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The Davos of Health IT?

BELLAGIO, Italy—As promised, I am at Week 3 of Making the eHealth Connection at the Rockefeller Foundation‘s unbelievably gorgeous retreat and meeting center on the banks of picturesque Lake Como. (Full disclosure: The foundation is paying my travel expenses and providing me with room and board on the campus.)

I am one of perhaps three or four members of the media here this week, which features mostly separate conferences on electronic health records and on mobile health and telemedicine. The sessions are pretty fascinating, but also off the record. I’m only allowed to report on general concepts, not quote people directly from the open forum. I may approach individuals for on-the-record chats during breaks, however, and the plenary sessions are on the record.

I had a story yesterday in Digital HealthCare & Productivity about Monday’s keynote speech of Strive Masiyiwa, founder and chairman of South Africa-based Econet Wireless Group. Masiyiwa, a confidant of Zimbabwe opposition leader Morgan Tsvangirai and a Rockefeller Foundation board member, has been called the “Bill Gates of Africa,” at least according to his Wikipedia entry. This bit of trivia, which was not in the bio I was provided, neglects the facts that: Gates is a hardcore geek, not an entrepreneur, which is why he turned over the day-to-day leadership of Microsoft to Steve Ballmer; and the Bill and Melinda Gates Foundation is pouring billions of dollars into Africa. (For a discussion on the accuracy of Wikipedia, see Or just watch the video below.)

Now that most of my deadlines for paid gigs are out of the way, I’ve got some time to blog. I will have a podcast with at least one Rockefeller Foundation executive on this series of conferences, which I’m taking the liberty of dubbing the “Davos of Health IT.” In fact, Davos, Switzerland, is less than 100 miles from here. Or should I say less than 160.9 km?

July 30, 2008 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

I submitted my Kolodner podcast to Health Wonk Review, and the latest rundown of the healthcare blogosphere is up at the Health Business Blog, hosted by David Williams. Kudos to David for his succinctness. Now I’m no longer scared to volunteer to host one of these. Just not in the next couple of weeks, as I’m off to Italy on Saturday evening for the third week of the Rockefeller Foundation‘s “Making the eHealth Connection” conference series.

I do expect to blog some from the conference and do expect to submit some stories to my regular outlets while I’m there, so I won’t be completely incommunicado. I’m just not volunteering for any extra work until I get back on Aug. 5 (I’m not going all the way to Italy without taking a few sightseeing days for myself) and wrap up a few other lingering assignments. So there.

Thanks again, David, for a good HWR. However, I don’t get your “Manumussionaries” comment about my post. I see there’s a Healthcare Manumission blog on the list, but I still need further explanation.

July 23, 2008 I Written By

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

Get on board

Is it me, or is this the week for changing organizational boards?

Actually, not all the board news was about new members, nor did some of the changes just happen, but I seem to be getting a bunch of announcements or application solicitations this week.

Today, HIMSS announced that its new elected officers and board members took office July 1. Yes, the announcement was dated today:

Advancing the Adoption of Health IT, New HIMSS Board Members Take Office
Chuck Christian and Liz Johnson assume top positions on Board of Directors for the Healthcare Information and Management Systems Society

CHICAGO (July 23, 2008) – Focused on improving the delivery of patient care through health IT and management systems, new officers and elected members of the HIMSS Board of Directors took office on July 1.

Charles E. Christian, FCHIME, FHIMSS, and Liz Johnson, RN, MSN, FHIMSS, began their terms as chair and vice chair, respectively. They replace Chair John Wade, FCHIME, FHIMSS, and Vice Chair Victoria Bradley, DNP, RN, CPHIMS, FHIMSS.

HIMSS Board Chair: Mr. Christian is the director of information systems and CIO of Good Samaritan Hospital, a 100-year-old, free-standing acute care community hospital in southwest Indiana. He is serving his 19th year in this role and his 37th year in healthcare.

