Last week was HIMSS19, a huge, global healthcare IT conference that occurs annually in the U.S. The Healthcare Information Management Systems Society (HIMSS) hosts it, and each year over 45,000 people attend. This year, my company exhibited in Microsoft’s booth.

A week in the Microsoft booth

I spent my entire week discussing healthcare and showcasing MazikCare to people from all over the world – Sweden, South Africa, Brazil, Australia – the list goes on. Thankfully, I learned a lot about global healthcare from my conversations, since I didn’t get a chance to attend a single educational session this year! Here’s a quick recap:

1. Because none of these countries have a healthcare system anything in the U.S., the specific use-cases of healthcare IT were different from those that are most poignant over here. Healthcare providers from the Netherlands, the UK, and Italy all shared that their healthcare models emphasize the delivery of home healthcare. In the UK, for example, cancer patients needing chemotherapy don’t have to visit an outpatient clinic to receive their dose of chemo drugs. Instead, the healthcare system assigns a nurse to visit the patient’s home to administer to the chemotherapy and pharmaceutical vendors deliver the medications to the patient’s doorstep. In many cases, the nurses teach patients how to administer their injections so they can be self-sufficient in their treatments. As a result, care coordination in more universal healthcare-based systems requires lots of referral management and complex scheduling of home visits and outpatient services.

2. While the U.S. market for Electronic Medical Records (EMRs) is saturated – mainly by EPIC and Cerner – many other countries are still working on implementing EMRs. In some cases, like in the Netherlands, a single EMR vendor has 70% of the market.

3. Despite provider hesitancy in cloud adoption, it is almost universally understood that data aggregation and interoperability are key to unlocking potential for improving patient administration and care delivery – everywhere. The MazikCare demo on consolidating EMR data into Dynamics 365 resonated with everyone I showed it to, as well as the consolidated patient profiles and flexible business processes that can leverage relevant medical data in extending patient engagement capabilities. My whitepaper Precision Medicine Starts with the Patient Relationship covers this concept in more depth.

Me talking to some lovely visitors from Italy at the HIMSS19 Microsoft booth.

HIMSS Awards and Recognition Gala

In an exciting stroke of luck for me, the Greater Illinois Chapter of HIMSS had an extra ticket to the black tie Awards Gala. Since I volunteer on their educational committee, they blessed me with their last ticket! I had quite the experience.

GIC HIMSS had reserved a seat for me at their table, but when I showed up, an unexpected VIP guest had needed a seat there. So instead of sitting with my fellow Chicagoans, they asked me to sit at the table beside theirs. I quickly learned that I was seated at the table for the award recipients! My whole table was taking turns standing up to go on stage to be honored and congratulating each other. All the honorees were quite gracious and welcoming to me, and I enjoyed a lovely meal getting to know some of them.

I can’t pass up an opportunity to pick the brains of experienced healthcare leaders on universal healthcare! Amidst a table of morally diverse opinions, we arrived at consensus in policy moving to support at least a base level of universal healthcare. In a capitalist country with a healthcare market dominated by wealthy insurance and pharmaceutical corporations, it doesn’t seem likely that the U.S. would ever consider a UK-like model with free healthcare for everyone. But I was encouraged to see that even persons who do not believe in universal or equal access to healthcare from a moral standpoint supported Medicare for All because it makes the most fiscal sense for our country. Furthermore, since the government is already funding most of our healthcare costs already between Medicare and Medicaid, even more conservative-leaning individuals felt that approving Medicare for All would be a feasible and welcome shift in government healthcare spending. Hearing these perspectives confirmed for that, regardless of political or moral beliefs, the U.S. is ready for Medicare for All.

Fancy and delicious dessert from the Awards Gala.

The awards themselves were awesome. From learning about progress in opioid addiction prevention and rehabilitation to seeing women of color standing on stage for bringing diversity, inclusion, and championing justice was inspiring. This was perhaps the first time it sunk in for me how much a technologist like a CIO or CTO can enact positive change in patient’s lives. I am very grateful to GIC HIMSS for including me in that experience and hope to attend again next year!

