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Podcast: Greenway Health CEO Tee Green on interoperability, consumerism and more

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. “Tee” Green III about this, I decided to take it a step further.

In all my years of covering health IT, I’ve never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn’t have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for “retail health”
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

I’ve been kicking around in my mind the idea of hosting a regular podcast, perhaps as frequently as weekly. If so, what day of the week would you prefer to hear a new episode?

September 12, 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.

Video: Aneesh Chopra on ‘The Daily Show’ for a long interview

Everybody else has the news about CMS offering leniency with Stage 2 Meaningful Use, letting providers use EHRs with 2011 certification to meet Stage 2 standards because so few vendors have been certified to the 2014 standards previously required for Stage 2. I won’t rehash here.

I will, however, share the very extended interview Jon Stewart had last night with former White House CTO — and, before that, HHS CTO — Aneesh Chopra on “The Daily Show.” Stewart is a comedian with a known liberal bias, but he is not a bad interviewer when dealing with a serious subject.

Stewart has been hammering the VA over its backlog of new registrations, and stepped it up in the wake of the recent revelation that VA bureaucrats in Phoenix were gaming the system to make it look like waits weren’t as bad as they really were. He’s also criticized the federal government for failing to link medical records between the Military Health System and the VA — you know, what we in health IT call interoperability. (In Part 4, Chopra discusses lack of interoperability in the broader healthcare sense.)

I found out about Chopra’s appearance last night shortly before the show aired. Unfortunately, we were having heavy rain at the time, and my satellite TV got knocked out, so I missed it. It’s OK, because the Chopra interview was long — more than 22 minutes — and the version that was on TV is heavily edited. Here’s the full interview of the “Indian Clooney,” as Stewart called Chopra, from the show’s Web site.

Part 1  (4:41)

 

Part 2 (7:27)

 

Part 3 (5:19)

Part 4 (5:35)

 

May 21, 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.

Still no consensus on digital/mobile/connected health

A while back — three months, to be exact — I asked readers if they had a preferred term to describe “the application of new, personalized technologies to healthcare.” I gave you the choice of digital health, connected health, wireless health, mobile health and telehealth, and surmised that the results would not be conclusive. On that part, I was right:

digital health poll resultsHowever, I was surprised that connected health, a relatively underutilized term, did so well and that telehealth got but one vote. Wireless health certainly has kind of become passé, but I was surprised nobody picked it at all.

In any case, these results, however unscientific they may be, are representative of the fact that it is so hard to reach consensus on anything in health IT. They also are symbolic of the silos that still exist in newer technologies.

May 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.

eHealth Initiative ‘2020 Roadmap’ panel needs consumers

This press release showed up my inbox on Tuesday:

eHealth Initiative Launches 2020 Roadmap Process

Framework to Change the Future of Nation’s Healthcare System

March 25, 2014, Washington, D.C. – The eHealth Initiative (eHI) announced the launch of the eHealth Initiative 2020 Roadmap, a public-private collaboration that will help guide the  transformation of the nation’s healthcare system by 2020. With the help and support of a  wide array of leading healthcare associations, organizations, and federal agencies, 2020 Roadmap will propose key policy recommendations to implement at a federal level and actions for the private sector to help transform healthcare.

“Health reform calls for transformation to a value-based interoperable system, but there is no direction on how to transition from our current work processes and systems. Clinicians, payers and providers are in dire need of leadership to help transform delivery systems and control cost,” said Jennifer Covich Bordenick, Chief Executive Officer of the eHealth Initiative. “The goal of our new initiative is to craft a multi-stakeholder solution that coordinates the efforts of both the public and private sector so that we can make this transition successfully.”

The 2020 Roadmap will be developed over the next six months through a series of surveys, webinars, executive roundtables, and events with key constituencies; the outcome will be a consensus on how to shape the future of our healthcare system.  Individuals are welcome to complete surveys, participate in upcoming events, and provide general feedback. A new survey is currently being fielded to gather information from the industry.

The 2020 Roadmap will focus on recommendations that:

•        Identify a sustainable glide path for meaningful use;

•        Promote interoperable systems;

•        Transform care delivery; and

•        Balance innovation and privacy.

