Interoperability

COO Jeff Williams said the framework will empower patients and care teams to have more formalized discussions with physicians, beginning with programs for Parkinson’s and post-surgical plans.

The American Health Information Management Association launched an effort to collect 100,000 signatures on a petition to ask the White House to address the need for a unique patient ID. While other groups, such as HIMSS and CHIME, have both supported a national patient ID – CHIME notably with a million dollar contest – AHIMA is taking a new approach. “As a patient, you know there’s only one you. But sometimes a name or some personal information is so similar to someone else’s that doctors’ offices or hospitals can have a hard time identifying records correctly,” AHIMA CEO Lynne Thomas Gordon said in a statement. “It’s a dangerous and costly problem that can lead to missed diagnoses, inappropriate treatments or unnecessary tests, as well as making it difficult for providers to exchange health information.” [Also: Epic CEO Judy Faulkner on the need for a national patient ID] Thomas Gordon suggested that the government could turn to experts in other sectors, such as banking and finance, as well as security experts, for help in making healthcare safer and more effective. “The voluntary patient safety identifier – created and controlled by patients – will be a complete and positive game-changer in healthcare in terms of patient safety, quality of care and financial consequences,” Thomas Gordon added. The petition asks for the removal of the federal legislative ban that has prohibited the U.S. Department of Health and Human Services (HHS) from participating in efforts to find a patient identification solution. The challenge of accurate patient identification is illustrated by a study conducted by the Harris County Hospital District in Houston, which found that, among 3.5 million patients, there were nearly 70,000 instances where two or more patients shared the same last name, first name and date of birth. Among these were 2,488 different patients named Maria Garcia and 231 of those shared the same birth date. AHIMA’s petition is available on petitions.whitehouse.gov. Officials said they have to collect the 100,000 signatures by April 19 to ensure a response from the Obama administration. Twitter: @HealthITNews  

Judy Faulkner readily admits that when she founded Epic Systems she had no idea how to start a company.  Faulkner discussed those early years as well as some of today’s most contentious topics including semantic data interoperability, why the U.S. needs a unique patient ID, and the impact that electronic health records software has on physician productivity. Semantic standards are key for data exchange. If you're going to do interoperability between organizations, which I think is critical, it's limited because you have to define and normalize and harmonize the data so that each group can understand the other. Let's examine gender. I may have one for male, two for female, and then two other kinds of genders, ambiguous and something else. [Also: Judy Faulkner: 'Good software is art.'] On the other hand, they may have one for female and a range of other values. How do you move that over when different groups have different ways of doing that? You need standards. There's a limited number of standards that we have to be able to transmit the data. I use such a simple example as gender, but as you go into the drug and other databases, there is even greater complexity. Within your organization you want to share. It's critically important to also get information back and forth from other groups who aren't yours. Unique patient ID has to happen. I think each person should have a medical identity. I don't care whether it's federal or not. However, the lack of this is not an excuse. You can do a lot of patient matching based on other attribute checking and so the identity would make it easier, but it is not an absolutely critical thing. Remote care is the future. Healthcare going to stay local to a great extent. I think it's going to also move to telemedicine much more than it is right now because we have to reduce the resources that we're using and the expense that we have in healthcare. Also people don't want to travel if they can help it. It will be a little slower than people would like. Physician productivity among Epic's priorities. Make sure your doctors are productive users. Focus on your doctors being productive users and all your users being happy. Because if that happens, then the rest will just fall out. Doctors happy, No. 1. And doctors happy means that they're taking good care of their patients, by the way, because doctors will not be happy if they're not, and I think that's really important, so I don't want to separate that out. 'I had no idea how you start a company.’ After I built it, I went around to a lot of different departments in University of Wisconsin and worked with them. One department had money for six months for a programmer to do something. There were only 20 data elements, and I remember charging them for 45 minutes of time. You can see why customers all around the country told people, ‘Look what they are doing." They'd call me up and say, "Start a company," and I would laugh and say, "No." This went on for about two years. Finally I said ‘Yes.’ You have to realize I wore blue jeans. In the summer I wore T-shirts; in the winter I wore sweatshirts. I cut my hair with scissors, no makeup. I was a normal programmer and I had no idea how you start a company. So I went to somebody who had spun off from the university, and he said three things: One, get permission from the university, get a good lawyer, get a good accountant. I did all three. It was great advice. I started the company, valued it at $70,000, and I invited my customers to join in and be part of the original shareholders. There are a lot of people then who helped start Epic … We divided it up, so if you had 5 percent of the company, you paid $3,500, and that got us started. We started with one and a half people. I had a morning assistant and an afternoon assistant. We were in a basement of an apartment house. That was it. We signed a bunch of contracts and never took outside money from venture capital or went public or anything like that. Twitter: @HealthITNews

HIMSS16 provided countless hours of must-see video content for Healthcare IT News, from fascinating interviews with thought leaders and speakers at the conference to in-depth panel discussions and show floor highlights throughout the week. We have compiled the top 5 videos to date for you to watch in case you missed them.

A new report based on customer scores found that the two companies outperformed other EHR-dependent and EHR-independent vendors.

CMS, ONC promise to not only accelerate adoption of the interoperability spec but also have some providers looking ahead at ways they can put it to use.

LAS VEGAS - The Staten Island Performing Provider System is running into all of the challenges inherent in implementing a value-based model for Medicaid payment reform in New York State. The Delivery System Reform Incentive Payment Program has as its goal to reduce avoidable hospital use by 25 percent over the next five years, according to Staten Island’s Executive Director Joseph Conte, speaking at HIMSS16 in Las Vegas. Asked how the program was going, Conte said, “In 11 months that’s the expectation to achieve. We’re not there yet. Looking at information we have from two hospitals, it’s a positive trend.” [Also: See photos from Day 2 of HIMSS16] Staten Island Performing Provider System is a corporation formed by Richmond University Medical Center and Staten Island University Hospital. Over 60 healthcare agencies and community-based organizations have joined Staten Island in the effort to reduce costs while increasing the quality of health for a very diverse population including 130,000 Medicaid recipients and 50,000 uninsured residents.  The big challenge, Conte said, is that timely data is not available from the state.  “It’s at least a six to nine month retrospective,” he said. “Everyone’s in a different place as far as electronic health records.” As of October 2015, an IT assessment showed that of the 26 healthcare systems partnering with Staten Island, 92 percent had an EHR platform or were in the process of getting one and 14 of them had different EHR vendors, Conte said. The overarching mission is to align IT strategy and execution, said Raj Lakhanpal, MD, CEO of SpectraMedix, and member of HIMSS Clinical and Business Intelligence Committee. To this end, Staten Island will be collecting data from providers and data feeds, and integrating it to create longitudinal records. They will apply population risk assessment models to predict high-risk patients and to flag those who should be included in disease registries and to identify gaps in care. [Also: See photos from Day 3 of HIMSS16] Conte said, “Data needs to be turned into business intelligence. Everyone needs prompt, accurate performance feedback.” The partners will need to make some IT investments to connect to state, Staten Island and other health IT platforms, he said. They’re starting to realize the value of receiving real-time measures of population health, he said. “Data six and nine months old is of zero interest to them,” Conte said. “What’s of interest to a doctor, (he or she) never knows that their patient is in the emergency room, or has been hospitalized.” Twitter: @SusanJMorse This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

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