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    Tasked with accomplishing what takes some health systems $100 million with less $10 million, the IT shop conceived a new approach that saved $4.5 million a year and streamlined IT infrastructure management.

    Phoenix Children’s Hospital recently implemented an electronic medical record, replaced many ancillary clinical systems to create a single database, built an enterprise data analytics program, and significantly increased the size of its organization.

    As a result, our team at Phoenix Children’s knew the enterprise needed a large-scale, cross-functional modernization of IT involving all aspects of the organization, from clinical operations and infrastructure to human resources, billing and research.

    Many of our peers were committing more than $100 million to replace their clinical IT systems, while we were tasked with delivering similar results for less than 10 percent of those costs. The purpose was to redirect the dollars to improve facilities, provide better care and enhance coverage for Arizona’s pediatric population.

    With the knowledge that every penny saved would benefit children in need, our team conceived the Lean IT initiative.

    [EHRs getting better? Readers rank vendors higher than last year in new survey]

    Running lean in health care is no easy proposition, of course. Heavy regulation, mandates around Meaningful Use of electronic health records, highly complex environments, and the need to support a large number of diverse endpoints – from servers to drug pumps – can be resource- and time-intensive.

    Even so, we built a comprehensive infrastructure that ensures the consistent performance, availability and security of critical clinical and operational systems as well as the ability to scale and modernize to meet demand.

    Among our efforts, we:

    • Reduced ongoing and one-time vendor contracts, creating a savings of $4.5 million per year
    • Streamlined IT infrastructure management
    • Built and implemented a comprehensive enterprise data warehouse containing real-time data from more than 60 systems and supporting 1,600 self-service reports with 300 active daily users – all in just three months
    • Developed patent-pending technology that places secured, managed, and patient-specific iPads in every patient room without any recurring annual costs
    • Created a large, scalable and isolated research computing environment – without the cost or complexity of traditional enterprise solutions – to support the hospital’s burgeoning work in research, genomics and imaging. Using open-source technologies, our team built a 180-TB research and video SAN array for $15,000, secured a supercomputer and high-speed fiber network with donated funds, and engineered a complete research environment, all with existing staff.

    Moreover, the initiative has produced significant financial and operational results, including:

    • An overall reduction in IT Capital Expenditure and Operational Expenditure per employee and per adjusted patient day
    • Savings of more than 30 percent per year on major annual IT contracts
    • Conversion of all outpatient clinics from paper processes to an EMR within 18 months, which in some clinics reduced net costs and improved patient throughput by up to 30 percent
    • Optimization of workflow processes that saved more than $2 million a year, while simultaneously scaling out IT operations and architectures with no increases to IT staffing

    “Doing more with less” is long overdue in the IT health care environment. With changing reimbursement  models, changes in our population, and the slow conversion from large 1990s client-server software solutions to cloud-based rapid-development cycle services, health care IT must move to a high-return, low-cost model.

    The Lean IT initiative is not one person, one system, one innovation or a one-time change. It’s an innovation of thought, approach, and vision – one that has resulted in many other technologies that solve business problems in a long-term, sustainable way.   

    David Higginson is the CIO at Phoenix Children’s Hospital


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    Author: 
    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/New%20hires_0.jpg
    Slideshow Title: 
    Running list: 2016 notable hires, promotions in health IT
    Slideshow Description: 

    Keep up with the top comings and goings, the changing roles and faces in the world of healthcare IT with this regularly updated gallery.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Embi_Peter.png
    Slideshow Title: 
    Peter Embi, MD, takes CEO position at Regenstrief Institute
    Slideshow Description: 

    Embi, an internationally recognized expert in biomedical informatics, will leave his post as interim chair of the Department of Biomedical Informatics and associate dean for research informatics at Ohio State University’s College of Medicine.

    Read the article.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Jerry_Esker_2.jpg
    Slideshow Title: 
    Jerry Esker takes CEO seat at Sarah Bush Lincoln Health System
    Slideshow Description: 

    Esker, who has been with the organization for more than 30 years, accepts the new roll just as the organization prepares to roll out a Cerner EHR system.

    Read the article.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Barnett.jpg
    Slideshow Title: 
    Thomas L. Barnett to join University of Rochester Medical Center as CIO
    Slideshow Description: 

    Thomas L. Barnett will take the post of CIO at the University of Rochester. Barnett has more than 20 years of experience in building information systems in complex healthcare settings, officials stated in a news release announcing their selection. Part of the vast experience he brings to the job is his work with Epic EHRs at other health systems. URMC is an Epic shop.

    Read the full article.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Mary%20E.%20O%27Dowd.jpg
    Slideshow Title: 
    Mary E. O'Dowd, former New Jersery health commissioner, to oversee health systems, lead population health initiatives at Rutgers University
    Slideshow Description: 

    Mary O’Dowd joins Rutgers as the academic medical center is embarking on a wide-ranging population health initiative to integrate specialities with more traditional fields.

    Read the full article.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Joy%20Grosser_1.jpg
    Slideshow Title: 
    Joy Grosser wins CIO post at University Hospitals in Cleveland
    Slideshow Description: 

    In addition to IT experience in large healthcare systems, Grosser brings strategic strengths to the job.

    Read the story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/mainehealth_marcydunn2_0.jpg
    Slideshow Title: 
    MaineHealth taps Marcy Dunn for CIO post
    Slideshow Description: 

    In her role at MaineHealth, Dunn will be responsible for IT operations across the system of nine member hospitals and other healthcare providers serving southern, western and central Maine, as well as Carroll County, N.H.

    Read the story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Jeff%20Hurst_1.jpg
    Slideshow Title: 
    Cerner names RCM expert Jeff Hurst to lead revenue cycle business
    Slideshow Description: 

    Cerner President Zane Burke said Hurst, currently a senior vice president at Florida Hospital, brings both vision and operational expertise to the software vendor.  

    Read the story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Rajiv%20Kumar%2C%20MD-HITN-1.png
    Slideshow Title: 
    Apple hires one of its HealthKit ambassadors: Rajiv Kumar, MD
    Slideshow Description: 

    The pediatric endocrinologist at Stanford University's Lucile Packard Children’s Hospital is known for his HealthKit pilot study on Type 1 diabetes patients.

    Read the story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/marcharrisonHFN_0.png
    Slideshow Title: 
    A. Marc Harrison to succeed CEO Charles A. Sorenson at Intermountain Healthcare
    Slideshow Description: 

    Intermountain Healthcare appointed A. Marc Harrison, MD, 52, as its new president and chief executive officer. Harrison will take the post when the current CEO Charles Sorenson, 64, retires on October 15, 2016.

    Read the fiull story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/paul_tang__md_480.jpg
    Slideshow Title: 
    Paul Tang, MD, joins IBM Watson
    Slideshow Description: 

    After 18 years of leading health IT innovation at Palo Alto Medical Foundation, part of Sutter Health, headquartered in Sacramento, Calif., Paul Tang, MD, is making his innovation work even bigger, broader and faster by teaming up with IBM Watson.

    Read the full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Jeffrey%20Carr-HITN_0.png
    Slideshow Title: 
    Jeffrey Carr takes position as Mercy Health's first-ever Chief Innovation Officer
    Slideshow Description: 

    Jeffrey Carr, formerly the entrepreneur-in-residence – at a Cincinnati startup incubator, is bringing his varied innovation background to bear at Mercy Health, which operates 23 hospitals in Ohio and Kentucky. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Valita%20Fredland.png
    Slideshow Title: 
    Indiana HIE puts longtime expert in charge of privacy, security
    Slideshow Description: 

    Valita Fredland is stepping into the triple role of vice president, general counsel and privacy officer at the Indiana Health Information Exchange, the largest health exchange in the country. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Patricia%20Flatley%20Brennan%20in%20CAVE.jpg
    Slideshow Title: 
    Patricia Flatley Brennan to head National Library of Medicine
    Slideshow Description: 

    Patricia Flatley Brennan, a professor at the University of Wisconsin at Madison, and a former practicing nurse with a Ph.D. in industrial engineering, will take the lead as director at the National Library of Medicine. Read full story here.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/1.%20Andrew%20Bindman%2C%20MD_0.jpg
    Slideshow Title: 
    UCSF professor, researcher Andrew Bindman to head AHRQ
    Slideshow Description: 

    Andrew Bindman, MD, takes the helm at the U.S. Agency for Healthcare Research and Quality. Under the umbrella of the Department of Health and Human Services, AHRQ is charged with finding ways to improve healthcare by making it more accessible, affordable, equitable – and safer. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Eric%20Dishman-HITN_0.png
    Slideshow Title: 
    Eric Dishman exits Intel to head National Institutes of Health precision medicine research
    Slideshow Description: 

    The longtime Intel fellow will be responsible for creating a longitudinal study to more effectively treat disease and ultimately improve health. Dishman also brings experience using precision medicine tactics to beat cancer he fought for 23 years. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/2.%20Neal%20Singh-HITN.png
    Slideshow Title: 
    Caradigm names Neal Singh its new CEO
    Slideshow Description: 

    Population health IT developer Caradigm promoted its chief technology officer Neal Singh the chief executive position. Singh will take over for Michael Simpson, who has led the company since it was founded as a joint venture by Microsoft and GE four years ago. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Adam%20Landman.jpg
    Slideshow Title: 
    Landman takes CIO spot at Brigham and Women's
    Slideshow Description: 

    As CMIO, Adam Landman has taken an active role in Partners HealthCare's Epic implementation and is 'experienced in designing early-stage technology innovation.'  Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/5.%20marklantzyhitn_1.png
    Slideshow Title: 
    Indiana University Health names new CIO
    Slideshow Description: 

    Mark Lantzy brings more than 20 years experience earned at Gateway Health, Accenture, Aetna, WellCare. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/6.%20glaserhitn.png
    Slideshow Title: 
    Cerner taps John Glaser to lead EHR company's population health efforts
    Slideshow Description: 

    Before joining Cerner, Glaser was the longtime vice president and chief information officer at Partners HealthCare. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/7.%20Jeff%20Brown%20seattlechildrens.png
    Slideshow Title: 
    Seattle Children's Hospital names Jeff Brown permanent CIO, senior vice president
    Slideshow Description: 

    Brown joined Seattle Children's from Lawrence General Hospital in Massachusetts in April 2015, serving as interim CIO. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/8.%20mechael.png
    Slideshow Title: 
    HIMSS taps Patricia Mechael to lead Personal Connected Health Alliance
    Slideshow Description: 

    HIMSS appointed Patricia Mechael executive vice president, Personal Connected Health Alliance at HIMSS, effective April 15. Read full story.

