Hospira, the developer of infusion technologies, is partnering with Iatric Systems to work toward better interoperability between Hospira's smart infusion pumps and electronic medical records.

Based on Iatric Systems' Accelero Connect integration software solution, the two companies are piloting smart pump-EMR interoperability at a U.S. hospital, the companies say – developing two-way communication that enables automation of pump programming with the validated medication order in the system and the sending of med administration data back into the EMR.
 
Iatric's Accelero Connect technology enables vendor-neutral interoperability between medical devices – low-acuity vital sign monitors, ventilators and now smart pumps – with hospital EMRs.

[Also: FDA seeks to reduce infusion pump risks]

Hospira MedNet safety software helps hospitals develop drug libraries that can automatically link to Hospira infusion devices, enforcing hard/soft upper and lower limits by drug type.

"Smart pump-EMR integration can help save lives and money," said Iatric President Frank Fortner in a statement.

"On the clinical side, we're sending IV medication orders from the EMR to the infusion pump, which significantly minimizes the chance of human errors and helps improve patient outcomes," he said. "On the financial side, we're sending start times, stop times, and other infusion details from the pump back to the EMR, which saves nurses time and may improve hospital reimbursements."

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

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The Indiana Biosciences Research Institute has unveiled a new effort to understand how type 2 diabetes varies from patient to patient. With access to data on more than 800,000 diabetics in the Hoosier State, researchers see it as a big step toward the development of new treatments and improved diagnostic tools.

"One of the areas of focus for the IBRI is the convergence between life science research, informatics and technology," said IBRI President and CEO David Broecker in a statement –  noting that every life science organization is working to understand how to connect biology to technology to drive both new discoveries and interventions, particularly in complex diseases like diabetes.

As Broecker sees it, the IBRI is uniquely positioned to bring together leading companies such as Lilly and Roche with academic collaborators like Regenstrief and Indiana University to explore problems from multiple perspectives and data sources; he calls the initiative, "the essence of big data."

[Also: CMS extends federal diabetes prevention pilot to all Medicare beneficiaries]

Diabetes is one of the leading causes of death in the United States and is associated with other health complications including cardiovascular and peripheral vascular disease, kidney disease, nerve damage, blindness and amputation.

The collaborators will analyze the available data in an effort to better understand each of the variations in type 2 diabetes patients and group those patients into subpopulations that share causes or complications from the disease. That ultimately would facilitate the development of more specialized treatments and interventions for the subpopulations.

The data to be analyzed will come from the Regenstrief Institute's Indiana Network of Patient Care database. The data set is drawn from across the state of Indiana, and provides a representative sample of type 2 diabetics that can be used to understand the variations of the disease in individuals across the nation.

The project is expected to be completed in the second quarter of 2017.

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

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President-elect Donald Trump selected Tom Bossert as White House homeland security and counterterrorism advisor -- and elevated the position as an assistant to the president, the incoming administration announced Dec. 27.

The position is an independent post with an elevated status, on par with the National Security Advisor, according to the announcement. Previously, the deputy would report to the advisor and not directly to the president.

From IoT attacks shutting down entire countries to ransomware plaguing the U.S. healthcare system, the elevation of the cybersecurity role may signal that Trump is placing high importance on cybercrime at a pivotal moment.

"We must work toward cyber-doctrine that reflects the wisdom of free markets, private competition and the important but limited role of government in establishing and enforcing the rule of law, honoring the rights of personal property, the benefits of free and fair trade and the fundamental principles of liberty," said Bossert in a statement.

"The internet is a U.S. invention, it should reflect these U.S. values as it continues to transform the future for all nations and all generations," he added.

Bossert was a homeland security adviser during the last year of the George W. Bush administration. He currently serves as a fellow with the Cyber Statecraft Initiative of the Atlantic Council think tank and runs a risk management consulting firm.

In his new role, Bossert will focus on domestic and transnational security priorities, while National Security Adviser nominee, retired Lt. Gen. Michael Flynn, will be in charge of international security challenges. Trump officials said Bossert will also advise the president on homeland security, counterterrorism and cybersecurity challenges, while working with the Cabinet to create new policies.

"Tom brings enormous depth and breadth of knowledge and experience to protecting the homeland to our senior White House team," Trump said in a statement. "He has a handle on the complexity of homeland security, counterterrorism and cybersecurity challenges will be an invaluable asset to our administration."

"I am looking forward to working closely with Gen. Flynn as we together help the President-elect advance the interests of the United States and its allies," said Bossert.

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

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DirectTrust put forth a list of four recommendations to spur health information exchange and improved interoperability to President-elect Donald Trump's transition team.

In a closed-door meeting on Dec. 20, officials from DirectTrust, an alliance comprising healthcare industry stakeholders who use the Direct network to exchange patient data, made the case that maintaining forward movement for interoperability – among providers, and between physicians and patients – is essential for care coordination.

"We've made significant progress in the areas of increased electronic health records adoption and interoperability during the past four years," said DirectTrust CEO David Kibbe, MD, in a statement. "Our hope is that the momentum established to this point will continue under the new administration."

Toward that goal, DirectTrust offered four suggestions to the Trump team:

Appoint a strong leader at ONC. Trump should select a National Coordinator for Health IT who is well-respected by the medical community and well-versed in current and emerging healthcare technologies, according to DirectTrust. This candidate should have "the skills to speak to technical audiences on the key standards for interoperability, security controls, and content delivery that support value-based payments."

Seek to "hold the gains" in EHR uptake and interoperability. New healthcare policies rolled out under the Trump administration should build on existing technologies for interoperable exchange already integrated into EHRs under the 2014 Certification Program, such as Direct Messaging, eHealthExchange, IHE-XDR and the CCDA – while also supporting development of new technology and evolving standards, such as FHIR, according to DirectTrust, which implored the incoming administration to avoid "throwing the baby out with the bathwater."

