“Mean­ing­ful use” dom­i­nates dis­cus­sions at HIMSS

HIMSS at­ten­dees urged to fo­cus on pa­tient care

Modern Healthcare - - News - —Joseph Conn, Gregg Blesch, David Burda and Nicole Vo­ges con­trib­uted to this re­port.

Though some tried to change the sub­ject, “mean­ing­ful use” of health in­for­ma­tion tech­nol­ogy—and the bil­lions of dol­lars in fed­eral stim­u­lus-law sub­si­dies that are at­tached to that term—dom­i­nated dis­cus­sions at the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety an­nual con­fer­ence and ex­hi­bi­tion March 1-4 in At­lanta.

Orig­i­nal es­ti­mates of the amount of money the fed­eral gov­ern­ment would dish out to help sub­si­dize health­care provider in­vest­ments in IT ranged be­tween $14.1 bil­lion and $27.3 bil­lion. How­ever, dur­ing a con­fer­ence pre­sen­ta­tion, John Halamka, a physi­cian who is chief in­for­ma­tion of­fi­cer at 621-bed Beth Is­rael Dea­coness Med­i­cal Cen­ter, Bos­ton, and Har­vard Med­i­cal School, said the cur­rent best think­ing was that the gov­ern­ment would be pay­ing be­tween $22 bil­lion and $23 bil­lion to those who met its mean­ing­ful-use re­quire­ments for health IT sub­si­dies.

HIMSS Chair­man Barry Chaiken kicked off the con­fer­ence by try­ing to shift the fo­cus from money to pa­tient care. He noted how IT pro­fes­sion­als need to cre­ate de­mand for their prod­ucts by de­vel­op­ing sys­tems and applications that providers want to use, rather than con­cen­trate on some­thing that might meet the re­quire­ments for a fed­eral sub­sidy.

“We can­not rely on in­cen­tive pro­grams or ex­ec­u­tive or­ders,” Chaiken said. “We must cre­ate elec­tronic sys­tems so ap­peal­ing that they make physi­cians want to leave their pa­per med­i­cal records be­hind.”

This sen­ti­ment was echoed by Eric Saff, se­nior vice pres­i­dent and CIO of three-hospi­tal John Muir Health, Wal­nut Creek, Calif.

“We kind of get caught up in the money, but the rea­son we’re do­ing this is to be more ef­fi­cient and to im­prove pa­tient care—and it’s go­ing to,” Saff said. “I’m re­ally ex­cited by it.”

To­tal at­ten­dance was pegged at 27,777, a bit more than the fi­nal of­fi­cial at­ten­dance fig­ure of 27,540 for the 2009 con­fer­ence in Chicago. There were 924 com­pa­nies on the exhibit floors, up from last year’s to­tal of 907.

There were some no­tice­able and sig­nif­i­cant ab­sences, such as elec­tronic health records gi­ant Cerner Corp., but Cerner man­aged to have a pres­ence without a booth by par­tic­i­pat­ing in the con­fer­ence’s “in­ter­op­er­abil­ity show­case” and co-spon­sor­ing a “CIO Night” with IBM Corp. at the At­lanta Hard Rock Cafe.

Ac­cord­ing to HIMSS, there were more ven­dors, but they brought fewer peo­ple with them. The lack of sales and mar­ket­ing staff, how­ever, was off­set by a 7% in­crease in the num­ber of health­care “pro­fes­sion­als.”

HIMSS also re­leased fig­ures stat­ing that nearly a third of all reg­is­trants were from health­care provider or­ga­ni­za­tions. About 10% of reg­is­trants were CIOs, while an­other 10% were CEOs. Al­most 8% of at­ten­dees were from out­side the U.S.

Key­note speeches were given by a num­ber of in­dus­try, gov­ern­ment and gen­eral in­ter­est speak­ers in­clud­ing Sprint Nex­tel Corp. CEO Dan Hesse, CNN med­i­cal cor­re­spon­dent San­jay Gupta, and “Mir­a­cle on the Hud­son” pi­lot Ch­es­ley “Sully” Sul­len­berger III, who closed the con­fer­ence.

Eas­ily the most an­tic­i­pated, how­ever, was David Blu­men­thal, the na­tional co­or­di­na­tor for health in­for­ma­tion tech­nol­ogy, who just the day be­fore his key­note speech re­leased long-awaited de­tails of how EHR sys­tems would be cer­ti­fied to meet mean­ing­ful-use re­quire­ments.

David Brailer, who served as the na­tion’s first na­tional co­or­di­na­tor af­ter Pres­i­dent Ge­orge W. Bush cre­ated the po­si­tion, criss­crossed the coun­try pro­mot­ing his plan and vi­sion. In com­par­i­son, Blu­men­thal—who founded the In­sti­tute for Health Pol­icy at 907-bed Mas­sachusetts Gen­eral Hospi­tal in Bos­ton—has not been much of a pub­lic fig­ure.

He used his ap­pear­ance at HIMSS to fur­ther in­tro­duce him­self and to rally the troops be­hind the Obama ad­min­is­tra­tion’s am­bi­tious health IT plan.

“I’m op­ti­mistic,” Blu­men­thal said, in sum­ming up. “I think the wind is at our back in so, so many ways.”

Blu­men­thal some­what echoed Chaiken’s pre­vi­ous key­note by not­ing that the fo­cus should be on im­prov­ing pa­tient care through the use of IT and not on just get­ting IT sys­tems in­stalled.

“As long as we keep the pa­tient and their needs and de­sires as our North Star, as our guid­ing light, we will not go astray with health in­for­ma­tion tech­nol­ogy,” he said.