If you’ve made it this far, thanks for reading – and don’t forget to subscribe! I have lots of exciting posts to share in the near future :)

HIT 421: Intro to Informatics

In my own words, I would define informatics as “the study of collecting, organizing, analyzing, and presenting information to facilitate processes.” Informatics combines both computer science and information science to encompass a broad range of computational technology, as well as the collection, storage, and analysis of information.

The focus area for my blog will be social justice and combating systemic racism in healthcare. Unfortunately, data has shown many disparities in quality of care, as well as health outcomes, based on race. Through the use of informatics, there are opportunities to mitigate these disparities in the following key areas:

Health informatics

IT systems are integral to collecting health and socioeconomic data, as well as providing tools such as machine learning to derive insights based on that data. These systems helps to identify disparities in health outcomes and quality, as well as to suggest the underlying root causes.

Dissemination of information

Informatics support social media networks, apps, portals, and many other platforms for disseminating information. In the modern world, public health awareness largely depends on informatics, such as in COVID-19 social distancing protocols. However, access to technology is a barrier that can prevent equal access to vital health information.

In the journal ScienceDirect, Timothy Carney and Amanda Kong wrote about the potential application of informatics in reducing health disparities and improving health equity.

See Table 1 below, from “Leveraging health informatics to foster a smart systems response to health disparities and health equity challenges.”

Table 1. Informatics domains, health equity challenges, and informatics strategies.

Informatics DomainsHealth Disparities Elimination and Health Equity Achievement ChallengesInformation Technology Tools, Data Sources, and/or Strategies
Public Health Informatics• Establish national guidelines, standards, and objectives for health disparities and health equity (e.g., Healthy People 2010 objective) • Foster timely translation of research evidence into practice through national health information clearinghouses • Evaluate state and local health department health disparities and health equity policy and practices•National surveillance and disease registries •State and local health department surveys •Public health program reporting •Public health research data hubs
Population Health Informatics•Foster equitable and empowering patient-provider communication •Emphasize primary care and preventive care and reduce the use of emergency care use for non-emergencies •Increase coordination of care through the use of Patient-Centered Medical Homes (PCMHs)•Electronic Health Records (EHR) •Health Information Exchanges (HIEs) •Clinical data warehouses •Regional research data collaborations •Hospital-based event and disease tracking through registries (e.g., medical errors, quality, safety)
Community Health Informatics•Leverage community-based participatory research hubs and community partnerships •Establish multi-organizational coalition network partnerships (e.g., community, academic, corporate, and government) to address collective large-scale challenges•Community Health Needs Assessments (CHNA) •Community health worker summaries •Community-based knowledge exchange networks
Consumer Health Informatics•Increase health literacy •Increase access to care •Increase emphasis on patient self-management and shared decision making•Patient reported outcomes •Patient health surveys •Patient advocacy (e.g., lay health advisors, social workers) •Electronic patient portals •Patient Health Records (PHRs)
From <https://www.sciencedirect.com/science/article/pii/S1532046417300369>

I hope to explore all of these areas throughout the HIT421 course and in my career. Stay tuned!

The Primary Care Crisis: What to Do?

Challenges in Primary Care

The world, and especially the U.S., is facing a total crisis when it comes to primary healthcare. There are a few contributing factors that have come together to create a dire situation. First, as time has progressed, we have learned more and more about healthcare, discovering hundreds of thousands of diseases. There is now so much information about health that no one can know it all.  This increase in knowledge has led to the creation of dozens of specialties within the healthcare field. As the healthcare field diversifies, fewer and fewer physicians are choosing to work in primary care. Understandably so, given that primary care providers are more often overworked, and they also make significantly less money than specialized physicians.