Keep a focus on cybersecurity. With widespread worry about data security in healthcare, use of  "the latest secure, reliable transport mechanisms to move data," is key, according to DirectTrust – and so is working to ensure that policy and operational efforts hew closely to core security requirements such as encryption and authentication.

Offer regulatory clarity. Rules holding healthcare providers accountable for improved outcomes, such as those laid out in MACRA, should be "clear, targeted and evidence-based," said DirectTrust – especially as the federal government works to reduce regulatory and documentation burden on providers, as laid out in the health IT provisions of the just-signed 21st Century Cures Act.

"We look forward to working with the new administration, and in particular with ONC and CMS, to support interoperability and provide the industry with reliable means for secure and easy exchange of health information," said Kibbe.

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

Healthcare IT News EHR Satisfaction Survey 2016
⇒ Comparison chart: How readers rated their EHR in 2016 vs. 2015
⇒ EHRs getting better? Readers rank them higher than last year
⇒ Health IT executives have a new favorite dirty word 
⇒ EHR interoperability: Ripe for disruption?

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Denizens of the healthcare IT realm know John as @techguy, the blogger and founder of HealthcareScene.com, but not as many are likely to know the other topics he blogs about.

Healthcare IT News queried the Social Media Ambassador, via Twitter no less, about what he hopes to see at HIMSS17, his pet peeves, and we asked him to reveal something his followers might not know about him.

Q: What are you most looking forward to at HIMSS17?
A: There are so many good parts to #HIMSSanity, it's hard to choose just one. However, the best part of any HIMSS is probably the opportunity to mix and mingle with thousands of incredible people that are doing their very best to make healthcare better. While there are a few bad eggs out there, I find that the majority of people in the HIMSS community really want to improve healthcare. Certainly we could argue about their ability to do so, but I've found most people in healthcare IT really have the right intentions and goals. Over the years, I've found that my favorite HIMSS memories were the times I really connected with someone on a deep level both personally and professionally. The week of HIMSS is a tremendous opportunity to do this and be inspired by so many people.

Q: What issues do you think are top-of-mind for your social media followers?
A: MACRA seems to be the dominant topic for most of my followers. While MACRA is really an extension of what was started with PQRS and meaningful use, I see a lot of organizations that are afraid of what MACRA is going to mean to them. I'm sure this will be a hot topic at HIMSS17. Outside of that, I think there's a tremendous focus on how to extract value out of their EHR investment. Organizations have spent hundreds of thousands, millions, and even billions implementing EHRs in the rush for government incentive money. Now those organizations are stepping back and asking "How do we get more value out of our investment?"

Q: Who's your favorite healthcare hero? Why?
A: Healthcare hero is a challenging idea. I think the real heroes in healthcare are the millions of people working the front lines with little recognition, tons of outside pressure, and yet they continue to provide amazing care to those in need. That said, the person who's most influenced my thinking about healthcare this year is Melissa McCool (@MelissaxxMcCool), founder of http://Stellicare.com. I've been blogging about healthcare IT for 11 years and meeting her this year has turned many of the things I thought about patient engagement and using technology to help patients on its head. Her approach to working with some of the most vulnerable patients is unique and will have a profound impact on healthcare organizations that adopt it. Plus, she's someone who's been very successful with her healthcare business, but she's also doing it for the right reasons. Her compassion for every patient, that's illustrated in the work she does, is something I really admire.

Q: What's your pet peeve? (Either on- or off-line?)
A: When people ask me if I want to meet for drinks or coffee (neither of which I partake). If they used the data that's out there, they'd know to offer me pizza or ice cream. Honestly, I don't have many pet peeves. If I were to choose a real pet peeve, I'd have to say people that lack substance. The song, "A little less talk, A lot more action" would be something that I wish more people would espouse. I also love Andy DeLao's (@CancerGeek) idea of impacting healthcare at the individual level or the N of 1 as he calls it. If we all made little changes that impacted even one patient, in aggregate that would have a powerful effect for good on healthcare.

Q: What is something your social media followers do not know about you?
A: I think my followers know me pretty well. I'm kind of an open book. Most know about my addiction to ultimate frisbee, anything Italian, and dancing. Fewer people know about my reality TV blogs. The most popular of these is about Dancing with the Stars (http://PureDWTS.com).

Related HIMSS17 profiles: 
⇒ Meet Drex DeFord: Former Air Force CIO who started as a rock-n-roll DJ
​⇒ Matt Fisher: Healthcare attorney who once worked as a Starbucks barista
⇒ Brian Ahier: A big fan of analytics, Don Berwick and Jerry Garcia 
⇒ Linda Stotsky: She writes poetry, sticks up for underserved and loves ... boxing? 
⇒ Jane Sarasohn-Kahn: Health economist, woman in HIT, Social Media Ambassador

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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By any measure, this has been a momentous year for healthcare information technology. Hospitals and physician practices continued rolling out and replacing electronic health systems. Policymakers in Washington kept the rule-makings coming. Providers worked in earnest to draw insights from their data and put it to work toward safer, more effective and efficient care.

Meanwhile, cybercriminals locked their sights on healthcare and set about targeting patient records with a scope and severity unlike in any years prior. And the election in November of Donald Trump left the industry in a state of suspense, as stakeholders tried to augur just what this unprecedented presidential candidate will mean for healthcare going forward.

All the while, big innovations – from cognitive computing and machine learning to the continuing evolution of telehealth – kept coming, setting the stage for evolution in 2017 and beyond.

Here are some of the most popular stories of the past year – and some that were especially emblematic of the trends that shaped it.

1. Donald Trump elected: His 7 point plan for healthcare
It wasn't the result most pollsters, pundits and prognosticators predicted (and it certainly wasn't the "landslide" the president-elect would later claim) but the real estate magnate will take the Oath of Office on January 20 – ushering in a new and unpredictable era for most facets of American life, not least for healthcare. We've written about Trump quite a bit since November, of course, polling our nervous readers about the win and reading the tea leaves about his plans for change. But this story was by far the most popular on our website in 2016, as readers looked for clues about how he – and his picks for HHS and CMS leadership– will shift health policy in the months and years ahead.

