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Why should I go to the mHealth Summit?

You’d think the annual mHealth Summit, set for next month at National Harbor, Md., would be right up my alley, but unless something changes very soon, it looks like I’ll be missing it for the third year in a row.

In 2012, it was a last-minute decision to skip due to a death in the family. Last year, the publication I would have covered it for was bringing three people already, two of whom were new and needed to experience all this mobile health in one place a lot more than I did.

This year, it’s coming down to my decision. At the moment, I don’t have anyone who absolutely needs me to cover it for them. (If you need me to help, let me know ASAP.) It also would be highly inconvenient and expensive for me to go.

As a freelancer, I’m usually on my own for travel expenses. Normally, the Washington area is a cheap trip for me, since I have family to stay with in Montgomery County, Md., and fairly good access to the Metrorail system and Interstate 270. However, National Harbor — a developer’s euphemism for struggling Oxon Hill — is just past the southern tip of D.C., near the Woodrow Wilson Bridge across the Capital Beltway. That’s a good 5o miles from where I would ordinarily stay, and not on a Metro line. Yes, there’s a shuttle from a Metro station and a water taxi from Old Town Alexandria, Va., but it would still take more than an hour to get to either place via Metro.

The handful of hotels in this isolated development are all more than $100 a night, and the conference now stretches four full days. As a kicker, this would be the end of a multi-city trip that already is taking me to the West Coast and the South before heading back to the Midwest. So there’s that to consider. With airfare and meals, it will cost me a good $700 for the privilege of doing little more than blogging for not a lot of money unless I find a solid client, and find one fast, before I book the rest of my trip, which I’m doing this week.

Why does the mHealth Summit need to be four full days anyway, not counting the pre-conference seminars that could keep some people there for six days? That’s actually longer than the huge HIMSS conference, which usually starts on a Monday and ends in the early afternoon on a Thursday — and HIMSS owns the mHealth Summit now.

How much mobile health is there anyways? Mobile health already is melding into wireless health, digital health, connected health and probably a few more variations of health that escape my mind right now. In a few years, they’ll all be part of health IT, e-health or just plain “health” anyway. Do we really need four full days of it in an isolated “resort” in a cold climate? (Fine, it’s not too far from Reagan National Airport, but good luck to you if you fly into Dulles or Baltimore-Washington International.)

 

November 6, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

HIMSS, Continua launch Personal Connected Health Alliance

ORLANDO, Fla.—As HIMSS President and CEO hinted at yesterday in his podcast with me, HIMSS today announced the formation of the Personal Connected Health Alliance, in conjunction with the Continua Health Alliance and the HIMSS-owned mHealth Summit.

This short video from HIMSS explains:

Also, Lieber mentioned that HIMSS has not signed on to a letter from 48 organizations—led by CHIME—to HHS Secretary Kathleen Sebelius, calling for more time and flexibility in meeting Meaningful Use Stage 2 requirements., Lieber said HIMSS declined to sign because the requests were, in his opinion, “very vague.”

Today, the letter, dated Feb. 21, was made public:

February 21, 2014
The Honorable Kathleen Sebelius
Secretary
Department of Health and Human Services
200 Independence Ave., S.W.
Washington, DC 20201

Dear Secretary Sebelius:

The undersigned organizations write to express immediate concerns confronting our respective members’ ability to comply with the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program. We recognize the vital role your department has taken in advancing the adoption of health information technology in the United States and appreciate your willingness to be flexible in extending the start of Stage 3 to 2017. We fear the success of the program is in jeopardy, however, if steps are not taken now to address our shared concerns.

Over the next seven months, more than 5,000 hospitals and 550,000 eligible professionals must adopt the 2014 Edition of Certified Electronic Health Record Technology (CEHRT) and meet a higher threshold of Meaningful Use criteria. Failure to do so will not only result in a loss of incentive payments, but also the imposition of significant penalties. With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers. This inhibits the ability of providers to manage the transition to the 2014 Edition CEHRT and Stage 2 in a safe and orderly manner.

