Sebelius and Blumenthal HIMSS 2011 Conference Keynotes

At the annual HIMSS conference, Secretary of Health and Human Services Kathleen Sebelius and National Coordinator of Health IT Dr. David Blumenthal discussed the progress made in healthcare IT.

While much has been accomplished, Sebelius warned the crowd of over 30,000 attendees about the long road ahead. In terms of health IT adoption, “there’s already a gap between large urban hospitals and small rural ones,” she said. As she pointed out, 30% of primary care physicians (PCPs) use an EHR system today. That represents progress since only 20% of PCPs used an EHR system two years ago, but it still means that seven in 10 primary doctors do not have electronic health records.

"The energy and creativity and commitment to improving health are a positive sign," Sebelius said. "Eventually, we'll see hospital after hospital clear out their file cabinets. For future generations, jokes about doctors' handwriting will be a thing of the past."

Moving forward in health IT, Secretary Sebelius stressed the need for engagement in health reform, a push for technological development, adoption of EHRs by small practices, and provision of health IT across all populations regardless of racial background, geographic location, and socioeconomic status.



Dr. Blumenthal delivered a positive message on the progress of health IT stating, "Meaningful use is no longer a hope or a theory -- it is a working, operating program -- as reality." In his keynote address, Dr. Blumenthal also provided an update on the progress of the electronic health record (EHR) incentive programs, regional extension centers (RECs), health IT training programs, and EHR modules.

The main topics of Dr. Blumenthal's keynote include the incentive programs, the national infrastructure designed to support the adoption of EHRs, and patient health information (PHI).

"Meaningful use provides us a way to set expectations and goals, a blueprint for what info should be available, to whom and when, in support of an improved health care system and improved health," Blumenthal said.

Direct Project ~ Specifications and Compliance

Doug Fridsma, M.D., Ph.D. is the Director of the Office of Standards and Interoperability in the Office of the National Coordinator for Health Information Technology (ONC). He is currently on leave from the Department of Biomedical Informatics at Arizona State University and from his clinical practice at Mayo Clinic Scottsdale. On Monday, March 21, 2011 he announced the Direct Project specifications are achieving widespread adoption and gave a glimpse into what's in store for the future of this project.

Important points in this announcement are:

• There are significant commitments by key national players (states and health IT vendors) that bode well for universal adoption for the Direct Project.
• The pilot projects and specifications related to IHE profiles and transitions of care demonstrate how the Direct Project is so much more than secure email.
• The Direct Project specifications (final) and compliance (draft) documents are now available.

Two key events are also coming up:

• On Monday March 21 at 1 PM ET, Arien Malec will be presenting the Direct Project update at the National eHealth Collaborative NHIN University course.
• And on March 29, the Direct Project will be on the agenda for the HIT Standards Committee meeting.

The post also pointed out that over 60 healthcare and health IT organizations, including many state based and private sector health information exchanges, leading IT vendors, and several leading integrated delivery systems, have planned support for the Direct Project. The full current and growing list is available here. Dr. Fridsma said:

"This broad swath of support for the Direct Project represents approximately 90% of market share covered by the participating health IT vendors. With over 20 states participating in the project, including many of the largest states in the country, nearly half of the total U.S. population can now benefit from the Direct Project’s growing integration into the national health IT ecosystem. Growing participation with the Direct Project will alleviate a healthcare system awash in a sea of paper and faxes."

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Reflections on HIMSS 2011

This year the annual 2011 Annual Healthcare Information and Management Systems Society (HIMSS) Conference & Exhibition broke all previous attendance records. 31,225 attendees showed up in Orlando, Florida for the conference between Monday February 21 to Thursday February 24 with pre-conference events beginning Saturday night. Total professional registration at this year’s conference also saw an increase with 14,639 registrants, compared to 13,672 registrants in 2010. But aside from record breaking crowds and the sheer size of the conference, the things that struck me were some of the themes illustrated in the content. I will explore some of them in future posts, and believe there was some great catalyst for innovation springing from this years conference.