2. Meaningful use will likely end in 2016, CMS chief Andy Slavitt says
In January, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Slavitt made waves when he suggested the guiding regulatory framework for health IT implementation since 2009 would soon go the way of the dodo. As he explained in a subsequent tweet, meaningful use, "as it has existed – with MACRA – will now be effectively over and replaced with something better." That statement was soon slightly walked back, since the situation wasn't quite so clear-cut, but the arrival of the Medicare Access and CHIP Reathorization Act, with its focus on the Merit-Based Incentive Payment System and advanced Alternative Payment Models, signaled a significant new policy approach to technology-enabled, value-based care for Medicare physicians.

3. Commentary: Big data and analytics to propel population health at HIMSS16
As 45,000 health IT industry stakeholders headed to Las Vegas for the 2016 HIMSS Annual Conference & Exhibition in February, contributor Brian Ahier penned this widely-read piece, offering his thoughts on how an industry "awash in information" – from EHRs, HIEs, wearable devices and more – could better bring actionable analytics to bear on it all, toward the lofty goal of pop health management. We all know about the ever-increasing volume, velocity and variety of healthcare data, said Ahier – but making the most of it also requires mastering its "variability and veracity."

4. Denver Health CIO, COO quit, blame pricey Epic EHR installation and Exec quits over patient safety concerns weeks before Epic go-live; hospital fires back that EHR will be safe
These two stories, one from January and one from March, show that, despite all the high-minded talk of a "post-EHR era," the down-and-dirty, elbow-grease-dependent work of electronic health records implementation is still extremely complicated, expensive and often contentious work. Nearly eight years after the federal EHR incentive program first spurred hospitals and health systems to digitize their patient records on a widespread basis, providers and vendors still face many big challenges – patient safety concerns, cost overruns – when trying to get these massive projects up and running.

5. Epic reveals R&D spending outstrips Apple, Google and its competitors
For years, the Verona, Wisconsin-based EHR behemoth – which raked in $1.77 billion in 2014 revenue, whose software contains the patient data of more than 56 percent of Americans – had felt little need or desire to talk much to the press. In the past year or so, however, that's changed somewhat. In 2016, Healthcare IT News Editor-at-Large Bernie Monegain traveled to the Badger State for a sit-down with Epic founder and CEO Judy Faulkner. She wrote a series of articles based on that visit, but among the most read was this one, which revealed that the company invests far more than even some of the flashiest Silicon Valley innovators on research and development projects.

6. Hollywood Presbyterian declares emergency after hackers cut off data, demand $3.4 million ransom 
If you weren't familiar with ransomware at the beginning of 2016, you sure knew what it was by the end of the year. (Hopefully, at least, not thanks to first-hand experience.) In a cyber threat environment with no shortage of bad actors and worse methods to hack, attack or otherwise compromise hospital IT infrastructure, this was the year where ransomware made its infamous name across healthcare. Hollywood Presbyterian was only one of the first and most high-profile victims of this data-freezing scourge in 2016. There were plenty of othersthroughout the year, each forced to face an unappealing choice: To pay, or not to pay?

7. Health Catalyst: Only 3 percent of hospitals meet CMS target for value-based care
The outgoing Obama administration and its landmark Affordable Care Act set some ambitious goals for accountable, high-quality healthcare delivery in the U.S. That's laudable, of course. But it's also worth asking whether the value-based benchmarks set by the Centers for Medicare and Medicaid Services might have been a mite too tall an order for hospitals grappling with long lists of other to-dos.

8. Telemedicine market to soar past $30B 
It's been a longtime and often vexing question: Why hasn't telehealth caught on to the extent many think it should? In an industry struggling with doctor shortages and concerns about cost and access, it would seem to be a no-brainer. Of course, reimbursement and regulatory challenges, physician resistance, high infrastructure costs and other technology hurdles mean the dream doesn't always match up with the reality. But the imperatives of value-based care look as if they may soon be forcing the issue.

9. Artificial intelligence, cognitive computing and machine learning are coming to healthcare: Is it time to invest? 
The future is now, Healthcare IT News Editor-in-Chief Tom Sullivan asserted in the April edition of his Innovation Pulse column. No longer the stuff of science fiction – not by a long shot – AI and machine learning and other leading-edge computing technologies are poised to transform healthcare in ways previously unimagined. Big dogs such as Google and IBM are already making big inroads with this stuff. And with some analysts estimating that nearly one-third of providers will run some sort of cognitive analytics on their patient data by the year after next, Sullivan writes, "the risk of investing too late may outweigh the risk of doing so too soon."

10. 27 hot health techs to watch in 2017 
As is customary as one year draws to a close, we look with cautious optimism to the next. In this list, compiled with our colleagues at HIMSS Analytics, we examine some of the technologies topping healthcare organizations' purchasing plans for 2017. From cloud-based storage to RTLS to lab-centered tech such as transfusion and specimen collection management systems, these are the tools hospitals are budgeting for to help them transform their processes toward better care at a lower cost.

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

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In a Jan. 2 New York Times opinion piece, Eric Topol, MD, professor at the Scripps Research Institute, and Kathryn Haun, a federal prosecutor who teaches a course on cybercrime at Stanford Law, take aim at what they call "quite a paradox": the fact that most patients still can't readily access their own health data, even as there's "an epidemic of cybercriminals and thieves hacking and stealing this most personal information."

The value of health data to cybercriminals is well-known by now -- as is the fact that the industry's oft-lagging security practices have made it an easy task for bad actors to access it.

"It is common for millions of patients’ health records to be stored together in huge central databases that, once breached, yield a trove of information," Haun and Topol write in The Health Data Conundrum. 