     

     

     

     

     

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Sue%20Schade.png
    Slideshow Title: 
    Sue Schade leaves University of Michigan, heads to Cleveland for interim CIO role
    Slideshow Description: 
    Schade, chief information officer at University of Michigan Hospitals and Health Centers, is leaving that role and will instead focus on consulting, coaching and interim management work after spending more than 30 years leading IT departments. See full story.
     
     
     
     
     
     
    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/10.%20Vindell%20Washington.png
    Slideshow Title: 
    Vindell Washington named principal deputy national coordinator at ONC
    Slideshow Description: 

    Washington most recently served as president and CMIO of Franciscan Missionaries of Our Lady Health System. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/11.%20Daniel%20Barchi%20NYPres.png
    Slideshow Title: 
    Daniel Barchi named NewYork-Presbyterian CIO, will lead telehealth launch
    Slideshow Description: 

    Barchi previously served as senior vice president and CIO at Yale New Haven Health System and Yale School of Medicine.

    Read full story.

    Teaser: 

    Keep up with the top comings and goings, the changing roles and faces in the world of healthcare IT with this regularly updated gallery.

    Thumbnail: 
    hires promotions health IT
    Custom OAS pagetag: 

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    Peter J. Embi, MD, will take the reins as president and CEO of the Regenstrief Institute in December, the Institute officials announced on Tuesday.

    Embi, an internationally recognized expert in biomedical informatics, will leave his post as interim chair of the Department of Biomedical Informatics and associate dean for research informatics at Ohio State University’s College of Medicine.

    Embi is a practicing physician and a researcher, known for his expertise in clinical and research informatics. He succeeds former Regenstrief President and CEO William Tierney, MD, who now serves as chair of population health for the Dell Medical School at The University of Texas at Austin.

    [See also: Regenstrief CEO begins new chapter .]

    Before joining Ohio State in 2010, Embi was the founding director of the Center for Health Informatics at the University of Cincinnati Academic Health Center. In addition to his interim chair and associate dean roles, Embi serves in a number of roles at Ohio State. He's director of the division of clinical and translational informatics in the Department of Biomedical Informatics, tenured associate professor of biomedical informatics, internal medicine and public health and chief research information officer at the Ohio State University Wexner Medical Center, among other roles.

    “This is a critical time for healthcare and biomedical research, and the work our investigators do, in collaboration with our healthcare partners, is essential to transforming the way we practice,” Embi said. “I am very enthusiastic about the impacts we can have on the health of our patients and communities.”

    Regenstrief is a global leader in biomedical informatics, health services and aging in innovations and research to improve health and healthcare. It's a supporting organization of the Indiana University School of Medicine and has several regional partners, including IU Health and Eskenazi Health.

    Founded in 1969, the Regenstrief Institute and its researchers have been responsible for major developments and studies demonstrating the use of electronic health records and related information technologies to improve the quality and efficiency of healthcare.

    In addition to his leadership position at Regenstrief, Embi will hold the positions of associate dean for informatics and health services research and professor of medicine at the IU School of Medicine, associate director for informatics at the Indiana Clinical and Translational Sciences Institute and vice president for learning health systems at Indiana University Health. He will also be named the Sam Regenstrief Professor of Informatics and Health Services.


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    In an effort to advance the use of patient-reported outcomes for research and care delivery, a coalition of nine universities has been awarded a $6.3 million grant by the National Center for Advancing Translational Sciences, part of the National Institutes of Health.

    Patient-reported outcomes surveys pose questions to patients about their physical, mental and social health. By comparing medical information with their responses, providers and researchers can see how clinical care is impacting the health of patients.

    This academic project, led by Northwestern University, is called EHR Access to Seamless Integration of PROMIS – or EASI-PRO. It will make it easier for researchers and clinicians to collect patient reported outcomes information and use it to improve clinical care and research.

    [Also: Linking patient-reported data to EMRs]

    PROMIS – it stands for the Patient Reported Outcomes Measurement Information System – is a computerized survey tool that adapts to each patient's answers. It's integrated into the patient's EHR along with their medical information.

    "We are very excited to see this multi-institutional project take off," said Donald Lloyd-Jones, MD, director of the Northwestern University Clinical and Translational Sciences Institute. "This approach to direct, efficient acquisition and integration of patient-reported information represents the future of patient care and medical research, and this project paves the way to that future."

    PROMIS has already been integrated into the Northwestern Medicine EHR and now the EASI-PRO team is building software that will integrate PROMIS with a large number of EHRs including Cerner and Epic, two of the largest vendors, officials say, enabling health systems nationwide to administer the surveys and easily compare results.

    University of Chicago, University of Illinois at Chicago, University of Alabama at Birmingham, University of Kentucky, University of Florida, University of Utah, Harvard Catalyst CTS and Southern California CTSI are also part of this project. Cerner and Epic have signed on as integration collaborators.

    "Our experience integrating the PROMIS tools into the EHR at Northwestern has convinced us that tight workflow integration of PROs into the clinical workflow brings many benefits to both quality and clinical research projects," said Justin Starren, director of the Center for Data Science and Informatics at Northwestern University Feinberg School of Medicine and principal investigator of EASI-PRO.

    Twitter: @MikeMiliardHITN
    Email the writer: mike.miliard@himssmedia.com


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    Vindell Washington, MD, the National Coordinator for Health IT, visited healthcare clinics and a long-term care nursing facility in St. Louis Oct. 25 to observe data exchange across different EHRs and record locator services.

    The exchange took place via the Carequality Interoperability Framework.

    SSM Health – including the St. Louis-area outpatient center that Washington visited – uses an Epic EHR to receive patient files from multiple community partners who use NextGen, athenahealth, MatrixCare with Kno2 interoperability services, and eClinicalWorks with Surescripts’ National Record Locator Service.

    Carequality announced live exchange in August, with 3,000 clinics and 200 hospitals live and ready for exchange. Today, the effort has grown to more than 150,000 clinicians across 11,000 clinics and 500 hospitals live and able to share health data records, regardless of the technology network, said Dave Cassel, director of Carequality, in a statement.

    [See also: Carequality says athenahealth, eClinicalWorks, Epic, NextGen, Surescripts now exchanging data via Interoperability Framework ]

    More than 50,000 care documents have been exchanged so far.

    "What’s happening here in the St. Louis area is being replicated around the country," Peter Schoch, MD, vice president of Value-Based Care & Payment for SSM Health St. Louis, said.

    "The exponential growth we’re seeing is a credit to the diverse stakeholders from across healthcare who came together and developed the framework specifically to be able to scale nationally and very quickly, by leveraging the existing investments and technologies of our implementers," Cassel said.

    He explained that connectivity among diverse health systems and EHRs is possible because Carequality delivered the necessary legal terms, policy requirements, technical specifications, and governance processes.

    To date, the framework has been adopted by 15 healthcare organizations with dozens more reviewing it for adoption, according to Cassel.

    Washington observed health data sharing at Midwest Nephrology Associates, Inc., SSM Health, and Mount Carmel Senior Living, all in St. Louis.

    Twitter: @Bernie_HITN
    Email the writer: bernie.monegain@himssmedia.com


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    Epic Systems CEO Judy Faulkner will be honored this fall with a prestigious Distinguished Alumni Award from her alma mater, the University of Wisconsin, according to the Wisconsin State Journal.

    It’s one of three Distinguished Alumni Awards the Wisconsin Alumni Association will hand out.

    John Daniels Jr., chairman emeritus of the Quarles & Brady law firm, and Doris Feldman Weisberg, a 1958 UW graduate a co-founder of the Food Network and professor emerita at City College of the City University of New York, will also receive Distinguished Alumni Awards.

    Faulkner heads a $2 billion company and has been on the Forbes billionaire list for several consecutive years. She has signed the giving pledge, which will leave her wealth to a charitable foundation she established.

    She founded Epic Systems in 1979, at a time when most healthcare systems kept patient records tucked away in manila folders.

    [See also: Epic reveals R&D spending outstrips Apple, Google and its competitors.]

    Faulkner coded the first Epic software herself. Today, she’s listed as one of the few healthcare billionaires on the Forbes billionaire's list, along with Neal Patterson, who heads rival health IT company Cerner.

    She believes her company is better off as a private entity, and she plans to keep it that way.

    Faulkner earned her undergraduate degree in math from Dickinson College in Pennsylvania and her master’s in computer science at University of Wisconsin - Madison.

    She recently told Healthcare IT News research and development is her sweet spot because she has a technical background. It was at UW-Madison she wrote the code, using the computer language MUMPS.

    Twitter: @Bernie_HITN


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    After advancing the uses of both Apple HealthKit and Apple ResearchKit in his position as Director of Mobile Strategy at Duke, Ricky Bloomfield, MD, is leaving the university to take a job on Apple's health team.

    A colleague of Bloomfield's broke the news on Twitter today and Apple confirmed the news.

