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Join the #hcldr tweet chat tomorrow at 8:30 pm, ET, as HL7Standards.com contributor Leonard Kish moderates a chat on patient engagement.

Get full details on the chat in the post Do We Have Patient Engagement Backwards?, published on the Healthcare Leadership Blog.

The following topics will be discussed:

  • When does patient engagement become DIY health care? Will patients go around the hc system?
  • As tools & tech improve, what will we do for ourselves in 5 years and will no longer require visits to physician offices?
  • There are 20% who are #quantified selfers, there are 20% who may never engage, what is the most critical time for engagement of the other 60%?
  • What can we do about multi-morbidity, when people become overwhelmed with multiple chronic conditions and can no longer DIY?

And, if you haven’t already, be sure and download Leonard’s new, free, comprehensive patient engagement eBook, titled, “Patient Engagement is a Strategy, Not a Tool. How healthcare organizations can build true patient relationships that last a lifetime,” published right here on HL7Standards.com.



I’ve been having some Internet speed issues as of late, so I searched online and found a speed test. Turns out my download speed is a less than lightning fast at a mere 7.8Mbps – even though I pay for 24Mbps. I called up my Internet provider and had a conversation that went something like this:

Me: I am getting less than 8Mbps speed and I am paying for 24Mbps.

Customer “Service” Guy (CSG): What are you using the Internet for?

Me: Mostly email and online reading. No streaming videos or anything like that.

CSG: Sometimes the speed appears slower because of the websites you are on.

Me: OK…so how do I make it faster?

CSG: Would you like to upgrade your speed to 45Mbps?

Me: Only if I don’t have to pay more.

CSG: Actually it’s $X more a month.

Me: No, I don’t want to pay more. I just want to get the 24Mbps speed I am paying for.

CSG: That’s not something I can help you with.

I confess: I hung up on customer “service” guy. And then I began to ponder how it is that we’ve become a society that fails to take responsibility when problems arise. For every person that steps forward and says, “yep, there’s an issue, let’s figure it out,” another dozen are either ignoring the problem because “fixing” is not part of their jobs, or, quickly placing the blame on someone or something else.

Blame GameAnyone who has worked in IT knows exactly what I mean. A customer’s system goes down and the software folks blame it on the hardware; the hardware guys blame the Internet provider; the Internet provider blames the customer…and so it goes. And no one is happy.

A more tragic example: Thomas Eric Duncan, the first Ebola patient to die in the U.S., went to the ER with stomach pains, fever, and a headache. Despite telling staff he came from Liberia, the information was overlooked by the physician and Duncan was released. By the time he returned to the hospital a few days later, his condition was severe and he eventually died. Between the first and second hospital visits, Duncan could have infected dozens of people – though thankfully that doesn’t seem to have occurred.

When everyone began asking how the hospital could have missed the Ebola diagnosis with the first visit, hospital officials were quick to blame a glitch on the Epic EMR. However, the EMR was apparently just a convenient scapegoat.

After Epic raised a bit of a fuss, the hospital admitted the fault did not, in fact, lie with the EMR. Let’s face it: the hospital PR folks initially blamed the computer because they thought it sounded better than admitting the doctor made a mistake and didn’t fully read the patient record.

And what about the VA’s appointment scheduling scandal?

Several dozen VA facilities apparently kept “secret” waiting lists for veterans waiting to see a doctor while maintaining “official” waiting lists for reporting purposes. Employees were essentially ordered to cook the books to create the appearance that appointments were made within the VA’s 14-days-from-request goal. The secret list scheme continued until a retired VA doctor came forward as a whistleblower. By the time the truth was revealed, dozens of veterans had died before ever seeing a physician; more than 57,000 waited over 90 days to get an appointment.

How many people were aware these lists were being created and maintained? Hundreds? Thousands? Did they remain quiet because they feared losing their job? Didn’t want to get anyone else in trouble? Didn’t think it was their job to say anything?

Maybe the world needs some sort of 12-step recovery program that encourages people to readily admit when there’s a problem, and, encourages more personal responsibility. Seems like a better alternative than practicing avoidance and continuing to allow the buck to stop on someone else’s desk.



Every November we wish each other a Happy Thanksgiving and express our gratitude for the important things in our lives like friends,  family, and good health. Though we often overindulge in foods that probably aren’t beneficial to our health during this time of year there is one thing you can do this holiday season to promote wellness – gather a family health history.