While it's become "increasingly difficult to combat this problem using traditional methods of enforcement and deterrence," they write, there are some strategies that could help -- especially disaggregation of data storage.

By allowing patient data to be kept in "individual or family units rather than in centralized databases," each patient "would have medical data in a personal cloud or a digital wallet," enabling them to share data with family and clinicians in the ways they see fit.

Emerging tech such as blockchain, with its "tamper-proof" encrypted platform, offers one way to enable that approach, they write

Topol and Hahn mention several EHR vendors by name, noting that their business success is thanks, in part, to an "old, paternalistic model" where data is "generated and owned by doctors and hospitals."

Instead, they call for a new approach: "Giving consumers control of their own medical data would revolutionize who owns medical data and how it is used."

Electronic health records are always front-and-center at HIMSS Annual Conference and this year will be no different. Whether on the show floor, discussed in keynotes, or education sessions containing best practices and hard-wrung insights, EHRs will be among the most dominant trends at HIMSS17. 

Multiple sessions and forums will highlight challenges, innovations, and the big promise of EHRs, while others will home in on related federal compliance programs, including MACRA, MIPS and APMs. Session will also offer attendees updates on OpenNotes, harnessing EHRs for clinical improvement as well as integrating other technologies into the EHR, notably for genomics and analytics.   

Here is our roundup of EHR sessions at HIMSS17:

Managing a legacy team through an EHR transition
Three years ago, Houston Methodist embarked on a journey to replace their existing clinical systems with an integrated EHR. A key success factor has been the effective management of the legacy application portfolio and the staff and leadership who are responsible for its effective functioning. This presentation will detail the approach taken at Houston Methodist to meet this challenge and will provide lessons learned for any health system planning or currently engaged in a large-scale EHR implementation.
Speakers: Penny Black, Director of EHR & Perioperative at Houston Methodist Hospital
Alan Perkins, Associate Vice President, The Chartis Group
When: February 21, 2017 — 8:30 AM - 9:30 AM
Where: Tangerine Ballroom F3

Integrating genomics results and EHR functionality
Since incorporating raw genomic data into EHR is fraught with performance impacts and regulatory restrictions, such reanalysis requires development of alternate solutions; also, it becomes vitally important to maintain an up-to-date knowledge base of current clinical knowledge. In this session, learn how to define how EHR interacts with genomic data, even as interpretation of that data keeps changing; analyze build vs. buy decision in genomic medicine; plan the structure of a team needed for launching genomic medicine; and assess the need for genomics technology in modern medicine.
Speakers:  Kamalakar Gulukota, Director of Bioinformatics, Northshore University Healthsystem
Henry Dunnenberger, Program Director, Pharmacogenomics, Northshore University Healthsystem
When: February 21, 2017 — 10 AM – 11 AM
Where: Room 331A

YourTurn: Identifying and resolving EHR usability and medical errors
EHRs were designed and adopted to make care more efficient for clinicians and safer for patients. However, some EHR layouts and designs referred to as usability have contributed to inadvertent patient harm, drawing concerns from providers, vendors and policymakers. Additional oversight and testing, and the establishment of a multi-stakeholder initiative to foster collaboration among providers, EHR vendors and government could help detect problems before safety errors occur.
Speaker:  Josh Rising, Director of Healthcare Programs, The Pew Charitable Trust
When: February 21, 2017 — 8:30 AM - 9:30 AM
Where: Room 300

Enabling advanced EHR analytics with clinical terminology
SNOMED CT is a globally-used clinical terminology that is freely available to U.S. users through NLM and is designated for problem representation by the 2014 EHR certification criteria. This session will focus on a variety of approaches using SNOMED CT to address different clinical analytics use cases, such as historical summaries, clinical decision support, population health and clinical research, along with an overview of guidance developed during a study of analytics deployments. The session will also cover practical experience from EHR vendors, healthcare provider organizations and other stakeholders, including benefits realization and challenges.
Speakers: David C. Markwell, Head of Education, IHTSDO / SNOMED International
Linda Bird, Senior Implementation Specialist, IHTSDO / SNOMED International
When: February 23, 2017 — 12 PM – 1 PM
Where: Room 207C

Designing for data-first - Rapidly deliver data from an EHR
Using a data first strategy, MD Anderson installed an enterprise-wide EHR and on the second day of operation was able to move over one thousand columns of data into its standalone data warehouse. The presenters will discuss the tools and approaches necessary to succeed in a data first strategy as well as techniques for overcoming organizational obstacles. This presentation will be valuable for organizations preparing to install a new EHR and ones where they must get data out of an existing one.
Speakers: John Frenzel, MD, Chief Medical Informatics Officer,  University of Texas MD Anderson Cancer Center
Chris Belmont, System President and CIO,  University of Texas MD Anderson Cancer Center
When: February 22, 2017 — 10 AM - 11AM
Where: Tangerine Ballroom F3

Open APIs: Crush your EHR conversions and legacy challenges
In this presentation, we will share how one health system and an affiliate deployed Open APIs and web services to connect and share data across two different EHR platforms as part of a legacy EHR management plan. We will explore the limitations of traditional data conversion approaches and the advantages of web services in meeting requirements for data access, end-user satisfaction, security, compliance and cost. We will show how this same approach can be extended to solve many other problems related to EHR integration. We will describe the challenges and limitations of the traditional approach to cross-platform data sharing and legacy data management and discuss OpenAPIs and web services as an alternative to traditional data sharing and integration approaches (extraction, CCD) and technologies (HL7).
Speakers: 
Peter Chang, MD, Chief Medical Informatics Officer, Tampa General Hospital
David Levin, MD, Chief Medical Officer, Sansoro Health
When: February 21, 2017 — 11:30 AM - 12:30 PM
Where: Tangerine Ballroom F3

