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Posts Tagged ‘interoperability’

15 Health IT Standards and Interoperability Rockstars to Know

Health IT standards and health information interoperability are at the forefront of the healthcare industry.  There are many challenges, unanswered questions and interested parties when it comes to the development of health IT standards and interoperability in healthcare. While advocates and leaders of standards and interoperability have their own opinions on the topic, I think we can all agree there is a need for standards and true interoperability is necessary to transcend healthcare. It is nice to see this topic front and center even if everyone isn’t on the same page.

There are many people contributing to the evolution of  health IT standards and healthcare interoperability efforts – above are 15 Health IT Standards and Interoperability Rockstars You Should Know. Some are more active than others on Twitter – follow all 15 of these leaders here.


Included in the list are:


  • Karen DeSalvo, MD National Coordinator for Health Information Technology (ONC); Acting Assistant Secretary for Health Twitter ID: @KBDesalvo
  • Doug Fridsma, MD President and CEO of the American Medical Informatics Association Twitter ID: @Fridsma
  • Keith Boone Standards Geek, GE Healthcare Twitter ID: @Motorcycle_Guy
  • Brian Ahier Director of Standards and Government Affairs at Medicity Twitter ID: @ahier
  • Rasu Shrestha, MD Chief Innovation Officer at UMPC and President, UPMC Technology Development Center Twitter ID: @RasuShrestha
  • Erica Galvez Interoperability Portfolio Manager at Office of the National Coordinator for Health IT Twitter ID: @EricaGalvez
  • Grahame Grieve Principal at Health Intersections Pty Ltd, Melbourne area, Australia Twitter ID: @GrahameGrieve
  • Steven Posnack Director of Federal Policy Division, ONC Twitter ID: @HealthIT_Policy
  • John Halamka CIO of BIDMC, Harvard Medical School Twitter ID: @jhalamka
  • Josh Mandel Lead Architect for the SMART project, Harvard Medical School Twitter ID: @JoshCMandel
  • Charles, Jaffe, MD, PhD Chief Executive Officer, HL7 Twitter ID: @cjaffemd
  • Stanley Huff, MD Chief Medical Informatics Officer at Intermountain Healthcare Twitter ID: @StanHuff52
  • Joyce Sensmeier, RN HIMSS VP of Informatics, President of IHE USA, co-founder and ex- officio chair of the Alliance for Nursing Informatics Twitter ID: @JoyceSensmeier
  • David McCallie, Jr., MD Senior Vice President, Medical Informatics, Cerner Corporation Twitter ID: @dmccallie
  • Gilad Kuperman, MD Director of Interoperability Informatics at New York- Presbyterian Hospital Twitter ID: @GilKuperman


Follow me @KateDTuttle

Air Travel or Healthcare Mega-Mergers: Same Impact on Customers

Mega-Mergers, Mega Concerns for Patients

The health insurance shakeup continues, and last week’s $37 billion merger of health insurance titans Humana and Aetna is the latest in a wave of deal-making that is likely to reduce the number of large U.S. health insurers from five to three. In addition to the Aetna/Humana merger, Anthem and Cigna have acknowledged discussions about a merger.

According to Leerink analyst Ana Gupte, “The Big Five will be a Big Three,” said Gupte, who estimated public companies led by Anthem/Cigna, Aetna/Humana and United would command about a third of the U.S. health-care market, with regional players and government programs covering most of the rest.

The mega-mergers between healthcare insurers are similar to what has happened in the airline industry. The major airlines have consolidated, which has resulted in less competition and fewer choices for travelers. Air travel has become a substandard service that people have to deal with because they don’t have any other options. These same consequences could happen in healthcare if health insurance giants continue to consolidate.

Health insurance companies are looking to consolidate in an effort to stay afloat and compete on the online health insurance exchanges set up under the Affordable Care Act (ACA). Since the ACA, health insurance companies have been required by law to provide coverage to everyone. This includes those with pre-existing conditions and chronic illnesses. Insurers have figured out how much more this is costing them and are seeking permission to raise premiums to cover their losses. In short, consolidation of health insurance companies trickles down to the patient, they will have fewer options for coverage, a reduction in the number of in-network doctors and fewer participating hospitals. These are all unintended consequences of the ACA.

