Breakthroughs in Accountable Care

Helping your organization move to accountablecare will require that you break through some technology walls.

InterSystems HealthShare® is the strategic informatics platform that will enable you to capture and share all patient data, and providereal-time active analytics that drive informed action.

To improve care across a hospital network, or a community, or even a nation, HealthShare is thebreakthrough you’ve needed.

InterSystems.com/Key8Z

© 2013 InterSystems Corporation. All rights reserved. InterSystems and InterSystemsHealthShare are registered trademarks of InterSystems Corporation. 1-13 Key8 HeITNe

The Key to

HealthShare

Key8 HeITNe_Layout 1 12/13/12 1:20 PM Page 1

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athenaCoordinatorSM, athenahealth’s new cloud-based care coordination service, makes your health system easier to do business with. Your providers can send orders with greater efficiency and less work than ever. You receive clean orders, reducing denials and bad debt. And your network grows larger and better connected every day.

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Benefits to Affiliated Providers

- Strengthened physician network

- Greater visibility into and control over order patterns

- Better care coordination with community physicians

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Benefits to Your Health System

The healthcare playing field is changing rapidly. Value-based and accountable care bring new challenges and new opportunities. Don’t just adapt to this new environment, get a competitive edge and thrive in it.

Allscripts Sunrise Financial Manager™ has the modern tools and technology that enable you to take advantage of new reimbursement models while remaining open to the future. It features a single database for ease of use, and we designed its unique visual workflow and open platform with your evolving practice in mind.

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A supplement to

A N N U A L CO N F E R E N C E & E X H I B I T I O N | M A RC H 3 – 7, 2 0 1 3 | N E W O R L E A N S , L A

1. ExpEriEncE thought lEadErsFrom President Bill Clinton to Dr. Eric Topol to Dr. Connie Mariano to the many other Keynote and Views from the Top sessions, these speak-ers will inspire and challenge attendees to think about the future of healthcare and technology.

2. advancE carEEr goalsHealthcare professionals can create an agenda that equips them with the knowledge and tools to help them and their organizations succeed. This year’s agenda has over 300 education sessions around key industry topics such as mobile health, clinical & business intelligence, care coordination, accountability for care and Meaningful Use.

EducationMeaningful Use, Mobile & More

ALSO INSIDE:

Networking 7Connect with Your CommunityCareers 8Launch Your Career or Take It to the Next Level

ExhibitionMake the Most of Your Time on the Exhibit Hall Floor

4

2

Why You Should Attend HIMSS13

Bill Clinton

3. accEss provEn tacticsHear real-world strategies and success stories from dozens of nationally recognized thought leaders who have improved access to care, bettered the delivery of care, and reduced healthcare costs through health IT.

4. MakE lasting connEctionsWhether through social media or networking events onsite, meet industry trendsetters, socialize with old friends and develop new relationships with like-minded professionals from across the healthcare industry.

5. connEct with latEst hEalth itExperience thousands of health IT products and services from over 1,100 exhibiting companies, and discover the latest health IT innovations and the creative minds behind them.

What is your top reason to attend? Share it on the HIMSS Facebook Page or on Twitter by using the #HIMSS13 hashtag.

REmINDER! HIMSS13 returns to its Sunday through Thursday schedule (March 3-7)

Featured advertisers

Published in partnership with

M&AAppealing to many, mergers can sometimes result in Frankenstein-like entities – and productsPAGE 20

The News source For healThcare INFormaTIoN TechNology n January 2013 www.HealthcareITNews.comMedTech Media / Vol. 10 no. 1

FootballIn a nod to player safety, NFL rolls out EHRs in its stadiumsPAGE 17

Benchmarks: no longer the domain of large health systems and academic medical centers, HIE is now for everyone. and it’s here to stay. PAGE 23

Policymakers, CIOs and vendors weigh in with their wishes for 2013. Most are optimistic about the rewards. They also expect a tough trek ahead.

New year, new goals

sEE PAGE 4

see page 10

MARCH 4, 2013

J.W. MARRIOTT • NEW ORLEANS

At t E N d

THE 4TH ANNUAL

Why you should attend. sPECIAl sECTIONsEE PAGE 17

PREVIEWA supplement to

A N N U A L CO N F E R E N C E & E X H I B I T I O N | M A RC H 3 – 7, 2 0 1 3 | N E W O R L E A N S , L A

1. ExpEriEncE thought lEadErs

From President Bill Clinton to Dr. Eric Topol to

Dr. Connie Mariano to the many other Keynote

and Views from the Top sessions, these speak-

ers will inspire and challenge attendees to think

about the future of healthcare and technology.

2. advancE carEEr goals

Healthcare professionals can create an agenda

that equips them with the knowledge and

tools to help them and their organizations succeed. This year’s

agenda has over 300 education sessions around key industry

topics such as mobile health, clinical & business intelligence,

care coordination, accountability for care and Meaningful Use.

Education

Meaningful Use, Mobile & More

ALSO INSIDE:

Networking 7

Connect with Your Community

Careers 8

Launch Your Career or

Take It to the Next Level

Exhibition

Make the Most of Your Time

on the Exhibit Hall Floor

4

2

Why You Should

Attend HIMSS13

Bill Clinton

3. accEss provEn tactics

Hear real-world strategies and success stories from dozens of nationally

recognized thought leaders who have improved access to care, bettered

the delivery of care, and reduced healthcare costs through health IT.

4. MakE lasting connEctions

Whether through social media or networking events onsite, meet industry

trendsetters, socialize with old friends and develop new relationships with

like-minded professionals from across the healthcare industry.

5. connEct with latEst hEalth it

Experience thousands of health IT products and services from over 1,100

exhibiting companies, and discover the latest health IT innovations and

the creative minds behind them.

What is your top reason to attend? Share it on the HIMSS Facebook Page or on Twitter by using the #HIMSS13 hashtag.

REmINDER!

HIMSS13 returns to its

Sunday through Thursday

schedule (March 3-7)

Breakthroughs in Accountable Care

Helping your organization move to accountablecare will require that you break through some technology walls.

InterSystems HealthShare® is the strategic informatics platform that will enable you to capture and share all patient data, and providereal-time active analytics that drive informed action.

To improve care across a hospital network, or a community, or even a nation, HealthShare is thebreakthrough you’ve needed.

InterSystems.com/Key8Z

© 2013 InterSystems Corporation. All rights reserved. InterSystems and InterSystemsHealthShare are registered trademarks of InterSystems Corporation. 1-13 Key8 HeITNe

The Key to

HealthShare

Key8 HeITNe_Layout 1 12/13/12 1:20 PM Page 1

ConneCtJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 3

JANUARY8-11: Digital Health Summit,

Las Vegas

15-16: Health IT Summit, Phoenix

FEBRUARY3-8: Leadership Strategies for

Information Technology in Health Care, Boston

4-5: National Health Policy Conference, Washington, D.C.

MARCH3-7: HIMSS13 Annual Conference

& Exhibition, New Orleans

26-27: Health IT Summit, San Francisco

APRIL16: The Hospital Cloud Forum,

New York

23-24: Health IT Summit, Atlanta

MAY5-7: 2013 American Telemedicine

Association meeting and tradeshow, Austin, Texas

13-17: Leadership Strategies for Information Technology in Health Care, Boston

BLOg:

The patient experience of EHRs

John Halamka, MD, offers his insight on the effect of EHRs on physician-patient interactions in this blog.

http://bit.ly/halamka-blog

VIdEO:

CIO Spotlight Episode 2: Barry Blumenfeld, MDBarry Blumenfeld, MD, CIO of MaineHealth and Maine Medical Center, discusses the rollout of its Epic EHR, the slow adoption of voice recognition and his relief over what the recent presidential election means for healthcare IT.

http://bit.ly/blumenfeld-video

CALENdAR OF EVENts

3 health IT must-haves for natural disaster preparednessR esponding to disasters is

something for which every healthcare institution needs

to be ready. From hurricanes to snow-storms to wildfires, having a plan in place and technology to back it up is critical to an effective response. Here are three tips to ensure your IT is ready to battle the elements.

http://bit.ly/3-HIT-must-haves

FEAtUREd EVENtThe District of Columbia will play host to the National Health Policy Conference this February.Kicks off in Washington, D.C., Feb. 4

WHAt’s INsIdE

insight 14

policy 8 clinical 17

business 22

data 24

The customer is always rightThe ONC Town Hall at the mHealth Summit this past month put the consumer at center stage, with its focus on patient engagement.

Money mattersMedicare and Medicaid EHR incentive payments were estimated to have reached some $10 billion by the end of 2012.

Not kids’ stuffPediatricians in the U.S. are years behind other physicians in their adoption of EHRs.

Sports medicineIn a win for players of a dangerous game, the NFL is making the move to EHRs.

FrankensystemsMergers and acquisitions can be hazardous to a company’s health. That holds true for hospitals.

Start-up does goodHealthrageous gets an infusion of new funding from its “parent,” Partners HealthCare.

Security failings2012 was a banner year – in all the wrong ways – for healthcare data breaches.

Getting it togetherWhy is interoperability “taking so darn long”? Technology is just one obstacle.

Motivation nationJoseph C. Kvedar, MD, introduces us to Wellocracy, which aims to help Americans get healthy with the right set of motivational tools.

Overcoming analysis paralysisA group of researchers point the way to a new model of analytics that could help provide a common road map for capabilities deployment.

Payer bewareA Nov. 29 report by the Office of the Inspector General (OIG) called for more oversight of the meaningful use program – including pre-payment audits. That obviously had some physicians concerned. While some conceded that it was “simply common sense” that a program spending that much money be better supervised, others made the point that the OIG report “contains no evidence of improper payments.”page 10

Benchmarks .............23

HIT X.0 ...................26

Trends .....................27

JobSpot ...................28

People .....................28

Newsmaker .............30

Hospital IT employees vent their frustrationsHealthcare IT News’ “2012 Where to Work: BEST Hospital IT Departments Annual Report and Employee Benchmarks” includes comments from IT staffers on what they dislike most about their departments. Click through this slideshow for a sampling of the anonymous comments.

http://bit.ly/IT-frustrations

Cover Story www.HealthcareITNews.com | HealthcareITNews | January 20134

Steady as she goesPolicymakers hope for continued progress in 2013By Diana Manos, Senior Editor

For policymakers, EHRs, used meaningfully, is not only a hope, it’s close to reality. At a Nov. 14 hearing held by the House Com-mittee on Science, Space, and

Technology, Subcommittee on Technology and Innovation, Farzad Mostashari, MD, national coordinator for health information technology voiced his optimism.

“[O]ur prog-ress to date has been steady and d e l i b e ra t e , ” he said. “We anticipate that the Stage 3 rules will allow us to continue to support trans-formed care by continuing to advance health IT capabili-ties by focusing on advanced clinical deci-sion support, team-based care, improving health outcomes, population health man-agement and patient engagement tools.”

Charles H. Romine, director of the Information Technology Laboratory at the National Institute of Standards and Tech-nology (NIST) wants to see NIST initiatives “that examine the best ways for humans to interact with next-generation health IT.” NIST plans to “significantly improv[e] medical device interoperability and mak[e] healthcare safer in the process,” he told lawmakers at the Nov. 14 hearing.

Rep. Michael C. Burgess, MD (R-TX),

vice chairman of the House Energy and Commerce Committee, Subcommittee on Health, said he would like to see better oversight in the EHR incentive program, “to address issues such as provider uptake and barriers to adoption, interoperability, the use of incentive payments thus far, and the impact of future penalties that could inad-vertently harm patients and providers.”

“I hope the next year sees a greater

effort to confront these issues to ensure the promise of EHR systems are realized for both patients and provider,” Burgess said.

“Finally, the next year provides even more opportunities for growth in the application of new technologies, such as the use of predictive modeling to pre-vent fraud and abuse in the Medicare and Medicaid programs,” he said. “The health IT industry continues to develop technological advancements, which the federal government has the potential to derive great benefit from as we aim to improve the quality and value of health care delivered in the U.S.”

“I hope continued efforts will be made to engage providers as they adopt new technologies and work to improve the quality of care delivered to patients.”Rep. Michael C. Burgess, MD (R-TX)

polIcy see Page 5

Great expectations

Policymakers, CIOs and vendors talk about their hopes and dreams for healthcare IT in 2013, focusing on the road that leads to transformation. Also: Associate Editor Erin McCann profiles

six health IT trailblazers under the age of 30, a new generation of fresh thinking, energetic leaders with an appetite for the work ahead.

POLICY VENDORS

The change we seekHealth IT developers offer their hopes for 2013By Mike MiliarD, Managing Editor

Free the data! Empower the patient! Break down those walls! Collabo-rate! Innovate!

Those are not revolutionary slo-gans, say the IT vendors – devel-

opers of electronic health records (EHRs), real-time location systems, data exchange technology and more – polled by Healthcare IT News for our year-ahead issue.

Rather, their wish lists for 2013 simply reflect the necessary steps the healthcare industry must take to truly effect the change we all want to see.

“My greatest hope is that 2013 is the year that hospital IT executives and physicians can link arms and become effective collabo-rators,” says Paul Brient, president and CEO of PatientKeeper.

He bemoans the fact that the “propaga-tion of physician-facing applications – CPOE, medication reconciliation and all manner of EHRs” in the past several years has “had the unfortunate effect of pitting physi-cians against IT.” Often less-than-optimal user interfaces have led to reduced physi-cian productivity, he points out. “There’s no other industry in the world that would accept reduced productivity as an outcome of automation.”

In the year ahead, Brient would like to see docs and developers working together to “ini-tiate a virtuous cycle of increased produc-tivity, cooperation and, ultimately, improve-ments in delivery of patient care,” he says.

Eric Leader, director of product manage-ment and business intelligence at Harris

Corp., has similarly high hopes for outside the hospital walls. “The biggest gap I see in the United States is population management in the community – that includes not just the traditional disease registries, but pro-viding the tools and supporting the process of collaborative care across the community of affiliated and unaffiliated providers,” he says. “We’ve got bits and pieces, but we don’t

VENDoRS see Page 5

Cover StoryJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 5

CIOs have high hopes for 2013Clarity, interoperability, patience, wisdom among many desiresBy Bernie Monegain, Editor

As healthcare chief informa-tion officers across the country consider the year ahead, they seem optimistic that 2013 will end with significant progress on

many fronts – putting the patient at the center of care, making the switch to ICD-10 smoothly,

achieving interoperabil-ity, finding clarity – and world peace.

Paul Tang, MD, vice president, chief inno-vation and technology officer at the Palo Alto Medical Foundation in California, also serves on the federal Health IT Policy Committee that

advises the Department of Health and Human Services (HHS).

In his view, the HITECH Act has been an invaluable catalyst for providers to focus on implementing essential information tools that are so important to making the right decisions related to individuals’ health and healthcare.

“Building up to the 2014 inflection point in health reform,” Tang says, “My hope is that we successfully lever-age the tools being implemented in mean-ingful use and invent new ones that will help us do a much bet-ter job engaging patients in shared decision making and coordinating care amongst all participants on the health team. I’d like 2013-

14 to be the turning point for patient-centered health.”

When we caught up with William Spooner, CIO of Sharp HealthCare in San Diego, he had just returned from eight days at his family’s place in Tennessee, where he spent a chunk of time driving his big orange tractor and thinking a little less about IT than he usu-ally does.

“To use a term popular in D.C.,” he says, “I wish that in 2013 we stop ‘kicking the can down the road’ as to patient identification,” he says.

Spooner is in favor of a national patient identifier to push data exchange forward. Though exchange is key to better and more cost-effective care, the accuracy of matching patient records is in the mid-to-upper 90 percent range at best, he says.

“While politicians avoid a national iden-tifier, I hope that we effectively deal with patient identification before we seriously harm any of those in the last 5 percent due to incomplete or incorrect patient records,” Spooner adds.

George Hickman, executive vice president and CIO at Albany Medical Center in New York, has three wishes: a smooth transition to ICD-10, with no one seeing revenue loss; more easily understood Stage 2 meaningful use requirements than experienced in Stage 1; and clarity regarding business and clinical priorities.

Oh, he has a fourth lofty wish: world peace.

Charles Christian, CIO of Vincennes, Ind.-based Good Samaritan Hospital, under-stands Hickman’s desire for clarity.

“Clarity is something that is on my wish list and has been for some time,” he says.

He wants clarity around how best to introduce technol-ogy in a clinical setting with-out putting it in the way of care processes and clarity about using technology to enhance the daily routines of the direct care team members.

“Clarity related to how we, as an industry, will implement and support additional layers of technology,” Christian says. To be effective, clarity needs to be in “an environment of decreased reimbursement.”

“Another item high on my list,” he says, is patience – patience to move the process along with the understanding that change is not easy, but it is necessary.”

Denni McColm, CIO of Citizens Memo-rial Hospital in Bolivar, Mo., wants the focus on interoperability to shift to the patient. Most of the talk and action about interoperability focuses on providers, she says. “Certainly

CIOS

John Halamka, MD, vice chair of the Health IT Standards com-

mittee, hopes f o r a c c e l e r -ated interoper-ability in 2013, through mean-ingful use Stage 2. He said he also hopes the new MU Stage 2 e c o s y s t e m results in many

new modular products that acceler-ate innovation and that an app store for EHRs evolves.

Halamka would also like to see accountable care organization for-mation result in normalized data repositories that support powerful new business i n t e l l i g e n c e a p p l i c a t i o n s and federated d a t a m i n i n g techniques such as the Quer y Health initia-tive, empower n e w c l i n i c a l research, com-parative quality analysis, and phar-maco-vigilience, “helping to trans-form our data into information, knowledge and wisdom.”

Halamka said he hopes “patient engagement provisions in meaningful use Stage 2 catalyze new entrants to the healthcare consumer marketplace.” In addition, he hopes that the Automated Blue Button (sending copies of records of patients) results in increased patient stewardship of their own data. n

really have a complete solution.”In the next 12 months, Leader hopes to see

some strides made in pulling those bits – pop-ulation management tools, health information exchange, secure communications, master patient and provider indexes, care man-agement technology, business intelligence, reporting and dash boarding – together.

“I don’t think we’ll see the whole inte-grated package, and there will be some gaps in the workflows,” he says. “But I think we will see some vast improvement. We’re starting to see a whole lot more interest from ACOs and clinical integration net-works in more of a consolidated approach. What we see declining is the expectation that a monolithic EHR is going to be able to do all that.”

For Edmund Billings, MD, chief medical officer at Medsphere, developer of the Open-Vista EHR, continued progress on reimburse-ment reform and accountable care organiza-tions – “whatever it takes to incentivize on quality of care” – is a good bet to help drive the growth of health IT.

“Meaningful use has been a nice kind of stimulus and has gotten people moving in the right direction, but it won’t really take hold until the reimbursement model shifts to help

control costs and control quality,” he says.And, of course, he’d like to see wider adop-

tion of open-source technology. “Healthcare is behind the curve on IT in general, and way behind the curve on open source,” says Billings. “Open source is pervasive in other industries. And in healthcare it’s negligible. Open source is about collaboration, and healthcare is about collaboration.” But too often, he says, “The lack of interoperability has become a business model. Closed systems have become the proprietary model. Health-care needs the opposite.”

Rick Lee, CEO of Healthrageous, hopes 2013 will be a year in which we stop paying lip service to patient empowerment and actu-ally do something about it.

“We have to become adults about what information the consumer is entitled to and what information can only be obtained through your doctor,” says Lee. With phy-

sician shortages loom-ing and the emphasis being put on patients managing their own health, “We need to have the tools.”

Access to informa-tion is key. “If I go to Quest or LabCorp and have a blood test taken to see how my diabetes

is doing, I have to go make an appointment with my doctor in order to get those results,” he says. “The lab shares them with my doc-tor, but not with me. How silly is that? It’s just insane how we infantilize adult Ameri-

cans and treat them like they’re children whoaren’t allowed to see certain informa-tion. And yet we don’t have enough doctors to share the information in a timely way with consumers.”

With more than 40 million newly insured

patients only exacerbating that physician shortage, Margaret Laub, president and CEO of Intelligent InSites, the developer of real-time locating systems, wants to see more technology being deployed to spur

operational efficiencies. “For 2013, we look forward to healthcare

providers embracing new enterprise plat-forms with open and flexible designs and innovative operational and cl inical qual-ity applications – and which are based on automated sensors and real-time data collec-tion, mobile technolo-gies and secure cloud computing solutions,” she says.

Paul Grabscheid, vice president of strategic planning at InterSys-tems, offered his own provocative hope for the coming year.

“My wish is to banish the term ‘health information exchange,’” he says. “While exchanging data is useful, it’s not nearly enough to achieve the quantum improve-ments needed in outcomes and efficiency.”

Rather, said Grabscheid, “We need to focus on aggregating, not exchanging, data, in order to provide a complete, holistic picture of each patient. Achieving more accountable care models will take more than messaging. To ensure the best outcomes across all care settings, clinicians need to have the most cur-rent and most relevant patient information at

polIcyCoNTINued from Page 4

VENDoRSCoNTINued from Page 4

paul Grabscheid

Margaret laub

cIoS see Page 6

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paul Tang, MD

George Hickman

John Halamka

Farzad Mostashari

William Spooner

“my greatest hope is that 2013 is the year that hospital IT executives and physicians can link arms and become effective collaborators.”Paul Brient

“Clarity is something on my wish list and has been for some time.”Charles Christian

Cover Story www.HealthcareITNews.com | HealthcareITNews | January 20136

Health IT up and comers under 30By erin Mccann, Associate Editor

Healthcare IT News has selected six up-and-coming health IT gurus who have made a name for themselves in the industry – all before their 30th birthday. These six best and brightest show that in health IT, wisdom often has little to do with age.