    The company declined to go into detail about what Bloomfield's role at Apple would be, but he's not the first high-profile hire the company has made lately. Since June 1st, the company has hired Rajiv B. Kumar, MD, a pediatric endocrinologist from Stanford University with experience implementing Apple's HealthKit to help patients manage their diabetes; Stephen Friend, MD, president and co-founder of Sage Bionetworks which built the data infrastructure for a number of ResearchKit apps; and Mike Evans, MD, a Toronto doctor who boasts 70,000 followers on his medical-themed YouTube channel.

    [Also: Duke Medicine talks HealthKit-Epic integration]

    Bloomfield was at Duke in 2014 when Apple announced Apple Health and Apple HealthKit. Duke became one of the first hospitals to integrate with Apple HealthKit via Epic, and to use the platform to incorporate patient-generated health data into its EHR. The initial pilot used HealthKit to track blood pressure and weight for patients with cancer and heart conditions. Bloomfield and Ochsner CIO Richard Milani spoke about HealthKit at a packed session at 2014's mHealth Summit. Two years later, at MobiHealthNews's event in San Francisco, Bloomfield broke the news that Apple would add HealthKit support for the HL7 Continuity of Care Document to iOS 10.

    ResearchKit, Apple's research-focused follow-up to HealthKit, also proved to be an area of interest for Bloomfield, who helped create Autism Beyond, Duke’s ResearchKit study designed to increase knowledge about how autism manifests in children. The study is looking at the application of a video analysis technology to quantify and analyze the emotions of children so that one day parents may be able to use it as a screening tool for conditions like autism, anxiety, and other behavior related conditions.

    [Also: Duke liberates Epic EHR data with Apple HealthKit and FHIR]

    Autism and Beyond includes a number of short surveys for parents and three videos for children to watch. As the kids watch the videos, which are based on the same kind of stimuli exercises child psychologists use during in-person behavior encoding sessions, Duke's app is using the iPhone's camera to analyze the child's expressions. Parents have the option of sending researchers the recorded video of their child along with the encoded data, or if they'd rather, they can opt to just send the analysis data without the full video recording. The video recordings the researchers do receive will also help them fine tune their algorithms.

    This story first appeared on MobiHealthNews.

    Twitter: @HealthITNews


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    What makes a hospital IT department a good place to work? Is it good bosses, who value your unique skills and treat you fairly? Good colleagues, willing to work together as a team toward a shared goal? Good pay and benefits? Good coffee in the break room?

    For the 6th annual Healthcare IT New Best Hospital IT Departments, we heard from thousands of information technology workers at hospitals and health systems nationwide. The nominated IT teams were large (1100 staffers), small (3 staffers) and everything in between.

    The people who took our 87-question survey were senior executives (CIO, CMIOs, etc.), directors of IT, clinical and systems analysts, technicians, help desk staff and others. They spanned ages from just-out-of-college to Medicare-eligible. Their hospitals ranged from Northern Maine to Southern California.

    Despite this diversity, the winners shared some common feelings about their working environment. As they filled in detailed responses about their day-to-day job duties, departmental colleagues, direct supervisors, senior management, workplace culture, development and advancement opportunities, compensation and recognition, these IT staffers tended to rate their workplaces quite highly indeed.


    Healthcare IT News Best Hospital IT Departments 2016: 
    ⇒ Meet the winners
    ⇒ CIOs reveal what makes an IT shop great 
    ⇒Interactive map: Best Hospital IT Departments 
    ⇒ Slideshow: See the people who make their IT departments winners


    But not just by picking high numbers on scales of 1 to 10. That's easy. No, these folks spoke – overwhelmingly – with something far more substantial: their career paths. In response to the statement, "I plan to continue my career with this organization," more than 88 percent either "agreed" or "agreed completely."

    Nearly 24 percent of respondents had been working for their current organization for between 10 and 20 years. Nearly 12 percent had been there for more than 20 years. That sort of loyalty doesn't come from office potlucks and Yankee swaps.

    Rather, it comes from finding value in the work – and in doing the work together.

    What employees had to say
    Healthcare IT News is taking a slightly different approach than in years past. Beyond just naming the winning departments – and capitalizing on the wisdom of their IT leaders to learn just what makes a satisfied technology shop run – we're seeking a much deeper and more informative dive into the data gleaned from those thousands of employee feedback surveys.

    On the topic of their day-to-day work, respondents said they appreciated departments that offered "support and autonomy to do the work that is asked of me." Another noted that their IT team makes its employees "feel like they are of value, and very important to the department. The work we do is always appreciated."

    Still another said being equipped with the right tools was essential to helping the IT department do a very important job to the best of its ability, applauding the hospital for being on "the cutting edge of technology: The company believes in upgrading systems in order to stay ahead and (give) the patients the best possible results."

    Coworkers matter too. One survey taker was thankful for a workplace culture that "fosters a spirit of teamwork that extends beyond department lines. Another liked the fact that "a point is made to engage team members in all aspects of the work we do and grant them customer facing time so that they can develop working relationships with them."

    Keeping a focus on what all this technology means to patient care, and supporting each other – irrespective of job title – in the challenging endeavor of keeping IT optimized, looks to be a common factor in a happy department.

    "The IT department is a team," said one respondent. "From the CIO to the operations team, everyone is treated with respect. We are encouraged to do our job well and supported in every effort. The IT department is like a family."

    As for bosses, managers and direct supervisors, again, clarity and consistency of mission is key. "Our leadership team is clear with our goals and keeps us focused on ensuring we have the time and resources to focus completely on improving patient care," said one staffer. Leadership "allows employees to work autonomously, trusts employees to get the work done, is supportive," said another.

    "There is complete transparency between senior leadership and the employees," said a third. "Our expectations are clear and we know where to turn if we need help or direction. There is a great team mentality here, nobody is left to handle things alone." Still another liked the fact that bosses "engage their employees toward the betterment of the department: We are involved in the decisions that are made," given the "tools we need to exceed at our jobs and encouraged to push the boundaries toward excellence."

    Essential to employees finding value and reward in the work they do each day is the chance for ongoing training and professional development – and opportunities for advancement

    "The department avails career tracks that fit the individual," said one IT employee. "Leaders and non-leaders can excel and be recognized for their contributions and rise to the top of their craft. Those that prefer a more routine role are still valued for their contributions.

    Another noted: "Our IT department is full of highly motivated, creative and intelligent individuals that work well as a team. Analysts and techs working with different applications and systems are always willing to share information and provide education. As a nurse in the IT department, I am learning the ropes."

    But perhaps the most reliable indicator of a happy, cooperative and successful department is a general workplace culture that recognizes that the mission-critical IT team is still only part of a larger and more significant goal: enablement of high-quality patient care.

    "Our IT department goes out of its way to provide the best service to the hospital and its staff," said an employee. "Everyone in my organization helps out equally and communicates openly. It’s a very open structure, meaning if we need assistance from another IT function we only need to pick up the phone."

    "Great communication and dedication to the mission," said one poll-taker of what make their team work as part of the larger hospital organization. "It helps that a lot of the staff and management in the IT department have an extensive background as hospital clinicians."

    Perhaps the most common theme is the satisfaction that many survey respondents taking in serving clinicians nurses, physicians and patients.

    "We continue to think 'outside the box' to develop new and innovative ways to provide quality patient care," a poll-taker said. Another agreed: "It is a place that deeply cares about our patients and we are all striving to provide the best care possible. I find great satisfaction that we are all pulling in this same direction."

    Twitter: @MikeMiliardHITN
    Email the writer: mike.miliard@himssmedia.com


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    Electronic health record vendor drchrono released a new version of its software for larger medical practices and provider groups. The company also said it has built the RCM Pro service to optimize workflow of coders, billers and billing managers.

    The updated EHR platform is targeted for larger medical practices that need to retire legacy EMR systems and upgrade to cloud-based technology, real-time business intelligence tools, RCM software and mobile applications, drchrono CEO Michael Nusimow said in a statement.

    The RCM Pro platform addresses current drawbacks in medical billing with software to streamline and reduce the amount of human labor involved in getting doctors paid from insurance companies and their patients.

    The update brings several features for larger practices, including security technology, cloud servers for HIPAA compliance and two-factor authorization. This latest iteration also includes business intelligence tools for advanced charting and reporting options to give the C-suite a complete view of the business, and a patient portal with messaging and payment processing and applications for smart phones and tablets.

    Through drchrono’s partnership with the Mayo Clinic, the new version offers advanced patient education material uploaded by the practice or accessed through a database and accessible via the web, iPad or iPhone.

     “drchrono has spent its formative years developing a physician first product building in customization and clinical tools all integrated into one platform,” Nusimow added. “The new features are specifically designed for larger provider groups who need to operate more efficiently.” 

    Twitter: @HealthITNews


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    The Centers for Medicare and Medicaid Services gave healthcare providers what they have rallied long and hard to get as participants in the Meaningful Use EHR Incentive Program: a 90-day EHR reporting period in 2016 and 2017.

    Also, CMS is making changes under the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals attesting to meaningful use by eliminating the clinical decision support and computerized order entry objectives and measures beginning in 2017.

    The changes also apply to hospitals that are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs – dual-eligible hospitals.

    [EHRs getting better? Readers rank vendors higher than last year in new survey]

    Also, CMS is reducing a subset of thresholds for the remaining objectives and measures for Modified Stage 2 and Stage 3.

    CMS is finalizing an application process for a one-time significant hardship exception to the Medicare EHR Incentive Program for certain eligible professionals in 2017 that are also transitioning to MIPS – the Merit-based Incentive Payment System

    As CMS officials put it, the additions increase flexibility, lower the reporting burden for providers, and focus on the exchange of health information and using technology to support patient care.

    HIMSS and CHIME, both healthcare IT industry advocates, lobbied for the 90-day reporting versus the full year reporting.

