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Athenahealth-EHRA news significant only that it shakes up the status quo

By now, you’ve likely heard the news that Athenahealth has decided to quit the HIMSS EHR Association. As Athenahealth’s Dan Haley put it in a blog post: “At the end of the day, athenahealth left the EHRA because we never really belonged there in the first place. The EHRA was founded in 2004 by a group of EHR software vendors. Today, a decade into the age of cloud technology, the EHRA is still dominated and governed by a group of EHR software vendors.”

Athenahealth long has billed itself as a services company, not a software vendor, going so far as to hold a jazz funeral for the “death of software” at HIMSS13 in New Orleans. Athenahealth didn’t join the EHRA until 2011 anyway. It sounded like a bad fit.

I contacted Athenahealth, and was told that the company remains “fully committed” to the CommonWell Health Alliance, a coalition of health IT companies — also including Allscripts, Cerner, CPSI, Greenway Health, McKesson and Sunquest Information Systems — that came together for the stated purpose of “developing, deploying and promoting interoperability for the common good.” (There’s also the unstated purpose of fighting the dominance of Epic Systems.)

Athenahealth is staying on the interoperability path, but as is befitting the corporate culture, is going rogue when it comes to EHRs. It’s not the first time. It won’t be the last time, because it’s not like most of the other vendors/service providers, if for no other reason than CEO Jonathan Bush doesn’t fit the buttoned-down model of an executive. For that matter, neither did his co-founder, Todd Park, whom I often called an “anti-bureaucrat” during his time with the federal government. Park’s brother, Ed, is COO of Athenahealth, and also has unconventional tendencies.

I can relate to this mentality in a way. I quit the Association of Health Care Journalists years ago because it didn’t feel like a good fit for me. That group tried to include health IT in its programming, but it really was an organization for consumer and scientific reporters, not those of us in the business and trade press. Eight years later, I still don’t think the national media are doing such a great job covering health policy or explaining the nuances of this complicated industry. And, as I’ve said many times before about healthcare, the status quo is unacceptable.

 

April 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.

Surprising results in the HIT100 list

The third annual HIT100 list, ostensibly listing the 100 most influential Twitter accounts in health IT, has been published at Healthcare IT News, and I’m more surprised than flattered to be at No. 44, named 14 times by tweets carrying the #HIT100 hashtag. More accurately, I am in a five-way tie for No. 41, with the likes of: “social venture entrepreneur” Sherry Reynolds (9,000 Twitter followers); Beth Israel Deaconess Medical Center CIO and health IT rock star Dr. John Halamka (10,600 followers); health IT product strategist Lisa Crymes (2,200 followers); and pre-eminent health IT social media researcher Susannah Fox of the Pew Internet & American Life Project (13,800 followers).

That doesn’t seem right, does it?

It also doesn’t seem right that I’m ahead of: “E-Patient” Dave deBronkart; true digital health rock star Dr. Eric Topol; The Health Care Blog and Health 2.0 founder Matthew Holt; Chilmark Research’s John Moore, one of the most insightful analysts I’ve ever come across; KevinMD founder Dr. Kevin Pho (though he focuses on a lot more than just health IT); health economist and patient engagement guress Jane Sarasohn-Kahn; well-known EHR consultant Jim Tate; health IT policy expert Shahid Shah; and, coming in at 100 on the list, White House CTO and technology entrepreneur-in-residence Todd Park, who previously was CTO at HHS and co-founded Athenahealth.

It’s nice to be mentioned among and even above some of those names, and I thank those who voted for me. I also thank the more than 3,600 people who follow me on Twitter. But am I really more influential in health IT than any of the people I mentioned above? I doubt it.

What are your thoughts? Is there a better way of measuring influence than just counting the number of people who tweeted your name with the #HIT100 hashtag?

For the record, topping the list was Dr. Wen Dombrowski, who is about as active as they get when it comes to health IT social media. No arguments here, though I wouldn’t have objected either if Brian Ahier, Regina Holliday, Lionel Reichardt, Gregg Masters, Paul Sonnier (his Digital Health LinkedIn group just passed 19,000 members) or Keith Boone had been No. 1. A case also could be made for John Lynn, founder of the Healthcare Scene network, which hosts this blog.

And then, there’s this:

July 25, 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.

About that Friedman editorial

Did you happen to catch Thomas Friedman’s commentary in Sunday’s New York Times entitled, “Obamacare’s Other Surprise”?