While patients will have fewer choices than they have had in the past, they will have options. That being said, it is critical for these mega-mergers to keep consumer experience a priority. Leveraging data will be a key to delivering a cutting-edge consumer experience for their existing and newly attained consumers. Data integration from all sources is an enormous undertaking, but one that will be the cornerstone for the success of these mega-mergers. As the health insurance market continues to transform it is becoming more apparent that a single payer model is in our near future.

Don’t Forget About Consumer Experience Amidst The Chaos of M&A


Don't Forget About Patient Experience Amidst the Chaos of M&A

The healthcare industry continues down the path of transformation with the goal to provide higher quality, lower cost care for individuals and overall populations. To meet these new objectives, healthcare providers are entering into newly formed partnerships and entities, which bring regional healthcare providers together with health plans to address population health, integrated care delivery models, and health information exchanges that span outside traditional geographic or organizational boundaries. Merger activity has rapidly increased and is expected to continue for the foreseeable future. A KPMG study suggesting M&A activity will increase seven percent this year. Horizontal and vertical merger activity across health systems, hospitals and other healthcare settings is forecast to continue as larger networks seek to expand their footprint, consolidate services, and ultimately drive toward the financial benefits of increased purchasing power while reducing overall costs. Read the rest of this post »

#HIMSS15 Recap: 4 Hot Topics That Left McCormick Buzzing

#HIMSS15 Recap: 4 Hot Topics That Left McCormick BuzzingOver 42,000 healthcare IT enthusiasts and thought leaders attended HIMSS15 this year in Chicago. Thousands of others joined form various locations using social media to engage in the conversations. The HIT Super Bowl did not disappoint those in attendance and those joining the social media conversations. The conversations were around several different health IT topics but there were 4 hot topics that were making McCormick buzz.

The HIMSS15 top buzzword was interoperability. Healthcare executives across the industry are focused on technology that streamlines communication and the exchange of data across their systems. The challenge within the healthcare industry is not the lack of information, in fact the amount of information available is overwhelming. The big pain point comes with making the information useful and leveraging it to provide better, more proactive patient care. Integrating disparate data systems has proven to be a hurdle that many healthcare organizations haven’t figured out how to get over.

The 40,000 square foot Interoperability Showcase at HIMSS15 provided visitors the opportunity to watch more than 140 interoperable health IT systems as they followed the patient’s journey across the care continuum. The show also offered over 40 educational sessions focused on interoperability.

mHealth and the Internet of Things (IoT)
The HIMSS conference was full of smartphone apps, wearable technologies and other devices used for connecting and engaging patients. Connected health strategies are used to engage patients outside of the walls of the care setting to help make them more active participants in their care. The HIMSS15 conference featured a Mobile Health Knowledge Center which offered educational sessions on mobile topics such as innovative care delivery, privacy and security and technical requirements. One of the best quotes I heard came from the #HITsm panel discussion. Rasu Shrestha, MD (@RasuShrestha) said “I can’t wait for the distinction between mHealth and just health to disappear. It is all the same.” I couldn’t agree more, we need to get to the point where we are leveraging the best tools and technologies to provide the very best healthcare without the need to distinguish between the two.

BI and Analytics
The amount of information that healthcare organizations have to manage provides another level of complexity to the industry. With the amount of information that flows between interoperable systems, it is not surprising that business intelligence and analytics were a hot topic at HIMSS15. Integrating clinical, financial, operational and claims data to generate a 360-degree patient view provides healthcare organizations with actionable insights. These actionable insights are necessary to provide proactive care for individuals and entire populations. With the ultimate goal of healthcare being to provide high-quality, cost-effective care,  BI and analytics is vital to making this goal a reality. BI and analytics are not only important for individual care but real-time, accurate and insightful data is a big part of population health management.