Since 2004, the U.S Surgeon General has designated Thanksgiving as National Family Health History Day. Health problems like heart disease, cancer and certain genetic issues often run along family lines. Having a family history of a disease often means that family members have an increased likelihood of developing the same illness. However, having a tendency for a disease doesn’t mean that you’re certain to develop it. Often interventions like exercise, diet or medications can help ward off disease and keep an individual healthy. But in order to intervene, patients and their healthcare professionals need to know what they’re up against. So now that you’ve divvied up all your Thanksgiving leftovers, it’s a good time to talk about and write down health issues that run in the family and create a family health history.

It’s never too early to start collecting a family health history. While I was pregnant, I was able to undergo a non-invasive test to see if I was a carrier for genetic abnormalities like Fragile X and Cystic Fibrosis. This was a new test not available a few years ago and it would be wise to have it performed before a woman becomes pregnant so she can be aware of the risks and treatment options.

The CDC encourages pregnant women and those considering pregnancy to know her and the baby’s father’s family health histories to help decrease or discover health issues. The agency says family health histories are valuable in early detection of genetic disorders in children. Young adults can benefit from early screening based on family history.

Both the CDC and National Institutes of Health have guides on how to collect and create a family health history.Recommendations include:

  • Writing down the names of blood relatives in your history. The most important relatives to include are your parents, brothers, sisters, and your children. You many also want to speak with grandparents, aunts and uncles.
  • Ask your family members’ ages and birthdays.
  • Find out if they have any chronic conditions like heart disease or diabetes. Also ask if they have any serious illness or diseases like cancer or stroke and how old they were when they developed an illness.
  • Ask if anyone has had problems with pregnancies or childbirth, or if there are any birth defects or developmental disabilities in the family.
  • Know what countries your family originated from as this can help detect genetic diseases that occur in certain ethnic groups.

This toolkit from Genetic Alliance includes booklets to help you collect a family health history.

To organize and access your family health history you can use the Surgeon General’s web-based tool My Family Health Portrait. It collects your information and creates a “pedigree” that can be downloaded and saved privately. You can share the information with your family and your healthcare provider.

And of course there are apps available to help you curate and save your family health history. Some of these include Capzule, GenieMD, and My Medical Records.

It’s often said that if you don’t have your health, you don’t have anything. Take advantage of the holiday’s family togetherness and get your family health history together.



For more than four years the HL7Standards crew has worked to build a community centered on all things health IT. With our foundation firmly planted in health data interoperability and standards, we have always found a strong connection to all things related to health technology. Along the way, we’ve encountered thousands of smart, thought-provoking individuals via our weekly #HITsm TweetChats who have helped shape the conversations the industry has about the current challenges of health technology and what the future can and should look like.

To help fast forward this mission, we’ll experiment with an editorial calendar in 2015 to help encourage guest submissions.

For example, in January we’ll designate workflow as the broad theme. It’s an important topic that I’ve found has different meanings to different people, so there’s a lot of fantastic ideas among our readers that I hope will lead to several guest columns. Anyone working with and thinking about workflow is encouraged to submit columns for publication on our site. All topics about how health technology affects, influences, or changes users’ workflow is fair game.

February will be devoted to Meaningful Use. In March we’ll begin looking into health data interoperability and some of the promising initiatives that are making strides toward this important topic.

View the Editorial Calendar page

The reason we’re opening things up to authors outside our regular contributors is because we believe in the power of the greater health technology community and the idea that your intelligence, experiences, and criticisms will move the industry forward.

The editorial calendar will be maintained here and all submissions can be made using the form toward the end of that page. If you have any questions not answered on the editorial calendar page, feel free to tweet me @OchoTex.

We’re looking forward to learning more from you.



A year without negative or challenging headlines would be an unreal one. Life always has challenges, just as health IT does. Here are just a few sample headlines of the challenges with electronic health records (EHRs), interoperability, and patient engagement”

Just Google “EHR” or “health IT” or a related term and add “challenge 2014″ to it and you will find many articles highlighting the challenges being taken on and worked through. Now do the same search with “success 2014″ at the end and you will find very few relevant articles.


We need to pause and change this. Join HIMSS and the healthcare community in expressing our thankfulness.

During this season of gratitude and giving, let’s share our gratitude by giving thanks for what health IT and healthcare professionals are doing every day to make our health system better. Join our annual campaign:

  • Tweet what you give thanks for in health IT, digital health, patient engagement, wearable tech, etc. Include the hashtage #HITthanks
  • Share a #HITthanks tweet you agree with and support
  • Write a blog post on what you are thankful for in health IT and share it to the #HITthanks community
  • Post the #HITthanks graphic on Facebook with a note of gratitude for what is working in health IT
  • Take a picture of your health IT team and post it on your favorite social channel with a note of gratitude

Let’s come together and celebrate the hard work done by the many (many) dedicated health IT and healthcare professionals, sharing our thanks and gratitude.

Are you in? What are you giving #HITthanks for in 2014?




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