Dr. Karen DeSalvo Named National Coordinator for Health IT

Dr. Farzad Mostashari tipped me off to the interesting video below:

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Dr. Karen DeSalvo at the 2012 ONC Annual Meeting

Below is a note from Secretary Sebelius to HHS staff, followed by a note from Dr. Reider to ONC staff.


Colleagues,

I would like to announce that Dr. Karen DeSalvo, who currently serves as the City of New Orleans Health Commissioner and Senior Health Policy Advisor to Mayor Mitch Landrieu, will be the next National Coordinator for Health Information Technology here at the Department.

During her tenure, Dr. DeSalvo has been at the forefront of efforts to modernize the New Orleans health care system. Following Hurricane Katrina, for example, she led projects to increase access to care by augmenting the city’s neighborhood-based medical homes for low income, uninsured and other vulnerable populations in the New Orleans area.

Throughout her career, Dr. DeSalvo has advocated increasing the use of health information technology (HIT) to improve access to care, the quality of care, and overall population health outcomes –including efforts post-Katrina to redesign of the health system with HIT as a foundational element. She served as President of the Louisiana Health Care Quality Forum, the Louisiana lead for their health information exchange and regional extension center grants. She has also served as a member of the Steering Committee for the Crescent City Beacon Community grant.

As the New Orleans Health Commissioner she has made the increased utilization of HIT a cornerstone of the city’s primary care efforts and a key part of the city’s policy development, public health initiatives and emergency preparedness. Further, she has led the planning and construction of the city’s newest public hospital, which will have a fully-integrated HIT network. Her work as commissioner has led to positive changes to the way healthcare providers deliver care to their patients, improved accessibility and outcomes for patients, and improved the health of all New Orleanians. Dr. DeSalvo is a graduate of Suffolk University, Tulane Schools of Medicine and Public Health, Harvard School of Public Health.

Dr. DeSalvo’s hands-on experience with health delivery system reform and HIT and its potential to improve health care and public health will be invaluable assets to the Office of the National Coordinator and the Department. I would also like to take this opportunity to thank Dr. Jacob Reider, the Acting National Coordinator for his leadership of ONC during this time of transition. I am pleased she is joining our committed team, and ask you to join me in welcoming her to HHS when she starts on Monday, January 13th.

Sincerely,


Kathleen Sebelius

Timeline Changes for Meaningful Use

There seems to be still some confusion around what exactly the announcement on Friday December 6, 2013 by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) means. First is a new timeline for the implementation of meaningful use for the Medicare and Medicaid EHR Incentive Programs. This change has simply added a third year to Stage 2 of the EHR meaningful use program and has delayed the start of Stage 3 until 2017. Providers with at least two years of participation in Stage 2 would be able to start Stage 3 in 2017, while providers who have started in either 2011 or 2012 will have an additional year of Stage 2.

The second change is the new regulatory approach to certification that ONC is proposing. First, it seems they are going to be soliciting even more stakeholder feedback in the process and giving clearer signals to developers on what will be expected. They intend to publish a proposed rule for a 2015 Edition of certification criteria which will improve on the 2014 Edition certification criteria. However, this new certification will be completely voluntary (and therefore likely to not be part of most organizations upgrade path). As the ONC explained:

"We expect to propose that the 2015 Edition would be voluntary in the sense that providers participating in the EHR Incentive Programs would NOT have to upgrade to 2015 Edition EHR technology and NO EHR technology developer who has certified its EHR technology to the 2014 Edition would need to recertify its products. Our intention would be for the 2014 Edition to remain the baseline certification criteria edition for meeting the Certified EHR Technology definition."

So while CMS and ONC are beginning to make some small changes to timelines and certification processes, this seems to be a small step in the right direction. As John Halamka pointed out, "This is NOT a delay of Meaningful Use in 2014 (Stage 1 or Stage 2). All 2014 certification and attestation deadlines are still in force." While I have written in the past about the need for greater flexibility in meeting Stage 2 requirements, this change does not address those concerns. Although I believe there are very likely more changes to come, it is very important that healthcare organizations and providers do not count on any delay or changes, but prepare for plans to proceed under this current current regulatory framework.

The 2013 WEDI Report

On December 5, 2013 Dr. Louis W. Sullivan, former Secretary of HHS and the creator of the Workgroup for Electronic Data Interchange (WEDI), released a new roadmap for the health IT industry, the 2013 WEDI Report. WEDI was formed in 1991 by Dr. Sullivan when he headed HHS, and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards bodies.

"We are grateful to the many healthcare industry leaders and for the countless hours spent by those that dedicated their efforts to this endeavor" said Jim Daley, WEDI Chairman. "We are excited to share this significant body of work with all healthcare stakeholders and look forward to the report’s adoption and implementation."

This report comes on the 20th anniversary of the original WEDI report which provided a vision for the industry to successfully transition to electronic data interchange standards as a way to bring cost-efficiencies to burdensome administrative processes. That report led directly to the administrative simplification provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). "Twenty years ago, as Secretary of HHS, I brought industry and government together under the WEDI aegis to collaborate on building a roadmap for the healthcare industry to apply information technology to facilitate exchange of healthcare data, improve quality of healthcare delivery, and reduce costs," said Dr. Sullivan on the release of the report. "I think it is appropriate on the 20th anniversary of the WEDI Report to revive that collaboration to draft a new roadmap to guide the next generation of healthcare information exchange that will lead to transforming the delivery of healthcare and improving the efficiency of the nation’s health system in the years ahead."

Release of the 2013 WEDI Report at the National Press Club (via @WEDIonline)

This latest report has four areas of focus:

• Patient Engagement
• Identify ways to enable consumer (patient) engagement through improved access to pertinent healthcare information.
• Payment Models
• Identify requisite business, information, and data exchange requirements that will help enable payment models as they emerge.
• Data Harmonization and Exchange
• Identify ways to better align administrative and clinical information capture, linkage, and exchange.
• Innovative Encounter Models
• Identify business cases for innovative encounter models that use existing and emergent technologies.

WEDI recognizes that while progress has been made in the past 20 years in moving healthcare processes from paper to electronic, the healthcare industry has yet to solve a significant problem: electronically getting the right data to the right place(s) at the right time. The 2013 WEDI Report includes 10 recommendations to provide a broad framework for facilitating improvement in the electronic exchange of healthcare information.

Patient engagement was defined as dialogue between patients and key healthcare stakeholders (e.g. physicians, health plans, care coordinators, and public health). However, the issue spanned several key areas of focus for the purposes of the report, including patient identification / matching, patient access to information, and how to leverage existing technology to facilitate consumer access to tools.

Recommendations for patient engagement are:

1. Standardize the patient identification process across the healthcare system.
2. Expand Health IT education and literacy programs for consumers to encourage greater use of Health IT, with a goal of achieving better care management and overall wellness.
3. Identify and promote effective and actionable electronic approaches to patient information capture, maintenance, and secure and appropriate access that leverage mobile devices and "smart" technologies and applications.

Recommendations for innovative encounter models are:

1. Identify use cases, conventions, and operating standards for promoting consumer health and exchange of telehealth information in a mobile environment.
2. Facilitate adoption and implementation of “best-in-class” approaches that promote growth and diffusion of innovative encounters across the marketplace and that demonstrate value for patients, providers, and payers.
3. Identify existing or proposed federal or state-based laws or regulations that create barriers to the implementation of innovative encounters (including licensure).

Recommendations for data harmonization are:

1. Identify and promote consistent and efficient methods for electronic reporting of quality and health status measures across all stakeholders, including public health, with initial focus on recipients of quality measure information.
2. Identify and promote methods and standards for healthcare information exchange that would enhance care coordination.
3. Identify methods and standards for harmonizing clinical and administrative information reporting that reduce data collection burden, support clinical quality improvement, contribute to public and population health, and accommodates new payment models.