Though not a key­note speaker, Ver­mont Gov. Jim Dou­glas, chair­man of the Na­tional Gov­er­nors As­so­ci­a­tion and co-chair of its State Al­liance for e-Health, pre­sented the states’ point of view. In con­trast to Wash­ing­ton squab­bling, Dou­glas said states are forced to con­front prob­lems and take action out of ne­ces­sity.

“Un­like the fed­eral gov­ern­ment, states can’t print money,” Dou­glas said. A Repub­li­can, Dou­glas added that—at the NGA’s re­cent meet­ing—he was “amazed” at how many is­sues GOP and Demo­cratic gov­er­nors agreed on.

Dou­glas said the Wash­ing­ton de­bate has been too nar­rowly fo­cused on ex­pand­ing cov­er­age and ar­gu­ing over who will pay the ad­di­tional costs. “No mat­ter who pays,” he said, health­care is on a track to bank­rupt fam­i­lies, em­ploy­ers and state gov­ern­ments.

Dou­glas said 25% of Ver­mont res­i­dents are on Med­i­caid, and the state has suc­ceeded in low­er­ing costs by con­cen­trat­ing on im­prov­ing the qual­ity of pri­mary care that Med­i­caid ben­e­fi­cia­ries re­ceive and as­sist­ing in the co­or­di­na­tion of their care through a health in­for­ma­tion ex­change fi­nanced by an “as­sess­ment” on health in­sur­ance claims. “We don’t use the ‘T-word,’ ” Dou­glas said, clearly re­fer­ring to the word tax.

Other state pro­grams Dou­glas cited as ex­am­ples in­cluded a Min­nesota ini­tia­tive to rank

providers ac­cord­ing to a cost and qual­ity for­mula based on the car­dio­vas­cu­lar, di­a­betes and pre­ven­tive care they pro­vide; and a Wash­ing­ton state ef­fort aimed at low­er­ing the overuse of cer­tain pro­ce­dures.

Mak­ing news

In what is some­thing of a tra­di­tion, com­pa­nies used the HIMSS con­fer­ence to make big busi­ness an­nounce­ments.

GE Health­care an­nounced that it has a name for its long-awaited soft­ware prod­uct born of its five-year col­lab­o­ra­tion with In­ter­moun­tain Health­care, Salt Lake City and a two-year de­vel­op­ment re­la­tion­ship with the Mayo Clinic, Rochester, Minn.

The sys­tem will be called Qual­ib­ria; it’s what GE de­scribes in a news release as a “clin­i­cal knowl­edge plat­form” that will bring to­gether real-time data from clin­i­cian IT sys­tems and com­pare them with “base­lines of ev­i­dence­based best prac­tices.”

The com­pany also an­nounced that Mayo has ex­panded its col­lab­o­ra­tion with GE and will con­trib­ute fur­ther to the de­vel­op­ment of clin­i­cal con­tent best prac­tices, in­clud­ing treat­ment pro­to­cols that will be made avail- able to other Qual­ib­ria cus­tomers, ac­cord­ing to the release.

Mean­while, IBM an­nounced it com­pleted its ac­qui­si­tion of Ini­ti­ate Sys­tems, a Chicago-based provider of prob­a­bilis­tic match­ing soft­ware sys­tems, a key tech­nol­ogy in the iden­ti­fi­ca­tion of med­i­cal records in in­for­ma­tion ex­change. IBM had an­nounced last month it in­tended to ac­quire Ini­ti­ate, which in 2006 re­ceived ven­ture-cap­i­tal fund­ing from In-Q-Tel, a ven­ture cap­i­tal firm founded by the CIA to in­vest in promis­ing tech­nolo­gies of use to the spy ser­vice.

And Cleve­land-based Hy­land Soft­ware, a maker of en­ter­prise con­tent­man­age­ment soft­ware, an­nounced that it had ac­quired eWe­bHealth, a Read­ing, Mass., com­pany that hosts med­i­cal­record work­flow so­lu­tions. In July of last year, Hy­land bought Valco Data Sys­tems, which pro­vides doc­u­ment man­age­ment and imag­ing, work­flow and health in­for­ma­tion man­age­ment ser­vices for hos­pi­tals, re­gional health in­for­ma­tion or­ga­ni­za­tions and in­te­grated de­liv­ery net­works. With this pur­chase, ac­cord­ing to a Hy­land news

release, the com­pany’s cus­tomer base now in­cludes more than 1,000 health­care or­ga­ni­za­tions.

An­other HIMSS tra­di­tion is the re­leas­ing of var­i­ous IT sur­veys and re­ports to serve as dis­cus­sion points for the con­fer­ence.

Among the most no­table of th­ese was Sure­scripts’ re­port Ad­vanc­ing Health­care in Amer­ica: 2009 Na­tional Progress Re­port on E-Pre­scrib­ing, Plus What’s Ahead for 2010 and

Be­yond, which re­ported that the num­ber of pre­scrip­tions routed elec­tron­i­cally tripled last year.

Ac­cord­ing to the re­port, Sure­scripts tal­lied 191 mil­lion elec­tronic pre­scrip­tions in 2009 com­pared with 68 mil­lion in 2008. Mean­while, the num­ber of e-pre­scrip­tions jumped to 18% of to­tal pre­scrip­tions writ­ten in the U.S. from 6.6% over the same pe­riod.

The re­port also stated that the num­ber of providers us­ing e-pre­scrib­ing more than dou­bled to 156,000 from 74,000.

More ven­dors ex­hib­ited at the HIMSS con­fer­ence, and over­all at­ten­dance rose slightly.

Chaiken: IT sys­tems must be prod­ucts providers want to use.

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