HIMSS organizers, in preparation of the annual conference and trade show, and as a way to rally attendees around several trending topics for the coming event, are once again asking the healthcare community how it feels about several key issues that are likely to resonate. As is often the case with this ongoing experiment, the folks in my position — those with a venue to voice their opinions who tell the rest of us what they think — pontificate on the potential impact of these trends.
Certainly, some of my fellow journalists are far better qualified than I to answer the questions posed by HIMSS with any level of authority. Therefore, I’ve given my small microphone to readers of this site so they can voice their opinions of the topics that conference goers are likely to hear about dozens of time while in Chicago.
This year HIMSS is asking what we feel will be the future of: the connected healthcare system, big data, security, innovation and patient engagement. Today, here, we focus on the future of the connected healthcare system, and what several insiders believe that future to be.
With that, enjoy and let me know if you agree with the following thoughts. If not, why; what’s missing?
Tom Bizzaro, vice president of health policy, First Databank
Tom Bizzaro
We’re hoping that the electronic health records (EHR) interoperability movement follows a trajectory similar to that of e-prescribing. To start, as an industry, we have to universally acknowledge the value of interoperability within healthcare IT systems. Indeed, sharing data across systems can help to improve care quality and efficiency in the country’s health system and lead to success of value-based reimbursement models. However, all players – providers, payers, patients and vendors alike – need to truly embrace the value EHR interoperability, putting it above any proprietary concerns.
Then, we need to get to work. We must continue to develop and implement a wide range of standards and vocabularies. Through these, we will ensure that our data is in synch and that systems will always be speaking the same language. Perhaps most important, we need a National Patient Identifier, which will make it possible to match information to specific patients as they traverse the health system. And, while it might seem like doing all this work will take a long time, if we roll up our sleeves and do what’s required, the EHR interoperability story will be on its way to its own happy ending soon enough.
Jonathan Isaacs, executive vice president and general manager, surgery solutions, SourceMedical
Jonathan Issacs
It’s 3:00 a.m. and you wake up with an acute pain in your side that won’t go away — you head to the ER. The CT scan shows nothing — you head to the GI specialist. The doctor says to get an endoscopy — you head to the ASC. The endoscopy says you have a chronic condition that will need to be managed by you, your PCP, and even more specialists. Where does all that data live? Everywhere!
It’s a changing world out there. From cancer centers to freestanding Emergency Departments, healthcare organizations must deliver quality care at lower prices. But information collected at different points can fall through the cracks, putting the patient at risk. That’s why data interoperability is a critical issue.
The solution is not to put every entity in the healthcare value chain on the same closed, monolithic EHR that tries to do everything. We have seen time and again what happens when innovation is stifled and vendors become “too big to fail.” But by embracing connectivity standards, providers and patients alike can leverage best-in-class tools purposely built for specific treatments and outcomes. The easier it is, the higher the likelihood of success. And isn’t that the whole point?
In this series, we are featuring some of the thousands of vendors who will be participating in the HIMSS15 conference and trade show. Through it, we hope to offer readers a closer look at some of the solution providers who will either be in attendance – with a booth showcasing and displaying key products and offerings – or that will have a presence of some kind at the show – key executives in attendance or presenting, for example.
Hopefully this series will give you a bit more useful information about the companies that help make this event, and the industry as a whole, so exciting.
Elevator Pitch
For over 20 years the mission of Omnicell has focused on improving the medication and supply distribution process. More than 3,000 acute care customers worldwide have used Omnicell’s medication automation, supply chain, and analytics solutions to improve efficiency, reduce errors, and lower costs.
About Statement
Omnicell is a leading provider of comprehensive, technologically advanced automation that enables healthcare facilities to acquire, manage, dispense, and deliver medications and supplies more effectively. The Company’s automation and analytics software deliver patient-centric medication and supply management across the entire healthcare continuum—from the acute care hospital setting to post-acute skilled nursing and long-term care facilities to the home.
Omnicell non-acute care solutions, including the MTS brand, enable institutional and retail pharmacies worldwide to optimize productivity and control costs. Moreover, the innovative medication adherence packaging solutions can reduce costly hospital readmissions. Omnicell also offers a suite of analytics software, a comprehensive training and education program, and leading customer support, and has been recognized with KLAS awards every year since 2006.
Founder’s Story
When his daughter was hospitalized at birth, Omnicell founder Randall Lipps observed much inefficiency in the way hospital supplies were managed, and he saw that it prevented nursing staff from spending more time directly caring for patients. He founded Omnicell, Inc. in 1992 on the premise that better management of supplies and medications would improve a hospital’s standard of care by allowing clinicians to spend more time with their patients.
Lipps has served as Omnicell’s Chairman since the company’s founding, and in 2002 he assumed the additional position of president and chief executive officer, taking a more active leadership role in the company’s operations.
In light of the Premera Blue Cross cyberattack and data breach — which, so far, is the second-biggest of its kind in industry history that exposed personal, financial and medical information of more than 11 million customers — Bob Swanson, compliance engineer at LogRhythm provides some wonderful detail and perspective regarding the news.