Just one recommendation was identified for payment models:

1. Develop a framework for assessing critical, core attributes of alternative payment models -- such as connectivity, eligibility/enrollment reconciliation, payment reconciliation, quality reporting and care coordination data exchange, and education -- and the technology solutions that can mitigate barriers to implementation.

The focus of much of the report is on developing an IT infrastructure that will improve care coordination and quality reporting, thus improving care and lower costs. The theme of the report is providing the right information to the right place at the right time - this is a laudable goal. The conclusion of the report states:

"The recommendations presented provide an opportunity for the healthcare industry to work collaboratively to leverage health IT infrastructure in order to allow the healthcare system to expeditiously move forward with new modalities of payment and care coordination. The 2013 WEDI Report recommendations serve as a framework for action. These recommendations will help advance the U.S. healthcare system in order to meet the dual objectives of decreasing cost and improving quality. They also will contribute to improved information for population health."

“The 2013 Report will help to set a common direction for the healthcare industry as we continue to evolve to greater focus on patients managing their own healthcare information, the movement towards fee-for-value arrangements, and the rise of new payment models and technologies”, said Dr. Devin Jopp, President & CEO of WEDI.

I believe this report will provide a clear roadmap for the future of health IT. I am sure that the recommendations will be strongly considered within HHS, including CMS and the ONC. Farzad Mostashari, former National Coordinator for Health IT said, "WEDI’s efforts to bring together industry and government, especially around the intersection of the administrative and clinical worlds, is a key component to helping people get better health and better care at lower cost." I think the recommendation on standardizing the patient identification process across the healthcare system is one that will get a lot of focus. The ONC has launched a Patient Matching Initiative to attempt to find solutions to this very issue. I expect to see a lot of activity in this area over the next few years. Overall, this report is going to be very influential and I strongly urge everyone to take a look. The full report can be downloaded HERE [PDF].

From Meaningful Use to Meaningful Analytics

I’ve written about the three data waves we are facing in healthcare: data capture, data sharing, and data analytics. Primarily due to the “meaningful use” program the United States has made huge strides in electronic health record (EHR) adoption and is beginning to make progress in health information exchange (HIE). These are the principal drivers of the increased capability and use of clinical analytics, since it is the patient data captured, shared, and aggregated by these applications that is the primary source of the data that healthcare organizations analyze using these clinical analytics tools. This allows us to turn those data into information - actionable information that actually provides the ability to improve quality and lower the cost of care. It is the meaningful use of EHR technology that will ultimately enable meaningful analytics.

Two key factors for using clinical analytics to translate data into information are: achieving high quality of care and improving patient safety, as well as increasing awareness about the costs associated with providing care. One way in which organizations are framing these quality of care issues is within the context of meaningful use. Because of incentives when meaningful use criteria are met, and the impending penalties when they are not, many healthcare organizations and providers are evaluating how they are capturing and sharing data. Since organizations are required to report on multiple measures to achieve meaningful use, they often attempt to find ways to capture and report successfully on all measures rather than focusing on only a handful of measures. Clinical data analytics do not only leverage meaningful use rules, but also can help satisfy compliance with them.

Meaningful Use Priorities

Since meaningful use is requiring greater interoperability and data sharing, there is now much greater opportunity to aggregate data at a community level and have an even broader data set than just the EHR to mine for clinical intelligence. One benefit from HIE, besides improved care coordination, is the ability to perform queries and apply analytical tools to those data that were not previously available. The five health outcomes policy priorities included in meaningful use are:

• Improve quality, safety, efficiency and reduce health disparities
• Engage patients and families
• Improve care coordination
• Improve population and public health
• Ensure adequate privacy and security protections for personal health information

Meaningful Use Analytics

Obviously the reporting requirements for meaningful use can make good use of clinical analytics tools, but some of this reporting capability is also useful when participating in new payment models such as accountable care organizations (ACOs). Although not directly called out in meaningful use, lowering costs is a high priority and part of the over-arching Triple Aim. I can not imagine succeeding in a truly transformed healthcare system without having the clinical and business intelligence tools that will allow for targeted interventions and not only a retrospective look via claims data, but the real-time capabilities of an Enterprise Data Warehouse with robust analytic and reporting functionality. .

In addition to a focus on meaningful use measures and ACOs, the industry’s shift to the use of ICD-10 (International Statistical Classification of Diseases and Related Health Problems-10th revision), mandated for the coding of all inpatient and outpatient claims beginning in October 2014, will also impact the use of clinical analytics. Conversion to the ICD-10 coding will dramatically increase the specificity and granularity, and therefore the value, of diagnostic datasets. For example, this change will increase the number of codes available for identifying diagnoses and procedures from 17,000 to 155,000. This will improve the classification of patient interactions by expanding the information that is relevant to ambulatory and managed care encounters, offer expanded injury codes and enable the combination of diagnosis and symptom codes to reduce the number of codes needed to fully describe a condition. This increased granularity, combined with the continued increased in digital capture of clinical data will yield new data sets which healthcare organizations will have the opportunity to translate into meaningful information that can be used to improve the delivery of healthcare.

Increasing Value of Clinical Analytics

As the healthcare system continues to harness bigger and better data sets, including claims data, genomic data, imaging and other important data sets, the value of clinical analytics will increase. Just because data is housed in a data warehouse still doesn't mean that access to information is easy or timely. Clinical analytics continues to be used primarily for retrospective analyses, rather than real-time clinical decision support. In my previous post on “Realizing the Value of Health IT” http://www.ahier.net/2013/09/analytics-realizing-value-of-health-it.html I wrote about some companies that are making good headway in this area, including Health Catalyst. The technical architecture used for a clinical data repository is a key consideration. As we continue to aggregate digital health data of all different stripes, analytics will provide real value to clinicians and healthcare organizations from both a quality and a financial perspective. I’m hopeful that we will continue to see development of the Healthcare Analytics Adoption Model and broader implementation of this critical technology.

This post originally appeared on HealthCatalyst.com

Talk to the Pen

Almost three years ago I wrote about the NextPen from NextGen using Anoto technology. At the NextGen User Group Meeting (UGM) in Las Vegas they have announced the launch of the new NextPen Voice which is designed to help providers stay more engaged with patients while streamlining and speeding detailed patient data capture. It looks to be a promising enhancement to the NextPen solution.

NextPen Voice intermixes handwriting and drawing just like before, and now can incorporate dictation. “Providers don’t need to return to their desks to complete the patient narrative,” said Roy Feague, VP of Development at NextGen Healthcare. “They just double-tap NextPen Voice in the field of a patient encounter form where they’d like to locate the narrative and speak right into the pen. The transcribed result is returned into the correct field automatically.”

NextPen Voice gives you a choice between written and voice input, depending upon clinical examination protocols, preferences and specialties. Providers using NextPen Voice can easily switch between voice dictation and handwriting during patient encounters, with just a simple double tap. Like the original NextPen Write, NextPen Voice utilizes the same miniature camera technology for its handwriting capture mode. In writing mode, the pen tracks its position on a paper form and records every stroke. Handwriting and drawings are recognized immediately and are flowed into the patient chart as structured data. The provider’s dictation captured by NextPen Voice is automatically routed for transcription, returned, and once approved by the provider with a simple click, is automatically flowed into the patient’s chart as narrative text.

“NextPen Solutions can easily save providers 10 to 15 minutes per new patient, especially during reception-area intake,” Feague noted. “As a result, many clients report saving two hours per day. Our new NextPen Voice digital pen adds dictation to NextPen’s proven track record of writing and drawing capture so providers have the ultimate digital pen solution to improve productivity and cut costs while simultaneously improving the patient experience.”