Halle Tecco, 29, is the co-founder and Ceo of rock Health, a san francisco-based seed accel-

erator for digital health startups. Tecco, a recent Harvard Business school graduate, helped launch rock Health back in 2011 and has already drawn in corporate funding from giants like micro-soft, Qualcomm and genentech. since its inception, the company has received hundreds of appli-cations from startups looking for industry guidance, seed capital

and legal counsel. Tecco has previously worked for Intel and apple was named one of CNN’s 12 entre-preneurs reinventing healthcare and one of Inc.’s 15 Women to Watch in Tech.

Mark Silverberg, 21, co-creator of the new disease-tracking Twitter application mappy-

Health, is this year’s youngest health tech star to watch. Cur-rently an information systems technology graduate student at the george Washington univer-sity, silverberg and two fellow colleagues developed mappy-Health which allows consumers and public health officials to track disease outbreaks world-wide in real-time. In addition to

the triumvirate winning $21,000 in a governmental contest, the department of Health and Human ser-vices is now hoping to implement the technology into their own systems. silverberg currently divides his time between tech and analytics at consumer health information company remedy Health media.

Tyler Kiley, 27, is co-founder and chief tech-nology of InQuicker, a Web-based service that allows

consumers to book emergency care appointments ahead of time – effectively eliminating er wait times. Kiley helped launched InQuicker in 2006 and has already seen 193 facilities across 22 states sign on. each month, these health-care facilities pay a member fee to InQuicker, and in turn, patients in the area can essentially make an online reservation for emergency care. Kiley has previously worked

as a developer at Viviti Technologies, recently acquired by Western digital.

Mike Dozier, 29, is the regional informa-tion officer at the Cape girardeau, mo.-based south-

eastHeaLTH system. dozier joined the healthcare system in 2011 and has been responsible for spearheading southeast-HeaLTH’s electronic medical records system, in addition to developing the central data cen-ter. after coordinating a partner-ship with missouri delta medical Center in sikeston, mo., the hos-pitals have reduced overall costs, and providers can now access

medical records form virtually any location. Prior to his position at southeastHeaLTH, dozier has had other senior management IT roles at healthcare organizations across the u.s.

Ryan Panchadsaram, 27, is a presiden-tial innovation fellow working with the White House, office of the National Coordinator of Health IT, and the department of Veterans affairs on Blue Button for america, which has seen more than one mil-l ion pat ients access their personal health record. Previ-ously, Panchadsaram worked at ginger.io, a spin-off from mIT media Lab that uses big data to transform health. He

has also been a fellow at rock Health. Panchad-saram graduated from the university of California-Berkeley with a degree in industrial engineering and operations research.

Eugene Medynskiy, 29, is the co-found-er and former chief technol-ogy officer at usable Health, a Web-based health startup that allows consumers to view restaurant menus online, order, view nutritional information of menu items and receive exer-cise advise based on one’s ordering history. Prior to his posit ion at usable Health, medynskiy also created salud!, an online health application

that provides consumers with self-monitoring health tools. medynskiy recently accepted a man-agement position at snapfinger. n

Eugene Medynskiy, co-founder, Usable Health

Ryan panchadsaram, presidential innovation fellow, oNc, VA

Mike Dozier, regional infor-mation officer, SoutheastHEAlTH

Tyler Kiley, co-founder, cTo of InQuicker

Mark Silverberg, co-creator of MappyHealth

Halle Tecco, co- founder and cEo of Rock Health

providers need to be able to exchange information regarding patients. But, more important and more powerful would be an environment where we allow patients to be the stewards of their medical record without regard to the network or geographic region that information was generated from.”

Scott MacLean, deputy CIO and director of IS Operations for Partners HealthCare in Boston, wants incen-

tives to align so patients care as much about healthcare infor-mation as they do about their money.

“Innovation and convenience has been driven in other eco-

nomic sectors by public demand for services and accuracy,” he notes. “A public that demands real-time, accu-rate personal health information would drive price and quality transparency, interoperability and customer service – and the information sys-

tems needed to support these functions in the healthcare sector.”

Rick Schooler, vice president and CIO of Orlando Health wants substantial prog-ress on the interoperability front and better technology.

“As our industry moves to value-based accountable care through clinical integra-tion and population health management, HIT solutions must truly be integrated across the expanded continuum of care,” he says.

“Providers and the industry overall need a healthy contingent of competent vendors and their solutions from which to invest for

healthcare’s future.”John Halamka, MD, CIO of Beth Israel Med-

ical Center in Boston, never one to settle for moderate expectations, offered three bulleted desires. Within the three items, he wished for interoperability, new products, new clinical research, comparative quality analysis and pharmaco-vigilience; innovation and data transformed into information, knowledge and wisdom; patient engagement and more. Of course, his wishes are all connected – or

as he might say, “interoperable.”These healthcare IT hopes and dreams – and perhaps world peace

– should make for a very good year. n

cIoSCoNTINued from Page 5

UP-AND-COmINg

John Halamka, MD

their fingertips.”Finally, JaeLynn Williams,

senior vice president at 3M Health Informa-tion Systems, said she hoped the industry would “free the data and open the work-flow” in 2013.

“Clinical data col-lected by EHRs has tremendous variation, so it can’t be easily mined or freely shared between people and institutions,” she explains. “Standardizing and normalizing data as it is stored is an essential first step in mak-

ing it accessible and usable. We know how to do this, but as an industry we haven’t made the effort. More importantly, we need to create open access to the

vast stores of clinical data that exist within healthcare.”

“Right now this data is available to only those who col-lect it and is limited, in large part, to the proprietary systems housing the data,” she adds. “We need

to free the data to drive better healthcare and better tools and systems. Eliminate barriers to data, and we will unleash an innovation firestorm.” n

VENDoRSCoNTINued from Page 5

Scott Maclean

Rick Schooler

“more important and more powerful would be an environment where we allow patients to be the stewards of their medical record.”Denni McColm

Jaelynn Williams

I see where Greenway’s moving and the technology it has. It’s staying on the cutting edge.”

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Policywww.HealthcareITNews.com | HealthcareITNews | January 20138

Breaches still a problem for hospitals, practices

The healthcare industry has made little progress in reduc-ing data breaches, according a new analysis of the past three years by the Health Informa-tion Trust Alliance (HITRUST). HITRUST’s retrospective anal-ysis of breaches affecting 500 or more individuals suggested a modest decline in the total

number of breaches since 2009, officials say, but that overall the industry’s susceptibility to certain types of breaches has been largely unchanged since new HIPAA and HITECH Act regulations took effect and breach data became available from the U.S. Department of Health and Human Services.

Doc use of EHRs up 24 percent

A new report issued by the National Cen-ter on Health Statistics (NCHS) has found that in 2012, 72 percent of office-based physi-cians used electronic health records (EHRs), up from 48 percent in

2009. That represents an increase of 24 percent. Compared with the national average pegged at 72 percent, the percentage of physicians using any EHR system was lowest in Connecticut, Illinois, Louisiana and New Jersey, according to the report, and higher in Arizona, Delaware, Hawaii, Iowa, Massachusetts, Minnesota, North Carolina, North Dakota, South Dakota, Utah and Wisconsin.

VA sets gold standard for EHR baseline

The Department of Veterans Affairs is slated to create a separate repository for its fully open source Gold Disk version of its VistA electronic health record (EHR) system to assure a common soft-ware baseline compared with the 133 instances of VistA operating at its hos-pitals and clinics across the

country. VA also will put in place a software testing platform, stan-dards supporting open-source development and documentation of open-source community outreach planning, according to a November announcement in Federal Business Opportunities.

Cash moneyEHR incentive payments top $10 billion in 2012By Mary Mosquera, Contributing EditorWASHINGTON – Medicare and Medicaid elec-tronic health record (EHR) incentive pay-ments are estimated to have reached $9.245 billion to 177,100 physicians and hospitals through November. They’re anticipated to reach $10 billion by the end of the year. (Healthcare IT News went to press before the Centers for Medicare and Medicaid Services posted final figures in late December.)

During November, CMS estimated that it paid 8,250 Medicare-eligible physicians $150 million; 4,000 Medicaid physicians $73 mil-lion; and hospitals under either of the two programs $645 million, for a grand total of $868 million, according to Robert Anthony, a specialist in CMS’ Office of eHealth Stan-dards and Services.

“We saw a large number of hospitals come in November – 525 hospitals were paid by either Medicare or Medicaid,” he said at the Dec. 5 meeting of the advisory Health IT Policy Committee.

Many providers, hospitals in particular, will attest and get paid in the final months of this year and early months of next year so they can be counted for 2012.

“The incentive payments were almost $1

billion more in November. We are on track for the end of December to hit the $10 billion mark for EHR incentives,” Anthony noted.

In October, the totals were $8.4 billion paid since the program’s start to 164,593 Medicare and Medicaid providers.

Each month, the percent of provider involvement in meaningful use steadily rises. As of October, 26 percent – or one out of every four Medicare eligible providers – are meaningful users of EHRs, Anthony said. Additionally, one out of every three Medi-care and Medicaid eligible providers has made a financial commitment to an EHR, he noted. And more than 65 percent of eli-gible hospitals have received an EHR incen-tive payment.

Data supplied by the regional health IT extension centers showed that, as they assist physician practices in adopting and using EHRs, they struggle most notably with the clinical summary, medication reconciliation, security review, patient reminders and the summary care record.

“We see that this information jibes very closely with what we’re seeing in attestation as well,” said Anthony.

Practices also find challenges as they try to become meaningful users of EHRs including, by rank, provider engagement

By November 2012, the CMS estimated that some $9.3 billion EHR incentives had been paid out to providers. End of year estimates were pegged to top $10 billion.

EHR sEE pagE 13

Telehealth poised to take center stage nationwide, experts sayVA uses the technology to prevent suicideBy Diana Manos, Senior EditorWASHINGTON – Telehealth used to be something few people knew about, or understood. Today, it is fast taking its place as a major aspect of health-care, according to experts at the National eHealth Collaborative’s Technology Crossroads Conference in Washington, D.C., on Nov. 27.

Peter Levin, chief technology officer for the Department of Veterans Affairs (VA), said the VA has recently used telehealth to focus on mental healthcare. Since last July, the VA has used instant messaging in a suicide prevention program to keep 6,000 vets online until help could arrive.

The VA is also focusing the use of telemedicine on oncology follow-up care. Ultimately, it’s about a patient’s peace of mind, said Levin. “That’s why we do what we do.”

According to Jonathan Linkous, CEO of the Amer-ican Telemedicine Association (ATA), telemedicine is growing by leaps and bounds, and is poised for double its current use in the next few years.

When Linkous began working in telehealth in 1993, stakeholders would say, “Any day now, tele-health will turn the corner.” But, “The corner has come and gone, and we never even noticed,” he said. “Telehealth is a mature industry now.

“The time is right,” for telehealth to grow, Linkous added. “Over the next year, you are going to see some very important people joining the telehealth bandwagon.”

Telehealth used to be only an emphasis in rural areas, where it is critical to care. But now, it is on the radar of healthcare CEOs in all parts of the country, Linkous said.

Telehealth has also attracted the interest of payers. In the next two years, several major healthcare payers will be making “some interesting announcements” about telehealth, he said.

According to Linkous, 200,000 patients nationwide use remote monitoring. It is used to monitor one million cardiac patients a year, and has provided 400,000 virtual visits this year to mental health patients, via Skype.

Eighty percent of patients being treated for neurological diseases are currently moni-tored outside of a hospital, Linkous said. Almost every major neurologic healthcare organization is “on board.”

“This is a real industry, making real money,” he said. “It’s an exciting time to be in telemedicine – and I thought it was back in ‘93.”

Chuck Parker, executive director of Continua Health Alliance said the greatest benefit derived from telehealth is using it to keep people well and out of the doctor’s office in the first place. Meaningful use Stage 3 should be a great help in moving this toward a reality, he added. n

Peter Levin, chief technology officer for the Department of Veterans Affairs

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Doctors against mU pre-pay auditsOIg calls for better program oversightBy Diana Manos, Senior EditorWASHINGTON – A report issued Nov. 29 by the Office of the Inspec-tor General (OIG) calling for more oversight of the meaningful use program, including pre-payment audits, has doctors concerned.

“We oppose prepay audits in the meaningful use program, as they would impose additional burdens on physicians who already face separate program requirements for multiple Medicare health IT and quality programs,” said Ameri-can Medical Association (AMA) Board Chair Steven J. Stack, MD. He added, however, that the AMA “supports the OIG’s other recommendations.”

“We agree that CMS should issue clear guidance about the types of documentation physicians must maintain to support their compli-ance with the meaningful use pro-gram,” Stack said. “We also sup-port the recommendation that ONC improve the certification process for EHR technology and require cer-tified EHR technology to produce compliant and accurate reporting documents.”

In the report, the Centers for Medicare & Medicaid Services (CMS) also disagreed with pre-pay audits, citing the burden on physicians.

Other stakeholders back over-

sight – purely as a routine part of fiscal responsibility over any fed-erally funded program – but were quick to point out that there has been no evidence of providers fraudulently reporting.

David Kibbe, MD, senior advisor to the American Academy of Family Physicians, said he agrees CMS needs to do a bet-ter job of overseeing the MU incentive program.

“It is simply com-mon sense that the spending of this much money ought to be accompanied by closer supervision, including audits,” he said. “I’d add that there is also a need for CMS to do a bet-ter job of assisting healthcare providers, especially physicians in small practices, to spend this money wisely and to get the features and functions from the EHRs they need to do quality improvement.”

Linda Fishman, senior vice president of public policy analysis and development at the American Hospital Association, said, “The OIG report contains no evidence of improper payments.”

“Hospitals take seriously their obligations to provide accurate reports to Medicare and are work-ing diligently to comply with the highly complex regulatory require-

ments in the meaningful use pro-gram,” she said. “In addition, CMS is currently conducting audits of hospitals that have received mean-ingful use payments.”

The report also called for the Office of the Nation-al Coordinator for Health Information Technology (ONC) to alter the EHR certifi-cation requirements to include yes/no-reporting capabilities for meaningful use.

“I think it’s worth noting that the OIG report does not reveal any inappropriate payments, nor does it insinuate they nec-essarily exist,” said Justin Barnes, vice president of market-ing, industry and government affairs at

Greenway Medical Technologies. “Its central point is a matter of con-sidering the establishment of any necessary financial oversight as the meaningful use program advances.”

“If federal agencies can deter-mine agreeable oversight – if nec-essary – as well as what eligible providers and hospitals need to put into place to document incen-tive funding and eligibility, I think that type of future transparency will benefit the entire system, but I don’t believe that retroactive audits would find any issues with either the Medicare or the Medic-aid pathway funding,” he added. n

“The OIG report does not reveal any inappropriate payments.”Justin Barnes

Bipartisan Policy Center focuses on consumerelectronicssmartphone use: good for healthcareBy Diana Manos, Senior EditorWASHINGTON – Electronic tools, including smartphones, can help patients, but the adoption of apps for smartphones and online tools for healthcare are still lagging, according to a new report released by the Bipartisan Policy Center in Washington, D.C.

At a Dec. 10 report-release briefing, Janet Marchiabroda, chair of the Health IT Initiative at the Bipartisan Policy Center, said smart-phones have changed every aspect of American life, including the way Americans shop, travel and manage their finances. “If we could apply that use of smartphones to healthcare, great things would

result, she said.Barriers on the con-

sumer side often include lack of awareness that the apps are out there, and more innovation is still needed in the marketplace.

Farzad Mostashari, MD, national coordina-tor for health informa-tion technology, who spoke at the briefing,

said one barrier is often providers’ lack of understanding of HIPAA. “Sometimes it’s interpreted that HIPAA means, ‘I can’t give you your health information.’ HIPAA gives people a right to access of the information in the format that they want.”

Mostashari said the main message from ONC’s tiger teams is that authentication for smart phones is here: “People want access to their healthcare records.”

Tom Daschle, former U.S. Senate Majority Leader and co-founder of the Bipartisan Policy Center said patient engagement is still a critical and missing piece to improving American healthcare and lowering costs – smartphones could be a part of that.

“At eighteen percent and rising, healthcare spending is placing CONSuMER sEE pagE 12

“While healthcare providers have widely embraced patient engagement, it’s sometimes hard to get there.”Janet Marchiabroda

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a considerable burden on our econ-omy,” added Marchiabroda. “Iden-tifying ways to decrease healthcare costs is critically important to our nation.”

Electronic tools can improve patient-physician communication, she said. Patient centered commu-nication is associated with fewer diagnostic tests and higher adher-ence to medication. It has also been associated with a positive impact on behavioral changes and patient self-care management. “Engaged patients are also more satisfied when they are knowledgeable, involved and empowered,” she added.

“While healthcare providers have widely embraced patient engage-ment, it’s sometimes hard to get there,” said Marchiabroda. Patient-doctor communication most often takes place in the exam room, for less than 20 minutes at a time, she added. This makes it difficult for phy-sicians and patients to communicate. The use of electronic communication tools could help tackle problems before they happen and improve the experience for patients. n

nehC continues its patient engagement pushEmpowerment is ‘blockbuster drug of the century,’ says mostashariBy Mike MiliarD, Managing EditorWASHINGTON – One week after unveiling its Patient Engagement Framework, the National eHealth Collaborative (NeHC) has launched

an online tool meant to help health organizations track their progress on involving patients in their care.

The NeHC Consumer eHealth Readiness Tool (CeRT) offers an organizational evaluation tool, real-time progress reports and a compre-hensive resource library designed to gauge the strength of organiza-tions’ engagement activities and help them prioritize their plans for improvement, officials say.

“The NeHC CeRT is a concrete resource created to help health-care organizations measure and grow their patient engagement strategies,” said NeHC CEO Kate Berry. “We hope the Patient Engage-ment Framework in combination with the NeHC CeRT will raise vis-ibility and build awareness for the importance of consumer engage-ment and help the industry make progress in this direction.”

NeHC has partnered with Farm-ington, Conn.-based consumer engagement company Health-CAWS to bring the technology to the market.

As meaningful use Stage 2 fuels a drive toward patient empower-ment, the Web-based tool is meant as a cost-effective business intel-ligence solution for organizations seeking help to accelerate their consumer engagement efforts, offi-

cials say – offering a structure and support for organizations to mea-sure their progress over time and a resource library to spur develop-ment of innovative new initiatives.

It’s aimed at an array of organi-zations, including health systems, provider groups, hospitals, health plans, health information exchang-es, regional extension centers and more.

Increasing consumer engage-ment is a strategic move that cultivates consumer loyalty and increases an organization’s com-petitive advantage in addition to improving health outcomes and, NeHC officials note, it can also be profitable. In addition to being mapped to the phases of the NeHC Patient Engagement Framework, the NeHC CeRT is also aligned with meaningful use consumer engagement criteria and several accountable care incentive programs.

“It has been exciting to work with the NeHC team and their many colleagues to advance con-sumer engagement in eHealth,” said Rose Maljanian, founder and CEO of HealthCAWS.

“Dr. Farzad Mostashari, Nation-al Coordinator for Health IT, said it best when he commented at a recent meeting that ‘consumer engagement is the blockbuster drug of the century.’ As an indus-try, we need to focus our resources on programs and tools that encour-age our patients to maintain their personal best health, avoid unnec-essary care and partner closely with their providers to achieve the best possible outcomes.” n

PolicyJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 13

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(25 percent); administrative issues (22 percent); vendor selection (6 percent); workfl ow adoption (14 percent); and financial issues at 10 percent. On vendor issues, the biggest area is the delay in imple-mentation or installation of EHRs.

“Meaningful use measures are not the lead challenge for most providers, except for very small providers,” said Anthony.

Neil Calman, MD, policy com-mittee member and president and CEO of the Institute for Family Health, was gratifi ed that meaning-ful use measures did not lead the challenges for physicians.

“I think that speaks a lot to how on target we are at bringing meaningful use into the spectrum of what’s good for the public,” he said. “Now we have the data about how right on this initiative is.” In mission-driven organizations where the patient is the focus, people don’t see meaningful use measure

as off target but rather part and par-cel with the work, Calman added.

Paul Tang, MD, policy committee vice chair and chief innovation and technology offi cer at the Palo Alto Medical Foundation, said he was encouraged that the fi nancial issue, which used to be the number one barrier, is no longer the top challenge for physicians. Now, it’s making sure that more standards are there with-out deterring providers. “We don’t want standards to be an excuse for not moving forward,” he said.

From the meaningful use attesta-tion data, providers reported that few patients know at this point that they can request an electronic copy

“We don’t want standards to be an excuse for not moving forward.”Paul Tang

of their health information, Antho-ny said. When patients have asked, however, physicians are providing their information at a very high rate, though a large number of physicians are putting off the objectives for electronic access to information and patient education resources.

Providers generally cite the same most popular and least popular menu objectives for meaningful use each month, he said. Besides the required measures, the most popu-lar menu objectives for physicians are drug formulary, immunization

registries and generating patient lists. For hospitals, it’s advance directives, drug formulary and clini-cal lab test results. The least popular menu measures for physicians are

the transitions-of-care summaries and patient reminders; for hospitals, it’s the transitions-of-care summa-ries and reportable lab results.

As of November, 117,284 have

attested successfully, with 230 unsuccessful at fi rst, and 214 later resubmitting successfully, Anthony said. Among hospitals, all 2,558 that attested did so successfully. n

I think that speaks a lot to how on target we are at bringing meaningful use into the spectrum of what’s good for the public. Now we have the data about how right on this initiative is.”Neil Calman, MD

insightwww.HealthcareITNews.com | HealthcareITNews | January 201314

$9B in EHR incentives: Success or failure?By Diana Manos, Senior Editor

No one would have guessed how far and how fast the federal incentive program for the adoption of EHRs

would grow. Funding was mandated in 2009 under the HITECH ACT, with an estimated total expenditure antici-pated at $20 billion. As of December, that payout had already reached $9.2B in the program’s second year of a five-year program.