    In a letter to acting CMS Administrator Andy Slavitt on September 1, HIMSS CEO Stephen Lieber and HIMSS Board Chair Michael Zaroukian, MD called swift finalization of a 90-day meaningful use reporting period for 2016.

    Meaningful Use, Stage 3 is slated to begin in 2018 with a full-year reporting period. 

    Twitter: @Bernie_HITN
    Email the writer: bernie.monegain@himssmedia.com


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    C. Martin Harris, MD, has been chief information officer at Cleveland Clinic since 1996. During those two decades he's helped establish the health system as one of the leading-edge innovators in health information technology.

    In his new book, "It's About Patient Care: Transforming Healthcare Information Technology the Cleveland Clinic Way," Harris gives firsthand perspective on the ways IT-enabled, patient-centric care can effect big improvements in clinical quality.

    He also offers a guidebook, of sorts, for other providers looking to follow Cleveland Clinic's lead, with advice for the design and implementation of IT systems, EHR optimization, care coordination, patient engagement and more.

    Harris spoke with Healthcare IT News about some lessons learned in his years as one of the world's most respected healthcare CIOs, and lays out his vision for the future of value-based care.

    Q. Why did you decide to write this book?
    A.
    The Cleveland Clinic has built an integrated health information technology network that connects all of its caregivers across many locations. With this infrastructure, it implemented a single, common electronic health record system. We continue to add image management, data capture and analysis, reporting transparency, and an entire menu of systems. Like us, many others across the country are taking this technological journey. I wrote this book to share what we've learned in the hopes that some of our best practices might help speed the creation of a more technology-enabled healthcare system that will better serve patients.
     
    Q. Do you feel we're at a pivotal moment – either in health IT generally, or in your career – that made this a logical time for some perspective?
    A.
    We're in a pivotal moment historically because the power and availability of technology solutions is inviting everyone in our industry to begin imagining how their organizations might benefit from a customized technology transformation. Personally, my path forward became clear when I started my career and applied IT and computerized tools to practicing medicine. Everything that followed – all of my experiences at Cleveland Clinic, my association with my colleagues in HIMSS, both nationally and internationally, the opportunities to work with the U.S. Department of Health and Human Services' Health Information Technology Standards Committee and the director of the National Institutes of Health – has all flowed directly from that moment when I realized that information and its management could transform the practice of medicine.

    Q. What lessons have you learned in pioneering healthcare IT at Cleveland Clinic?
    A.
    Every participant in the practice must be a full partner in our shared transformative journey. Communication, at every phase of every project, is critical. Caregivers' needs, patients' demands, and regulators and payers' requirements must all be indexed and considered, analyzed, and resolved in a way that reflects the comfort and consideration of the people who will use the systems we design, build, and implement.

    Q. The power of technology is expanding as software, devices, and systems are integrated into coordinated networks. Where is the Cleveland Clinic at in this process?
    A.
    We have a full range of interactions, from a centralized help desk and other support functions, that can be efficiently delivered across the enterprise to highly specialized, highly specific solutions that require the full attention of extremely skilled, onsite resources – so the presence and power of technology systems is woven into the fabric of the Cleveland Clinic practice model.

    Q. You say that EHRs are now as integral to the practice of medicine as a stethoscope or X-ray. As a longtime leader in the field, are you surprised it's taken this long?
    A.
    It's taken actually less than 20 years for medical practice to fully embrace technology. The Internet only started becoming part of a significant portion of the population around the year 2000. Smartphones have put that Internet in the palm of your hand for perhaps half that time. We've gone from online banking catching on after the Y2K bug passed without major incident in 2000, to secure online virtual visits that connect physicians and patients through high-speed Internet systems in about 15 years.

    Q. Cleveland Clinic is a world-class institution. But what advice do you have for a smaller hospital, with limited budgets and staff, that's still using its EHR for basic care but would like to do more with its IT systems and patient data?
    A.
    Start thinking about your IT investment differently. Traditionally, those charged with running a healthcare organization considered an IT expenditure in terms of a return on investment. They accounted for an IT system much like you would a fixed piece of equipment that could depreciate, and bill for using. But by having that opinion, they will miss a big piece of technology's true value.

    The EHR is quickly becoming the one, single practice environment in which every member of a patient's care team comes together in the same place. As this technology becomes interoperable, practices that do not participate in this contemporary virtual practice space will exclude themselves from it – which is not a strategy for success over the long term.

    Q. How do EHRs empower patients to take more control of their own healthcare?
    A.
    EHRs are a patient's direct link to the information recorded about them, as well as the ongoing activities that help to keep them healthy and address issues. I can't think of a better way for a patient to become more involved in the activities that will help them to preserve their precious health, than to be connected – anytime, anywhere – directly to their care team. To see what healthcare providers can see and to be able to ask questions about it, either during a visit, or through an online service like the one we offer at Cleveland Clinic that we call "Ask Your Doc," make the relationship active and dynamic.

    Q. Telemedicine systems are eliminating geography and physical distance as barriers to expert care. How has telemedicine been used at your institution?
    A.
    At Cleveland Clinic, the idea that we collectively call "distance health" is an organized set of solutions that helps remove distance as a consideration when we connect the right patient, to the right clinician, at the right time and place. Patients with serious health issues are connected directly to some of the world's leading experts. We've also given millions of patients access to their own personal medical information through MyChart. Critical care specialists serve as consulting monitors to intensive care units across our health system through an advanced EHR-based connectivity system called eHospital. And our Express Care Online service, which quickly connects patients to doctors through an Internet-based virtual visit system, helps patients decide how they want to interact with our organization.

    Q. You made the statement, "medicine at its most technically advanced is medicine at its best, because it is still rooted in the bedrock principles of compassion and healing." How so?
    A.
    Since its beginning, the concept of providing care to someone in need has remained essentially unchanged. a person with knowledge and experience focuses on a patient's situation, gathers information, applies critical thinking skills to the problem, identifies potential causes, tests each idea until a diagnosis is verified, and then creates and conducts a treatment plan. Technology is simply a set of tools that a clinician has available to make the process of care work better.

    Q. Many physicians complain about EHRs, saying their documentation requirements are burdensome, and cause them to have to look away from patients in the exam room. Do their arguments have merit, in your view?
    A.
    Yes, that argument has some validity, but the EHR itself is not the issue. Rather, it's more about the timeline of the EHR as a medical tool's development. Clinicians are being asked to account in much greater detail the care they deliver. As more information becomes available through the EHR and other systems, demand for that information will increase. But because capabilities have been added to the EHR over time, doctors have assumed responsibility. What needs to happen now, which is something the Cleveland Clinic is doing, is to decide who on a care team would be the most appropriate person to do each task. By spreading out the tasks, we can help everyone practice to the top of their license, and free each contributor to the encounter to concentrate on what they were trained to do.

    Q. Please shed some light on the coming frontiers of health information and technology.
    A.
    In the last chapter of my book I write about the coming of what I call the Internet of Healthcare – a systematic evolution of a portion of the Internet as it exists today to meet people's healthcare needs worldwide. Imagine "a secure portion of the Internet that uses the web's infrastructure not only as it presently exists, but as it is developing in both its speed and capacity to contain and move information," to bring patients, providers, and everyone else involved in the contemporary medical ecosystem together into "a protected digital practice space that is connected to thinking EHR technologies in a way that will allow us all to transcend the limitations of our current structures and discover ways of doing things that will change the way medicine is conceived and practiced."

    I believe this can truly happen if everyone starts moving toward simplicity, while simultaneously making every effort to "avoid the kind of magical thinking that might encourage us to place a totally unjustified level of faith in our technology's inherent ability to design, create, or police itself."

    I go on to say that it's important to have built-in mechanisms that can monitor and correct automatically for any deliberate or inadvertent lapses that may impinge upon security and trust.

    Finally, I write that "we must demand that the Internet of Healthcare, as it evolves and grows, is simple enough to be used by people with widely varying amounts of experience and sophistication, while remaining inherently flexible enough to support and encourage the kind of ongoing innovation that will lead to entirely new service categories and treatment advances about which we can only dream today, and that will only be imagined tomorrow."


    Healthcare IT News Best Hospital IT Departments 2016: 
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    The Office of the National Coordinator for Health IT has named the Phase 1 winners of its Move Health Data Forward Challenge, which seeks innovative uses of APIs than can enable consumers to more easily share their personal health data.
     
    The total prize amount available for the three phases of the Move Health Data Forward Challenge is $250,000, with the two finalists winning a total of $75,000.

    Each Phase 1 winner – who had to show the technical, operational, financial and business aspects of their proposed technologies – will receive a $5,000 award.
     

    • With an eye toward improving coordinated care in ACOs through open standards, TrustedCare and ARM aim to develop devices that enable patients to interact with multiple providers in a secure, authenticated and auditable way.
    • The CareApprove app from CedarBridge Group enables consumers to consent to share their data with their providers from their smartphone and, optionally, to choose which sections of information may be shared with a given provider.
    • The HealthToGo service from EMR Direct is focused on apps that can integrate patient data from multiple sources through software that supports scalable deployment of APIs.
    • Docket, from Foxhall Wythe, optimizes patient-health care provider communication by empowering mobile users to securely maintain their critical health information and authorize the transmission of that information to trusted care professionals.
    • Technology from kreateIoT, Technatomy and Koncero aims to give people power to both access their health information electronically and also actively direct their health information's flow to help make informed decisions through a browser on a laptop or mobile app. The team is using SMART and FHIR to create a secure way of sharing sensitive patient data.
    • The HealthyMePHR system from Lush Group enables patients to import their health data from their primary care EHR system, define how it is shared with others, and authorize electronic access. Other features will speed patient clinical data sharing on a patient-by-patient basis.
    • Live and Leave Well is an end-of-life planning platform designed to help individuals create, manage and share end of life plans using APIs.
    • MedGrotto, developed by SpunJohn Consultants, gives patients an easy, simple and secure platform to store and access their complete health record while sharing with their providers and/or surrogates with fully customizable access levels from any device, anytime and anywhere.
    • MyHealthRec.com, from Thoughtkeg Application Services Corporation, is an enhanced patient portal web application that uses modern web technologies for front-end design that is responsive to users and enables patients and their proxies to control the movement of their health data.
    • The tools developed by Resilient Network Systems, Webshield and SAFE Biopharma, in partnership with Carebox and InterSystems, aims gives consumers the ability to conveniently access and share their own health records on demand. It will demonstrate a unique nationwide capability to conveniently verify a consumer's identity, locate and electronically request a consumer's records, and deliver them to a secure cloud-based personal storage service.
       