The NextPen Voice currently requires dictation services, but eventually we should see speech recognition technology incorporated into the offering. This would take it to the next level in terms of usability and functionality. I'll be watching this product offering to see how well it is adopted and what improvements are in the pipeline. My hope is that we can eventually get healthcare to a place where all of this unstructured data we are capturing and be put into discreet fields, but at least for now we can make this as natural as possible. Everyone knows how to use a pen, and now you can talk to it too :-)

“In the past year, our clients have experienced the most rapid change the healthcare market has witnessed to date,” said Mike Lovett, executive vice president and general manager, NextGen Healthcare. “Our expanded NextPen Solutions platform, including our new model, NextPen Voice, is another example of how we’re growing an innovative ancillary product suite that offers integrated functionality into our EHR and practice management systems. NextPen Solutions provide our clients with an important tool to keep winning the everyday challenge to combine productivity, accuracy and care in the practice of medicine.”

Mirth and NextGen Join Forces

First, it is important to understand the difference between HIX and HIE. HIX usually refers to health insurance exchange or marketplace insurance, which is a central component of the Patient Protection and Affordable Care Act, Obamacare, the ACA or whatever you want to call it. The ACA requires healthcare coverage for everyone and HIX is supposed to allow individuals to compare health insurance plans online (if the government can manage to fix the websites and back end infrastructure). HIE stands for health information exchange (oftentimes still used as a noun, but increasingly it has become the action word for data exchange). HIE plays an important role in the healthcare system. It gives doctors, nurses, hospitals, pharmacies, laboratories, payers and ultimately patients, the ability to exchange health information electronically in a secure environment. One of my favorite HIE solutions has been Mirth primarily because of Mirth’s commercial open source model, you get the benefits of a commercial quality product and also an open source, agile, community-driven development process.

In September Mirth announced their acquisition by Quality Systems, Inc. the parent company of NextGen Healthcare who is one of the leading electronic health record (EHR) vendors in the ambulatory space. At the time Jon Teichrow, President of Mirth Corporation said, "We are excited about the opportunity to combine forces with NextGen Healthcare. Our shared vision is a game-changing product platform that enables clients to quickly assemble and link components that inform and transform clinical processes, taking care management and delivery to the next level. Together, we can enable our clients to respond with agility to the demands of a rapidly evolving health care environment." The idea was that QSI would continue to market Mirth's products and services while integrating them into the NextGen platform. We may have seen some of this integration during the first day of NextGen's UGM with the launch of NextGen Share.

During the unveiling of this new interoperability platform from the combination of NextGen's widely deployed EHR and Mirth Corporation's health information exchange solution, Steven T. Plochocki the President and CEO at Quality Systems, Inc. (QSI)said. “Mirth’s reputation as one of the most adopted, open and globally trusted interconnectivity platforms is a natural fit for NextGen’s established network of providers." He added, "NextGen Share affords our client base an unprecedented level of data exchange that will allow our providers, patients and healthcare facilities to participate fully in a collaborative and connected care environment."

"It’s the first phase of a broad enterprise interoperability initiative to supply clients with advanced, scalable data exchange capabilities," noted Steve Puckett, CTO at QSI. "In this first phase, NextGen Share will allow providers to locate other NextGen providers across their community and the country to send real-time, secure provider to provider email... and exchange C-CDA records securely between network participants." A year ago Surescripts announced NextGen's connection to the Surescripts Network for Clinical Interoperability. Now NextGen and Mirth are sister companies and they will be able to build out their own network and connect to other EHR's and HIE software using Direct. Mirth is already the software behind numerous Direct Project implementations and has provided resources and been involved in the efforts from the beginning.

Some notable HIE initiatives that make use of Mirth technology are the very successful HealthBridge, the Colorado Beacon Community, the Crescent City Beacon Community, the San Diego Beacon Community, the Inland Northwest Beacon Community, as well as Mayo Clinic and the Lone Star Circle of Care, and ACO in Texas.

This new NextGen Share is intended to enable providers to safely, securely, and accurately exchange clinical data and provide referrals without leaving their EHR. It is based on Mirth's proven HIE solution, however this initial phase will only connect with other NextGen users. Using Mirth technology and their capabilities as a HISP, NextGen will be able to  When the network is expanded this will enable exchange to really scale with connectivity to other EHRs and HISPs in the community. This is where the real value will be in terms of having the technology to participate in new payment and care delivery models.

Michigan Health Information Network Completes Onboarding with HealtheWay’s eHealth Exchange

The Michigan Health Information Network Shared Services (MiHIN) has announced completion of the onboarding process with Healtheway to the eHealth Exchange, opening a path for any Michigan qualified data sharing organization to securely share electronic healthcare information with participants in the nationwide eHealth Exchange network, including the Social Security Administration (SSA), the Veterans Health Administration (VHA) and other states.

The eHealth Exchange is a group of organizations operating together to improve patient care, streamline disability benefit claims, and improve population health. The group accomplishes these goals through the secure, trusted exchange of health information – matching patients to their data without a national patient identifier, sending health information to other participating organizations, finding and requesting patient information from other participating organizations where permitted by law and policy, and subscribing to receive updates to patient information.

“Participating in the eHealth Exchange enables secure, electronic Health Information Exchange to occur across diverse technical platforms, geographies and legal requirements,” said Mariann Yeager, Executive Director of Healtheway. “Enabling Michigan’s healthcare providers to exchange information electronically with federal organizations and other participants in the eHealth Exchange community will help improve patient care, through information availability, and expedite payment of benefits for the disabled.”

MiHIN is the first state-designated entity for exchanging health information to complete onboarding to the eHealth Exchange with the new testing and onboarding process as guided by the Certification Commission for Health Information Technology (CCHIT). Healtheway, Inc. supports the eHealth Exchange community (formerly NHIN Exchange) and ensures there is an efficient onboarding process.

MiHIN is also the first organization in the U.S. to onboard to the eHealth Exchange using the Consolidated Clinical Document Architecture (C-CDA). The C-CDA is a requirement under Meaningful Use Stage 2 regulations and is being implemented across the country under those regulations as a standard format to support Health Information Exchange (HIE).

“By successfully onboarding MiHIN with our new testing process in a way that supports Meaningful Use Stage 2 requirements, we mark another milestone in Healtheway’s journey to enable secure, trusted exchange of health information nationwide,” Yeager said. “Collaborative efforts such as this, when like-minded organizations commit their resources to deploy a solution for the betterment of healthcare, are a core reason that HIE is transforming healthcare.”

MiHIN’s testing and onboarding broke new ground not only with its focus on C-CDA and Meaningful Use 2 requirements, but also in the type of health information used during the process. “We worked closely with a Michigan behavioral health data sharing organization, PCE Systems, to test and complete the onboarding process,” said Tim Pletcher, Executive Director of MiHIN. “There’s an impression that the focus of HIE has centered on physical health, but this pioneering support of a behavioral health data sharing organization reflects Michigan’s commitment to integrated coordination of care between behavioral and physical health providers.

“Involving behavioral health in the Michigan HIE environment provides an important tool to share information across a person’s care continuum, and does so in a manner that respects a person’s rights and privacy relating to sensitive information. We’re grateful to PCE Systems for contributing its time and resources to this project.”

PCE Systems, a Michigan data sharing organization, provided its HIE platform using CONNECT 4.2 to allow the MiHIN Common Gateway to communicate with the automated test lab, the Developers Integration Lab (DIL), during the testing process. PCE Systems also utilized their Electronic Medical Record (EMR) as an “edge” system to initiate and respond to CCHIT test transactions through the MiHIN Common Gateway.

The MiHIN Common Gateway, developed with Nitor Group and used for the onboarding process, allows data sharing organizations to send and receive Patient Discovery, Document Query, Document Retrieve and Document Submission messages in multiple protocols including NwHIN SOAP and XCA to and from other eHealth Exchange participants.

When Michigan data sharing organizations agree to exchange information through MiHIN, they can choose from a number of Common Gateway use cases, including options to exchange information with Veterans Health Administration (VHA), the Social Security Administration (SSA), Centers for Medicare and Medicaid Services Electronic Submission of Medical Documentation System (CMS esMD), non-federal eHealth Exchange participants, or other organizations that have entered into Michigan’s legal structure for data sharing.