HIMSS Board Vice Chair: Ms. Johnson is vice president of applied clinical informatics for Tenet HealthSystem. She is responsible for the strategic vision and the tactical plan for all clinical systems used throughout Tenet’s 57 provider organizations. Under her leadership, Tenet has developed and is implementing a comprehensive clinical informatics vision and strategy. Ms. Johnson speaks nationally and internationally on clinical applications and their strategic use as a tool for enhanced patient safety.

Chair-Elect and Vice Chair-Elect: In recent elections by the board, Barry Chaiken, MD, MPH, FHIMSS, was selected as chair-elect, and Ms. Johnson was reelected as vice chair-elect.

Dr. Chaiken has more than 20 years of experience in medical research, continuous quality improvement, risk management and patient safety. As founder of his own company, he worked on quality improvement studies and clinical investigations for the National Institutes of Health, the Framingham Heart Study, and Boston University Medical School. Dr. Chaiken is board certified in General Preventive Medicine and Public Health as well as Health Care Quality Management.

New Board Members: Four new board members began their three-year terms on July 1.

David S. Finn is vice president and CIO/privacy and information security officer at Texas Children’s Hospital in Houston. Holly D. Miller, MD, MBA, FHIMSS, is the vice president and CMIO at University Hospitals in Cleveland, Ohio. Carol R. Selvey, MHSA, FHIMSS, is principal of The Revere Group, headquartered in Chicago. Charlene S. Underwood, MBA, FHIMSS, is director of government and industry affairs at Siemens Medical Solutions in Malvern, Pa.

New Nominating Committee Members: The following individuals began their two-year term on the Nominating Committee: Kathleen Covert Kimmel, RN, MHA, CHE, FHIMSS, vice president, nursing informatics, McKesson, Louisville, Colo.; Donald Levick, MD, MBA, CPHIMS, physician liaison, information services, Lehigh Valley Hospital, Allentown, Pa.; and Janet K. Stanek, FACHE-designate, RHIA, CPHIMS, FHIMSS, vice president, support services, and CIO, Stormont-Vail Healthcare, Topeka, Kan.

New Advisory Board Members: Two individuals began their terms on the Advisory Board: Michael J. McGill, PhD, Internet2, Health Sciences; Howard A. Burde, Esq., Blank Rome LLP.

et al.

The HIMSS Electronic Health Records Vendors Association also recently seated a new board. Justin Barnes, vice president of marketing and government affairs at Greenway Medical Technologies is now chairman, while Andy Ury M.D., Seattle-based chief medical officer of McKesson Physician Practice Solutions, is vice chairman.

The immediate past chair of the EHRVA, Don Schoen, CEO and president of MediNotes, was elected to the group’s executive committee. Others chosen for the committee include: Charlie Jarvis, assistant VP for healthcare industry services and legislative affairs at NextGen Healthcare Information Systems; Michele McGlynn, strategic manager in government and industry affairs for Siemens Medical Solutions; Charles Parisot, manager for architecture and standards at GE Healthcare; Rick Reeves, R.Ph., senior clinical manager of corporate development at Computer Programs and Systems Inc. (CPSI) in Mobile, Ala.; and Steve Tolle, Phoenix-based VP of product management for Allscripts.

Meanwhile, the AHIC Successor search team announced it was soliciting nominations for the board of the private-sector successor organization to the American Health Information Community panel that advises the secretary of Health and Human Services.

Nominations are being accepted through Aug. 4 at note, former Centers for Medicare and Medicaid Services Administrator Mark McClellan, M.D., in his current role as director of the Engelberg Center for Health Care Reform at the Brookings Institution, is leading the effort to establish the AHIC Successor.

