InformationWeek Stories by Neil Versel

InformationWeek Stories by Neil Verselhttp://www.informationweek.comInformationWeeken-usCopyright 2012, UBM LLC.2013-05-22T10:19:00ZMedicare Proffers $1 Billion For Healthcare Innovation ProjectsFederal health agency offers funding for new models of nonhospital care that cut federal health expenditures, improve health of specific patient populations.http://www.informationweek.com/healthcare/policy/medicare-proffers-1-billion-for-healthca/240155363?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>  The U.S. Centers for Medicare and Medicaid Services (CMS) will spend as much as $1 billion on a second round of innovation awards for projects that show strong potential to reduce costs and improve care for Medicare, Medicaid and Children's Health Insurance Program (CHIP) patients outside hospital environments. "CMS is interested in finding models that change the way we deliver care in America," CMS spokesman Alper Ozinal told InformationWeek Healthcare. "These awards are designed to test models." While a <a href="http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Project-Profiles.html">previous round of 107 innovation awards</a> in 2012 were general in nature, this time CMS is seeking to fund projects that test care-delivery models in four categories: -- reducing government healthcare expenditures in outpatient and post-acute settings; -- improving care for populations with specialized needs; -- helping certain categories of providers transform their financial and clinical models; and -- improving population health. [ Mobile apps can help patients track, improve their health. See <a href="http://www.informationweek.com/healthcare/mobile-wireless/10-mobile-health-apps-from-uncle-sam/240145790?itc=edit_in_body_cross">10 Mobile Health Apps From Uncle Sam</a>. ] "These Innovation Awards will be given to organizations whose creative solutions to our most pressing healthcare challenges have the potential to serve as models for improving care and lowering costs across the country," Dr. Richard Gilfillan, director of the Center for Medicare and Medicaid Innovation (CMMI) within CMS, wrote in a <a href="http://blog.cms.gov/2013/05/15/administration-announces-1-billion-initiative-to-provide-better-health-care-and-lower-costs/">blog post explaining the program</a>. "As with last year's awards, we're seeking out innovative practices that have a high likelihood of delivering better care and lower costs on a national scale. The last few years have seen us make tremendous strides towards keeping healthcare spending in check, and a lot of that is thanks to innovations that have helped improve the quality and efficiency of care delivery and payment systems." In its official <a href="http://innovation.cms.gov/Files/x/HCIA-Two-FOA.pdf">funding announcement</a>, CMS encouraged models that employ technologies such as data analytics, health information exchange, telemedicine and clinical decision support, but with an important caveat. "Award dollars may be used to implement specific technology, software applications or other analytical tools, but only if they are being implemented and tested in the context of a healthcare service delivery model that has a clear pathway to a payment model," CMS said. Specifically, CMS is looking for models that boost performance of physician specialties and subspecialities and for pediatricians serving "children with complex medical issues." Programs should include mechanisms for shared decision-making to get Medicare, Medicaid and CHIP enrollees -- as well as their families and caregivers -- more involved in their own care. Special populations CMS would like to focus on include children in foster care, children at high risk of dental disease, adolescents in crisis, people with Alzheimer's disease and HIV/AIDS patients, according to the funding announcement. For population health, CMS will consider projects that define communities by geography, disease state or socioeconomic status. The federal agency will give priority to models and programs that address prevention and control of cardiovascular disease, hypertension, diabetes, chronic obstructive pulmonary disease, asthma and HIV/AIDS, as well as the promotion of healthy behaviors that can reduce risk of developing chronic diseases. These goals seem aligned with the <a href="http://www.informationweek.com/healthcare/interoperability/interoperable-it-crucial-for-accountable/232600731">Triple Aim</a> of producing better patient outcomes and improved population health at a lower cost -- a concept devised by former CMS administrator Dr. Donald M. Berwick when he headed the private-sector Institute for Healthcare Improvement (IHI). However, CMS is not using the Triple Aim moniker with this challenge. CMS plans on handing out about 100 awards in this round, ranging in size from $1 million to $30 million each, though the agency is not required to disburse all the money or have a minimum number of winners. The funding comes from an appropriation in the Patient Protection and Affordable Care Act, the 2010 healthcare reform legislation often called Obamacare. The Medicare agency will accept letters of intent to apply from June 1 to 28 and applications may be submitted between June 14 and Aug. 15. CMS expects to announce the winners in two phases next January, and the three-year award period will begin April 1, 2014.2013-05-17T10:19:00ZHealthcare Reform Too Focused On Doctors: Telemedicine PioneerHopkins physician Jay Sanders, known as the father of telemedicine, says emphasis should be on changing patient behavior.http://www.informationweek.com/healthcare/interoperability/healthcare-reform-too-focused-on-doctors/240155122?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>  Policy-makers are going about healthcare quality improvement all wrong. They are focusing too much on physicians rather than on the behavior of patients that lead to so much illness, according to a longtime advocate of telemedicine and telehealth technologies. But practitioners also need to let go of the attitude that they know what is best for patients, said Johns Hopkins School of Medicine physician Dr. Jay Sanders. "The real change we need to effect is the consumer," said Sanders, who, as president and CEO of McLean, Va.-based The Global Telemedicine Group, chair of the technology board at Vesalius Ventures and a founding board member of the American Telemedicine Association, is widely known as the "father of telemedicine." He said so many reform efforts are aimed at changing physician behavior when the patient is the real barrier to better health. "They never look in the mirror and see the No. 1 problem," Sanders said of patients. "It's not the doctor's fault that the patient continues to smoke or eat cheeseburgers every day." [ Meet the folks who are making a difference. Read <a href="http://www.informationweek.com/healthcare/leadership/20-health-it-leaders-who-are-driving-cha/240154651?itc=edit_in_body_cross">20 Health IT Leaders Who Are Driving Change</a>. ] For this reason, Sanders is no fan of the idea of <a href="http://www.informationweek.com/healthcare/clinical-systems/pay-for-performance-make-healthcare-metr/232500544">pay-for-performance</a>. "What a ridiculous program," he scoffed in a recent interview, explaining that such ideas penalize doctors for the unhealthy habits of their patients. "I look at them as taking money out of my pocket because of their behavior," Sanders said. Instead of penalizing providers for the unhealthy habits of their patients, Sanders said the health system should provide incentives to get healthy -- which many companies and payers offer as employee and member wellness programs. There also can be a "stick" in the form of higher insurance premiums for people who do not take care of themselves. "We need to get the patient to embrace it," Sanders said. Sanders sees the <a href="http://www.informationweek.com/healthcare/patient/healthcare-patient-engagement-remains-el/240153526">requirement in Stage 2 Meaningful Use</a> that 5% of patients log into and upload data via a portal or personal health record in the same light as pay-for-performance. "It's putting the onus on the physician for the patient's behavior," he said. One form of telehealth, namely remote patient monitoring, could go a long way to making patients and clinicians alike more aware of health problems, according to Sanders, who chairs the Federal Communications Commission's Rural Health Care Committee and is on the executive committee of the board of directors of the Friends of the National Library of Medicine. "We need to bring the exam room to where the patients are," Sanders said. Taking blood pressure in the sterile, confined environment of a clinic fails to replicate the stress people face in the real world, he explained. The same is true with measuring lung function in a medical office. "They're not breathing the air in our office all day," Sanders said. Sanders also said the national push to computerize medical records has not made much of a difference in terms of better quality because there are no true standards for practicing medicine. "I often say in my talks that the electronic medical record is dangerous to your health," noted Sanders, who spoke at the ATA annual conference this month in Austin, Texas. "Nobody is looking at the integrity of the data acquired." Additionally, physicians still skate by on their credentials and their reputations, in no small part because patients judge doctors on name only. "That's Jay Sanders. He's professor of medicine at Johns Hopkins," Sanders said somewhat mockingly of his own reputation. "There is a reality that many of my colleagues have trouble accepting, and that's the fact that there are no standards," Sanders said. "Each individual doctor is his or her own standard." Physicians simply cannot and do not stay up to date on changes in medical knowledge without clinical decision support, he noted, echoing what <a href="http://www.informationweek.com/healthcare/leadership/informatics-pioneer-says-healthcare-need/240150506">health IT pioneer Dr. Lawrence Weed</a> has been saying for close to 60 years. "The way you bring collective expertise to the bedside," Sanders said, "is to use predictive analytics and use artificial intelligence."2013-05-09T11:05:00ZKolodner Joins Telehealth Firm ViTel NetFormer national health IT coordinator moves to the vendor side, aims to use high-speed mobile data infrastructure to give patients more care options.http://www.informationweek.com/healthcare/leadership/kolodner-joins-telehealth-firm-vitel-net/240154561?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/ss01081310mobilehealthappsunclesam/240145790"><img src="http://twimgs.com/informationweek/galleries/automated/937/01_Opening_Image_tn.jpg" alt="10 Mobile Health Apps From Uncle Sam" title="10 Mobile Health Apps From Uncle Sam" class="img175" /></a> <div class="storyImageTitle">10 Mobile Health Apps From Uncle Sam</div>(click image for larger view and for slideshow)</div> Former national health IT coordinator Dr. Robert Kolodner has been named VP and CMO of <a href="http://www.vitelnet.com/">ViTel Net</a>, a McLean, Va.-based telehealth and mobile health services company. This is his first venture into the vendor world after more than three decades of government service and, more recently, work with an open-source health IT software. But in some ways, the move represents a return to an earlier point in his career -- and the maturation of the telehealth market. Kolodner coordinated telehealth at the U.S. Department of Veterans Affairs (VA) in the mid-1990s, promoting the technology and explaining its potential to Congress. "It's fun to come back around … at time when it's ready to move to that next level of adoption," Kolodner told InformationWeek Healthcare this week at the American Telemedicine Association (ATA) annual conference in Austin, Texas. ViTel Net offers several kinds of telehealth technologies, including mobile telemedicine kits for first responders, mobile patient monitoring, online patient visits and traditional telemedicine service between fixed points. ViTel Net's founder and CEO, Allen Izadpanah, just completed a term on the ATA board of directors. [ What can healthcare learn from the airline industry? Read <a href="http://www.informationweek.com/healthcare/leadership/himss-should-healthcare-be-more-like-air/240150017?itc=edit_in_body_cross">HIMSS: Should Healthcare Be More Like Airline Industry?</a>] "I didn't expect myself to be joining a technology company," Kolodner said, but now he sees the landscape has changed even from when he left ONC in 2009. He pointed out that the infrastructure of high-speed mobile data and video technology is in place so telehealth can flourish on smartphones, tablets, and wireless monitoring devices. "[This new infrastructure] lets people get care anywhere, anytime." "This particular technology can help accelerate the shift from provider-centric to patient-centric healthcare," Kolodner explained. "Healthcare was patient-centric when doctors made house calls. This enables us to actually make virtual house calls." In many ways, this is similar to the current state of electronic health records (EHRs). Kolodner ran ONC from September 2006 until April 2009, in the pre-Meaningful Use days, when the office, created in 2004, really was just getting up to speed. Now, as providers nationwide achieve Stage 1 of Meaningful Use, the infrastructure is being built for transforming care in future stages of the federal EHR incentive program. It also mirrors some of the work Kolodner did at the VA, where he was chief health informatics officer, directing development of the Veterans Health Information Systems and Technology Architecture (VistA) EHR and the related My HealtheVet patient portal before being <a href=" http://www.informationweek.com/us-government-names-new-interim-health-i/193004192">named interim ONC chief</a>. (Kolodner got a permanent appointment in April 2007, and stepped down two years later when Barack Obama named Dr. David Blumenthal to the post at the beginning of his presidency.) Kolodner recalled conversations he had between 2000 and 2002 with Gary Christopherson, then the CIO of the VA's Veterans Health Administration, about giving VA beneficiaries the ability to ask health questions online at 3 a.m., get an answer, and be back in bed by 3:10. Today, telehealth is an integral part of care at the VA. A year ago, the department eliminated the copayment for patients of VA health who receive care at home by videoconference from VA health professionals. This year, the Obama administration is asking Congress to appropriate $460 million for home telehealth, 4.4% more than in 2012. In the private sector -- and with ViTel -- Kolodner foresees the telehealth rapidly becoming "parallel to the choices now available in banking," where customers have all kinds of options, including ATMs, the telephone, online, mobile apps and in-person service, thanks to the Internet and the mobile data infrastructure. "We're really going to give people more choice about where and how they engage with the healthcare system," he said.2013-05-07T11:18:00ZUniversity of Kentucky HealthCare Revamps Order SetsKentucky health system beta-tests Elsevier authoring tool as it streamlines a decade of CPOE history.http://www.informationweek.com/healthcare/cpoe/university-of-kentucky-healthcare-revamp/240154327?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ 9-mobile-ehrs-compete-for-doctors-attent/240144143"><img src="http://twimgs.com/informationweek/galleries/automated/923/mobile_doc_i mage_175.jpg" alt="9 Mobile EHRs Compete For Doctors' Attention" title="9 Mobile EHRs Compete For Doctors' Attention" class="img175" /></a> <div class="storyImageTitle">9 Mobile EHRs Compete For Doctors' Attention</div> (click image for larger view and for slideshow) </div> University of Kentucky HealthCare was an early adopter of computerized physician order entry (CPOE), starting in 2003, when the Leapfrog Group, representing large, corporate purchasers of healthcare, was <a href=" http://www.psqh.com/julaug08/cpoe.html">widely promoting CPOE</a> as a "leap" hospitals should take to improve patient safety. It turns out that CPOE implementation is exceedingly difficult. A "big bang" rollout at Cedars-Sinai Medical Center in Los Angeles failed in early 2003 after medical staff rebelled, refusing to use the poorly planned system. It took eight years for Cedars to successfully implement CPOE. Research also has shown that <a href=" http://www.informationweek.com/computerized-systems-can-cause-new-medic/159400302">CPOE can introduce and magnify errors</a> without proper precautions. UK HealthCare did not have those types of problems, according CMIO Dr. Carol Steltenkamp. "Sometimes it's better to be lucky than good," she joked. [ The first speech-enabled mobile CPOE app shows promise, but has a ways to go. Read more at <a href=" http://www.informationweek.com/healthcare/cpoe/first-speech-enabled-mobile-cpoe-lacks-d/240150952?itc=edit_in_body_cross">First Speech-Enabled Mobile CPOE Lacks Decision Support</a>. ] But after nearly a decade of CPOE usage, UK HealthCare had amassed a large, redundant, and occasionally contradictory list of order sets. "We have too dang many," Steltenkamp told InformationWeek Healthcare. Now, the organization is updating its technology as a beta customer of <a href=" http://www.clinicaldecisionsupport.com/inorder">Elsevier's InOrder</a> cloud-based system for creating and managing order sets. Elsevier launched the service in late February, just before the start of the 2013 Healthcare Information and Management Systems Society (HIMSS) conference. Steltenkamp, a pediatrician who practices part-time, has enlisted clinical teams to identify and address duplicate order sets and to augment the make sure the resulting order sets are supported by appropriate medical evidence. "I call it making the sausage of making the order set," Steltenkamp said. InOrder allows for asynchronous participation of clinicians in the editing process, Steltenkamp says. "It puts standardization around the work processes," she explained. "You can assign tasks and the amount of time each person has to author [order sets]." Elsevier is a publisher of medical evidence, and the system makes it easy to link that content to order sets, according to Steltenkamp, providing clinical decision support at the time of order entry. When the effort started, UK HealthCare had nine order sets related to stroke care across its main UK Chandler Hospital, the adjacent Kentucky Children's Hospital and the community-based UK Good Samaritan Hospital, according to Steltenkamp. "We have now condensed that to two order sets, and we have evidence behind it," she reported. But the health system really is in the early stages of it CPOE revamp across many medical conditions and treatment protocols. "We just started going through the first dozen or so," Steltenkamp said. "We're just learning how to do it." Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/040113hc/?k=axxe&cid=article_ax xt_os">The Right Health IT Priorities?</a> issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)2013-05-01T11:44:00ZRx Abuse Data Tools Sought By HealthcareDoctors, pharmacies could more easily join fight against drug diversion if states followed uniform data rules, says standards organization NCPDP.http://www.informationweek.com/healthcare/interoperability/rx-abuse-data-tools-sought-by-healthcare/240154001?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div> A standards development organization focused on pharmacy services is calling on state governments and the healthcare industry to adopt a common communications process to apply existing data in the fight against prescribing fraud and abuse of prescription drugs. "<a href="http://ncpdp.org/ind_WP.aspx">An integrated workflow solution</a> to provide a streamlined, standard communication process would enhance the ability of the health care provider to address the epidemic and mitigate patient care risks," reads an action plan to adopt standards for prescription drug monitoring programs, detailed in a white paper from the National Council for Prescription Drug Programs (NCPDP). "The current prescription monitoring communication process is outside the workflow process and systemically burdensome. It does not effectively provide information in a timely manner or evaluations across all state lines and across all pharmacies." The recommendation for standardization includes a call for a "nationally recognized clinical risk score" to help prescribers and pharmacies assess whether a patient might be abusing prescription drugs. [ Find out how pharmacies are working toward interoperability. Read <a href="http://www.informationweek.com/healthcare/interoperability/ehr-vendors-pharmacy-chains-pump-up-sure/240144396?itc=edit_in_body_cross">EHR Vendors, Pharmacy Chains Pump Up Surescripts Network </a>. ] The paper grew out of an NCPDP focus group held in October 2012 that included representatives of pharmacies, pharmacy benefit managers, health IT vendors, the U.S. Department of Justice's Drug Enforcement Agency (DEA), state and federal regulators, and the Mitre Corp., a research and systems engineering organization. NCPDP subsequently convened a task group, wrote the paper, and delivered the report to the Office of the National Coordinator for Health Information Technology (ONC) within the U.S. Department of Health and Human Services (HHS). NCPDP published the document in March but just started publicizing it. Law enforcement agencies in particular are concerned about the safety consequences of diversion of addictive prescription drugs, while HHS and other payers want to cut down on unnecessary expenditures related to illegal or excessive prescribing. "It's widely publicized that more people are overdosing on prescription drugs than are overdosing on illegal drugs," NCPDP board chairman Charlie Oltman told InformationWeek Healthcare. He added that more die from overdoses of prescription medications than from street drugs. For the most part, when pharmacies tell authorities about medications they dispense, they send the information in batch reports, as infrequently as once a month in some states. "We get zero feedback about what we're reporting," said Oltman, who also is manager of government programs and standards compliance for Target Corp., although he said he was referring to retail pharmacies in general because he is not authorized to speak on behalf of Target on this issue. "Pharmacies don't know if there is a problem." If there were a standard system, pharmacies could run checks in real time and doctors who write electronic prescriptions could know immediately if there was a pattern to be concerned about, Oltman said. About two-thirds of physicians in the U.S. now <a href="http://www.informationweek.com/healthcare/admin-systems/e-prescribing-growth-to-pop-as-penalties/240146166">write at least some of their prescriptions electronically</a>, according to Black Book Market Research. With e-prescribing, pharmacies can have access to real-time transactions, including insurance claims. "This is not something that's in the future," Oltman said. "This is proven." The NCPDP Telecommunications Standard has helped verify patient insurance eligibility and process claims for nearly every outpatient prescription dispensed in the U.S. for more than a decade, he said. Another NCPDP creation, the SCRIPT Standard, is Medicare's preferred format for electronic transmission of new prescriptions. "These are already standards that have been incorporated into the workflows of physicians and pharmacists," said Steve Mullenix, senior VP for communications and industry relations at Scottsdale, Ariz.-based NCPDP. As of mid-February, all states except Missouri had established prescription drug monitoring programs, although eight of the programs, including those in the District of Columbia and Guam, were not operational, according to Brandeis University research cited in the NCPDP report. But data transmission standards and report frequency vary from state to state, making communication difficult if not impossible. About a year ago, NCPDP and others in the pharmacy business decided that "there needed to be sharing across state boundaries," Mullenix said. "Some of the perceived abusers were jumping back and forth across state lines," added Mullenix, a registered pharmacist. "This screamed for a national standard." Adopting de facto national standards would help spread the burden for stopping prescription drug abuse, according to the NCPDP. Mullenix said the DEA is asking pharmacies to assist in efforts against drug diversion. "We just don't have the best tools in place to make that happen," Mullenix said. But Oltman said prescribers also should have a role in preventing diversion. "Physicians and pharmacists should be working together," he said when asked whether the onus should be on the prescriber or the dispenser to stop drug abuse. Mullenix said ONC will consider standardizing the monitoring of prescriptions as part of the forthcoming Stage 3 regulations for Meaningful Use of electronic health records (EHRs) that apply to care providers. 2013-04-24T12:17:00ZHealthcare Patient Engagement Remains ElusiveProcesses, attitudes, poor design, even fear of too much data stand in the way of true care partnerships. Is greater patient autonomy the answer?http://www.informationweek.com/healthcare/patient/healthcare-patient-engagement-remains-el/240153526?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div> It seems as if everyone in healthcare is talking about patient engagement, yet few know how to achieve it. What people do seem to agree on is that patient engagement will not be easy, but technology will be an essential part of the process. "We know today that key patient needs are not being met," Dr. Laura Esserman, director of the University of California at San Francisco's Carol Franc Buck Breast Care Center, said Friday at the <a href=" http://www.healthtechnologyforum.com/conference/health-technology-conference-2013/">Health Technology Forum Innovation Conference</a> Friday in San Francisco, on a panel I moderated. Stage 2 of the Meaningful Use electronic health records (EHR) incentive program <a href=" http://reports.informationweek.com/abstract/105/9436/Healthcare/Strategy:-The-Next-Phase-of-Meaningful-Use.html">requires 5% of patients</a> to log into and upload data via a portal or personal health record for providers to earn bonus Medicare payments. The panelists actually did not talk about Meaningful Use once I finished my short introduction. Although the 5% requirement clearly weighs heavily on the minds of healthcare CIOs, it seems less important to others pushing greater patient involvement in their own care. Amy Tenderich, founder and editor-in-chief of DiabetesMine.com, a popular patient resource and community for those living with diabetes, said that little has changed since she was first diagnosed with that disease in 2003. "I was presented with the myth of the healthcare team," Tenderich recalled. She said her care was not well coordinated and that she felt "lost" as a patient, which led her to create DiabetesMine. [ How do online consults affect patient engagement? Read <a href=" http://www.informationweek.com/healthcare/clinical-systems/online-consults-increasing-despite-physi/240148283?itc=edit_in_body_cross">Online Consults Increasing, Despite Physicians' Concerns</a>. ] Perhaps patients do not feel engaged in their own care because systems, processes, products and outreach efforts are all poorly designed. For example, Tenderich said creators of diabetes supplies are "detached" from how patients use the products. Otherwise, there wouldn't be so many steps and pieces needed to test blood sugar and deliver insulin. Indeed, medical products often are ugly and intrusive, which may explain why patients often do not use them as directed, nor always follow proper diet and exercise regimes, take their medications, or generally comply with doctor's instructions. Dr. Kyra Bobinet, senior instructor and researcher in health engagement at the <a href=" http://captology.stanford.edu/">Stanford University Persuasive Technology Lab</a> in Palo Alto, Calif., has a theory about that. "People don't respond to managing their health," Bobinet said. "They respond to managing their self-image." Tell them that fighting obesity could be more about fitting into a swimsuit than preventing a heart attack, she suggested. The exception, according to Bobinet, is when there is a "community experience" such as a support network for fighting cancer or diabetes, as Tenderich sought when she got her diagnosis. Bobinet said that she actually learned the most about patient engagement from the chronic violent juvenile offenders she assisted in a previous job heading an organization that worked with troubled youths. She said these "worst offenders" taught her that efforts to change behavior should focus not on what people should do, but what they actually will do. Jan Oldenburg, VP for patient and provider engagement at Aetna subsidiary <a href=" http://www.informationweek.com/healthcare/patient/patient-centric-technology-really-does-i/240009094">Accountable Care Solutions</a> in Menlo Park, Calif., also expressed the opinion that new strategies are needed. For example, she said, it is shortsighted to expect residents of underserved communities to go out of their way for routine health services. Oldenburg suggested that community centers and even soup kitchens might be good venues for spreading messages about getting involved in their own health and healthcare. Esserman expanded that thought by saying mobile health should be an option even for low-income populations. "Everybody's got cell phones," she noted, adding that patient engagement and patient satisfaction can drive the kinds of outcomes and cost reduction that policymakers seek. "Patients become the catalysts [for improvement]," Tenderich said. Bobinet agreed, describing patient engagement as the juggernaut for fixing a broken healthcare industry. The convergence of big data is helping to foster patient engagement, she added. However, Tenderich worried that there was too much data piling up to be useful to patients. "Less, not more," Tenderich advised in the context of designing consumer-friendly apps and products. She mentioned Glooko, a system that connects glucose meters to iPhones and automatically logs readings, as a simple, effective application for collecting data and managing diabetes. On the clinician side, Esserman said patient engagement is part of a continuous learning system for practitioners. If patients have the opportunity to provide information, they become more engaged in their own care, she explained, adding that some studies have shown these patients have better health outcomes. However, Esserman expressed doubt that a lot of current physicians would be receptive to ceding autonomy to patients. "I don't think we have enough critical mass to drive this," she said, adding that she's hopeful that the next generation of doctors will be more open to the idea. Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/040113hc/?k=axxe&cid=article_axxt_os">The Right Health IT Priorities?</a> issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)2013-04-22T09:50:00ZWill Doctors 'C' The Way To Accountable Care?Health IT vendor Lumeris develops "Nine C's" framework to help primary care physicians achieve healthcare reform goals.http://www.informationweek.com/healthcare/electronic-medical-records/will-doctors-c-the-way-to-accountable-ca/240153330?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/news/galleries/healthcare/policy/240005118"><img src="http://twimgs.com/informationweek/galleries/automated/848/SS_ACO_dreamstime_01_tn.jpg" alt="8 Accountable Care Organizations Worth Closer Examination" title="8 Accountable Care Organizations Worth Closer Examination" class="img175" /></a> <div class="storyImageTitle">8 Accountable Care Organizations Worth Closer Examination</div> (click image for larger view and for slideshow)</div>  A technology company focused on health system transformation has introduced a new framework meant to serve as a how-to guide of sorts for physicians to become providers of accountable care. The Accountable Primary Care Model, from Maryland Heights, Mo.-based Lumeris, incorporates a series of concepts and steps called the <a href="http://www.lumeris.com/NineCs/">Nine C's</a> to help physicians achieve what Lumeris calls the "Triple Aim Plus One." The <a href="http://www.informationweek.com/healthcare/interoperability/interoperable-it-crucial-for-accountable/232600731">Triple Aim</a>, developed by Dr. Donald M. Berwick at the Cambridge, Mass.-based Institute for Healthcare Improvement (IHI) before he ran the U.S. Centers for Medicare and Medicaid Services (CMS) in 2010-11, calls for care that produces better patient outcomes and improved population health at a lower cost. Triple Aim Plus One adds physician satisfaction, a concept Dr. Tom Doerr, director of innovation research at Lumeris, added in 2010 based on the work of the IHI and others in healthcare quality improvement. [ Venture capitalists bet big on healthcare tech. Read <a href="http://www.informationweek.com/healthcare/mobile-wireless/health-it-investments-approach-500-milli/240153263?itc=edit_in_body_cross">Health IT Investments Approach $500 Million In Q1</a>. ] Doerr told InformationWeek Healthcare that he based the model on proven workflow strategies and accepted best practices, as well as research he conducted on accountable care. Lumeris is leveraging its own patient-clinician portal and online communications hub to assist in adoption of the Accountable Primary Care Model, which includes the following: C1: First contact for each patient's health needs; C2: Comprehensive care, spending more time with patients for most of their health needs and referring to specialists only when absolutely necessary; C3: Continuous, longitudinal, person-centered care, including the development of personalized care plans; C4: Coordinated care across the entire spectrum of providers; C5: Credibility and trust through engaging communication that respects each patient's wishes; C6: Collaborative learning, which means a dedication to IT-enabled continuous education about specific patients and medicine in general, collaboration with colleagues, communication across departments and organizations, and monitoring for safety, cost and outcomes; C7: Cost-effectiveness by providing appropriate, efficient care to the right patient at the right place and the right time; C8: Capacity expansion through new models of care that allow physicians, nurse practitioners, care managers, social workers and others to practice to the fullest extent of their professional licenses, as well as through electronic communications; C9: Career satisfaction for physicians. The first four items come from the <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-practice-consolidation-can-alleviat/240145931">patient-centered medical home</a> concept. "The medical home is not enough but it's a good start," Doerr said. "There are important pieces in the medical home that are missing." That is where the idea of the accountable care organization (ACOs) comes in. According to Doerr, ACOs are "blending the role of payers and physicians," Doerr said, echoing the <a href="http://www.informationweek.com/global-cio/interviews/5-underrated-healthcare-trends-from-a-to/240151865">sentiments</a> of some entities that include both payer and provider elements. Lumeris is a spinoff of such an organization, Esse Health, a group of about 70 primary care physicians in the St. Louis area. In 2004, Esse Health doctors started Essence Health Care, an insurer that offers coverage under the Medicare Advantage program, privately administered managed care for Medicare beneficiaries. Lumeris provides operational support to Essence Healthcare and Esse Health, as well as others, Doerr said. One Esse-affiliated physician, Dr. Thomas Hastings, a solo practitioner in Chesterfield, Mo., has been sold on the idea of accountable care for a long time. "I like to think I've been doing this for 20 years," Hastings said. "It's not rocket science. It's just taking a lot of common sense and bringing it together," he added. Hastings said he receives 60% of his insurance reimbursements in the form of bundled payments or other risk-sharing formulas, and he has been participating in Medicare Advantage and its precursor, Medicare+Choice, since its inception in 1997. Hastings said he goes to the Lumeris portal daily. "It allows us transparency to cost," listing the out-of-pocket patient responsibility for various services and prescription drugs, based on each person's particular insurance coverage and deductible. Based on claims data collected by Essence, users can see if individuals have filled their prescriptions or have received recommended care, including preventive screenings. "I can look up to see if they've had a mammogram or a colonoscopy," Hastings explained. He also can make sure he gets a clinical report if he sees a billing claim or, if there is a report but no claim, Hastings can know if a patient has gotten a health service or test elsewhere. "It's a way of closing the loop," he said. Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/040113hc/?k=axxe&cid=article_axxt_os">The Right Health IT Priorities?</a> issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)2013-04-17T16:20:00ZNavy To Digitize Shipboard Medical ImagingAgfa to supply digital radiography, PACS, speech recognition technology for 42 U.S. ships to connect to Walter Reed radiologists.http://www.informationweek.com/healthcare/clinical-systems/navy-to-digitize-shipboard-medical-imagi/240153125?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/ 9-mobile-ehrs-compete-for-doctors-attent/240144143"><img src="http://twimgs.com/informationweek/galleries/automated/923/mobile_doc_i mage_175.jpg" alt="9 Mobile EHRs Compete For Doctors' Attention" title="9 Mobile EHRs Compete For Doctors' Attention" class="img175" /></a> <div class="storyImageTitle">9 Mobile EHRs Compete For Doctors' Attention</div>(click image for larger view and for slideshow)</div>The U.S. Navy is upgrading its shipboard medical diagnostic capability with a fully digital image acquisition and reporting system and a ship-to-shore <a href="http://www.informationweek.com/teleradiology-requires-effective-managem/171202342"> teleradiology</a> network. Agfa HealthCare, a unit of the Belgium-based Agfa-Gevaert Group, has won a five-year contract from the Navy to upgrade imaging technology aboard all 42 U.S. Navy ships that have radiology suites, according to the company's U.S. subsidiary. The contract covers the retrofit of current ships that have computerized radiography (CR) technology and the installation of digital systems on any new ships that enter service in that time period. Digital radiography captures images on an electronic sensor, while the older computerized radiography technology uses metal plates similar to film X-rays. Agfa has been supplying computerized radiography equipment to the naval fleet since 1999. "The initial driving factor was to get rid of darkrooms and chemicals," Tim Artz, director of global government accounts for Greenville, S.C.-based <a href=" http://www.agfahealthcare.us">Agfa HealthCare USA</a>, told InformationWeek Healthcare. [ What trends is your organization missing? Read <a href="http://www.informationweek.com/global-cio/interviews/5-underrated-healthcare-trends-from-a-to/240151865?itc=edit_in_body_cross">5 Underrated Healthcare Trends From A Top CIO</a>. ] Agfa is supplying three classes of digital radiology units: a top-of-the-line DX-D 400 for fixed X-ray rooms; portable DX-D 100 systems for emergency rooms, operating rooms, and bedside usage; and "low-capability" devices from third parties, according to Artz. The vendor also will be providing a small-scale implementation of its IMPAX picture archiving and communication system (PACS) for the fleet that will link to the enterprise PACS at Walter Reed National Military Medical Center in Bethesda, Md., where the Navy's teleradiology unit is headquartered. In addition, Agfa will provide its TalkStation voice recognition technology for dictation and reporting of diagnostic imaging studies on the ships, just as it does at Walter Reed. (Formerly known as the National Naval Medical Center, the Maryland campus got a new name when it consolidated with the former Walter Reed Army Medical Center in Washington, D.C., in 2011.) "There's no radiologist on board the ships," Artz noted. The Navy has to care for hundreds or thousands of people at a time at sea for months at a time, and telemedicine allows the service to run its ships more efficiently and better cope with medical emergencies. "If they don't have that, they have to evacuate," Artz noted. This is expensive and logistically difficult, especially in combat zones. The Navy takes care of ship-to-shore communications, so Agfa will not have to maintain the satellite links, but the vendor will tie all imaging and reporting into the PACS at Walter Reed, which handles teleradiology for other military sites. "The ship images will just be commingled with that work list," Artz said. With the technology, radiologists at Walter Reed will be able to dictate, edit, code, and sign reports within minutes of receiving images from naval ships. The PACS communicates with the legacy <a href="http://www.informationweek.com/healthcare/electronic-medical-records/coast-guard-awards-14-million-ehr-contra/227701093">Composite Health Care System</a> (CHCS), which the Military Health System still uses for radiology. CHCS is the precursor to the current -- but aging -- Armed Forces Health Longitudinal Technology Application (AHLTA) electronic health records (EHR) platform. U.S. Navy officials were not available for comment on this contract.2013-04-12T12:38:00ZNCQA Tests New Healthcare Quality MeasureUnified, risk-based model of assessing healthcare performance expected to be more clinically relevant to physicians than current measures.http://www.informationweek.com/healthcare/electronic-medical-records/ncqa-tests-new-healthcare-quality-measur/240152819?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div>  The group that developed many of the quality measures in the <a href="http://www.informationweek.com/healthcare/electronic-medical-records/hospitals-make-strides-to-show-meaningfu/240150251">Meaningful Use</a> standards for electronic health records (EHRs) is testing a new approach that pulls data from EHRs to help assess quality in a way that the organization believes to be more clinically relevant than current methods. The <a href="http://www.informationweek.com/healthcare/policy/medical-specialists-encouraged-to-use-mo/240001986">National Committee for Quality Assurance</a> (NCQA) has landed an 18-month grant from the Robert Wood Johnson Foundation (RWJF) to evaluate a single measure for assessing risk of cardiovascular disease called the "Global Cardiovascular Risk" score, or GCVR. Data collection will start this summer and NCQA expects to report its findings during summer 2014. GCVR is based on a measure created by Archimedes, a Kaiser Permanente affiliate that applies mathematical principles to solve pressing healthcare issues. San Francisco-based Archimedes developed a metric, called the <a href="http://content.healthaffairs.org/content/31/11/2441.abstract">Global Outcomes (GO) Score</a>, including the logic behind it and a tool for calculating it. The metric was described at length in a paper in the November 2012 issue of policy journal Health Affairs. "This will be the first large-scale test" of the GO Score, Archimedes founder and retired chief medical officer Dr. David Eddy told InformationWeek Healthcare. Eddy said his goal in the NCQA test is to have the GO Score become a part of widely accepted clinical performance measures, which he hopes ultimately will lead to more accurate treatment choices. Archimedes will be providing technical support to NCQA. "It is based on outcomes. It is not based on processes and targets," Eddy explained. [ Want your patients to get more involved in their own health? See <a href="http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137?itc=edit_in_body_cross">7 Portals Powering Patient Engagement</a>. ] For this reason, Dr. Mary Barton, NCQA's VP for performance measurement, is optimistic that the GCVR can change the way healthcare professionals assess patient risk and allocate resources. "The evolution [of quality measures] over time has depended on the accumulation of evidence-based data," Barton said. However, risk of any given disease is based on a complex set of variables. "These are all interventions you should be giving your patients, but some will give you more bang for your buck," Barton continued. Existing measures of quality are "extremely binary," as well as "clumsy and one-size-fits-all," Barton said. Providers either meet or fall short of their goals for each patient's LDL ("bad") cholesterol goals. But if one patient is just five points above the LDL target and another exceeds the standard by 40 points, physicians might be tempted to put their efforts into reducing the cholesterol level of the patient just five above the threshold, even though the one with the higher number is a greater risk of heart disease, Barton suggested. "Now I'm going to be measured on the benefit I bring to my patients" with the GCVR score, said Barton, who trained in internal medicine. She described the GCVR score as a "vision" and a "dream" for performance measurement. "It's a big change in the primary care paradigm," Barton said. She called the RWJF grant a first step toward realizing that vision. "The dream is, we can help more people and we can do much more good" by giving physicians the motivation to assess entire populations of patients and by helping organizations better allocate their resources, according to Barton. "It lets you look at the big picture." Eddy likened existing standards to a compass without a map. "Our current performance measures are directing people north but not telling them how to get to the North Pole," he said. The GO Score becomes the portion or percentage of the target providers hit with each patient. "The score is very meaningful," Eddy said. He believes it has three advantages: accuracy, simplicity and a basis in reality. To Eddy, the score says, for example, that an organization is preventing half of the heart attacks that can be prevented, not simply that the doctors are prescribing beta blockers for, say, 63% of those at high risk of heart attack. It is a single score, not a series of yes/no questions. Plus, it does not have any "sharp cut points," as Eddy put it, arbitrary cutoffs that encourage physicians to treat everyone in the same way. "Physicians are frustrated with current clinical measures because they are not clinically relevant," Eddy said. "This method leaves them free to choose how they treat their patients." The proliferation of EHRs makes the test feasible now, though NCQA will be working only with organizations with enough EHR history to report clinical data electronically. This test will not have to rely on data from billing claims. Barton said she was unable to share names of testing partners because NCQA has not signed formal agreements yet. Still, Barton and Eddy both envision measures like GCVR becoming part of Meaningful Use Stage 3. The current Stage 1 just asks for "electronified versions of otherwise existing measures," according to Barton. Stages 2 and 3 will take fuller advantage of the "rich data" from EHRs, she said. She hopes that the third stage, which will not begin before 2016, will count such things as how many patients are able to lower their blood pressure by 10% or 20% or some other metric likely to have a bearing on medical outcomes. "I'm very confident that it is possible with at least some of the current EHR systems," Barton said. Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/040113hc/?k=axxe&cid=article_axxt_os">The Right Health IT Priorities?</a> issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)2013-04-08T10:19:00ZHospital Cuts Readmissions With Focus On Primary CareSoftware links emergency department patients with follow-up care to cut nonessential return trips to the hospital.http://www.informationweek.com/healthcare/electronic-medical-records/hospital-cuts-readmissions-with-focus-on/240152458?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>  A Missouri hospital has been able to cut inpatient readmissions by a third, mostly by improving communication between its emergency department (ED) and area clinics. The plan: make sure patients have primary care physicians for follow up and only come back to the ED for true medical emergencies. Cox Medical Center Branson (Mo.), formerly known as Skaggs Regional Medical Center until Springfield, Mo., based CoxHealth took over at the beginning of the year, augmented its embrace of the patient-centered medical home model with software to match patients with primary care physicians and to identify ED "frequent fliers" and others at high risk for readmission. "We're trying to get them to establish a relationship with a provider," explained Michael Elley, Cox Branson CIO and VP of support services. Cox Branson is somewhat small, with 165 licensed beds, but, befitting its location in a tourist magnet, has 40,000 ED visits annually, with heavy traffic during the summer months. Four out of five inpatient admissions come through the ED, according to Amy Swanson, IT clinical analyst and project manager of the implementation of Care Continuity, a software-as-a-service application from T-System, a Dallas-based electronic health records (EHR) vendor specializing in ED information systems. [ Do you know where the next health IT opportunities will be? See <a href="http://www.informationweek.com/global-cio/interviews/5-underrated-healthcare-trends-from-a-to/240151865?itc=edit_in_body_cross">5 Underrated Healthcare Trends From A Top CIO</a>. ] According to T-System, the technology lets ED personnel send an email or text message to each patient's primary care physician at various times during an ED visit or inpatient stay, with links to a secure portal containing medical records and test results. Before discharging a patient, the hospital sends a referral request to a primary care doctor, who then can accept by setting up an appointment, or decline. If a physician declines, the ED tries to match the patient with another provider to make sure the individual receives proper follow-up care. Cox Branson employs physicians at 19 affiliated clinics, all of which have access to the T-System platform through the Web. "We are working out how to roll it out to independent practices," Swanson said. Elley said 9% of the population in the hospital's service area is uninsured, and staff at Cox Branson tries hard to connect discharged uninsured patients with primary care physicians. "We don't want them using the ER or even urgent care for primary care," he said. "There should not be an open-ended discharge of the patient to the curbside," T-System CEO Sunny Sanyal emphasized. Sanyal said the Care Continuity app produces discharge instructions for each patient. Cox Branson currently prints the notes, though the software does have the ability to transmit the notes electronically, which is one way providers can meet a requirement in the Stage 2 Meaningful Use standards that 50% of patients have the ability to <a href="http://www.informationweek.com/healthcare/electronic-medical-records/patients-like-online-health-records-acce/240152164">view their own health information online</a>. Cox Branson already has achieved Stage 1 Meaningful Use with a McKesson inpatient EHR and has a patient portal supplied by Beaverton, Ore.-based Kryptiq, Elley said, though the hospital will be migrating to CoxHealth's Cerner EHR. The Care Continuity system flags high-risk patients who might need special attention and identifies people upon their third visit to the ED so the hospital can make it a priority to find primary care for them. It also helps the hospital determine why patients are being readmitted or why they are coming to the ED instead of visiting a primary care physician or a dentist or a behavioral health professional, Swanson said. Cox Branson had a soft launch of Care Continuity in late November but a full rollout in January. "In the first two months, we were able to connect 400 people to primary care physicians who didn't have one before," Elley reported. In 2012, the hospital had an overall 30-day readmission rate of 9%, according to Elley, below what he said was the statewide average of 11%-12%, but that dropped from 11.5% in January 2012 to 7.7% by the end of the year after the focus on primary care began. (The Dartmouth Atlas of Health Care reported that in 2009 the <a href="http://www.dartmouthatlas.org/downloads/reports/Post_discharge_events_092811.pdf">national average readmission rate</a> among Medicare beneficiaries was 16.1% overall and 12.7% for surgical patients.) This is particularly important for Cox Branson because the hospital derives 65% of its patients and 59% of revenue from Medicare, according to statistics provided to InformationWeek Healthcare. That federal program for Americans 65 and older <a href="http://www.informationweek.com/healthcare/electronic-medical-records/hospitals-look-to-ehrs-to-reduce-readmis/240005621">no longer reimburses</a> hospitals for preventable 30-day readmissions of patients treated for heart attacks, heart failure or pneumonia. Elley said Cox Branson is worse than the national average for all three of those conditions. "We want to be judged on quality," Elley said.2013-04-04T15:45:00ZSupercomputer Apps Tackle Cancer, Autism, Heart AttacksHealthcare and life sciences apps sweep top three spots in YarcData contest, a unit of supercomputing pioneer Cray, showcasing the power of graph analytics.http://www.informationweek.com/healthcare/leadership/supercomputer-apps-tackle-cancer-autism/240152325?