“Among the many benefits of this connection between MiHIN and the eHealth Exchange is the greater speed with which requests to and from federal agencies can be processed by electronic submission,” Pletcher said. “For example, by submitting electronic disability claim eligibility determination requests to a Michigan data sharing organization from the Social Security Administration, eligibility can be determined electronically within a day or two instead of many months of waiting. This is a win for the provider, the SSA, and especially for the patient.”

About PCE Systems
PCE Systems is an information technology and services company based in Farmington Hills, MI specializing in custom, hosted solutions beyond the capabilities of typical "off-the-shelf" software. PCE is the largest community mental health (CMH) Electronic Medical Record (EMR) and provider management system vendor in the State of Michigan, with clients encompassing over 70% of the Michigan Medicaid mental health budget. PCE is also a qualified data sharing organization with MiHIN, providing secure, consent-based health information exchange to the behavioral health community in Michigan. PCE seeks to break the mold of typical software vendors by providing innovative solutions and unparalleled support services under a model that engenders trust and collaboration among PCE and its clients. For more information about PCE Systems, please contact Jeff Chang at jchang@pcesystems.com

About Healtheway
Healtheway, Inc. is a non-profit organization chartered to operationally support the eHealth Exchange, a rapidly growing community of exchange partners, who securely share information under a common trust framework and a common set of rules. Currently, there are more than 40 participants including four federal agencies, six states, and more than two dozen Health Information Organizations (HIOs) and health systems, representing hundreds of hospitals, thousands of providers and millions of patients. Healtheway collaborates across the healthcare industry to develop implementation strategies that enable secure, interoperable nationwide exchange of health information. For more information about Healtheway and the eHealth Exchange: www.healthewayinc.org.

About Michigan Health Information Network Shared Services (MiHIN)
MiHIN is dedicated to improving the healthcare experience and decreasing cost for Michigan’s people by supporting the statewide electronic exchange of health information and making valuable data available at the point of care. MiHIN is a public and private nonprofit collaboration between the State of Michigan, the Office of the National Coordinator, sub-state Health Information Exchanges, insurers, payers, providers and patients. For more information please visit www.mihin.org.

For more information about MiHIN, contact:
KatyAnn Zimbelman
zimbelman@mihin.org

Federal Government Opens With An Odd Twist

Well, the Federal Government is back open (for now), but not without any drama. As the House voted to reopen the government and raise the debt ceiling, the House stenographer decided it was time to tell everyone her thoughts about God, Congress, and the Freemasons.



Identified as Dianne Reidy, the stenographer somehow made it all the way to the clerk’s podium at the top of the chamber's dais, where the president delivers the State of the Union address.

"He will not be mocked, Don't touch me!" she yelled. "The greatest deception here is that this is not one nation under God. It never was. It would not have been. The Constitution would not have been written by Freemasons. They go against God. You cannot serve two masters. Praise be to God. Praise be to Jesus."

Audio is below via @toddzwillich:

Reflecting on National Health IT Week

As National Health IT Week came to a close, and my curation of posts for the blog carnival and hectic travel slowed to a more moderate pace, I was struck by the sense of collaboration I am seeing across the healthcare industry. There were an incredible number of submissions received for the 2nd Annual NHIT Week blog carnival. With over seventy posts chosen in a five day span from stakeholders across the spectrum – vendors, providers, government leaders and others, it was outstanding with both the caliber as well as the number of posts. Activity on Twitter, Facebook and other social media platforms was also impressive. It was a very busy week of events besides blogging, starting the week with the Consumer Health IT Summit (see intro below) and leading into the 12th Annual HIMSS Policy Summit with many other events through the week, both in DC and around the country.

Farzad Mostashari introduces National Health IT Week and the Consumer Health IT Summit


ePatient Dave Debronkart gives a rousing and powerful keynote at the Consumer Health IT Summit


Of course, for me the blog carnival was a massive part of NHIT week. The blog carnival was a true celebration of the value of health IT from everyone’s perspective. While there were several common themes that were addressed including standards, interoperability, patient engagement, and predictive analytics, it is clear that each stakeholder has a slightly different view of IT’s role in healthcare, but it seems we are unified in the end goal: improving the quality of healthcare delivery and the patient experience while lowering costs. Even though the amount of effort which goes into creating a post for a blog carnival is miniscule compared to the coordination needed for all of these stakeholders to collaborate in the actual healthcare system, the common thread between all the posts demonstrates that we are in fact united. There is power in a community that moves as one and, as we continue building awareness of the value of health IT within our own circles, it is important that we leverage this unified voice next year to continue building awareness beyond the industry.

I want to especially thank the awesome team from SHIFT Communications and HIMSS for there absolutely wonderful work during National Health IT Week. Without the support of Cari, Jennifer, Michael and Victoria this could not have happened. I am honored and grateful to have been able to play a small part in making NHIT Week a little bit better, by hopefully getting the word out and engaging and connecting with such a diverse group of stakeholders across the healthcare industry.

Global Directions 2013

I am presenting this week at the Global Directions 2013 conference which is being held in Washington, DC from September 22-25. This event is convened by Kodak, or more specifically Kodak Alaris. Kodak Alaris is basically a $1.3 billion startup spun off from Eastman Kodak which includes four businesses:

• Film Capture, which includes some of the world’s most popular and recognizable award-winning still film for professionals and consumers;
• RSS, a worldwide leader in instant printing with the retail instant photo kiosks offering consumers personalised photo products and the industry-leading APEX dry labs;
• Paper and Output Systems, the broadest portfolio of high quality media, including traditional photographic paper, for a variety of professional print operations and workflow solutions for photo specialty retailers, professional and wholesale labs; and
• EIS, the leading provider of digital souvenir photography services and solutions at theme parks, iconic destinations & resorts

The new company is building on the rich history of the Kodak brand starting with the birth of Kodak when their first camera was placed on the market in 1888, with the slogan, "You press the button - we do the rest." With less than one month in existence, but substantial capital and a serious dedication to innovation, I expect to be hearing a lot more about Kodak Alaris in the future.

Global Directions has really brought together an impressive group of thought leaders, starting with the keynote from Ray Kurzweil. Kurzweil has written seven books and hundreds of articles. In recent years, there have been hundreds of articles each year by or about Ray Kurzweil in leading publications, including most major national magazines. His first book, The Age of Intelligent Machines (MIT Press), was named Best Computer Science Book of 1990. I was fortunate to receive a copy of his recent book "How to Create a Mind: The Secret of Human Thought Revealed" and have it signed by Ray. It is a fascinating read and I highly recommend it. In his keynote address Ray discussed the exponential increase in computing power and intelligence, and explored the inexorable impact they will have on transforming information management for the enterprise. This was followed by a great panel discussion with Ray including Neil Isford, Vice President of Smarter Solutions at IBM, Bruce Richardson, Chief Enterprise Strategy Officer at Salesforce, Steve Fox, Director of Microsoft's Azure business unit, and moderated by CIO Journal editor Michael Hickins. Each of the panelists then gave keynotes throughout the day.

National Health IT Week Blog Carnival

National Health Information Technology Week is an event with various activities in Washington D.C. and communities all around the country. Over at healthitweek.org they have a good list of ten ways to participate in National Health IT Week. I am looking forward to hosting the National Health IT Week Blog Carnival which will run from September 16-20, 2013. This year the theme is "The Value of Health IT." My first post this week is on achieving the value of health IT through the use of analytics. Below are a few of the early posts to kick off the carnival that I want to highlight, and then I'll be updating this post each day during National Health IT Week as the posts come rolling in.