On first read, I gave it a big “Duh!” for the explanation that the Patient Protection and Affordable Care Act (that’s how the law is officially known, Mr. Friedman) creates a “new industry” of innovation by encouraging the federal government to release of terabytes of health data — information already legally in the public domain — and then allowing the private sector to figure out how to structure, interpret and use the data. As you probably are, I’m well aware of digital health, Health Datapalooza, federal CTO Todd Park and some of the companies Friedman mentions. (Health Datapalooza IV is less than a week away.)

But on second read, I realized Friedman needed to write that column because America needs a lot of education about the Affordable Care Act, education that the Obama administration and its supporters don’t seem all that willing to provide. The public still thinks of Obamacare largely in terms of health insurance coverage. It’s much more than that, including, as Friedman points out, an attempt “to flip this fee-for-services system (which some insurance companies are emulating) to one where the government pays doctors and hospitals to keep Medicare patients healthy and the services they do render are reimbursed more for their value than volume.”

Coupled with the 2009 American Recovery and Reinvestment Act, which created the $27 billion EHR incentive program for “meaningful use” of electronic health records, the ACA takes some steps toward actual reform of actual care, not just insurance coverage. Friedman does not discuss Accountable Care Organizations, an experiment in realigning incentives around care coordination, nor does he mention the Medicare policy, dictated by the ACA, of not reimbursing for preventable hospital readmissions within 30 days of initial discharge for certain specific conditions, currently heart attack, congestive heart failure and pneumonia. Likewise, he fails to bring up outcomes research, another component of Obamacare. But at least he gets something out there that’s not about insurance coverage.

Unfortunately, many of the online comments posted in response to Friedman’s commentary predictably focus on insurance coverage or government control, but some actually discuss EHRs, population health, healthy behaviors and payment incentives. That’s good. Still, those are just people who read Friedman and the Times. Hyperpartisan conservatives — probably even some hyperpartisan liberals, even though the ACA is more centrist than a lot of folks wish to admit — and the less-educated won’t read the column and won’t comment on the Times site. Those are the people who misunderstand this imperfect but occasionally reform-minded law the most.

 

May 27, 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.

Mostashari, Chopra get down to ‘Meaningful Yoose’ rap

Now it makes sense.

A couple weeks ago, I got the latest update from fictional EHR vendor Extormity:

Extormity to Federal Health IT Leaders – ‘Take a chill pill, fellas.’

Brantley Whittington, fictional CEO of make-believe electronic health record vendor Extormity, is urging Aneesh Chopra, Farzad Mostashari and Todd Park to tone down their optimism and exuberance about the clinical benefits and cost savings associated with implementing health information technology.

Whittington, speaking to reporters from the offices of a K Street lobbying firm in Washington, D.C., expressed dismay at the unbridled enthusiasm exhibited by White House, ONC and HHS officials. “For years, vendors like Extormity have worked hard to cultivate a healthcare IT culture that combines complexity with closed-mindedness, creating a pervasive and stifling sense of futility.”

“Instead of the sober and staid leadership we are accustomed to, these gentlemen are inspiring new models of industry development,” added Whittington. “The Direct Project is a great example of supercharged public/private collaboration designed to simplify the flow of health information without spending a dime of taxpayer money. This may benefit patients and providers, but the lack of convoluted infrastructure does little for the Extormity bottom line.”

“While I have been known to muster up some counterfeit fervor for shareholder meetings, the consistent passion and zeal demonstrated by these officials is proving disruptive to those of us dedicated to proprietary and expensive solutions,” added Whittington. “I suggest dialing back the levels on the gusto meter to preserve the status quo, stifle meaningful innovation and ensure consistent and sizable returns to a handful of large healthcare IT vendors.”

Chopra, Mostashari and Park are exuberant, that’s for sure. The first time I saw Park and Chopra share a stage together, I labeled them the “anti-bureaucrats.” I have since added Mostashari to that category. But it was only over the weekend that I learned that Mostashari and Chopra were getting down to the “Meaningful Yoose” rap from Dr. Ross Martin at a recent ONC meeting.

Here is the video of that spectacle, courtesy of John Lynn. (Unfortunately, I cannot find an embeddable version.)

Perhaps this is why Mr. Whittington wants the anti-bureaucrats to tone it down. Or perhaps (more likely) extormity feels threatened by innovation. Yeah, let’s go with the latter.