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/healthcare/mobile-wireless/10-medical-robots-that-could-change-heal/240143983"><img src="http://twimgs.com/informationweek/galleries/automated/920/RP-VITA_tn.jpg" alt="10 Medical Robots That Could Change Healthcare" title="10 Medical Robots That Could Change Healthcare" class="img175" /></a> <div class="storyImageTitle">10 Medical Robots That Could Change Healthcare</div> (click image for larger view and for slideshow) </div> Healthcare and life sciences applications took the top three spots in a $100,000 contest from YarcData, a unit of supercomputing pioneer <a href="http://www.informationweek.com/hardware/supercomputers/crays-xk6-supercomputer-promises-50-peta/229700091">Cray</a>, to showcase the power of graph analytics. A team from the Seattle-based <a href=" https://www.systemsbiology.org/">Institute for Systems Biology</a> won the $70,000 first prize for matching unstructured data from medical journals with structured data from genomic and proteomic registries to study thousands of patients with more than 25 varieties of cancer, according to YarcData. Their work used YarcData's new uRiKA graph analytics appliance to help understand how each type of cancer disrupts various biological networks and to identify drugs approved for other conditions that might help treat certain cancers. In second place were researchers from the University of California at Santa Barbara, who probed clusters of disease precursors for clues that might shed light on the causes of autism. Dr. Abraham Flaxman, an assistant professor at the University of Washington's Institute for Health Metrics and Evaluation, took third for developing a computer model to predict patient risk and mortality in the 30 days after a heart attack. "The winning entry demonstrated classic features of big data problems: a large volume of complex information from a variety of disparate sources and a need to manage data input and output at a high velocity. The team's submission exemplified the power of graph analytics for gaining insight into difficult knowledge-discovery problems," one contest judge, Dr. Bruce Hendrickson, senior manager for computational sciences and mathematics at Sandia National Laboratories in New Mexico, said in a <a href="http://www.yarcdata.com/press-release-4-4-13.html">statement from YarcData</a>. In an interview with InformationWeek Healthcare third-place winner Flaxman was more humble about his achievement. "I'm not here to tell you I've solved the problem of predicting 30-day mortality [for individual patients]," he said. "This is where computer scientists have been overpromising for years." [ IBM's cognitive computing platform could do much more than win at "Jeopardy." See <a href="http://www.informationweek.com/software/business-intelligence/ibms-watson-could-be-healthcare-game-cha/240148273?itc=edit_in_body_cross">IBM's Watson Could Be Healthcare Game Changer</a>. ] However, using the uRiKA technology and records from the federal Agency for Healthcare Research and Quality's <a href=" http://www.hcup-us.ahrq.gov/sidoverview.jsp">state inpatient databases</a>, Flaxman applied the <a href=" http://www.informationweek.com/development/database/postgresql-adds-proximity-search/229402894">K-Nearest Neighbor algorithm</a> to help estimate mortality risk for populations based on patient age, sex, condition and hospital. The uRiKA appliance essentially is a Web interface, supporting SPARQL queries, for supercomputer technology that otherwise would be difficult to harness the power of, according to Flaxman, who wrestled with a supercomputer at the U.S. Department of Energy's Pacific Northwest National Laboratory in Richland, Wash. "It was extremely promising but it had a high bar for being able to use it," Flaxman said of the lab's computer. Flaxman, a mathematician by training, said he picked 30-day risk for heart attacks because there is a wealth of data available and because it is important to hospitals. Indeed, the federal Medicare insurance program for Americans 65 and older no longer reimburses hospitals for preventable readmissions within 30 days of initial discharge for heart attack, heart failure and pneumonia. Estimating mortality at the population level essentially provides a view of how well hospitals are allocating their resources, Flaxman explained. For example, if a facility has a high number of deaths of patients presenting with heart attacks, the graph analysis can help determine if the mortality rate is due to a large group of patients who already were at high risk of dying. Flaxman said his next step in refining his research will be to define exactly what it means to do a good job in adjusting mortality data for risk and then finding the best ways to perform risk adjustment. "Graph analytics seems like a really promising approach," he said. Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/040113hc/?k=axxe&cid=article_axxt_os">The Right Health IT Priorities?</a> issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.) 2013-03-29T10:44:00ZNational Patient ID System: Debate StokedHoping to spark a national conversation on information exchange, health IT advocate petitions to lift ban on HHS national patient identification system.http://www.informationweek.com/healthcare/admin-systems/national-patient-id-system-debate-stoked/240151956?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/clinical-systems/ss1120126hievendors/240142427"><img src="http://twimgs.com/informationweek/galleries/automated/910/01_Medicity2_tn.jpg" alt="6 HIE Vendors: How They Measure Up" title="6 HIE Vendors: How They Measure Up" class="img175" /></a> <div class="storyImageTitle">6 HIE Vendors: How They Measure Up</div>(click image for larger view and for slideshow)</div>  A well-known health IT advocate and consultant has started a petition on WhiteHouse.gov asking Congress to lift its prohibition on the U.S. Department of Health and Human Services (HHS) setting up a national patient identification system. The <a href=" https://petitions.whitehouse.gov/petition/ask-congress-no-longer-prohibit-hhs-establishing-standards-unique-patient-identifier/3PxKLcQc">petition</a>, posted this week on the official White House website, calls on a rollback of restrictions that have been in place for nearly a decade and a half. "Congress should permit HHS to develop standards, especially if this could increase efficiencies and prevent medical errors," the petition states. The original Health Insurance Portability and Accountability Act (HIPAA) legislation from 1996 called on HHS to develop a system of unique patient identifiers to help promote privacy and security of personally identifiable health information. But <a href=" http://www.gpo.gov/fdsys/pkg/PLAW-105publ277/html/PLAW-105publ277.htm">federal appropriations legislation</a> for fiscal year 1999, passed in 1998, denied funding for HHS to implement a patient ID program. [ Data analytics could be a game-changer for healthcare, but establishing a framework first is key. Read more at <a href="http://www.informationweek.com/healthcare/clinical-systems/big-data-use-in-healthcare-needs-governa/240151395?itc=edit_in_body_cross">Big Data Use In Healthcare Needs Governance, Education</a>. ] Though the Obama administration officially remains opposed to a national patient ID, some in the health IT industry believe the vision of a nationwide network of interoperable electronic health records (EHRs) is unrealistic without a standard means of locating and authenticating records. "We're trying to apply a 1990s policy framework to a 21st Century technology problem," said the petition's creator, Brian Ahier, a part-time health IT "evangelist" at Mid-Columbia Medical Center in The Dalles, Ore., who also consults on health IT issues. "Right now, over three-quarters of Congress was not a member in 1998 when that law was passed," he added. EHR vendor Cerner is among those now <a href=" http://www.cerner.com/about_cerner/stimulus_and_hitech/the_abcs_of_systemic_healthcare_reform/?langtype=1033&WT.mc_id=abc">advocating for unique patient IDs</a>. The Healthcare Information Management and Systems Society (HIMSS) also is calling for at least a <a href=" http://www.informationweek.com/healthcare/patient/himss-asks-congress-for-patient-identity/240007949">national patient ID matching strategy</a>. HIMSS said such an approach, which does not necessarily include a unique ID number for each person, would better facilitate health information exchange (HIE) and improve patient safety. Ahier is a board member of the Oregon chapter of HIMSS and serves as president of Gorge Health Connect, an HIE in north-central Oregon. By Thursday afternoon, the petition had fewer than 100 signatures, but Ahier said he does not expect to meet the listed goal of 100,000. The White House <a href=" http://www.informationweek.com/government/leadership/white-house-flooded-with-online-petition/231700238">promises an official response</a> to any petition that receives at least 100,000 signatures within 30 days -- though the threshold was 5,000 and later 25,000 during Barack Obama's first term as president. "Direct contact [with the Obama administration] is more effective anyway," Ahier said. He and his allies have had plenty of contact with the HHS Office of the National Coordinator for Health Information Technology and other Washington insiders. He also said social media is helping to spread the idea of re-opening the dialogue about patient identification. Ahier described the petition as more of a "firestarter" to urge Congress to reevaluate its 1998 decision. "We've hamstrung our policy development at HHS with this imposition," Ahier said of the funding ban. "Not everyone agrees, but at least we're having the conversation." A 2008 <a href=" http://www.rand.org/pubs/monographs/MG753.html">report from Rand Corp.</a> said that the prohibition against unique patient IDs would hinder development of a nationwide system of interoperable health records. While that report garnered headlines at the time, it did not spark much momentum toward changing the law. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-27T15:51:00ZTopol Gives Colbert a Dose of 'Destruction'Scripps cardiologist and noted proponent of wireless health technologies Eric Topol shows off gadgets to comedian's audience.http://www.informationweek.com/healthcare/mobile-wireless/topol-gives-colbert-a-dose-of-destructio/240151858?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/mobile-wireless/10-wearable-health-gadgets/240012613"><img src="http://twimgs.com/informationweek/galleries/automated/894/01_IMEC_tn.jpg" alt="10 Wearable Health Gadgets" title="10 Wearable Health Gadgets" class="img175" /></a> <div class="storyImageTitle">10 Wearable Health Gadgets</div> (click image for larger view and for slideshow)</div> Stephen Colbert's injured eardrum is going to be just fine. Why should InformationWeek Healthcare readers care? Because Tuesday night Dr. Eric Topol, chief academic officer of Scripps Health in San Diego and director of the Scripps Translational Science Institute, took a look inside the comedian's ear canal with the help of an otoscope smartphone accessory -- still a premarket product -- from a startup company called CellScope. "It's healing," Topol said, after showing the Comedy Central cameras a live image of Colbert's eardrum on a smartphone screen. Though the <a href=" http://www.colbertnation.com/the-colbert-report-videos/424776/march-26-2013/eric-topol">segment</a> featured a lot of laughs, Topol won over "The Colbert Report" studio audience and the fake pundit himself with some technical wizardry demonstrating that smartphones and tablets are unshackling healthcare from traditional, clinical settings. "We have new tools to be able to understand each person at an individual, granular level we never could before," Topol said, explaining the premise behind his 2012 book, The Creative Destruction of Medicine. [ The doctor will see you -- online. Read <a href="http://www.informationweek.com/healthcare/mobile-wireless/online-medical-consults-save-money-study/240147836?itc=edit_in_body_cross">Online Medical Consults Save Money, Study Says</a>. ] "Why do we want to creatively destroy medicine? Medicine is keeping us alive. Leave it alone," Colbert quipped. Topol explained that he was talking about "radical innovation" in the practice of medicine. When Topol mentioned smartphones, Colbert whipped out his iPhone and asked, "Well, I have a smartphone. Am I a doctor?" Without missing a beat, Topol said, "That smartphone is going to be the conduit of data and information about your health, about your medical essence like you've never had before." "Is Siri a doctor?" Colbert joked, before asking the Apple virtual digital assistant, "Siri, am I dying?" The phone answered, "I really can't say." But some of the apps and gadgets Topol brought with him really could say, as the Scripps cardiologist showed the health IT community earlier this month when he was the <a href="http://www.informationweek.com/healthcare/leadership/it-changes-doctor-patient-relationship-f/240150074">keynote speaker</a> at the Healthcare Information and Management Systems Society (HIMSS) conference in New Orleans. Topol had Colbert try AliveECG, an electrocardiogram attachment for the iPhone from Oklahoma City-based startup AliveCor, showing the host's heart rhythm in real time. Then he demonstrated the ViSi monitor from Sotera Wireless, a company Topol is an investor in, to show heart rhythm, blood pressure, oxygen saturation and other vital signs on a device not much bigger than a watch. "We can do an intensive care unit on the wrist," Topol explained. That's when the banter picked up."Are you Dick Tracy?" Colbert asked. "But why do you want that? I have a doctor to do that," Colbert continued. "I go to a doctor, I complain to him, he says, 'You're going to be fine,' and he gives me a pill." Topol responded that sensors can help people monitor their own health anywhere. "But what happens if I'm actually sick? What if I'm having a heart attack or something?" Colbert asked. Topol said devices like ViSi and AliveECG could help in such situations. Although he did not mention it on the air, Topol reportedly used the AliveECG to <a href="http://www.utsandiego.com/news/2013/mar/05/topol-save-defib/">diagnose atrial fibrillation</a> in another passenger on his flight home from the HIMSS keynote. It was at least the second time that device helped Topol treat someone on a commercial flight, according to the San Diego Union-Tribune. "So if I'm having a heart attack, it calls my phone?" Colbert asked, and some in the studio audience chuckled. But the question was as serious as, well, a heart attack. "At Scripps, we're setting up a little sensor that we can put in your bloodstream that will sense if you're going to have a heart attack days or a couple of weeks before and give you a heart attack ringtone on your phone to warn you, prevent a heart attack," Topol said. Colbert actually had some rather insightful thoughts during the interview: "This information, I'm sure it's going to come down the line that the insurance companies will say, 'Hey, listen, we'll give you a cut if you have a monitor on you so we can stay healthier, but then they're going to sell that information about your present health to other people and I'm going to get like a ringtone that says, 'Would you like 20% off on caskets?'" he joked. Indeed, professional ethicists have been <a href="http://www.informationweek.com/837/prdataethics.htm">raising questions</a> about the mining of highly personal data for years. Colbert also brought up a question related to patient engagement and the changing role of healthcare professionals: "If I'm doing the monitoring, why do I need the doctor?" he asked. Topol didn't say so in the five minutes of airtime he had Tuesday, but in a longer segment that aired on NBC's "Rock Center with Brian Williams" in January, he talked about a shifting relationship between patient and physician. "The patient [of] tomorrow is the biggest switch. People need to take ownership. They need to seize the moment and seize the data," he told NBC chief medical editor Dr. Nancy Snyderman. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-26T11:50:00ZAllscripts Drops Suit Against NYC Public Health SystemN.Y. health system disputed the claim that it will overpay for rival Epic Systems' electronic health record system.http://www.informationweek.com/healthcare/electronic-medical-records/allscripts-drops-suit-against-nyc-public/240151711?