    The ten winners now move to Phase 2, where up to five finalists will be awarded $20,000 each for prototypes and test performance of their solutions. Those winners will move to Phase 3, which will award $50,000 for up to two winners each based on the participant's ability to implement their solution.
     
    "As health information technology becomes more accessible, consumers are playing an even greater role in how and when their health information is exchanged or shared," said National Coordinator Vindell Washington, MD, in a statement. "The Move Health Data Forward Challenge will help consumers unleash their health data and put it to work."


    Healthcare IT News reveals Best Hospital IT Departments 2016: 
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    Physician executives are in the driver's seat as healthcare reform redefines the ways leadership roles are conceived and compensated, according to the new 2016 Physician Leadership Compensation Survey from the American Association for Physician Leadership and Cejka Executive Search.

    The poll collected self-reported compensation data from 2,353 physician leaders in July 2016 based on 2015 total compensation, including salary, bonuses, incentive payments, research stipends, honoraria and distribution of profits.

    It finds that the total median compensation for physicians in leadership in 2016 is $350,000 – a gain of 8 percent since the last survey in 2013. 

    One group in particular far outpaced those gains, however: chief information officers and chief medical information officers, whose average 2016 compensation of $372,500 is up 18 percent from three years ago.

    [Also: Healthcare IT News Best Hospital IT Department winners reveal what it takes to make a great IT shop]

    That increase could be explained by the roles' shift in focus and growth in importance as they move away from EHR implementation and toward ensuring the usability of data to support preventative care at the individual provider level and risk-based accountable care at the enterprise-level.

    "Clearly, there is perceived value in having a physician leader drive these initiatives and facilities are willing to compensate accordingly," said Paul Esselman, Cejka Executive Search's managing director, in a statement.

    Other physician C-suite roles that saw gains: CEO, with an average of $437,500 (up 7 percent) and chief medical officer ($388,000, up 6 percent). Chief quality/patient safety officer salaries remained unchanged at $375,000.

    Interestingly, some of the highest-paid physician executives – earning, on average, $499,000 –  were not CEOs. Instead they served in emerging C-suite positions such as chief strategy officer, chief transformational officer, chief innovation officer, chief integration officer and physician-in-chief.

    "Physicians in these transformative roles are often tasked with 'connecting the dots' across the organization and care continuum to achieve the greater efficiency and effectiveness of care required by newer reimbursement models, including population health management and accountable care," added Joyce Tucker, Cejka Executive Search's managing principal.

    Beyond the C-suite, the highest three-year gain in compensation was 26 percent for physician leaders focused on clinical initiatives serving as president of the medical staff or medical director, assistant or associate, showing the importance of clinical quality leaders as outcomes are increasingly tied to reimbursement.

    "Given healthcare reform and the continued attention on costs, including executive compensation, we don't expect physician leader compensation to return to pre-recession growth rates anytime soon," said Esselman. "However, there are emerging roles in response to the shift toward value-based care that provide physician leaders with significantly greater opportunities for earnings, as well as strategic input and organizational influence."   


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    'Miles to go before we see and benefit from the ROI from fully interoperable digital health records'

    Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control.

    About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015.. Only 9 percent of physicians took advantage of all four functions.

    Full use of EHRs varies by state:

    • The percent of doctors who electronically sent patient health information to other providers ranged from a high of 56.3 percent in Arizona to a low of 19.4 percent in Idaho.
    • The percent of doctors who electronically received patient health data from other providers ranged from a high of 65.5 percent in Wisconsin to a low of 23.6 percent in Louisiana and Mississippi.
    • The percent of doctors who electronically integrated patient health information from other providers ranged from a high in 49.3 percent in Delaware to a low of 18.4 percet in Alaska.
    • The proportion of doctors who electronically searched for patient information from other providers ranged from a high or 61.2 percent in Oregon to a low of 15.1 percent in Washington, DC (the District of Columbia).

    These data come from the 2015 National Electronic Health Records Survey which polled a national sample of nonfederal office-based patient care physicians between August and December 2015.

    Health Populi’s Hot Points:  Most U.S. physicians have purchased, installed and are using electronic health records systems, driven primarily by financial incentives they’ve derived from the HITECH Act — part of the Stimulus Bill (more formally, the American Recovery and Reinvestment Act of 2009). Why was this part of the Stimulus package? The policy thinking was that health care costs in America were a key driver of the long-term deficit and so the U.S. health system had invest in the means to measure health spending and outcomes and then manage what we measure.

    Without interoperability — that is, the ability to move data where it needs to go throughout the continuum of care and shared across providers who all serve the patient — we can’t fully measure, and thus manage, costs and quality for that N of 1 patient.

    U.S. taxpayers have made the investment into EHRs for their doctors. But we’ve still miles to go before we see and benefit from the ROI from fully interoperable digital health records systems. There are promising technologies and standards beginning to be adopted by pioneering informaticists and healthcare systems — FHIR standards for innovating within the EHR environment, and APIs bringing patient-generated data to their personal health records. May 2017 be a new year for health data liquidity and sense-making out of EHRs

    .This post originally appeared on Health Populi.


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    Author: 
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    Slideshow Title: 
    Running list: 2016 notable hires, promotions in health IT
    Slideshow Description: 

    Keep up with the top comings and goings, the changing roles and faces in the world of healthcare IT with this regularly updated gallery.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/GerryLewis-712_1.jpg
    Slideshow Title: 
    Gerry Lewis takes reins as CEO of Ascension Health's IT
    Slideshow Description: 

    Ascension Health promoted Lewis to CIO and senior vice president. He will also serve as CEO for Ascension Information Services, the organization's IT unit.

    Read the article.

    Slideshow Image: 
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    Slideshow Title: 
    Peter Embi, MD, takes CEO position at Regenstrief Institute
    Slideshow Description: 

    Embi, an internationally recognized expert in biomedical informatics, will leave his post as interim chair of the Department of Biomedical Informatics and associate dean for research informatics at Ohio State University’s College of Medicine.

    Read the article.

    Slideshow Image: 
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    Jerry Esker takes CEO seat at Sarah Bush Lincoln Health System
    Slideshow Description: 

    Esker, who has been with the organization for more than 30 years, accepts the new roll just as the organization prepares to roll out a Cerner EHR system.

    Read the article.

    Slideshow Image: 
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    Thomas L. Barnett to join University of Rochester Medical Center as CIO
    Slideshow Description: 

    Thomas L. Barnett will take the post of CIO at the University of Rochester. Barnett has more than 20 years of experience in building information systems in complex healthcare settings, officials stated in a news release announcing their selection. Part of the vast experience he brings to the job is his work with Epic EHRs at other health systems. URMC is an Epic shop.

    Read the full article.

    Slideshow Image: 
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    Slideshow Title: 
    Mary E. O'Dowd, former New Jersery health commissioner, to oversee health systems, lead population health initiatives at Rutgers University
    Slideshow Description: 

    Mary O’Dowd joins Rutgers as the academic medical center is embarking on a wide-ranging population health initiative to integrate specialities with more traditional fields.

    Read the full article.

    Slideshow Image: 
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    Joy Grosser wins CIO post at University Hospitals in Cleveland
    Slideshow Description: 

    In addition to IT experience in large healthcare systems, Grosser brings strategic strengths to the job.

    Read the story.

    Slideshow Image: 
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    MaineHealth taps Marcy Dunn for CIO post
    Slideshow Description: 

    In her role at MaineHealth, Dunn will be responsible for IT operations across the system of nine member hospitals and other healthcare providers serving southern, western and central Maine, as well as Carroll County, N.H.

    Read the story.

    Slideshow Image: 
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    Cerner names RCM expert Jeff Hurst to lead revenue cycle business
    Slideshow Description: 

    Cerner President Zane Burke said Hurst, currently a senior vice president at Florida Hospital, brings both vision and operational expertise to the software vendor.  

    Read the story.

    Slideshow Image: 
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    Slideshow Title: 
    Apple hires one of its HealthKit ambassadors: Rajiv Kumar, MD
    Slideshow Description: 

    The pediatric endocrinologist at Stanford University's Lucile Packard Children’s Hospital is known for his HealthKit pilot study on Type 1 diabetes patients.

    Read the story.

    Slideshow Image: 
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    Slideshow Title: 
    A. Marc Harrison to succeed CEO Charles A. Sorenson at Intermountain Healthcare
    Slideshow Description: 

    Intermountain Healthcare appointed A. Marc Harrison, MD, 52, as its new president and chief executive officer. Harrison will take the post when the current CEO Charles Sorenson, 64, retires on October 15, 2016.

    Read the fiull story.

    Slideshow Image: 
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    Slideshow Title: 
    Paul Tang, MD, joins IBM Watson
    Slideshow Description: 

    After 18 years of leading health IT innovation at Palo Alto Medical Foundation, part of Sutter Health, headquartered in Sacramento, Calif., Paul Tang, MD, is making his innovation work even bigger, broader and faster by teaming up with IBM Watson.

    Read the full story.