Several advisors representing different stakeholders are leading the 2020 Roadmap activities, including:

·         John Glaser, PhD, Chief Executive Officer, Health Services, Siemens (representing vendors)

·         Sam Ho, MD, Executive Vice President and Chief Medical Officer, UnitedHealthcare, Chair eHI Board of Directors, (representing payers)

·         Christopher Ross, MD, Chief Information Officer, Mayo Clinic (representing providers)

·         Susan Turney, MD, Chief Executive Officer, Medical Group Management Association (representing clinicians)

·         Micky Tripathi, PhD, President and Chief Executive Officer, Massachusetts eHealth Collaborative (representing information exchanges)

·         Joseph Touey, Senior Vice President, North American Pharmaceuticals, Information Technology, GlaxoSmithKline (representing pharmaceutical manufacturers)

“The impressive caliber of individuals leading our effort reflects the importance of the 2020 Roadmap,” said Jennifer Covich Bordenick. “We invite all organizations to participate in this important process and bring the best thinking to the table.”

Visit the 2020 Roadmap webpage for more information at http://www.ehidc.org/2020-roadmapMore information about the eHealth Initiative is available online at www.ehidc.org.

###

About the eHealth Initiative: The eHealth Initiative (eHI) is a Washington D.C.-based, independent, non-profit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information and information technology. eHI is the only national organization that represents all of the stakeholders in the healthcare industry. Working with its membership, eHI advocates for the use of health IT that is practical, sustainable and addresses stakeholder needs, particularly those of patients. www.ehidc.org .

What immediately jumped out at me was the list of advisors. I’m familiar with most of the names, and I am sure all are qualified to provide valuable input on how to promote interoperability and improve our nation’s broken healthcare infrastructure. But the notes on representation raise an important question: How come nobody is representing consumers?

It’s after hours as I read the press release and I post this commentary, but I’ve e-mailed the press contact to see if the eHealth Initiative has a good answer. I will report back as soon as I hear anything. In the meantime, consumer and patient advocacy groups should take Bordenick up on her offer to participate.

UPDATE, March 27, 11 am CDT: I’ve just received this response directly from Bordenick:

Please know that the news release just highlighted just a few of the individuals and groups that will be involved.  We absolutely welcome the representation and involvement of patient and advocacy groups, and any stakeholder groups who want to participate— that is one of the reasons we put the announcement out, and asked people to fill in contact info in the survey. We are at the very start of this process, so now is definitely the time to get engaged. We currently work with National Partnership for Women and Families, Center Democracy & Technology, American Cancer Society, and have just started work with Smart Patients, and many others. We expect all of these groups to continue working with us, and many others to join in the process.

So there you have it. As I said in the original post, consumers and patient advocacy groups should take Bordenick up on the offer. It sounds like she would appreciate it.

March 26, 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.

All my HIMSS coverage in one place

The last of my 10 MedCity News stories from HIMSS14 has been posted. It’s a nice mix of news, features, analysis and commentary. Here are links to all of them, in chronological order.
NantHealth launches Clinical Operating System – biggest of big data startups – with $1B (Feb. 25)

Body + biology + behavior: Intel exec explains how technology is making N=1 care possible (Feb. 26)

Tavenner: 2014 is your last chance for a hardship exemption for Meaningful Use 2 (Feb. 27)

HIMSS crowd skeptical of promise for flexibility on MU2 hardship requests (Feb. 27)

Google Glass startup expecting third healthcare client in less than 6 months (Feb. 27)

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017 (Feb. 28)

DeSalvo meets and greets – briefly – while Tavenner keeps her distance at HIMSS (March 3)

HIMSS Intelligent Hospital tracks patients, pills and clinicians in completely connected loop (March 5)

Interoperability Showcase uses car crash to show how connected data really can improve patient care (March 5)

Athenahealth’s first inpatient product isn’t quite an EHR, but a ‘Trojan horse’ into hospitals (March 10)

 

March 12, 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.

The ‘Hospital of Tomorrow’

WASHINGTON—I’ve just finished 2 1/2 days of helping US News and World Report cover its inaugural Hospital of Tomorrow conference. My assignment was to sit in on four of the breakout sessions, take notes, then write up a summary as quickly as possible, ostensibly for the benefit of attendees who had to pick from four options during each time slot and might have missed something they were interested in. Of course, it’s posted on a public site, so you didn’t have to be there to read the stories.

