Goodbye to 2011 - A Recap of the Year's Events - Part 1

As 2011 washes into history making way for 2012, I want to send my warmest and most sincere wishes for a Healthy, Happy and Most Blessed New Year in 2012 for all. 

I entered 2011 finishing up my duties as Interim CEO for CareSpark.  I have had the pleasure of working with CareSpark since 2005 first as a volunteer and then starting in 2009, I contracted to provide strategic and technical services in support of their implementation of the Nationwide Health Information Network (NwHIN), the SSA Sponsored Project as well as a limited CMS pilot with three HIE's. 

Unfortunately, CareSpark made the decision to close and announced it in July 2011.  I had really hoped that the community would be able to come together to move the services forward under the CareSpark umbrella.  I am still busy running my business, Serendipity Health, LLC, that has provided full time employment for me this year for which I am grateful.  It has been quite some time since I have posted, so I will start this first post of the year giving you a recap of some of the highlights that I experienced in 2011.  

In January 2011, I had the opportunity to volunteer my time as one of the IHE North American Connectathon monitors helping grade/evaluate vendor tests for various Integrating the Healthcare Enterprise (IHE) profiles. Over 4000 tests were completed by over 450 health IT system engineers.  These engineers represent over 100 HIT organizations who had the goal of testing interoperability and working to fine tune their implementations in over 150 products to meet the requirements of the various IHE International profiles. These same profiles make up components of the many NwHIN and Meaningful Use standards. This group picture is of all the monitors that worked together to pull off the grand task of grading the over 4000 tests over the one week event.

January in Chicago is not my favorite place to be, but I feel honored that I was asked to help and gladly volunteered my time to help the healthcare industry with this worthwhile effort. The event this year will be held January 9-14, 2012.  

In February 2011, I attended the Healthcare Information Management and Systems Society (HIMSS) Annual Conference along with some 30,000+ other attendees. The week started with me being one of the presenters at the Interoperability Workshop held early in the week.  My contribution to the agenda was to wrap up the workshop with the overview of US relevant standards including NwHIN and The Direct Project that are required for providers to implement Meaningful Use. The workshop sold out attendance and was very interactive for all attendees. I shared the presenter duties with Lee Jones, Keith Boone, and Bob Yencha.   

The week was full of activities and networking. Steve Leiber and David Blumenthal presented to a standing room only audience at the HIMSS Interoperability Showcase.  The next several topics were all included in the Showcase which was the largest ever at nearly one acre in size.  It had all the typical areas represented as well as the area hosted by Office of the National Coordinator (ONC) showing approximately 40 demonstrations highlighting how health practitioners are securely exchanging health data between doctor's offices, hospitals, benefit providers, government agencies and with other health organizations, all across America.  I am happy to report that two stations within the ONC area, showcased some of my contracted endeavors from 2010 through 2011.  

The AmeriHealth Mercy and Independence Blue Cross station showcased the initiative created by both organizations that gives health care providers better access to health plan information and improves the quality of member care.  I am proud to have been involved in a small way with this innovative way of leveraging the standards by various stakeholders focusing on two use cases - sharing medication information and hospital admission through secure patient portals, provider portals, and HIEs.

The second station that I was involved with was one of eight pilots demonstrating the use of Direct Project specifications.  I have been involved with the Direct Project since it's launch in March 2010. This demonstration illustrated the feasibility of utilizing the Direct Project constructs to enable secure messaging between a federal agency (Veterans Affairs), and a regional health information exchange network (CareSpark). This demonstration showed the secure, standards-based transmission of a referral for mammography from a VA medical center to a private sector provider clinic, and the reply from the private sector provider clinic with a text based report. 

This CareSpark pilot demonstration  transitioned to the Health Information Partnership for Tennessee (HIP-TN) after the HIMSS conference and resulted in the delivery of live patient information in September 2011.  I feel very lucky to be managing the Direct Project strategy as well as the NwHIN Exchange onboarding and acting as the CTO contracted to HIP-TN both last year and now going into 2012.  I count my blessing each day and give thanks for the priviledge to help my own state and Keith Cox, CEO of HIP-TN with our go forward strategies to improve the healthcare quality while reducing the costs associated.  

Michael J. Fox was one of the keynote speakers and the DeLorean time machine used in the Back to the Future trilogy was on display on the showroom floor.  I had a good friend offer to take the picture of me in front of it. Yes, it is a bit silly, but I just had to when the offer was made.  Thanks Cliff...

One of the days there was a Tweetup of of us "technogeeks" in the HIT industry who showed to support the cause of outreach and education.  I finally got to meet up with some of the wonderful folks I have had the opportunity to work with over my 22 year career in HIT. 

