Podcasts about century cures

Play Episode Listen Later Feb 24, 2023 30:10 Transcription Available

February 24, 2023: The nature of healthcare is changing and many, including Frank Harvey, CEO of Surescripts, have some predictions. Physicians will take up the role of primary care provider once again and the legislature will shift to aid in preventing physician burnout. This is a big problem because what happens when 150,000 physicians pull out of the occupation? How will these transitions impact the big players like CVS and how will it impact IDNs? With pharmacists peaking patient's trust and time, we need to better our compensation structures and legislature. What does the new competition in the field, Walmart and Minute Clinic mean for healthcare? How will hospitals grow their interoperability? Will specialty medications play an even larger role? There is a cooperative future in healthcare and we are working towards closer working relationships all over. Key Points:20% of primary care physicians plan to retire over the next two years.In the first half of this year, over 10 and a half million messages have gone back and forth between physicians and pharmacistsThe pharmacists see patients on average 35 times a year while their primary care doctor sees them only 4 on average.30% of rural healthcare systems will close within the next year21st Century Cures' requirements on the providers and payersSurescriptsHealthcare needs innovative ways to address staffing shortages from clinical to IT employees. Are you curious about how technology can help support your Healthcare staff? Join us on our March 9 webinar, “Leaders Series: The Changing Nature of Work,” to explore how Health IT can be used to supplement Healthcare professionals https://thisweekhealth.com/leaders-series-the-changing-nature-of-work-remote-hybrid-onsite-shortages/Subscribe: This Week HealthTwitter: This Week HealthLinkedIn: Week HealthDonate: Alex's Lemonade Stand: Foundation for Childhood Cancer

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TEFCA & The Intersection of Policy, Standards & Innovation

