blockchain,cloud,cybersecurity,HIMSS,HIPAA,IOT,Revation Systems

HIMSS 2017: Security, cloud and the future of healthcare

Perry Price, President, Chief Executive Officer and Founder, Revation Systems

Written by: Perry Price

With 45,000 attendees and 1,200 exhibitors assembled at the country’s leading healthcare conference, HIMSS 2017 bustled with the latest and greatest in health IT innovations. While sifting through the hum of thousands of conversations could be challenging, the discussions spurred from so many key influencers coming together to discuss their visions for the future was enlightening. After three days of mingling with some of the brightest minds in healthcare and IT, attendees came away with two major themes emerging above the noise: security and the cloud.

As Ginni Rometty, chairman, president and CEO of IBM, reflected in her keynote, the U.S. finds itself on the precipice of transformation and change in 2017 as the country transitions into a new White House administration. This transformation, paired with advances in health IT, are resulting in a year of tremendous possibility and opportunity for accelerating the quality of care — particularly within the scope of security and cloud technologies for healthcare.

IoT cybersecurity: Friend or foe?

Although recent advancements in technology have increased the work efficiency for medical professionals and, consequently, improved care for patients, there is a fear that private health information (PHI) security may be compromised. This new technology coming into play weighs heavily on the minds of many in the industry. With an increasingly interconnected world, the topic of cybersecurity in healthcare has, perhaps, never buzzed quite as loudly as it did at HIMSS 2017.

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21st Century Cures Act,Ambra Health,Cancer Moonshot Initiative,cloud computing,interoperability,patient access

Interoperability and patient access just became law

Morris Panner, Chief Executive Officer, Ambra Health

When President Obama signed the 21st Century Cures Act (HR 34) into law in December, the world of healthcare IT was turned on its ear. Interoperability and access – two concepts that have eluded old-school healthcare IT vendors – became enshrined as the cornerstone of the newest and most comprehensive healthcare innovation legislation to date.

In addition, although the Act didn’t intend to push healthcare IT into the cloud age, it may very well have, as the required access and sharing will be exceedingly difficult to accomplish without an agile cloud-based system. Like the financial services industry and others before it, the cloud may become a key driver of how information can be easily shared and consumers can be empowered.

Some leading edge vendors and institutions were already making waves by breaking down data barriers both within and across facilities that have previously impeded the creation of a holistic patient health record. The holistic patient health record not only reduces risks of medical errors and dangers such as radiology overexposure, but it can also provides a goldmine for medical research across shared and readily accessible data.

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Affordable Care Act,HCAHPS,Infor,interoperability,value-based care

Looking ahead: The future of healthcare delivery in 2017 and beyond

Mark Weber, Senior Vice President, Healthcare Development, Infor

Well, the election results are in with significant changes proposed with respect to the Affordable Care Act. While what ultimately gets implemented in law will unfold over time, the desire to reign in the cost of healthcare is shared by both major political parties. As big as they may be, these will be changes in means not the goal.  It is not as if the new administration is trying to figure out how to increase the cost of care!

Working against the goal of lowering the total cost of care is the fact that the total volume of care is increasing. People are living longer, with more chronic disease, and there are an increasing number and sophistication of treatments available. The demographics of the baby-boom generation is driving a significant increase in Medicare enrollment.

As such, the macro trends in provider healthcare continue. Some will accelerate, some will adjust, but providers are being forced to adapt to an overall decrease in spend (i.e., lower revenues) through changes in how care gets paid for, how much is being paid, where it is delivered, and who pays. This creates big opportunities for some, and a diminished role for others.

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CDS,clinical decision support,clinical documentation,electronic medical records,Electronic Medical Records and Genomics,EMRs,interoperability,medCPU

How clinical decision support fills gaps in clinical data for higher quality care


Liora Guy-David, Ph.D., Vice President of Data, medCPU

As long as the healthcare industry lacks true interoperability among dissimilar systems, clinicians will have incomplete patient information at the point of care. This includes gaps over time, as when a clinician is unaware of imaging tests already completed, and gaps across care team members who record documentation in separate systems. Both types of gaps can compromise patient safety.

While we don’t typically think of gap-closing as being a primary clinical decision support (CDS) function, CDS systems do exactly that. Its success in informing decisions depends largely on the ability to analyze information from multiple systems, closing gaps in real-time. As a result, CDS is emerging as an essential tool for improving quality of care.

Decision-making support built with a more complete view of the patient

CDS systems run on top of EMRs, analyzing documentation as it is being entered and issuing alerts in EMR windows when conditions indicate the possibility of a medical error or compromised patient safety. This is often a matter of giving clinicians information of which they were unaware.

