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).
  

Analytics: Realizing the Value of Health IT

This is my post on the value of health information technology for National Health IT week. So far we have not yet fully been able to realise the value of health IT. While great efforts at adopting electronic health records and interoperability and  we are beginning to see some results from the billions of taxpayer dollars invested, we still have a long way to go before we see the true value of health IT.

Healthcare has been slowly moving through three waves of digitization and health data management: data collection, data sharing, and data analytics. While the data collection and sharing waves have been having some success, spurred on by the HITECH Act and implementation of electronic health records and health information exchanges, they have not yet significantly impacted costs or quality in healthcare, the third wave is ready to crash on our shores and I believe we will actually begin to see an IT infrastructure than support the new payment and care delivery models which are emerging.

This third wave of analytics will enable large numbers of healthcare organizations to realize some significant returns on their IT investments and thrive in the healthcare marketplace of the future. Developing a consensus model for adoption of analytics capabilities could help healthcare leaders and vendors succeed by providing a common roadmap for the deployment of these capabilities. But much of the success of these analytics platforms will depend on the underlying architecture and I think the "late-binding" data warehouse model holds the most promise.

The term late-binding dates back to at least the 1960s, where it can be found in Communications of the ACM. The term was widely used to describe languages such as LISP, though usually with negative connotations about performance. In the 1980s Smalltalk popularized object-oriented programming (OOP) and with it late binding. Alan Kay in History Of Programming Languages 2 laid out the fundamentals of OOP and late-binding architecture in The Early History of Smalltalk section. In the early to mid-1990s, Microsoft heavily promoted its COM standard as a binary interface between different OOP programming languages. COM programming equally promoted early and late binding, with many languages supporting both at the syntax level.

The late-binding data warehouse model is a just in time method and is more adaptable to new analytics use cases and data content than those that make use of early binding and tightly coupled enterprise data models. Late-binding is a method of assembling data from disparate sources just in time for particular analytic use cases, known as the late-binding model of data warehousing, is starting to gain traction in healthcare as many provider organizations gear up for population health management. The advantage of this approach is that it allows users to combine disparate data very quickly for targeted analyses without locking data warehouses into a predetermined data model.

This late-binding model for use in healthcare analytics was developed by Dale Sanders who after witnessing and reflecting upon the failure of several multimillion-dollar data warehousing projects during his work in the US military, saw the same patterns in data engineering as those in software engineering prior to OOP. In the late 1990s, while employed by TRW Inc., he was sponsored by the Pentagon to study advanced decision support in nuclear warfare operations, a project called the Stratgic Execution Decision Aid. He turned to the healthcare industry for what he expected to be role-model examples of computer-aided analytics to drive better decisions in time-critical, life-critical situations but instead found almost no examples, with the notable exception of a scattered few such as at Intermountain Healthcare in Salt Lake City.

Last month I was able to get a peek behind the curtain at the Health Catalyst analytics solution, which Dale has been helping develop. Health Catalyst is a data warehousing company that recently has gained a number of customers and investors among large healthcare organizations. For example Partners HealthCare System has joined with the investment arms of Kaiser Permanente and Indiana University in an $8 million equity investment in Health Catalyst. Health Catalyst uses a late-binding data warehouse model. There is a very good Slideshare on Late Binding in Data Warehouses that helps to illustrate some of the concepts.

Last year The Advisory Board Company acquired clinical analytics vendor 360Fresh. 360Fresh offers two products. Pulse360 uses text and data mining to extract information from EHRs and other systems to provide answers to clinical and quality questions. They also have Track360, which is a clinician care coordination and workflow tool designed to streamline provider handoffs, provide alerts, and improves patient communications. Both of these products are targeted for use by academic medical centers, independent community hospitals, and large-scale ambulatory providers. 360Fresh will augment The Advisory Board Company's Crimson offering which provides retrospective data review, by adding real time analytics capabilities.

Dale Sanders, along with colleagues Jim Adams, Ernie Hood and Meg Aranow of The Advisory Board Company; Denis Protti of the University of Victoria, British Columbia; Dr. Dick Gibson, Providence Health and Services; Mike Davis of Mountain Summit Partners; along with Dr. David and Tom Burton, both of Healthcare Catalyst, worked to develop an eight-stage Analytic Adoption Model similar to the seven-stage EMR Adoption Model (EMRAM) from HIMSS Analytics. This model was initially described in ElectronicHealthcare in September 2012. The hope is that this model will enable healthcare organizations to fully understand and leverage the capabilities of analytics so that we can begin to see the real value of health IT in laying a technology foundation to achieve the triple aim.

This model borrows lessons learned from the HIMSS EMRAM, and describes a similar approach for assessing the adoption of analytics in healthcare. The Healthcare Analytics Adoption Model provides:

• A framework for evaluating the industry’s adoption of analytics
• A roadmap for organizations to measure their own progress toward analytic adoption
• A framework for evaluating vendor products

HIMSS Analytics has also partnered with the International Institute for Analytics (IIA) to create a benchmarking survey designed to measure and score clinical & business intelligence and analytics maturity in healthcare organizations. They will use the DELTA model (data, enterprise-focus, leadership, targets and analysts) to assess analytic capabilities. I expect we will see a lot more about the Healthcare Analytics Adoption Model as the work continues to progress. This will lead us into the future of health IT where value will ultimately be realized.

Here is a good Slideshare on the Healthcare Analytics Adoption Model being developed: