirements mentioned by Karen Smiley – making profits much easier for providers without having to hire even more staff just to get paid for work done long ago. In addition, the alleged upcoding software threatens to eliminate the need for recently-graduated coding professionals – whose education was backed by ARRA stimulus (taxpayer) money. While our nation’s leaders might wink at institutional investors’ highly-profitable algorithmic trading on the stock market, unemployed coding specialists with outstanding college loans would only increase the potential embarrassment for the administration should doctors and hospitals be permitted to computerize billing decisions – leading to payment for services previously given away because they weren’t worth the hassle and expense of documentation!

Assessment

Unlike investors playing the stock market, according to Medicare’s emerging rules, doctors’ use of algorithms to increase profits is considered unsportsmanlike conduct. With the election only days away, can you blame them?

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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The Rise of Digital Doctors?

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Physicians and the Use of Social Media

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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How to Get Started in Healthcare IT [Video Presentation]

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An Encore Presentation from a ME-P Thought-Leader

By Ann Miller RN MHA [Executive-Director]

In this ME-P, Shahid N. Shah MS shares his best advice for information technology workers looking to get started in the healthcare industry.

Mr. Shah is also known as the Healthcare IT Guy [http://www.healthcareguy.com] informing us about technology issues in the healthcare field.

Link: http://www.physbiztech.com/video/shahid-shah-how-get-started-healthcare-it

###

More Expert Advice from Leaders in Healthcare Management

And, sourced below are related interviews with these experts:

  • Todd Linden, President and CEO of Grinnell Regional Medical Center (about rural healthcare management);
  • Paul Levy, former CEO of Beth Israel Deaconess Medical Center; and
  • Dr. Robert Wachter, Professor of Medicine, University of California, San Francisco (author of “Understanding Patient Safety” and the blog “Wachter’s World”).

Link: Health Administration Degrees http://www.healthadministrationdegrees.com

Assessment

Shahid also authored Chapter 13 on eMRs, HIT and Clinical GroupWare [INTEROPERABLE e-MRs FOR THE SMALL-MEDIUM SIZED MEDICAL PRACTICE] in our best-selling book, the “Business of Medical Practice” http://businessofmedicalpractice.com/chapter-13-2/

So, the text and videos are worth a look www.BusinessofMedicalPractice.com Our colleague, and uber hospitalist Robert Wachter MD, is also mentioned in the book.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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The Hospital Room of Tomorrow?

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[By Staff Reporters]

[Click on image to enlarge]

Have you ever wondered what’s just around the corner in terms of the technology we can expect to see in hospitals. You might be surprised by some of the gizmos, gadgetry and other medical advancements that will soon become regular fixtures. This infographic offers a fascinating glimpse into how hospital rooms might look in the very near future.

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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MasterCard Warns of Possible “Massive” Data Breach

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“Breaking-News” Report

According to Andrew R. Johnson, MasterCard Inc. MA -1.36% just reported that it is investigating a possible breach of cardholder account data involving a U.S.-based payment processor.

The Purchase, N.Y., credit-card company said law enforcement has been notified of the matter and an “independent data security organization” is conducting an ongoing forensic review of the matter. The company is alerting card-issuing banks regarding “certain MasterCard accounts that are potentially at risk.”

Assessment

Link: http://online.wsj.com/article/SB10001424052702303816504577313411294908868.html

Is there an object lesson here for HIT data protection and EHR identity theft?

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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