Patient Privacy and Data Security
Healthcare data breaches are up by 138% and that astonishing number is predicted to continue to rise. No one wants to be the next Anthem, surrounded by lawsuits and huge patient privacy liabilities. The HIMSS15 Cybersecurity Command Center offered educational sessions from industry and government experts as well as product demos and a “capture the flag” game that allowed users to compete for prizes to protect the virtual hospital network. Visitors to the Cybersecurity Command Center were able to take a look at products and services that can assist with training, preparation and response techniques. The healthcare industry continues to balance the need to keep patient data secure and private while also providing this data across the continuum of care for better outcomes.

Another HIMSS has come and gone, but these four topics left McCormick buzzing and will continue to be hot topics for many months (years) to come. I’m already looking forward to HIMSS16 – see you all in Vegas.


Connected Health Top 10: #8 Interoperability Steps Into Limelight

Top-Ten-300x298Healthcare organizations are beginning to realize that enabling consumer engagement and population health strategies are not possible unless the capability of effectively and efficiently communicating across care venues and systems exist as well. This is a big ask considering the increasingly complex care continuum that matches patient to care provider. This calls upon Connected Health and Interoperability solutions to work together in new, mission critical, ways.

  • For health systems this is made more complex due to the mergers and acquisitions activities of the past few years that have left a complex system of systems in its wake.
  • For the health plan this is made more complex by the complicated montage of systems that are required to navigate data through an even more complex process payment of care post healthcare reform.

When making decisions related to collaborative technology investments, the CIO has traditionally viewed integration with the EHR as the most important decision making criterion. However, it is now becoming more clear that while the EHR serves as a critical source for healthcare information, more often than not the EHR is just one of tens or hundreds of systems across an organization that need to be integrated to gain business value from Connected Health investments.

Greater Data Access vs. Data Security

Patients continue to want greater data access to their care data. Connected Health and Interoperability must work together to balance this want against the need for increased assurances of the confidentiality of health information. Due to new and existing trends both inside and outside of the industry, data security will become increasingly important to the healthcare consumer.  Experian predicts that healthcare breaches will increase due to:

  • Potential economic gain
  • Increased digitization of records.
  • Introduction of wearable technologies to care protocols

HIPAA data breaches are at an all-time high with a recorded 138% jump in the number of health records breached in 2013 as compared to 2012

38% of providers said electronically exchanging data decreases their ability to separate sensitive health information from other data being exchanged.

Tackling ACO Data Challenges

How do we engage patients, coordinate care, improve quality, lower costs and share savings all at Tackling ACO Data Challengesonce? A group of Accountable Care Organizations (ACOs) will be in Baltimore this week discussing this and other topics on establishing and sustaining ACOs.

One of the challenges of forming and sustaining ACOs is establishing shared goals and shared knowledge. I was involved in the airline industry earlier in my career and was part of the team who automated the On-time Departure and other performance metric bonuses at then Continental Airlines. Prior to this, I had dabbled in Change Management and Quality Assurance topics but this was my first real experience with “what you measure is what you improve” or “pay for performance”.

The ACO challenge is similar to the challenges of Performance Management within the diverse units of a hospital but it is complicated by the many different types of organizations (and communication languages) that may be partnering. I’m really looking forward to learning more about ACOs and how we can apply clinical analytics to costing solutions to measure and report shared savings.

Stay tuned for updates!

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2015 Healthcare ACO Trends and The Key to Success [Infographic]

Accountable Care Organizations (ACOs) as a model to deliver high-quality, cost-effective care across the continuum and improve population health management (PHM) has significantly increased. In an ACO, healthcare providers take responsibility for the health of a defined population, coordinate care across the continuum, and are held to benchmark levels of quality and cost. In 2015 ACOs will continue to be on the rise! Read the rest of this post »

Patient Information Really Doesn’t Matter

We live in a world of information, everywhere we turn someone is collecting information about us. The technology advancements over the last 10 years are mind-boggling, but new technology is usually escorted by apprehension as our privacy continues to diminish and security is anything but secure. From cookies on Patient Information Really Doesn't Matterthe internet to a basket analysis at the supermarket, “big brother” is always watching.

