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HIMSS Federal & Stage Public Policy Update

Speaker:  Jeffrey R. Coughlin, MPP
Senior Director, Federal & State Affairs
HIMSS North America

This luncheon appropriately took place in the relatively new and beautiful Alder Commons Auditorium on the University of Washington Campus. Jeff briefed me (I cannot speak for others in the room) on Meaningful Use current events (what CMS expected upon inception and the reality of now) and the new incentives to push interoperability. I graduated from UW with a degree in Clinical Informatics in 2011 when CMS was just rolling out EHR incentive program, now 4 years later it is an interesting perspective, the positivity outlook I once saw is fading. In 2011 CMS estimated by 2019 that 100% hospitals and 70% professionals would be utilizing EHRs. As of June 2015 537k eligible professionals and 48 hospitals registered for Medicaid/Medicare incentives; a whopping 31 billion incentives were paid out. With all that money paid, it raised question of what was actually bought with those dollars with only 48 hospitals registered. I am sure Congress and the House will try very hard to find this out exactly!

I know that the carrot and stick approach to EHR incentive payments are producing results in regards to getting eligible professionals and hospitals to get on board with Meaningful Use (MU), I am more drawn to the value of care improvement I can see myself in the works; interoperability. Jeff talked about this subject as well with more interest and I sat up in my chair. After the slides he presented on numbers/facts interlaced with disappointment that CMS is no doubt feeling over MU and EP/Hospitals are actually frustrated by, the subject matter of interoperability I was very happy to see. The Office of the National Coordinator for Health IT (ONC) defines interoperability “… as the ability of systems to exchange and use electronic health information from other systems without special effort on the part of the user.” I believe that EHRs are worthless without the ability to follow patients throughout their lives; we are no longer born, live and die in the same town, even less so go to the same doctor, hospital or clinic our entire lives. Therefore it is more important than ever for the 2015 Interoperability Standards Advisory to “…coordinate the identification, assessment, and determination of the best available interoperability standards and implementation specifications for industry use toward specific health care purposes.” Please check out this wonderful graphic that very nicely lays things out.

Jeff’s closing remarks were centered around how important it is for us to advocate the role Health Information Technology has on creating a healthcare system based upon patient centered care and with National Health IT week coming up October 5-9 what better time to knock on your senators door. Also the HIMSS policy summit is October 7-8 and you can sign up for early bird registration until Sept. 10th.

Posted in: Health Regulations, Healthcare Policy, Healthcare Technology, Interoperability, Meaningful Use

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Adopting Technology in Healthcare for the Right Reasons

Regulations, process, and records keeping are all important parts of managing health IT; however, when implemented without a strategy focused on patient and business value, they can create headaches for CIOs, not to mention patients and healthcare providers. This was an emerging theme Institute for Health Technology Transformation Conference held in Seattle at the end of August.

IHT2 Summit in SeattleThe conference featured speakers from across major healthcare organizations. Mayo Clinic CIO Chris Ross gave the final keynote which summarized many themes of the conference and provided direction for the future. He described Mayo’s tradition of using industrial and process engineering to deliver on Mayo’s promise of team-based integrated care. Viewed through this lens, imperatives to integrate EMRs, adopt ICD-10 and attest to Meaningful Use became opportunities that aided the business, and enhanced patient care. However, he was clear that while these projects were necessary, they were not sufficient by themselves to achieve Mayo’s vision. He went on to describe projects underway to optimize the workflow for their clinicians, in one instance reducing the amount of time doctors spent using IT tools from 30 minutes to 5 minutes per patient. He also described the vision of having hundreds-of-millions of lives under Mayo’s care, and the patient-centric model that they were following to achieve this. This included projects like delivering the Mayo app deeply integrated with Apple’s HealthKit technology.

Ross also asked his peers to consider the move to electronic records keeping to be a move to digitizing the healthcare industry to keep pace with the innovation available in other industries instead of a regulatory requirement. He envisions a system where a unified data platform provides digital care and knowledge management and recording keeping is a by-product of that system.

Focusing on the right strategy was also a theme in a talk by Dr. Nick Wolter of the Billings Clinic. Wolter described a 1993 merger with Deaconess that nearly bankrupted the organization. The merger was focused on regulatory and process integration while ignoring the vision for the new organization. In 1997, with financial losses posted, they hired turnaround experts who focused on physician leadership development. By 2005 they had established a vision to be best in the nation for patient safety, quality, and service. In 2010 Billings Clinic added value to their mandate and are looking closely at ACO metrics to make sure they are delivering on these promises.

Throughout the two-day conference, panelists called out EMRs as a significant driver of physician dissatisfaction. While meaningful use requirements have increased the focus on moving to electronic records, in many cases this is apparently happening without a vision that leverages these transformations to improve physician efficacy and patient care, which is unfortunate as these two areas if provided with appropriate electronic tools could see some of the biggest benefits.