Using EHRs and case management to improve patient care and population health
Swedish-American Medical Group (SAMG) has applied analytics to its EHR data for care management insights for four years. Combining multiple types of clinical data from the system's health records has helped clinicians identify and stratify chronically ill patients. Attendees at this presentation will learn how SAMG applied analytics to their EHR data to improve quality of care and how they have used data and analytics to prevent hospitalizations among high-risk patients. They will learn how clinical data in EHR systems helped facilitate the evolution of care management from a payer-driven exercise to a provider-focused model.
Speakers: 
Thomas Schiller, MD, President, Swedish-American Medical Group
Jennier Kuroda, Quality Improvement Manager, Swedish-American Medical Group
When: February 22, 2017 — 4 PM – 5 PM
Where: Room 331A

MeRLin (Medical Record TimeLine): Improving EHR clinical chart review through effective visualization of longitudinal medical record data
Exhaustive lists of textual EHR documents are inefficient and cognitively burdensome. We report our experience piloting a Medical Record timeLine (MeRLin) that aggregates and filters EHR-derived events in real time into an interactive, single-screen visualization of the longitudinal medical record to improve clinical chart review and decision making. Participants can define the common methods for visual display of textual/report-based EHR data and their limitations, learn alternative visual display methods for longitudinal EHR data, specifically as implemented in novel MeRLin timeline tool, and outline challenges with longitudinal clinical data visualization.
Speakers: Matthew Nolan, MD, Mayo Clinic Rochester
Vitaly Herasevich, CPHIMS, MD, PhD, Associate Professor of Medicine, Mayo Clinic
When: February 19, 2017 — 8 AM - 4:30 PM
Where: Room 331A

Developing innovative EHR rools to prevent lost revenue
CMS instituted the 2 Midnight Rule impacting reimbursement on unsigned inpatient admission orders by the time of discharge. This meant that any admission order for inpatient stays entered by a provider without active admitting privileges would require a co-signature by the actual admitting or attending provider prior to discharge. If an authenticating signature was not obtained at the time of discharge the visit charges would need to be downgraded to outpatient stay resulting in lost revenue. This poster will show the tools that were developed and the Pre/Post Impact of revenue retention as a result of their implementation.
Speaker: Demeree Whitt, Physician Informatics, Baylor Health Care System
When: February 21, 2017 — 10 AM – 5 PM
Where: This is part of a special program called Emerging Professionals Poster Sessions.

Aligning CMS hospital quality reporting and payment for value
In 2017, CMS will require all eligible hospitals to electronically report electronic clinical quality measures for Inpatient Quality Reporting. CMS leadership will discuss EHR-enabled quality reporting requirements and strategic focus for aligning claims driven Value Based Purchasing Programs with EHR clinical quality data reporting. The speaker will identify the 15 clinical quality measures and reporting mechanisms that hospitals must report on in 2017 order to avoid the Medicare Inpatient Quality Reporting Program negative payment adjustment for FY2019; detail the strategic plan for CMS to align payment for value programs with clinical quality reporting programs for hospitals; and identify strategic opportunities to identify quality improvement opportunities within your organization that align with CMS quality improvement priorities.
Speaker: TBD
When: February 19, 2017 — 3:15 PM - 4:15 PM
Where: Room 208C

MHS GENESIS: Driving successful business transformation
This session will provide an overview of MHS GENESIS, how MHS GENESIS compares with private sector EHR implementations, and how the MHS intends to navigate the road to success. Speakers will demonstrate that while MHS GENESIS is a large and complex business transformation, it is an accomplishable endeavor. They will recognize that MHS Leadership is actively partnering to lead the transformation effort, and will illustrate that adherence to the MHS GENESIS Guiding Principles helps focus MHS efforts.
Speakers: Paul Cordts, MD, Electronic Health Record Functional Champion, Military Health System, Office of the Functional Champion, Defense Health Agency
Colonel Richard "Chip" Terry, Acting Military Health System Chief Information Officer and Acting Director, Defense Health Agency
Stacy Cummings, Program Executive Director, Defense Healthcare Management Systems
When:February 21, 2017 — 11:30 AM - 12:30 PM
Where: Room 311A

OpenNotes - Overall status, approaches and experience: One year later
This session will discuss the benefits and risks of providing patients' easy and secure access to their EHR information. We will provide an update on the overall status of OpenNotes adoption in the U.S. and highlight some of the experiences and approaches that organizations have taken in opening their EHRs to direct patient access. The work of the NW OpenNotes Consortium and Geisinger Health Systems will be highlighted. Examples from other organizations will be presented as well. Speakers will list several known benefits that result from providing patients easy and secure access to their EHR notes and describe the impact of implementing OpenNotes on physicians and other healthcare providers; identify the key steps necessary to implement Open Notes in a healthcare organization; and describe two key reasons why a community consortium approach can accelerate the implementation of OpenNotes among healthcare organizations in that community.
Speakers: Homer Chin, MD, Physician Champion,  OHSU / WCDB / KP NORTHWEST / BIDMC
John Kravitz, CIO, Geisinger Health System
When: February 22, 2017 — 8:30 AM - 9:30 AM
Where: Tangerine Ballroom, F3

African-American SIG
Join the African-American SIG for a discussion of ways to advance knowledge and decrease disparities within the African-American community utilizing health information technology in the delivery of healthcare, EHR adoption and patient engagement.
When: February 22, 2017 — 03:45 PM - 04:45 PM
Where: Room W303A

Integrating non-DICOM images using XDS
Non-DICOM image and multimedia capture increasingly proliferate across most organizations with limited integration capabilities. Utilizing XDS profiles and an ECM utility as a basic foundation, an enterprise archive with HL7 integration with the EHR and an enterprise viewer, we designed, developed and deployed a standards-based working model for centralized non-DICOM image capture, storage and EHR distribution. In this session, we detail the work and technical data flows used to achieve this integration.
Speakers: Dawn Cram, Application Systems Development Manager, University of Miami Health System
Brian Hart, Vice President, Research and Development, Merge Healthcare, an IBM Company
When: February 21, 2017 — 8:30 AM - 9:30 AM
Where: Room 311A