In the following conversation, Swanson discusses what we know about the beach so far, how organizations can strengthen their security efforts, motivations of hackers, as well as provides a vast level of insight to help navigate the situation and guidance for others hoping to avoid breach,
What do you know about the hack and what don’t you know? How similar/dissimilar is it to other major hacks?
Although Premera has said the breach was detected back on Jan. 29,2014, the first signs of the attack date back to May 5, 2014. So with the breach going undetected for over six months, the culprit(s) had ample time to navigate through Premera’s network and find exactly what they were looking for – sensitive data with value in the black market, regardless of whether there is evidence indicating it has surfaced. Given time, a proficient hacker will set false trails and distort clues of their activities to confuse investigators or IT security professionals. However, they are currently under federal investigation working with the FBI and cyber security firm, Mandiant, to better understand the nature and scope of the attack. Many additional details will come to light as the investigation continues, but it is clear that early indicators were not picked up on. Similar to other major breaches in the healthcare and other industries, as the mean-time-to-detection (MTTD) increases, this gives proficient hackers time to navigate the network, find what they are after and make it more difficult to discover the true details around the attack.
Is it related to the Anthem hack? Several Blues plans that aren’t part of Anthem still were business partners and were affected by the hack. As Premera was investigating the effect of the Anthem hack, did they discover their own hack?
With many of the facts surrounding the breach still unclear or undefined, initially it does not appear to be linked to the Anthem breach; however, consider their targets or objectives for similarities. In healthcare, patient information containing elements of social security numbers or other protected health information (PHI) has a significant worth in various markets, both known and unknown. With this comes a demand and hackers are seeking out organizations to exploit and provide the supply. Also, as seen in both Anthem and Premera, the intrusion went on for some time without detection or actions taken to remediate compromised systems. The similarities between the attacks can be seen at a higher-level where the industry as a whole finds challenges in gaining the necessary budget allocation to support sound cyber security programs. Many healthcare organizations have highly integrated systems, so all you need is one back door to be left open, say a compromised account, and hackers can navigate to their targets unseen for lengthy periods of time.
This is the reason that the Affordable Care Act is not going away, despite the continuing conversations about its demise: In its first five years, the Affordable Care Act (ACA) has already left an indelible mark on the $2.9 trillion health sector. By energizing five fundamental shifts, the law has accelerated the rise of a new health economy predicated on value, according to a new report from PwC’s Health Research Institute (HRI), “Five Trends to Watch as the Affordable Care Act Turns Five.”
“Although the ACA will continue to face crosswinds, it has already had a profound impact on the healthcare business,” said Kelly Barnes, PwC’s U.S. health industries leader. “The ACA has catalyzed major changes in an industry historically slow to change. Our report provides a roadmap that outlines what industry leaders should be doing as these shifts continue over the next five years.”
“Most striking, the five trends have led to the creation of more than 90 new companies that have entered the sector since 2010,” said Ceci Connolly, managing director of PwC’s Health Research Institute. “The ACA has opened gates for savvy investors and startups to take a piece of the $2.9 trillion industry.”
According to the report, although much groundwork was laid in advance of the law’s enactment, health industry business models and imperatives will likely never be the same post-ACA. These five key trends fueled by the ACA have ignited sector-wide transformation:
Risk Shift: Raising the stakes for all healthcare players. The ACA added force to new payment models that reward outcomes and penalize poor performance such as high rates of readmission and hospital-acquired conditions.
Primary care: Back to basics. Experimentation in new payment models and expansion of insurance coverage are making primary care once again the critical touch point.
New entrants: Innovators in the New Health Economy. New entrants are rushing into the market to meet the demand for lower-cost, consumer-oriented care options in the post-ACA era. More than 90 new companies have been created since 2010, according to HRI analysis.
Health insurance: From wholesale to retail. Rapid enrollment in the ACA’s public exchanges has demonstrated the potential of retail-style health insurance and spawned renewed interest in private exchanges.
States: Reform’s pivotal stage. States have emerged as key players in the reconfigured healthcare landscape, as the ACA gave states notable discretion in how the law could be implemented.
Senate health committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) are urging insurer Anthem to notify all 78.8 million Americans whose sensitive personal information may have been exposed in a cyber attack discovered in January.
Lamar Alexander
In a letter to Anthem, the committee leaders note that more than a month and a half after a cyber attack identified on Jan. 29, 2015, “more than 50 million Americans … have yet to receive notice directly from Anthem” that their personal information, including addresses, birth dates, employer information, Social Security numbers and email addresses, may have been compromised, exposing them to resulting security threats like identity theft.”
The senators write, “…[T]he highly sensitive nature of this information makes early notification essential, and we are concerned with your slow pace of notification and outreach thus far. We are writing to formally request that you speed up the pace of notifications, and share with our committee what steps you plan to take in the next few days, to dramatically increase the pace of notification. This slow pace is of particular concern given that many of the individuals whose information has been compromised are not Anthem customers and may still be unaware that their information was contained in the attacked database.”