The healthcare industry is no different. Healthcare organizations are surrounded by data: clinical, operational and financial; internal and external; structured and unstructured. There is so much information that healthcare providers don’t know what to do with it. The problem with healthcare is not a lack of information. The problem is healthcare organizations often have disparate systems that lack continuity. The absence of interoperability within IT infrastructures ultimately means that the right information is not available to the right people at the right time. Healthcare organizations can have all the information in the world, but if the information is not cohesive and can’t be used efficiently to improve clinical outcomes than information really doesn’t matter.

In order for healthcare organizations to improve outcomes, communication between systems is paramount. Despite industry standards such as EDI/X12, HL7 and CDA, information delivery is not effective. Most healthcare organizations understand the importance of untangling the interoperability web, but those same organizations don’t know where to begin.

Government regulations such as Meaningful Use Stage 2 (MU2) are putting additional pressure on healthcare organizations to improve the quality of care, coordination of care and population health management. A strong interoperability backbone that provides system connectivity is the key to attaining MU2. Interoperability transforms information into key insights that drive better clinical outcomes and improve the lives of individuals and communities.

Do you understand the importance of interoperability but not sure where to start? Perficient will be teaming up with technology partners IBM and Oracle to bring you 2 complimentary webinars:

Tackle Healthcare Interoperability Challenges and Improve Transitions of Care
Thursday, September 25th @ 12 CT
Learn More and Register

Engage Patients, Reduce Manual Processes and Drive Key Insights with Interoperability
Tuesday, October 2nd @ 2 CT
Learn More and Register

7 Features the Market Wants in Your Patient Portal: Blog Series

In case you missed it, we recently concluded our blog series on What the Market Says You Need in Your Patient Portal. Two of our healthcare experts, Melody Smith Jones, Manager of Connected Health (@melsmithjones) and Nick Lecker, Director of Architecture and Interoperability teamed up to take a deeper look into the 7 features that the market wants in your patient portal:7 Features the Market Wants in Your Patient Portal Blog Series

Healthcare consumers are at the center of the industry’s evolution and patient portals are going to continue to be a vital tool for connecting, engaging and empowering them.


Market Driven Patient Portal: Integration of Data

In our last conversation about  “What the market says you need in your patient portal” we discussed the needs of integration and interoperability. This is an area that, while interesting to the IT team, often does not get a lot of attention. This is not because this topic lacks interest, rather, it’s just not the most appealing topic to talk about. For example, when you are Market Driven Patient Portal: Integrate Dataremodeling your bathroom, you discuss the fixtures, the new shower, the new faucets, even the fancy commode; but do you get excited talking about the plumbing? Likely not, however it is the ability to move and connect the items of interest together that makes the project all come together. If you do not connect something the right way you get water all over…or worse.

So, what does this have to do with clinical and financial data? For one, the data is generally in various systems and data stores throughout the organization and generally it comes from multiple organizations. For example, if you look at these concepts from a health plans point of view, the clinical data is coming from HIE’s, provider facilities, clinical labs, purchased data sources, and others. The financial data is coming from claim systems across multiple lines of business, GL systems, AR/AP systems, and others. All of this data still has to be aggregated, cleansed and organized to make it useful. This is not an easy task and having the strategy, the information models, the plan and the governance are all key to ensuring success of these efforts.

Another reason integration is important is it helps define the consumer of the information. Typically, financial data has been reserved to back office functions or it is used to help define/negotiate the cost of services whether they be premiums, reimbursements, subsidies, etc. With the advent of consumerism, the patient is demanding more information in this arena. Patients want to know what their total cost of services are. They want to know the details of the fees. They want the ability to compare costs, values, outcomes so they can make a well-defined choice. Patients generally look at the cost as the driver, yet there are behavioral changes that need to be overcome; e.g. the higher priced option must be the best, right?

There is a lot still to overcome in this area as providers have typically held on to this information and patients may not be able to understand the complexities of where the money actually flows. Integrating the clinical and financial data is a stepping stone in the path to a full consumer-driven healthcare model. Government mandates are forcing the need for change, however, breaking down the walls to integrate information will not be easy. Meaningful Use Stage 2 (MU2) will be one of the drivers to help make healthcare interoperability a reality.