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ 9-mobile-ehrs-compete-for-doctors-attent/240144143"><img src="http://twimgs.com/informationweek/galleries/automated/923/mobile_doc_i mage_175.jpg" alt="9 Mobile EHRs Compete For Doctors' Attention" title="9 Mobile EHRs Compete For Doctors' Attention" class="img175" /></a> <div class="storyImageTitle">9 Mobile EHRs Compete For Doctors' Attention</div> (click image for larger view and for slideshow) </div> Electronic health records (EHR) vendor Allscripts Healthcare Solutions has dropped its lawsuit against New York City's public hospital system and rival vendor Epic Systems, Allscripts and city officials said Monday. "Allscripts Healthcare Solutions, Inc., has discontinued its legal action against the New York City Health and Hospitals Corporation regarding the award of the Integrated Clinical Information System contract and looks forward to having the opportunity to work with HHC on other matters in the future," Chicago-based Allscripts said in a brief <a href=" http://www.allscripts.com/content/dam/allscripts/documents/Statement_HHC_032113.pdf">statement</a> sent to the media. Similarly, the <a href=" http://www.nychhc.org">New York City Health and Hospitals Corp.</a>, (NYCHHC), which runs 11 hospitals, dozens of clinics, and a health plan serving 420,000 people across the Big Apple, released a brief statement indicating that it was "pleased that Allscripts has withdrawn the lawsuit." [ It's time for healthcare to push the technology envelope. Read more at <a href=" http://www.informationweek.com/healthcare/leadership/allscripts-dbmotion-deal-speaks-to-large/240150265?itc=edit_in_body_cross">Allscripts' dbMotion Deal Speaks To Larger Trend</a>. ] Neither Allscripts nor the health system would comment further, though an Allscripts spokeswoman confirmed that the company also has dropped its case against Epic, of Verona, Wis. An Epic media liaison relayed via e-mail an explanation from COO Carl Dvorak that the suit was really an issue between NYCHHC and Allscripts and that the case was resolved "prior to our active engagement." Allscripts <a href=" http://www.informationweek.com/healthcare/electronic-medical-records/allscripts-files-complaint-against-nyc-h/240009176">sued New York City and Epic</a> in October after the NYCHHC awarded Epic a $302.8 million contract the previous month to replace an existing patchwork EHR with an integrated system to cover 11 hospitals, 70 outpatient clinics, four long-term care facilities, and six diagnostic treatment centers. Epic beat Allscripts in its bid for the 15-year contract, which includes software, database licenses, maintenance, upgrades and other services. The suit, filed in New York state court, claimed the Allscripts technology would cost NYCHHC half the estimated $1.5 billion it would spend in total to install, operate and maintain Epic's product over a decade and a half. The typically tight-lipped Epic had no comment on the suit at the time -- Epic as a rule does not issue press releases -- but the New York health system disputed that claim. "Epic was chosen for its functional superiority, outstanding level of integration, its strong corporate foundation, and for being more able to service the diverse needs of HHC," Ian Michaels, spokesman for the NYCHHS said in an e-mail at the time Allscripts sued. "Allscripts' allegation that its proposal is significantly less expensive than Epic's is false and fails to acknowledge all of the costs HHC considered to support its integrated, patient-centered model of care. HHC anticipates that the Allscripts complaint will be found to be without merit." Epic has won a number of big-dollar enterprise contracts in recent years at the expense of Allscripts and many other competitors. This month, Allscripts joined Cerner, McKesson, Athenahealth, Greenway Medical Systems and McKesson subsidiary RelayHealth to <a href=" http://www.informationweek.com/healthcare/electronic-medical-records/ehr-vendors-form-alliance-on-data-sharin/240149948">form the CommonWell Health Alliance</a>, an interoperability consortium widely seen as a response to Epic's domination of the large-system market. The same day, Allscripts also announced acquisitions of <a href="http://www.informationweek.com/healthcare/leadership/allscripts-dbmotion-deal-speaks-to-large/240150265">dbMotion</a> and Jardogs, two companies involved in health information exchange and interoperability linkages. In December, Allscripts fired longtime CEO Glen Tullman and president Lee Shapiro and brought in former Cerner executive Paul Black to run the business. The Allscripts spokeswoman did not address whether the decision to drop the suit was part of the company's new direction. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-22T13:36:00ZCould Clinical Decision Support Empower Patients?It's time the medical establishment heeded the longstanding advice of informatics pioneer Larry Weed and used "participatory" diagnostic methods.http://www.informationweek.com/healthcare/clinical-systems/could-clinical-decision-support-empower/240151522?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>Ideas long espoused by medical informatics pioneer Dr. Lawrence L. Weed but shunned or ignored by the medical establishment might find a perfect fit in a world of <a href="http://en.wikipedia.org/wiki/Participatory_medicine">"participatory medicine,"</a> suggests a well-known proponent of patients taking an active role in their own care in concert with healthcare professionals. As he explained this month at the Healthcare Information and Management Systems Society (HIMSS) conference in New Orleans and in a 2011 book he co-authored with son Lincoln, Weed believes in "coupling" medical knowledge to specific patient problems with the <a href="http://www.informationweek.com/healthcare/leadership/informatics-pioneer-says-healthcare-need/240150506">aid of computers</a>. Any attempt to practice medicine based on a physician's knowledge alone invites diagnosis error, according to Weed. That opinion struck a chord with Terry Graedon, co-editor-in-chief of the Journal of Participatory Medicine. "Recent research reports have shown that misdiagnosis is an Achilles heel for the current practice of medicine," Graedon wrote in a <a href="http://www.jopm.org/opinion/editorials/2013/03/18/is-larry-weed-right/">commentary</a> published this week. [ A study suggests patients don't like it when doctors use computers to diagnose them. Read <a href="http://www.informationweek.com/healthcare/clinical-systems/clinical-decision-support-a-turnoff-for/240147681?itc=edit_in_body_cross">Clinical Decision Support A Turnoff For Patients, Says Study</a>. ] Indeed, the Journal of the American Medical Association's JAMA Internal Medicine just last month published a study showing that <a href="http://archinte.jamanetwork.com/Mobile/article.aspx?articleid=1656540">physicians missed</a> a surprisingly high number of common diseases in ambulatory care. Although Graedon's article does not mention this study, it does raise similar themes. Proper diagnosis, Graedon argued -- as Weed, creator of the problem-oriented medical record, has been doing for decades -- starts with a complete problem list. Then, a computer system couples problems to specific medical knowledge. "If diagnosis begins with standardized data collection, doctors bring clinical judgment to bear at the final stage of diagnosis. Treatment should then be evidence-guided but individualized for the particular patient," Graedon wrote. "We trust that at this point the patient would make his or her preferences known and share in the decision," she added, bringing in the element of patient empowerment, because the Journal of Participatory Medicine is a publication of the <a href="http://participatorymedicine.org/">Society of Participatory Medicine</a>. Graedon, along with her husband, Joe, helped the late Dr. Tom Ferguson develop the idea of participatory medicine and patient empowerment that led to creation of the society after Ferguson's 2006 death. "Diagnosis needs to be much more precise," Graedon told InformationWeek Healthcare. That was one of the sentiments Weed expressed in New Orleans, although Weed is no fan of evidence-based medicine, which relies on statistical probabilities and thus is not precise enough for his tastes. "The patient isn't interested in what's probable. They're interested in what's wrong. And if it's highly improbable, they expect you to find it," the octogenarian Weed said at HIMSS13. What Weed said both in his address to the HIMSS symposium on physician informatics and in <a href=" http://www.amazon.com/Medicine-Denial-Lawrence-L-Weed/dp/1456417061">Medicine in Denial</a>, the book he co-wrote with his son two years ago, was that physicians need to put aside their egos and accept that they need better information from patients and computerized help in matching medical knowledge to known patient problems. "The Weeds' vision of how the data would be collected and used is appealing from the perspective of participatory medicine," Graedon wrote in her editorial. "The patient would fill out a comprehensive standardized computerized questionnaire prior to a face-to-face clinical encounter. Some data that can only be derived from physical examination or laboratory tests might need to be provided by a clinician, perhaps a physician extender such as a nurse or physician's assistant. Collecting the initial data in this way should mean that physicians wouldn't need to spend extra time to use this decision support tool. Instead, once the software suggests a set of options for potential diagnoses to be considered, clinical judgment and (possibly) further testing to refine the diagnosis come into play." Graedon, who said she has known about problem-knowledge couplers for about 15 years, told InformationWeek Healthcare that she hopes to get clinicians and patients associated with the SPM to "think about whether this idea would be advantageous to patients, and how to implement it." She also knew her words would be controversial. "I figured I would get some doctors very excited," Graedon added. Graedon said she got the idea for the editorial at Johns Hopkins University's <a href=" http://www.hopkinscme.edu/CourseDetail.aspx/80028747">Fifth International Diagnostic Error in Medicine</a> conference last November. "I asked why weren't Weed's proposals being taken seriously," Graedon recalls. "I didn't get a good answer." As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-21T11:44:00ZBig Data Use In Healthcare Needs Governance, EducationUsing big data effectively requires everything from setting up a basic management framework to teaching analytics in medical school, says one consultant.http://www.informationweek.com/healthcare/clinical-systems/big-data-use-in-healthcare-needs-governa/240151395?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div>Healthcare organizations should adopt a standardized framework for data governance if they want to harness the power of big data, says a new report. But governance is but one element in the highly complex world of healthcare information, where many long-held practices must change, says the <a href=" http://ihealthtran.com/wordpress/2013/03/iht%C2%B2-releases-big-data-research-report-download-today/">report</a>, from the Institute for Health Technology Transformation (IHT2), a New York-based research and consulting firm. Citing a <a href="http://www.mckinsey.com/insights/business_technology/big_data_the_next_frontier_for_innovation">2011 McKinsey & Co. study</a>, IHT2 said the U.S. healthcare industry could potentially save $300 billion a year with the help of advanced analytics, but healthcare organizations continue to struggle with managing and leveraging the vast stores of data they are building up. By 2011, U.S. healthcare organizations had generated 150 exabytes -- that's 150 billion gigabytes -- of data, IHT2 said. Kaiser Permanente alone might have as much as 44 petabytes of patient data just from its electronic health record (EHR) system, or 4,400 times the amount of information held at the Library of Congress. [ How keen are healthcare pros to use big data? Read <a href="http://www.informationweek.com/healthcare/clinical-systems/healthcare-organizations-go-big-for-anal/240151060?itc=edit_in_body_cross">Healthcare Organizations Go Big For Analytics</a>. ] "It's true that big data promises to ease the transition to authentic data-driven health care, allowing healthcare professionals to improve the standard of care based on millions of cases, to define needs for subpopulations, to make more personalized decisions for individual patients, and to identify and intervene for population groups at risk for poor outcomes," the report states. "But while big data has transformed much of American industry, it's also true that massive information sharing and analysis has yet to generate significant benefits within health care." "There are so many executives out there that just don't know where to start," IHT2 CEO Waco Hoover told InformationWeek Healthcare. Having a framework is "extremely important" to sorting it all out, he said "A carefully structured framework for enterprise-wide data governance is arguably the first and most critical priority to ensure the success of any effort to leverage big data for health care delivery," said the report, which includes a summary of the Data Governance Institute's <a href=" http://www.datagovernance.com/dgi_framework.pdf">sample framework</a>. The Data Governance Institute defines this framework as a "logical structure for classifying, organizing, and communicating complex activities involved in making decisions about and taking action on enterprise data." But a management framework is not enough, says IHT2. The report recommends that healthcare organizations include providers in analytics planning because doctors often are resistant to efforts to change their practice styles. They are the ones "in the driver's seat" of care provision, so they are the most reluctant to change, Hoover said. Healthcare organizations also need to "close the quality loop," said the report, by having data analytics specialists work closely with quality improvement teams to assure their strategies are aligned. "Achieving health care transformation requires dramatic and sustainable changes to the structure and processes of health care," the report said. Hoover said he heard at a recent executive forum that some healthcare networks are hiring mathematicians with PhDs who "really understand how to extract data." Longer-term, medical schools need to "bake analytics into training," according to IHT2. "It becomes a part of how medicine is practiced," Hoover explained. "As we move forward in this new era of care, that has to be an integral part of delivering care," he continued. However, Hoover he predicted it would take 10-15 years before medical schools add this to their curriculum and start producing physicians trained in analytics. In the meantime, more than a few provider organizations are counting on big data to help them manage population health and reduce variations in care. "Electronic health records and automation tools already exist to identify and stratify individual patients who need special attention or care; identify care gaps; measure outcomes; and encourage patients to assume more responsibility for their health. However, they cannot store, manage, and distribute comprehensive, timely, and relevant information to the degree needed for public health management (PHM)," the report notes. "In addition, many clinical analytics tools currently in use are quite primitive, reporting just a few basic facts and figures about a patient panel. The next generation of BI tools will have to be predictive and prescriptive to make PHM a reality." A lot of the direction of an analytics strategy depends on how organizations define "big data," though. "What we're really talking about is leveraging your data," Hoover said, whether the database is big or small. "It's about getting value from data." Sharp Community Medical Group, part of the Sharp HealthCare organization in San Diego, is starting to look at <a href="https://www.informationweek.com/big-data/news/big-data-analytics/6-questions-to-guide-natural-language-pr/240148378?cid=SBX_bigdata_related_mostpopular_Big_Data_Analytics_big_data&itc=SBX_bigdata_related_mostpopular_Big_Data_Analytics_big_data">natural-language processing</a>, according to medical informatics officer Dr. Neil Treister, one of the authors of the IHT2 report, because that seems to be helpful to physicians. "[Sharp's analytics strategy] is driven by our doctors' priorities," Triester said. "Data is extremely important, but getting through their day is more important." Triester said analytics are great for population health, but it is perhaps harder to derive benefits at the individual level. He told InformationWeek Healthcare said there has been an internal debate at the practice over how much granularity clinicians need. Many Sharp physicians are inputting a lot of data as free, unstructured text. "It doesn't make business sense to have discrete data" in some cases, according to Triester. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-19T12:00:00ZPathology Network Offers Global Remote Diagnostic ServicesNew PathCentral Pathology Network enables remote consultation and image sharing via cloud, with hopes to address specialist shortages in developing regions.http://www.informationweek.com/healthcare/mobile-wireless/pathology-network-offers-global-remote-d/240151132?