Solving the drug-disease interaction over-alerting dilemma
Drug-disease interaction clinical care guidance is a highly desired EHR functionality supporting patient safety, yet physician acceptance and implementations remain low due to poor usability. We set out to solve this long-standing problem, improving the usability and utility of drug-disease CDS by creating a disease interaction knowledge base subset followed by implementation and testing within the Kaiser Permanente (KP) EHR system. Phase I: The Disease Interaction Scoring Tool (DIST) was developed for assessing knowledge base content to aid in the reproducible creation of the most significant subset of contraindicated disease interaction alerts. We describe DIST in detail, present results of the clinician-validated subset that was then later implemented in the KP Northern California EHR system. Phase II: Relevancy was demonstrated during implementation of the clinician-validated subset. While results varied depending on diseases, the acceptance rate was favorable based on alert data captured over a three-month period.
Speakers: Jeff Bubp, Manager, Clinical Editorial, First Databank
Brian Hoberman, MD, Kaiser Permanente KP Health Connect Physician Leader
When: February 21, 2017 — 2:30 PM - 3:30 PM
Where: Room 311E

Northwell clinical snapshot: Improving primary care with point-of-care clinical quality dashboard
Northwell Health's Clinical Snapshot improves Primary Care quality and efficiency. Clinical Snapshot is integrated into outpatient EHR, provides a point-of-care huddle-report, enables clinically intuitive workflows and guided review of pertinent data to support modern care requirements, and was developed to support rapid transformation of practices into Patient Centered Medical Homes. For discussion will be clinical quality improvement, care coordination at visit, and reporting.
Speakers: Vishnoo Kothapeta, StrategistClinical Provider Tech Solutions, Northwell Health
Barry Goetz, MD, Director Clinical Information Systems, Northwell Health
When: February 19, 2017 — 8 AM - 4:30 PM
Where: This session is part of the Physician's IT Symposium at HIMSS17.

The role of technology in transitioning to a new care model
Widespread adoption of electronic health records (EHRs) is nearly complete, but now that the majority of care centers have implemented this technology, how do we maximize the benefits of integrating data into the care delivery? More importantly, what do you do when your institution’s EHR is unable to evolve with the organization, limiting the ability to address the changing landscape and needs of your institution? The introduction of new healthcare delivery models present unique and complex challenges for institutions that are exploring and implementing new models of care delivery in preparation for the value-based care reimbursement structure. This session will identify best practices for overcoming EHR integration challenges and implementing technologies to meet the needs of an organization embarking on a new care model. Speakers will discuss learnings through a real-world case study from an advanced comprehensive primary care organization for transitioning to a Patient Centered Medical Home (PCMH) approach to healthcare delivery.
Speakers: Amy Mechley, MD, Medical Director, Wellness Division, Christ Hospital Health Network
Sandra Selman, Director of Ambulatory Quality and Care Management, Christ Hospital Health Network
When: February 22, 2017 — 4 PM – 5 PM
Where: Room 311E

Emerging infectious diseases, clinical decision support, and electronic health records meaningful use
Under the EHR Incentive Programs, the CMS has made payment incentives available for Medicare and Medicaid eligible providers and hospitals that purchase, implement, and use certified EHRs systems. This session will demonstrate how collaborative efforts between the CDC and ONC, and close partnerships with the healthcare and health information technology sectors, were instrumental in the development and deployment of critical clinical decision support tools to address the emerging public health threat of Zika virus. CDC, and ONC worked, in-collaboration with software vendors to develop resources to support rapid deployment of critical information through EHRs and other clinical software. The session will also discuss how this collaboration established repeatable processes to support the current response and future crises and how vendors and local sites can use the content.
Speakers: Sanjeev Tandon, MD, Lead Zika Health Information Technology Team, CDC
Daniel Chaput, MM, Office of Standards and Technology, ONC
Nedra Garrett, MS, Senior Informatics Advisor, Office of the Director, Centger for Surveillance Epidemiology and Laboratory Services, CDC
Floyd Eisenberg, MD, MPH, FACP, President, Iparsimony, LLC
When: February 20, 2017 — 01:30 PM - 02:30 PM
Where: Room 307A

Related HIMSS17 guides: 
⇒ A guide to precision medicine at HIMSS17
⇒ A guide to cybersecurity at HIMSS17
⇒ A guide to population health at HIMSS17
⇒ A guide to Women in Health IT happenings at HIMSS17

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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In spite of all the newest and greatest technology available to nurses, doctors, hospital systems – and consumers – across the country, the digital divide is not only stubborn but it’s also growing wider.

That’s according to research firm Black Book, which asked 12,090 consumers to evaluate the technology they were exposed to, know of or interacted with as an active patient in the last 12 months.

The result? Fifty-seven percent of consumers with access to hospital, physician or ancillary provider’s technology in 2016 indicated being skeptical of the overall benefits of technologies such as patient portals, mobile apps and electronic health records.

The survey, "Healthcare's Digital Divide Widens," showed that recent data hacking and a perceived lack of privacy protection by healthcare providers played a role in consumer attitude concerning healthcare technology. The Black Book report showed that patient adoption of healthcare technology dropped over the past year.

[Healthcare IT News survey: The year ahead in health information technology]

Black Book also found that the fear of breaches translated to consumers being hesitant to share information. Eighty-seven person of consumers surveyed indicated they would hesitate to share their information.

The unwillingness of patients to comprehensively divulge all their medical information rose to 87 percent in Q4 2016.

Black Book found respondents especially alarmed that their prescriptions, mental health notes, and chronic conditions were being shared not only with their healthcare provider, but also with retailers, employers, and the government without their knowledge.

Black Book found this year that 70 percent of Americans distrust health technology, indicating a steep climb from 10 percent in 2014.