Here’s what I cranked out from Tuesday and Wednesday:

Session 202: A Close-Up Look at EHRs — ‘Taking a Close Look at Electronic Health Records”

Session 303: The Future of Academic Medical Centers — “Academic Medical Centers ‘Must Become More Nimble'”

Session 305: Preventing and Coping With Infections — “How Hospitals Can Better Prevent and Cope With Infections”

Session 401: Provider and Patient Engagement — “Hospitals Grapple With Patient Engagement”

The one on infection control was particularly interesting, in large part due to the panel, which included HCA Chief Medical Officer and former head of the Veterans Health Administration Jonathan Perlin, M.D., Johns Hopkins quality guru Peter Pronovost, M.D., and Denise Murphy, R.N., vice president for quality and patient safety at Main Line Health in suburban Philadelphia.

The session on patient engagement was kind of a follow-on to my first US News feature in September.

If you want to read more about the whole conference, including US News’ live blog, visit usnews.com/hospitaloftomorrow

November 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.

Top 10 things wrong with Fox News smear job on EHRs

Today, FoxNews.com published a hit job on health IT and EHRs in the guise of another hit job on Obamacare. I found out about it courtesy of this tweet:

First off, it’s clear that Mostashari feels unshackled from having to watch his words now that he’s no longer national health IT coordinator. Secondly, he’s right. This story contains so many errors and misleading statements that it’s almost funny. Let’s count down the top 10.

10. “Under a George W. Bush-era executive order, all Americans should have access to their medical records by the end of 2014, part of a concept referred to as e-health. President Obama then made electronic medical records (EMRs) central to the success of the Affordable Care Act”

When Bush issued the executive order in 2004 that created the Office of the National Coordinator for Health Information Technology, he set as a goal interoperable EMRs for “most” Americans. The “all” part came after Barack Obama took office in 2009.

9. Though Obama did reiterate the 2014 goal and up the stakes by saying “all Americans,” nobody realistically thought it could happen. After all, the HITECH Act, which created Meaningful Use, didn’t pass until March 2009 and Meaningful Use didn’t even start until 2011. Before the HITECH Act, ONC barely had any funding anyway. For five years, Congress failed to pass much in the way of health IT legislation, even though a federal EHR incentive program had bipartisan support, symbolized by an unlikely alliance between Newt Gingrich and Hillary Clinton.

8. “Doctors, practitioners and hospitals, though, have been enriching themselves with the incentives to install electronic medical records systems that are either not inter-operable or highly limited in their crossover with other providers.”

Meaningful Use was never intended for enrichment, or even to cover the full cost of an EHR system.

7. While systems mostly are not interoperable yet, that wasn’t the intent of Stage 1 of Meaningful Use. Stage 1 was meant to get systems installed. Stage 2, which has barely started for the early adopters among hospitals and won’t start for 2 1/2 months for physicians, is about interoperability. That’s where the savings and efficiencies are supposed to come from.

6. We’re years away from knowing whether Meaningful Use program did its job, though I don’t fault members of Congress such as Sen. John Thune (R-S.D.) for putting pressure on the administration to demand more for the big taxpayer outlay.

5. “‘The electronic medical records system has been funded to hospitals at more than $1 billion per month. Apparently little or none of that money went to the enrollment process which is where the bottle neck for signing up to ObamaCare’s insurance exchanges appears to be,’ Robert Lorsch, a Los Angeles-based IT entrepreneur and chief executive of online medical records provider MMRGlobal, told Fox News.”

The money wasn’t supposed to go to the insurance enrollment process. The Meaningful Use incentive program was from the HITECH Act, part of the 2009 American Recovery and Reinvestment Act. The Patient Protection and Affordable Care Act, a.k.a. Obamacare, came a year later. Again, someone is confusing insurance and care. They are not the same thing.

4. “Lorsch, at MMRGlobal, offered the U.S. government what it describes as a user-friendly personal health record system for one dollar per month per family – a fraction of what it has cost the taxpayer so far.”

MMRGlobal’s product is an untethered personal health record. No untethered PHR anywhere is “user-friendly,” which is why adoption has been anemic. Without data from organizational EHRs, PHRs are worthless. Besides, the direct-to-consumer approach in healthcare has failed over and over, since people are used to having someone else — usually an insurance company — pick up the tab.