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/news/galleries/healthcare/mobile-wireless/232602982"><img src="http://twimgs.com/informationweek/galleries/automated/763/01_philips_eICU_tn.jpg" alt="Telemedicine Tools That Are Transforming Healthcare" title="Telemedicine Tools That Are Transforming Healthcare" class="img175" /></a> <div class="storyImageTitle">Telemedicine Tools That Are Transforming Healthcare</div> (click image for larger view and for slideshow)</div>A new telemedicine network purports to be the first cloud-based, open platform for pathologists to consult with each other and share images in a secure environment. The <a href="http://www.pathcentralpro.net/">PathCentral Pathology Network</a>, a product of pathology software vendor PathCentral, Irvine, Calif., launched this month. The network combines digital imaging, a remotely hosted laboratory information system, and social media. "Pathologists all over the globe can seek consultations with each other," explained Dr. Gregory Henderson, recently retained as part-time chief medical advisor for PathCentral Pathology Network. Henderson, president of Pacific Pathology Partners, Silverdale, Wash., also founded and runs PathForceDx, a startup digital pathology networking company that facilitates online consultations. His company is a member of the PathCentral network. [ Telemedicine is bringing relief to some home-bound patients. Read <a href="http://www.informationweek.com/healthcare/mobile-wireless/telemedicine-improves-health-of-diabetic/240008169?itc=edit_in_body_cross">Telemedicine Improves Health Of Diabetics, Research Says</a>. ] As chief medical advisor, Henderson is charged with building a network of consulting pathologists and developing a training and mentoring program in digital pathology. Pacific Pathology Partners will be a pilot site for the PathCentral Pathology Network, Henderson added. "It's a powerful tool, but there's some refinement going on," he said of the nascent network. PathCentral said the network will allow physicians from around the world to upload digital images and case files for review by remote pathologists. PathCentral Pathology Network clients also are able to consult live with diagnostic specialists. This technology will allow pathology practices in the U.S. and other technologically advanced nations to earn ancillary revenue from remote consultations, but also expand diagnostic services to underserved communities around the world. "IT doesn't cut across all providers equally," Henderson told InformationWeek Healthcare. The lack of access to diagnoses is a public-health challenge in many regions, according to Henderson, as is a shortage of pathologists in emerging economies, such as the BRIC countries: Brazil, Russia, India and China. "The belief is there is a pretty high demand," Henderson said. A company statement said the network also had <a href="http://www.pathcentral.net/component/content/article/7-press-releases/47.html">"humanitarian" potential</a>. Henderson reported that at least 10% of PathForceDx's work is pro bono. Henderson said that PathForceDx is the first company to practice diagnostic medicine remotely. Teleradiology has been popular for years, as has remote intensive care, but there is not much available in telepathology. Since 2008, Omnyx, a joint venture of GE Healthcare and the University of Pittsburgh Medical Center (UPMC), has been <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ge-upmc-announce-digital-pathology-break/228000194">digitizing lab samples</a>. Although initially touted as a way to speed up diagnoses, a <a href="http://www.omnyx.com/company/overview">disclaimer on the Omnyx website</a> says the system is intended for research only, not diagnostic medicine. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-03-11T15:18:00ZInformatics Pioneer Says Healthcare Needs Better SystemsDr. Lawrence Weed continues his longstanding advocacy for computer-aided healthcare and revamping medical education.http://www.informationweek.com/healthcare/leadership/informatics-pioneer-says-healthcare-need/240150506?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div>  Numerous reports have shown that the medical profession is responsible for hundreds of thousands of preventable deaths a year, according to medical informatics pioneer Dr. Lawrence L. Weed. "Where's the outrage? You get one plane crashing and it's on the evening news for days. Well, there's no outrage. No one's investigating it," Weed said during a rare appearance at the Healthcare Information and Management Systems Society (HIMSS) last week in New Orleans. Weed, 89, has been advocating -- often to deaf ears -- for the computerization of healthcare because he strongly believes the human mind simply is not capable of remembering every nuance of medicine and disease without assistance from what we now know as <a href="http://www.informationweek.com/news/galleries/healthcare/clinical-systems/232300511">clinical decision support</a> systems. "The public thinks that you know all 70-odd causes of chest pains," he told a rapt audience of mostly fellow doctors during a HIMSS symposium on physician informatics."They think we know all 70 causes. They think we know the five or six things about each cause that you should check on a routine history and that you can keep score in your head and say, 'Mrs. Jones, I think you've got such-and-such,'" Weed said. "There's not a doctor in this room who would stand up and say, 'I know all of that,'" according to the longtime University of Vermont educator. "What does that mean? We're all playing with half a deck," Weed continued. "No two doctors ever play with the same part of the deck and no one plays with a full deck." The reason, according to Weed, is a fundamental flaw in the way medical education is set up. [ Want to know more from HIMSS? See <a href="http://www.informationweek.com/healthcare/interoperability/ehr-interoperability-a-hot-topic-at-hims/240150443?itc=edit_in_body_cross">EHR Interoperability A Hot Topic At HIMSS</a>. ] Weed, who created the problem-oriented medical record and the <a href="http://www.physio-pedia.com/SOAP_Notes">SOAP (subjective, objective, assessment, plan) note</a> recalls one student asking him why airplane pilots are so willing to undergo such rigorous training, testing and discipline, but medical students are not. "I said, 'Well, it's because the pilot has to get in the plane. You don't have to go up on the operating table,'" Weed said, to considerable laughter. Weed said he developed the problem-oriented medical record because he needed a system. "The worst, the most corrupting of all lies is to misstate the problem. Patients get run off into the most unbelievable, expensive procedures ... and they're not even on the right problem," according to Weed. "We all live in our own little cave. We see the world out of our own little cave, and no two of us see it the same way," he added. "What you see is a function of who you are." Knowledge is in books and literature, and patient information is in the history and physical, but there's a "gulf" between this information and a "transmission line" that leads to physician action, according to Weed. Being thorough and reliable are important, for sure. "But those are like Sunday school platitudes until you have a system. I can't teach until I have a system," Weed said. Medical students are taught a core of knowledge, not a core of behaviors. "You're developing a discipline of not being very thorough, reliable. If you get 60% or 70% in those national board exams, you'll get that MD and eat. You won't know why you were learning it, you won't use it rigorously, but you will get authority," Weed said. "We have an education problem. Nobody went through four years of medical school and all that expense to do the wrong thing, and it's not very pleasing to be told about it," he explained."We don't have a system," Weed said about healthcare. There is a transportation system that works because the knowledge is in the system, not in someone's head, and because parents teach their children how to interact with it. "Medicine is a 2 1/2 trillion-dollar industry with no <a href="http://www.informationweek.com/healthcare/admin-systems/6-healthcare-revenue-cycle-management-sy/240062614">accounting system</a>, and it's killing us economically." Businesses standardize accounting systems, Weed noted. "The scandal in business, at Enron, there was an accounting system and they corrupted it. The scandal in medicine is there's no accounting system. We don't know [all that] actually goes on," he said. "There would be a scandal in travel systems if California had different stop signs than New Jersey. I mean, let's get things standardized. Let's move knowledge through tools." Some have touted evidence-based medicine as a way of improving healthcare, but Weed has long dismissed that concept as being too reliant on probabilities, not the patient's actual problems. "We start thinking statistically," said Weed, who advocates the "coupling" of medical knowledge to problems with the help of computers. "The patient isn't interested in what's probable. They're interested in what's wrong. And if it's highly improbable, they expect you to find it," said Weed, who received two standing ovations in the 75 minutes he commanded the podium. Weed formerly ran a company called PKC -- which stands for "problem-knowledge couplers" -- that has roots stretching to 1982. He was fired in 2006 because of a conflict with management he had brought in several years earlier. Sharecare, an Atlanta-based health and wellness social network founded by TV host Dr. Mehmet Oz and WebMD founder Jeff Arnold, <a href="http://www.informationweek.com/healthcare/patient/webmd-founder-dr-oz-buy-clinical-decisio/240002394">bought PKC last year</a>. Despite the ouster, Weed still believes in the power of couplers. Knowledge couplers eliminate typing, document cases and lead to automatic outcomes studies. "You realize when you see something like that, we're in the dark ages about moving information," Weed said. "Never move it through heads." Instead, let computers do the work, he said. Ever the Renaissance man, Weed has a fondness for quoting literary and historical greats. "The cause and root of nearly all evils in the sciences is this -- that while we falsely extol and admire the powers of the human mind, we neglect to seek for its true helps," is one of his favorite lines. It was written by Francis Bacon. In 1620. "We keep talking about artificial intelligence as if intelligence is the standard," Weed quipped. "If you've got a big pile of dirt in your yard, and you can't shovel it all out, you get a bulldozer. We don't call a bulldozer an artificial arm. We don't call telescopes artificial eyes," he explained. "The mind is a very dangerous instrument," Weed added. Weed also had some choice words for the President's Council of Advisors on Science and Technology (PCAST) <a href="http://www.informationweek.com/healthcare/policy/presidents-council-calls-for-universal-d/228800073">health IT report</a>, released in December 2010. That report called for the White House and the U.S. Department of Health and Human Services to work together to develop metrics for measuring progress toward a national health IT infrastructure and for federal officials to designate a "universal exchange language" for sharing health data. Weed quoted from the report: "We believe that any attempt to create a national health IT ecosystem based on standardized record formats is doomed to failure." "That's what people in the profession, from the universities, are saying to the president of the United States," he added, somewhat incredulously, then compared health IT infrastructure to the Interstate Highway System. "They didn't say to Eisenhower ... 'any reason to standardize the national transportation system is doomed to failure,'" Weed said.2013-03-08T11:10:00ZBill Clinton Stumps For Health IT At HIMSSFormer president touts IT's potential to empower small players in a massive system, as HIMSS pledges $2.5 million to further Clinton Global Initiative goals.http://www.informationweek.com/healthcare/leadership/bill-clinton-stumps-for-health-it-at-him/240150379?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div>  Health IT can bring "huge collective clout" to "little people," including small hospitals, lower-income populations and consumers in general, a factor that could help determine whether health reform succeeds or fails, according to former U.S. President Bill Clinton. Speaking Wednesday to an overflow crowd at the Healthcare Information and Management Systems Society (HIMSS) annual conference in New Orleans, Clinton noted that health IT can improve the cost and quality of access to care in addition to cost and quality of care itself. Clinton said that the ultimate outcome of the Patient Protection and Affordable Care Act depends on how the 2010 law is implemented, and on decisions that people make outside the framework of the law itself. "Into this maelstrom, information technology will become very important," the former president said, after describing some of the ills of American healthcare and public health, including an utter lack of cost transparency for consumers. "What lies before us is an imperative to change," Clinton told the largest health IT gathering of the year, a conference that drew more than 35,000 people. "We need much more transparency in pricing," Clinton said, to a smattering of applause. "There is no correlation between the price people pay and the quality of care they get." The whole premise of IT is to manage data "so we know what the heck is going on," Clinton continued in his typical, folksy style. "Think about the role of IT to empower people to take a bigger role in healthcare, in being healthy and [in] simply understanding the system," he advised [ Healthcare has to change, but should it be this dramatic? See <a href="http://www.informationweek.com/healthcare/leadership/himss-should-healthcare-be-more-like-air/240150017?itc=edit_in_body_cross">HIMSS: Should Healthcare Be More Like Airline Industry?</a> ] According to Clinton, when systems become entrenched, as obsolete processes have been in healthcare, transactional costs eventually grow unsustainable, creating a climate ripe for innovation. "You can't keep defending the status quo," Clinton said. "We can't continue to spend money in the same way or perpetuate inequities." The former president's William J. Clinton Foundation last fall started the Clinton Health Matters Initiative, in partnership with General Electric, Tenet Healthcare and Verizon Communications, to work toward closing health disparities between different socioeconomic groups in U.S. communities. A side effect of keeping people healthy is that there will be fewer sick people to treat, according to Clinton. The ex-president talked about his foundation's collaboration with makers of soft drinks and snacks to remove sugary drinks and unhealthy food from schools in the fight against obesity. He said the effort was able to reduce children's intake of calories from beverages by 90% in about 90% of participating schools. Clinton did not mention the Health Matters Initiative during his speech, but he has spoken of the <a href="http://www.informationweek.com/global-cio/interviews/global-cio-bill-clinton-on-technologys-p/229218913">power of IT</a> to build and reform institutions. The CEO of the Clinton Health Matters Initiative, Ginny Ehrlich, did say Monday at a press conference announcing the beta test of a Verizon health information exchange project that underserved communities, including Federally Qualified Health Centers, "are not getting the information they need" to improve population health and encourage healthy lifestyles. HIMSS, itself a member of the <a href="http://www.clintonglobalinitiative.org/">Clinton Global Initiative</a> (CGI) since September, announced this week that it would commit $2.5 million over the next five years to its <a href="http://apps.himss.org/transformation/about.asp">HIMSS Healthcare Transformation Project</a> as part of its pledge to take action furthering the goals of CGI. The HIMSS Healthcare Transformation Project is a collaborative forum of senior healthcare executives, while the CGI looks to address a variety of problems around the world, including inequities in the provision of public services.2013-03-07T12:11:00ZBig Data Helps Kaiser Close Healthcare GapsAnalytics from massive clinical data repository are central to closing gaps in care, HIMSS attendees told.http://www.informationweek.com/healthcare/electronic-medical-records/big-data-helps-kaiser-close-healthcare-g/240150269?