Is this a 2012 Washington success story or a travesty? Well, that depends on whom you ask. If you ask ONC chief Farzad Mostashari, MD, you would get glowing adages of unsurpassed suc-cess, with an eye toward an even more higher adoption rate in the future. If you ask certain fiscal conservatives on Capitol Hill, you would get a glower-ing eye and a resolved shake of the head. This is money that the govern-ment can’t afford to spend, they’d say.

Added to this already wary outlook, GOP lawmakers are also distressed with what they fear is a lack of oversight to the meaningful use incentive program. Are providers self-declaring their MU correctly? Is there fraud under way?

Step outside of the Beltway, and you will be hard-pressed to find a physician practice or hospital system that has com-pleted the difficult process of transition-ing from paper to EHRs that is not fully convinced that EHRs don’t improve care.

The federal budget is going to be the congressional battleground in 2013, above all other aspects of federal jurisdiction. Sparks are going to fly, and (figurative) blood is going to be shed. Despite the landmark federal efforts made at light-ning speed to overhaul a paper-based system, there will be some hearings on Capitol Hill calling for explanation and defense of the MU program. There already have been some in 2012.

Does this mean there is a report card that can be made, for or against the MU program? Probably not. The pro-gram is riddled with problems yet to be resolved – privacy issues, interoperabil-ity, to name just two. But can the health-care system continue to operate in the past, when the U.S. marketplace oper-ates in an electronic world? Doubtful.

Some say the government didn’t need to interfere; the market would have sooner or later forced adoption of EHRs. If you’re a solo-practitioner, that might not have been for many years to come. Let’s ask the small physician practices: Is the $9 billion payout for EHR incen-tives – so far – a success or failure? n

We love the prospect of a new year ahead – 365 new days. It’s just a calendar, of course, a tool for order-ing days, setting meetings,

making appointments and remembering birthdays. But as we move from the last day of one year to the first day of the next, our Outlook and Google calendars seem so much more than a way to schedule yet more tasks, more appointments, more projects and more deadlines.

A new year presents potential for a fresh start, for new ideas, for innovation, for revamping, or plenty of tweaking.

We are just back from two health IT events – the mHealth Summit and the Healthcare IT News/HIMSS Media Privacy & Security Forum, both high energy events, where the resolve for making health IT be the best cata-lyst it can be to create a new approach to patient care, was palpable.

At the mHealth Summit, we met Katy Fike and Stephen Johnston from Aging 2.0, an organization dedicated to finding new ways to address the healthcare needs of an aging population.

“I love trying to be that bridge between really understanding what’s changing for older adults, what’s going on in their bodies and minds and families and communities and trying to convey those needs to businesses and help them create better solutions.” Fike told us.

HigH Hopes: the make-it-happen kind

We caught up with Joseph Kvedar, MD, founder of the Center for Connected Health, part of Partners HealthCare in Boston. Long before mHealth became part of the health-care IT vernacular, Kvedar was at work con-necting people with diabetes and other chronic conditions to monitors that helped manage their disease. Not one to rest on his laurels, he and his team are developing a new initiative called Wellocracy (see Kvedar’s commentary below).

At the Healthcare IT News/HIMSS Media Privacy & Secu-rity Forum last month Tim Zoph, CIO of Northwestern Memorial Hospital in Chicago, called on attendees to raise the bar on pri-vacy and security change at their own orga-nizations. Nothing short of a culture change would do, he asserted.

We spoke with Leon Rodriquez, director of the Office of Civil Rights, which is charged with enforcing the HIPAA Privacy and Secu-rity Rule. To push healthcare into the digital age, “there has to be bedrock patient trust,” he told us. As he sees it, enforcement has to be assertive, yet balanced with education.

Fike, Johnson, Kvedar, Zoph and Rodri-guez are a tiny fraction of the thousands upon thousands of individuals making a huge dif-ference in the healthcare IT industry today. Some leaders have been at work for many

years, while others are emerging as leaders. Associate Editor Erin McCann profiles a few ‘up and comers’ (Page 6).

In the spirit of a new year, Healthcare IT News editors asked policymakers, vendors and

CIOs (Page 4) what they wanted to see done on the healthcare IT front in 2013. There are many hopes and dreams, needs and wants: EHRs that work, better technology all around, national patient identifiers, patients who are engaged in their own care, tight security for patient data, interoperability, a smooth tran-sition to ICD-10 are just a few.

The industry leaders we talk-ed with would not be content with merely dropping coins in

a fountain or wishing upon a star for what they want: Each and every day they work to make their vision of improved patient care a reality. They are innovating even as they keep shoulders to the wheel. No one we know is on standby.

Some told us they long for productivity and cooperation. Others waxed eloquent about clarity, patience and wisdom. Yes, let’s go for those elusive goals in 2013. They help keep everything in perspective, and somehow everything else begins to fall into place – even the transformation of a $2.6 trillion, unwieldy healthcare system into one that provides top-notch care in an elegant, efficient way. n

Washingtonwatchdiana manos, Senior Editor

BERniE monEgain, Editor

Wellocracy Is comINg!By Joseph c. KveDar, MD

After working at this remote patient monitoring game for about 10 years now, we are ready to bring self-care to consumers – couch potatoes, weekend warriors and

all of us in between hoping to live a little healthier, lose a few pounds or just feel a little better. Meet Wellocracy.

The goal of Wellocracy is at once simple and daunting – to get America moving, and to motivate our citizens to move to a healthier state. It turns out that the formula is straight-forward: a) track your activity; b) find your individual set of motivational tools; and c) find ways to increase your activity without disrupting your life.

But let’s take a quick look at how we got here. In the early days of remote monitoring, we thought the big value add would be giv-ing a doctor or nurse a more rich data stream about your vital signs ,and this would enable her to make better just-in-time decisions about your care plan. Turns out, we were right. The best example of this is the 50 per-cent reduction in hospital readmissions we’ve seen by employing home telemonitoring for our heart failure patients.

But the biggest insight that I’ve gained

in my 18-plus years of working in connect-ed health came when some of our earliest patients on that same telemonitoring pro-gram began to sig-nificantly improve their self-care. We noticed that they used their daily monitoring results (weight, blood pressure, heart rate) as a numeric yardstick for their progress, enabling them to better understand the basic pathophysi-ology of congestive heart failure. They began to realize that salt intake leads to fluid reten-tion and if your heart is weak, a buildup of fluid in the lungs can be quite dangerous. As a result, they started being much more fastidi-ous about salt and fluid balance.

As we observed this phenomenon, we broke it down into two sets of factors we could study: the use of objective data in feedback loops and the use of motivational psychology to help our patients strive to keep those data in the right range. In most cases,

the motivational tool was a phone call from one of our telemonitoring nurses (highlight-ing our partnership with Partners HealthCare at Home). One lovable and amusing quote from a patient comes to mind: “I can’t eat fudge because I can’t fudge my data.”

Another profound, reproducible find-ing over the years has been the attachment patients feel for these home-monitoring devices. Patients almost universally plead not to be taken off a remote monitoring pro-gram. This led us to the observation that self-tracking is contagious or in Internet parlance, ‘sticky.’ Most people enjoy seeing how their lifestyle affects some sort of number. Self-tracking keeps health top of mind and can keep people motivated.

A sNeAk Peek INTo WellocrAcy…I thought for years that if there was some way to bring this insight, this stickiness into the homes of regular folks that we would see a corresponding improvement in health and wellness in the population at large. As the quantified-self movement caught on to self-tracking and the deluge of self-tracking devic-es and apps that is now available came on the market, the conditions improved even further.

JosEpH C. KvEdaR, md

kvedAr see page 15

insightJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 15

Then I met two impressive colleagues who shared this vision for bringing connected health into the living room, namely Carol Colman, an accomplished author specializing in the self-help genre, and Justin Mager, per-sonal trainer turned physician and expert in lifestyle interventions. Soon we were joined by media relations maven extraordinaire, Gina Cella, and Wellocracy was born. Along the way, we picked up some awesome advis-ers, including Andy Donner, James Fowler, Emily Hackel, David Rose and Charlotte Yeh.

How will we achieve our goal to motivate individuals to move to a healthier state? We start with the premise that the self-tracking market is crowded, confusing and oriented toward techies. We will simplify the language and drive home the value through a series of books (short eBooks to be followed by a

traditional book later). These books will be tightly coupled to a website where we can build community around Wellocracy and continue to update our members’ knowledge about the fast changing field of self-tracking and behavior change.

We’re excited to have the opportunity to launch our first eBook and our website at the Consumer Electronics Show, Jan. 8, 2013. There, at the Silvers Summit, I’ll have the pleasure of moderating a panel on health apps for the 50-plus crowd. I hope we see you there. In the meantime, we’re looking for early adopters to join the Wellocracy com-

munity and share their own stories about how the combination of self-tracking, moti-vational tools and steps and bursts can lead to improved health. I’m excited to be working with Carol, Justin, Gina and our advisers as we launch this effort to improve the health of our nation. More to come on Wellocracy, as we ready for the official launch in January… n

Joseph C. Kvedar, md, is the founder and director of the Center for Connected Health, a division of partners HealthCare in Boston. He can be reached at jkvedar@partners.org. His commentary first appeared on The cHealth Blog.

New model for healthcare analytics adoptionBy JiM aDaMs, Denis protti, Dale sanDers anD Detlev h. sMaltz

Healthcare in the United States and many other parts of the world has slowly been progressing through three waves of computer-ization and data management: data

collection, data sharing and data analytics. So far, however, the data collection and sharing waves, characterized by the urgent deploy-ment of electronic health records (EHRs) and health information exchanges, have failed to significantly impact the quality and cost of healthcare, even when the focus and will to improve healthcare existed.

The third wave – data analytics – prom-ises to reverse that trend and enable large numbers of healthcare organizations to at last realize a significant return on their EHR investments. A consensus model for adoption of analytics capabilities could help healthcare leaders and vendors succeed by providing a common road map for beneficial deployment of critical capabilities.

The promise of analytics lies in its ability to transform healthcare into a truly data-driven culture – one better able to take advantage of the many evolving financial incentives for providing optimum health at lower cost. The technology foundation of this data-driven transformation is the enterprise data ware-house (EDW). By enabling the analysis of both clinical, financial and other operational data from across the enterprise, an EDW lets provider organizations better understand their patients, providers and practices. For example, an EDW technology could help a healthcare organization find and address the waste in their delivery processes, while making qual-ity improvement interventions more effective.

Virtually all healthcare organizations have some capabilities to report and analyze data with siloed point solutions. These solutions provide value but lack the broad perspec-tive on patient care and risk management enabled by an EDW. Organizations can end up with a fragmented view of “the truth,” or even multiple sources of truth as different data definitions or versions of data across

multiple systems produce wildly different answers to the same question. As a result, their IT departments and analytics consum-ers can easily become labor-intensive “report factories” struggling to satisfy the demands of clinicians, who nonetheless complain they cannot get the information they need to track and improve quality or reduce cost.

In this dysfunctional environment, one might think the need for an enterprise data

solution would be obvious. Yet EDW adop-tion lags far behind that of the EHR. Fewer than one in 10 healthcare organizations today have an EDW, and even fewer use the technol-ogy to its utmost.

We believe it is possible to accelerate the adoption and meaningful use of an EDW by learning from and expanding upon the tools that encouraged the adoption of EHRs, notably the seven-stage EMR Adoption Model (EMRAM) from HIMSS Analytics. The 2004 publication of EMRAM created a piv-otal framework for measuring the industry’s advancement towards the use of EHR. Before EMRAM, organizations were left to guess at the level of their EHR capabilities; the model

revealed for all to see just how rudimentary the true level of EHR capability was across the industry.

Just as EMRAM accelerated the under-standing of EHR adoption – helping pave the way for HITECH funding – we propose an Analytic Adoption Model (AAM) for health-care to provide a framework for more rapid progression through analytic capabilities. As you may have noticed, our model purposely mirrors the look and feel of the EMRAM. We propose eight levels of adoption that CIOs and other healthcare leaders can use to quickly assess their organization’s maturity and plot a roadmap to achieve higher levels of adop-tion and utilization. Likewise, analytic prod-uct vendors can quickly assess their products’ current capabilities and refer to the AAM as a high-level product development roadmap.

We believe that an Analytic Adoption Model, which was described initially in Elec-tronicHealthcare, (Vol.11 No.2 2012), will enable healthcare organizations to fully understand and leverage the capabilities of analytics and so achieve the ultimate goal that has eluded most provider organizations – that of improving the quality of care while lowering costs and enhancing clinician and patient satisfaction.

We are hopeful that our colleagues in the industry will review this model and con-tribute to its evolution. An updated version, incorporating comments, will be published in an upcoming version of ElectronicHealthcare. n

Jim adams is executive director of The advisory Board Company.

denis protti is professor emeritus at the University of victoria (British Columbia) and the founding director of its school of Health information science.

dale sanders is senior vice president of Healthcare Quality Catalyst, a senior research fellow at The advisory Board Company, and mentor Cio for the national Health system of the Cayman islands.

detlev H. (Herb) smaltz is co-chair and CEo of Healthcare dataWorks.

“One lovable and amusing quote from a patient comes to mind: ‘I can’t eat fudge because I can’t fudge my data.’”Joseph C. Kvedar, MD

“Organizations can end up with multiple sources of truth as different data definitions or versions of data across multiple systems produce wildly different answers to the same question.”

kvedArcoNTINued from page 14

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1. ExpEriEncE thought lEadErsFrom President Bill Clinton to Dr. Eric Topol to Dr. Connie Mariano to the many other Keynote and Views from the Top sessions, these speak-ers will inspire and challenge attendees to think about the future of healthcare and technology.

2. advancE carEEr goalsHealthcare professionals can create an agenda that equips them with the knowledge and tools to help them and their organizations succeed. This year’s agenda has over 300 education sessions around key industry topics such as mobile health, clinical & business intelligence, care coordination, accountability for care and Meaningful Use.

EducationMeaningful Use, Mobile & More

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Why You Should Attend HIMSS13

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3. accEss provEn tacticsHear real-world strategies and success stories from dozens of nationally recognized thought leaders who have improved access to care, bettered the delivery of care, and reduced healthcare costs through health IT.

4. MakE lasting connEctionsWhether through social media or networking events onsite, meet industry trendsetters, socialize with old friends and develop new relationships with like-minded professionals from across the healthcare industry.

5. connEct with latEst hEalth itExperience thousands of health IT products and services from over 1,100 exhibiting companies, and discover the latest health IT innovations and the creative minds behind them.

What is your top reason to attend? Share it on the HIMSS Facebook Page or on Twitter by using the #HIMSS13 hashtag.

REmINDER! HIMSS13 returns to its Sunday through Thursday schedule (March 3-7)

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SympoSia SpoTLiGHT

sunday, March 3

Clinical & Business Intelligence Symposium: A Practical Guide“There are two critical things that we hope attendees will take away,” says speaker Cynthia McKinney, MBA, FHIMSS, PMP. “Clinical & business intelligence (C&BI) requires a full project lifecycle with dedicated resources and organizational commitment. It is something that an organization must be willing to fully commit to as it is a major change to how they can/will do business. [In addition,] to fully achieve the benefits of C&BI, an organization must realize that it needs to leverage and intertwine both the clinical and business aspects of business intelligence.” McKinney is co-editor of Implementing Business Intelligence in Your Healthcare Organization (HIMSS, 2012), which will be for sale at the HIMSS13 Bookstore.

Connect on Twitter: #bizintel and #HIMSS13

Innovation Symposium: The Science and Practice of InnovationThis Symposium will focus on the science and practice of innovation, which will help you understand and apply proven principles to create value in your organization.

Traditionally, innovating in healthcare is very difficult due to a wealth of regulations and a dearth of funding and risk-taking behavior, says speaker Alex Fair, MS. “We hope to show how traditional barriers can be overcome, and enable more creative innovations to succeed in healthcare. I hope every professional leaves with the understanding that through innovation, they can reinvent healthcare in ways that produce better outcomes with fewer resources.”

Connect on Twitter: #innovation and #HIMSS13

Meaningful Use Symposium: Transform MU from an IT Project to an Organizational InitiativeThis Symposium will address the challenges of becoming a meaningful user, while also exploring success stories, and providing practical takeaways.

Speaker Liz Johnson, MS, FHIMSS, CPHIMS, RN-BC, is excited for the “opportunity to network with health IT leaders across a complex set of care environments, all working on achieving

Meaningful Use and sharing ideas to make solutions smarter, faster and better.” Johnson adds: “Complex organizational initiatives are part of every health IT professional’s work responsibilities. The concepts utilized in achieving Meaningful Use can be reapplied in the diversity of other initiatives.”

Says speaker Robin Raiford, RN-BC, CPHIMS, FHIMSS, “The scope is so wide for Meaningful Use. It is helpful there is a ‘one-stop shop’ for discussion and networking about the same goals and challenges. This Symposium has something for everyone—no matter what year or stage of Meaningful Use you are in.”

Connect on Twitter: #MUS2 and #HIMSS13

NEW WorkSHopSCovering a wide variety of topics critical to health IT professionals today, HIMSS13 Pre-conference Workshops are designed as interactive programs where attendees will actively participate in a highly collaborative environment.

More details about each Workshop are at www.himssconference.org/education

Workshop B: mHIMSS RoadmapmHealth Guidance for Hospitals and Health Systems explores strategies to integrate mobile/wireless technology into healthcare delivery through interactive break-out discussions on technology, policy, infrastructure, new care models, ROI, privacy/security, and standards/interoperability, all driven from the mHIMSS Roadmap.

Connect on Twitter: #mHealth, #mhimss and #HIMSS13

Workshop C: Clinical Workflow Methods and Tools for Clinical Workflow Analysis will describe the activities of individuals and clinicians related to clinical workflow; discuss various levels, types, and characteristics or properties of clinical activities comprising patient care; describe the general approach for the evidence-based Clinical Workflow Capture and Analysis Framework and evaluation methods; explain best practices for the careful capture and analysis of clinical workflow; outline an effective and comprehensive approach to evaluate a key workflow within their own organizations; and identify the resources and expertise necessary to execute the plan.

Connect on Twitter: #healthdata and #HIMSS13

Workshop D: Solving the Healthcare IT Adoption Dilemma This Workshop will describe the five measures of success for any health IT project; explain the three actions required from every sponsor to get to sustained adoption; describe which of the three actions required from sponsors is most important and why; and identify two key elements of a best practice communication plan.

Connect on Twitter: #healthIT, and #HIMSS13

Workshop E: Technology & Trajectory of Mobility in a New Healthcare Model This Workshop will identify the growing trends and technologies behind next-generation mobile networks; describe how to plan and prepare for mobility’s transformational effect on workflow, policy and security; demonstrate how to build an organization’s wireless prac-tice; describe the problems to avoid when implementing these new technologies and identify areas still needing answers; and detail how to integrate biomedical and IT resources around mobility and the wireless LAN.

Connect on Twitter: #mobiletech and #HIMSS13

Workshop F: Build Your Own Mobile AppThis Workshop will describe the mobile health application lifecycle and the tools needed to develop mobile applications; practice real-world development using industry accepted techniques and an extensive library of app function modules; create and test a real mobile application; and evaluate benefits of mobile development.

Connect on Twitter: #healthapps, #medapps and #HIMSS13

Workshop J: Fundamentals of Data Warehousing in HealthcareThis Workshop will differentiate the variety of clinical, operational, research and other data that are typically collected and stored in data warehouses; identify the forms of organization and structure that will best meet our needs; evaluate how a data warehouse design supports data privacy and security concerns; and explain the functional, technical, and project issues that will impact data warehousing.

Connect on Twitter: #healthdata and #HIMSS13

Returning Symposia & WorkshopsDay 1: saturday, March 2Workshop A: Meaningful UseAddressing the New Requirements of the EHR Incentive Program for Small Ambulatory Practices will provide information about the changes to the EHR incentive program for physicians in ambulatory practices. Workshop attendees will have opportunities to address workflow and other issues so that they arrive at solutions that will work within their own practices.

Workshop H: Preparing for an OCR AuditEvaluating Your Privacy & Security Programs will explain current federal and state legislative privacy and security updates; discuss how to balance access to information for patient care with privacy and security; describe t he three things that must be addressed for Meaningful Use Stages 1 & 2; discuss how to prepare, collect and present documentation as a body of evidence in an OCR audit; and list business associates obligations for HIPAA Privacy and Security compliance.

Nursing Informatics Symposium: The Road to Technology Enabled Quality CarePractical strategies will be shared by nurses engaged in the advancement, implementation and evaluation of technology-enabled quality care during this day and a half Symposium.

Day 2: sunday, March 3Workshop G: Health IT 101: An Introduction to Healthcare and IT Enabling Technologies Offers a practical understanding of the various processes and roles that form a health IT structure within our healthcare systems.

Workshop I: Healthcare Project ManagementIn this workshop attendees will learn how to teach project management basics to staff and leadership; learn effective project management tools and techniques; identify the critical and non-critical processes of project management; and influence leadership to adopt more rigid project management methodologies.

The ICD-10 Symposium: All Hands on Deck: Implementation, Optimization and Weathering the Perfect StormThis year’s ICD-10 Symposium will feature industry experts who will address critical topics such as collaboration, managing competing priorities, testing and overall impact of the transition.

The Clinical Engineering and IT Leadership Symposium: Executing Your Medical Device Integration RoadmapThis Symposium will address medical device security, privacy, human factors, failure planning and project lifecycle in a case study format.

HIE Symposium: Results Driven Health Information ExchangeThis Symposium reviews HIEs that have progressed post-HITECH and how HIE overlaps with national, state and local healthcare initiatives.

The Physicians’ IT Symposium: Reviewing the Past, Assessing the Present and Planning for the FutureThis Symposium will examine opportunities pertaining to Meaningful Use Stage 2, analytics and business intelligence, as well as patient engagement through social media and mobile applications.

The RFID & RTLS in Healthcare Symposium: Using Data Analytics to Improve Patient Care and Safety This Symposium will explore the latest auto-identification /data capture solutions and related implementation best practices to build the necessary technology bridges between data capture, aggregation, management, analytics and utilization.