NHIT Week Day One

One of the major highlights of day one of NHIT Week was the 8th Annual Consumer Health IT Summit (which Lygeia Ricciardi, the ONC Consumerista wrote about last week). US Chief Technology Officer Todd Park spoke at the event and set the focus on Blue Button. He termed it a movement which allows patients to access their data and share it with their clinicians and family members. Robert Tagalicod, director of eHealth at CMS said over one million CMS patients used Blue Button to access their information. Marina Martin, the CTO at the VA, which really started this Blue Button movement, spoke about the VA no longer just provides dumb ASCII text but now supports continuity-of-care documents to veterans in a machine readable and actionable format. Todd Park talked about how investors entrepreneurs have embraced Blue Button which Farzad Mostashari, the current national coordinator for Health IT, said this shows what a great idea was developed and incubated by the government and has now filtered into the private sector. Government as a platform for innovation!

• Lygeia Ricciardi, the Director of the Office of Consumer eHealth for ONC, and well known Consumerista has written a post "The Blue Button Movement: Kicking off National Health IT Week with Consumer Engagement" which highlights the ONC’s 3rd annual Consumer Health IT Summit: Accelerating the Blue Button Movement being held Monday September 16, 2013 . Lygeia provides a basic overview of the Blue Button initiative: who’s it for (consumers), how it has influenced the broader healthcare community and its future. The Consumer Health IT Summit is full, but you can attend virtually via webcast.

• Dr. Nick van Terheyden, CMIO of Nuance, wrote a nice post called "#NHITweek: Technology That Works for Physicians vs. Against Them." This post focused on how to make speech technology is an example of health IT working for doctors, versus against them (example, EHR templates). It was an expansion of Dr. van Terheyden’s recent Fast Company article entitled “Could The Future Of Health Care Mean No Waits In Hospitals?”

• Brian Parrish of Dodge Communications wrote "NHIT week: the impact of population health on the HIT space." This post is a Q&A with Healthcare Informatics’ Editor-in-Chief, Mark Hagland, focusing on population health management. Mark emphasizes how important it is for the industry to not rely on a single “off the shelf” population health management solution, but instead encourages health IT leaders to leverage existing IT in a skillful, strategic approach. The post really highlights analytics as a particularly valuable health IT tool.

• Over on the entarasys blog Ali Youssef, the Senior Wireless Solutions Architect at Henry Ford Health System and member of the mHIMSS advisory council, wrote "Is it time for a dedicated mHealth manager, and team?" about the need for a dedicated mHealth manager and team. He disagrees with the thought that mHealth is a silo in an organization and will not need its own distinction in the future. In his opinion, this view takes for granted the level of expertise required to ensure seamless mobility functions properly, along with the patient data security and privacy measures.

• Dave Levy, Senior Account Manager at SHIFT Communications (disclosure: SHIFT does the PR for HIMSS) wrote a  blog carnival recap of his own entitled "What We Talk About When We, The Communicators and Patients, Talk Health IT." The post offers a glimpse at the work of the SHIFT HealthyComms team. To answer the question of the value of health IT, Dave states that it comes back to one answer: there is a way technology can make our health needs more about care and less about paperwork. He the highlights three recent HealthyComms posts that touch on this topic.

• Carla Smith, Executive Vice President at HIMSS wrote "How Do You Measure the Value of Health IT?" which stays with the theme of the “value of health IT.” Carla takes her post one step further by answering the question that many providers and health IT advocates in the healthcare industry are facing today: what proof do you have of the value of health IT? The post includes a series of proof points, including data from CMS and data from a HIMSS Davies Award winner, Hawai’i Pacific Health. The data from the latter organization is available in HIMSS’ Health IT Value Suite, a new robust library of value-focused, evidence-based use cases documenting the value of health IT.

• Beth Walsh, the Editor at Clinical Innovation + Technology, wrote a post called "The value of health IT." In it Beth highlights the fact that health IT not only offers financial benefits, but it also improves elements of patient care such as patient safety and clinician efficiency. She sees the value of health IT demonstrated by its ability to transform our healthcare system into one that is truly focused on health, a focus achieved through the coordination of vast amounts of available data from multiple resources throughout our healthcare system.

• Jonathan Handler, M.D., the CMIO at M*Modal, wrote "Recycling Automation Back Into HIT" offering examples of how health IT’s ability to automate tests, labs and even clinical documentation that directly supports patient care. However, health IT is being underutilized on one key administrative area because of the current fee-for-service model: billing. Dr. Handler asserts that the current fee-for-service, many clinicians believe that health IT can lead to fraud accusations, forcing clinicians to re-document information that’s already in a medical record. If we move to a value-based model, provider and payor incentives would align rather than conflict, and HIT automation would be seen as desirable rather than deceitful. This trend is already growing across the industry but has yet to become the norm, but perhaps that will change by NHIT Week 2014?

• Trey Lauderdale, the Founder and President of Voalte, penned "Nurse Communication is Just Beginning" where he highlights the proliferation of mobile health, specifically smartphones and tablets, as an example of health IT’s value and how it is improving the way caregivers deliver patient care. Trey focuses on a few key examples including the ability for clinicians to easily review imaging reports with patients at the point of care and the ability to move and share information with patients with speed.

• Blair Butterfield, President, US Management at VitalHealth, posted "What is the value of health IT?" where he takes readers back to basics and reminds everyone that we must remember to observe the value of health IT through the lens of caring for patients. Blair then looks at several key factors and breaks down each accordingly: efficiency, accuracy, accessibility, quality and cost.

• K Royal, the Privacy Counsel at Align Technology and the International Association of Privacy Professionals, has an interesting write up "On Where Health IT and Privacy Meet." To address the value of health IT, K Royal highlights what she deems as “leading topics in health IT,” offering specific praise for the advanced level of patient care that telehealth and telesurgery affords providers. But K Royal cautions that in order to seize and maximize upon these benefits and advancements in patient care, the healthcare industry must collaborate with all stakeholders from day one. For example, IT developers should be working hand-in-hand with patient privacy experts at the initial point of creation, not retrospectively.

• Alan Portela, the CEO of Air Strip, wrote on Mobile Health Matters "An Industry Retrospective Demands a Call to Action" where he offers cautious praise for the value of health IT, imploring that health IT vendors must collaborate with each other to offer solutions the provider can use today. Alan reflects on the various events that he feels have placed an undue financial strain on hospitals and health systems across the country which includes the following: introduction of reimbursement penalties, the politics of the ACA and Obama’s election, unexpected sequestration cuts, industry consolidation (ex. Vanguard Health Systems and Tenet Healthcare), ICD-10 and MU Stage 2.

• Jon Mertz, the Vice President of Marketing, Corepoint Health, wrote the catchy post "What’s the Value of Health IT? It’s About Me, Me, Me" (perhaps Ross Martin, MD could make this into a song? :) Jon brings back the value of health IT to the patient, encouraging what we in the healthcare industry refer to as “patient engagement.” As his aptly titled post indicates, health IT should be about “me, me, me.” Examples of simple ways to become an engaged patient include: maintaining a healthy lifestyle and tracking it accordingly, be active members of support communities to encourage our peers or fellows patients to become engaged and know that we (patients) have the right to have easy access to our medical history at any point in our lives.

• CDW Healthcare posted "Patient Satisfaction Rx? Health IT" and identified ways in which health IT are already adding value to the patient care via patient satisfaction. Examples of specific health IT initiatives include EMRs, patient engagement tools and technologies to streamline check-ins at doctor visits. CDW Healthcare asserts that IT offers ways to provide patients with better (and more) information and that this is the key to improving patient care.

• Elizabeth Boehm, the Director of National Patient Experience Collaborative at Vocera wrote "WHEN TECHNOLOGY IS HUMANIZING" where she plays off of the common ding against health IT in that technology lacks the same warmth and human touch as, well, humans. But there are examples of when health IT can offset the limitations of human-to-human interactions. These examples include bridging physical gaps (telehealth), reinforced communications and virtual support groups.

• Reid Coleman, MD,the CMIO of Evidence-Based Medicine at Nuance wrote "How Health IT Can Help Physicians Master the Evolving Patient Narrative." Dr. Coleman highlights the capabilities of clinical language understanding technology, demonstrating its value to healthcare by its ability to make clinical documentation easier for physicians, allowing them to perform at the top of their license.