Play Episode Listen Later Jan 19, 2023 53:15

Pooja Babbrah, Point-of-Care Partners Payer & PBM Lead kicked off the episode by acknowledging guest, Dr. Steven Lane, Chief Medical Officer with Health Gorilla and Point-of-Care Partners co-host, Jocelyn Keegan , Payer/Practice Lead and HL7 Da Vinci Project Program Manager. Pooja then outlined the discussion for this episode. The hosts talked with Dr. Lane about: Trusted Exchange Framework and Common Agreement (TEFCA)Information blocking…or rather information sharing, Dr. Lane's transition from being part of a large health system to joining the health IT company, Health Gorilla and the different perspectives on innovation and change that come with operating in these quite different organizations. The cycle of innovation and the role of policy. Before jumping into the discussion both Jocelyn and Dr. Lane introduced themselves and explained that over the years they have worked with each other several times through the HL7 FHIR (Fast Healthcare Interoperability Resources) Accelerators with Dr. Lane participating in the Da Vinci Project and Jocelyn serving as the program manager of Da Vinci. Today's hosts, Pooja, Jocelyn and the guest are all interoperability champions and share a passion for leveraging technology to improve healthcare. This episode's guest, Dr. Steven Lane, Chief Medical Officer of Health Gorilla, member of the Health Information Technology Advisory Committee (HITAC) and longtime advocate for interoperability identifies as being a clinician first and that role brought him into the health IT space. Dr. Lane shared that he started using an EHR (Electronic Health Record) back in 1989. Worked on EHR implementation during the 1990's and helped launch one of the first patient portals connected to an EHR back in 2001. He explained that he's had more of an opportunity to engage in health IT throughout his career than most primary care physicians. He explained that the importance of interoperability started to be a real focus starting in 2008 and he had the opportunity to work with HIEs (Health Information Exchanges) and then was invited to take part in an ONC (Office of the National Coordinator) taskforce and just continued to say yes to any the opportunities that have come his way so he could contribute to progressing interoperability. He continued to say that in his view if we're going to fix healthcare, we need to first focus on improving the health of our population. Second, improve the value of the healthcare being provided (reduced costs with optimal outcomes). Third, improve the overall experience of obtaining and delivering healthcare for the patients and for the providers, acknowledging that physician burnout is a real issue. Last, improving health equity. Pooja asked Dr. Lane to share a little more about the mission & vision of Health Gorilla to familiarize the audience.Dr. Lane explained that Health Gorilla started initially by addressing physician burden around lab orders and results. From there, they built a platform and started aggregating data they were exchanging and created a private HIE (Health Information Exchanges). They build a robust record service, master patient index, and then aggregate, normalize and de-dupe the records. The focus really being on data quality and utility. He compared the work to some of the regional HIEs, but Health Gorilla's audience is much broader. Health Gorilla made early connections with CommonWell, eHealth Exchange, Carequality framework – Epic Care Everywhere, with Direct messaging through 3rd party health information service providers (HISPs)Dr. Lane shared that what he found special about Health Gorilla is the commitment to innovation and bringing in more data types like social determinants of health or data from wearables. Pooja then asked Dr. Lane to share his view of TEFCA and why Health Gorilla decided to apply to become QHIN (Qualified Health Information Networks)?Dr. Lane described the history of TEFCA, the initial idea for it being included in the 21st Century Cures legislation. He recalled that while interoperability had been a major focus of policymakers and the industry, providers and other stakeholders were still voicing frustration that they still couldn't access the data they needed. The idea of TEFCA was for it to be an onramp to support all kinds of interoperability, data exchange and use cases. He expressed that he has had to learn patience as things in health IT never move as quickly as one might want. Dr. Lane went on to convey that early on after the announcement of TEFCA, Health Gorilla came out with a public commitment to apply to be a QHIN and be part of a diverse community of regional and national private and not-for-profit entities. He continued that becoming a QHIN for a private company is a big deal. They are inviting government oversight and commit to robust governance, state-of-the-art privacy, security and compliance practices. Health Gorilla is committed to supporting a broad range of cases and user communities like:Health Data UtilityPublic HealthCommunity based social servicesPayer-providerIndividual Access ServiceQHINs (Qualified Health Information Networks) will pursue multiple architectural approaches. Health Gorilla will be a data aggregator and platform. Health Gorilla will leverage TEFCA exchange as they do current HIN (health information networks) exchange to continue to build their secure cloud-based repository of health data with the goal to become the nation's largest and most secure repository of high quality, high utility health data.Dr. Lane likened his vision of the role of a QHIN to that of a dance studio operator. He went on to explain that a dance studio operator creates a safe supportive space for people to come to dance. Different types of people - individuals or groups. Different types of dances – flamenco, ballet, private party. Everyone is invited to creatively use the space within specified constraints to ensure safety and privacy. Pooja followed up to clarify whether Dr. Lane likened becoming a QHIN as more opportunity for innovation. Dr. Lane said that absolutely it does. He explained that TEFCA is supplying a framework or single on-ramp and allows for more innovation in various use cases from treatment to payment and operations to public health. Pooja asked Dr. Lane to talk about TEFCA and FHIR. She explained that there has been some feedback in the industry voicing concern that even with the TEFCA FHIR roadmap there isn't enough alignment between TEFCA and the FHIR community. Dr. Lane responded that many were disappointed that when TEFCA was originally announced there was no mention of FHIR at all but since then the TEFCA FHIR Roadmap was published. Some may not be satisfied with the current roadmap but it's a good step in the right direction.Related to the TEFCA FHIR Implementation guide, Dr. Lane summarized some of the responses explaining that there were 16 commenters – Provider organizations, EHR and other HIT (Health Information Technology) vendors, public health departments, HL7, DirectTrust, HISPs, and othersSome commenters called out the challenges of scale especially around registering and managing endpoints. Others pointed out the need to leverage and align with other work in the FHIR community. Others still pointed out the need to clarify the priority between developing to IHE (Integrating the Healthcare Enterprise) document vs. FHIR exchange for specific use cases.Dr. Lane went on to point out that there has been concerns about “if we build it will they come” but the number of QHIN applicants and the engagement seen with the comments submitted are a great sign that people are engaged with TEFCA.Pooja asked Jocelyn to chime in and share what she is hearing from the FHIR Accelerator community related to TEFCA and FHIR? Jocelyn agreed with Dr. Lane about seeing the level of engagement being a great sign. She added that there is starting to be a little bit of a cultural shift related to thinking about data outside of clinical data and how to use data to support billing, operations and more and how to use FHIR to do some of those things. Jocelyn explained that we're starting to