Aneesh Chopra is talking so why wouldn’t I attend?  Need I say any more?  Even before he starts, you can tell he is an energetic speaker.

• Innovations in Health IT would be good for the economy.
• We are coming from “There’s a form for that.” to “There’s an app for that.”  Government reality doesn’t reflect public reality.
• The US is 15th in Higher Education, 22nd in E-Government, and 40th on the Innovation Trends.  This was out of 40 countries.  The US had 2.7% growth.  Obama wants to return to number 1 by 2020. (Reasonable, but challenging) 
• Perceives Healthcare and Energy as the growth areas for the economy.
• Stimulus act called for an increase in health It R&D.
• Broadband is important.  If patients don’t have broadband, how do they access their records remotely.  Same for doctors at home.  (Suspect that doctors have a higher percentage of broadband than patients)
• Trying to bring the R&D side of the house with IT procurement (CIO Vivek Kundra).
• Told story of how in Virginia it took 1.5 years to procure a 150K, 6-week, web application.
• Text4baby is a partnership with the wireless carriers, who are waving fees, to send SMS updates to expecting mothers based upon the due date.
• (Trying to sell how things are changing in Washington. Haven’t seen it yet.)
• Prioritization, transparency, engagement, and rapid results (90-day measurements) are the Core Principles on how they are trying to get Washington to work.
• Releasing next week, guidance to federal agencies on prizes and rewards for innovation.
• Open Government plans will be published April 7th.
• NHIN: A set of policies, standards, and services that enable the Internet to be used for secure and meaningful exchange of health information to improve health and health care”
• NHIN Direct: Open transparent collaborative process to evolve the NHIN.  An Gov20 initiative that was launched today.
• Don’t abandon 5 9s reliability for core systems, but look for the innovation for new ways to serve.

Say what you want about the president, the CTO has a good vision and the enthusiasm to push towards it.  That is a very good thing.

Time for the exhibit hall until close.  Always interesting as the vendors are tired and giving everything away.

Disclaimer

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.

Here to hear Capt Michael Weiner talk about the Defense Health Information Management System (DHIMS) and the lessons that the DOD have learned.  I have a personal interest as I grew-up in the military health system and my parents and a large number of family members are in it now.  I haven’t been posting a lot of notes as I’ve just been absorbing, but this session should has lots of good information.

• This isn’t a technical issue.  It is a “cultural, paradigm, shift”.
• Don’t  be HIPAA compliant for the sake of compliance.  Be compliant because it will protect your patient’s information.
• Challenges to be faced when implementing:
  • Development of functional requirements
  • Maintainability/Interoperability
  • Acquisition Process
  • Enterprise Architecture
  • Theater Communications and Bandwidth
• Steady and reliable network is critical
• Buy-in from the team, physicians and support staff, is critical
• EHR will not fix a broken process. Take time to document the workflow and understand How You Do It. Used a great analogy for that by talking about Starbucks’s great workflow and a hotel coffee shop’s poor workflow. (I had a similar bad experience at a coffee shop at the airport. Had to find the spot with the lids and crossed paths twice.)
• Try it out first.  Pilot it and include it everyone in the office from day one.
• New and Shiny May Not Be Best.  Test the ergonomics of the hardware.  Different participants may need different hardware options.  A tablet has to be carried, so they put a computer on wheels that let them move other things as well.
• System needs to be intuitive.  IT guys aren’t always around.  The system needs to make it easy for the physicians that may not be technical.  Needs visual feedback mechanisms.
• See One, Do One, Teach One: hybrid education efforts.  Classrooms, 1-on-1, over-the-shoulder, and computer-based resources for training.
• Use the Web: Look at web hosting and virtualized solutions, especially for smaller clinical offices. (Talk of using the cloud without the term “Cloud”. Awesome.)
• Wireless networking and no mice.  Wires are bad and cause problems.
• Use multiple methods to input clinical healthcare data.  Use templates, auto fillers, macros, scribe, speech recognition (not everyone can type), dropdown menus.  It should support Workflow.
• Change is not always accepted, so empowering staff to get their “buy in” will help with adoption.  The team has to be involved, though that doesn’t diminish the need for a champion.
• Make it Personal: Patient centric care and patient portals is a shift for the patient community.  It will be a generation+ transition for the patients.
• Sharing is Caring. The Nationwide Health Information Network (NHIN) is the “dial-tone” for the future.  Every EHR is going to have to fit in.

Captain Weiner was a great presenter.  Loved the presentation.  Lot’s of good lessons that apply to large and small facilities.  Now off to catch-up with my colleagues.

Disclaimer

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.

So I missed the keynote due to a conference call that was not to be missed.  I also realized that coffee is going to be a battle in lines.  Luckily I had heard those rumors and planned ahead and brought chocolate covered espresso beans.

To kick things off, I’m going to listen to the Governor of Vermont, Jim Douglas.  He is going to be talking about how HIE (Health Information Exchange) is important for the States in their interactions with the Federal Government.  Let’s see what I can learn.

• (This is a little more like a speech, with a healthy political bent, than I would have liked. Will likely lead to less notes.)
• Wants to turn patients into consumers of their own health information.
• Vermont uses health teams centered around the Primary Care Physician (PCP) to break down silos of information at different locations.
• (A lot of examples of WHY to go electronic and have interoperable information.  Vermont seems to be making some solid strides in that direction, but I suspect that many here already are sold.)
• Federal and State officials, providers, insurers, vendors, and patients need to all work together to make HIE work.
• What will work in one state may not work everywhere.  Same applies to physicians.  Need to maintain flexibility on the details.
• Long-term funding for information exchanges is important after the recovery money runs out.
• Health IT is not the end, but the means to the end. (Obvious, but important to reinforce)
• Vermont has a 0.2% assessment on insurance claims to assist with sustainable funding for HIE.
• State lines cannot demarcate HIE as hospital systems and patients don’t stay in one state. (Where I live in DC metro, we have Virginia, Maryland, and DC, so this is an important point.)

Enough of the Q&A as I need sustenance.  Heading to a pair of Federal Health Community Synergy Sessions next.

Disclaimer

All information in this post was gathered from the presenters and presentation. It does not reflect my opinion unless clearly indicated (Italics in parenthesis). Any errors are most likely from my misunderstanding a statement or imperfectly recording the information. Updates to correct information are reflected in red, but will not be otherwise indicated.