Although there is was definitely a dissatisfaction expressed with the current state of health IT, it was promising to see shifts towards tools that are more focused on provider workflow and patient engagement. Even more promising was the general understanding at this conference that digital healthcare can and should be better delivered. At Wellpepper we’re excited to support this shift to a patient- and value-centered system.

Posted in: Health Regulations, Healthcare Disruption, Healthcare Technology, Seattle

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Wellpepper’s Top Health Tech Stories of 2013

It’s the time of year to reflect and make lists! It’s been a great year for Wellpepper: our first full year in business. We’ve enjoyed bringing new features to our users and learning more about the needs of both patients and healthcare providers. We’re committed to building useful tools that patients and providers love to use. We’ve been inspired at conferences meeting with end-users, hospital administrators, and other startups who share the same mission of changing how patients and providers engage around their health. We’ve experienced the power of social media, met new friends through Twitter, and learned so much from Tweetchats. As a young company, it’s been a year of firsts for us that, while monumental for us, pale in comparison with the changes going on in health IT, so rather than telling you more about us, let’s talk about the year in Health Tech.

There is no scientific basis to this list, just what we think stands out from the year in Health Tech.

Healthcare.gov

The beleaguered website was definitely the top Health IT story of the year. At Wellpepper we were unable to make it through the registration process ourselves, and ended up going to a broker to find out our healthcare options. As the news came out on why the site was so bad, it was pretty obvious there was a lack of accountability and no project management. It’s really unfortunate that the Affordable Care Act was mired in this mess of an implementation, but we’re very excited that former Microsoft exec Kurt DelBene is taking the reins. Ship It!

Quantified-Self Hits the Mainstream

tec-gift-guide-fitness-trackers.jpeg-1280x960Or, “everyone is tracking.” The mainstream press started writing about fitness gadgets and our Facebook feeds were full of friends who got new FitBits for Christmas. Not sure what this means about the trend though. We have found the FitBit to be really interesting to calibrate activities, for example, a game of Ultimate Frisbee but after you know how inactive or active you are do you really need to track? And do you become okay with your activity or lack thereof?

Meaningful Use Phase Delayed

The Centers for Medicare and Medicaid have delayed the deadlines for implementing Meaningful Use Stage 2. Stage 2 will be extended through 2016 and Stage 3 won’t begin until at least fiscal year 2017 for hospitals. Meaningful Use Stage 2 focuses on patient engagement, which is very minimally defined as patients interacting with healthcare information electronically. We’ve always said that electronic medical records vendors are not the best equipped to deliver tools that patients (ie consumers) want to use, so it’s not surprising that healthcare providers are struggling with this phase. That said, m-health is poised to deliver on these requirements.Wellpepper2-1195a

M-Health Comes of Age

While we can definitely debate where we are in the m-health hype cycle, there is no question that M-Health is a formidable category. The FDA is now monitoring and releasing guidelines, albeit with little clarification. Eric Topol made headlines by using an iPhone EKG on a plane to diagnose a heart attack and and advise the captain to make an emergency landing. Most positively, we’re hearing less talk of ‘apps’, and more talk of integrating mobile health into the overall patient experience and the official hospital records.

23andMe Ignores FDA

Source: Wikipedia commons

You might consider this one to be a bit specific, but it’s representative of a number of key stories in 2013: big data, the explosion of healthcare investing, and the dramatic gulf between current Health IT and other technologies, and between Silicon Valley and the FDA. 23andMe, which does cheap DNA testing, direct to consumer, was forced to stop providing genetic results and only include ancestry after effectively ignoring FDA warnings for over a year. Speculation is that they were trying to get to a million tests (they are at about 500K) so that they could prove their tests were valid and thereby circumvent long FDA approval processes. Those on the side of the FDA saw this as Silicon Valley thumbing their nose at patient safety and regulations. Those on the side of 23andMe saw this as tech disruption at its purest. As recipients of some of the last full genetic and ancestry tests before the shut-down, expect more from us on this topic. 😉

This one is not healthtech, but we’d be remiss if we didn’t mention the focus on costs of care. Time Magazine, and the New York Times both published rather scathing interactive features on the costs of healthcare in the US. One of Reddit’s top threads right now is about a $50,000 appendectomy. It’s great to see these issues called to light. Let’s hope we see progress in solving them in 2014.


NewYearWP

We’re pretty excited to see what 2014 brings Wellpepper and what new innovations, disruptions, and improvements are brought to the healthcare industry as a whole. Best to you and yours from all of us at Wellpepper!

Posted in: Health Regulations, Healthcare Disruption, Healthcare Technology, M-health

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