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Podcast: Gartner’s Vi Shaffer on HIE, ACOs and meaningful use

Back in June, I covered the Wisconsin Technology Network’s Digital Healthcare Conference in Madison. That conference featured a panel with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner, Judy Murphy, vice president of information services at Aurora Health Care in Milwaukee, and Epic Systems CEO Judy Faulkner, based in nearby Verona, Wis.

The panel discussed the question, “Is meaningful use a floor or a ceiling?” as I reported for WTN News. The conference also featured several sessions on how business intelligence and health information exchange can support Accountable Care Organizations.

A month later, I saw Shaffer again at AMDIS Physician-Computer Connection meeting in Ojai, Calif. There, she presented preliminary data from Gartner’s annual survey of CMIOs. After the conference ended, I got a chance to sit down with Shaffer for this podcast. Since the fog and clouds finally lifted on the final day, we decided to record this outdoors at the beautiful Ojai Valley Inn, which is why you will hear some birds and other (human) creatures in the background. We don’t care, it was too nice to sit indoors.

We mostly discussed how HIE can support ACOs, but we also touched on meaningful use and health reform in this lively interview. Enjoy.

Podcast details: Interview with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner. Recorded July 15, 2011, in Ojai, Calif. MP3, mono, 64 kbps, 7.9 MB. Running time 17:14.

1:35 ACO as a business model and a fundamental change in the needs of patients (chronic disease)

3:00 Interoperability for care coordination 3:50 Will ACO model be better than disease management as it exists today?

4:50 Nature of proposed rules

7:30 Importance of innovation because “meeting the metrics is average.”

9:05 Is meaningful use a floor or a ceiling? Is an ACO a floor or a ceiling?

10:46 Ambulatory services growing faster than hospital services

12:38 “Oligopolies” in healthcare building interoperability and continuums of care

14:40 How far can you go with interoperability in this changing healthcare climate?

15:19 Targeted panel management rather than population health

Podcast: Anthelio’s Rick Kneipper on why current EMRs don’t improve quality

Why are physicians still resisting EMRs? Maybe it’s because systems aren’t easy to use and lack interoperability. That’s the hypothesis of Rick Kneipper, co-founder and chief strategy officer of Anthelio Healthcare Solutions, a Dallas-based business process services firm that until February was known as PHNS.

In my latest podcast, Kneipper joins me to discuss the shortcomings of current EMRs and current EMR policy, and offers his remedies for the problems. Give it a listen, then share your thoughts, too.

Podcast details: Interview with Rick Kneipper, co-founder and chief strategy officer, Anthelio. MP3, mono, 64 mbps, 12.7 MB. Running time 27:50

1:05 Why he thinks current EHRs aren’t meeting their promise of improving safety, quality and efficiency of healthcare
2:00 Money for meaningful use is starting to flow
2:30 Lack of interoperability in lower levels of in HIMSS Analytics EMR Adoption Model
3:35 Similar problems in meaningful use standards
4:15 No “silver bullet”
5:15 Per PCAST report, many EMRs create electronic versions of patient charts
6:25 Systems for creating billing documentation, not for improving care
7:05 Anthelio’s approach on workflow
7:55 Why aren’t we reengineering workflows?
9:10 Process doesn’t end when EMR goes “live”
10:05 Ultimate objective of meaningful use
10:43 Some physicians are just doing it for the money
12:15 Limitations of certification
12:45 Waiting on Stage 2 requirements
14:20 Caveat emptor and the rush to book revenue
15:33 Interoperability missing from Stage 1
16:00 Physician engagement in EMR selection
18:55 Usefulness of EMR data
20:45 Clinical decision support in MU
23:00 Patient safety compared to aviation safety
25:00 Public apathy toward patient safety
26:20 Advice to vendor community

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June 7, 2011 I Written By Neil Versel

Filed Under: EMR/EHR Healthcare IT patient safety podcast quality

Tags:Anthelio Healthcare Solutions interoperability usability

Podcast: mHealth Initiative’s Peter Waegemann

In 2009, after 25 years of moving “Toward an Electronic Patient Record” (TEPR), the Medical Records Institute disbanded and its founder, Peter Waegemann, shifted his focus to mobile healthcare by creating the mHealth Initiative.