3. For that matter, MMRGlobal is a bad example to use as an alternative to EHRs. (The Fox story is correct in saying that other vendors do have close ties to the Obama administration, though the former Cerner executive’s name is Nancy-Ann DeParle, not “Nance.”) I could be wrong, but I haven’t seen a whole lot of evidence that MMRGlobal isn’t much more than a patent troll.

2. “But this process could have been easier if a nine-year, government-backed effort to set up a system of electronic medical records had gotten off the ground. Instead of setting up their medical ID for the first time, would-be customers would have their records already on file.”

Actually, as I wrote in a story just published in Healthcare IT News, we could have had national patient identifiers 15 years ago, as called for by the 1996 HIPAA statute. But Congress voted in 1998 not to fund implementation of a national patient ID and President Bill Clinton signed that into law. Since then, interoperability and patient matching have been mighty struggles.

1. “‘Plus, unlike under ObamaCare, the patient would be in control of their health information and, most importantly, their privacy,’ Lorsch said.”

Where in Obamacare does the patient lose control of health information? Less than a month ago, I was in Washington listening to HHS Office for Civil Rights Director Leon Rodriguez say, ““There is a clear right [in the HIPAA privacy rule] not only of patient access, but patient control over everything in their records.” This may come as news to some people, but patients own and control the information. They might not know it, but the language is pretty clear.

Already, the Fox story has been reposted in a number of blogs shared all over the Internet, so it’s being accepted as fact in some quarters. If you want the truth, you sometimes have to do the work yourself.

October 15, 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.

Comprehensive coverage of WTN Media’s Digital Health Conference

As you may know from at least one of my earlier posts, I was in Madison, Wis., last month for a great little health IT event called the Digital Health Conference, a production of the Wisconsin Technology Network and the affiliated WTN Media. In fact, WTN Media hired me to cover the conference for them, so I did, pretty comprehensively. In fact, I wrote eight stories over the last couple of weeks, seven of which have been published:

I still have an overview story that should go up this week.

Why do I say it’s a great little conference? The list of speakers was impressive for a meeting of its size, with about 200 attendees for the two-day main conference and 150 for a pre-conference day about startups and entrepreneurship.

Since it is practically in the backyard of Epic Systems, CEO Judy Faulkner is a fixture at this annual event, and this time she also sent the company’s vendor liaison. Informatics and process improvement guru Dr. Barry Chaiken came in from Boston to chair the conference and native Wisconsinite Judy Murphy, now deputy national coordinator for programs and policy at ONC, returned from Washington. Kaiser Permanente was represented, as was Gulfport (Miss.) Memorial Hospital. IBM’s chief medical scientist for care delivery systems, Dr. Marty Kohn, flew in from the West Coast, while Patient Privacy Rights Foundation founder Dr. Deborah Peel, made the trip from another great college town, Austin, Texas. (Too bad Peel and Faulkner weren’t part of the same session to discuss data control. That alone would be worth the price of admission.)

July 2, 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.

Video: My interview with Hands On Telehealth

I recently was a guest on a vodcast with Nirav Desai, founder and CEO of telehealth consulting firm Hands On Telehealth, whom I met because I moderated a panel he was on at the American Telemedicine Association‘s annual conference in May. In a Skype interview that went up late Friday, we chatted for 45 minutes about telehealth, the broader  health IT landscape and how it all fits into U.S. healthcare reform.

I’m unable to embed the video on this page, so please visit the Hands On Telehealth page to watch the interview. (That’s a screen grab below.) The page contains a detailed description of the interview, much as I like to have for my own podcasts. Perhaps next time I’ll spend more time looking directly at the camera. :)

Hands On Telehealth screen grab

July 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.

DoD-VA integration failure is no laughing matter, even to Stewart

Last week, I had a clip from “The Colbert Report” because Dr. Eric Topol appeared on the show to discuss digital health in a lively segment with Stephen Colbert. (I reported on it for InformationWeek Healthcare. The editors told me to have fun, so I did.) This time around, I’m going to give Jon Stewart equal time, not because I feel like having more fun with “fake news,” but because the host of “The Daily Show” had some insightful comments about the failure of the Military Health System and the Veterans Health Administration to get their EHRs to interoperate.

Though his job is to make people laugh—and ostensibly to upset conservatives—Stewart has been an outspoken advocate for America’s veterans, and when he heard the Obama administration has created a massive backlog for disabled veterans to receive VA health benefits, he went off. As far as I can tell, he got everything right, too.

April 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.