see a lot more traction. After attending the Carequality, Sequoia and eHealth Exchange meetings in DC in December and hearing the cacophony of voices talking about how to make TEFCA a reality and leverage FHIR was amazing. From a community perspective, Jocelyn explained that she is hearing a lot of positive feedback after seeing more real alignment happening with TEFCA and the FHIR community and there seems to be a feeling there is more of an openness akin to what happens in the standards development communities which was a needed next step. Jocelyn went on to say that in the near future the industry will need the volunteers to help pilot some of this work and prove we can move beyond point to point and settle the trust issue through these networks. What will be critical is technology meeting us where we are and solving real business challenges. Ultimately, while documents will continue to be part of certain transactions we really have to strive to get to codified data to get to the level of automation the industry needs. Dr. Lane seconded the notion of piloting now and not waiting until policy deadlines are looming. This is the time test, pilot and work out the bugs. Pooja remarked that it will be interesting to see how Sequoia as the Recognized Coordinating Entity (RCE) of TEFCA decides to engage more closely or not with the Accelerators, specifically FHIR at Scale Taskforce. Then Pooja asked Dr. Lane to discuss the huge transition from working for Sutter health, a huge health system to working with a health IT company. Pooja asked him to explain the different approaches to innovation he's noticed. Dr. Lane acknowledged that it is a big challenge to change the course of the huge ship that is healthcare. Things have evolved over the last 100 years or so resulting in the way healthcare is delivered today and it can be hard to change. Many providers may be resistant to change but then you have big disrupters like telehealth and other innovations that force that change. Dr. Lane explained that he has personally been deeply passionate about health IT and being innovative but for many years, he was the only provider in the room for years. That's starting to shift but if the industry wants to see more engagement and willingness to change by providers, there needs to be the right incentives. The most efficient way to innovate is to have all parties at the table with representation to make sure the work being done is solving the right problems. Dr. Lane expressed that he's been at this for 20-30 years and he has recognized the improvement in the process for standards development, policy changes and innovation with people thinking about how we can do this in a coordinated and repeatable way to gain efficiencies. From a policy perspective, Dr. Lane explained, there will always be a need for carrots and sticks. Pooja then asked Jocelyn to share her perspective on the health systems that are members of Da Vinci and whether there are common attributes/factors that lead some systems to be more open to engaging with standards development and FHIR adoption?Jocelyn shared that before she jumps in she wants to point out that CMS (Centers for Medicare and Medicaid Services) has done a lot over the last decade to move the policy levers shifting the industry from a pay for service to a value-based care. This shift will require real-time interaction from a 60-90-day lag in information in provider systems. Health systems likely to be at the standards development table have recognized this shift to real-time exchange and own and master their own data. Jocelyn explained that one of the big attributes she's seen in health systems who are more engaged in standards development are those that area a little further along in the value-based care journey and have strong partner relationships. A second attribute is having a willingness to go first and help prod their partners to move a little faster. Jocelyn went on to say that it isn't just the big health systems that can engage, APIs will help level the playing field and enable smaller systems to operate more efficiently. She went on to say that sometimes all it takes is an individual with a passion like Dr. Lane to volunteer, come to the table and be willing to speak up and share the challenges they are facing during use case development. Standards development isn't just for big health systems to participate and represent providers, it isn't just for developers and implementers. For valuable work to be done the standards development process needs to understand the real-world problems that need to be solved. There is space for providers, pharmacists, grad students, really anyone in the ecosystem. Pooja made the point that this discussion is really about innovation, there is a role for and intersection of policy and standards development and the importance of stakeholder engagement and participation in these areas. She asked Dr. Lane to share his view of the policy role in innovation. Dr. Lane responded by saying that Jocelyn had it right when she talked about the importance of having different perspectives represented, especially when creating the initial use cases. Dr. Lane went on to say that in his role on HITAC and working on USCDI (United States Core Data for Interoperability). After the first version, other stakeholders were invited to the table to contribute and provide feedback and now there is a repeatable process that is done to update USCDI annually. He added that HL7 has been invited in as well and there is coordination there to ensure implementation guides reflect the latest coming version of USCDI. Pooja responded by saying that policy is really important in moving the industry forward but there is also a solid connection between standards development and policy and that in her role as chair of the NCPDP board, she may be biased, but feels organizations who don't participate in standards development are really missing a big opportunity. HL7 and NCPDP see the value of coordinating and working together and CMS and ONC have made it clear through their roadmaps that standards will be named in coming policy so why not come to the table and make sure your organizational interests are being represented while also working to solve the big, complex issues in healthcare? Pooja then shifted the conversation mentioning that as we close out, we like to ask our guests if they have any final message or calls to action, they want to send to the industry?Dr. Lane responded by saying that he sees TEFCA as a once in a decade opportunity to really take nationwide interoperability to the next level. Right now, the general public probably has no idea what TEFCA is and that there should probably be more of a nationwide, public discourse and awareness so people can move towards it versus being dragged along. Pooja then asked Jocelyn for any concluding thoughts or calls to action she would like to send out. Jocelyn expressed her agreement with Steven, what are you doing to advance us as an industry, we're all consumers of this data and ecosystem. She added that we are at an unprecedented time when the industry is leading and CMS and ONC are playing a critical role in alignment. The standards version advancement process (SVAP) is a notable example of CMS and ONC listening to the industry. They are no longer putting a ceiling on the level of advancement and progress the industry can make but rather focusing on establishing a floor. Jocelyn reiterated her encouragement of organizations and individuals to come and participate in the standards development process and give voice to your challenges so the industry can solve real problems. Pooja thanked cohost and interop expert Jocelyn Keegan and the well-informed guest, Dr. Steven Lane from Health Gorilla And thanks to our audience for tuning in! A friendly reminder to new listeners that you can find us on Apple Podcast, Spotify or whatever platform you use to pick up your podcasts, including HealthcareNOW Radio and the Podcast Channel. We also post videos of our podcast episodes, sometimes longer versions, on the POCP YouTube channel. And don't forget, Health IT is a dish best served Hot!