Learn more and register for these sessions at www.himssconference.org.

EduCatioN: PrE-CoNfErENCE SymPoSia & WorkShoPS

Pre-Conference Sessions Tackle Critical Health IT IssuesHIMSS13 Pre-conference Symposia and Workshops invite a diverse and growing audience of profes-sionals to participate in specialized and highly interactive education sessions in the days leading up to the Annual Conference. New sessions introduced this year address the most pressing topics in health IT, including Meaningful Use, clinical & business intelligence and mobile health. Visit the HIMSS13 website (www.himssconference.org/education) for more details on these and other sessions, and to register.

UniqUe ‘Views’ on HealtH itV iews from the top sessions

at HIMSS13 bring together nationally recognized speakers to discuss the industry’s hot-test issues.

On Monday, March 4, prepared for the 21st century: Military healthcare and health it in an interoperable word will give attendees greater insights into the Military Health System’s innovations in

healthcare delivery. On tuesday, March 5, David Kennedy,

OSCE, OSCP, CISSP, ISO 27001, GSEC, MCSE, Founder, Principal Security Consultant, TRUSTEDSEC, LLC, will present hacking Your life. This presentation will discuss the different types of attacks hackers are lever-aging and how to build your security pro-gram in a way that can prevent and detect an attacker in the event of a data breach.

Also on tuesday, Karen B. Desalvo, MD, MPH, MSc, Health Commissioner, New Orleans Health Department, will present healthcare recovery: critical lessons learned from hurricane katrina. She will give an update on how health IT transformed the healthcare system in New Orleans.

On wednesday, March 6, lessons in Medicine and leadership from the white house doctor Dr. Connie Mariano,

will share her journey to the White House and vignettes from her nine years as White House Physician.

Also on wednesday, political pundit Paul Begala will examine the post-election envi-ronment in political outlook, healthcare debate, and 2012 Election results.

Visit www.himssconference.org/education to learn more and to register.

january 2013 hp-3www.himssconference.org PREVIEW

Specialty Programs Offer ‘Uncommon Opportunities’Explore emerging healthcare models and seek out new investments and market potential—HIMSS13 has a wealth of uncommon opportunities for you.

HIT X.0: Beyond the Edge Tuesday & Wednesday, March 5-6HIT X.0: Beyond the Edge is a popular and unique event that provides healthcare leaders a glimpse into emerging technologies and industry innovations. Seating is limited; registration is required to guarantee a seat.

Global Health Forum Monday, March 4Global health has become a strategic priority for the US government. Two global organizations, the World Bank and USAID, as well as HHS, will provide an over-view of projects, public-private partnerships and discuss how this area is being proactively addressed.

HIMSS International Forum Tuesday, March 5Learn more about current and future international eHealth strategies and how foreign governments are investing to manage the future demographic challenges, increased regional collaboration and implementation and usage of a growing number of mobile devices and remote monitoring.

The Patient Experience Through Health IT Forum Tuesday, March 5This one-day forum features three sessions dedicated to the value of enhancing the patient experience. Topics will include meeting the new Meaningful Use Stage 2 engagement requirement, proven outcomes of patient-centered strategies and innovative technologies/market drivers.

TIGER Institute Monday – Thursday, March 4-7The TIGER Institute at HIMSS13 will address critical factors in how technology and informatics can guide and impact education reform. Attendees will learn the next efforts of The TIGER Initiative Foundation, including its recently launched Virtual Learning Environment and “TIGERs in Action.”

Leading from the Future Sunday, March 3Leading from the Future will tackle the critical need to link explore the intercon-nectedness of the cost of care and the quality of that care. New to this year’s event is the ACO Encounter—a series of presentations that feature representa-tives of successful ACO models from the payer, physician and health system perspectives. Separate registration is required for this event.

Healthcare Transformation Project Tuesday & Wednesday, March 5-6The Healthcare Transformation Project provides exclusive access to activities and resources promoting thought leadership, an open exchange of ideas, networking and commitments to action that will help you realize your mission of transforming healthcare where you live.

Summit for Healthcare Information and Financial Technology (SHIFT) Tuesday, March 5SHIFT explores how advances in banking and healthcare information systems can be combined to improve reimbursement, automate workflows and advance the quality of patient care. The optimal audience for SHIFT includes hospital CFOs, revenue cycle managers, software vendors, payers, banks and small practices. SHIFT registration includes access to HIMSS13.

HIMSS13 OnlineIf you are unable to attend HIMSS13 in person, take the second best seat by attending the online extension of the Annual Conference & Exhibition. HIMSS13 Online provides access to select portions of both live and on-demand events for only $39. The online extension’s live hours include Tuesday, March 5; Wednesday March 6; and Wednesday, March 13.

Visit www.himssconference.org for more details on each of these programs.

EduCatioN: GENEral SESSioNS & SPECialty ProGramS

Meaningful Use, Mobile & Morew ith more than 300 edu-

cation sessions, specialty programs and activities

available at HIMSS13, picking the right schedule for your profession-al development can be daunting. However, a broader look at what’s being offered at HIMSS13 finds sev-eral themes that connect to sessions held throughout the Annual Confer-ence, including ICD-10, Meaningful Use, mobile health and clinical & business intelligence.

Learn more about 23 general ses-sion topics, such as revenue-cycle management and clinical decision support at the HIMSS13 website.

MEaningful usEMeaningful Use continues to be a force at the Annual HIMSS Confer-ence—and this year is no exception.

HIMSS13 offers dozens of gen-eral sessions from Monday, March 4, through Thursday, March 7, fea-turing leaders from both hospital systems and ambulatory practices demonstrating how they are pre-paring for Stage 2 Meaningful Use and beyond, including leveraging an emergency medicine EHR, integrat-ing with inpatient systems, employ-ing sourcing strategies, conducting security risk assessments.

“Meaningful Use has become part of the fabric of our strategies for implementing clinical systems in the healthcare environment. HIMSS is a leader in educating healthcare information systems leaders in understanding the requirements of, tactics to be employed and ben-efits to be gained in all major health IT-related initiatives,” says Liz Johnson, MS, FHIMSS, CPHIMS, RN-BC, a speaker at the HIMSS13 Meaningful Use Symposium.

clinical & BusinEss intElligEncEAt HIMSS13, clinical & business intelligence (C&BI) is given sig-nificant attention throughout the conference—both in general educa-tion sessions and the Exhibit Hall.

More than 10 general education sessions are scheduled from Mon-day, March 4 to Thursday, March 7. Sessions will cover hot topics such as predictive analytics, enterprise business intelligence, benchmark-ing, empowering clinical leadership and accountable care organizations.

Cynthia McKinney, MBA, FHIMSS, PMP, who will speak at the C&BI Symposium on Sunday, March 3, says, “Our hope is that the [education] is practical and relat-able. We hope it will help attendees develop their plan or enhance their current project.” She adds that the education sessions will help attend-ees take advantage of the enormous opportunities presented by C&BI—such as the ability for organizations to make better business decisions because they are able to fully lever-age clinical, operational and financial information—as well as ably address organizational challenges, such as extensive cultural change and cost.

icd-10It is a crucial time for organizations as the required ICD-10 implementa-tion date draws near. More than ever, communication and careful planning are key factors to a successful transi-tion. HIMSS13 will offer many educa-tion and exhibit-based sessions and presentations throughout the confer-ence, as well as specialty programs.

“Attendees should gain a more comprehensive understanding of the depth and breadth of ICD-10 impacts to their organization and their trad-ing partners,” says Jim Daley, WEDI Chairman and Co-Chair of the WEDI ICD-10 Workgroup. “They will hear about ways to work together to col-lectively address the testing and implementation process and reduce the overall effort needed by leverag-ing knowledge and resources.” Daley will speak at the ICD-10 Symposium on Sunday, March 3.

“The goal is for attendees to learn about the coordination needed between physicians and coders going forward in ICD-10 to make

the transition from ICD-9 to ICD-10 easier and better for patients and for organizations,” says Don Rappe, MD, who will co-present at the ICD-10 Symposium. “ICD-10 documen-tation and coding is a ‘team sport’ with contributions and cooperation needed from professional coders and physicians who each have their own role to play in making this a success.”

“Quality Measures Reporting is becoming an important revenue source for providers. ICD-10 has the potential to disrupt quality reporting and negatively impact that revenue stream, and my goal is to help attend-ees understand where their business operation may be at risk,” says speak-er Stephen Spain, MD, FAAFP, CPC. “I hope to be able to provide insight into the problems that might be encountered in reporting Meaning-ful Use measures as we transition to ICD-10, and to help attendees prepare for the challenges they may face.”

MoBilE hEalthMobile health continues to be a game-changer in the health IT indus-try. HIMSS13 will continue exploring and educating on this ever-changing and dynamic topic through pre-con-ference programs, general education sessions, exhibit hall presentations and specialty sessions.

Three pre-conference workshops address mobile healthcare at HIMSS13. These include Workshop B: mHIMSS Roadmap—mHealth Guidance for Hospitals and Health Systems; Work-shop E: Technology & Trajectory of Mobility in a New Healthcare Model; and Workshop F: Build Your Own Mobile App: A Hands-On Experi-ence—all on Sunday, March 3.

General education session on March 4-7, will focus on such varied topics as mobile health applications, federal mHealth policy, mobile eVis-its, legal issues, mobile health from the health IT executive’s perspective and much more.

For more information, please visit www.himssconference.org/geninfo.

himSS13 ENdorSErS

USA

january 2013hp-4 www.himssconference.orgPREVIEW

monday, march 41 pm – 6 pm

tuesday, march 59:30 am – 1 pm2:30 pm – 6 pm

Wednesday, march 69:30 am – 1 pm2:15 pm – 6 pm

himSS13 ExhibitioN hourS

trend-spotting: What’s New at the HIMSS13 Exhibition?O

ver the past few years, HIMSS and exhibiting companies have expanded the learning experience and the use of technology at the

annual conference’s exhibition. The HIMSS13 Exhibition validates this trend further—with even more learning opportunities and chanc-es to interact with technologies firsthand.

“This is an exciting time in the health IT industry, and the HIMSS13 Exhibition will be showcasing the movement in the industry,” says Elli Riley, HIMSS Director of Exhibits and Meeting Services.

This year’s exhibition will feature nearly 1,100 exhibitors representing thousands of health IT products and services. And, more than 250 of them will be exhibiting for the first time at HIMSS13.

Education opportunitiEs galorE on thE show floorAcross the exhibit floor, themed pavilions and designated areas will provide attendees with the “one-stop shop” experience, says Riley. “Collectively there will be over 200 learning sessions in these specialty pavilions and areas.”

Among the new features, Meaningful use Experience (Booth 149) is the desti-nation to connect with proven, certified EHR solutions. Through demonstrations and pre-sentations, attendees can evaluate certified EHR products and services side-by-side and meet with company representatives. Health-care professionals will also present their per-spectives on proven products that are certi-fied Stage 1 and the 2014 edition regulations during scheduled sessions.

Back by popular demand, three knowl-edge centers feature a combination of education sessions, case study presentations, and opportunities to connect with industry experts and resources. This year’s Knowledge Centers are themed around Mobile Health (Booth 8653), Clinical & Business Intelligence

(Booth 869), and ICD-10 (Booth 4581). Attendees can also learn about the lat-

est innovations in health IT. Over 250 new products and services will be launched at the HIMSS13. And now attendees can explore them all in one location. At the inaugural new product launch area (Outside LaNouvelle Ballroom – Level 2), companies will showcase their new products and ser-vices through interactive kiosks.

HIMSS is also organizing three walk-and-learns while the exhibit hall is closed. Dur-ing these small-group guided tours, attendees will meet companies and learn about their products and services through presentations around Patient Portals, Clinical Decision Sup-port and Revenue Cycle Management.

grEatEr intEgration of tEchnologY into ExhiBitsMore than ever exhibitors are incorporating the use of mobile devices into their exhibits. “The aim is to provide attendees with a more hands-on experience with their products and services,” says Riley. “Exhibitors will demon-strate their products one-on-one with attend-

ees via their devices.”The intelligent hospital pavilion (Booth

8711) is one of the locations where attendees can directly experience IT products. This pavilion simulates how mobile technologies along with medical devices, clinical applica-tions, auto-ID, RFID, RTLS, sensors and wire-less technologies are seamlessly integrated in the hospital setting. Through numerous unique use cases, attendees see how this integration enhances patient care, optimizes workflow and management of healthcare resources.

Riley also pointed out that the hiMss interoperability showcase™ (LaNou-velle Ballroom – Level 2) is another inter-active demonstration area that offers both education sessions and guided tours. At the HIMSS Interoperability Showcase attendees assume the role of the patient and watch their personal health records move across multiple points of care via seamlessly integrated clini-cal information systems.

Learn more about the HIMSS13 Exhibition and this year’s exhibiting companies at www.himssconference.org/exhibition.

‘Meaningful Use Experience’ to Make Its Debut at HIMSS13 Exhibit Hall

new to the 2013 Annual HIMSS Conference & Exhi-bition is the Meaningful Use Experience, a special

demonstration area on the exhibit floor that puts providers in the middle of proven, certified EHR solutions—including complete EHR and EHR modules for acute and ambulatory set-tings. Visitors to this interactive event will be able to connect with vendors, hear presentations and see demonstra-tions side-by-side for a credible oppor-tunity to assess criteria achievement and evaluate certified products based on specific needs. Space is still available for companies to apply to exhibit at this event. Visit www.himssconference.org for eligibility criteria and to submit an application. Exhibiting companies will be selected on a first-come, first-serve basis once they are approved. Check back to www.himssconference.org for more information.

thE Exhibit hall: ProduCtS aNd dEmoNStratioNS for EvEry arEa iN hEalth it

HIMSS13 Website Adds New Tools

The newly enhanced HIMSS13 website makes planning your confer-ence experience a snap. The website features responsive design, enabling attendees and exhibitors to easily customize their expe-rience. From the homepage, select your profession—C-Suite executive, clinical engineering professional, nurse, physician, etc. This will take you to HIMSS13 activities tailored to your area of expertise. The list includes pre-conference education, general edu-

cation and exhibit sessions, as well as other activities such as career and network-ing opportunities and specialty events. Attendees can also view specific activities under broad topic silos, including Meaningful Use, mobile health, health information exchange, and clinical & business intelligence.

You can also sign up for free e-mail alerts on HIMSS13 registration, education sessions, exhibit hall events, discounts and other HIMSS news and events. In addition attendees will be able to access the website from their mobile devices while at conference.

Visit the HIMSS13 website at www.himssconference.org

oN thE WEb

about HiMSSHIMSS is a cause-based, not-for-prof-it organization exclusively focused on providing global leadership for the optimal use of information tech-nology (IT) and management systems for the betterment of healthcare. Founded 52 years ago, HIMSS and its related organizations are head-quartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents nearly 50,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 570 corporate members and more than 225 not-for-profit partner organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote informa-tion and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care.

To learn more about HIMSS, and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org.

january 2013 hp-5www.himssconference.org PREVIEW

5 Tips to Tackle the HIMSS13 Exhibition1. Pre-plan your exhibition experience. You might not get down every aisle at HIMSS13, but the more you pre-plan the more knowledge you will walk away with. It is important to determine which companies are critical to see, what new products are available and what learning opportunities will be offered on the show floor this year. Start your planning using the Conference Exhibitor Guide, Exhibit Floor Maps and specialty resources at www.himssconference.org/exhibition.

2. Don’t miss any of the HIMSS specialty pavilions on the show floor. The exhibit hall is filled with innovative specialty pavilions—including the Meaningful Use Experi-ence, ICD-10 Knowledge Center and Mobile Health Knowledge Center. Learn more about these “one-stop shop” areas on the show floor at www.himssconfer-ence.org/exhibition.

3. Check out conference deals and targeted exhibitor listings prior to conference.

■■ Get a sneak peak of the deals and giveaways exhibitors will offer at annual conference via Exhibitor Spotlight, which will be available in late January at www.himssconference.org/exhibition.

■■ Opt-in to receive Conference Daily Deals while registering for the conference and get an e-mail a day with an exclusive deal on an exhibiting company’s prod-ucts or services. These deals are only offered pre-show.

■■ HIMSS13 Yellow Pages is a directory of the exhibit hall to help attendees easily navigate the products on the show floor. This guide can be found online prior to annual conference and onsite in pub-lication bins around the convention center.

4. Be ready to network and start developing business relationships. Bring plenty of business cards—they will be exchanged with industry colleagues, company representatives and used to enter a lot of giveaways.

5. Be comfortable. Comfortable walking shoes are a must. Also consider a bag with wheels so you can take home companies’ materials and giveaways.

HIMSS Interoperability Showcase™ Moves Up

A must-attend staple of the Exhibit Hall in past

years, the HIMSS Interoperability ShowcaseTM

is moving. The Interoperability Showcase will

be located in La Nouvelle Ballroom–Level 2

at HIMSS13 in order to allow easy and more access to the

exhibit’s hands-on learning opportunities.From Monday, March 4, through

Wednesday, March 6, 2013, you can visit the Interoperability Showcase™ for in depth view of both federal and private initiatives in interoperability. For those new to HIMSS and the Annual Confer-ence, the Interoperability Showcase™ is an interactive demonstration of live clinical information systems that allows visitors to assume the roles of patients and watch their personal health record move across multiple points of care.

Health IT vendors come together to dem-onstrate standards-based interoperability and their dedication to making health information exchange happen for provid-

ers around the world by using Integrating the Healthcare Enterprise (IHE) profiles in their technology solutions. Clinical use case stories span multiple patient care set-tings including acute care, ambulatory, and inpatient settings.

The Interoperability Showcase™ will host state-of-the-art education sessions in the Showcase Theater. And new this year, the Showcase’s education sessions and tours will offer continuing education units toward CPHIMS certification.

Full session listings and more details about the HIMSS Interoperability Showcase™ are available through the HIMSS13 website at www.himssconference.org.

thE Exhibit hall: ProduCtS aNd dEmoNStratioNS for EvEry arEa iN hEalth it

Have tips to successfully navigate the HIMSS13 Exhibition? Share them on the HIMSS Facebook Page or on Twitter by using the #HIMSS13 hashtag.

By the NumBers

The Annual HIMSS Conference & ExhibitionNumber of attendees at the 2012 Annual HIMSS Conference & Exhibition in Las Vegas, the highest total attendance in the history of the event: 36,531

Number of attendees at the first HIMSS Conference, held in April 1962, in Baltimore: 54

Average number of room nights booked by attendees and exhibitors: 72,000

The number of football fields, including end zones, required to cover the 3 million square feet of the Ernest N. Morial Convention Center in New Orleans: 53

Annual HIMSS Conference & Exhibition registrants who are first-time attendees: 45%

Attendees who use an Apple mobile device during HIMSS12: 70%

Attendees who prefer the second most-used mobile device, Android: 14%

Estimated number of steps required to walk from Lobby A of the Ernest N. Morial Convention Center to Lobby J: 1,166

Average number of calories burned completing the walk: 57

The last year the Annual HIMSS Conference & Exhibition was held in New Orleans: 2007

Number of attendees at HIMSS07 in New Orleans: 24,076

Number of exhibitors expected at HIMSS13: 1,100

Days it would take for an attendees to visit each booth in the exhibit hall for 10 minutes: 7.6

‘Tweets’ per hour generated at the 2012 Annual HIMSS Conference & Exhibition in Las Vegas: 167

Estimated number of people reached by social media participants at HIMSS12: 85 million

The number of former US presidents to keynote at the Annual HIMSS Conference & Exhibition: 2—George h.W. Bush (1999) and Bill Clinton (2013)

The Interoperability Showcase™ will be moving to enhance access to hands-on learning.

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27133Ogilvy Mather

GET CONNECTED! AT CDW HEALTHCARE BOOTH #229HIMSS13 | March 3-7 | New Orleans

Whiteboard Sessions!

COLLABORATEwith our technology experts

Prizes!Games!

with peers at the Connections Bar

HANG OUT

TALK TRENDS

with industry thought leaders

from other healthcare organizations

HEAR SUCCESS STORIES

the latest I.T. innovations

Interactive Touchscreens!

EXPLORE

TOGETHER WE’LL CONNECT I.T.For more information, visit CDW.com/HIMSS

@CDW_Healthcare #HIMSS13

©2012 CDW LLC. CDW®, and PEOPLE WHO GET IT™ are trademarks of CDW LLC.

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january 2013 hp-7www.himssconference.org PREVIEW

3 Reasons to Go Social at HIMSS13h ealthcare continues to embrace

the use of social media in the way it engages patients, disseminates infor-

mation and even how it tracks and treats diseases. As social media’s value is realized, it will give us new ways to better connect healthcare stakeholders. Like in healthcare, social media, too, continues to be a dimen-sion that grows the value of the Annual HIMSS Conference & Exhibition experience.

How can you harness social media in your daily activities to make your HIMSS13 experi-ence even more valuable?

1. social learning. While it is nearly impossible to attend all of the education ses-sions or see all of the exhibitors, you can stay connected to the conversations you would normally miss by monitoring the #HIMSS13 hashtag Twitter stream or watching the best of the conference as it is showcased on HIMSS

Facebook Page and Blog.2. networking. Whether you are looking

to meet new business contacts, discuss health IT topics with like-minded professionals or

finally meet those you have been tweeting with all year, social networks are an oppor-tunity to get a pulse on the who’s who around your key areas of interest.

3. thought leadership. You can estab-lish yourself as a thought leader or follow what thought leaders at the conference are saying about the use of technology in health-care by staying connected to the conference buzz. Social networks are the platform where you can proactively contribute to and identify new opportunities to grow your participation in the health IT community.

HIMSS13 Mobile WebsiteStart planning your education agenda, access educa-tion session handouts and navigate HIMSS13 edu-cation and exhibition on the go. You can access the HIMSS13 Mobile Website by visiting himssconfer-ence.org from your mobile device.