We are concerned this dynamic will cause providers to either abandon the possibility of meeting Meaningful Use criteria in 2014 or be forced to implement a system much more rapidly than would otherwise be the case. The first choice limits the success of the program to achieve widespread adoption of EHR, while the second is highly disruptive to healthcare operations and could jeopardize patient safety. As you know, our members’ number one priority must be to provide safe and high quality care to patients.

Providers need adequate time to learn how to use the newly deployed technology, including examining staff assignments, workflows, and practice processes. If providers move forward, as dictated by the current policy, our concerns regarding rushed implementations are heightened. Furthermore, we believe the “all or nothing” approach – where missing a single objective by even a small amount results in failure for the program year – compounds our concerns.

For these reasons, our organizations strongly recommend that HHS:
1. Extend the timelines providers have to implement 2014 Edition Certified EHR software and meet the Program requirements (Stages 1 and 2) through 2015;
2. Add flexibility in Meaningful Use requirements to permit as many providers as possible to achieve success in the program.

Given that we are well into 2014, immediate attention to these concerns is warranted. This additional time and new flexibility are vitally important to ensure that hospitals and physicians continue moving forward with technology to improve patient care. By making such changes, HHS would be demonstrating needed flexibility to maximize program success, without compromising momentum towards interoperability and care coordination supported by health IT.

We remain committed to the success of the program and look forward to hearing from you on this important matter. Please contact Jeffery Smith, Senior Director of Federal Affairs, CHIME, (jsmith@cio-chime.org) should you have any questions. Thank you for your consideration.

Sincerely,

AMDA-Dedicated to Long Term Care Medicine
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology Association
American Academy of Family Physicians
American Academy of Home Care Medicine
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Orthopaedic Surgeons
American Academy of Otolaryngology—Head and Neck Surgery
American Association of Neurological Surgeons / Congress of Neurological Surgeons
American College of Cardiology
American College of Osteopathic Family Physicians
American College of Osteopathic Internists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Health Information Management Association
American Hospital Association
American Medical Association
American Osteopathic Academy of Orthopedics
American Osteopathic Association
American Psychiatric Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society of Anesthesiologists
American Society of Cataract and Refractive Surgery
American Society of Hematology
American Urological Association
America’s Essential Hospitals
Association of American Medical Colleges
Catholic Health Association of the United States
Children’s Hospital Association
College of Healthcare Information Management Executives
Federation of American Hospitals
Heart Rhythm Society
Infectious Diseases Society of America
Medical Group Management Association
National Rural Health Association
North American Spine Society
Premier healthcare alliance
Society for Cardiovascular Angiography and Interventions
Society of Thoracic Surgeons
The Endocrine Society
VHA Inc.

Yes, that is kind of vague, but that’s what you get when you involve four dozen organizations. Will it be effective? As I mentioned yesterday, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be news about Stage 2 flexibility, likely Thursday morning at a joint ONC-CMS town hall. Reider made that statement at the CIO Forum, hosted by CHIME.

 

 

February 24, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: HIMSS CEO Steve Lieber, 2014 edition

It’s time for my annual podcast interview with HIMSS President and CEO Steve Lieber, this time from the Orange County Convention Center in Orlando, Fla., on the day before the official opening of the 2014 HIMSS Conference, rather than in his Chicago office a week or so in advance.

Lieber reiterated HIMSS’ position that the federal government should extend the attestation period for Meaningful Use Stage 2 by one year. I wasn’t there, but today at the CIO Forum, one of the preconference educational symposia, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be an announcement on Stage 2 flexibility, possibly Thursday morning at a joint ONC-CMS town hall. That session will feature CMS Administrator Marilyn Tavenner and new national health IT coordinator Karen DeSalvo, M.D. I’ve never heard either of them speak, and now I’m excited to be covering that session.

We also discussed other aspects of healthcare reform, trends in health IT and expectations for HIMSS14. Of note, on Monday morning, HIMSS and two other organizations will announce a new initiative on “personal connected health.”