• And Chad Johnson, the Managing editor of HL7Standards.com and marketing communications manager at Corepoint Health, wrote "It’s Not Complicated: Health IT Makes Our Lives Better" where he discusses how health IT provides information and allows connections in many ways: payers to providers, providers to other providers, caregivers to patients, and now the most fundamental connection of patients to data about their care and their bodies.

NHIT Week Day Two

• We start day two of the NHIT Week Blog Carnival with Jane Sarasohn-Kahn of the very popular HEALTHPopuli blog and a health economist and management consultant who wrote the post "Healing the Patient-Doctor Relationship with Health IT." Jane focuses on the consumer adoption and involvement in personal health IT, pointing to recent findings that show most health-engaged people may trust a physician less than a non-engaged patient. Simultaneously, these patients are also turning to online health resources (over physicians) for health information. In order to preserve the doctor-patient relationship, Jane asserts that providers must “open up the digital health kimono – EHRs” in order to successfully transition from the volume-based payment model to the value-based model.

• Russell P. Branzell, President and CEO at CHIME wrote the important piece "HIT Capabilities – They Are Personally Important to Me." Russell shares how he has personally witnessed the power of health IT through a personal story. His son was diagnosed with Landerhans Cell Histiocytosis, a rare cancer-like blood disorder, four years ago and while the experts that can treat his son are within the state, they are still 65 miles away at Denver Children’s Hospital. Health IT enabled the remote treatment of Rusell’s son, making him one of the first non-adult chemotherapy patients treated and managed remotely by the experts at Children's Hospital. Russell and family are glad to report that there is a happy outcome to this story: after intensive treatments during his junior and senior year of high school, Russell’s son is in full remission and doing great at college. Russell offers this as an example of the simple and profound ways that wires, software and computers (health IT) can be the difference between life and death.
  

• Udayan Mandavia, the CEO at iPatientCare, submitted the post "Value of Healthcare IT from my perspective" which highlights how health IT helps patients and physicians remain engaged and proactive in their health. He also points to how health IT bridges gaps in care caused by socioeconomic disparities, leveling the playing field for communities across the country (and the world). Udayan concludes with this point: healthcare IT leads to “better outcomes, lower costs, meaningfully.” 

• Nick Giannas, Senior Associate at Witt/Kieffer, writes "What’s the Value of Health IT? The CIO Has the Answer." Nick asserts that health IT is actually invaluable as it enables what we understand as the continuum of healthcare. He instead asks why everyone in healthcare doesn’t share this same viewpoint, asserting that guidance and leadership on the value of health IT must come from the C-suite, thus the CIO is extremely valuable. As an executive recruiter, Nick offers several defining characteristics that every new CIO should have. 

• Cortney Nicolato, Vice President at Get Real Health, has written "Get Real Health is Participating in National Health IT Week." Cortney states that health IT brings effective, evidence-based healthcare to patients that enables improved, scalable patient-provider collaboration that transcends geographic boundaries.

• Charles Christian, the VP/CIO, St. Francis Hospital, has written "Using Health IT to Resolve the Unknown." In this post Charles offers an example of the value of health IT through a story of how the Indiana Health Information Exchange (IHIE) helped patients in the aftermath of the August 2011 Indiana State Fairgrounds event when a temporary roof structure collapsed, killing seven and injuring 58. All of the surrounding medical facilities were connected to the IHIE, providing a centralized method of knowing where patients have been transported so that families and loved ones could track down any injured patient accordingly.

• Geeta Nayyar, M.D. the CMIO at PatientPoint added the post "National Health IT Week Provides a Glimpse of the Future." Dr. Nayyar offers her perspective on health IT’s role in improving the quality of healthcare delivery as a practicing physician. Throughout the week, she’ll be offering a series of blog posts that will touch on specific topics ranging from new patient engagement strategies for physicians to the value of predictive analytics. To close out her opening post, Dr. Nayyar insists that health IT will only see its full potential when it becomes completely integrated into the daily lives of patients and families.

• Brett Davis, a Principal at Deloitte Consulting, wrote "Leveraging 'real world evidence' to answer the hard questions in health care." Brett feels that we are in a place where today’s healthcare environment can be captured in this quote: “It was the best of times; it was the worst of times.” Modern day medicine coupled enables advancements like “personalized medicine” but the unsustainable cost structure of the system threatens future innovation. Brett indicates that many characterize the value vs. volume reimbursement model as one that stifles innovation and offers an alternative: a data driven, value-based, personalized healthcare system.

• Scott Mace the Editor at HealthLeaders Magazine wrote a great article entitled "Patients Define Evolving Expectations for HIT" whereby through a series of interviews with key stakeholders across the healthcare spectrum, he finds the true value of health IT lies in the happy-medium space where patients are empowered by their providers to be engaged and proactive in their own care and encouraged to view physicians as the “curator, guide, Sherpa, coach and counselor.

• Gail Latimer, MSN, RN, the VP and Chief Nursing Officer at Siemens, wrote "The Value of Health IT – A Nursing Perspective." Gail touches on the themes that are echoed in advocates of Accountable Care Organizations and the Patient Centered Medical Home: one key way to improve and streamline patient care is by allowing all healthcare professionals across the continuum to function at the top of their license. Gail touches on nurses specifically and highlights how health IT can help support nurses in this new setting by providing timely access to key clinical information they need to deliver care.

NHIT Week Day Three

• Author: Debr L. Ness, President at the National Partnership for Women & Families, wrote a post "Realizing the Value of Health IT: Jumpstarting Efforts to Reduce Health Disparities." Debra asserts that health IT is a valuable tool we can use to reduce disparities for millions of Americans and improve the quality of health care. She highlights a new resource that offers “real hope” to realize the potential value of health IT: the Disparities Action Plan from the Consumer Partnership for eHealth (CPeH). She offers a high-level overview of the Action Plan, which offers a policy roadmap for reducing healthcare disparities while advancing patient- and family-centered care, better outcomes and lower costs.

• Author: Geeta Nayyar, M.D., CMIO at PatientPoint, is a prolific writer and adds her second post "Predictive Analytics: Crunching the Numbers to Deliver Personalized Care" where she shares a relatable patient situation to show how predictive analytics can impact can improve healthcare delivery. Geeta then offers other examples of how predictive analytics will help all healthcare providers in the future but cautions that the following must happen first: the integration of patient data across all healthcare stakeholders, including pharmacies, laboratories and other non-traditional providers (ex. Holitic healthcare). Dr. Nayyar also points out that prior insurance claims may also be used here as well as they shed light into a patient’s medical history.

• Hans J. Buitendijik, M. Sc., a Senior Key Expert at Siemens Healthcare submitted "Interoperability: How Much Progress Have We Made?." Hans highlights how “interoperability” is a big buzz word in the healthcare industry and defines it, at the core, as the following: the ability to consistently and unambiguously exchange data between two or more computer systems. This means that there needs to be a clear understanding, on both sides of that communication channel, of when, what, and how to exchange the relevant data. Hans then reflects on the interoperability successes he has witnessed at his organization and speaks to the next wave of challenges.
  

• Cindy Munn, MHA, the Executive Director at Louisiana Health Care Quality Forum, which is an NHIT Week partner and the overseer of Louisiana’s REC and HIE, wrote "Building A Healthier State Through Health IT" where she breaks down specific patient benefits of EHRs and living in a state that supports a robust, interconnected HIE system.

• Stoltenberg Consulting, Inc. submitted the post "Reflecting on the Today’s Value of HIT to Celebrate NHIT Week." Five members of the Stoltenberg Consulting team ponder the value of HIT from the small scale of a personal physician’s appointment, to a wide view of the impact on nationwide healthcare progress.