Why is this a problem? Well, primary care is actually the most important kind of healthcare. The purpose of primary care is to keep us healthy by catching minor health issues as they arise and preventing them from becoming more serious, chronic ailments. Some refer to this as the Wellness Cycle. However, in today’s healthcare landscape, we are stuck in an Illness Cycle – treating illnesses over long durations once they have become more advanced. This results in more pain, more treatments, and more medical bills for patients, and causes healthcare systems to have very high expenditures for providing care. Consistent primary care is the key to preventing this cycle from happening, and ultimately creates significantly lower healthcare spending over the long term.

However, in addition to a shortage of primary care physicians, the U.S. faces a huge challenge in access to healthcare. While the government funds healthcare insurance for vulnerable populations, such as the elderly, low-income people, and people with disabilities through the Medicare and Medicaid programs, those programs are not completely free and still leave a large portion of the population uninsured. According to the Center for Disease Control, 30.1 million people under 65 (11.1%) were uninsured in 2018.1 For many, lack of insurance coverage means not being able to afford copays and other costs associated with receiving medical care. Unfortunately, this often leads people without insurance to put off visiting a doctor until they have an emergency – which can end up costing thousands of dollars in out-of-pocket costs and exacerbating poverty for families when a medical emergency arises. For anyone without health insurance, it is still important to receive preventive and primary care, and there are options available that offer services free-of-charge. Sites such as freeclinics.com can help with locating free or reduced-cost healthcare services of every kind. 

Even for those who are fortunate enough to have health insurance, costs can still prove unaffordable. Furthermore, the fee-for-service payment model of the U.S. healthcare system has eroded patient trust in their physicians’ recommendations. With the knowledge that providers receive more money for providing more expensive or extensive treatments, patients are often wary of whether they really need treatments or procedures physicians suggest to them. The discovery of illegal referral kickback schemes that compensated primary care physicians for referrals to specialists also impacted overall trust in the referral system. While rare, public knowledge of these schemes has certainly created uncertainty in patients’ minds about whether they really need that extra test, prescription, or treatment. In fact, physicians often do recommend more testing or treatments than are necessary due to the litigious nature of American society – to protect themselves from potential malpractice lawsuits, they recommend tests or likely unnecessary care to avoid negligence claims on the off chance a very unlikely problem arises that could have been detected earlier from a test.

The Path Forward

So, how can we improve patient trust in their physicians and help them reap the benefits of primary care? First, expanding the use of bundled payment models could relieve the financial temptation that struggling physicians can succumb to by providing an all-encompassing payment per patient for all medical care provided. This payment structure is the opposite of fee-for-service, grouping all services into a set compensation bundle for each patient. Some areas of healthcare have already began to use bundled payment models. Studies have found that bundled payments significantly reduced costs for lower extremity joint replacements but not for more complex conditions. Refinements to the models could include better accommodation of risk stratification and expanding bundled payments for simpler procedures or non-chronic conditions.

Second, shared decision-making can help patients make more informed choices about their healthcare journeys. This practice requires better education and transparency with patients about their treatment options, and the pros and cons of each option. Many patients, especially older ones, want to avoid overuse of healthcare – even with awareness of potential risks to their health down the line. To avoid the fear of lawsuits, patients could sign a waiver acknowledging that they understand possible health risks associated with opting out of certain tests or treatments. Increasing the amount of education patients receive about preventive services or treatment options can go a long way in helping patients feel equipped to make the right choices about their healthcare.

The expanding use of telehealth visits and SMS-based chatbots have expanded access to healthcare consultations, especially in more rural or remote areas. These technology-based solutions are helping more patients receive medical advice no matter where they are – however, we must be wary of inequities in the quality of care. Telehealth consultations are only possible for patients who have a smartphone or computer and internet connection. This blocks many lower-income or rural communities from accessing this convenient new way of receiving healthcare. As technological advances provide new ways of providing healthcare, intentional measures must be taken to prevent inequalities in care based on income or location, such as expanding access to health insurance and providing technological infrastructure to enable rural communities to leverage AI and other digital healthcare capabilities.