HIMSS Conference Exhibitor GuideFor those interested in meeting with exhibiting compa-nies at HIMSS13, utilize the HIMSS Conference Exhibi-tor Guide to start planning your tour of the Exhibition and prospecting who you want to meet once you get there. Start navigating the Conference Exhibitor Guide at exhibitorguide.himss.org

Pre-Conference & On-Site GuidesBefore the Conference, be sure to download the HIMSS13 Brochure to start planning your activities on-site. Pocket & Resource Guides will be given to attendees as they pick up their tote bags. The Pocket Guide will be posted on the website one week prior to HIMSS13.

Web Access On-SiteWi-fi access will be available in all public areas includ-ing lobbies, education and meeting rooms throughout the convention center. As Keynote and larger educa-tion sessions generate bigger crowds mobile device service will also be increased in addition to Wi-fi.

‘Women in Health IT’ Convene at HIMSS13a t himss13, co-founders of the

Women in Health IT Network Reception, Carol Selvey and

Sharon Klein, will welcome addi-tional co-hosts at this year’s reception on March 4. The two leaders will be joined by the current HIMSS Board of Directors Chair Willa Fields, current HIMSS Board of Directors members Judy Murphy and Carol Steltenkamp, former HIMSS Board of Directors member Miriam Paramore, and HIMSS Executive Vice President Carla Smith as co-hosts in New Orleans.

The event now brings with it an even more robust perspective as it connects today’s leading and emerging women in health IT to share insights on key issues in healthcare through their com-pelling stories and experiences.

“We are grateful to Carol and Sha-ron for their many years of leadership in convening the Women’s Reception at the Annual HIMSS Conference. This year, we are delighted to welcome additional hosts for the event, enabling all guests to feel welcomed and pro-vided an opportunity to network with their peers,” added Smith.

While the Reception will undoubt-edly be a notable social event, the abil-ity to learn from today’s most influen-tial women in health IT positions it to be a memorable occasion.

The HIMSS Women in Health IT Reception takes place on March 4, 2013, from 5:30 – 7 PM. Registrations are available on a first-come, first-served basis through the HIMSS13 registration process.

other power networking opportunities include:

■■ Opening Reception: March 3, 5 – 7 PM

■■ Communities Open House: March 4, 5:30 – 6:30 PM

■■ HIMSS13 Awards Banquet – A Sparkling Affair: March 5, 6:30 – 9 PM

■■ Wednesday Night Special Event: March 6, 2013, 7:30 – 10:00 PM

Learn more about all the networking events at HIMSS13 at www.himssconference.org/network.

Learn, connect and grow with HIMSS13 by: ■■ Following @HIMSS on Twitter and the #HIMSS13 tweet stream■■ Checking out the HIMSS Blog at blog.himss.org ■■ Finding HIMSS on Facebook■■ Connecting with the HIMSS Group on LinkedIn

NEtWorkiNG EvENtS: SharE idEaS With hEalth it lEadErS from arouNd thE GlobE

Planning & Attendee Tools to Optimize Your HIMSS13 ExperienceOn-Site Navigational KiosksNew and improved to ensure you don’t get lost at Annual HIMSS Conference & Exhibition. These on-site navigational tools will be placed throughout the con-vention center, allowing attendees to locate session rooms, locate specific speakers, navigate products on the exhibition floor, and more.

Exhibitor-Hosted Events PortalHaving been a feature for three years, this is an area on our exhibition website that will be live in January to showcase all of the events that exhibitors will be hosting, from giveaways in their booths, sessions they are hosting, to events after-hours. Find more informa-tion at himssconference.org/exhibition.

HIMSS13 is PaperlessGet your mobile QR readers ready as education ses-sion handouts will be easily accessed via QR codes on signage throughout the convention center and at himssconference.org/handouts. Attendees will also have the opportunity to claim Continuing Edu-cation credits online. More information available at himssconference.org/education.

Internet/Recharge StationsCharge your devices at one of our many Recharge Stations that will be located throughout the convention center. These areas will be equipped with charging

devices, outlets and wireless capabilities to get work done or keep tabs on the Conference’s happenings.

New FeaturesMany new learning opportunities on the show floor – from the New Meaningful Use Experience – to hot topic Knowledge Centers, with topics based around Clinical & Business Intelligence, ICD-10 and Mobile Health. Also be sure to check out the ever-changing HIMSS Interoperability Showcase™ and Intelligent Hospital Pavilion.

himSS13 CommErCial SuPPortErS

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CODENAME: NoneJOB TYPE: Print

JOB CATEGORY: CDW MechanicalsTO APPEAR IN: HealthcareITNews

DATE/TIME: 12-11-2012 10:46 AMOPERATOR: Peter Schafer

SLUG FONTS: DIN Light, DIN Regular

FONTS: Prelo (Black, Medium, Medium Italic, Light, Book, SemiBold)

IMAGES: twitter-bird-blue-on-white.eps, Rubbermaid_F.eps

COLOR PROFILES: NoneTRAPS: None

DIE CUT: NoneINKS: Cyan

Magenta Yellow Black

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EXEC. CREATIVE DIRECTOR: NoneCREATIVE DIRECTOR: M. Haddock

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27133D_123503.indd — 12/11/2012_11:56 AM Operator: mh Proof#: 1

27133Ogilvy Mather

GET CONNECTED! AT CDW HEALTHCARE BOOTH #229HIMSS13 | March 3-7 | New Orleans

Whiteboard Sessions!

COLLABORATEwith our technology experts

Prizes!Games!

with peers at the Connections Bar

HANG OUT

TALK TRENDS

with industry thought leaders

from other healthcare organizations

HEAR SUCCESS STORIES

the latest I.T. innovations

Interactive Touchscreens!

EXPLORE

TOGETHER WE’LL CONNECT I.T.For more information, visit CDW.com/HIMSS

@CDW_Healthcare #HIMSS13

©2012 CDW LLC. CDW®, and PEOPLE WHO GET IT™ are trademarks of CDW LLC.

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january 2013hp-8 www.himssconference.orgPREVIEWmovE uP thE CarEEr laddEr at himSS13

Opportunities Abound at Career Services Center

In a rapidly changing world, healthcare organizations are recognizing the need not just for new health IT professionals, but also the continued development of the existing workforce.That’s where HIMSS Career Ser-vices comes in.

Located in the River Gate room in the convention center, the HIMSS13 Career Ser-

vices Center, March 4-6, is a centralized location for recruiters, job-seekers, consultants and others who contribute to the development of the health IT work-force. Co-located with HIMSS JobMine, the Career Ser-vices Center is a gathering point for both health IT job seekers and health IT organizations looking for talent.

EducationEducation sessions will be offered at Career Services Center and as part of the HIMSS13 general education program. A visit to the Career Services Center is all inclusive with a HIMSS13 registration. These sessions will provide attendees with the tools and resources they need to succeed in a competitive marketplace.

On Monday, March 4, learn how to polish your resume so that it stands out (Education Session CSC1); understand ethical theory in the context of the health-care industry and discuss common ethical dilemmas you will face as a health IT leader (Education Session CSC2); learn the importance of emotional intelligence and listening (Education Session CSC3); and explore techniques to recover from the loss of a job and making sure that your attitude doesn’t get in the way of finding a new one (Education Session CSC4).

On tuesday, March 5, learn what it takes to transi-tion in to a healthcare consulting career (Education Ses-sion CSC5). At the Emerging professionals poster presentations (Education Session CSC6), see col-leagues on similar career paths spotlight and present their health IT projects. During the healthcare it talent shortage (Education Session CSC7), you’ll learn details on Price Waterhouse Cooper’s Health Research Institute’s

upcoming report on human capital in health IT.On wednesday, March 6, attend sessions that

explores expanding changes in technology education programs (Education Session CSC9); learn what it means to be mentor or find a mentor (Education Ses-sion CSC10); and find out about the more than 50,000 health IT job opportunities created by the ARRA/HITECH legislation (Education Session CSC11).

A fourth session on March 6 is scheduled, but was not confirmed at the time of publication. Please visit the HIMSS13 website (www.himssconference.org /career) for update and additional details.

MEntoring prograMThe HIMSS Mentoring Program gives members the opportunity to become connected via social media to nationally recognized leaders in health IT. HIMSS13 attendees will have a chance to connect with our Men-tors at the Career Services Center.

“The eMentoring program has been a great oppor-tunity for me to share some of the experiences and wisdom that I’ve learned during my 40+ years in health-care,” says Charles E. Christian, FCHIME, FHIMSS, CIO at Good Samaritan Hospital and HIMSS Mentor. “I’ve also had the opportunity to gain additional knowl-edge and expertise from the others mentors.”

So what do the HIMSS Mentors advise for those looking to make the most of their time at the HIMSS13 Career Services Center?

“Those new to health IT, new to healthcare or even in need of a significant career change are especially advised to first take inventory of their skills, abilities and career aspirations (both short-term and long-term) and then seek input from the Center as how to proceed toward successful use of this most valuable industry resource,” says eMentor Rick Schooler, FACHE, FCHIME, MBA, Vice President & CIO, Orlando Health.

Visit www.himssconference.org/career for more details.

REGISTRATION DETAILSRegistration for HIMSS13 is open and will remain open throughout conference.

Advanced registration rates apply through feb. 4; after this date, late/on-site

registration rates apply. HIMSS13 registration includes entrance to the core

educational program, exhibition, Opening Reception on Sunday, March 3,

and registration tote bag materials (while supplies last). Self-service registra-

tion kiosks will also be available for attendees to register for conference and

optional events on-site; however, registrants can modify their registration

online at any time. Details on registration categories and registration for

optional events are available at www.himssconference.org/registration.

MAKE HOTEL RESERvATIONS EARLYHIMSS has contracted with numerous hotels to provide discounted room

rates for attendees and exhibitors. Be sure to secure reservations early as

hotels fill up quickly. To make a reservation or check availability, visit www.

himssconference.org/travel or contact onPeak, the official and sole housing

partner for HIMSS13, at himss@onpeakevents.com or 877-517-3038, Monday

through Friday, 8 am to 6 pm CST. Reservations are made with no upfront,

out-of-pocket costs, only a credit card to guarantee. The deposit will not be

charged until approximately two weeks prior to the conference.

HOTEL RESERvATION ALERT FOR HIMSS13 ATTENDEESIt has come to HIMSS’ attention that several unaffiliated wholesale hotel/

travel groups have been soliciting attendees and offering hotel accommoda-

tions for HIMSS13. Unofficial companies may be offering discounted or

wholesale hotel pricing. Neither HIMSS nor onPeak can verify the authentic-

ity of such companies or their representations, and will not be able to provide

a resolution to issues related to such reservations. Feel free to contact onPeak

if you have any questions about booking hotel reservations. If accommoda-

tions were booked through any party other than onPeak, HIMSS urges you

to immediately cancel the reservations and book rooms through onPeak.

AIR TRAvEL & CAR RENTAL SERvICESAir travel reservations may be made online through HIMSS Travel Services at

www.himsstvl.com or by calling 877-408-4522, Monday through Friday, 8:30

am to 6:30 pm CST. Attendees can search air fares and book flights on any

scheduled carrier; however, exclusive discounts and benefits are available

through HIMSS Travel Services. Discounts of up to 9 percent are available from

American Airlines and Delta. Car rental discounts are available with Avis,

Enterprise and Hertz. Visit www.himssconference.org/travel for more information.

INTEROPERABILITY SHOWCASE™ MOvES UPThe HIMSS Interoperability Showcase™, March 4 to March 6, will be mov-

ing out of the Exhibit Hall for HIMSS13. The Showcase will be positioned at

the La Nouvelle Ballroom—Level 2 at the Ernest N. Morial Convention Center

in New Orleans. For those new to HIMSS and the Annual HIMSS Conference

& Exhibition, the Interoperability Showcase™ is an interactive demonstration

of live clinical information systems that allows visitors to assume the roles of

patients and watch their personal health record move across multiple points

of care. Turn to page 5 for more on the HIMSS Interoperability Showcase™. HIMSS Certifications Demonstrate Industry Knowledge cphiMsCertified Professional in Healthcare Information and Management Systems (CPHIMS) is a professional certification program for healthcare information and management systems professionals. For more information on the CPHIMS Exam, visit www.cphims.org or e-mail certification@himss.org.

rEviEW CourSEwhat: Full-day session features lecture, discussion, practice questions and the most current study materials. Not required for the CPHIMS Exam, but highly recommended.when: Sunday, March 3fee: $285

Examwhat: The CPHIMS Exam certifies you for the CPHIMS credential. Candidates must register through the HIMSS13 registration page by Friday, Feb. 15, 2013. Only 150 seats are available for the HIMSS13 administration. Exam sessions will be filled on a first-in/first- confirmed basis.when: Five sessions held between March 4 and March 6 in Room 397 S-W. Visit www.himssconference.org/career for details. Each session is limited to 30 candidates.fee: $270 for HIMSS Individual Organizational Affiliates; $300 for HIMSS members; and $375 for non-members.

cahiMsCAHIMS—Certified Associate in Healthcare Information & Management Systems—is a new HIMSS health IT certification designed for emerging professionals within the industry. This certification demonstrates knowledge of health IT and management systems, facilitating entry-level careers in health IT. It is designed to be a career pathway to the CPHIMS credential.

rEviEW CourSEwhat: Full-day session features networking and interaction with the CAHIMS instructor and other CAHIMS candidates. Participants will take part in discussions, lectures and practice questions; and gain a solid foundation from study materials available exclusively through this review course.when: Sunday, March 3fee: $225

Examwhat: Candidates must register through the HIMSS13 registration page by Friday, Feb. 15, 2013. Only 100 seats are available for the HIMSS13 administration. Exam sessions will be filled on a first-in/first-confirmed basis.when: Five sessions held between March 4 and March 6 in Room 297. Each session is limited to 20 candidates.fee: $140 for HIMSS Individual Organizational Affiliate; $175 for HIMSS members; and $225 for non-members.

Career Services Institute Debuts at HIMSS13

ON TUESDAY, MARCH 5, HIMSS13 will see the debut of the HIMSS Career Services Institute, a day-long networking and education event open to all attendees. Hosted at the Marriott Convention Center, the Institute is an opportunity for attendees to network and will focus on supporting the various pieces that

go into a health IT career—those soft and transferable skills we often hear about.The program will support attendees of all levels of skill sets—those who are entry-

level, intermediate, and advanced-level professionals, currently in the health IT field or wanting to enter the field and who are seeking career guidance on various aspects of career skill support along with even possible job opportunities.

This one-day event, entitled Is Your Personal Brand Connected…or Unplugged? The ABCs of Authentically Standing Out From the Crowd: Appearance, Behavior, Communication, will teach participants the soft and transferable skills they need to move toward the outcomes and actions they need to advance their careers. The session will be presented by Peggy M. Parks, AICI CIP, international image and business etiquette consultant and the founder of The Parks Image Group Inc. in Atlanta.

There is no additional fee to attend the Career Services Institute. However, special registration is required for this event, as space is limited. Register online at www.himss conference.org. For more information on the HIMSS Career Services Institute, please contact Helen Figge, PharmD, MBA, CPHIMS, FHIMSS, Lean Six Sigma Black Belt, Senior Director, Professional Development, Career Services, at hfigge@himss.org.

imPortaNt NotES

CliniCalJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 17

ACOs now providing healthcare to 31 million

As many as 31 million Ameri-cans now receive healthcare through an accountable care organization (ACO), accord-ing to a November report from consulting firm Oliver Wyman. The report contends that while

many believe that ACOs have had little impact on the market to date, the sheer numbers of patients getting healthcare via an ACO tells a different story. Oliver Wyman researchers determined that about 2.4 million Medicare beneficiaries were receiving care via the different Medicare ACO programs; another 15 million non-Medicare patients received care at these Medicare ACOs; and a potential 14 million are part of ACOs run by large national and regional insurers for their non-Medicare populations.

Nurses making more use of smartphones More than two-thirds of hospitals surveyed for a new study reported that their nurses use their personal smartphones while on the job

for personal and clinical communications. Still, IT support for those devices is lacking. The report, from Spyglass C o n s u l t i n g G r o u p , showed 69 percent of hospitals indicating that their nurses use their

personal mobile devices. They’re often used to fill in communica-tion gaps with the technology provided by hospital IT departments – which some nurses find difficult to use and complain has limited functionality, researchers found.

EMR use up among primary care docsSixty-nine percent of U.S. primary care physicians reported using electronic medical records in 2012 – up from 46 percent in 2009,

according to findings from the 2012 Commonwealth Fund International Health Policy Sur-vey. Primary care physicians in the U.S. – the only country in the study without universal health coverage – stand out in the sur-vey, with 59 percent reporting that their patients often cannot afford care. Moreover, American physicians also were the most

negative about their country’s health system, with only 15 percent agreeing the health care system works well.

NFL adopts EHRsPlayers union makes the case for safety value of digital recordsBy Mike Miliard, Managing Editor

A s the National Football League play-offs kick-off this month, there will be no shortage of excitement on the

gridiron. There will also be one big difference taking place behind the scenes: The NFL will make the switch from paper to electronic health records (EHRs).

On Nov. 19 it was announced that the league would contract with ambulatory vendor eClinicalWorks to serve 32 teams nationwide.

“The health and safety of our players con-tinues to be our number one priority,” Brian McCarthy, NFL’s vice president of communi-

cations, told Healthcare IT News.“We are continually improving everything

we do to make the game safer, including rule changes, developing next-generation equip-ment, research and partnerships,” he added. “Working with some of the leading companies in the world, such as eClinicalWorks, we want to provide team medical staff with the latest technology that will help with their care and treatment of players in real time at the team facility, in the locker room, on the sidelines. This solution will help medical staff with secure real-time information to make deci-sions that will benefit the player.”

“The NFL prides itself in staying ahead of current healthcare developments,” said Anthony Yates, MD, president of the NFL Physicians Soci-ety, in a statement. Yates, a physician at UPMC

Nfl see Page 20

As mandated by its collective bargaining agreement, the Nfl is adopting EHRs.

Telemedicine takes on reproductive healthIowa program deemed effective for abortion servicesBy erin Mccann, Associate Editor

In recent years, telemedicine has been on an upward trend, with successful programs seen across a diverse variety of medical special-ties. Reproductive healthcare is

now the latest area making use of tele-medicine’s efficacy, and, according to a recent study published in the American Journal of Public Health, it’s been an all-around success.

The subject of the study, a four-year-old Heartland, Iowa-based telemedicine program aimed at improving a woman’s access to medical abortions, has both reduced the number of surgical abortions throughout the state and expanded care to women living in more rural areas.

Conducted by researchers at the Oak-land, Calif.-based Ibis Reproductive Health, the University of California at San Francisco, Planned Parenthood and the University of Texas in Austin, the study found that medical services to women liv-ing in more remote areas improved, with medical abortions increasing by 8 percent.

Study findings show that although over-all early abortion encounters increased by 1.7 percent as a result of expanding the

services to more rural parts of the state (particularly for women living more than 50 miles from a surgical abortion clinic), surgical abortions after 13 weeks decreased by a significant 7 percent.

Dan Grossman, MD, co-author of the study, said, “It doesn’t make more women get abortions, which makes sense. I don’t think women have abor-tions because they’re easy to access, but it does improve access so it helps women get in earlier.”

Iowa is one of a handful of states that doesn’t allow mid-level providers to pre-scribe the abortion pill but require only a physician to do so. With physicians already in short supply, particularly in rural locations, many women in Iowa had only limited access to the services, one of the driving factors to create this tele-medicine program.

“We saw this as a way where we can provide the abortion pill in a safe and legal manner both while not having to spend the money to drive a physician all over the state to essentially hand out the pill,” said Todd Buchacker, co-author of the study and former regional director of health services at Planned Parenthood of the Heartland.

If Iowa did allow mid-level providers

The study found that although total medical abortions increased due to making services more available to women in rural areas, surgical abortions decreased significantly as a result of the Iowa telemedicine program.

AboRTIoN see Page 20

CliniCal www.HealthcareITNews.com | HealthcareITNews | January 201318

Physicians use EHRs, but…Communication, teamwork challenges in all countriesBy Bernie Monegain, EditorNEW YoRK – Sixty-nine percent of U.S. primary care physicians report-ed using electronic health records (EHRs) in 2012 – up from 46 per-cent in 2009, according to findings from the 2012 Commonwealth Fund International Health Policy Survey.

Primary care physicians in the U.S. – the only country in the study without universal health coverage – stand out in the survey, with 59 per-cent reporting that their patients often cannot afford care.

By comparison, between 4 per-cent and 25 percent of physicians reported affordability problems for their patients in Norway (4 per-cent), the U.K. (13 percent), Swit-zerland (16 percent), Germany (21 percent) and Australia (25 percent). Moreover, more than half of U.S. doctors (52 percent) said insurance restrictions on their care decisions are a major time concern – by far the highest rate in the 10-country survey. U.S. physicians also were the most negative about their country’s health system, with only 15 percent agreeing the healthcare system works well.

The survey of nearly 8,500 pri-mary care physicians in Austra-lia, Canada, France, Germany, the Netherlands, New Zealand, Nor-way, Switzerland, the United King-dom and the United States, finds that communication and teamwork across the health system is a chal-lenge in all countries.

In each, only a minority of pri-mary care doctors reported always receiving timely information from specialist physicians after referring patients to them. In the U.S., just 11 percent of physicians said they had such information available when it was needed. And from one-third to more than half of doctors across countries said they are not always notified when their patients leave the hospital.

In the study, “A Survey of Prima-ry Care Doctors in Ten Countries Shows Progress in the Use of Health

Information Technology, Less in Other Areas,” the U.S. stands out for having the lowest rates of after-hours care with 34 percent of U.S. physicians reporting they provided options for their patients to receive after-hours care, compared with 95 percent in the U.K; 94 percent in the Netherlands; 90 percent in New Zealand; and 89 percent in Germany.