Near the end, I reference the podcast I did last week with Dr. Ray Dorsey about remote care for Parkinson’s patients. For easy reference, here’s the link.

This is, I believe, the seventh consecutive year I have done a podcast with Lieber at or just before the annual HIMSS conference. Another interview that has become somewhat of a tradition won’t happen this time, as Athenahealth CEO Jonathan Bush is not making the trip to Orlando this year.

 

Podcast details: Interview with HIMSS President and CEO Steve Lieber, Feb. 23, 2014, at HIMSS14 in Orlando, Fla. MP3, stereo, 128 kbps, 36.2 MB. Running time 39:35.

0:40 “It’s time to execute.”
1:40 Challenges for small hospitals and small practices
3:10 New ONC EHR certification proposal and continued questions about Meaningful Use Stage 2
5:00 Prioritizing with multiple healthcare reform initiatives underway, including proposed SGR repeal
6:30 Surviving ICD-10 transition
7:35 HIMSS’ position on MU2 timelines
9:05 Remember “macro objective” of Meaningful Use
10:00 Letter to HHS from organizations not including HIMSS calling for what he says are “very vague” changes to MU2 criteria
11:40 Things in MU2 causing providers fits
13:05 Fewer EHR vendors certified for 2014, but more HIMSS exhibitors
15:00 What this means for providers who bought products certified to 2011 standards
17:20 Progress on Meaningful Use so far
21:00 Looking toward Stage 3
22:42 What healthcare.gov struggles might mean for health IT
25:35 Other aspects of the Affordable Care Act being lost in the public debate
27:10 Political considerations related to health IT
29:40 Patient engagement and new HIMSS exhibitors
32:20 Why healthcare spending and provider shortage forecasts don’t account for efficiency gains made from technology and innovation
35:10 Demographic challenges for healthcare
35:45 Shift from hospitals to ambulatory and home care and consolidation of provider organizations

February 23, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My HIMSS agenda

After a couple of weeks of uncertainty, I now know I will be covering HIMSS for MedCity News. A lot of vendors and PR firms have of course pitched me for meetings, and the reality is, I’ve not always found vendor meetings all that interesting. In fact, the absolute worst thing about the annual HIMSS conference—and I’ve covered every one since 2002—is the few weeks beforehand, when I’m trying to juggle my schedule.

I have occasionally double-booked or simply forgotten to enter appointments into my calendar, but these things do happen when you are juggling dozens if not hundreds of e-mails, you don’t have a secretary and, oh, by the way, have regular work to do a the same time. Sometimes I’ve scrambled to change appointments up to the moment I get on the plane. It’s just a mess most of the time because of the sheer volume of requests and the need to fit it into my normal routine. (Interestingly, and scarily, it’s similar to how healthcare often operates, and mistakes made in healthcare can be deadly.)

The bottom line is, there are more than 1,200 vendors at HIMSS these days, and there is one of me. I can maybe meet with 10-12 of them over the five days of HIMSS, counting Sunday and Thursday, and most of the vendors have gone home by Wednesday evening. One thing a I’ve found is that lot of vendors don’t understand that there are also more than 300 educational sessions to choose from; HIMSS doesn’t just happen in the zoo known as the exhibit hall. I tend to find a lot of great stories from those sessions, so I make them a priority.

Anyway, I have about 10 stories to do for MedCity News during and immediately after HIMSS, and some have fairly specific requirements. (I also have to find time to, you know, write the stories. Sometimes, it’s a trade-off between covering a session/meeting with a vendor and doing my work. Doing the work necessarily wins. Two years ago in Las Vegas, I had to cancel two or three vendor meetings after CMS and ONC dropped the proposed Meaningful Use Stage 2 rules during a town hall-style session. If you recall, the thousands of people trying to download the proposal all but crashed the public Wi-Fi network at the Venetian.)