Core to solving these problems is having a clear understanding of the business capabilities and processes that drive the solutions. Understanding (documenting) the business capabilities, defining the information needs (again documenting) and then defining the business processes (yes writing it down) that act between the capabilities and information will be the blueprints and guides to setting and achieving the vision. With the vision established, we then can begin the process of connecting the dots of where the information lives to where it needs to go and the format which it needs to be in. There are a number of technical challenges given that interoperability is not just a simple plug-n-play solution. The movement of the information needs to follow standards (which by-enlarge exist) yet all of the connections and the subtleties of the content need to be clearly outlined in the road map of integrating clinical and financial data.

This concludes our “What the market says you need in your patient portal” blog series.

Market Driven Patient Portal: HIE Across Diverse Care Settings

So far in this discussion about “What the market says you need in your patient portal” we have been driving toward changes that are core to new engagement models. However, we have not addressed a core enabler: “It’s all about the data!”

Consumers demand access to information that meets their needs and they are not complacent Market Driven Patient Portal: Health Information Exchange Across Diverse Care Settingswith becoming hunters and gatherers for the information is truly about them. Consumers in today’s market demand accurate and up-to-date information about their health profile, just like they do with respect to their financial profile. However, the systems and processes to make that information available are not all there.

There are various sources of the information that are relevant to the patients/consumers (and also to the providers providing care to their patients). Much of this data has been distributed through the provider community. Some of the data is in the provider’s own systems. Some of the data is in the hospitals EHR systems. Some of the data is in outpatient facility systems. Other data is isolated and hard to locate.

With the push to HIEs some of the data is now becoming more available to the providers and to the patients they serve. However integrating the data into a holistic view is still a challenge. The information still needs to be gathered / extracted from the source systems, transformed into a structure that the HIE can understand and then there are the issues of translating the codes and values to normalized/consistent terms following a defined set of vocabularies. Additionally, ensuring a unified view of the individual can be a challenge. Enterprises IT groups are leveraging Enterprise Master Person Index (EMPI) solutions to construct the golden record of the individual but this also has its challenges.

Once all of the data is assembled (assuming that it is) the next challenge is to get the information to the right person at the right time. The HIE now needs to be integrated to the rest of the enterprise. Exposing the information in terms of the services or APIs can now begin. Finally the Portal (and this is just one of the consumers) can begin to consume these services and make the information available to the consumers. What’s also of importance is that the consumers can access this data from multiple perspectives. The provider can see full episodes of care across multiple care locations. The patient can see their health profile all in one location.

Having a single view of one’s health profile (or even the illusion of) is a powerful tool. Not only does it provide insights for better care, it breaks down the walls of information silos that have challenged providers and patient’s alike. Again, it is all about the data, and integration and interoperability are the key.

Reframing the ACO Analytics Problem with Malcolm Gladwell

I just finished watching a quick slideshow on the Health Data Management website, “Enterprise Analytics: Moving on Up” and as luck would have it, I also watched several sessions of the live Webcast from the Healthcare Innovation Day Conference 2014 in Washington, DC, sponsored by West Health Institute and the Office of the National Coordinator for Health Information Technology (ONC).

Malcolm Gladwell quoteWhile I was watching these, I was intrigued by the thought of how Accountable Care Organizations (ACO) can leverage existing solutions, combined with point solutions, to accomplish their reporting, analytics and beyond, and use interoperability wisely.  One of the key learning points for me from these sessions was this:  “Reframe the problem”….advice from Malcolm Gladwell’s keynote address.

How do we “reframe the problem” when it comes to ACO reporting and analytics?  There are defined metrics that are required for these organizations, so how can we leverage existing systems to create these reports and analytics?  Do we “build vs. buy”?  Depending upon the organizational size, legacy systems and IT support, the decision can be difficult.  What is good for one system may not work in another.  So where do we start?

A strategic evaluation of current state and desired future state with the development of a road map may be a logical first step.  Data Governance also needs to happen early on in the process to allow an organization to create data standards that will drive reporting and analytics.  Once these steps have occurred, an organization can feel confident that they can make an informed decision to “build or buy.”

Read the rest of this post »