N.B. I am writing this while 33,000 feet above northeastern New Mexico, just about to cross into the Texas Panhandle, on a flight from Tucson to Chicago. I love me some Wi-Fi in the sky!

December 19, 2011 I Written By

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

Hyperbole doesn’t work in health IT

I’m still rather slammed with work, but I might as well take a few minutes to post on a Friday afternoon to call out someone else who’s pumping up the health IT hype beyond reasonable levels.

A publicist for UnitedHealth Group wanted me to attend yesterday and today’s New York eHealth Collaborative Digital Health Conference in New York City. Never mind the fact that I live in Chicago and the invite came in two days ago. To be fair, though, I was offered phone interviews. I declined based on the second paragraph in the e-mail:

This event is the first and only national summit dedicated specifically to advancing the role of health information technology (HIT). Hundreds of leading stakeholders and thought leaders from across the HIT space will gather under the same roof to discuss the latest technologies, achievements and challenges impacting the industry. HHS Chief Technology Officer Todd Park is the keynote speaker.

This is the first and only national summit dedicated specifically to advancing the role of health information technology, huh? Other than HIMSS, AHIMA, AMIA, AMDIS, CHIME, ANIA-CARING, iHT2, Health Connect Partners, HL7 and a few more, that is absolutely a true statement. Let’s not leave out the dearly departed TEPR, either.

I hope others didn’t fall for that ridiculous statement.

December 2, 2011 I Written By

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

Health Wonk Review, unadorned but chock full of health IT

In the latest edition of Health Wonk Review, hosted by Chris Fleming on the estimable Health Affairs blog, there’s not much in the way of a fun theme, but that’s OK. It’s still full of some good perspectives, including more than the usual share of health IT.

My post that aggregated a bunch of tweets from the Health 2.0 Conference made the biweekly blog carnival, as did a much longer-form way of covering the event, David Harlow’s series of video interviews. Harlow got 18 different people on camera, including HHS gurus Todd Park and Dr. Farzad Mostashari.

Elsewhere, patient advocate Jessie Gruman,  president and founder of the Center for Advancing Health, took on mobile apps as a means of changing patient behavior, Tom Lynch of the Workers’ Comp Insider blog discussed predictive modeling in healthcare claims administration and Healthcare Economist blog author Jason Shafrin wonders why patients don’t seem to care much about healthcare quality.

In particular, I invite you to share Shafrin’s short post, if for nothing more than a conversation starter.

October 13, 2011 I Written By

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

A public official with a sense of humor

It’s a good thing not all public officials are all work, no play. I’ve said for a couple of years that the tag team of federal CTO Aneesh Chopra and HHS CTO Todd Park are the anti-bureaucrats. (If you ever get a chance to see them speak together, take it.)

Add Doug Fridsma, M.D., Ph.D., the director of ONC’s Office of Interoperability and Standards, to that list. His Twitter account (@Fridsma) features a picture of himself as a Simpsons character. (Unfortunately, the place to do that, SimpsonizeMe.com, appears to be on hiatus.)

June 15, 2011 I Written By

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

Park defends plain-text format of ‘Blue Button’

Todd Park

Well, I guess everything else pales in comparison to the news late Sunday night that Osama bin Laden has been killed and that his body is in U.S. custody, but I had been meaning to bring you something from another part of the government. So now, nearly three hours after I sat down to start writing, here goes.

Remember back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was much ado about nothing because the add-on outputs data in plain, unstructured text that’s essentially useless when imported into an EHR? Well, government officials continue to defend it.

At the Microsoft Connected Health Conference last Wednesday in Chicago, HHS CTO Todd Park extolled the virtues of Blue Button, saying that it was a conscious decision on the part of the people behind the idea—particularly ex-Google and Microsoft star Adam Bosworth and author/Internet scholar Clay Shirky—to export patient information in untagged text format as a quick means of “liberating” data from proprietary systems. It then is up to the patient and his/her providers to decide what do do with the exported record.

“We decided that the burden shouldn’t have to be on the vendor to parse the data,” Park told me offstage.

Well, what do you think of that? Should Blue Button follow some established protocol that organizes data in discrete format like the Continuity of Care Record, Continuity of Care Document or Clinical Document Architecture, or is raw, unorganized text good enough?

UPDATE, 10:50 pm CDT: I found the rest of my notes and see that Park said 270,000 unique users have downloaded data through Blue Button, an average of three times each, even though the government hasn’t done much in the way of marketing. “Simplicity is the key,” he said.

 

May 1, 2011 I Written By

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