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-engines-look-to-reinvent-medi/240144641"><img src="http://twimgs.com/informationweek/galleries/automated/930/Opener_image_tn.jpg" alt=" 7 Big Data Solutions Try To Reshape Healthcare" title=" 7 Big Data Solutions Try To Reshape Healthcare" class="img175" /></a> <div class="storyImageTitle"> 7 Big Data Solutions Try To Reshape Healthcare</div> (click image for larger view and for slideshow)</div>  One benefit of Kaiser Permanente spending an estimated $6 billion for an <a href="http://www.informationweek.com/healthcare/electronic-medical-records/kaiser-permanente-finishes-emr-rollout/223500016">integrated electronic health records (EHR) system</a> to serve 9 million people across eight regions from coast to coast is it that has amassed a vast repository of clinical data. That storehouse also contains information from a patient portal, ancillary systems, smart medical devices and even home-based patient monitoring systems. All those terabytes of electronic data now are helping to fuel a massive analytics operation, part of an overall organizational goal of improving care and reining in costs. "It's all about the data and information, not the electronic health record," Carol Cain, senior director of clinical information services for the <a href="http://kpcmi.org/">Kaiser Permanente Care Management Institute</a>, said this week at the Healthcare Information and Management Systems Society (HIMSS) annual conference in New Orleans. Kaiser has embraced a concept of "complete care," which one Southern California Permanente Medical Group described as "giving my patients everything they need, whether they know it or not," according to Cain's presentation. "We need to incorporate so much more data that is available," Cain said. Data needs to be "synthesized in a meaningful way" and delivered to primary care physicians at the point of care to help suggest appropriate interventions. Cain said Kaiser views <a href="http://www.informationweek.com/healthcare/electronic-medical-records/7-big-data-solutions-try-to-reshape-heal/240144641">big data</a> as being characterized by "volume, variety and velocity." The term "refers to datasets whose size is beyond the ability of typical database software tools to capture, store, manage and analyze," she said. "Our ability to monitor our members' health is greater than our members' ability to know what needs to be monitored," Cain explained. [ Are your patients taking leadership for their own health? See <a href="http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137?itc=edit_in_body_cross">7 Portals Powering Patient Engagement</a>. ] Kaiser Permanente has developed several modules of population management, all designed to identify and close gaps in care. If a patient shows up with knee pain, for example, management tools suggest doctors ask about a cancer screening, in an effort to make office visits "proactive" and organize care around the concept of the <a href="http://www.informationweek.com/healthcare/electronic-medical-records/health-it-alone-wont-improve-primary-car/226300284">patient-centered medical home</a>, Cain said. The analytics also has to be done in a way that won't make patients feel like Big Brother is watching over them, Cain said. Instead, Kaiser wants people to think that the integrated delivery system is helping to prevent illness and find health problems early. If patients allow Kaiser to access information linked to their supermarket loyalty cards, the organization will not send warnings every time they purchase a candy bar, Cain said. What Kaiser can do is rely on its platform to combine patient-specific knowledge, such as whether an individual has filled a prescription. This can help with medication adherence, according to Cain. Analytics are helpful for developing care plans before patients are discharged from hospitals, too. Kaiser also can advise patients to telephone or schedule e-visits if a primary care physician determines a problem is not worth an in-person appointment. "That is something that is often appreciated by our members," Cain noted. Cain said that patient needs are not always clinical, either. During a 12-hour hackathon in the analytics department, Kaiser IT professionals were able to correlate access to parks with rates of obesity in Oakland, Calif. "In some of our communities, we are investing in building parks," Cain said. Kaiser also has partnerships with YMCA and schools in some areas to address lifestyle issues that can affect health.2013-03-05T13:27:00ZHIMSS: Hospitals Making Progress On Meaningful UseSurvey of healthcare CIOs reveals good progress toward fully functional EHRs, but questions about ACOs, staffing, interoperability loom.http://www.informationweek.com/healthcare/leadership/himss-hospitals-making-progress-on-meani/240150042?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>  If the Healthcare Information and Management Systems Society (HIMSS) <a href="http://himss.files.cms-plus.com/HIMSSorg/Content/files/leadership_FINAL_REPORT_022813.pdf">annual CIO survey</a> is any indication, hospitals are doing very well on their journeys toward Meaningful Use of electronic health records (EHRs) and, eventually, safer and more cost-effective care. But health IT leaders expect to be challenged in the near future by other healthcare reforms, including the imperative to create accountable care organizations (ACOs). A remarkable 66% of the 298 healthcare CIOs surveyed online between December and February said their organizations had already qualified for Meaningful Use stage 1, and another 4% had expected to do so before the end of 2012. And 75% of respondents, representing nearly 600 hospitals nationwide, said they plan on attesting for stage 2 in 2014, the first year of the second stage, HIMSS officials announced Monday at the organization's annual conference in New Orleans. Nearly half (47%) of the CIOs said their IT budgets would "definitely increase" this year, and another 29% said expenditures would "probably increase." Only 15% said their budget would be flat, and 8% expected a decline. Among the survey pool, 21% said their key health IT business objective in 2013 was to sustain the financial viability of their organizations, up from 15% last year. Nineteen percent said the top objective was to improve patient care, down slightly from 2012. A year ago, achieving Meaningful Use was the top business objective, named by 24% of respondents, but that fell to No. 4 on the list this time, at 15%. "That's a consequence that a lot of our respondents are well-positioned to meet not only stage 1 but stage 2," Jennifer Horowitz, senior director research at HIMSS research affiliate HIMSS Analytics, said. [ Want to learn about a dramatic proposal for healthcare reform? See <a href="http://www.informationweek.com/healthcare/leadership/himss-should-healthcare-be-more-like-air/240150017?itc=edit_in_body_cross">HIMSS: Should Healthcare Be More Like Airline Industry?</a> ] Even though some struggled with attempts to <a href="http://www.informationweek.com/healthcare/electronic-medical-records/take-a-hard-look-at-ehr-costs-benefits/240010611">measure return on investment</a> from EHRs and others have <a href=" http://www.informationweek.com/healthcare/electronic-medical-records/guerra-on-healthcare-is-hitech-a-bait-an/229100123">questioned whether there can be an ROI</a> from participating in the Meaningful Use program, most of those surveyed by HIMSS expected a positive return from stage 1. About 30% of hospital-based CIOs said they planned on seeing an ROI of up to $2 million in stage 1. Another 23% expected a return of $2 million to $3 million in stage 1, while 16% pegged their return at $4 million to $5 million. While the survey did not ask if anyone expected to lose money on either stage 1 or 2, HIMSS CEO H. Steven Lieber reiterated the organization's longstanding belief that the Meaningful Use bonus money was never meant to cover the full cost of an EHR and that the government was not going to "buy" health IT systems for healthcare providers. "This is much more of a policy decision [to participate in Meaningful Use] than a financial decision," Lieber said. "It really is about long-term value" in terms of quality and patient safety gains. When asked where IT can have the most impact on patient care, 31% said it was on improving quality outcomes, down from 38% a year ago, but still the most common response. Another 25% said it was on reducing medical errors, while 12% endorsed standardizing clinical care. "The top three areas here really are direct patient outcomes," Horowitz said. Interestingly, enabling remote access of data was far down that list, at just 5%, while merely 3% said providing remote monitoring of patients could have the greatest effect on patient care. Last year, nobody named remote patient monitoring. "Everyone is discussing that and realizing it can make a difference in accountable care," said Mike Rozmus, VP and CIO of <a href="http://www.rmhonline.com">RMH Healthcare</a>, an affiliate of Sentara Healthcare that operates Rockingham Memorial Hospital in Harrisonburg, Va. However, accountable care remains a pipe dream in many quarters and has taken a back seat to building general IT infrastructure. "You have to pave the last mile before you can ride that highway," according to Rozmus. At this point, CIOs have not thought much about it yet. Other aspects of healthcare reform are on the minds of CIOs, too. About 37% named healthcare reform as the business issue having the most impact on healthcare this year, down slightly from 40% in 2012. This, according to Horowitz, included ACOs and payment reform. The second most common response was financial considerations, named by 16% of respondents. Policy mandates, including meeting Meaningful Use, fell to 14%, from 23% a year ago. The primary clinical IT focus among CIOs was getting a fully operational EHR in place, named by 19% of respondents, down from 25% last year. Focus on physician systems and linking clinical systems to quality measures tied for second place on that question, at 16% each. "The top three here really are some key systems," Horowitz said. Some 21% of respondents expressed concern that they would not be able to keep up with staffing needs, and their greatest need is for expertise in clinical informatics. This is in line with earlier reports suggesting a serious <a href="http://www.informationweek.com/healthcare/electronic-medical-records/it-staff-shortages-may-short-circuit-mea/240008255">health IT workforce shortage</a>.2013-03-04T12:54:00Z4 Health IT Themes To Watch At HIMSS13Interoperability challenges, patient experience, mobile technology will be in spotlight at annual health IT conference.http://www.informationweek.com/healthcare/electronic-medical-records/4-health-it-themes-to-watch-at-himss13/240149925?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href=" http://www.informationweek.com/healthcare/clinical-systems/7-portals-powering-patient-engagement/240147137"><img src="http://twimgs.com/informationweek/galleries/automated/943/Cerner-patient-portal_tn.png" alt=" 7 Portals Powering Patient Engagement" title="1 7 Portals Powering Patient Engagement" class="img175" /></a> <div class="storyImageTitle"> 7 Portals Powering Patient Engagement</div>(click image for larger view and for slideshow)</div>The annual <a href="http://www.himssconference.org">Healthcare Information and Management Systems Society (HIMSS) conference</a> kicks off Monday in New Orleans. About 35,000 people are descending on the Big Easy for the largest health IT event of the year, featuring about 1,200 exhibitors and 300 educational sessions. As usual, attendees will get updates on the direction of health IT policy from the U.S. government's Office of the National Coordinator for Health Information Technology (ONC), in the form of a keynote Thursday from national coordinator Dr. Farzad Mostashari and several other ONC-led sessions. There is sure to be plenty of talk about electronic health records (EHRs) and the Meaningful Use incentive program. Also on the minds of CIOs are the conversion to <a href=" http://www.informationweek.com/healthcare/policy/cms-finalizes-one-year-delay-on-icd-10/240006300">ICD-10 coding</a> in the next year and a half, as well as implementation of various aspects of the Patient Protection and Affordable Care Act. [ Lack of standardization is delaying commercial applications for home monitoring devices. Read <a href="http://www.informationweek.com/healthcare/patient/patient-engagement-key-to-better-health/240148773?itc=edit_in_body_cross">Patient Engagement Key To Better Health: AHRQ Report</a>. ] Those are the obvious subjects, but there are plenty of other issues emerging or lingering in health IT. In an interview with InformationWeek Healthcare at HIMSS headquarters in Chicago last week, HIMSS CEO H. Stephen Lieber discussed some of the other topics his organization is highlighting at the annual conference, as well as themes he expects to emerge. Here are four trends to watch for: 1. EHR-Device Interoperability. Much of the recent <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-continue-to-take-a-beating/240146424">angst about EHR efficacy</a> has stemmed from the slow pace of connecting disparate information systems at different healthcare organizations and even between inpatient and ambulatory departments under the same roof. But, as HIMSS and other groups, including the U.S. Food and Drug Administration, discussed last fall, it's even more complicated than that: a new generation of <a href="https://www.informationweek.com/big-data/news/healthcare/interoperability/medical-devices-neglected-in-ehr-chase/240146700">"smart" medical devices and monitors</a> is producing electronic data, and EHRs generally are not equipped to handle that output. Even if they are, the links are not there yet. "It is much more complex from a technological standpoint than getting two electronic applications in a common format with the technical framework between them for them to share data," Lieber said about EHR-device interoperability. Information coming out of medical devices has to be formatted properly, as does the EHR to be able to accept and process such data, he noted. The Interoperability Showcase, a regular feature on the HIMSS show floor, this year will feature a demonstration of connectivity between medical devices and clinical information systems, but the technology still is in the testing stages. Unlike pretty much every other aspect of the Interoperability Showcase, this demonstration will not be using "live" patient data. "It's a demo. This is what's possible. This is how can it be done. It doesn't reflect active products on the market," Lieber said. When interoperability between devices and EHRs becomes widespread, it could go a long way to alleviate the nursing shortage by making nurses and other clinicians more efficient because they no longer will have to engage in laborious data transcription from medical devices. "This is what technology does. It makes people more efficient because they can rely upon technology doing things that we did manually before. It very much can have an impact on nursing shortages, physician shortages in remote areas, rural areas, and inner-city areas," Lieber said. "There's a tremendous amount of improvement with the workforce that is possible and isn't possible any other way. You simply can't make nurses more efficient, more productive without some new tools. Otherwise, you're just left to ask them to work more, work harder, work faster." 2. Patients As Consumers. The idea of patient-centeredness is not new, nor is the idea of empowered patients. But neither concept is widespread -- yet. As accountable care takes hold, healthcare providers necessarily will have to pay more than lip service to improving the patient experience, including medical outcomes. "Finally, the American healthcare system is starting to pay attention to and take seriously the idea of patient-centered care. People have talked about it for a generation," Lieber said. With this in mind, HIMSS13 will feature a three-session forum on patient engagement. Patient engagement is about more than just patient satisfaction scores and ratings, Lieber said, and it stretches beyond the walls of the hospital or clinic. "It's looking at how technology enhances the patient experience and the healthcare consumer experience," Lieber said. "[It means] actually doing things that make it easier on the healthcare consumer before they're in an institution and being a patient, absolutely." The HIMSS chief said healthcare providers have not always made things easier on patients, largely because consumers still are not asking for it. "As consumers we're not there yet in terms of saying, 'I'm not going to go to you if you don't do these things,'" according to Lieber. "We as consumers still aren't demanding of our healthcare like we ought to. When I think about obtaining results, most physicians still make you go to the office to get the results on paper. They don't post them online," Lieber said. Scheduling also is an inefficient, inconvenient manual process, taking place on the phone more often than online. Online consultations would be "a huge efficiency," Lieber added, if only physicians could be reimbursed for their time.3. Mobile Goes Mainstream. In December 2011, <a href="http://www.informationweek.com/healthcare/mobile-wireless/himss-launches-mobile-health-it-project/232300105">HIMSS launched its mHIMSS project</a> and later purchased the annual mHealth Summit from the Foundation of the National Institutes of Health. Last year, for the first time, the HIMSS conference included a mobile track. "There is still some unique audience there," Lieber said of mHIMSS. "On the other hand, we are also integrating mHIMSS into the HIMSS13 event because you really can't fully separate mobile health and mobile technology" from other aspects of health IT. How integrated? Dr. Eric Topol, director of the Scripps Translational Science Institute at Scripps Health in San Diego, and a well-known advocate of mobile and wireless technology in medicine, is keynoting Tuesday morning. Sprint CEO Dan Hesse was the keynote speaker at HIMSS in 2010, talking plenty about telemedicine and wireless connectivity, but a sure sign of a maturing conference topic is the presence of end users rather than vendors as speakers. Topol, author of The Creative Destruction of Medicine, is very much the user of cutting-edge technology, as he demonstrated to a mainstream audience on NBC's "Rock Center with Brian Williams" in January. Topol has been called a "rock star of science" by GQ magazine. He commanded the stage at TEDMED in 2009, famously dropping his stethoscope into a trash can on stage. "It's not only using what we'll call mobile-type devices, but he's also on the forefront of innovation in general," Lieber said. Meanwhile, the specialty program "HIT X.0: Beyond the Edge," which featured a lot of mobile technology as a standalone adjunct to the HIMSS conference the past two years, is more integrated into the main event this time. "We still call it out because there is so much technology and activity that falls into more routine, status quo [processes]," Lieber said. "The heavy lifting of healthcare technology is still vested very much in applications, systems, and activities that have been around for a few years, but the movement towards some of the cutting-edge technologies, the approaches used by people focused on mobile technologies, mobile applications -- that really is becoming more mainstream." 