To fully inform alerts, advanced CDS systems supplement the structured data in EMRs and pull information retrieved from other systems such as those in labs and imaging departments. CDS leverages its comprehensive patient view by applying rules-based analysis regarding diagnoses and courses of care. By augmenting a physicians’ expertise with real-time information retrieval and gap-closing, CDS systems play a key role in promoting patient safety.

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C-CDA,Consolidated-Clinical Document Architecture,Fast Healthcare Interoperability Resources,FHIR,HL7,Infor,interoperability,Interoperability Experience Task Force,KLAS,Patient Generated Health Data,PHGD

FHIR ignites new possibilities for interoperability


Joel Rydbeck, Director Healthcare Strategy, Infor


Corey Spears, Director Product Management, Infor

In 1950, there were 98 TV stations in the United States. Contrast this with 2015 when there were 1,780. (Statista, 2015) Keeping up with relevant information over the years has become an even bigger challenge, with news delivered through email, smart phones, web sites, social media, and other evolving mediums. The good news is that we have technologies like Google Alerts, Digg, Reddit, RSS and the recent addition of Apple News to tightly tailor our consumption to the content we want.

In healthcare, the demands for interoperability – which is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged – grow and evolve with each passing day. For true interoperability to work, we must work together to find ways to connect patient information across the entire care continuum. This means integrating patient records across care systems. It’s a huge challenge, with many U.S. hospitals operating more than 500 different software systems and exchanging around 5 million HL7 messages every day. One hospital saw clinical data traffic volume (measured as the HL7 message count) increase 10 times when it began connecting all the equipment in patients’ hospital rooms.

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Andrew Slavitt,EHR,electronic medical record,GAO,Government Accountability Office,interoperability,Medical errors,middleware,WHO,World Health Organization,Zoeticx,“EHRs: Nonfederal Efforts to Help Achieve Health Information Interoperability”

Is the technology gap the reason why medical errors are the 3rd leading cause of death in the U.S.?

Thanh Tran, CEO, Zoeticx

Thanh Tran, Chief Executive Officer, Zoeticx

Hardly a day goes by without some new revelation of an information technology mess in the United States that seems like an endless round of the old radio show joke contest, “Can You Top This” except that increasingly the joke is on us. From nuclear weapons updated with floppy disks to needless deaths from medical errors, many of which are caused by preventable interoperability communication errors.

According to a report released to Congress, the Government Accountability Office (GAO) has found that the U.S. government last year spent 75 percent of its 80 billion dollar technology budget just maintaining aging computers where floppy disks are still used, including one system for U.S. nuclear forces that is more than 50 years old. In a previous report, the GAO outlines the challenges facing health IT interoperability.

Lack of “EHR interoperability” is not an academic issue, it impacts the healthcare of millions of Americans, and it is a major factor behind the deaths of hundreds of thousands of patients every year as a result of “medical errors.” A study from the British Medical Journal cites medical errors as the third leading cause of death in the U.S., after heart disease and cancer.

The GAO report, titled “EHRs: Nonfederal Efforts to Help Achieve Health Information Interoperability” details the status of efforts to develop infrastructure that could lead to nationwide interoperability of health information. The report, which was requested by Congressional leaders, describes a variety of efforts being undertaken to facilitate interoperability. The report concludes that most of these efforts remain “works in progress.” The GAO identifies five barriers to interoperability:

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direct messaging,Infina Connect,interoperability,longitudinal patient record,value-based payment

The critical path to value: Community wide, coordinated care delivery

Mark Hefner

Mark Hefner, Chief Executive Officer, Infina Connect

Community wide, coordinated care delivery is a foundational element of a successful transition to value-based payment models. The future success, in fact the future viability, of all healthcare organizations depends on it. Unfortunately, vendors have not made it easy. With few exceptions, the billions of dollars spent on electronic health records (EHR’s) and health information exchanges (HIE’s) have yet to deliver the clinical integration and collaboration necessary across the continuum of care.

The ability to share information is fundamental to better coordination and improved outcomes. Today, information is often unavailable at the point of care, and when it is shared the primary mechanisms, fax and phone, are highly inefficient and unreliable. In order to address this problem, the primary focus in terms of development and ongoing investment by healthcare organizations has been on interoperability. There are several ways that interoperability is currently being tackled, but for the most part they fall into one of three buckets, each of which has its own challenges. At the highest level though, it is interesting to note that all three strategies emphasize point-to-point connections and data exchange, rather than addressing the fundamental issue of community-wide coordination.