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16th Century Cures

RTÉ - Drivetime

Play Episode Listen Later Nov 17, 2022 6:43

Dr. Siobhán Barrett, Post-Doctoral Researcher in the Early Irish Department of Maynooth University

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The Impact of Standards and Policy on Legacy Data

Play Episode Listen Later Oct 12, 2022 34:52

This episode's guest is Dave Navarro, Senior Director of Data Science for Harmony Healthcare IT, a data management and lifecycle solutions firm. Dave joins the Dish on Health IT host, Ken Kleinberg, and co-host, Jocelyn Keegan,to talk 21st Century Cures Act and the change in the definition of “EHI”, critical components of plans to purge, archive, or transition data to new platforms, and how to marry data in various formats and versions of CCDA and FHIR. Ken kicked off the episode by asking co-host, Jocelyn Keegan, to briefly introduce herself and to share what she's looking forward to learning from today's guest.Jocelyn responded by explaining that she is the payer-practice lead at POCP, devoted to positive change and building/getting stuff done. She went on to say that her focus is on interoperability, prior authorizations, and the convergence of tech, standards, and product strategy. She also serves as the program manager for the HL7 Da Vinci Project. Da Vinci started as a conceptual idea of emulating the great work produced by the argonaut project but with a focus on payers and providers, value-based care, and clinical data interoperability and has become likely the most expansive of the FHIR Accelerators to date, focused on payer-provider collaboration.Ken then asked guest, Dave Navarro to briefly introduce himself and to include his professional background and journey to Harmony Health.Dave reiterated that he is the Senior Director of Data Science at Harmony and that he started his career about 22 years ago in the health IT world. He explained that he started by configuring EHRs and building clinical integrations for financial systems and clinical systems for Cerner Corporation.Dave explained that early on he had a lot of exposure to different data formats and files and that he's been spending the last 17-plus years in the health information exchange world. He landed at Harmony Health to work on the interoperability of legacy data and the legacy data solutions Harmony provides.Ken asked Dave to expound a little more on the work Harmony Health is doing.Dave explained that Harmony helps their clients' archive data from a legacy system or in some cases transition data from a legacy system to a new system. If data are archived, they must still be in a format that can be managed, accessed, and consumed to inform clinical decisions.Harmony offers the Health Data Archivers solution, which includes extraction services. Clients can also earmark data that they'd like to have posted in their new system.Ken then shifted the conversation by asking how the industry as a whole or different stakeholders in particular view 21st Century Cures differently and whether Dave wishes there was a perspective the industry would share about how they approach compliance.Dave started by admitting that he hasn't read the entire 21st Century's Cures Act but has familiarized himself with the portions related to interoperability. He shared that he believes this legislation is a good thing. Dave pointed out that while it was signed back in 2016, the industry is just now seeing the results.He explained that he believes Cures has pushed the industry towards the adoption of content standards such as USCDI and transmission standards like HL7 CDA and now FHIR. Dave then went on to talk about the data blocking provision explaining that nobody wants to be a data blocker. This portion of the Act helps open the data stream and make data available where EHRs and ultimately patients can view it.Concerning what perspective he wishes the industry would share, Dave explained that it's about FHIR. He realizes that FHIR is a little bit scary to some, but that the industry should be starting with FHIR. Dave explains that one reason he believes this is the relative ease to understand and use FHIR compared to CDA, which has been a bit challenging to figure out. He went on to say that with FHIR, someone can study an implementation guide for an hour and pretty much figure it out. Dave also pointed out the FHIR US Core data set as being a good specification.Dave then went on to explain that while FHIR isn't an architecture guide it can be used to help make architecture decisions when an implementer is getting started. He added that FHIR builds on the work the industry has done on CDA and takes the lessons learned and fixes a lot of what the industry was frustrated by with CDA.Ken asked Jocelyn to share her view of Cures based on her day-to-day work as program manager of Da Vinci Project focused on payer-provider data exchange. Jocelyn expressed that everything Dave said is so incredibly important. From the Da Vinci perspective, she explained that there is an ongoing dialogue about the intersection of and confusion about the year-end USCDI V3 and FHIR R4 capabilities along with everything in the electronic health information (EHI) requirement. Joce expressed that this is a great example where folks are looking for additional guidance before making new investments. She explained that most EHRs have a big lift to meet that requirement in a meaningful way. Joce continued by saying that FHIR alone isn't necessarily going to get the industry to the semantic interoperability that it's striving for but that if the industry would pick up the FHIR implementation guides in addition to the more advanced workflow