TEPR had grown into a rather substantial event, peaking at 3,800 attendees in 2004, when newly appointed national health IT coordinator Dr. David Brailer was the featured speaker. But attendance and vendor square footage rapidly declined after that, as much of the action in the realm of EMRs either moved to medical specialty societies or the huge HIMSS conference.

Taking a more content-driven than vendor-driven approach, the mHealth Initiative has tried its hand at conferences since last year. (I spoke and served on a panel at the organization’s 2nd mHealth Networking Conference last fall.) A week ago, the group held its third such event in that paradise for lovers of jet noise, Rosemont, Ill., and I sat down with Waegemann to record this podcast.

Podcast details: Interview with Peter Waegemann, chairman and founder of the mHealth Initiative. Recorded March 30, 2011, at the mHealth Initiative’s 3rd Networking Conference in Rosemont, Ill. MP3, mono, 64 kbps, 6.0 MB. Running time 26:02.

0:20     Transition from e-health to m-health after 25 years of running TEPR
1:50    “Total paradigm shift” for documenting and accessing information at the point of care
2:20     No country he’s seen has a complete, effective EMR yet
2:40    Movement from an industrial society to an “information society” of knowledge workers
4:40    Beyond voice communications
6:20    Behavior change in healthcare and adapting to technology
7:20    Lack of connectivity among mobile devices and shortcomings in current technology
8:55    The politics of standards for m-health devices and systems
10:40    Always “five years away”
11:20    Searching for the iPhone of home monitoring
12:00    iPad’s role in healthcare and its shortcomings
13:00    Apps
14:20    EMR vendors discovering mobile devices
15:25    Distinctions between wired health, wireless health and connected health
15:50    “Three pillars” of m-health
16:40     “Communication-enhanced healthcare”
17:35    Better care for less money
19:05    Cell phones in hospitals
20:30    Integration issues
21:00    Patients and younger physicians driving change
22:00    “Unified communications”
22:42    Payment for home monitoring
24:30    European approaches to m-health

Podcast: HIMSS CEO Steve Lieber

The 2011 HIMSS conference gets underway this weekend in Orlando, Fla. For the fifth year in a row, I interviewed HIMSS President and CEO H. Steven Lieber to preview the annual conference. Check Health Data Management’s HIMSS microsite now and MobiHealthNews next week for write-ups of parts of this interview, but this is the only place you can hear the whole thing.

The audio is pretty clear, but you may hear faint music in the background. The recorder seems to have picked up some radio interference. That’s not entirely unexpected in a downtown Chicago office building, namely HIMSS headquarters at 230 E. Ohio St. Ah, well. Enjoy the podcast, and I’ll see you in Orlando.

Podcast details: Interview with HIMSS CEO Steve Lieber. MP3, stereo, 128 kbps, 30.6 MB. Running time 33:26

0:30 Attendance “well in excess of 30,000”
1:00 Increasing interest in health IT because of meaningful use
1:35 ICD-10 and 5010 somewhat “sidelined” but still important
2:40 The march toward meaningful use
3:00 25 percent of membership already at Stage 1 meaningful use
4:20 “Uncertainty” about future stages replacing confusion about what Stage 1 meaningful use is
5:15 Questions about whether early Stage 1 attestation shortens the timeline for Stage 2
6:00 Efforts by some new members of Congress to repeal or cut funding to HITECH
7:30 Questions about meaningful use he hears from HIMSS members
8:40 Balancing meaningful use with 5010 and ICD-10 compliance efforts
12:00 Incentives from private payers
12:40 Quality vs. cost savings
14:00 Public perception of healthcare reform
16:10 PPACA hasn’t had time to make an impact yet
16:55 Expectations for David Blumenthal’s HIMSS keynote and politicization of health IT
19:10 Speculation about next national coordinator?
21:25 New, parallel HIT X.0 conference-within-a-conference
24:30 Mobile and wireless technology at HIMSS and in healthcare
27:10 Hype cycle in mobile apps
28:10 Home care and telehealth reimbursement
30:00 Technology and ACOs
31:00 Berwick speaking at HIMSS this year after several previous attempts to get him