Among Black Book’s key findings are incomplete patient records that raise questions about analytics. Other concerns raised include overworked nurses, especially in small hospitals where it’s more difficult for both providers and nurses to find time or have the training for patient portals and other engagement technology.

Then there are the physicians who are overwhelmed with too much information.

94 percent of physicians responding to the provider section of the survey found the amount of data overwhelming, redundant and unlikely to make a clinical difference, Black Book reports.

Black Book concluded that patient technology illiteracy is the next roadblock to achieving population health success. 

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

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SnapMD is partnering with athenahealth, putting its cloud-based virtual care management platform on the athenahealth marketplace via its More Disruption Please program. The technology will be integrated with athenaClinicals and athenaCollector EHR and revenue cycle management tools.

The white-label SnapMD telemedicine platform features robust back-end technology to manage digital health, with an intuitive workflow in a single interface – enabling easier patient encounters for departments across the health system, officials say.

The technology aims to help providers more directly engage patients remotely via consumer-based devices, using its HIPAA-compliant platform to extend care delivery.

[Also: athenahealth CMO: Our big moonshot for 2017 is EHR ROI]

The company's partnership with athenahealth will make its enterprise-level VCM tools available to more than 85,000 healthcare providers, helping them offer telehealth consults under the brand they choose.

"With the athenahealth relationship and integration, healthcare providers delivering single or multiple telehealth services can now effectively deliver care remotely in a convenient digital environment under their operating umbrella," said Dave Skibinski, CEO of SnapMD, in a statement.

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

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U.S. Secretary of Health and Human Services Sylvia Mathews Burwell posted this cabinet exit memo on January 5.

Pamela Arora, senior vice president and CIO of Children’s Health in Dallas, has been named the 2016 John E. Gall, Jr. CIO of the Year.

The award, sponsored by CHIME and HIMSS, recognizes healthcare IT CIOs who have made significant contributions to their organizations and demonstrated innovative leadership through effective use of technology. It’s named for the late John E. Gall Jr., who pioneered implementation of the first fully integrated medical information system in the world at California’s El Camino Hospital in the 1960s.

CHIME and HIMSS executives cited Arora’s commitment to transforming healthcare.

“Through an ambitious telemedicine program, an unwavering commitment to information exchange and willingness to help small provider organizations, Arora has helped the Dallas-based health system break down barriers to care,” they said.

“This recognition reaffirms that, though technology may not always be visible, the work we are doing is making a difference in the lives of patients,” Arora said in a statement. “In our case, we’re delivering on our mission of making life better for children”

Under Arora’s leadership, Children’s Health has bolstered information sharing by hosting electronic medical records for physician practices and other providers. The health system also forged strong partnerships with regional health information exchange programs.

Children’s Health is a Stage 7 hospital, the highest level on HIMSS Analytics EMR Adoption Model.

Through a 2013 pilot with the Office of the National Coordinator for Health Information Technology, Children’s Health became one of the first health systems in the country to give parents untethered access to their children’s health information.

Also, an expanding telemedicine program enables nurses at nearly 100 schools to conduct virtual consultations with hospital-based clinicians.

“Pamela Arora continues to push the envelope of what it means to be a CIO,” CHIME CEO Russell Branzell added. “Time and time again, she shows how we can use health IT to not only support an organization’s overall strategy, but truly transform patient care across the entire continuum.”

HIMSS CEO Stephen Lieber also commended Arora for her leadership and vision.

Arora “understands and advances the strategic connection between quality patient care and the best use of IT,” Lieber said.

Arora has served on both the CHIME and HITRUST boards. She has also represented CHIME and HIMSS on the international front, working to build partnerships and share best practices around the world.

Arora will receive the award Feb. 21, 2017, at the HIMSS Annual Conference & Exhibition in Orlando.

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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A recent KLAS report indicates that healthcare organizations have been selecting their electronic medical record partners at a record pace. The next step associated with these selections that many in the industry are in the midst of is the implementation and adoption of new systems.

With a majority of health systems now having the ability to leverage a foundational electronic medical record, I anticipate many CIOs focusing on what lies ahead in this realm, and investigating EMR capabilities at this year's Health Information Management Systems Society (HIMSS) scheduled for February 19, 2017 through February 23, 2017 in Orlando, Florida. 

For Penn Medicine, 2017 will focus on several cornerstone topics, which I believe are in alignment with similar organizations across the country.

1. Cyber. As health systems have become more reliant on their information systems, further securing and protecting both their patient data and the overall operations has become the utmost priority for many.  Failure in this arena may result in financial, operational and reputational harm to the organization.  Given the volume of projects associated with cyber and the rapid pace in which most organizations must operate to deploy these projects, CIO's will be in search of cyber solutions and resources that can assist in addressing this ever growing threat.

2. Analytics. With growing volumes of data now associated with an organization's electronic medical record, the potential to leverage this data to make breakthroughs in patient care and research becomes ever more present.  Focus is now shifting to CIO' s to drive significant value from this data; which in many instances has come with a significant investment.  Driving value can come in a variety of forms ranging from simple report development through surveillance solutions that constantly hover and report on abnormalities of patient data.  At HIMSS, CIO's will have the opportunity to exchange analytic strategies as well as attempt to navigate the morass of analytical solutions that now reside within the industry.

3. The Next Big Thing. In recent years, the Penn Medicine Information Services team has been nationally recognized for leveraging innovative technologies to advancement patient care and research. For these achievements, we did not need to invent a new technology, but simply found a unique and productive way to leverage already existing technologies. With this approach in mind, there are several interesting technologies that have caught our eye and will certainly require more investigation in the HIMSS conference center. Companies like Amazon, Apple and Google have introduced their speech recognition/artificial intelligence solutions to the consumer market. Of interest is how to leverage these technologies to improve linkages with patients, enhance patient care and drive operational efficiencies. Along the same lines, Virtual Reality ("VR") has become more mainstream and applying VR for the benefit of our patients and staff is an area of exploration.  Finally, tools that provide more self-service access to the volumes of data now at their disposal will be of interest. The HIMSS exhibition hall is sure to be much more entertaining as one explores and tests-out some of these emerging technologies.