    Slideshow Image: 
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    Slideshow Title: 
    Jeffrey Carr takes position as Mercy Health's first-ever Chief Innovation Officer
    Slideshow Description: 

    Jeffrey Carr, formerly the entrepreneur-in-residence – at a Cincinnati startup incubator, is bringing his varied innovation background to bear at Mercy Health, which operates 23 hospitals in Ohio and Kentucky. Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Indiana HIE puts longtime expert in charge of privacy, security
    Slideshow Description: 

    Valita Fredland is stepping into the triple role of vice president, general counsel and privacy officer at the Indiana Health Information Exchange, the largest health exchange in the country. Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Patricia Flatley Brennan to head National Library of Medicine
    Slideshow Description: 

    Patricia Flatley Brennan, a professor at the University of Wisconsin at Madison, and a former practicing nurse with a Ph.D. in industrial engineering, will take the lead as director at the National Library of Medicine. Read full story here.

    Slideshow Image: 
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    UCSF professor, researcher Andrew Bindman to head AHRQ
    Slideshow Description: 

    Andrew Bindman, MD, takes the helm at the U.S. Agency for Healthcare Research and Quality. Under the umbrella of the Department of Health and Human Services, AHRQ is charged with finding ways to improve healthcare by making it more accessible, affordable, equitable – and safer. Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Eric Dishman exits Intel to head National Institutes of Health precision medicine research
    Slideshow Description: 

    The longtime Intel fellow will be responsible for creating a longitudinal study to more effectively treat disease and ultimately improve health. Dishman also brings experience using precision medicine tactics to beat cancer he fought for 23 years. Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Caradigm names Neal Singh its new CEO
    Slideshow Description: 

    Population health IT developer Caradigm promoted its chief technology officer Neal Singh the chief executive position. Singh will take over for Michael Simpson, who has led the company since it was founded as a joint venture by Microsoft and GE four years ago. Read full story.

    Slideshow Image: 
    http://m.healthcareitnews.com/sites/default/files/Adam%20Landman.jpg
    Slideshow Title: 
    Landman takes CIO spot at Brigham and Women's
    Slideshow Description: 

    As CMIO, Adam Landman has taken an active role in Partners HealthCare's Epic implementation and is 'experienced in designing early-stage technology innovation.'  Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Indiana University Health names new CIO
    Slideshow Description: 

    Mark Lantzy brings more than 20 years experience earned at Gateway Health, Accenture, Aetna, WellCare. Read full story.

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    Slideshow Title: 
    Cerner taps John Glaser to lead EHR company's population health efforts
    Slideshow Description: 

    Before joining Cerner, Glaser was the longtime vice president and chief information officer at Partners HealthCare. Read full story.

    Slideshow Image: 
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    Slideshow Title: 
    Seattle Children's Hospital names Jeff Brown permanent CIO, senior vice president
    Slideshow Description: 

    Brown joined Seattle Children's from Lawrence General Hospital in Massachusetts in April 2015, serving as interim CIO. Read full story.

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    Slideshow Title: 
    HIMSS taps Patricia Mechael to lead Personal Connected Health Alliance
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    HIMSS appointed Patricia Mechael executive vice president, Personal Connected Health Alliance at HIMSS, effective April 15. Read full story.

     

     

     

     

     

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    Sue Schade leaves University of Michigan, heads to Cleveland for interim CIO role
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    Schade, chief information officer at University of Michigan Hospitals and Health Centers, is leaving that role and will instead focus on consulting, coaching and interim management work after spending more than 30 years leading IT departments. See full story.
     
     
     
     
     
     
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    Washington most recently served as president and CMIO of Franciscan Missionaries of Our Lady Health System. Read full story.

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    Barchi previously served as senior vice president and CIO at Yale New Haven Health System and Yale School of Medicine.

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    David A. Williams, MD, steps into the newly created role of chief scientific officer at Boston Children's Hospital
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    Keep up with the top comings and goings, the changing roles and faces in the world of healthcare IT with this regularly updated gallery.

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    Burke Mamlin, MD, and Paul Biondich, MD, of the Regenstrief Institute and Indiana University School of Medicine, will receive the 2016 Donald A.B. Lindberg Award for Innovation in Informatics from the American Medical Informatics Association for their work on open source software.

    AMIA's Lindberg award recognizes individuals for technological, research, or educational contribution that advances biomedical informatics.

    Mamlin, an internist, and Biondich, a pediatrician, are pioneers in the development, testing, and use of open source software to support the delivery of healthcare in developing countries. 

    OpenMRS – the system that stemmed from their concept – is designed to be usable in resource-poor environments and can be customized with modules – laboratory test ordering and reporting, for example, or public health reporting – without programming. It is intended as a medical record system platform that can be adopted and modified wherever required. 

    [Also: Post-EHR era: Bunk buzzword or here before long?]

    As recently as 2015, when commercial electronic medical record systems were not equipped to handle the problems encountered in the Ebola outbreak in West Africa, OpenMRS was adapted to help the large number of patients in extreme conditions.

    Today, the OpenMRS community forms the world's largest open source project to develop health information technology for resource-constrained environments. The OpenMRS platform is deployed in more than 80 countries throughout the world.

    In addition development of OpenMRS, which Mamlin led, he is also focused on computerized physician order-entry and provider interfaces with medical record systems. Biondich, who leads the Global Health Informatics program at the Regenstrief Institute and spearheads health information exchanges within resource emerging environments, also developed a decision support system, Child Health Improvement through Computer Automation.

    Both Mamlin and Biondich joined Regenstrief Institute’s Center for Biomedical Informatics in 2001. The center focuses on clinical applications, computer-based decision support, data mining, advanced analytics, healthcare information standards and global health.

    Mamlin is an associate professor of clinical medicine and Biondich is an associate professor of pediatrics at IU School of Medicine.

    Approximately 2,500 informatics professionals are expected to attend AMIA's 2016 symposium in Chicago  November 12, when Mamlin and Biondich will receive their awards.


    Healthcare IT News' Best Hospital IT Departments 2016: 
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    The advent of telemedicine has introduced an unprecedented degree of convenience and immediacy, data sharing and communications among care teams and resource availability for value-based, patient-centered care.

    But ensuring uniformly high-quality telehealth requires providers, technology vendors and ethicists to address and answer some big questions about the efficacy of remote vs. in-person care, the extent to which physicians can be reimbursed for telemedicine services and the ethical standards to which telehealth should adhere.

    The quality issue
    A unique intimacy attaches to medical care that is, literally, hands-on and puts physicians, nurses and patients in the same physical space. It's a valid concern that the virtual-visit character of telemedicine could depersonalize the doctor-patient relationship and compromise its pastoral element. But if a telehealth plan is put in place that caters to a patient's special needs and takes a global look at care, that concern can be eliminated or at least greatly eased.

    "In thinking about how we care for all of our patients, we're not just relying on the visits we have with them," suggests Shivan Mehta, MD, director of operations at the Penn Medicine Center for Health Care Innovation and author of "Telemedicine's Potential Ethical Pitfalls," which appeared in the American Medical Association's Journal of Ethics. "I also think about how you could engage and interact with them in between visits and in an efficient way."

    In Mehta's view, a whole range of possible telehealth formats, including social media and text messaging, could be employed to forge an even deeper connection – particularly for underserved populations that have few doctors in their communities or must travel long distances to see a physician.

    "Telemedicine could complement existing delivery of care, and if it's designed well, in a way that maintains personality and allows for interaction and for people to connect with people, then that's very reasonable," he said.

    Aside from therapeutic closeness, how do you also ensure that the effectiveness of telemedicine services doesn't suffer, either? By looking at the whole "value equation" of the healthcare in question, said Mehta.

    "It's not just about the outcomes that happen but also the efficiency that leads to them," he said. "So if you can provide acceptable quality by measuring the right outcomes, but do it in a more efficient way, by using technology that actually improves quality for everyone, you can actually see and interact with more patients.

    "Just as we want to measure quality for our live visits, we want to measure quality for our virtual visits to make sure that the patient experience is acceptable – just like we would in a clinical setting – and to make sure that the outcomes the patients have are comparable."

    The increasing availability of telemedicine hasn't always synced up with the need to create high-quality clinical standards. That's why telemedicine care platform developer Carena has developed a set of virtual practice guidelines that are, in part, based its experience with 35,000 virtual clinic encounters. These treatment guidelines for clinicians emphasize patient safety, clinical quality and evidence-based medicine and can be customized to fit a particular health system's care protocols.

    The ethics issue
    Just as traditional medical care demands the highest ethical standards, the same is true of telemedicine. The need to protect the privacy and confidentiality of patient data and patient exchanges with care team members is no less paramount in the latter than in the former.

    With telemedicine, however, there is "the added dimension to ensure that no one is 'off-screen' or observing that the patient is not aware of and that permission has been obtained" for that presence, said David Fleming, MD, co-director of the MU Center for Health Ethics at the University of Missouri School of Medicine.

    Fleming lays out several ethical considerations that either are singular to telemedicine, or apply differently to it than to traditional care. One of these involves the need to avoid discrimination against patients who may be denied access to telemedicine venues because of logistics, cost or reimbursement barriers.

    "Patients still need to be able to get to the telehealth site unless they are using mobile devices," he points out. "If the ability to travel even short distances is a barrier, then access is a problem for some patients. The cost of the equipment can be a problem for some less well-to-do healthcare systems in starting a telehealth program. And if telehealth is not reimbursed both patients and physicians will be reluctant to use it."

    Part of the solution, according to Fleming, is for medicine and society to develop "more affordable and less complicated technology," make reimbursement more readily available, and adopt "better and more informed healthcare policies to deploy telehealth services in under-served areas.