guides, the industry would be making progress toward where it wants to be.The group spoke briefly about the expansion of the definition of EHI to expand outside of USCDI V1 and that many stakeholders are not ready to meet the October deadline. Dave pointed out that ultimately every journey starts with one step, and everyone just needs to pick a place to start which ideally would probably be USCDI V3, and start the work.Jocelyn pointed out that by nature stakeholders under regulation want to achieve certification She went on to say that investments were already made in CDA & CCDA and there's lots of CCDA data moving around. She went on to add that the big question is how the industry is going to manage the collision and misalignment of data formats. And how will the industry decide what needs to be codified, and cleansed and what's OK to remain unstructured? There are several stakeholders in the industry that have stood up to say that it's important that data created today needs to be usable and shareable going forward.Dave shared the experience he's had working in the historical archive world. He explained that for the most part, he encounters more organizations simply interested in checking the regulatory and requirements box, but that Cures pushes toward data being structured and codified simply by setting the expectation that patients will be able to access all their data which means that data, even unstructured data isn't going away. He went on to say that even if only minimum pieces of data or data from specific timeframes are migrated to a new system, archives must be able to be queried so a patient can access that data whether it's in the current EHR system or not. The perpetuity of data required by the info-blocking rule must change the industry's mindset.Ken asked Dave to share some of the surprising or challenging questions from Harmony clients or notable projects. Dave explained that sometimes clients can share their entire database at the start of a project and this is ideal so the Harmony team can go through everything, and it makes extraction a little easier. What is being seen in many of these projects is that as the team goes through and looks for NDC codes, signature lines, problem descriptions, or allergy lists, the data isn't codified. This information will be there as text. For this data to be queried from any archive, it's got to be codified.Dave added that they use the specifications from USCDI and cross-reference them with FHIR US Core. Dave continued to explain in more complex detail some of the data types and mapping that occur to ensure the archived data can be queried effectively in the future. Dave pointed out that as painful as it sounds, he has been through every single element in the FHIR specification for US Core. He expressed how well put together US Core is and it's critical to how they do their work.Ken then asked about how consent is handled during these archiving projects. This led to a robust conversation with Dave sharing that consents get archived if they are found, however the most recent consent on record in the current EHR would likely be applied to how any data pulled from the archive would be shared.The group went on to discuss the complexity of consent and the importance of establishing and maintaining eConsent in a scalable way. Jocelyn pointed out that through the discussions she's had with stakeholders and through her personal experiences, the industry needs to solve this so that patients can manage their consents in a secure, central place so they can update and change their consents based on their changing lives.Jocelyn then shifted the conversation toward the nature of adoption. She explained that she's heard some express resistance to FHIR because they perceive a push to rip and replace everything with FHIR. Jocelyn shared that she and most other industry leaders aren't proponents of that rip-and-replace concept but rather an incremental adoption approach where you adopt and use FHIR in the use cases it can best support and that FHIR can co-exist and interact with other standards. Jocelyn asked Dave to share his thoughts on FHIR adoption.Dave responded by saying that as much as he's been talking about FHIR, he doesn't yet have anyone with FHIR capabilities coming to query and retrieve data. Dave explained that what he has seen are stakeholders on the eHealth Exchange are part of Commonwell and they're familiar with exchanging data via those networks primarily using CDA formats. We start with where our clients are now but it's important to have FHIR capability built in so multiple formats are supported. He went on to say that in some instances you may have an instance where a FHIR API is used to request data in a CDA document. The industry certainly isn't going to be purely FHIR anytime soon if ever.As is tradition, Ken asked Dave to close out the podcast by sharing what he would like to see from the industry.Dave joked that as cliché as it must sound, interoperability is a journey and not a destination. The industry isn't going to fix everything by some policy deadline, and we aren't going to solve everything with just FHIR alone.Dave went on to say that the industry can learn a lot about how to architect their data by examining these standards to help guide those decisions. While FHIR is not intended as a data model, it is a good specification that can inform a well-formed database.Ken thanked guest, Dave Navarro, and co-host Jocelyn Keegan before reminding listeners that they can find and subscribe to The Dish on Health IT podcast on Apple Podcast, Spotify, or whatever platform listeners use to pick up podcasts and that videos of episodes can be found on the POCP YouTube Channel.