The challenges within primary care are complex and require solutions from many angles. Expanding access to primary care will be vital to improving health outcomes and reducing overall healthcare expenditures. Changes in payment models, patient-provider relationship dynamics, and use of technology can all play a role in enabling better primary care.


  1. National Center for Healthcare Statistics. “Health Insurance Coverage.” Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2018, 2018. Centers for Disease Control and Prevention, www.cdc.gov/nchs/fastats/health-insurance.htm. Accessed 23 May 2020.
  2. Advisory Board. “Do bundled payments actually reduce costs? Here’s what a new review found.” The Daily Briefing, Advisory Board, 9 Jan. 2020, https://www.advisory.com/daily-briefing/2020/01/09/bundled-payments. Accessed 23 May 2020.

Does Emotional Support Improve Health Outcomes?

Anyone who has been diagnosed with a chronic disease has experienced the unsettling cycle of emotions that accompany such often-shocking news. Fear. Anxiety. Denial. Depression. And in many cases, isolation. The feeling that no one can understand what you are going through.

No matter how life-threatening or relatively low-impact a diagnosis may be on one’s health, these feelings are a natural reaction to anything that promises to upset one’s equilibrium. We have routines, goals, and plans for the future. When facing a new diagnosis, we are subject to almost-certain change. Amidst navigating the decisions in how to handle our care, we wrestle with our fears and anxieties towards the future. While each individual will have different concerns on a micro-level, the overarching questions will be the same. Is my life in danger? How will my lifestyle be impacted by this diagnosis? Is the future I have planned at risk?

Usually, any diagnosis comes with some sort of care plan. Whether it’s lifestyle change, medications, or a more intensive treatment like surgery, physicians will recommend treatment options to address or improve a patient’s medical condition. Physicians will equip you with as much medical knowledge as they can to help patients make informed decisions about their treatments. And while good doctors will also ensure that patients feel taken care of emotionally, that responsibility is not included in a physician’s job description. Most hospitals have social workers, who help patients navigate any changes that come with a new diagnosis. These resources range from legal and monetary to practical to spiritual and emotional.

In many cases, mental health plays a huge role in a person’s ultimate health outcomes. Plenty of research has shown that emotional support impacts the overall effectiveness of patients’ treatments1. Health outcomes usually depend on how well we follow our care plans – the more we take our prescribed medicines, adjust our diets, and exercise, the more our health will improve. In light of all these changes, it can be hard to maintain a positive attitude, especially when facing a potentially terminal illness, financial stress, or other challenges. A human truth presents itself. When we feel depressed, we lose motivation. Without motivation, we stop following our care plans. The result is a downward spiral in care plan adherence, health condition, and emotional health.

What can break this negative feedback loop and bring back motivation? Hope. The assurance that someone has been through the same thing before and survived, or settled in to a new normal. Empathy. Talking to someone who understands. These kinds of connections can make or break an individual’s emotional capacity to fight through a difficult care plan or prognosis, thus affecting their physical recovery. While social workers and other hospital resources can alleviate some of the emotional burden on patients, true empathy can only come from speaking with others who have shared experiences. For example, Chicago-based nonprofit Imerman Angels provides one-on-one peer mentoring for cancer patients, survivors, and caregivers. With a large global database of volunteer survivors and caregivers, Imerman Angels pairs these volunteer mentors with individuals currently facing cancer or supporting a loved one. Their support seekers’ testimonials show the power that hope and empathy can have in overcoming life-threatening diseases.

Emotional support is often an opt-in addition to care. But empathy benefits everyone. If emotional support should were part of the standard of care, rather than an afterthought, I think we would see positive outcomes in care plan adherence and even survival rates.


  1. Jane Turner, Brian Kelly. “Emotional dimensions of chronic disease.” West J Med. 2000 Feb; 172(2): 124–128. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070773/).