“The U.S. spends far more on medical care than the other countries we surveyed, yet our doctors are tell-ing us their patients can’t afford care, they don’t always have the patient information they need, they spend too much time dealing with insur-ance companies, and we need major change,” said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. “The insur-ance expansions under the Afford-able Care Act will make care more affordable – but we also need to simplify insurance to free up phy-sicians to provide timely access to high-quality care for their patients.”

INfoRmATIoN ExcHANgE RARE The ability of primary care phy-sicians to exchange information electronically with doctors outside their practice is not routine in any country. New Zealand, the Neth-erlands and Switzerland lead on information exchange, with about half of the doctors having that capa-bility, compared with just 31 per-cent of doctors in the U.S.

“The substantial increase in U.S doctors’ use of electronic medical record systems reflects the incen-tives and national investment included in the 2009 economic stimulus legislation,” said Common-wealth Fund President Karen Davis. “As we look to the future, we hope to see similar progress as health reform provisions take hold, includ-ing patient-centered medical homes and healthcare systems that foster teamwork and coordination. With improvements in these areas, we will be able to improve patient outcomes and experiences, and make a posi-tive difference for physicians.”

fuNcTIoNAlITY lAcKINgAccording to the survey, while the U.S. and Canada have made improve-ments in health information technol-ogy use, both countries continue to lag behind the leaders in EMR use and the range of functions supported by practice systems. Just 27 percent of U.S. physicians and 10 percent of Canadian practices indicated their systems have multi-functional capacity, with the ability to: generate patient information, such as medica-tion lists; manage patient registries, such as seeing which patients are overdue for care; order prescriptions or diagnostic tests electronically; or provide decision support, such as alerts about drug interactions.

Although not a part of the Com-monwealth report, EHR usability

to prescribe the abortion pill, Buchacker said the group most likely would not have pursued the telemedicine program.

One finding of the study that surprised Grossman was data showing that the distance women traveled to get care decreased only slightly.

“We thought we would see more of a decrease,” he said. How-ever, he cited several factors that could explain the numbers, such as women trying to get an appointment sooner, or, if they live in a small town, maybe they don’t want to have that proce-dure done in that town.

In 2008, the year of its inception, the telemedicine clinic provided some 74 percent of all abortions in Iowa. Citing a recently published cohort study, researchers say the telemedicine program was “equal-ly effective compared to a model involving an in-person visit with a physician,” and also came with a low rate of adverse events.

How it works, Buchacker said, is that a physician sitting in a central office connects with a patient with a staff member at any rural clinic site via a HIPAA-secure videocon-ference. After the woman’s lab work, patient education and ultra-sounds have been completed and have subsequently been checked and confirmed by the physician, the doctor will then have access to open essentially a “cash drawer,” where the medication is held.

“Essentially it’s like choosing a printer from a list of printers,” Buchacker said. “The physician will say, ‘Okay, I’m going to open this drawer in front of you,’ and so the drawer pops open just like a cash register does.” Inside the drawer are two labeled pills for the patient to take in front of the physician.

Although many officials hail the many benefits of Iowa telemedicine when it comes to cost savings and improved access to care, other groups have different sentiments. The Wichita, Kan.-based anti-abortion group Operation Rescue, for example, lodged a complaint with the Iowa Board of Medicine back in 2010 about a year after the program was established. In a press release issued by the group, President Troy Newman said that Planned Parenthood exemplified “dangerous misuse of technology that kills innocent babies and endangers the lives of women.”

The board found that technology had not been misused. Buchack-er said in last year’s Iowa legislative session, there was a bill that went through the House and made it to the Senate to ban the use of telemedicine when it came to abortion services. “That did not pass or make it to the governor’s desk,” he said. But other state attempts banning the use of telemedicine for abortion services have been successful. He cited Nebraska as one example.

Overall, however, he said, the program has been a success for women’s health across the state and has provided valuable services to women in need. n

AboRTIoNCoNTINued from Page 17

EHRs see Page 21

In the survey, the u.s. stands out for having the lowest rates of after-hours care. The telemedicine

program “doesn’t make more women get abortions … I don’t think women have abortions because they’re easy to access, but it does improve access, so it helps women get in earlier.” Dan Grossman, MD

and team doctor for the Pittsburgh Steelers, is also a member of member of the EMR Committee for the NFL.

“We are always looking for inno-vative ways to enhance the organi-zation,” he said. “Electronic health records are the next logical step, and we look forward to partnering with eClinicalWorks on this initiative.”

In fact, the NFL is required to move to digital health records, thanks to the collective bargaining

agreement reached in 2011 with the players union, which called on the NFL to “develop and implement an online, 24-hour electronic medical record system.” The deadline for implementation is August 2013.

Although owners initially opposed the move, the union even-tually pressed the case that EHRs were a vital tool for protecting play-ers’ health and safety, according to an NFL Players Association official.

By implementing EHRs across the organization, the NFL is able to streamline processes between

locations and coordinate care. All 32 teams will have access to the EHR system, which will be accessible at stadiums during games, on the side-lines and at the training facilities.

Girish Kumar Navani, CEO and co-founder of Westborough, Mass.-based eClinicalWorks, says this implementation has some simi-larities to certain other ambulatory EHR deployments.

“It’s not very different in capabili-ties from an orthopedics and physi-cal therapy clinic,” he says. “eClini-calWorks has had orthopedic and

physical therapy components within the EHR, so this will be the same system as we traditionally imple-ment, with a few added features.”

Still, Navani says, “extensive club visits” have led to the incor-poration of some capabilities to the EHR that reflect “the uniqueness of the NFL.”

One big difference? “In this imple-mentation, there will be a direct video feed from the NFL for play-ers, play-by-play, and we are inte-grating these feeds into the EHR,” he says. “The League will be able

to view video footage in the EHR of the injury occurring, which will help with treatment plans and follow-up once the player is off the field.”

And, of course, there are other features necessary for an EHR tai-lored toward athletes playing a dangerous game, where injuries are common – and which has seen a marked increase in concern for the long-term effects of concussions and traumatic brain injury.

“The EHR will connect with labs, radiology, PACS imaging and a con-cussion app,” says Navani. n

NflCoNTINued from Page 17

CliniCalJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 19

has been a chief concern of the U.S. government in recent years. The Office of the Nation-al Coordinator has devoted a four-year initiative to finding ways to improve EHRs to make them more user friendly.

Jiajie Zhang, at National Center for Cognitive Infor-matics and Decision Making in Healthcare at the University of Texas Health Science Center at Houston, leads that project.

“Only a small number of EHR vendors have their in-house team doing EHR usabil-ity,” Zhang says. “Most EHR vendors do not do that sys-tematically.” n

experts point to complexity, unique features of pediatric systemsBy erin Mccann, Associate Editor

P ediatricians in the U.S. con-tinue to adopt electronic health records (EHRs) at an

underwhelming rate, citing costs and hesitancy over potential system benefits, according to a report pub-lished in November.

The study, published in Pediat-rics and conducted by researchers at the Seattle Children’s Hospital, East Carolina University and the American Academy of Pediatrics, sought to shed light on the often opaque and limited data surround-ing pediatricians and health IT adoption rates.

After examining survey results on adoption rates and potential bar-riers, researchers estimated that pediatricians are on average about one to two years behind physicians in other specialties when it comes to EHR adoption.

Although self-reported pediatri-cian EHR use was pegged at 41 per-cent, findings show only 19 percent of the systems met the definition of a basic EHR, and a paltry 6 percent were considered “fully functional.”

Moreover, data confirms only 3 percent of pediatricians used a sys-tem that was both fully functional and “pediatric-supportive.”

“Even if the pediatricians are adopting the systems, the systems they’re adopting don’t have the features that would really make the practice easier,” said Michael Leu, MD, co-author of the study. “Pediatric systems have to be designed so they’re a little bit more complicated.”

There are several key differences between pediatric system needs and adult system needs, he points out. Normal EHR systems typically don’t have something called “weight-based dosing” because adults usu-

EHRsCoNTINued from Page 20

Pediatricians fall behind with EHR adoptionally have one dose amount across the board, for instance.

“In pediatrics, we support kids that are all different sizes and shapes,” Leu said. “So a small child gets a small amount of medicine, and a large child gets a larger amount of medicine.” Without this capability, pediatricians would need to calcu-late the dosages on their own.

In the study commentary, S. Andrew Spooner, MD, pediatrician

at Cincinnati Children’s Hospital Medical Center, wrote, “The pro-gramming logic that would support well-child visit tracking or immuni-zation prediction is not trivial.” He further added that it wasn’t likely that vendors would implement these “sophisticated features.”

According to data conducted by healthcare research firm SK&A and shared with the American Medical Association, EHR adoption among

pediatricians is pegged at 48.5 per-cent. Adoption among family prac-tice physicians was estimated to be at 54 percent.

Report authors said the most significant factor dissuading phy-sicians from adopting such sys-tems was financial barriers, with more than half (56 percent) of pediatrician respondents citing cost concerns.

Moreover, some 40 percent

reported that actually finding a system that met the provider’s par-ticular needs was another substan-tial concern. Because EHR systems don’t typically have weight-based dosing features, in addition to automatic growth chart plotters, immunization tracking and catch-up immunization calculations, Leu said it makes sense that providers are concerned over finding a sys-tem that meets pediatric needs. n

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Nuance launches CLU technology for imaging

At RSNA 2012, Nuance Com-munications announced the release of Assure, a clini-cal language understanding (CLU) tool that can identify quality errors and omissions in radiology reports prior to final signature. Officials say Assure, the first product offering to leverage CLU, will benefit from Nuance’s recent

acquisitions of Quantim and J.A. Thomas and Associates. As radiology moves from fee-for-service to a value-based reimbursement model, voice-enabled radiology reporting can spur more efficient delivery of diagnostic reports and reduce imaging costs.

HLI expands language engine for Stage 2

Health Language, Inc. (HLI) has released a new terminology map-ping designed to sup-port providers and EHR vendors in meeting the Stage 2 meaning-ful use requirements for SNOMED-encoded problem lists. This new content set, combined

with HLI’s Language Engine software enables one-to-one matches of ICD-9-CM diagnoses to SNOMED CT problems and decreases clini-cian time spent converting codes while enhancing use of SNOMED CT-encoded problems, officials say.

WellStar acquires former Gingrich think tank

In November, WellStar Health System acquired the trade name, trade-mark and other assets of the bankrupt Center for Health Transformation (CHT), a for-profit think tank founded by Newt Gingrich. Originally based in Washington, D.C., CHT offices will be relocated to WellStar’s home state of Georgia, and it will oper-

ate as a nonprofit entity. WellStar plans to form a collaborative network of 20 non-competing, not-for-profit health systems in the Southeast.

Healthrageous and its ‘parent’ Partners HealthCare see stridesNew funding for machine learning, encouraging news on hypertension biofeedbackBy Mike Miliard, Managing EditorBOSTON – An infusion of cash from Partners HealthCare is set to spur a promising 2013 for Healthrageous, whose health self-manage-ment technology traces its roots to Partners’ Center for Connected Health.

Healthrageous received $700,000 in Series B financing from the Partners HealthCare Innovation Fund in late November – close on the heels of a $6.5 million round of financing from other investors in October.

“They originally created us, so we’re coming home to our parents after being the prodigal children that went off and went around the world,” says Healthrageous CEO Rick Lee of Partners, from whom the startup spun off in 2010.

Lee explains that a big controversy in Bos-ton around that time, exposed in a week-long series in the Boston Globe – Harvard physi-cians who’d sat on pharmaceutical boards received money to render positive opinions about drugs – had “resulted in a change in the conflict-of-interest rules” at Partners.

“We had been in discussions about an equity stake in 2010 in Healthrageous, and

because of that rule change [Partners] was not permitted to do that at that time,” says Lee. “So it took two years or so for the pen-dulum to swing back to a reasonable loca-tion, where the approval was easy to attain.”

“So, what they created they can now pub-licly be proud of, as well as recoup some of the financial benefits through their equity,” he adds.

“Our investment in Healthrageous is a prime example of Partners’ goal to take medical innovations discovered by our researchers and provide the appropriate support and infrastructure to allow technol-ogy development, commercialization and, ultimately, the development of products to benefit patients,” said Peter Markell, chief financial officer of Partners HealthCare.

Together with a round of $6.5 million in Series B financing received in October from several other venture capital firms, Healthra-geous is well-positioned to make some stra-tegic technology investments, says Lee.

“We made a major bet on machine learn-ing as a key variable and differentiator in our solution,” he says. “That’s an ongoing devel-opment project. For really good machine learning, you need data. And we’re just now getting to the point where the amount of throughput, the amount of data coming through our platform is sufficient to do some

HealTHrageOuS see page 22

M&a can be hazardous to health ITSayonara interoperability, hello ‘Frankenstein’By erin Mccann, Associate Editor

Mergers and acquisitions (M&A) can be hazardous to a company’s health, industry experts often warn. In the

realm of health IT, this caveat has proved no exception.

Robert W. Holthausen, professor of accounting, finance and management at the University of Pennsylvania Wharton School, is one among many experts issuing the caveat. “Various studies have shown that mergers have failure rates of more than 50 percent,” he wrote in a university piece. In fact, he added, one recent study found that a whopping 83 percent of mergers fail to actually create value.

Health IT professionals also have expressed concern over industry M&A activity. For example, Barry Blumenfeld, MD, chief information officer at Maine-Health, Maine’s largest healthcare system, has cited poor electronic health record (EHR) product integration resulting from M&A as one of the biggest reasons its hos-pitals will transition from Allscripts and MEDITECH – companies that have recently struggled due to M&A activity – to Epic.

With Allscripts, for instance, “We found we weren’t getting the integration we needed,” Blumenfeld said. Maine Medical Center, the system’s largest hospital, has already replaced Allscripts Sunrise Clini-cal Manger (SCM) with Epic systems, as SCM has fallen short in terms of integration with the ancillary and departmental side of things. Blumenfeld cited examples of try-ing to connect pharmacy, emergency room, decision support and ambulatory, which became very difficult with the previous sys-tems. One of the reasons Epic’s products are often preferred, he said, is because Epic has not expanded by mergers and acquisitions. Consequently, all its products are essentially unified and compatible with one another.

“The workflows are all integrated, so you can move seamlessly between the dif-ferent products,” said Blumenfeld.

In June 2010, Chicago-based Allscripts, which developed ambulatory EHRs, announced it would merge with hospital IT firm Eclipsys in a $1.3 billion deal. That merger, said to have united some 180,000 physicians and 1,500 hospitals nationwide, has had some high-profile consequences for Allscripts recently.

Health IT companies that have grown by M&a often don’t have seamless integration between eHr systems, and sometimes the product can turn out looking like “Frankenstein.” acquISITIONS see page 22

“ I would highly recommend the Paragon system to those looking to drive both quality and cost-effi ciency.”

“ We’ve used Paragon for over 10 years and are even more convinced today it’s the right choice for our future.”

With the pace of change in healthcare, organizations need a system that fi ts their needs today but that can also quickly adapt to those of tomorrow. The Paragon® HIS has been named best in KLAS for the community hospital for 6 years running and is ranked in the most recent report as the #2 Overall Software Suite.1 Fully integrated, user-friendly, and with an average contract to “go-live” of 14 months, it’s no wonder more and more institutions are selecting the Paragon HIS as their path to the future.

To learn why Jack and others have selected the Paragon HIS to help chart their path forward, visit www.mynewHIS.com

1Source: 2006-2011 ‘Top 20 Best in KLAS Awards: Software & Professional Services’, www.KLASresearch.com. © 2011 KLAS Enterprises, LLC. All rights reserved.© 2012 McKesson Corporation and/or one of its subsidiaries. All rights reserved. Paragon is a trademark of McKesson Corporation

and/or one of its subsidiaries.

Jack Roberts, Director of Information SystemsTwin County Regional Healthcare

“ We’ve used Paragon for over 10 years and are even more convinced today it’s the right choice for our future.”

organizations need a system that fi ts their needs today but that can also quickly adapt to those of

HIS has been named best

running and is ranked in the most recent report Fully integrated,

“go-live” of 14 months, it’s no wonder more and

MCKP056 TwinCounty ITNews JrnlAd JR FINAL 091112.indd 1 9/11/12 1:49 PM

Business www.HealthcareITNews.com | HealthcareITNews | January 201322

rather sophisticated mathematical computations, like neural networking.”

The reason for that, of course, is that there are more Healthrageous users. “We’ve got about a 10x increase in participants on the platform,” says Lee. “So we’re getting a lot more data.”

That’s led to some “impressive results in our best bio-feedback loop, which is the hypertension loop,” says Lee.

The October issue of American Heart Journal spotlights some of that success: reporting on six-month, controlled trial, conducted at Hopkinton, Mass.-based EMC Corporation that demonstrated how a Web-based self-management program has helped individuals with prehypertension or hypertension achieve significantly lower blood pressure.

A total of 404 employees with those conditions participat-ed in the study, which enabled individuals to easily collect their blood pressure readings, monitor trends and securely share their personal data with their providers using a home blood pressure cuff and Web portal. It was based on this self-management technology platform, developed by the Center for Connected Health at Partners HealthCare, that Healthrageous was founded, officials say.

The change in diastolic blood pressure was significantly different between the intervention and control groups, although the change in systolic blood pressure was not significant, according to the research. Nearly one quarter of intervention participants experienced a greater than 10mmHg decrease in systolic blood pressure (22 percent), or a greater than 5mmHg decrease in diastolic blood pres-sure (29 percent) compared to the control group.

Moreover, intervention participants were twice as like-ly to report starting a new medication and more likely to report improved communication with their doctor. Just a 5mmHg decrease in blood pressure can reduce mortality due to stroke and heart disease by 14 percent and 9 percent, respectively.

Data from individuals participating in Healthrageous’ hypertension self-management program over the past 18 months show a sustained engagement rate of 70 percent among those focused on improving their hypertension. Sig-nificantly, 30 percent achieve a meaningful clinical improve-ment as defined by the original study completed in 2009 by the Center for Connected Health, officials say.

These advancements will be “highly refined by the com-bination of the biofeedback loop and the machine learning,” says Lee. “We can constantly come back to you with those real-time data numbers, which are your numbers. Based on

you taking your blood pressure. And we can start to cor-relate your lifestyle behaviors with those elevated scores.” As the user’s health improves, the Healthrageous platform can provide positive feedback.

“It comes down to the personalization that is achieved with machine learning,” says Lee. “If I can deduce from your wireless pedometer that you’re a type A personality, because I have a time/date stamp of you running six-minute miles, six of them, this morning at 5:30 a.m. in the pitch dark in Boston, now I have a pretty good understanding of what makes you tick. And then I can embellish that when I start asking ques-tions like, ‘Have you ever smoked? Are you in a long-term relationship? Do you watch hours and hours of TV at night?’”

“These are just further informing me so I can come back to you and, in bite-sized bits of information, help you achieve the kind of health you’re striving for with pointers and tips and hints and suggestions.”

“Our findings indicate that self-management can be an effective way to improve blood pressure control,” said Joseph C. Kvedar, MD, founder and director of the Cen-ter for Connected Health at Partners HealthCare. “Shifting interventions from the clinic to home and workplace is an innovative and potentially effective approach to achieving increased self management, improving quality of life and clinical outcomes, while reducing healthcare costs.” n

Insurance exchanges under wayCritical deadline to enroll individuals is Oct. 1Mary Mosquera, Contributing EditorWaSHINgTON – The continuing saga around the deadline delay for states to decide whether they’ll establish their own health insur-ance exchanges doesn’t change the final upshot: All states are antici-pated to have an online insurance marketplace, one way or another.

The delays may also make a fed-eral/state partnership model for the exchange more palatable and a way out for unprepared states, at least in the initial years, according to an expert on state healthcare issues.

Health and Human Services (HHS) Secretary Kathleen Sebelius in November extended the dead-line to Dec. 14 for states to not only submit their blueprints for a state-based health insurance exchange but to decide whether they would establish the exchange on their own or seek federal help.

In announcing the delay, Sebelius said HHS is “committed to providing states with the flexibility, resources, and time they need to deliver the benefits of the healthcare law to the American people.”

Some states were revisiting their decision in light of President Barack Obama’s reelection, said Patrick Howard, who leads Deloitte Con-sulting’s state healthcare practice.

“The reality of the situation is that to get something like this decided is a collaborative process – the depart-ments of insurance and health and human services, perhaps members of the governor’s office all have to be on board – to make that final decision of which way you are going to go,” he said, adding that the HHS secretary may have decided to give the states more time to complete that thought process inside their organizations.

Some states had held hard and fast to not making any plans, “But a number were doing, as well they should, contingency planning on both alternatives,” Howard said. The most critical deadline is Oct. 1, 2013, when state exchanges must be ready to start enrolling indi-viduals. The exchanges become operational Jan. 1, 2014.

“You’re marching toward a pretty tight timeline. I think a number of states will look at their own pre-paredness, and realistically ask, can we get all things done that we need to get done by Oct. 1, 2013,” Howard said. If they have been doing con-tingency planning, it’s possible that they can get there.

“If they haven’t been doing things in the background and are starting from square one, the odds of them actually making an Octo-ber implementation are relatively slim,” he said.

What may become a more attractive option is the federal partnership model.

“I think more states will embrace that federal partnership model per-haps for a year and then transition to a state-based exchange, giving them a little more time to think through their business processes and tech-nology,” Howard said.

Some states can enable an exchange through an executive order, while others need legislative

authority for setting up the organi-zation to administer the program. Some state legislatures won’t be meeting again until early 2014.

“That gets you to more states looking at the federal partnership model and eventual transition if they can get enabling legisla-tion. I think that makes sense for them,” Howard said. “We’ve all been waiting with bated breath to look at what the results of this determination are,” he said, add-ing that it will be “a key landmark what they are going to say in those blueprints.”