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Newsday - From the Hill: The Looming Interoperability Deadline and Challenging Compliance Landscape

This Week Health: Community

Play Episode Listen Later Aug 1, 2022 34:59 Transcription Available

Aug 1, 2022: https://www.linkedin.com/in/mari-savickis-42b9817/ (Mari Savickis), Vice President, Public Policy at https://chimecentral.org/ (CHIME) joins Bill for the news. What's happening on the Hill? The October 6 interoperability deadline is looming. Information blocking. 21st Century Cures. Where are we at? What is https://chimecentral.org/ (CHIME) doing to help prepare its members for this deadline? How much of this is falling on the EHR providers and how much is falling on the systems themselves? Navigating the compliance landscape is challenging. Even for larger health systems who are more well equipped. And what about the problem of the haves and the have nots? Does big tech have too much access to healthcare data? What's being talked about in regards to privacy? What's going on in the telehealth world? Key Points: A downturn in an economy is not a bad thing. It's an opportunity. Do we need this much labor to provide a level of care that we've provided before? The Medicare Payment Advisory Commission is conducting a study on the expansions of telehealth services We have a demoralized and depleted workforce, and yet we have amazing technology https://infoblockingcenter.org/ (InfoBlockingCenter.org) https://www.congress.gov/bill/117th-congress/house-bill/2471/text (Consolidated Appropriations Act, 2022 - congress.gov) Webinar: How's Your Front Line? Recruit, Retain and Optimize Your Cybersecurity Team - Thu Aug 11 @ 1pm ET / 10am PT “Cybersecurity-what's your emergency?” “We need help. It's an attack.” “Hello? Hello!” What can we do about the staffing shortage in cybersecurity? With research suggesting that nearly a third of the cybersecurity workforce is planning to leave the industry in the near future, organizations are left in a worrisome position, especially as attack surfaces are growing. So, where do we move forward from here knowing that we are facing low numbers in the field already and it's likely to get even worse?https://thisweekhealth.com/webinar-sempris-cyberstaffing_recruit-retain-optimize-cybersecurity-team/ ( Register here) Webinar: Don't Pay The Ransom - Thu Aug 18 @ 1pm ET / 10am PT Is your health system paying out for attacks on your data? How can we stop the cycle? Rubrik is offering incredible insight into the arising issues in cyber resilience in ransomware attacks, cloud data management with securing Epic in Azure, and unstructured data. In this webinar, we analyze the best practices to initiate in our hospital systems.https://thisweekhealth.com/dont-pay-the-ransom-insight-into-cyber-resilience-in-ransomware-attacks-cloud-data-management-unstructure-data/ ( Register here)

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Dr. Brett Oliver and Andy Truscott On IT Trends, Social Connections, and COVID's Effects On Health

Play Episode Listen Later Mar 3, 2022 30:38 Transcription Available

March 3: Today on Townhall, https://www.linkedin.com/in/brett-oliver-md-1b1b6017/ (Brett Oliver), Family physician and Chief Medical Information Officer at https://www.baptisthealth.com/ (Baptist Health) interviews https://www.linkedin.com/in/andrewtruscott/ (Andy Truscott), Global Health Technology Lead for https://www.accenture.com/us-en (Accenture). Health Level Seven or HL7 refers to a set of international standards for transfer of clinical and administrative data between software applications used by various healthcare providers. What is top of mind for HL7 and how does it relate to the frontline clinicians and organizations taking care of patients? How does it relate to interoperability, cybersecurity and 21st Century Cures? What 2022 trends are we seeing in the healthcare IT space?

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Lee Milligan and Mark Stockwell on Data Governance, 21st Century Cures Act, and Mentorship In Health IT

This Week Health: Community

Play Episode Listen Later Feb 15, 2022 21:29 Transcription Available

February 15: Today on TownHall. https://www.linkedin.com/in/ldm007/ (Lee Milligan), CIO for https://www.asante.org/ (Asante) interviews their Director of ITS Enterprise Services, https://www.linkedin.com/in/mark-stockwell-8ba7928/ (Mark Stockwell). What exactly does a Director of ITS Enterprise Services do? It takes Project Management, technical and leadership skills. Mark gets into the nitty gritty of HL7 interface, transaction engines and serving the medical device integration team and the HIM department including functions, scanning deficiency analysis for release of information plus data governance and the after effects of 21st Century Cures. Plus what is it like coming from a non-healthcare background? How does a leader with extensive IT experience in other industries deal with the shock of the complexity of healthcare?

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Health IT Leaders Weigh In On Biggest Moments of 2021: Drex DeFord, Lee Milligan, Anne Weiler & Frank Nydam

Play Episode Listen Later Dec 27, 2021 38:37 Transcription Available

December 27, 2021: What were the biggest moments in healthcare IT in 2021? What do you think will be the biggest movement in 2022? Bill is joined by the Advisors to This Week in Health IT, https://www.linkedin.com/in/drexdeford/ (Drex DeFord) of CrowdStrike, https://www.linkedin.com/in/ldm007/ (Lee Milligan) of Asanta Health, https://www.linkedin.com/in/anneweiler/ (Anne Weiler) of AWS and https://www.linkedin.com/in/franknydam/ (Frank Nydam) of Tausight. What did the Scripps Breach teach us about cybersecurity? Will life in a health system ever be the same as it was pre-pandemic? Are we going to lose critical interactions between the analysts, the technologists and the clinicians if we continue to work remotely? 21st Century Cures didn't come easy but it had a huge impact. And why is it that the VCs are throwing so much money at all of these health startups but the hospitals are still losing money? Key Points: 00:00:00 - Introduction 00:04:30 - Healthcare is really, really hard and Big Tech knows it 00:05:00 - One of the biggest stories of the year was the Scripps breach 00:06:45 - 2021 was the year of The Great Resignation. In 2022 there will be IT staff shortages, nurse shortages and even more people leaving their jobs. 00:26:15 - Hats off to the many primary care physicians who have sat down one-on-one with many of their patients and walked through the pros and cons of vaccination. That is really, really hard work to do. 00:34:50 - Investment in healthcare inequities was big news in 2021

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What's Next for This Week In Health IT in 2022?