One of theses themes was health information exchange (HIE). The HIE Symposium held on Sunday before the conference kicked off explored how HIEs are leveraged to meet the 'new era' challenges of leveraging HIE in achieving Meaningful Use and reaching patient care quality goals. There were sessions from experts and state legislators, a panel on federal initiatives and many other valuable educational opportunities. There was also a Town Hall session focused on the intersection of HIE with Accountable Care Organizations, Healthcare/Payment Reform and Insurance Exchanges. There were at least 16 educational sessions after the symposium touching on HIE.

Of course, the Interoperability Showcase also continued this theme with numerous educational opportunities and presentations from industry leaders. There were tours scheduled throughout the conference and this was one of the more important areas of the exhibit hall (although tucked away off to the side). There were also demonstrations from each of the Direct Project pilots getting under way, and many announcements from vendors during the conference on their involvement in the project. Just take a peak at the Interoperability Showcase Use Case Selection web pages for a taste what attendees had the opportunity to experience.

Another important theme was the topic of the Accountable Care Organization (ACO). The Leading from the Future: A Thought Leadership Event on Accountable Care Organizations sessions were outstanding and there were also numerous focus groups and roundtable breakfasts on the topic. Aneesh Chopra brought the subject up at the Venture Fair presentations and HIT X.0 and one thing he started the Intel sponsored breakfast roundtable is still ringing in my ears: "By January 2012 you will see these organizations and new payment models so you had better be prepared." I am increasingly convinced that without the technical infrastructure in place to enable new payment and delivery models, healthcare in this country will continue to drag down our economy and keep us from improving quality.

The other theme that emerged from this conference was the explosion of social media. Every where you looked you saw exhibitors drawing attention to their Facebook, Twitter and YouTube pages, and Keith Boone even managed to have his Twitter handle printed on his official conference badge :-) But the new Social Media Pavillion at HIMSS was a huge hit. There were many excellent presentations, and despite being somewhat difficult to find, the center was a hubub of acticity. Throughout the conference, attendees used social media to share their observations, comments, photos, and videos. You can see the enthusiasm from activity on the HIMSS page on Facebook, discussion groups on LinkedIn, the HIMSS Channel on YouTube and tweets all over Twitter! The educational sessions, panel presentations, and fellowship and sense of community in the social media center was a definite highlight of this years conference. I'm really excited about what next year may hold...


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The Pen is Mightier than the Keyboard

There were some pretty innovative solutions being demonstrated at the 2011 HIMSS Conference. One of the most interesting demonstrations I saw was at the NextGen booth on the new NextPen. Roy Feague Vice President, Development at NextGen Healthcare showed me some the uses for the pen and explained future plans for its development. "There are really only three modes of communication being used in healthcare: typing, voice and writing. We have done a good job at capturing data from typing and voice recognition, but up until now we've done a poor job of capturing writing," said Roy. "This will extend the reach of the EHR quite a bit. Anybody who can hold a pen can become a data contributor to the EHR, including patients."

The immediate use case available now is to allow patients to complete intake forms while waiting to be seen. Future plans include allowing clinicians to enter data into forms that will be captured as discrete data elements within the EHR templates. This could be handy to help those practices using NextGen that may have some clinicians struggling moving to digital from paper. But capturing patient demographics and other patient provided information prior to rooming is an immediate win, saving time and increasing accuracy.

Using laser printers and ordinary copy paper (although the results are definitely best with a color laser printer - I would not recommend using back and white), NextGen prints an intricate algorithm of barely discernible dots on the background of the page. Printing this dot pattern on the paper makes it possible for the NextPen's built-in camera to detect pen strokes and record handwriting that can then be stored and sent digitally. Every small area of the pattern has a unique combination of dots with different positions. When the user writes on the digital paper, the digital pen captures information about what the user writes and where, by registering the pattern close to the pen tip.

A tiny camera in the pen’s tip captures everything as it is written or drawn. The camera automatically takes digital snapshots of the dot pattern on the paper at a rate of between 50 and 100 images per second. Every snapshot contains enough data to enable the pen’s image microprocessor to determine the exact position of the digital pen, what it writes or draws, and what form is being used. Then the pen is placed in a USB docking station, the data is approved, and NextPen automatically fills the structured data fields into the EHR. An image of the form can also be captured and automatically attached to the patient’s record. Saving the image would create an ideal situation for signatures and drawings, while also keeping an exact record of the data entered.

Here is a brief video demonstrating the pen:




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