Podcast: SRSsoft CEO Evan Steele

One of the more interesting figures in health IT is Evan Steele, the outspoken CEO of ambulatory EMR vendor SRSsoft. For years, Steele pushed his Montvale, N.J.-based company’s “hybrid” EMR as a product that won’t slow down “high-performance” physicians. After passage of the American Recovery and Reinvestment Act in 2009, Steele openly boasted that his customers—mostly specialists—were prepared not to receive bonuses for “meaningful use,” a program he believes is skewed toward primary care.

Recently though, Steele has shifted his stance. SRSsoft has rebranded “hybrid” EMR as SRS EHR and now is seeking certification so customers can qualify for the federal incentive program. What makes Steele tick and what led to his change of heart? This podcast provides some answers.

I apologize for the audio quality. I was using a new telephone recording device, and clearly don’t have the settings right. I edited this on an airplane, and the recording was tolerable. Just listen with a bunch of background noise and it’ll be fine. :)

Podcast details: Interview with Evan Steele, CEO of SRSsoft. MP3, stereo, 128 kbps, 27.8 MB. Running time 28:22.
0:57 “Hybrid” EMR and physician productivity
1:40 Change in direction for the company with certification
2:15 What has and hasn’t changed with the product itself
3:10 Still targeting “high-performance” physicians
5:25 Why he says SRS EHR won’t slow physicians down
6:40 Documentation options
7:30 Why he believes Stage 1 meaningful use is skewed toward primary care
9:40 Changes in final regulations that focus on specialists
10:35 Why SRS is seeking certification now
13:00 Differences between SRS and other vendors
14:00 Physician confusion about meaningful use
15:40 “Unnatural” elements for specialists in meaningful use
16:30 Innovation being “sapped” from marketplace
17:00 Gamble of the stimulus
18:15 How SRS is innovating within the confines of the new rules
20:00 Expectations for HIMSS11
22:05 What SRS gets out of going to HIMSS
23:30 SRS’ niche among large, enterprise systems vendors
26:20 Message for HIMSS attendees

Video: Overview of mobile healthcare technologies

I haven’t done much with my YouTube page since I launched it last month, but here’s some new video of me, courtesy of Nuesoft Technologies. Nuesoft hosts a podcast series, and they recently invited me, along with Health Data Management Editor-in-Chief Greg Gillespie to discuss mobile healthcare technologies. We all had webcams, so the result is this YouTube video.

In a bit of serendipity, Gillespie happened to be looking for freelance help with HDM’s HIMSS Microsite, a collection of articles previewing HIMSS11. My first story should be up within the next hour.

Podcast has been fixed

There was a problem with the podcast I posted a few days ago from September’s mHealth Initiative conference. The file has been fixed and everything should be working fine at this link.

Thanks for your patience.

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November 5, 2010 I Written By Neil Versel

Filed Under: mobile podcast

Tags:mHealth Initiative

Podcast: Panel discussion on mobile healthcare

Nearly two months ago, I was honored to be a participant in the closing panel session at the mHealth Initiative’s 2nd mHealth Networking Conference in San Diego. I happened to record the audio of that session directly off the sound board. I present that recording here.

Other participants on the panel, which addressed hype vs. reality in mobile healthcare, were: C. Peter Waegemann, mHealth Initiative founder; John Mattison, M.D., CMIO of Kaiser Permanente; and Paulanne Balch, M.D., physician lead for KP Health Connect messaging.

You should know my gravelly, hesitating voice by now. The man with the German accent is Waegemann and the other male voice is Mattison’s. Obviously, the female voice belongs to Balch, though mHealth Initiative President Claudia Tessier makes a couple of appearances.

Podcast details: Panel discussion from mHealth Initiative 2nd Networking Conference on hype vs. reality, featuring Neil Versel, Peter Waegemann, Paulanne Balch, M.D., and John Mattison, M.D. Recorded Sept. 9, 2010. MP3, stereo, 128 kbps, 77.6 MB, running time 1:21:26.