Play Episode Listen Later Dec 10, 2021 50:12 Transcription Available

December 10, 2021: Welcome to one of our End of Year Shows. Bill gives an update on what's coming up for This Week in Health IT in 2022 plus a chronological look at the healthcare news that shaped 2021. The biggest stories were the pandemic, cybersecurity, diversity, equity and inclusion, the change in government and the vaccine rollout. He also looks at telehealth, patient centric interoperability, 21st Century Cures, the HIMSS, HLTH and CHIME conferences, price transparency, information blocking, care moving to the home, the labor shortage and remote work culture. Hope you enjoy! Key Points: 00:00:00 - Intro 00:10:00 - The pandemic is the story that shaped all stories 00:14:15 - Healthcare systems took a significant financial hit in the months that they couldn't do elective surgeries 00:19:50 - We made a significant number of mistakes in terms of marketing the vaccine 00:38:20 - Rural healthcare is set for a lot of progress in 2022

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Bridging Interoperability Across Healthcare and Human Services and the Role of Consent

Play Episode Listen Later Dec 9, 2021 43:54

This episode features guest, Daniel Stein, President of Stewards of Change Institute (SOCI). The discussion explores why connecting the healthcare ecosystem with human services is critical and goes on to highlight the role of consent specifically highlighting the new “Modernizing Consent to Advance Health and Equity” report published by SOCI with industry input.Co-host, Ed Daniels, Senior Consultant with POCP, then introduced himself explaining that he's worked in Health IT for over 30 years and has been working in the world of electronic informed consent over the last several months. Guest, Daniel Stein, President of SOCI then introduced himself and gave an overview of the work of Stewards of Change. He first focused on SOCI, which is a non-profit that cuts across and connects all the public welfare and safety net programs from healthcare to social services. SOCI has worked to bring together all the different players in these realms. Daniel explained that he got started in this work 20 years ago after a career at Kraft Foods working in project management. He started working with a non-profit in California and became intrigued by how certain business practices could be applied in the non-profit world and that's how he started on this path. Daniel explained that he gained insight from work he did related to child welfare in California and New York, he observed there were huge disconnects between the services families really needed and the ability of families to access these services. It was clear these families were already stressed and then were asked to jump through hoops and hurdles to understand eligibility, fill out documentation and such to get the services they needed. On top of that there was a lot of duplication between service providers. He made the point that If you wanted to design a worse program, you really couldn't. Daniel explained that he started to ask how this bumpy process of accessing services could be smoothed out. Ken then pivoted to ask Ed about his background in emergency services and other work he's done to give his perspective of the problem outlined by Daniel. Ed agreed that he recognizes that disconnection Daniel outlined and its impact on people and their families. Ed then pointed out the role of consent in contributing to that problem of disconnection. Ed then asked Daniel how he feels the industry is doing at tackling these issues. Daniel responded by saying that he's encouraged that there has been movement over the last couple of years specifically the acknowledgement of the importance of social determinants of health and the need to explore how to capture that information. While healthcare is taking steps in the right direction, there still seems to be some hesitancy. Healthcare is so large and so complex, it's still somewhat insular with just a few systems and solutions starting to look at connecting outside of healthcare. Ken followed up by asking for Daniel to dig into the work to connect healthcare and human services, and specifically about Project Unify. Daniel responded that in the beginning of the Obama administration, SOCI had the opportunity to work on the Affordable Care Act (ACA) through a contract with the Administration for Children and Families (ACF). In the ACA, there was a provision that explicitly looked to integrate health exchanges, the infrastructure of the ACA and all the services under HHS. This provision is still in the rules and regulations. Recent guidance coming out of CMS has reiterated this provision. SOCI helped translate this provision and communicate it out to the states at the time. Unfortunately, things didn't go as smoothly as one would hope primarily due to the complexities of the ACA. It also became clear that there was a lack of connection between the Centers for Medicaid and Medicare Innovation, CMS, Office of the National Coordinator (ONC) and ACF. SOCI was instrumental in helping bring these federal agencies together to better understand the whole person approach to care. Daniel explained that Project Unify grew out of a 4-year initiative funded by the Kresge Foundation. SOCI's proposal to Kresge outlined the need to bring together subject matter experts (SMEs) from across healthcare and social care to avoid recreating the wheel. SOCI used the funding they received to establish the National Interoperability Collaborative (NIC). The NIC's purpose is to bring all these various stakeholders together to share information about the challenges and initiatives to solve problems being done across the various fields and cross-pollinate. The NIC has been holding conferences and has hosted over 75 webinars over the last several years. While sharing information on these webinars and conferences was helpful, those involved in the NIC wanted to do more than talk and to take on a project that was really doing something. Something. That is how Project