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: Dr. Robert Kolodner on the national HIT strategy

I love the annual Association of Medical Directors of Information Systems (AMDIS) Physician-Computer Connection. It’s a chance to hear some of the smartest and most accomplished people in healthcare, namely medical informaticists, in a small, informal setting. This year’s event, held last week in beautiful, laid-back Ojai, Calif., featured an appearance by Robert Kolodner, M.D., the national coordinator for health information technology.

After Dr. Kolodner’s presentation—more of a Q&A with his peers in medical informatics—he graciously sat down for an audio interview with me. Here is the result.

Podcast details: Robert Kolodner, M.D., on the national health IT strategy. Recorded July 16, 2008, in Ojai, Calif. MP3, stereo, 64 kbps, 14.3 MB, running time 31:24.

0:40 Background on
national health IT strategic plan toward interoperable electronic health records
3:35 Goals of the plan
4:08 Distinction between “health” and “healthcare”
5:25 Explanation of “patient centeredness”
6:20 Physicians’ role in promoting patient centeredness
7:30 IT’s role
8:50 Population health
10:40 Why physicians should care about national IT strategy
12:55 Making the issue personal
13:35 Financial incentives for technology adoption
14:37 Incremental advances
16:18 Medicare e-prescribing incentives as one step in a series of improvements
17:30 Convincing healthcare organizations to cooperate
18:08 Greater public awareness about electronic health information
18:32 Privacy and security concerns, and coming framework
20:50 Convincing doctors to share data
22:10 Trial National Health Implementation Network implementations
22:55 Where physician IT leaders can make a difference
AHIC successor
25:25 Complexity of healthcare in the U.S. and abroad
27:18 Profound workflow changes from IT and maximizing skills of healthcare professionals
29:06 Possible effects of 2009 administration change
30:15 Health IT’s fundamental role in healthcare reform

July 22, 2008 I Written By

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

Behind the times?

OJAI, Calif.—I’ve just learned of the Society for Exorbitantly Expensive and Difficult to Implement EHR’s (SEEDIE), which describes itself as ” healthcare IT standards organization that is completely funded and operated by a select group of proprietary electronic health record vendors.”

According to this beautifully designed site, “Unlike independent, objective, professional organizations created to help medical professionals select and implement interoperable EHR solutions, SEEDIE promotes healthcare IT systems that play well in the sandbox if, and only if, it is in the best interests of a particular vendor.” A picture of a smiling young girl has nothing to do with EHRs, “but it does register a 10 on the warm and fuzzy meter.”

A fictional vendor called Extormity (“Expensive, Exasperating, Exhausting”) already has earned SEEDIE certification. The company’s logo depicts two intersecting highways with exit ramps that don’t actually connect to anything. I’m guessing there aren’t too many people laughing in executive suites of software companies in, say, Kansas City or Madison, or perhaps Alpharetta, Ga., Malvern, Pa., or Waukesha, Wis. Just throwing some town names out there.

This apparently is not new; the Extormity site has a 2003 copyright and SEEDIE has 2007. But I just found out about it from EHI Europe. A Google search on “seedie” turned up 11,200 results, including links to several other HIT blogs that have written about it. Where have I been?

July 17, 2008 I Written By

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

AMDIS notes

OJAI, Calif.—I’m at the Physician-Computer Connection, the annual symposium of the Association of Medical Directors of Information Systems (AMDIS), a high-level meeting of chief medical information officers and other leading medical informatics specialists. I’ll have a bunch on a couple of surveys on the attitudes, job functions and salary ranges of CMIOs and physician executives in IT, most likely in Digital HealthCare & Productivity in the next couple of weeks. (I need to pay for this trip, after all, and the recent run-ups in airfares, car rental costs and, of course, gasoline, are not helping my cause. But I digress.) Let’s just say a need for leadership skills is prominent.

I have plenty of other news and notes that are worthy of posting here, however.