    Another ethical conundrum is how to prevent technology advances in telemedicine from inadvertently, or even deliberately, exploiting patients. In Fleming's view, that requires a collaborative effort by physicians, physicians' groups, healthcare systems and the larger society to develop "well-seasoned and evidence-based policies for the use of telehealth technology." The technology must be deployed "for the right reasons and in the best interest of patients – in particular, vulnerable patients who are at risk if something goes wrong. It's wrong to use telehealth primarily for financial gain."

    The reimbursement issue
    The scalability of telemedicine, i.e., how readily health care systems adopt that modality, depends in no small part on the extent to which government (Medicare, Medicaid) and private payers are allowed, and willing, to reimburse providers for telemedicine services. The current landscape contains a hodgepodge of practices and regulatory approaches on what, and how much, can be reimbursed and what is eligible for coverage.

    The bottom line is, providers need to know they will be paid for telehealth delivery, and right now there are 31 states and the District Columbia that have payment mandates, but those vary greatly in language and scope. And Medicare fee for service providers are only paid if the patient's care happens in a rural, clinical site, so telehealth services delivered to patients in homes or in cities are excluded.

    So that begs the question: Is there any movement to establish reimbursement uniformity across all types of payers?

    Kofi Jones, director of government affairs for telehealth services provider American Well, said we're not there yet, in part because reimbursement rules are established in different ways for Medicare (the Social Security Act), Medicaid (the states) and private insurers (insurance codes).

    But Jones said that efforts are underway to get policy-makers to view telehealth as "simply a modality of care delivery, not a different type of health care, and should be viewed in a similar light."

    Hence, the momentum is towards expanded reimbursement. "From the commercial standpoint, you will see more and more health plans either complying with the laws that have been passed or even going beyond that to establish their own telehealth reimbursement policies," Jones predicts.

    The corollary concern about uniformity is parity regulations, which require reimbursement for telehealth services at the same or an equivalent rate paid for in-person care. One problem is that mandates in this regard oftentimes speak to either coverage or reimbursement or both. So in some states with mandates, people still have problems getting claims paid.

    Delaware is a good example of how to resolve that discrepancy. In 2015, the state passed law specifically requiring coverage and reimbursement to be paid at the same levels.

    "When you have a bill that's that clear, it tends to compel greater claims payments," Jones said, adding that the upshot, in Delaware, has been that "telehealth claims are being submitted more often, that they're being paid, and that there's been great success in increasing reimbursement for appropriately provided telehealth care.

    "The key to provider adoption is really provider payment," she said. "It's critical for providers to know what they're going to be paid, which is why there's such a great effort underway in the telehealth community to resolve the issue of reimbursement."

    Though quality, ethics and reimbursement issues remain to be resolved, it's clear that growing attention is being paid to them.

    Twitter: @HealthITNews


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    The crucial foundation of the U.S. healthcare system and its patients rests upon interoperability and the ability of providers to make the transition to efficient flow of electronic health information.

    So said the Office of the National Coordinator for Health Information in its annual report to congress, asserting the need for interoperability to further the goals set forth in ambitious projects such as the Precision Medicine Initiative.

    With nearly all of hospitals (96 percent) and 78 percent of physician offices now using certified electronic health record technology, it's no longer enough to merely adopt these tools, according to ONC. The healthcare industry needs to fully utilize the EHR and other health IT tools to improve patient care and outcomes.

    "The impact of the dramatic increase in health IT adoption since passage of the HITECH Act goes beyond digitizing paper health records," the authors wrote. "The rapid adoption of health IT has facilitated increased use of functionalities that have real-world clinical impacts."

    To increase interoperability, ONC is focusing on three priorities:

    • The creation and promotion of common standards for seamless data exchange, especially through the use of open application programming interfaces.
    • An overhaul of delivery systems to improve interoperability and the way CMS pays for care to reward quality.
    • A culture change with regard to access to information, helping combat data blocking, educating individuals on their rights to access information and reminding providers they're legally allowed to exchange healthcare information when it comes to treatment.

    One major step, according to officials, is HL7's FHIR standard to promote and integrate electronic health information exchange. The spec allows providers to transmit patient data to the consumer or an app chosen by the patient.

    While ONC found that more providers are exchanging information than in the past, there is still much work to be done.

    "Despite progress on standards and economic incentives, many health IT developers, healthcare providers and hospitals still choose not to share electronic health information for a variety of reasons," the report's authors said.

    "To achieve the seamless and secure flow of electronic health information, public and private sector efforts must foster culture change around access to information – including combating information blocking – in addition to addressing technical and economic factors," they added.

    More specifically, officials said common standards are necessary for successful interoperability, as are innovations at the community level. So too is the elimination of information blocking. ONC is targeting these providers and exploring avenues to fix the problem.

    Further, as providers shift toward value-based care, ONC and the Center for Medicaid and CHIP Services are collaborating to help state Medicaid agencies have a unified approach for all data systems and programs.

    "In the years to come, HHS will continue to work with federal partners, the private sector and Congress to make electronic health information accessible when and where it matters most, to bolster care delivery and coordination, improve the health of individuals and communities, reduce disparities, fuel research and innovation and spur advancements in scientific discovery," according to ONC.

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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    Though healthcare did not get the attention during the campaign as many would have hoped, President-elect Donald Trump has already laid out a plan that many feel will cause massive disruption to the industry. His 7-point plan begins with the repeal of the Affordable Care Act, which could result in the loss of insurance for up to 20 million people.

    [Also: Trump will face cybercrisis in first 100 days, Forrester predicts]

    Also on his list: Allowing insurance companies to sell across state lines, creating health savings accounts to help pay for coverage, giving people the ability to deduct insurance premium payments from taxes, mandating healthcare price transparency, pushing Medicaid control to the state level and reforming access to pharmaceuticals.

    One day after his election, we polled our readership of healthcare managers and clinicians to see what they think the short and long-term effects will be of Trump's policies on the healthcare sector, and we were flooded with responses. While most of them detail the deep concerns industry professionals have, a small few felt the businessman's idea could improve competition and lower costs.

    On the other hand, many respondents paint a bleak picture.

    Here are nearly 100 of the answers we got, broken down by the titles of the people who shared them with us.


    Executive director

    "Young people will feel emboldened to avoid purchasing health insurance causing losses to the industry. Low-income people will lose access to insurance within 24 months and conditions will be established for a popular--and potentially successful--push for a single payer system (Medicare for all) in 2020."

    Medical Data Abstractor

    "Get sick, stay sick."

    President

    "Block grants to the States on Medicaid, capping federal match and forcing states to prioritize coverage. Some states who cover illegal aliens who are not edible for Medicare will have to make tough decisions."

    Owner

    "Cheaper health insurance!"

    Inpatient coder

    "Millions more losing coverage across the board. Pre-existing coming back."

    CIO

    "More people being able to afford health insurance through increased personal economic stability."

    Senior director

    "He'll repeal the ACA, and hold onto the provisions people like without the proper balance to offset the actual costs. Prices will continue to rise because the coverage pool will be too large. Caps will return and people will once again go bankrupt or go without care. Layoffs and slow growth for the H.C. industry in general. Will not address the Rx price negotiation problem and costs will continue to be unaffordable even for those with HSAs or insurance."

    Senior director

    "Massive disruption in the health insurance markets and many individual consumers being priced out of coverage due to the reinstatement of individual underwriting, the exit of young healthy consumers from the risk pool, etc."

    CEO

    "Increase on uninsured patients, closure of hospitals in rural areas, decrease in quality of care and denial of services."

    Strategic vice president

    "None. It takes a significant amount of time to turn a ship. Policy will likely take years to shift, even if the ACA is overturned."

    State HIE outreach coordinator

    "With the information that has been presented, it appears that there will be millions who will lose their health coverage and Medicaid will be put in a no-win situation in most states."

    Medical director for healthcare informatics

    "It will be an unmitigated disaster to the effort to control costs, which can only be achieved through universal healthcare coverage."

    Office manager

    "Chaos."

    CEO

    "Burden on taxpayer, waste of corporate resources, increase in healthcare costs."

    Senior vice president of product development

    "After the market gets things sorted out it will be positive."

    CIO

    "Allow patients to manage their health, not government agencies."

    Instructional designer

    "Individuals will be discouraged from starting their own businesses."

    Informatics manager

    "More coverage, lower costs, Providers will have more control over how they treat their patients, Hospitals will be able to provide more services and spend less on meeting multiple regulations".

    Consultant

    "Insurance companies will have more influence in care provided. More access to care providers but emphasis will be on limitation of services provided and less programs for preventive care. in an attempt to improve insurance companies."

    COO

    "Replace mandates with market-driven strategies to reduce cost to consumers and increase profitability for healthcare organizations."

    Registered Nurse

    "Confusion. More will be without healthcare now as they won't have health insurance. With Healthcare Reform more Americans have insurance then any other time. I worry the ERs will fill up again with people who use the ER as their PCP. Hospitals will be financially vulnerable as a large population will no longer have insurance."

    Retired healthcare administrator

    "Due to the lack of his understanding of the healthcare system, he will push the system backwards by at least 25 years and patient care will suffer and provider fraud will increase because of poor documentation."

    CEO

    "Greater confusion in the business of running a healthcare organization, be it a physician owner/operator; hospital exec; health services leader, etc."

    Director of IT

    "At first it will seem to help lower costs and give Americans more choices/freedom as well as financial stability, however that will quickly disappear as privatization becomes encouraged and large companies are allowed to buy up all of the small companies and individual practices, eliminating competition and leading to monopolistic practices in healthcare."

    CEO

    "The reality is that there has to be some compromise to change the system. I don't think the change will be cataclysmic. It will be evolutionary, rather than revolutionary."

    Pharmacy informatics

    "More price transparency More generic drug availability Portable heath care plans (plans that cross state lines)."

    CEO

    "My guess is they will de-fund the ACA and we will just lose the concessions we gave to get it passed."