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EHR,electronic health record,interoperability,MACRA,Medicare Access and CHIP Reauthorization Act,middleware,Zoeticx

As interoperability still stymies healthcare IT, plug and play middleware use grows

Thanh Tran, CEO, Zoeticx

Thanh Tran, Chief Executive Officer, Zoeticx

The lack of EHR interoperability continues to pose a serious threat to healthcare initiatives, according to a recent report published by the American Hospital Association (AHA).  The report discusses the various aspects of the healthcare industry and care delivery that are negatively impacted by a lack of interoperability.

The report notes that the exchange of health information is critical for the coordination of care.  When patients receive care from multiple different providers, physicians should be able to securely send relevant patient information to the practicing physician. However, that tends not to be the case because EHR systems are not interoperable and cannot exchange information.

Last year, The ECRI Institute released a survey outlining the Top Ten Safety Concerns for Healthcare Organizations in 2015. The second highest concern was incorrect or missing data in EHRs and other health IT systems caused by interoperability.  For the second year in a row, EHR data is identified as a concern. 

The Partnership for Health IT Patient Safety, a branch of the ECRI Institute, has released safe practice recommendations for using the copy and paste function in EHRs that can adversely affect patient safety, such as the use of copy and paste that can overpopulate data and make relevant information difficult to locate, according to the partnership’s announcement.

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CommonWell Health Alliance,HIMSS,HIMSS'16,IHT2,IHT2’s Cleveland Big Data Conference,interoperability

A conversation with Jitin Asnaani, Executive Director, CommonWell Health Alliance

mark stevens

Mark W. Stevens, Contributing Editor

As a part of our “Countdown to IHT2 Cleveland Big Data Conference,” I spoke with Jitin Asnaani, Executive Director of CommonWell Health Alliance, a national not-for-profit interoperability collaborative dedicated to the vision that health data should always follow the patient, regardless of where care occurs. Prior to CommonWell, which was founded in 2013 by industry titans athenahealth, Allscripts, Cerner, Evident, Greenway Health, McKesson and Sunquest, Asnaani worked for athenahealth, where he helped build and expand their cloud-based interoperability platform. Previously, Asnaani was an appointee at the Office of the National Coordinator for Health IT (ONC), where he helped incubate and launch the S&I Framework and led The Direct Project. He received his undergraduate degree in computer Science & Engineering from M.I.T. and his MBA from Harvard, and has been with CommonWell since March, 2015.

Stevens:  You just returned from HIMSS16, how did it compare with last year’s conference and with what were you able to come away?


Jitin Asnaani, Executive Director, CommonWell Health Alliance

Asnaani: What jumped out at me most was the enthusiasm for the value of putting the patient at the center of care. I think providers acknowledged the concept of patient-centered care some time ago, but I think they’re starting to experience the powerful role of health IT in committing to that transformation. That’s why CommonWell is so laser-focused on deployment. By putting our cross-vendor interoperability services in action, we’re able to help providers transform the model so that care is truly centered on each individual. I was very enthused by the industry readiness for services like our patient record locator, not just in the hospital and clinic settings, but in the post-acute market as well. After all, healthcare doesn’t stop when a patient leaves the hospital, so the patient record shouldn’t stop there either. It’s time to start bringing the tangible value of interoperability to patients and caregivers, and I’m excited to see how CommonWell services will have a role in that transformation.

Stevens: There is much activity on the interoperability front. What among the current initiatives do you see ultimately gaining traction, and do you see HHS as the leading driver of progress and innovation, the vendor community or providers/payers?

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AMA,Centers for Medicare and Medicaid Services,Chronic Care Management Program,CMS,EHR,Electronic Health Records,HIMSS,HITECH,interoperability,patient data,transition care management,Zoeticx

Connecting the disconnected, five scenarios for interoperability action

Thanh Tran, CEO, Zoeticx

Thanh Tran, Chief Executive Officer, Zoeticx

Despite the yearly spate of announcements at HIMSS from vendors and the ONC about future EHR interoperability, I still find there have been few strides in solving this problem. Physicians’ satisfaction with electronic health record (EHR) systems has declined by nearly 30 percentage points over the last five years, according to a 2015 survey of 940 physicians conducted by the American Medical Association (AMA) and American EHR Partners. The survey found 34 percent of respondents said they were satisfied or very satisfied with their EHR systems, compared with 61 percent of respondents in a similar survey conducted five years ago.

Specifically, the survey found:

42 percent of respondents described their EHR system’s ability to improve efficiency as difficult or very difficult;

43 percent of respondents said they were still addressing productivity challenges related to their EHR system;

54 percent of respondents said their EHR system increased total operating costs; and

72 percent of respondents described their EHR system’s ability to decrease workload as difficult or very difficult.

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