• Harry Greenspun, MD, Senior Advisor over at Deloitte Center for Health Solutions, wrote the piece "Health IT: adding lasting value to the “fly-by” appointments." Harry compares a recent experience attending a “Back to School” event for his son with the traditional physician visit. Like the “Back to School” event, Dr. Greenspun and his wife only got to meet the teachers for a brief moment, much like a regular annual check-up at the doctor’s office. However, unlike our healthcare system, the teachers ended their conversations by deferring to the online resources, including everything from test results to a teacher/parent portal to speak directly with the teachers. Dr. Greespun then points to the increase in EHR adoption rates but notes that their recent survey indicates that a majority of physicians aren’t using health IT in their primary work-setting (and the system has a long way to go).

• Andrew Litt, M.D., Dell Chief Medical Officer, wrote the very thought provoking post "Breaking the code: The potential of the $100 genome." Dr. Litt asserts that the race is on to bring the process genome sequencing to $100/per complete genome, a cost drop that will make personalized medicine truly accessible and offer a gateway to understanding the underlying molecular pathways for disease. He then spells out the steps the industry needs to take before getting there and how big data analytics will be needed to make sense of all the data (once available) to treat diseases – and perhaps, in the far future, prevent them in utero. 

• Andrew Mellin, MD, Vice President and Medical Director of Enterprise Intelligence at Relay Health, wrote "Population Health Management: A Risky Business." Dr. Mellin emphasizes the importance of risk management models in the new value-based, population health-focused healthcare system. He offers tips on how healthcare leaders can integrate risk models into their population management strategies in three specific areas.

• John Yurkschatt, DCA Project Manager at Direct Consulting Associates, submitted a post posing the question "A Career in Healthcare IT…Do You Have the Right Stuff?" As a HIT search consultant, John shares his insights into the “qualities and soft skills” – those skills beyond education, knowledge and experience – that healthcare organizations are looking for when hiring a HIT professional. He highlights the following six traits: communication skills, integrity, work ethic, problem-solving skills, ability to act as a team player and flexibility/adaptability.

• Larry Grandia, Board Member at HealthCatalyst and Former Intermountain CIO, wrote the awesome piece "My Thanks to Healthcare IT Professionals … Along with a Look Back and Forward." Larry reflects on his lifetime of work in the healthcare industry, offering high praise for all health IT professionals that have worked tirelessly in automating critical work processes, at all levels and in widely diverse areas of healthcare organizations. He also calls out specific points throughout his years in healthcare where the industry has lagged and dragged its feet in the development of data warehouses and the digital architecture/networks to support it but concludes on a positive note, offering these encouraging words, “I firmly believe the peak is in sight!” I highly recommend reading this one!

• Michael Graham, VP, Program Development and Marketing Services at Priority Consult, wrote "Three Steps to Ensure that the EHR Boom Isn’t Another Fad." Michael offers thoughts on how EHR system design can be adjusted to continue being relevant in the clinical community. His three suggestions include: ensuring access to information for the purpose of analysis and benchmarking; recognizing the individuality of clinical specialties; and promoting interoperability among a variety of systems.

NHIT Week Day Four

• Charlene Underwood, Senior Director, Government & Industry at Siemens Health Services, wrote the post "What does HIT mean to me?" where she offers her perspectives as a vendor representative on the HIT Policy Committee Meaningful Use Workshop Group. Charlene asserts that EHR adoption is already here and now the task getting the U.S. healthcare system to start delivering healthcare in a 21st century way. To do that, we must begin laying out the framework for an information technology infrastructure that can support this in how care will be delivered and paid for, a task that is inextricably intertwined with interoperability. While we still have plenty of work to do, Charlene says “Bring it on – there is not an industry that needs it more! It’s time to join the 21st century.”

• David Harlow, Founder of The Harlow Group, LLC, submitted "OCR and ONC release model NPPs" David offers his perspective on how the recently released HIPAA Notice of Privacy Practices (NPP) compliance tools – released during the “H-hour” to before the HIPAA Omnibus Rule compliance rules drops next week -- could be better handled via using basic health IT. He states that while telephone and snail mail are nice, many patients would prefer to be in contact with their health care providers via text message or email and that it is their right to have such access. But he does over praise for the model NPP, noting that the model NPP is a useful tool.

• Geeta Nayyar, M.D., CMIO at PatientPoint. submitted another great post entitled "Unlocking the Potential of Mobile Technology." Dr. Nayyar shares her perspective on the why it is important to ingrate the currently siloed mobile health technology space, where there are provider apps and patient apps, using statistics and research from various mobile health adoption studies. She asserts that we will see a dramatic positive transformation in our healthcare system when patients and providers should be able to use the same tools and access the same information in real time.

• Scott Rupp from Electronic Health Reporter wrote "What is the Value of Health IT?" Although the question for HIMSS’ 2nd Annual NHIT Week Blog Carnival is simple, Scott points out that there seem to be no easy answer as the responses are very different depending upon who you ask (as is clearly evident from this Carnival!). Scott thus put the question out to experts in the community and features comments from 14 leaders across the industry.

• And the amazing John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston, reposted his fantastic piece "Patient and family engagement in ICUs" on Government Health IT. Dr. Halamka uses his father’s recent passing and end of life experience to demonstrate the value of developing a cross-disciplinary, multi-institutional, open source application to turn critical care data into wisdom for patients and families. Dr. Halamka’s father suffered from multiple sclerosis for 23 years along with several other comorbidities since 2009. Upon arriving at his ICU bedside in early March, Dr. Halamka spoke with all his clinicians to create an impressive mental dashboard of his progress which he then turned into a scorecard. Dr. Halamka combined both of those with his father’s end of life wishes and leveraged his 20+ years of experience as a CIO, practicing physician and clinical team leader to determine that hospice care was the best decision. Ideally, patients and families should have the tools to make such decisions regardless of their medical sophistication and he is working to make that possible at his facility. Read more about how his healthcare organization is undertaking this ambitious project.

• Ruby Raley over at Axway wrote "The Future is at the Intersection: Where Healthcare Information Technology meets the Internet of Things." Ruby is writing about the intersection of the The Quantified Self movement and the Internet of Things and how if used in conjunction together they can help to shape the future of Health IT. Ruby contends that using the low-cost technology sensors employed by users of the Quantified Self Movement one could potentially use those sensors to accelerate healthcare information by giving those sensors to patients to wear and following the platform laid out by the Internet of Things, constantly gather the data to serve as predictors of future health conditions.
  

• John Main at Modernizing Medicine wrote "The Promise of Health IT." John is essentially asserting that in order for Health IT to continue to move forward patients need to start to take on more personal responsibility for their health through the use of technology. John points out that this movement began with the passing of the HITECH Act but despite the fiscal incentive to develop new technology people have yet to catch on to the importance of using that technology to collect data on their personal physical well-being. The rest of the piece simply speaks to the advantages that come from having a large amount of personal healthcare data.
  

• Olivia Goodwin of the Medical Tourism Association wrote "Patient Engagement: Can Age-Old Question be Solved Online?" This piece talks about the importance of the healthcare industry switching from paper to digital and general failure of the populace to take accountability for their personal health by aiding in this process. Olivia then goes on to point out many of the advantages a fully digital healthcare system would bring. With the emergence of new technology, specifically smart phones, people already have the hardware in their hands that is necessary to make this a reality. They simply need to put forth the effort.
  

• Laurance Stuntz at the Massachusetts eHealth Institute submitted the post "Mass Appeal for Health IT: How Innovative Health technologies are Transforming Care in the Commonwealth." Laurance begins the article by asserting that Health IT is directly benefiting Massachusetts’ economy and the importance of Health IT in Commonwealth. He then goes on to speak specifically to the issue of switching from paper to electronic health records (EHR’s). Laurance then gives a few specific examples of patients with extremely complicated treatment plans that might not be possible or advisable unless the patients’ records are electronic. The piece concludes by pointing out that Massachusetts can save a lot of money by having better patient follow-up care which with the embracement of EHR’s , will follow naturally.
  