I attended several events over the course of the week in Orlando at HIMSS, including the H.I.T. Men and Women Reception which toasts the art and inspired vision of today's most powerful healthcare IT leaders. I am honored to serve on the TN HIMSS Board with Michael Hollis who is the brainchild for this event. At HIMSS 2011, I was lucky enough to walk the red carpet with Michael and Antoine Aggasi both of which are working to advance interoperable healthcare. I am going to end this post update today since I have written quite a bit for your to digest and tomorrow morning will be here before i know it.  

I will give the update on the remainder of the year tomorrow so stay tuned for another post soon.  I have been asked by so many of my friends lately what I have been up to, so I share this with those who care. If you don't care, then you would not have read this far.  I promise to post more often this coming year and reconnect with many of you who I look forward to seeing and working with again in 2012.  Until next time.....

Temporary Certification Announced and Tennessee excels toward HIE

In my first blog post dated January 5, 2010, I mentioned that our nation is at the forefront of aligning the stars with monetary incentives to stimulate the adoption and meaningful use of the Electronic Health Record (EHR). Some have dubbed this as the perfect storm of Healthcare reform. Earlier this month, the Office of the National Coordinator for Health IT (ONC) issued a final rule to establish a temporary certification program for EHR technology. This program will establish processes that organizations will need to follow in order to be authorized by ONC to test and certify EHR technology. Use of "certified EHR technology" is a core requirement for providers who seek to qualify to receive incentive payments under the Medicare and Medicaid EHR Incentive Program. 

Certification will be used to provide "assurance and confidence" that a product or service will work as expected. By purchasing certified EHR technology, hospitals and eligible providers will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of EHRs to qualify for the payment incentives and begin to use EHRs in a way that will improve quality and efficiency in our health care system. Systems will include the capabilities a hospital or provider envisioned when they purchased the EHR. The certification will also ensure the capabilities are available to achieve meaningful use incentives.

Exchanging health information among disparate systems quickly and in usable formats, might be the vision for improving healthcare, but getting information beyond point-to-point transactions is a challenge for even the most engaged, forward thinking organizations. As the drive for information exchange standards continues, some healthcare systems as well as Tennessee are gearing up to purchase tools to harness, index, route, and harmonize patient data to make it available at the right place and at the right time to enable the clinical caregiver to improve the patient care process.

Tennessee has been making incremental strides towards improving the patient care process and was recently recognized as one of the top five most improved states in routing prescriptions electronically. Surescripts, a health information network that operates the country's largest electronic prescribing network, announced that Tennessee ranked second behind Vermont and just ahead of Kansas, Illinois and Missouri on the top five list. Tennessee Gov. Phil Bredesen co-hosted the fourth annual Safe-Rx Awards event as part of the recent State Alliance for e-Health meeting. Bredesen has long supported improving the process and co-chairs the alliance with Vermont Gov. Jim Douglas. Surescripts created the Safe-Rx Awards to raise awareness of e-prescribing as a way to improve patient safety by providing a secure, accurate and informed prescribing process. This is the first of many steps our state will have to make to truly improve the quality of patient care.

Tennessee's department of eHealth, in conjunction with nine other states, is conducting market research regarding enterprise medication management technologies and services. An RFI was published June 17, 2010 and is due July 12, 2010. The responses to this RFI will assist the nine states in understanding the current state of the marketplace, including commercial/government best practices, industry capabilities, innovative delivery approaches, commercial market service levels, and performance strategies and measures. Information gained through this RFI will greatly assist TN in determining how best to advance innovative medication management services.

In addition to the above RFI, the Health Information Partnership for Tennessee (HIP TN) also released an RFP on June 25, 2010. Responses are due July 13, 2010. HIP TN is the state designated entity charged with coordinating activities for the Regional Extension Center (tnREC) as well as the Health Information Exchange (HIE) strategy for Tennessee. HIP TN, a non-profit organization, works to improve access to health information through a statewide collaborative process by providing services and infrastructure for the secure electronic exchange and use of health information between state-wide agencies and local or Regional Health Information Organizations (RHIO). This RFP is soliciting proposals to provide a statewide HIE infrastructure platform for Core Services and other functions to be accessed by physicians, hospitals, other health care organizations, and consumers.

HIP TN has defined Core Services to include:

• Service Access Layer
• Patient Matching Service
• Master Clinician Index
• Master Facilities Index
• Trust Broker
• NHIN Gateway

In addition, the RFP will describe hosting services and operational expertise in support of the Core Services that will be administered on behalf of HIP TN by the Solution Provider. I currently volunteer on the Technology work group who has been leading the RFP process. While the remainder of the year ahead is full of deadlines and deliverables, I look forward to assisting with one of the biggest challenges, to keep various stakeholders in HIP TN, across my state, and various other states abreast of all the technology and standards that are out there.