0:00 Intro (Waegemann)
0:45 Hype around untethered PHRs (Versel)
2:40 PHRs and projections for future (Mattison)
5:50 Why there’s hype (Versel)
7:15 Consumer perspective on connectivity (Balch)
8:15 “Mind-blowing” applications in m-health (Waegemann)
8:50 iPhone replacing the stethoscope (Versel)
9:45 M-health as the “horseless carriage” (Balch)
10:25 What problem m-health addresses and what’s missing (Mattison)
12:10 Power of text messaging (Versel)
12:55 Patients texting during exams (Balch)
13:35 Audience question: What’s next after m-health
13:55 M-health is an enabler (Waegemann)
15:15 Too much unfiltered information (Mattison)
16:55 Movement to a knowledge-based society (Waegemann)
18:00 Machine-data interactions, escalated to experts as needed (Mattison)
19:00 Vision of personalized shopping experiences to choose healthy food (Balch)
19:45 Evolution of information sharing in healthcare (Waegemann)
21:40 How computers have changed teaching to focus on heuristics (Mattison)
23:15 Understanding context (Versel)
24:10 How m-health will change health information management (Waegemann)
24:35 The evolution of transcription and HIM (Claudia Tessier)
26:30 Changes in how information is collected (Balch, Mattison)
27:30 What you can’t find on the Internet (Mattison)
28:15 Audience comment: The future will favor those who can integrate information
28:55 Different types of information processing (Mattison)
29:30 Audience question: Where does consumer trust come from in healthcare?
31:25 Loss of collegiality due to EHRs and text messaging (Mattison)
33:45 Trusted entities (Mattison)
35:40 Generational differences in trust of doctors (Versel)
37:40 Lessons from early adopters (Balch)
39:25 Migration away from direct social contact (Mattison)
41:00 Systems for patients to describe their conditions (Waegemann)
41:50 Clinical Document Architecture to handle structured and unstructured data (Mattison)
44:35 Gaming for better health (Balch/Mattison)
45:50 Audience question: How much leadership does Kaiser show in this area?
46:30 Aneesh Chopra’s visit to KP’s Garfield Center (Mattison)
48:20 Can other organizations close the digital divide? (Waegemann/Mattison)
49:45 Kaiser looking at open-source technology (Mattison)
50:25 Power of text messaging and social networking (Balch)
50:50 Encouraging healthy behavior through information (Waegemann)
51:40 Embracing basic mobile technologies (Versel)
53:25 Mobile is changing economics of healthcare (Mattison)
54:30 Consumers equating more care with better care (Versel)
55:30 Technology vs. cultural attitudes (Mattison)
56:15 Audience comment: Fee-for-service model needs to change
56:40 Kaiser vs. fee-for-service model (Mattison)
58:20 Audience question: What is boundary between health/fitness and clinical/therapeutic apps?
59:25 Standards for evidence-based medicine (Mattison)
1:02:15 Audience question: How do you accelerate cycle time for discovery?
1:02:35 EHR as an observational, enrollment and tracking tool (Mattison)
1:04:00 Consumers will drive app acceptance (Balch)
1:04:20 User interfaces (Waegemann)
1:04:55 No comment (Mattison)
1:05:10 Audience question: Will mobile widen digital divide between healthcare and “enemies” of population health?
1:07:05 Who is custodian of individual data? (Mattison)
1:08:20 Knowing consumer preferences (Balch)
1:08:40 Wish list for m-health (all panelists and some audience members)
1:20:10 “Journey” of mobile health (Waegemann)

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October 29, 2010 I Written By Neil Versel

Filed Under: mobile podcast

Tags:Kaiser Permanente mHealth Initiative

Podcast: HIMSS CEO Steve Lieber, 2010 edition

Last Thursday, for the fourth consecutive year, I sat down with HIMSS CEO H. Stephen Lieber for an interview ahead of the opening of the annual HIMSS conference. For the third consecutive year, the recording actually worked. And for the second consecutive year, I went to HIMSS headquarters in downtown Chicago for the interview, rather than waiting for the conference itself. Unfortunately, the HVAC system in the conference room was rather noisy, so there is some background noise. Still, the voices come through loud and clear.