4. Global Health. HIMSS13 includes a new program, the Global Health Forum, featuring speakers from the U.S. Department of Health and Human Services (HHS), the U.S. Agency for International Development (USAID), and the World Bank discussing public-private partnerships related to global health initiatives. Former President Bill Clinton, he of the Clinton Global Initiative and the recently introduced <a href="http://www.clintonhealthmatters.org/">Clinton Health Matters Initiative</a>, is due to deliver a keynote on Wednesday. Lieber said he did not know exactly what Clinton would be speaking about, but a Verizon Communications press conference about health information exchange, scheduled for Monday afternoon, will feature Clinton Health Matters Initiative CEO Ginny Ehrlich. Verizon already is a partner in the Clinton Health Matters Initiative, supporting technologies such as remote, home-based patient monitoring and systems to alert doctors when patients with chronic diseases need medical interventions. The initiative is meant to close health disparities between different socioeconomic, racial and ethnic groups in the U.S. and abroad. HIMSS itself has taken a more global focus in recent years, branching out to Europe, Asia and the Middle East. Attend Interop Las Vegas, May 6-10, and attend the most thorough training on Apple Deployment at the NEW Mac & iOS IT Conference. Use Priority Code DIPR03 by March 9 to save up to $500 off the price of Conference Passes. Join us in Las Vegas for access to 125+ workshops and conference classes, 350+ exhibiting companies, and the latest technology. Register for <a href="http://www.interop.com/lasvegas/?CID=MP_ILV_IWK_Article_TL&_mc=DIPR03">Interop</a> today!2013-03-01T10:28:00ZEHRs Underused For Hospital Infection ReportingHalf of infection prevention specialists are unaware if their organizations even participate in electronic health information exchanges, says study.http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-underused-for-hospital-infection-re/240149786?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/clinical-systems/ss1120126hievendors/240142427"><img src="http://twimgs.com/informationweek/galleries/automated/910/01_Medicity2_tn.jpg" alt="6 HIE Vendors: How They Measure Up" title="6 HIE Vendors: How They Measure Up" class="img175" /></a> <div class="storyImageTitle">6 HIE Vendors: How They Measure Up</div>(click image for larger view and for slideshow)</div>  Not only are electronic health records (EHRs) and health information exchange (HIE) underutilized by those on the front lines of preventing and reporting infections, many infection control professionals are unaware of their own employers' health IT capabilities, newly published research suggests. In a survey conducted by informatics researchers at the <a href="http://www.regenstrief.org"> Regenstrief Institute</a> and the affiliated Indiana University-Purdue University Indianapolis, just one in 10 "infection preventionists," or IPs, said the organization they work for was "formally engaged" in health information exchange. In fact, 49% said they were unaware of whether their organization even participated in HIE. One of the central functions of public-health agencies is to conduct surveillance of disease and infection outbreaks, including sexually transmitted diseases and cases of methicillin-resistant Staphylococcus aureus (MRSA). "Unfortunately, many notifiable diseases are reported less than half the time, and the time lag between diagnosis and submission for those reported to public health can be as high as three weeks," said the <a href=" http://www.ajicjournal.org/article/S0196-6553%2812%2901388-0/abstract">study</a>, which appears in the American Journal of Infection Control. [ How can we make HIEs better? Read <a href=" http://www.informationweek.com/healthcare/interoperability/5-ways-to-improve-healthcare-information/240148735?itc=edit_in_body_cross">5 Ways To Improve Healthcare Information Exchanges</a>. ] According to the study, 71% of infection control specialists said they primarily reported relevant cases to health departments by printing and faxing information, and another 26% said they electronically fax at least a portion of reportable public health data. Only 8% said their hospitals use electronic laboratory reporting technology, and just one of the 38 people who answered the question said her organization reported data electronically via an HIE. "Although available to many [infection preventionists], EHR systems are providing little more than an electronic window into a patient's chart," the authors wrote. "By simply replacing paper medical records with electronic folders, IPs will continue to spend significant portions of their time manually combing through laboratory, physician, and nursing reports to determine whether or not a notifiable disease is present and should be reported to public health," they added. Lead author Brian E. Dixon, who conducted the survey as part of his Ph.D. dissertation, actually expected to hear that many infection control specialists were not sure whether their organizations even participated in an HIE. "To me, it's not surprising," Dixon said, "especially given the low percentage of infection prevention specialists who were involved in health IT design." Some 72% of those surveyed said their organizations used an EHR, but only 18% said the infection control department had been invited to participate in design, selection or implementation of the EHR. "Based on our findings, there is a need for more IPs to be more aware of and engaged in EHR and HIE activities," the study said. Dixon told InformationWeek Healthcare that other studies he has done showed that even many hospital executives were unsure if their organizations participated in HIEs. "It's not quite in the culture yet," Dixon said. "When organizations look at a new health IT system, their emphasis is on front-line care." Pathologists are not typically on the front lines of care, and laboratories often have specialized information systems that might not be integrated with institutional EHRs. Plus, infection reporting still tends to be a manual process, Dixon said. Citing 2010 data from the U.S. Centers for Disease Control and Prevention (CDC), the Regenstrief researchers said that no state health department receives 100% of notifiable lab reports electronically. However, they noted that <a href=" http://www.informationweek.com/healthcare/policy/meaningful-use-stage-2-rules-finalized/240006128">Stage 2 of the Meaningful Use</a> electronic health records (EHR) federal incentive program requires hospitals to send electronic lab reports to public health agencies. HIE, another component of Meaningful Use, can help improve infection control, previously published research has shown. The Regenstrief researchers said they were unaware of any earlier studies looking at the attitudes of infection-prevention professionals about the potential of health IT to improve disease surveillance. "The adoption and use of EHR systems and HIE also provides an opportunity to address redundant and variable reporting mechanisms that make notifiable disease reporting inefficient," they wrote. However, EHR user interfaces currently are set up for manual routing of pertinent information regarding infectious diseases, according to Dixon. "It doesn't show up in the workflow of an IP," he said. Dixon said there are two keys to changing the prevailing culture. First, there needs to be greater awareness among infection-prevention professionals of the need to be involved in EHR planning and implementation. Second, vendors and system designers need to start supporting public health reporting. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.) 2013-02-27T09:06:00ZElectronic Records Increase Preventive Testing, Study SaysWomen's health screening rates for many common conditions rise as IT becomes more sophisticated, study finds. http://www.informationweek.com/healthcare/electronic-medical-records/electronic-records-increase-preventive-t/240149501?cid=SBX_iwk_related_commentary_Attacks/breaches_security<div class="inlineStoryImage inlineStoryImageRight"><a href="http://www.informationweek.com/healthcare/electronic-medical-records/9-mobile-ehrs-compete-for-doctors-attent/240144143"><img src="http://twimgs.com/informationweek/galleries/automated/923/mobile_doc_image_175.jpg" alt="9 Mobile EHRs Compete For Doctors' Attention" title="9 Mobile EHRs Compete For Doctors' Attention" class="img175" /></a> <div class="storyImageTitle">9 Mobile EHRs Compete For Doctors' Attention</div> (click image for larger view and for slideshow) </div>Practices with electronic medical records (EMRs) tend to order more mammograms and other preventive health services for women than those that still keep records on paper, according to newly published research. The more sophisticated the EMR, the more tests ordered. In a <a href="http://jamia.bmj.com/content/early/2012/10/08/amiajnl-2012-001099.abstract">study</a> published in the Journal of the American Medical Informatics Association (JAMIA), a multidisciplinary team from the University of Cincinnati measured 11 variables, based on preventive care recommended by the U.S. Department of Health and Human Services' <a href="http://www.womenshealth.gov/">Office on Women's Health</a>. "For seven of the 11 healthcare outcomes studied, the presence of some type of EMR system was important," said the study, which first appeared online last fall but was in the February print edition of JAMIA. The researchers presented an earlier version of their study as an unpublished poster at the 2011 International Society for Pharmacoeconomics and Outcomes Research annual meeting, they said. [ Should you trust the information in electronic health records? Read <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ehr-accuracy-remains-problem-chime-says/240147454?itc=edit_in_body_cross">EHR Accuracy Remains Problem, CHIME Says</a>. ] The incidence of breast and pelvic exams, Pap tests, mammography, cholesterol tests, bone mineral density (BMD) and chlamydia screening all went up "significantly" in the presence of even a minimally implemented EMR. As EMR functionality increased, so did usage of these tests, the Cincinnati researchers found. "The key independent variable was the level of EMR system sophistication," they said. "Across the providers [studied], 29.23%, 49.34%, 15.97%, and 5.46% had no, minimal, basic, and fully functional EMR systems, respectively," the researchers said, using the classifications in the annual <a href="http://www.cdc.gov/nchs/ahcd.htm">National Ambulatory Medical Care Survey</a> (NAMCS), as compiled by the U.S. Centers for Disease Control and Prevention (CDC). They examined data in the 2007 and 2008 surveys. "The breast examination rate was 20.27%, 34.96%, 37.21%, and 44.98% for providers without or with minimal, basic, and fully functional EMR systems, respectively," the JAMIA paper said. However, EMRs did not seem to affect rates of testing blood pressure, nutrition counseling, diet and exercise counseling, or administration of flu vaccines. What is not known from this study is whether the level of EMR functionality affects quality of care or health status from preventive screenings, because the NAMCS data do not indicate whether a patient actually got the recommended care or if a physician merely placed an order. "It cannot be assumed that patients necessarily followed through with tests and examinations, let alone followed advice on diet and exercise," the researchers noted. Still, they concluded that their findings "strongly suggest that EMR systems have a positive impact on preventive women's healthcare. The use of a national database along with advanced statistical techniques allow for confidence in this conclusion." The Cincinnati team did allow that they were working with rather old data, from 2007 and 2008, which were the most recent NAMCS statistics available when putting together their analysis. "However, because of the fast-paced development and adoption of EMR system technology, the results of this study will become dated fairly quickly," they said, noting that the CDC's National Center for Health Statistics reported in 2011 that 57% of office-based physicians had some form of EMR. "Guidelines for women's health also change periodically depending on the latest research findings," they added. Attend Interop Las Vegas, May 6-10, and attend the most thorough training on Apple Deployment at the NEW Mac & iOS IT Conference. Use Priority Code DIPR02 by March 2 to save up to $500 off the price of Conference Passes. Join us in Las Vegas for access to 125+ workshops and conference classes, 350+ exhibiting companies, and the latest technology. Register for <a href="http://www.interop.com/lasvegas/?CID=MP_ILV_IWK_Article_TL&_mc=DIPR02">Interop</a> today!2013-02-25T13:48:00ZAetna Consolidates Health IT AssetsNew Healthagen business unit will sell integrated care coordination, population health management, physician workflow transformation services.http://www.informationweek.com/healthcare/clinical-systems/aetna-consolidates-health-it-assets/240149333?cid=SBX_iwk_related_commentary_Attacks/breaches_security <div class="inlineStoryImage inlineStoryImageRight"> <a href="http://www.informationweek.com/healthcare/electronic-medical-records/ 9-mobile-ehrs-compete-for-doctors-attent/240144143"><img src="http://twimgs.com/informationweek/galleries/automated/923/mobile_doc_i mage_175.jpg" alt="9 Mobile EHRs Compete For Doctors' Attention" title="9 Mobile EHRs Compete For Doctors' Attention" class="img175" /></a> <div class="storyImageTitle">9 Mobile EHRs Compete For Doctors' Attention</div> (click image for larger view and for slideshow) </div>  Health insurer Aetna, which has acquired and created a portfolio of health IT companies in recent years, has rolled its IT, population health management, and business incubation assets into a new business unit called Healthagen. The goal, according to the Hartford, Conn.-based company, is to have a common brand for addressing provider and consumer needs in the areas of care coordination, value and greater transparency in healthcare. The new business unit includes such Aetna holdings as mobile app <a href="http://www.informationweek.com/healthcare/mobile-wireless/walgreens-tests-mobile-scheduling-app/240004963">iTriage</a>, analytics and population health services company Active Health Management, health information exchange provider <a href="http://www.informationweek.com/healthcare/interoperability/aetna-to-buy-medicity-for-500-million/228600189">Medicity</a> and home-grown physician workflow transformation tool Practice iQ. The Healthagen name comes from the developer of iTriage, which Aetna bought in 2011. "Practice iQ was a business we created to allow physician practices to become patient-centered medical homes," newly named Healthagen CEO Dr. Charles Saunders told InformationWeek Healthcare. "[Healthagen] really is an innovation crucible or innovation arm of Aetna," he said. [ With its new Latitude tablet, Dell is focusing squarely on the healthcare market. Read about it here: <a href="http://www.informationweek.com/healthcare/mobile-wireless/dell-targets-healthcare-with-windows-8-t/240149319?itc=edit_in_body_cross">Dell Targets Healthcare With Windows 8 Tablet</a>. ] Saunders had been named Aetna's president of strategic diversification in 2011 and later served as CEO of the insurance company's Aetna Emerging Businesses business incubator. Healthagen now brings all those operations under a single brand name. "This was an attempt to basically formalize it," Saunders explained. Healthagen also will operate <a href=" http://www.informationweek.com/healthcare/patient/patient-centric-technology-really-does-i/240009094">Accountable Care Solutions</a>, another Aetna business unit. Saunders said that all of Healthagen's offerings will be integrated to allow Aetna to offer customized packages of services to consumers, healthcare providers and "risk bearers" such as accountable care organizations, employers and even other health plans. Saunders indicated that the Healthagen moniker Saunders is intended to be "neutral" so potential clients, including other payers, have no qualms about working with a division of Aetna. "Most of the [Healthagen companies] are payer-neutral," Saunders said. "Medicity doesn't send data back to Aetna," he added, as an example. Companies operated or incubated by Healthagen will, however, have access to Aetna's distribution channels. This currently includes about 22 million enrollees as well as other customers, according to Saunders. Being too closely associated with a parent company has hurt other players in health IT before. Notably, electronic health records vendor Cerner bought clinical decision support content developer Zynx Health from Cedars-Sinai Medical Center in Los Angeles in 2002, but sold it to publisher Hearst Corp. less than two years later, ostensibly because other health IT software companies did not want to do business with a Cerner subsidiary. As large healthcare providers test the limits, many smaller groups question the value. Also in the new, all-digital <a href="http://www.informationweek.com/gogreen/021813hc/?k=axxe&cid=article_axxt_os">Big Data Analytics</a> issue of InformationWeek Healthcare: Ask these six questions about natural language processing before you buy. (Free with registration.)