They continue, “We formally request that you provide a clear action plan that accelerates the current pace of notification and ensures that all affected families receive notification in the upcoming days. …This is a critical and pressing issue, and while we understand there are many complications given the size and scope of the attack, we look forward to your response by April 1, 2015 on your progress and a clear target for when you will have reached out to every affected individual.”
The College of Healthcare Information Management Executives (CHIME), the professional organization for chief information officers and senior IT executives, is calling on innovators throughout the U.S. to participate in the CHIME National Patient ID Challenge.
In an effort to find a universal solution for accurately matching patients with their healthcare information, CHIME will launch a $1 million challenge early this summer on the HeroX platform, co-founded by XPRIZE CEO Dr. Peter Diamandis.
The digitization of the U.S. healthcare system maintains that electronic health records must be able to seamlessly share and exchange information. According to CHIME, interoperability is not enough — to realize their full potential, patient data contained in the EHR must be accurate to support the requirements of coordinated, accountable, patient-centered care, the organization says.
“There is a growing consensus among payers and providers that a unique patient ID would radically reduce medical errors and save lives,” said CHIME CEO and president Russell P. Branzell, FCHIME, CHCIO.”Incomplete or duplicate health records present significant issues in terms of patient safety, and there is a pressing need for preventing, detecting and removing inaccurate records so hospitals can positively match the right data with the right patient in order to provide the best possible care.”
Duplicate or inaccurate patient records can occur from manual data entry errors, or when two or more individuals share the same name. This presents considerable concern for different individuals being identified as the same patient, potentially resulting in inadequate treatment or unintended injury.
In this series, we are featuring some of the thousands of vendors who will be participating in the HIMSS15 conference and trade show. Through it, we hope to offer readers a closer look at some of the solution providers who will either be in attendance – with a booth showcasing and displaying key products and offerings – or that will have a presence of some kind at the show – key executives in attendance or presenting, for example.
Hopefully this series will give you a bit more useful information about the companies that help make this event, and the industry as a whole, so exciting.
Elevator Pitch
PatientKeeper provides workflow applications for physicians that transform hospital EHRs from what they typically are – a distraction or hindrance topatient care – into what they should be: an intuitive support system for physicians.
About Statement
PatientKeeper, Inc. is a leading provider of healthcare applications for physicians. PatientKeeper’s highly intuitive software streamlines physician workflow to improve productivity and patient care. PatientKeeper’s CPOE, physician documentation, electronic charge capture and other applications run on desktop and laptop computers and popular handheld devices and tablets. PatientKeeper’s software integrates with many existing healthcare information systems to help provider organizations drive physician adoption of technology, meet Meaningful Use, and transition to ICD-10. More than 60,000 physicians across North America and the UK use PatientKeeper software.
Market Opportunity
PatientKeeper plays in two different market segments: (1) EHR optimization, and (2) revenue cycle optimization. In the former, we target 100+ bed community hospitals and hospital networks that rely primarily on affiliated physicians (vs. employed physicians) for patient admissions – clinicians whose loyalty (and business) must be “courted” and competed for – and which have not deployed or committed to an Epic EMR system. In the “Revenue Cycle Optimization” side of our business, we target physician practices of 25 doctors or more (but typically larger academic medical groups), and hospitals with a significant corps of employed physicians.
The Workgroup for Electronic Data Interchange (WEDI), a nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, released the findings from its recent survey on industry awareness and adoption regarding the usage of the “Blue Button” implementation guide for exporting patient healthcare records.
Devin Jopp
WEDI conducted its first survey on Blue Button in 2013, and as a follow up on the progress of industry adoption since that time, WEDI re-evaluated the industry in 2014. WEDI conducted the survey from Oct. 31, 2014 to Dec. 8, 2014, which included 274 respondents across multiple stakeholders, including providers, health plans, vendors and clearinghouses.
The full survey results can be viewed online and summarized through WEDI’s March 13 letter to the Department of Health and Human Services (HHS). Some key observations WEDI notes from the 2014 survey in comparison to the 2013 findings include:
Relying on integrated electronic health record and medical device data to populate personal health records (PHRs) increased. While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014.
Ensuring awareness of Blue Button as an industry-wide tool remains an opportunity.
Offering the PHR to all patients when implementing a PHR continues to be significant. There is a high percentage (80 percent in 2014) of respondents that are offering the PHR to all patients/members as opposed to only making it available to select subsets of their patients/members.
Enabling the patient/member to retain control over who has access to their PHR data through privacy controls continues to be important.
Transmitting data to patients, providers or authorized third parties appears to occur through DIRECT. Health plan and provider respondents both showed an increase in use of DIRECT for transmitting data, while government and technology developer respondents showed a decrease in use of DIRECT.
Providing patients with a better overall experience continues to show traditional communication methods as top priorities.
For over 20 years the mission of 
PatientKeeper provides workflow applications for physicians that transform hospital EHRs from what they typically are – a distraction or hindrance topatient care – into what they should be: an intuitive support system for physicians.