For one, look out this fall for “Improving Medication Use and Outcomes with Clinical Decision Support: A Step-by-step Guide,” an update to the 2005 “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide.” According to lead author Jerry Osheroff, M.D., chief clinical informatics officer of Thomson Reuters Healthcare (formerly Micromedex), this one defines CDS as “providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care.” The guide will follow a modified set of the “five rights” for safe healthcare: The right information to the right person in the right intervention format through the right channel at the right point in the workflow, Osheroff says.

The new volume also involves many more industry stakeholders than the previous edition. It will carry the names of HIMSS, AMDIS, AMIA, the Institute for Safe Medication Practices and the Scottsdale Institute, and is sponsored by the Agency for Healthcare Research and Quality, two clinical IT vendors and two health systems. Osheroff didn’t name the vendors or health systems, but it’s a safe bet Thomson Reuters is involved.

Contrary to rumors, healthcare executive recruiter Betsy Hersher is not retiring, but she is shutting down her Hersher Associates firm and moving into consulting. At least a couple of her employees have taken jobs at Witt/Kieffer.

Earlier this week, I reported in Digital HealthCare & Productivity about the recent reorganization at Sage Software Healthcare. I since have learned that the company will be hiring a new, permanent CEO sooner rather than later. I’m guessing that means within a few weeks. I have no idea about who the candidates might be.

While I’ve been out here on the West Coast, the Medical Records Institute published a scathing critique of the national EMR strategy. That organization is working hard to market itself and stay relevant after a poorly attended TEPR conference a couple of months ago. This article certainly is an attention-grabber, listing the optimism about meeting the goal of getting interoperable EHRs to most Americans by 2014 among a number of “health informatics myths.”

If you want an impassioned defense of the national health IT strategy, check this space in the next 24 hours for my podcast with national health IT coordinator Robert Kolodner, M.D., who spoke at this conference yesterday. This might be my biggest podcast “get” to date.

I Written By

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

Global news

I’ve got some international items on the agenda today:

First off, did anyone catch the big “oops” in Australia this week that knocked out telecommunications services across the state of Queensland? Apparently, a backhoe at a construction site cut a cable that took phone lines down statewide, and a major backup system failed as well. The outage reportedly affected phone calls in and out of a number of regional hospitals, but what was not reported was whether any health IT infrastructure was affected. Perhaps that’s a problem in and of itself.

A couple of weeks ago, a health trust in Scotland had to declare a “data amnesty” to encourage employees to return a misplaced USB drive that reportedly contained the health records of 137 patients. Left unanswered is why the records were not secured before being transferred to the portable drive.

I hopefully will be reporting some international health IT news in a couple of weeks, as I’ve been invited to attend one week of the Rockefeller Foundation‘s “Making the eHealth Connection” conferences in Bellagio, Italy. Consider this a solicitation to editors looking for coverage of EHR and mobile-health issues in developing countries.

July 16, 2008 I Written By

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

Congress includes eRx in Medicare bill

Finally Congress has paid more than lip service to health IT. Late yesterday afternoon, the Senate approved the Medicare Improvements for Patients and Providers Act of 2008, halting the planned 10.6 percent physician fee rollback and, significantly, including financial incentives for physicians to move to electronic prescribing.

Reportedly, Sen. Edward M. Kennedy (D-Mass.), a strong advocate of health IT, surprised a lot of his colleagues by returning to the Senate in time for the vote, his first appearance there since his cancer surgery last month.

According to the eHealth Initiative, calls for bonuses of up to 2 percent for providers who use “qualified” e-prescribing systems for five years, beginning in 2009. Starting in 2012, providers would be subject to 2 percent penalties for not writing electronic scripts. The Department of Health and Human Services would have the option of adding a hardship exemption for certain providers.

This is not a done deal, however, as President Bush has threatened to veto the legislation over its proposed Medicare Advantage cuts. The bill passed the Senate by unanimous consent, but the eHealth Initiative says 69 senators voted in favor, making the margin veto-proof. The House vote on June 24 was 355-59, also enough to override a veto.

July 10, 2008 I Written By

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