• James Tcheng, MD, Chair of the Informatics and Health Information Technology Task Force at The American College of Cardiology, wrote "What’s Next for Meaningful Use?" Dr. Tcheng speaks to the fact that cardiology is the leader in terms of qualifying for incentive payments as part of the Electronic Healthcare Incentive (EHR) program. Despite this fact, Dr. Tcheng writes that there is still a long way to go for cardiologists, specifically regarding the implantation of the second phase of the EHR program in early 2014. Dr. Tcheng contends that unless there is a change in the law those in the healthcare industry who do not implent EHR’s, even cardiologists, will face reduction in their Medicaid payments. Essentially, he is approaching the belief that EHR’s are essential for the betterment of the healthcare community from an angle other then patient comfort/recidivism.
  

• Sunny Singh, CEO of Edifecs, wrote "Health IT’s $200 Billion Savings Proposition[pdf]." Sunny points out the importance continuing the growth of the healthcare industry by reducing administrative waste. Sunny contends that health insurers are the crux of the solution as a single-average insurer could save $60 million annually by embracing modern technology and streamlining how the process healthcare information. Simply switching to electronic billing will make a clear and measurable difference in costs. Sunny concludes by reiterating the importance of continual healthcare growth and that this is only one way in which to further the industry.
  

• You will absolutely want to take a look over on HIStalk where healthcare technology entrepreneur Kyle Samani wrote "Healthcare IT Donuts." The post begins with a photo of a whiteboard that equates various social networking sites with some metaphor of a donut. Kyle takes this same idea and applies it to the Healthcare IT world; writing a donut metaphor for various Healthcare IT companies. Although it is humorous, it is essentially a photo followed by bullet points.
  

• Jon Mertz wrote "What is the Value of Health IT? Data Freedom." In this piece Jon provides two bullet pointed paragraphs; one defining Health IT and the other defining Data freedom. Although, the title poses an interesting question and plausible answer, Jon fails to articulate the correlation between the two.
  

• Frank Irving, Editor at Medical Practice Insider, wrote "Mostashari’s thoughts on HIT value for office-based physicians." Frank was on the call where Tom Sullivan interviewed National Health IT Coordinator Farzad Mostashari, MD. For his question Frank asked how physicians benefit from the use of health information technology aside from the EHR Incentive Program. Mostashari initially provided a few stock answer statistics but then pointed out that through the integration of EHR physicians will be able to focus on treatments for entire populations rather than being restricted to individuals.
  

• The Commonwell Health Alliance wrote up "The Value of Health IT." This piece immediately asserts IT solutions are beneficial in the IT community and that given the grandiose nature of the transition there are bound to be frustrations and roadblocks (Affordable Care Act, ICD-10 etc) . Given the difficult nature of these roadblocks and the necessity of continuing healthcares transition into the full embracement of technology and EHR’s , this piece contends that suppliers and providers need to focus on interoperability. The piece concludes with an interesting comparison drawn between the transition from cell phone to smart phone and the transition the health care industry is going through today.
  

• VoiceFirst Solutions submitted "Healthcare CIOs are raising the bar on 5 key healthcare metrics by leveraging mobile, voice-driven technology solutions at the patient’s bedside." the bloggers from VoiceFirst Solutions offers examples of how CIOS are honing in on 5 key patient care metrics, encouraging their providers to utilize mobile, voice-driven technology to improve the face-to-face time with patients. The advancements in this technology space show how health IT can foster better in-person relationships during the patient/provider consultation.
  

NHIT Week Day Five

• Steven Posnac, the Director Federal Policy Division at ONC, wrote a ,b>VERY IMPORTANT,/b> post called "6 Things you need to know about Meaningful Use and EHR Certification in 2014." Steven has written a six question, itemized FAQ for the 2014 EHR reporting period for Meaningful Use. Steven notes that 2014 is the final year Medicare eligible professionals (EP) can receive incentive payments through Meaningful Use. Steven also speaks to the direct correlation between 2014 Meaningful Use performance and the 2016 Medicare payment adjustments.

• Fred Bazzoli, Senior Director of Communications at CHIME, wrote "A Decade of Progress with HIT, But Patients Are Counting on More." Fred begins this piece by claiming that the healthcare industry is in the midst of a crisis and that health IT is only part of the solution. He then articulates his fear that although the healthcare industry has made progress since 2004, it is not enough. Fred then links back to a prior column he wrote in 2004 for Healthcare IT News.

• Michael Burger, Senior Consultant at Point-of-Care Partners "The Value of Health IT: Healthier and Longer Living Citizens." Michael provides a unique perspective on the value of health IT in the future. Rather than following the trend of accentuating the fiscal benefits that health IT provides, Michael contends that the most important change health IT can bring to the healthcare industry is the enablement of principles articulated within the Hippocratic Oath. According to Michael the focus really is on advancing population health under the premise that, “…a healthier citizen is a less costly citizen.”

• Angela Dunn wrote over on the HL7 Standards Blog "Growth of Quantified Self, Part 4: The Future of Health Design." where she discusses the growth of the Quantified Self movement and demonstrates how health IT can begin to merge patient-generated health information with provider expertise to create new models of health design, facilitate better decision-making, and improve lives.

• Jessica Clifton, Product Marketing Manager at Billian’s Health Data wrote "The Provider, Personal & Public Value of Health IT." Jessica details three main areas that she believes health IT offers the greatest value for providers, patients and the public at large: streamlined care and workflow efficiency; paradox of patient engagement (ex. educated but convenience-driven); and moving from reactive to proactive (ex. predictive analytics).

• Jennifer Dennard Social Media Director at Billian(@SmyrnaGirl)over at EMR and EHR wrote "The Internet of Everything Puts New Face Value on HIT" Jennifer asserts that the value of health IT has increased exponentially in the sense that what is defined by “health IT” is much broader than ever before. She predicts that one day, IT will automatically be integrated with healthcare because of the “Internet of Everything.” She credits this idea to a recent policy memo she read by Michael Mandel and the Progressive Policy Institute.

• Equicare Health submitted the post "Better Communication For All." Equicare Health bloggers single out communication as the single most important feature that IT contributes to healthcare. To celebrate NHIT Week, the bloggers delve into the benefits of improved communication for 5 different stakeholders in the healthcare spectrum.

• Peter Ots of CHIME wrote "What is the value of HL7 to health IT?" Peter focuses on the value of health IT through HL7, specifically the IHE Newborn Admission Notification Information (NANI) Profile, which he believes is just the beginning of what HL7 can do to revolutionize patient-centric healthcare. NANI provides hospitals the means to automate the creation and transmission of newborn admission information, and then send it in real time to multiple public health programs.
  

• Davida Dinerm from Schwartz MSL wrote "NHIT Week Survey: What Health IT Topics are Top of Mind for Influencers?." This post highlights a results from a poll of IT influencers, offering statistics regarding the impact social media has on healthcare IT (positive), confidence in the implementation of the second phase of Meaningful Use, and the future of EHR’s. The post concludes with figures around the fact that many in the industry are still working toward thoughtful application of health IT.
  

• Gilbertson and David Wayne, Practice Director of Analytics Consulting and Performance Improvement Advisor at Lumdex submitted "Healthcare IT: Looking to the Future." This piece addresses the value investing in health IT brings to the healthcare industry as a whole. Gus and David point out that health IT solutions can provide real-time data which benefits not only the physicians but the patients as well. The article then concludes by speaking to the importance of continual investment in innovative health IT.
  

• Joseph Cermin, the President/Founder of Viztek, wrote over at Applied Radiology the post "Imaging: You ain’t seen the evolution yet." Joseph discusses the advantages that will follow with the continued advancement of healthcare technology. Joseph’s contends that in order to understand where the radiology business is heading, one must understand where overall technology is going, offering his predictions for the latter.
  

• Lauren Wiseman, MSN, Clinical Application Specialist at the Central Illinois Health Information Exchange wrote the aptly titled "National Health IT Week" post which offers her perspective on how health IT contributes to improving patient care, specifically via enabling patient engagement and how patient-driven data from this engagement can be integrated into the system via health information exchange (HIE).