Two stories are about companies I discover at the new Startup Showcase. If you’re among the startups on display there, let me know. I’ve got one story to do on the Intelligent Hospital Pavilion and another on the Interoperability Showcase. I’ll probably just spend an hour or so walking through and asking questions, but if you’re there and think you have a compelling angle for me, I’m listening.

That’s four stories right there. Three more are from coverage of specific sessions, so those are already booked. I’ve also got three opinion/analysis pieces to write in the week after the fact, and I’m pretty flexible on those. I’m just going to see what I discover and what jumps out at me. A theme usually emerges by the second day.

Away from the madness, I will be at the fifth annual New Media Meetup on Tuesday evening, Feb. 25, hosted by the one and only John Lynn, who also hosts this very blog as part of the Healthcare Scene network. It’s free, but there is limited space, so you do need to preregister.

I will see you in Orlando in a little more than a week.

 

February 14, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

CCHIT, KLAS might signal new era in EHRs

Two stories that have hit in the last 48 hours illustrate how the status quo in EHRs is being upset.

First off, as John Lynn broke late Tuesday night—first as a rumor and then as a confirmed fact—on his EMR and HIPAA blog, CCHIT, formerly known as the Certification Commission for Health Information Technology, is getting out of the health IT certification business, thus making sense out of the name change. The organization will continue to offer preparatory courses for ONC-sanctioned testing and certification, but no more actual certification.

CCHIT recommended that vendors turn to another authorized testing and certification body, Verizon-owned ICSA Labs, though there are others that still do offer certification, including Drummond Group, SLI Global Solutions, InfoGard Laboratories, and, for e-prescribing technology, Surescripts. Interestingly, CCHIT also announced that it will partner with HIMSS to offer a series of health IT events for vendors and providers. This is interesting because HIMSS was one of the three founding organizations of CCHIT in 2004, and CCHIT was under fire five years ago for maintaining too close of a relationship with HIMSS (also see this link).

When Meaningful Use came along with the passage of the American Recovery and Reinvestment Act in 2009, CCHIT lost its exclusivity in certifying health IT products, as EHR certification essentially became commoditized. Other certifying bodies also have undercut CCHIT on price, so this move really does not surprise me.

The other big story, if you pay attention to things such as vendor rankings, is that Athenahealth just unseated Epic Systems as KLAS Research’s “Best in KLAS Overall Software Vendor” of 2013. Epic had held the top spot for eight years in a row. “The old guard of HIT leaders is finally being displaced by more nimble, innovative models designed for health care’s future—not for its past. The latest KLAS rankings show that closed-system, traditional software offerings are not robust or flexible enough to meet providers’ demands anymore,” Athenahealth CEO Jonathan Bush said in a statement.

I’m not sure I’d go that far, as Epic is still eating everyone else’s lunch in the enterprise market. But, to me, this shows that smaller physician practices that don’t have IT departments are adopting EHRs and want a cloud-based product that is easy to maintain. That certainly heralds a major shift in health IT.

January 30, 2014 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

I sense a delay in MU2

I have no evidence to back this up, but I have a sneaking suspicion that the feds are giving serious thought to delaying some of the timelines in Stage 2 of Meaningful Use.

The pushback has been building for some time, and advanced in the past couple of weeks with the opinions of three important industry associations.

The American Association of Family Physicians called for a one-year delay and proposed separating providers into “three distinct cohorts,” depending on what year they first met Meaningful Use standards. HIMSS wants the attestation period for the first year of MU2 extended to April 2015 for hospitals and June 2015 for physicians and other “eligible professionals.” The MGMA asked CMS not to penalize physicians who reach Stage 1 but can’t make it to Stage 2 when penalties are due to start in 2015.

All cited the short timelines for vendors to get their products ready and certified for Stage 2.

And then there was the big news this month, the resignation of national health IT coordinator Dr. Farzad Mostashari, seemingly without warning. I can’t take credit for this idea, but an industry insider I spoke with this week suggested Mostashari may have wanted out because he didn’t want to be in charge of a watered-down or delayed program. Again, I have no evidence to support the idea, but it sounds absolutely plausible.