In general, the recent election did not significantly change the grip that Republicans have on state legislatures, meaning that state roles in implementing features of the health reform law will still face challenges. Many states, for exam-ple, require enabling legislation for health insurance exchanges.

After the election, 26 state legis-latures remain in GOP hands, while Democrats gained four for a total of 19, and four state legislatures are divided, according to Tim Storey, senior legislative fellow, National Conference of State Legislatures. It’s also a factor at the governors’ level, where only 11 states have divided governments.

“States have really coalesced around one party or another,” said Storey. n

The most critical deadline is Oct. 1, 2013, when state exchanges must be ready to start enrolling individuals. The exchanges become operational Jan. 1, 2014.

Chairman Phil Pead, who came to the company from Eclipsys, was fired this past April, and three additional board members fol-lowed him out in protest. Company shares plummeted nearly 40 percent, with Chief Executive Officer Glen Tullman citing “lower than expected sales” as a big reason for Allscripts’ dismal numbers.

Insiders, however, pointed to the company’s failure to integrate products and company cultures as the merger’s biggest misstep.

“The question is can you make Company A work under Company B’s structure,” said Thomas Lys, professor of accounting information and management at Northwestern University’s Kellogg School of Manage-ment to Chicagobusiness.com. “And the general answer is, probably not.”

Other health systems have joined MaineHealth in choosing Epic over others. The New York Times reported back in October that Allscripts lost its bid to replace the New York City public hospital network’s outdated EHR system. Instead, the state’s health system – one of the largest in the nation – selected Epic as the beneficiary of the $303 million contract.

McKesson Corporation also followed a similar path to that of Allscripts, with M&A activity of its own, including the 2010 merger with US Oncology; the September 2012 acquisition of health IT com-pany MedVentive; and the October 2012 acquisition of MED3OOO.

The problem with these acquisitions, according to Blumenfeld, is that it makes interoperability between a hospital’s health IT system nearly impossible – and that’s simply unfavorable from a user’s perspective.

“When you get to vendors like McKesson or GE or Allscripts, the problem is that they’ve grown mostly by acquisition, and they have these potpourri of products and different platforms and operating systems,” Blumenfeld told Healthcare IT News. “It becomes very dif-ficult – standards or not – to carve together something that feels coherent or feels consistent.”

When these systems don’t integrate well with each other, the results can be alarming, he said.

“Sometimes it ends up looking like Frankenstein. The ear’s a little too big, and you’ve got a different head and a different arm.” Because many vendors struggle with effectively integrating their products, Blumenfeld added, “The vendors that have chosen that approach and have grown by acquisition are facing an uphill battle right now.”

According to a July 2012 KLAS report on clinical market share, McKesson lost footing for the year, together with Allscripts, MEDI-TECH and Siemens. Moreover, a 2012 Medscape report asking phy-sicians to rank the top EHRs revealed that more than one-fifth (22 percent) of physicians bestowed Epic with the top-ranking honor. By contrast, 10 percent of physicians favored Cerner, with Allscripts fol-lowing close behind at 9 percent.

All that said, M&A acquisition is a part of nature for the business world, and simply because companies merge and acquire does not necessarily portend failure, of course. The stock value of publically traded companies such as McKesson and Cerner has been on the upward trend since 2009. (Epic is privately held.)

Meaningful use has certainly helped boost bottom lines. With more providers looking to replace or upgrade EHR solutions to meet Stage 2 requirements, in many cases, business can’t help but be booming. n

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BenchmarksJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 23

HealtH InformatIon excHange

Public or private, noun or verb, HIE is here to stayBy Mike Miliard, Managing Editor

Not too long ago, health infor-mation exchange – the verb, not the noun – was something someone else had to worry about. It was complicated, sometimes contentious. But

many providers could sleep well, comforted by the fact that it was large hospitals and aca-demic medical centers – not them – who were the ones dealing with it. Not anymore.

Health organizations are “going to have to demonstrate the ability to exchange informa-tion as part of meaningful use Stage 2,” says John Hoyt, executive vice president of HIMSS Analytics.

Everyone from the Office of the National Coordinator on down have been paying close attention to parts of speech when it comes to health information exchange lately. Quoth Farzad Mostashari, MD: “I refuse to speak of HIE as a noun. HIE is a verb.”

But no question, the mechanisms of HIE are very much nouns – and very different types of nouns, at that.

There are private HIEs: “I’m the hospital and we own a bunch of doc practices and some of them run one brand and some of them run another, and we bring their data into a central repository,” says Hoyt. There are public HIEs: “There is some sort of a neutral entity to which we all subscribe somehow, and we send the data to it – it’s the broker, it sends it to the requesting orga-nization, or to all organizations.”

There’s also a third category, “which has been around for a while,” says Hoyt. “I’d argue that it’s not quite in the spirit of what health information exchange is. It’s organizations who electroni-cally participate, by law in some immunization registry or disease registry.”

But for these purposes, health information exchange refers to a public or private mechanism that shares data in order to “help improve the continuity of care.”

Public and private models, of course, are inherently different in conception, funding, and, per-haps most consequently, staying power. Which is best positioned to thrive in the long-term?

“Boy, that’s the ultimate question,” says Hoyt. “The public is going to have to have some sort of funding mechanism to keep it alive. Everybody wonders what’s going to happen when the feds say, ‘OK, we’ve given you enough money for enough years. You’re on your own.’ There is serious question whether they’ll build a business model that will keep them alive.”

And what if many of them fall victim to lack of revenue? “The next question – and this is all theory – but if a bunch of them sit down because they all went broke, does the federal government recognize, ‘Oops, we’re not get-ting the continuity of care that we want,’”

and toss some more money at them?On the other hand, of course, “The feds

could say, ‘Don’t worry about it, I only deal with ACOs, which have private information exchanges.’”

And make no mistake, says Hoyt, for all the terrific state-level HIEs out there, “There are some great examples of privates.” For one, he points to Adventist Health System in Florida, which enjoys a “very robust exchange,” in more than 40 hospitals, from Wisconsin to Miami.

“All of those hospitals have relationships with physicians in their communities, with whom they are exchanging information. You could be a physician in Appleton, Wis. today, and tomorrow you’re in the ED in Orlando, and you can get the data. That is impressive.”

Pam Matthews, RN, senior director of regional affairs at HIMSS, says, “We are see-ing another evolution,” in HIE.

“Public exchanges – the most noteworthy are the state HIEs – that came through the ONC funding out of HITECH,” continue to grow and evolve. Some more than others, of course.

“We are seeing states, where some are not as aggressive, we are seeing some being very aggressive in establishing a state-level HIE,” says Matthews. “They are either estab-lished under the auspices of the state, or they can actually identify their state-designated entity.”

On the other hand, “We also are seeing some states that are using Direct, and are looking at other options instead of actually setting up a full-fledged state level HIE,” says Matthews. “There are various flavors that are

materializing. Each state has its geographic market drivers, as well as political drivers. The states have to look at what their market and political environment will bear.”

She adds: “I will tell you, states are eager to share, they’re eager to learn from each other.”

Still, says Hoyt, “I think the trend lines going forward will be creation of regionals on a private basis. If the state is not acting quickly enough, the hospitals have to be able to demonstrate that they can do health infor-mation exchange for Stage 2: ‘If we’re going to have to do that, why don’t we just build one with the docs that are serving us?’”

“My own guess is that I would still bet on the privates.”

However the next few years shake out, there’s no mistaking how far things have come in the past few years.

“We’ve made great strides, and we will continue to,” says Matthews. “We will con-

tinue to see advancements in technology, and a lot of those advances over the next five years can be leveraged by organizations exchanging data, [so] it can be accomplished more easily and efficiently.” n

InformatIon age

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Datawww.HealthcareITNews.com | HealthcareITNews | January 201324

Kansas HIE to share pop health data with CDCOfficials at the Kansas Health Information Network say the exchange has begun sharing anonymous patient data with BioSense, a public

health system coordinated by the Centers for Disease Control and Prevention (CDC) that systematically tracks hospital emergency department visits. The data sharing between the two entities, officials say, will enable public health profes-sionals to monitor a broad

array of potential public health threats. The CDC-coordinated system was recently redesigned to improve the information provided by the system and to promote standardization and collaboration across states.

RSNA expands its image-sharing network

The Radiological Society of North America (RSNA) has received a contract from the National Institute of Biomedi-cal Imaging and Bio-engineering (NIBIB) to help expand the NIBIB-funded pilot project that created the RSNA Image Share network. The

contract provides two years of support at $5.3 million and two addi-tional option years at $5.5 million, officials say.

Intermountain taps Siemens for image archivingSiemens Healthcare announced the signing of an $11.7 million, multi-year contract with Salt Lake City-based Intermountain Healthcare to deploy Siemens Image Sharing & Archiving (ISA) ven-

dor neutra l a r c h i v e t o handle Inter-m o u n t a i n Healthcare’s e n t e r p r i s e i m a g i n g needs. Sie-

mens ISA is a hosted archive that stores images from any modality in the Siemens Healthcare Computing Center; images are redun-dantly hosted in a Dell data center, and the archive is managed with Dell’s clinical data management software.

Interoperability is ‘taking so darn long’The road to getting there involves four numbersBy Neil Versel, Contributing EditorCHICAGO – Hospitals can have hundreds of IT systems. Vendors have built proprietary data-bases. Not everyone follows the same stan-dards. Health systems fear sharing data with competitors. Policymakers have not focused on health information exchange or EHR usability.

These are just a few of the reasons why true interoperability of health information remains so elusive, according to informatics experts.

“Technology is only one obstacle to interoperability,” said Gilad Kuperman, MD, director of interoperability informat-ics at New York-Presbyterian Hospital, who moderated a recent panel at the American Medical Informatics Association (AMIA) Annual Symposium about why interoper-ability is “taking so darn long.

Charles Jaffe, MD, CEO of standards devel-opment organization Health Level Seven Inter-national (HL7) described a “circle of blame” involving government agencies and regulators, hospitals and healthcare systems, technology vendors, clinicians, academicians like those at AMIA and, yes, standards development orga-nizations (SDOs), such as HL7. “The policy always preempts the technology,” said Jaffe.

“And just like [in the 1983 Cold War movie] WarGames, in this finger-pointing,

no one wins.” He noted that not-for-profit HL7 in September made most of its stan-dards and other intellectual property avail-able free as a means of building trust for HL7 communications messaging. “Without trust, none of this is possible,” Jaffe said.

Harry Solomon, interoperability architect at GE Healthcare, and a lecturer at Oregon Health and Science University, explained the road to interoperability with four numbers: 2, 4, 3 and 5.

There are two overarching concepts that need to be defined, namely interoperabil-ity and standards, and Solomon said “good enough” definitions exist from Institute of Electrical and Electronics Engineers (IEEE) and the International Organization for Standardization, known as ISO. Therefore, healthcare should not have to do any more in this arena. “We can’t afford to have custom integrations for every data transfer that we have,” Solomon advised.

The number 4 stands for the levels of interoperability specification: workflow, messaging, format and vocabulary.

The other two numbers represent three phases – standards development (generally handled by an SDO), product development (vendors), and system deployment (users) – and five process steps for each phase.

These steps include: the decision to proceed

10 largest HIPAA breaches of 2012By eriN MccaNN, Associate Editor

I t’s a hard knock life for patient privacy – with this past year alone seeing some of the largest data breaches yet inves-

tigated by the Department of Health and Human Services (HHS).

Some 21 million patient health records have been compromised since the Aug. 2009 Breach Notification Rule, which requires that HIPAA-covered groups give notification following a data breach involv-ing 500 or more individuals. And, although a December analysis from The Health Information Trust Alliance found a slight decline of these data breaches since 2009, industry susceptibility is still going strong.

Analyzing data from the HHS, Health-care IT News compiled a list of the top 10 data breaches in 2012. All told, nearly two million patient records have been compro-mised at these organizations:

1. Utah Department of Health con-firmed that a server containing personal health information (PHI) of some 780,000 patients had been actively hacked into starting in March. Officials reported that thieves had begun removing information from the server. Addresses, dates of birth, Social Security numbers, diagnoses codes, national provider identification numbers, billing codes and taxpayer identification numbers were all included on the server. The Utah Department of Technology Ser-vices shut down the server when the breach was discovered April 2. The Utah breach stands as the 9th largest data breach ever reported to the HHS.

2. Emory Healthcare, the Atlanta-based hospital system announced April 18 that it had misplaced 10 backup disks con-taining information for more than 315,000

Technology is seen as one obstacle to interoperability. There are many others.

breACH see PAge 25 INTer see PAge 25

The 10 largest data breaches of 2012 represent nearly 2 million patient records that have been improperly accessed, stolen, hacked or misplaced.

DataJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 25

on each phase; allocation of resources; develop-ment; validation; and deployment.

Healthcare IT has been burdened by too many standards, off ered University of Penn-sylvania sociologist Ross Koppel, a former chair of AMIA’s evaluation working group, and a frequent critic of large, established EHR vendors. For example, he said, there are 40 diff erent ways to record blood pressure in EHRs, and perhaps three of them are “proper” from an informatics standpoint.

Koppel argued that meaningful use stems

from a plan hatched by vendors 30 years ago to sell more software with the help of gov-ernment subsidies and did not always have interoperability in mind. Koppel said a 2009 New England Journal of Medicine article by then-national health IT coordinator David Blumenthal, MD, Ashish Jha, MD, and other Harvard researchers that heavily informed Stage 1 meaningful use regulations did not ask a single question about usability, patient safety, interoperability, data standards or what Koppel called “clunky interfaces.”

One attendee, David McCallie Jr., MD, the vice president of medical informatics at Cern-

er, challenged Koppel’s assertion, saying that vendors got together with ONC and created the open-source Direct Project that anyone can use right now to exchange health information securely. The complexity comes from incorpo-rating it into EHR code and into workfl ows.

McCallie further noted the speed in which the industry developed the continuity of care document. “It happened in two years, which in standards terms is lightning fast,” he said.

Koppel was more praiseworthy of the new Stage 2 rules. “I really appreciate what has been done in MU2. It’s a marked step for-ward,” he said. �

patients. The disks contained information on surgical patients treated between 1990 and 2007 at Emory University Hospital Midtown and the Emory Clinic Ambulatory Surgery Center. Some 228,000 of the fi les included patient Social Security numbers, names, sur-gery dates, diagnoses and procedure codes.

3. The South Carolina Department of Health and Human Services reported a data breach that started in January when an employ-ee compiled data on more than 228,000 people and transmitted it to a private email account. Offi cials estimate some 22,600 people had their Medicaid ID numbers stolen, which were linked to their Social Security numbers. Patient names, addresses and birth dates were also stolen as a result of the act. The former employee, Christo-pher Lykes Jr., was charged with fi ve counts of violating medical confi dentiality laws and one count of disclosure of confi dential information.

4. Alere Home Monitoring, a Livermore, Calif.-based company that provides home health anticoagulation monitoring services, reported that on Sept. 23 an unencrypted lap-top containing patient names, Social Security numbers, addresses and diagnoses was stolen from an employee’s car.

5. Memorial Healthcare System in Florida notifi ed some 102,153 patients of a breach that occurred between January 2011 and July 2012. A letter sent to aff ected patients explained that an employee working for an affi liated physi-cian’s offi ce might have improperly accessed patient names, dates of birth and Social Secu-rity numbers.

6. Howard University Hospital in Washing-ton, D.C., notifi ed 34,503 patients of a potential breach of their PHI that occurred in January. An unencrypted laptop was stolen from a con-tractor’s vehicle. The records stolen did contain patient names, addresses, Social Security num-bers and diagnoses for many aff ected. More-over, the hospital reported that the contractor had stopped working at Howard University Hospital in 2011 but violated policy and con-tinued to download patient data.

7. Apria Healthcare, a Lake Forest, Calif.-based home healthcare service company, reported that in June an unencrypted laptop containing the PHI of some 64,846 patients was stolen from an employee’s locked car in Phoenix. Patient names, phone numbers, Social Security numbers and possibly clinical data were contained on the laptop.

8. The University of Miami reported a July data breach after two university employees were inappropriately accessing some 64,846 patients’ “face sheets,” which included names, dates of birth, insurance policy numbers, partial Social Security numbers and clinical information. Moreover, in both Medicare and Medicaid insurance plans, patient Social Secu-rity numbers are used as the insurance policy number, thus, in these cases, full Social Secu-rity numbers may have been compromised.

9. Safe Ride Services, the Phoenix-based healthcare transportation company announced in February that a former employee may have accessed computer systems starting in August 2011 without authorization and ultimately may have deleted service fi les. The fi les con-tained both insurance information and patient demographics.

10. Integrated Medical Services of Fajar-do, Puerto Rico reported a data breach in Janu-ary after a laptop was stolen containing the PHI of some 36,609 patients. The medical services company is affi liated with the San Juan, Puerto Rico-based Quantum Health Consulting. �

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new productsAT&T to launch new RPM SaaSAT&T has announced a new cloud-based remote patient monitoring software-as-a service (SaaS) from Ericsson that utilizes its service enablement plat-form and Intuitive Health software to facilitate better management of chronic diseases and help reduce hospi-tal readmissions. The interactive service’s video component will provide helpful coaching, reminders and health educa-tion, officials say AT&T has been piloting the RPM SaaS solution with large health systems, academic medical centers and home care providers. It is expected to be available in 2013.

Infor announces next-generation interoperability technologyInfor has announced the availability of Infor Cloverleaf Integration 6.0, the next genera-tion of its interoper-abi l i ty technology. Designed to impact virtually every level of a healthcare organiza-tion, enhancements in version 6.0 bring a greater level of agility organization-wide, providing industry-specif-ic tools that focus on speed of creation and speed of delivery, officials say. The new version offers improved interface capabilities, more efficient translation routing, clearer visibility into issue detection and more.

Allscripts launches new Sunrise Financial Manager tool

Allscripts has released Sunrise Financial Manager, a tool that enables hospitals and health systems to manage revenue in an integrated way across the enterprise. The latest in a long line of revenue cycle solutions from Allscripts, SFM breaks new ground with its Visual Workflow capabilities, allowing users to configure the financial pro-cess to meet the organization’s needs and to address constantly changing regulations and pay-ment models in the new world of accountable care, officials say.

GE Healthcare unveils Centricity 5.1 RCM technologyGE Healthcare has launched Cen-tricity Business 5.1, the next gen-eration of its healthcare revenue cycle management technology. Aimed at integrated delivery net-works, hospitals and large prac-tices, Centricity Business 5.1 fea-

tures new capabilities to address emerging reimbursement models – shared savings, capitation and bundled payments – as well new task management and clearing-house enhancements to help drive greater profitability, efficiency and enhanced quality of care.

Man and MachineComputer models augur big things for personalized careBy Mike Miliard, Managing EditorBALTIMORE – “Disease is too com-plex to just think your way through it,” says Raimond Winslow, direc-tor of The Institute for Computa-tional Medicine at Johns Hopkins. “We can no longer work with what I call purely mental models of how biological systems function, in either health or disease.”

Thankfully, we have technology to lend a hand. The burgeoning and com-plex field of computational medicine is showing promise for the treatment of illnesses such as Alzheimer’s, heart disease, cancer and more, as technol-ogy and troves of data are harnessed to investigate the underpinnings and map the progression of diseases.

Technological advancements have precipitated a significant leap forward for the discipline over the past decade or so, but it still has a long way to go before realizing its true potential.

“Computational medicine is a discipline where we try to develop experimentally based computer models of disease, so we can very quantitatively understand what disease is, what affects disease, and then try to model therapeutic interventions,” Winslow explains.

He likens it to “the way a flight sim-ulator has a computer model of how the airplane behaves.” Intentionally in this case, something goes wrong with the flight simulator and the pilots, aka the physicians, make an intervention, and the simulator responds the way a

simulator would respond.“The analogy is: We have a model

of the plane, a/k/a the disease, and we have the people who are mak-ing interventions when something goes wrong – the physicians – and learning how to correct for what-ever goes wrong,” he says.

The Institute for Computational Medicine was founded in 2005 as a partnership between Johns Hop-kins’ Whiting School of Engineer-ing and its School of Medicine. But the concept has been around for more than 50 years.

“Probably the oldest discipline in which this kind of approach has been used is cardiovascular science,” says Winslow. It began in 1960, with work by Oxford University biologist Denis Noble. “He published the first electrical model of how the cardiac myocyte generates its electrical activ-ity, which leads to the contraction of the heart. He did it for a single cell. But that was the beginning of model-ing cardiac muscle cells and trying to understand how they function in health and in disease.”

Nowadays, says Winslow, “com-putational models of heart disease are being developed, from the molecular level to the cellular level to the whole-heart level.”

Those models, of course, are cen-tral to the burgeoning field of per-sonalized medicine. Cardiac care is just one field that stands to gain from computational learning.

“Models have begun to appear in other disciplines, over the past 10 years or so,” says Winslow. “Mod-eling has been done on lung disease,

cancer, certain types of brain dis-eases. Increasingly, these models are being tailored to the individual and used to guide selection of therapy to treat the disease.”

The research, he says, “Has truly taken off over the last 10 years or so.” Biological knowledge is expanding. Experimental tools are improving. “There’s a lot of data to feed quanti-tative models.” And, of course, “the ever-expanding power of comput-ing is making it possible to simulate very large scale systems.”

Winslow has described the intri-cate interplay of genetic material, proteins, cells and bodily organs as something like a hugely complex jigsaw puzzle. Advances in compu-tational models have equipped biol-ogists with powerful ways to make sense of the microscopic mecha-nisms of disease – and offered new opportunities to test treatments

based on that knowledge. Some examples of recent research

include models that are helping sci-entists understand how networks of molecules are implicated in can-cer – helping them predict which people might be most at risk – and a field called computational physi-ological medicine, which uses computational modeling to show how biological systems shift from a healthy to an unhealthy state.

Computational anatomy uses imag-ing technology to look for changes in the shape of certain structures in the brain – changes that could indicate Alzheimer’s disease or schizophrenia.