With the assistance of government incentives, the healthcare information technology industry has made significant strides in advancing patient care and research by ensuring the right data is made available to the right care provider and the right time in the right location.

The year ahead seeks to further accelerate these advancements through traditional and emerging technologies all for the benefit of our patients and our communities.

Mike Restuccia is the CIO of Penn Medicine. 

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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Paul Griffin, previously professor in the Stewart School of Industrial and Systems Engineering at Georgia Tech, has joined Purdue University as the new director of the Regenstrief Center for Healthcare Engineering and professor of industrial engineering.

He was appointed to the post January 1, after Purdue completed a national search.

"I believe we are uniquely positioned to improve healthcare delivery and inform health policy through an interdisciplinary approach based on systems engineering principles, data analytics, lean thinking and organizational behavioral management," Griffin said in a statement.

Purdue's executive vice president for research and partnerships and professor of mechanical engineering Suresh Garimella said in a statement Griffin is well suited and prepared to take on "this vital directorship role at RCHE, where he will be applying engineering principles to the complex healthcare delivery system."

At Georgia Tech, Griffin was also the research director for healthcare delivery in the Center for Health and Humanitarian Systems, and he co-led the Center for Health Analytics. Prior to his Georgia Tech appointment, he headed the Department of Industrial and Manufacturing Engineering at Penn State for six years.

RCHE is a national leader in collecting and analyzing medical device alert data through its Regenstrief National Center for Medical Device Informatics, REMEDI. To date, more than 275 hospitals and clinics from 23 states contribute data to the REMEDI database. More than 45,000 reports using REMEDI's analysis tools have been generated by hospital clinicians, resulting in a major impact on patient safety, according to Regenstrief officials.

RCHE brings together Purdue's engineering, management, clinical, social and basic sciences disciplines to investigate the numerous and complex avenues of the healthcare continuum, from wellness to care delivery. Tool development and the implementation of innovations and improvements in healthcare delivery are among RCHE's large-scale interdisciplinary projects.

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

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It’s almost cliche at this point to explain that IT must be aligned with the business strategy for either to succeed yet it’s still as true in healthcare as anywhere.

"IT strategic planning is very dependent on and must be aligned with the enterprise strategy. Yet, traditionally these two activities have been done separately - and in many cases, not aligned and integrated as one overall organizational plan,” said Bob Schwyn, director at The Chartis Group.

Schwyn explained that the challenge is without IT being part of the business strategy development itself, and at the table to evaluate what is needed to achieve it, it is difficult to fully understand the capabilities, investments and processes needed to position for where the organization is going and how to position IT to meet the needs.

What’s more, it is also nearly impossible to influence the business strategy with new directions and services made possible by information technology without the close and aligned integration of these two activities. Instead of two distinct and unaligned planning approaches, his and Ward’s point of view is that IT be an integral part of enterprise strategic planning.

While many organizations recognize the importance of alignment, most are still challenged in executing a planning process that truly spans all dimensions of where IT can accelerate and support the organization's business imperatives, Schwyn said.

Schwyn, along with TriHealth Senior Vice-president and CIO John Ward, will be presenting at HIMSS17 in Orlando during the education session “How to Make IT the Underpinning of the Enterprise Strategy,” on Wednesday, Feb. 22, 2017, from 8:30-9:30 AM EST in room 307A.

"Our presentation will outline a case study of how IT became a strategic underpinning of the enterprise strategy at TriHealth. We will be sharing an actual case study where this process was well aligned, orchestrated well with the business and resulted in significant clarity of IT's future role and a significant change in IT capabilities,” Ward said.

Ward said he and Schwyn will describe how and why IT can and should become a leading component in setting an organization's business strategy. Attendees will learn why the process matters and the specific steps to take. They will learn IT's role in the process and the key steps CIOs can take in guiding and steering strategy conversations.

HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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The University of Vermont Medical Center filed a certificate of need, or CON application, with the state of Vermont Jan. 3, seeking approval to create a unified electronic health record system across four hospitals in the University of Vermont Health Network.

The submission of the CON application signals the start of a regulatory review process for the project.

A unified EHR would significantly improve patient care by having all of a patient's information available to a healthcare provider regardless of location whenever it is needed, health system officials noted in their CON application.

"If a patient needs to go from their primary care provider's office to a specialist, that specialist would have instant access to the patient's full record rather than just portions that can be shared electronically today," John Brumsted, MD, president and CEO of UVM Health Network, in a statement.

"There are still times when the medical records are faxed or even hand-delivered by the patient at the appointment," he added. "In urgent situations, and especially during an emergency, having immediate access to important information is critical. A unified EHR is foundational to our ability to collaborate fully to provide the highest quality care possible."

The capital cost of the project, which is subject to CON review, is $112.4 million. It includes $3.1 million in capitalized interest. The total cost of the project over the first six years of implementation and operation is expected to be $151.6 million.

Done independently, it could cost up to $200 million for the four hospitals to upgrade their own systems, and it would lack the network connectivity, UVM officials calculated.

Today, the health system stores information on separate EHRs in the four hospitals, Brumsted noted.The systems were built by different vendors, and they are only partially connected.

By contrast, a unified EHR would include health and clinical information as well as information on registration, billing, scheduling and insurance across the network.

Once approved, the project would take more than three months to complete.

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

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Following a disaster, healthcare organizations need to minimize disruption to patient care delivery by ensuring that mission-critical systems get up and running soon after a disaster. Automating processes within managed recovery and workplace recovery programs is key, along with continuous testing and updating of disaster recovery plans based on best practices.

Learn more about cloud solutions for disaster recovery in healthcare IT