    Managed care director

    "Since there is no plan in place, it will be devastating to the vast majority of people who have come to rely on healthcare."

    Analyst

    "He has no positive effect on any aspect of government or life, in general."

    Developer

    "People will die because they are uninsured."

    Senior clinical business analyst

    "He has no clue how insurance pools work so only those who are sick will sign up for it therefore costs will skyrocket!"

    Registered nurse

    "Many facilities will no longer be able to take advantage of "minimum Obamacare requirements" by having the maximum allowed deductibles for their employees."

    Regional IT manager

    "Hopefully fairer and more cost-effective options and more choice. The ACA was forced on us though most do not like it."

    CIO

    "Delay efforts within systems to comply with regulations but that will be a mistake for those organization that do."

    EHR administrator

    "Does Russia have healthcare?"

    CEO

    "Delay implementation of improvements to health systems. Reduce CMS's drive to make providers accountable. Roll back progress in which healthcare industry recognized inefficiencies. Reduction in funding for pilot programs."

    CEO

    "I believe more funding will be given to Commercial Health Plans and Medicare Advantage Programs. Medicaid funding will be cut significantly. Privatization of Healthcare Funding is what I see."

    Quality reporting

    "Initiate competition. Eliminating billing nightmare."

    Executive director

    "Chaos but then loss of coverage to insured individuals. This leaves coverage for charity cases to be pooled by community. If a community decides it won't care for indigent patients, will they be legally forced to provide care?"

    Consultant

    "Tax credits for people buying insurance in the individual market. Also, changing the mandated benefits and enabling people to buy the insurance specific to their needs and budget."

    Analyst

    "The ACA had many bad components as it was written by lobbyists; however, I hope that certain aspects related to data and coding are retained."

    Director of product management

    "Healthcare may be slightly cheaper."

    CIO

    "For too long we have not been accountable for our costs. This may change."

    Registered nurse

    "If he stands true to his promises, I expect it to get better."

    Director

    "There will be some short-term volatility but that is necessary."

    Administrator

    "Health care 'reform' will be simplified and support the small businesses that are the physician practices."

    Analyst

    "Health systems have done a lot of work on community health, and this injects a high degree of uncertainty into the equation."

    Nurse practitioner

    "Emergency room visits will be up over time as more people are forced to use ER and for more serious problems that they could not be seen by other healthcare provider. Closure of more community hospitals as more people will be uninsured, be sicker and do not have money to pay."

    CFO

    "Elimination of health care coverage for exchange patients. We will have in treatment patients suddenly without insurance."

    Public relations

    "Increased costs of doctors visits and prescriptions."

    Analyst

    "We will quickly be back where we were; 10 million or more people will lose access. Pre-existing conditions will once again block coverage. He may even repeal CHIPS."

    Associate vice president

    "The long term effects on healthcare will be devastating. All the gains that have been made in increased access will probably be turned back."

    Executive director

    "The poor will suffer more."

    Medical research librarian

    "Pre-existing conditions for retirees, self-employed workers, and contractors will make adequate health care unaffordable if insurance companies are allowed to discriminate."

    Director of health economics

    "A significant slowdown or complete stalling of reform initiatives while this megalomaniac with a wrecking ball mentality gets taught how the business of medicine differs from real estate investing. He's proven time and again that he doesn't have or can't articulate his vision, let alone any sort of tangible plan. But there's some comfort in knowing that whatever is to come will be "really great.""

    Registered nurse

    "Big business/big money will only get bigger with more burden on those that can't afford anymore costs. So, many with no health care insurance!"

    Clinical informatics

    "Long-term, I think people will be paying a lot more out-of-pocket due to lack of coverage, denial of claims, and high deductibles. Countries who are successful in healthcare have it governed, not privatized to businesses. I see this as a huge mistake that only benefit the business owners and everyone else will have negative results."

    Director of IT project management

    "Marketplace Dynamics change thru competition will be disruptive but the right thing to do."

    Vice president of customer solutions

    "Whether ACA is repealed and replaced or overhauled the components of ACA that support the migration from fee-for-service to value-based care and value based payment reform, such as ACO shared savings and bundled payment models, will remain in place."

    Director

    "Lack of investment in health IT and standards."

    Financial manager

    "Little impact."

    Psychologist

    "Improved efficiency, making medical advancements more possible and more available. More of the healthcare dollar going to healthcare and not to wasteful redundancies of paperwork and bureaucracy."

    Clinical informatics

    "Insurance companies denying coverage; increased healthcare costs; less regulation; less consistency across the country; advantages to the rich; payers unwilling to accept patient risk, etc."

    COO

    "Maybe healthcare coverage and costs can be negotiated so more people can be covered at reasonable costs."

    Project manager

    "Lower healthcare GDP."

    Consultant

    Shift to HSAs and elimination of state line mandates driving more competition. Providers will stress due to the need to make better cost decisions and providing more pricing transparency.

    CEO

    "I am curious on his plans for High Deductible Health Plans and how the out-of-pocket and contribution amounts will change for consumers. As a business owner providing HDHPs and HSA options for my employees I am curious on if any changes are expected to that I maintain a mutually beneficial plan for both my company and my employees."

    IT lead pharmacist

    "As people move past their initial impressions of him and see what kind of leader he's going to be, I think he will positively effect healthcare. I believe his business experience and expertise will serve our nation well."

    Senior director

    "Increase on uninsured patients, closure of hospitals in rural areas, decrease in quality of care and denial of services."

    Informatics specialist

    "Better, more accessible insurance and healthcare for all Americans."

    Senior vice president of marketing

    "Our healthcare costs will skyrocket again because people never anticipate getting sick but when they do, they expect free or low cost care. Doesn't work that way. Having insurance allows providers an incentive to provide maintenance, monitor ongoing health risks and stop them before they escalate and get expensive. Giving people the option will send sick people back to the ER."

    Associate counsel

    "Acceleration of rural hospital bankruptcies."

    Senior analyst

    "People will die because of delaying prevention if it is not covered at 100% as the ACA requires. The ACA is more than "requiring people to buy coverage" it has many regulatory items that no one seems to care about until it happens to them. My opinions here are my own."

    Clinical analyst

    "Insurance companies will survive and thrive."

    CEO

    "Change in the health exchange model, pay-for-value models (MSSP, Bundles, MIPS, MACRA) hopefully here to stay because it is in line with principles of lowering cost improving quality and choosing own providers."

    IT director

    "There are some things that should not be under free market control and healthcare is one of them."

    Product manager

    "As a vendor in this space, there is now nothing but uncertainty. We have just moved through 2017 investment planning, and I don't know if any of the software plans to support CJR, EPM, or MACRA will stand if the Affordable Care Act is truly rolled back, completely. Without the CMMI, there is no model to support - and no product need."

    Implementation specialist

    "This will be catastrophic for many low income families and people with a previously diagnosed condition."

    Professor of healthcare management

    "Chaos from the provider's perspective and the patient's perspective, particularly if he tries to repeal and replace too soon."

    Director

    "He will help protect hospitals with passing stronger security laws. He will improve VA hospitals."

    Clinical director

    "Young, low-risk people will opt out of health insurance and the rest of us will pay for their treatment if they have a catastrophic illness."

    Vice president

    "Putting control back with the states and opening access to all insurance providers in states as well as holding providers accountable with price transparency will bring prices down and give individuals more choice."

    Nurse administrator

    "Top medical research moving to other countries. Abandonment of Healthcare IT. Healthcare tourism to Europe."

    Executive director of IT

    "Care will be reduced to vast segments of the population. It will just further exacerbate the problems this country is facing."

    Analyst

    "Rising health care costs, individuals unable to receive services, a sicker population."

    Vice president

    "Sicker population."

    Vice president

    "We can only hope for the best."

    Executive manager

    "People lose their health insurance and companies lay off."

    Managing partner

    "Legislative changes around healthcare requirements for insurance, no change to value-based reimbursement and bundled payments."

    Assistant professor

    "Decreased access to care and limited minimums for coverage."

    Vice president of communications

    "Bigger focus on Medicare Advantage to embrace the free market. Additional focus on states to legislate.

    Share your view at our survey: How will Donald Trump's presidency affect healthcare?

    Twitter: @HenryPowderly
    Contact the author: henry.powderly@himssmedia.com


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    Major League Baseball will introduce a standardized format for medical information, which will outline the data that must be disclosed during trade talks, MLB Chief Legal Officer Dan Halem said Wednesday, according to Baseball America.

    The news comes on the heels of the 30-day suspension of Padres General Manager A.J. Preller. In September, MLB ruled that he failed to disclose pertinent medical information to the Red Sox during the trade of left-handed pitcher Drew Pomeranz. Pomeranz was found to have pitching discomfort and took oral medication to ease the pain.

    Preller kept two sets of medical records: a detailed account for the team and a more streamlined list for trade partners.

    "We've talked about medical records given the issues we had this season," Halem said, during the annual GM meetings last week. "I think we're going to focus on trying to do even a better job of standardizing that process when clubs exchange records."

    [Also: Healthcare big data draws lessons from 'Moneyball' stats]

    The league has been moving toward a consistent and standardized system, Halem said. A committee of athletic trainers determined the records types every club should maintain and the best way to maintain that information.

    "This is kind of an area where we've been moving each year since we adopted the electronic medical records," he told Baseball America, "to get more consistency and standardization across clubs.

    "We're going to formalize it a little more and contemplate pushing for guidance in terms of what has to be in and what has to be out; just make sure everybody has confidence in the system," he added.

    Halem didn't provide a timeline for when the guidelines would take effect. By and large, the majority of general managers at Wednesday's meeting supported the move to a more formal system.

    Further, Halem said the move for standardization was not in response to the Preller suspension, noting that the idea had been circulating for a while.

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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