I welcome your thoughts on this matter.

August 22, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Counting the health IT accelerators

Have you noticed all the digital health “accelerators” and “incubators” out there? I count the following, in alphabetical order:

In addition, the USC Center for Body Computing has announced plans for its own incubator/accelerator in Los Angeles, but we continue to await details.

That’s a lot. Is it too many? We have seen plenty of failures in digital health entrepreneurship over the years, in no small part because too many companies don’t understand the unique economics of healthcare, particularly in the U.S. With the possible exception of fitness products, direct-to-consumer simply does not work in healthcare because most of the expenses are paid for by third parties. (I’d argue that wellness and fitness are distinct from traditional healthcare anyway because healthcare really does focus on sick care.)

At least one report from the California HealthCare Foundation backs up my belief that the DTC focus is a recipe for failure, one reason why health accelerators probably have it harder than their counterparts in other industries.

June 4, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

HIMSS CIO survey visualized

I already reported the results of the annual HIMSS healthcare CIO survey in a story I wrote for InformationWeek the other day. Since everybody seems to love infographics these days, HIMSS produced one visualizing some of the highlights, including the finding that two-thirds of U.S. hospitals already have met Stage 1 meaningful use. Based on this, I’m guessing that close to 90 percent should be there by the end of the year, which means that CMS and ONC will have achieved their objectives for Stage 1, at least on the hospital side. (Of course, the physician part is proving to be much more difficult.) Someone in the know at ONC told me last night that people in that office are expecting 80 percent hospital success by the time fiscal year 2013 closes Sept. 30.

March 7, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Podcast: HIMSS CEO Steve Lieber: 2013 edition

Once again, as has become custom, I sat down with HIMSS CEO Steve Lieber at the organization’s Chicago headquarters the week before the annual HIMSS conference to discuss the conference as well as important trends and issues in the health IT industry. I did the interview Monday.

Here it is late Friday and I’m finally getting around to posting the interview, but it’s still in plenty of time for you to listen before you get on your flight to New Orleans for HIMSS13, which starts Monday but which really gets going with pre-conference activities on Sunday. At the very least, you have time to download the podcast and listen on the plane or even in the car on the way to the airport. As a bonus, the audio quality is better than usual.

Podcast details: Interview with HIMSS CEO Steve Lieber about HIMSS13 and the state of health IT. Recorded Feb. 25, 2013, at HIMSS HQ in Chicago. MP3, stereo, 128 kbps, 46.0 MB. Running time: 50:17.

1:00        Industry growth and industry consolidation
2:50        mHIMSS
3:45        Why Dr. Eric Topol is keynoting
6:00        New Orleans as a HIMSS venue
6:50        Changes at HIMSS13, including integration of HIT X.0 into the main conference
8:55        Focus on the patient experience
9:35        Global Health Forum and other “conferences within a conference”
13:00     Criticisms of meaningful use, EHRs and health IT in general
17:00     Progress in the last five years
20:45     Healthcare reform, including payment reform
22:30     Why private payers haven’t demanded EHR usage since meaningful use came along
23:50     Payers and data
26:28     Potential for delay of 2015 penalties for not meeting meaningful use
29:15     Benefits of EHRs
30:40     Progress on interoperability between EHRs and medical devices
32:52     Efficiency gains from health IT
35:27     Home-based monitoring in the framework of accountable care
36:55     Consumerism in healthcare
39:40     Accelerating pace of change
41:10     Entrepreneurs, free markets and the economics of healthcare
43:25     Informed, empowered patients and consumer outreach
46:30     Fundamental change in care delivery

March 1, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

ICD-10 explained in a minute and a half

It’s Sunday, so it’s time for something light.

University of Utah Health Care put together this handy little video that explains ICD-10 to physicians as well as their role in making the transition. There is one footnote I’d like to add: the compliance deadline has been delayed to October 2014 since this video was made.

 

Thanks to the HIMSS social media team for pointing this out to me, via their Facebook page.

October 21, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.