That is “one area of computa-tional medicine that I think is clos-est to truly meaningful, large-scale, clinical application,” says Winslow.

Already, he says, it’s at the point where, by looking at the structure of the hippocampus, researchers

could say a patient has Alzheimer’s, or is at the early stages, has indi-cations that portend a significant progression of the disease.

Despite these near-term advances, however, computational medicine is “definitely not being used to its full potential.” Still, he’s hopeful.

“We should all understand that this is a slow process,” says Winslow. “We’re at the very beginnings of com-putational medicine. Constructing these models is difficult. It relies on data that is difficult to get as well.”

And the advances are coming faster every day. “As we develop better technologies for measuring what’s going on in the body, with the emerging power of genomics, it’s likely that these new kinds of data that we can measure in every patient are going to be really valu-able in helping to constrain models for that patient’s illness,” he says. n

“We can no longer work with what I call purely mental models of how biological systems function, in either health or disease,” says Raimond Winslow.

TRENDSJanuary 2013 | HealthcareITNews | www.HealthcareITNews.com 27

BI focus should be on ‘end game’But how do you get there from here?BY JOHN ANDREWS, Contributing Editor

THERE ARE many elements of busi-ness intelligence in play within the healthcare IT continuum, but without a specifi c focus, the initia-

tive is stuck in neutral. In fact, that is where many healthcare providers fi nd themselves with their BI programs, system specialists say – wondering how to proceed and in which direction to move.

But despite whatever paralysis may be going on, it can be eased by keeping an eye on the “end game,” says Mike Garzone, solutions director for technology at Bu� alo, N.Y.-based CTG Health Solutions.

“We think the end game is the ability of hospitals to improve – whether it is through outcomes, a decrease in readmissions, or identifying hospital-borne conditions before they occur, like sepsis or infections,” Garzone said. “It comes down to how BI functions with care deliv-ery and how it relates to reimbursement. The end game is about improving how to get there.”

In order to steer the BI component in the right direction, hospitals need to make it a priority, which Garzone admits is a tall order in an envi-ronment where person-nel are preoccupied with meaningful use and other directives. Still, the pieces of a strong BI system are largely in place within the hospital sector and are mostly ready to be deployed, he says.

“We’ve enabled it – we haven’t codified everything and it isn’t interoperable, so there is still work to do – but it is there,” Garzone says. “Now is the time to act and leverage it. We are getting to the point where accountability and perfor-mance will really start to matter and that is when BI will bubble to the top.”

For the past two years Houston-based HealthPost has deployed a cloud-based search and booking platform that enables BI through the gathering of data and intelligence around the healthcare industry. CEO Omar Alvi describes it as “covering the spectrum and connecting all the points in the health-care ecosystem.”

Engineering a system that resembles both Google and Expedia.com in form and func-tion, HealthPost’s core business is improving access to care by increasing hospitals’ avail-ability to partner with other providers in the community. The search-and-book digital method replaces what has traditionally been a “slow, cumbersome process” with phone and fax, Alvi said.

“Now all these transactions come through a single point, creating complete

data intelligence on who is booking with providers,” Alvi said. “With the hosp i -tal as the sponsor of these opportunities, the entire outpatient provider network is in alignment. For the first time ever, they have complete visibil-

ity into booking activity.”BI capability also allows for data mining on

a number of fronts and in fact is superseding the decision support function, says Taylor Moorehead, partner for Carmel, Ind.-based Zotec Partners’ west region.

“Imagine a world where there are 425 data points to bill insurance, ranging from ICP to ICD-9 to other points across the board – you can dissect all of those data points in a granu-

lar way and correlate them to the billable amounts,” he said. “BI can take all the different aspects of services and relevant points of the claim and run them in various forms and fashions to mine for all the right data.”

APPLYING ANALYTICSB I t e c h n o l o g y h a s advanced to the point where it can handle larg-er volumes of data, larger analytical models and put them in the hands of lay-man users, says Dan Foltz, vice president of Blue Bell, Pa.-based Anexinet.

“Data visualization is getting better,” he said, “but a lot of organizations just aren’t there yet.”

Anexinet works with other industries on BI and Foltz says healthcare lags behind in utilizing its full potential. By con-trast, the fi nancial servic-es sector is well ahead of the pack, he says.

“Things are starting to happen in healthcare, but there are some barriers,”

Foltz says. “Currently, analytics reporting is retrospective, charting care that was deliv-ered yesterday. Healthcare needs to move toward prospective and predictive analytics.”

Prospective analytics, he says, is determin-ing why a patient didn’t fi ll a drug prescrip-tion and acting proactively while predic-tive analytics is looking at a population to determine co-morbidities and complications among chronic disease patients.

For healthcare to truly transform, the industry needs to use BI as a measuring stick for results, not activities, Foltz says.

“Currently hospitals are being paid for activity and not outcomes – the incentives need to change,” he said. “We need to work toward a system where everyone is incented by outcomes, including payers, drug compa-nies and patients.”

Ann Arbor, Mich.-based Arbormetrix has been conducting analytics around the popula-

tion and is generating some interesting statis-tics based on its evaluations, says CEO Brett Furst. For instance, because the majority of the chronic disease population is likely to experience a co-morbidity or episode, there are inconsistencies within the acute care set-ting, he said.

“There is a 30 percent cost variation from hospital to hospital and they need to look for trends on the reason for this di� erence,” he said. “They need to consider demograph-ics and co-morbidities and their infl uence on outcomes. And while the disease state management piece is an important piece, the majority of spending remains inside the acute care setting. Population health and DSM are here to stay, but for the near term, the con-cern is more on acute care.”

DEVICE TRACKINGBI isn’t just for tracking activities and outcomes – gauging the performance of medical devices is also an important part of the equation, says Peter Witonsky, president and chief sales o� -cer for Panama City, Fla.-based iSirona.

By combining its apps with greater intel-

ligence and algorithms, the iSirona system enables hospitals to anticipate and prevent potential sentinel events related to improp-er device usage, such as ventilator-induced pneumonia.

“The sta� is alerted if a vent patient’s head angle is not 30 degrees,” he said. “It also issues an alert if is not rotated properly to prevent skin ulcers. These are things that are not typ-ically included in electronic medical record tracking – it is all about predictive modeling.” �

Whatever paralysis may be happening on the BI front, it can be eased by keeping an eye on the end game, experts say.

Brett Furst

“These are things that are not typically included in electronic medical record tracking – it’s all about predictive modeling.”Peter Witonsky

“We’ve enabled it – we haven’t codifi ed everything and it isn’t interoperable, so there is still work to do – but it is there.”Mike Garzone

Job Spot www.HealthcareITNews.com | HealthcareITNews | January 201328

HIMSS takes workforce IT to the Big EasySigns formal agreement with BioDistrict New OrleansBy Bernie Monegain, EditorCHICAGO – HIMSS and BioDistrict New Orleans will work together to advance workforce health IT initia-tives anticipated to grow in the next several years in the district.

The two entities have signed a formal agreement that focuses on educational, career support and online initiatives before and during the 2013 Annual HIMSS Conference & Exhibition, which will be held in New Orleans on March 3-7, 2013.

The synergies between the two organizations focus on career devel-opment resources offered by HIMSS, recognizing the ongoing demand for skilled health IT employees in the BioDistrict. The BioDistrict, Louisiana’s No. 1 employment cen-ter, encompasses 1,500 acres span-ning the Downtown and Mid-City areas of New Orleans. It focuses on the development of the biosciences industry in New Orleans that will

provide world-class biosciences research and development; local, regional, and global healthcare delivery; and stable, high-paying jobs for professionals, managers and workers representing a wide range of skills, officials said.

“This new collaboration with HIMSS and BioDistrict New Orleans is positive news for our city,” said New Orleans Mayor Mitch Landrieu. “I am hopeful that this partnership will help to cre-ate new economic and workforce

development opportunities in the hospitality, health IT and innova-tion sectors for New Orleanians.”

HIMSS will work with BioDis-trict to provide career development resources, through white papers, webinars and other online and career-supporting tools to help pro-fessionals learn, grow and advance in their health IT careers.

Additional services include HIMSS JobMine job listings, online mentoring and an emerging profes-sionals community, resources that

can be used in the BioDistrict. Also available will be various HIMSS online tools for current, new and transitioning professionals who are interested in a career in health IT.

“HIMSS recognizes the ongoing need for skilled health IT profes-sionals across the country, and in BioDistrict New Orleans,” said Carla M. Smith, HIMSS executive vice president. “Our career services provide an employment, education and networking center with valu-able online resources and tools for current and aspiring healthcare and IT professionals.

Smith said HIMSS would work with BioDistrict New Orleans, before and during the upcoming annual conference in New Orleans.

CAreer COACH At HIMSS13, BioDistrict will be part of the conference Career Services Institute, a full-day program on Tuesday, March 4. The Career Ser-vices Institute will feature a nation-ally recognized career coach and will support networking opportu-nities for all participants.

In addition, the Career Services Center at HIMSS13 provides a cen-

tralized location at the conference for recruiters, consultants and oth-ers who contribute to the develop-ment of the health IT workforce. Smith said she expected it to be a gathering point for both job seekers and organizations looking for talent in health IT.

This partnership with HIMSS will serve as an example of how BioDistrict New Orleans is creat-ing opportunities for workforce development and training to build a successful biosciences industry in New Orleans,” said James P. McNamara, president and CEO of BioDistrict New Orleans. “Through our work with HIMSS, new com-panies will be recruited, creating more high paying jobs in the bio-science and healthcare IT industry and providing the foundation for viable careers for the people of New Orleans.”

“Any time there is a chance for economic development and job creation, especially in the growing healthcare IT industry, it’s consid-ered a win for the future of New Orleans,” said Ben Johnson, presi-dent and CEO, New Orleans Cham-ber of Commerce. n

HIMSS will work with BioDistrict in New Orleans to provide career development resources.

Mark A. Meyers has been appointed to ApolloMed’s board of directors and

will serve as its chief strategy officer. David Gregg, MD, has been appointed to

the position of chief medical officer at StayWell Health Management. Cognov-

ant recently hired Andrew Lambert as EVP business development. Continua

Health Alliance announced the appointments of Kaoru Hiraoka, general man-

ager of advanced technology and standardization, Mobile Phones Unit, Fujitsu

Limited, and Thierry Zylberberg, executive vice president of the France Tele-

com-Orange Group, and director of Orange Healthcare to its board of directors.

The American Medical Association (AMA)-convened

Physician Consortium for Performance Improvement

(PCPI) has named colorectal surgeon Frank Opelka, MD, as the new chair of the PCPI. David Jackson has assumed the position

of president of The Association of Health Information Outsourcing Services

(AHIOS). MRO Corp.’s chief technology officer, David Borden, was appointed

to the Pennsylvania eHealth Partnership Authority, established by the Pennsyl-

vania eHealth Information Technology Act. Awarepoint

Corporation has named Keith B. Pitts, vice chairman

of Vanguard Health Systems, to its board of directors.

Orion Health has appointed Tracey Sharma as sales

director; Sergei Maxunov as senior solutions consultant; and Heather Lin-kletter as project director. Ken Christensen has been appointed senior vice

president of operations of SPi Healthcare. Jeremy Bradley, of Owensboro,

Ky. has been honored with the prestigious Ambulatory HIMSS Davies Award

for 2012. Peter Rudd, MD,has been hired as chair of

the Department of Medicine at Alameda County Medi-

cal Center. The Workgroup for Electronic Data Inter-

change (WEDI) has appointed the following new board members: Gail Kocher, Blue Cross Blue Shield Association; Tom Meyers, America’s Health Insurance

Plans; Catherine Mesnik, St. Joseph Healthcare; Nancy Spector, American

Medical Association; Annette Gabel; Ed Hafner, TIBCO; Charlie Jarvis,

NextGen Healthcare; and Marian Reed, McKesson.

The College of Healthcare Information Management

Executives (CHIME) has announced that members

Edward W. Marx and Randy McCleese have earned

the organization’s esteemed Fellowship status. CHIME recently honored those

who have maintained continuous membership since its inception with the Life-

time Membership (LCHIME) designation. The inaugural group of 26 CHIME

Lifetime Members are as follows: Gary L. Barnes, Richard Caldwell, Francis H. Cheung, Charles E. Christian, Frank C. Clark, James Cramer, Adrienne M. Edens, Mark F. Fehling, Andrew T. Fowler, Roland A. Garcia, Mark B. Gorrell, D. Arlo Jennings, Ludwig A. Johnson, Dennis P. L’Heureux, David T. McCobb, Kym A. Pfrank, Joseph M. Pleasant Jr., D. Jerome Powell, Patricia C. Skarulis, Bruce D. Smith, John T. Stanley, William W. Stead, MD, Peter B. Strombom, Lynn H. Vogel, Richard D. Warren and David A. Weiss.

Ken Christensen

David Borden

David Gregg, MD

David Jackson

Peter Rudd, MD

on THE MovEBUZZ By BenjaMin Harris, Contributing Writer

Healthcare IT heavyweights convened in Washington, D.C., for the mHealth Summit 2012 (#mhs12) this past month. HIMSS President & CEO H. Stephen Lieber said there were more than 3,800 registered participants and 300 companies in attendance. On the docket this year were the 20th birthday of the text message, gains made in patient-provider collaboration and the use of mobile technology to combat rising healthcare costs.

Ask anybody at the summit: Mobile devices are everywhere. @eFuturist wrote on Twitter that “25% to 50% of viewers of hospital Web pages coming from mobile devices,” and saw the “need for mobilized Web and dedicated hospital Apps grow-ing.” Still need convincing? At the opening keynote, speaker Patricia Mechael noted that “more people in world have access to mobile phones than they do to clean water or bank accounts.” (via @bharris_hitn)

Government finance found its way into the conversation, with many mentions of the so-called fiscal cliff. At the opening keynote, Harry Totonis remarked that the healthcare system needs to “bend the cost curve” to become affordable. As @Sure-scripts tweeted: “Over 10 years, e-pre-scribing will save the health care system up to $240 billion in added efficiencies.”

Just because there is a wide array of mHealth apps doesn’t mean they’re magic bullets, though. There was talk aplenty about how to make their usefulness stick. @NicStrauss noted that “gathering per-

sonal health data [is] not enough, [you] need to put it where you’ll see it + moti-vate you to change behavior.” At the State of Science in Research on Mobile Health Technologies panel, Bonnie Spring of Northwestern University said integrat-ing social media with health applica-tions helped provide support and boost accountability for mHealth app users.

Big takeaways from the Summit? Wrote @DJCoreyMeyer: “Reach patients how they want to be reached.” And @alison-pilsner said, “Morning lesson of #mhs12: convenience + simplicity = engagement.”

@epilkington predicted: “The Inter-net changed telecomm, TV has changed, computing has changed, and now health-care will experience a revolution.” Wrote @judywawira: “Among all the geek talk I remember a famous quote: ‘A doctor that is worried about being replaced by tech-nology should be replaced.’” n

Got something to say? Let us know by tweeting @HITNewsTweet or finding us on Facebook and LinkedIn.

NEWSMAKER www.HealthcareITNews.com | HealthcareITNews | January 201330

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ROY SCHOENBERG on telehealthAmerican Well CEO sees dramatic market opportunity BY BERNIE MONEGAIN, EditorBOSTON – Roy Schoenberg, CEO of Ameri-can Well Systems, discusses his vision for the future of telehealth. Schoenberg heads the company’s product development as well as the rest of its operations divisions. He and his brother, Ido, who serves as CEO of the corporation, have worked together for many years, both as physicians and as entrepre-neurs. Roy Schoenberg discusses his path to American Well and his vision for telehealth. Its impact on healthcare, he says, could be as dramatic as the one online sales had on the retail marketplace.Q: What prompted you and your brother to move from providing patient care to forming a telehealth company?A: It wasn’t a direct transition. American Well is our third company. At the time, practic-ing medicine, we both lived in hospital sys-tems, and worked in intensive care units. The fi rst company we formed – a company called MDSoft – was all about computerizing systems. This was many, many years ago. We created a computer system that connected to the di� erent devices in an intensive care unit and collected all the information and tried to interpret it and present it to the physicians and nurses on the fl oor in a way that made more sense. When you walk into ICU every-thing is beeping and bleeping at you, and it’s an overwhelming experience of trying to understand what’s going on there. We created a system that consolidates all of that informa-tion and makes sense out it, and only alerts and only presents information for the provider that needs intervention on. That worked very well. It was a very successful company and sold. So, we did well in that.Q: What about your second company?A: The second company that we formed was already a second-generation. This was already the Internet age – the beginning of it. It was a company called CareKey, and that company established the notion of Web-based medical records – essentially what today are called PHRs, portable health records. This was at the time that HIPAA was enacted, and we had a solution over the Web that allowed patients to pretty much control their records and control the dissemination of their information, and luckily for us, all of the health plans out there realized that with HIPAA comes a great bur-den on them to communicate with patients

because patients now have control over their information. So suddenly every plan out there decided they needed to have a patient portal and they needed to have a patient communi-cation strategy that included a di� erent set of tools – over technology, over the Web and telephony and everything else. We were ready with a very mature platform, so that company did well and got acquired by TriZetto.Q: What is the future of telehealth?A: When we think of telehealth, we think, “Here’s a cool video-conferencing that gener-ates convenience for patients. When you take a step back and realize what the signifi cance of telehealth is, then it’s a very di� erent kind of story. Telehealth changes the fundamental par-adigm that existed for hundreds of years: If you are a patient and you’re sick, you need to go to where healthcare is to get care. With the intro-duction of telehealth, we have the ability to reverse that paradigm, and say, “No, if you’re sick, healthcare can come to you where you live, where you work, when you need it, where you need it, under your own terms. Suddenly the healthcare industry is using technology to reach its end consumers. Not unlike the impact of what online retail has done to the retail industry, where it’s actually said, “The shops are going to where the buyers are.” This is the same impact that you are going to see of this technology on the healthcare industry. It fundamentally changes the reach of that indus-try and how patients are engaging consumers. Q: In what ways?A: There’s a variety of di� erent applications for this. Many people think of telehealth as, “Here’s a way to give patients in rural areas access to healthcare.” That’s kind of the low-hanging fruit. The reality is much, much broader. There are patients who live in metropolitan areas who have trouble reach-ing healthcare because they’re elderly or because they have chronic conditions, and they’re homebound. They can’t go to the physician o� ce every day in order to care for their fl uctuating blood sugar levels. And you have oncology patients who are taking chemo-therapy and are at home that don’t want to leave their houses. You have a lot of patients who have undergone surgery in the hospital, and because we need to kick them out of the hospital quickly because every day in the hos-pital is so expensive. They go home for their recovery period, and we know that for the fi rst month of recovery a lot of bad things happen, and our ability to use technology to monitor them and follow up with them at home allows us to prevent readmissions, which is a huge chunk of money that the healthcare system spends – the payer, or the delivery system,

whoever it is. There is a whole di� erent world that deals with compliance. If I’m the patient and I’m told I have to adhere to a certain phar-maceutical regimen, and many patients are not compliant. My ability to see that patient on a regular basis in order to make sure that they do follow up on what they need to do increases compliance dramatically. We know that patients who are not compliant show up in emergency rooms.

Then there is the notion of healthcare reform with 34 million Americans who don’t have access to an already stretched-thin pri-mary care physician. We are facing a melt-down. We have to fi nd a better way of uti-lizing PCPs that we have and making them available through technology to allow fewer physicians to care for more patients. When you think about the dramatic impact of the ability through technology to take the health-care system to where the patient is, you pretty much get an understanding of how dramatic telehealth is in this market. Q: How big is the opportunity?A: I would say it’s the opportunity of let’s say online retail and how dramatic that change was for the retail industry. It’s a watershed event. It continues to morph in front of our eyes with more technology, with more pen-etration, with more mobile broadband, with

the production of di� erent payment methods. This is one of those technologies that life will never be the same once it’s out. This is pretty much where the infl ection of telehealth is.Q: What are the challenges remaining to get to the point that you imagine?A: I think a lot of people in this industry still don’t know how this technology works and what it can do. That’s true about providers, and it’s true about patients, and it’s true about payers and the government. Now growth – that is becoming less of an issue. I can tell you that three years ago, four years ago, carrying the fl ag of telehealth – it felt like being a mis-sionary. Today, carrying the fl ag of telehealth is ‘you’re the person everyone wants to talk to. So it’s a very, very signifi cant shift in terms of the number of people who want to do this. Just like at the dawn of online retail, people were very skeptical about punching in their credit cards. They were concerned about it, and I think that has largely gone away. We are metaphorically at the same step where people are extremely curious. They kind of know that it’s going to work, and they are kind of dip-ping their toes into it. But the thing is that they are. We know that the use cases are very sound. We know that the infrastructure in terms of security and confi dentiality and appropriateness and quality of care is there.Q: What, in your view, would be the best scenario for the future of telehealth?A: I know it sounds a little bit non-traditional to think of the healthcare industry as a service industry. We hear it left and right. At the end of the day, healthcare is going to be a better industry if patients are going to begin to be aware and be accountable for how their health is – whether it’s stop eating the wrong thing, begin to exercise, follow up and do preven-tive tests, that’s going to change the needle of healthcare altogether. I think what that does is it puts the focus on the consumers of the service, essentially the patients. And, if you ask me about what’s the end game? The visible, gratifying end game for telehealth is getting to the point that live healthcare becomes part of your medicine cabinet at home. If that is how you use telehealth as a consumer, it becomes a no-brainer. You know that healthcare is available to you. You can from home engage it when you need it as you need it, irrespective of where you live and irrespective of time of day or coverage. If live healthcare and live health-care professionals are part of your medicine cabinet, that’s one of the mental transforma-tional endpoints of what telehealth is trying to do. That is our mission as a company, but also as an industry to do just that. �

“This is one of those technologies that life will never be the same once it’s out.” Roy Schoenberg, MD

www.voltage.com

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