I wrote a story based on this interview in Monday’s FierceHealthIT, but here is the world premiere of the full recording.

Podcast details: Interview with HIMSS CEO H. Stephen Lieber on the 2010 HIMSS conference, recorded Feb. 18, 2010. MP3, stereo, 128 kbps, 31.7 MB, running time 34:36.

1:00 State of the HIT industry a year after ARRA
2:20 HIMSS10 registration patterns
5:00 Types of vendors exhibiting this year
6:30 Mobile applications
8:20 HIPAA, 5010 and ICD-10
10:15 Health IT’s role in healthcare reform
13:45 Health IT alone can’t fix healthcare
15:40 Getting the word to physician practices about meaningful use
17:55 Hospital-based physicians and meaningful use
19:15 Pressure to achieve meaningful use
20:15 Why HIMSS doesn’t support weakening of requirements
21:40 Health IT workforce issues
25:10 Hiring IT professionals laid off from other industries
26:40 The future of certification
30:00 Clinical decision support comes of age
31:55 Focus of the 2010 conference

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February 22, 2010 I Written By Neil Versel

Filed Under: ARRA health reform HIMSS HIPAA meaningful use mobile podcast

Tags:certification health IT workforce ICD-10

Podcast: TriZetto’s Jeff Margolis

Jeff Margolis, founder, chairman and CEO of The TriZetto Group, has written a book, called “The Information Cure.” In it, Margolis discusses his vision for “integrated healthcare management,” the combination of information technology and process improvement on both the administrative and clinical sides of healthcare to change deeply ingrained behaviors.

We recorded this way back on Sept. 10, the day after President Obama pitched his healthcare bill to a joint session of Congress, and I unfortunately sat on this recording for more than four months. The legislation may have changed considerably since then—and may be headed for the trash heap anyway—but the problems plaguing healthcare in the U.S. persist. Thus, I present this podcast, still as fresh as the day it was made.

Podcast details: Interview with Jeff Margolis of The TriZetto Group. MP3, stereo, 64 kbps, 16.4 MB, running time 35:54

0:25 Integrated healthcare management
2:05 Health reform and quality of care
3:20 The book’s consumer focus
4:40 Collection of massive amounts of administrative data
5:25 Fragmentation of data
6:20 Payers managing “healthcare supply chain”
7:15 Using information to identify “value-based benefits”
8:00 Consumers and cost, prevention and chronic diseases
9:20 Physicians and “value-based reimbursement”
11:10 Slow diffusion of information in healthcare
12:05 Physicians clueless about what things cost patients
13:50 Price transparency to consumers
14:30 Real-time claims adjudication/eligibility checking
15:50 Thoughts on the stimulus
17:15 Avoiding “digital silos”
19:10 No single, right answer in health reform
20:30 Assembling “virtual supply chains,” like Amazon
21:30 EHRs in the big picture
22:20 Patient as the aggregator
24:15 Vision for new eligibility transactions
26:15 Data enabling physician cash flow
27:50 Role of personal health records
28:30 His definitions of EMR, EHR, PHR
30:10 Why EHR vendors are “overreaching”
31:05 Organizing principles of health information exchange
33:05 Patients vs. consumers
34:45 Takeaway message of the book

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January 22, 2010 I Written By Neil Versel

Filed Under: health reform podcast

Tags:Jeff Margolis TriZetto

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Podcast: Gartner’s Vi Shaffer on HIE, ACOs and meaningful use

Podcast: Anthelio’s Rick Kneipper on why current EMRs don’t improve quality

Podcast: mHealth Initiative’s Peter Waegemann

Podcast: HIMSS CEO Steve Lieber

Podcast: SRSsoft CEO Evan Steele

Video: Overview of mobile healthcare technologies

Podcast has been fixed

Podcast: Panel discussion on mobile healthcare

Podcast: HIMSS CEO Steve Lieber, 2010 edition

Podcast: TriZetto’s Jeff Margolis

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