Unify was born. The vision for Project Unify was to demonstrate how data interoperability and data exchange could happen across all the siloes of healthcare, human services, and other areas. The work on Project Unify led to the work on consent that SOCI has started to focus on. Ed added that he has participated in several SOCI webinars and recounted a particular session where a local county agency's project to connect the various services in their locale. The attendees of that session expressed that their agencies don't even have standard systems within their own agency. Many expressed that they are just working to create standard forms they can use across agencies and that they'll work on harmonizing the technology later. Ken pivoted to focus of the conversation to health equity and social determinants of health. Daniel explained that SOCI's focus on social factors and health equity grew during COVID. SOCI was preparing for a conference in early 2020 and pivoted to make it virtual rather than cancel because they didn't want to lose momentum and then focused on what the NIC could do during the pandemic to make a difference. The NIC brought together stakeholders almost every week and this effort was nicknamed the “interoperability support group”Daniel went on to say that one of the things that stood out during COVID was that so many of the communities hit hardest by COVID were the poor, black, brown, and undocumented people. The lack of services, access and transportation in these communities exacerbated the issues. It became clear that if these challenges were going to be overcome, that these communities needed to be at the table to offer their perspective. Health equity has become a major focus of the administration and of the industry. For SOCI and NIC, as they began bringing members of these communities into the conversation, the issue of consent, data stewardship and trust bubbled to the surface. Ken picked up the thread of consent and brought up the comprehensive report SOCI recently published entitled “Modernizing Consent to Advance Health and Equity”. Ken explained that as he sees it, consent is a complex and layered issue because most people don't have medical or legal degrees and understanding the information, they have been given access to and the consequences of consenting to give access to others. Ken asked Daniel to explain his perspective and how this paper on consent came to be. Daniel responded by saying that exploring consent has been one of the more fascinating roads he's been down. Over the course of holding all these meetings with this diverse group of stakeholders, they started to ask what one or two things could be done to really make an impact. Through an iterative process, the group came up with about six recommendations and consent was one of them. Consent has such a broad impact and not just in healthcare. For example, if one wants to share school attendance or grades, foster care status, consent is needed. Consent is the blocker of data sharing and interoperability. It became clear that this was a challenge across every area and if small improvements could be made, it could have a tremendous impact.The group recognized that this issue was certainly bigger than healthcare. There needs to be a whole person view through coordinated care. Daniel added that fixing one thing doesn't get us to the goal line but at the root of coordinated care is giving people the ability to access data from different areas. The only way that will ever happen is people can give consent to remove a lot of the friction of sharing data. The technology piece can be figured out later.Ed, who was involved in helping develop this report, added that through talking with various organizations about their challenges and attempts to solve the issue of consent, they gained a lot more insight into the complexities of the issue. In healthcare, privacy has always been a big issue but at the same time we all want the right information to be shared with the right people if it's going to impact our care such as advanced directives or clinical trial matching. Add to that social factors that impact health or indicators of issues in non-healthcare settings would also be helpful to have in the healthcare setting. But the same is true in non-healthcare settings. In social programs having a more complete picture of someone's life can help the program provide more appropriate resources. As people move from state to state, having those consents following them is another factor. Daniel explained that there was consensus across the board that consent is a challenge but there was a lack of awareness of the work being done across jurisdictions, programs, and care settings and it was impossible to build upon the work that's already been done so one of the first things SOCI did was identify and document the consent work already being done so that work can be built from. Daniel added that there is another side of the equation. It may be necessary to temper our enthusiasm for getting and sharing this kind of data. As SOCI has talked to people in these communities, they were told it's very important for this information to be taken back to the family so a decision can be made as a family. Ed agreed and added that while solving the technical ability to document consent, we can't forget that the data being exchanged belongs to a person. We're all patients so this shouldn't be a hard perspective to keep in mind for any of us. Ken brought up 21st Century Cures regarding who regulates the data once the patient has given consent to share it with a 3d party app or another actor not covered by HIPAA. One must wonder if the data is really being protected. Daniel said that they found that most people assume their information is being shared and don't want to be filling out a consent form for the 14th time. Many times, it's the lawyers who are advising multiple documentation of consent to mitigate risk. Ultimately, we have the capability to make this information accessible, but we need more uniformity and not have the data all over the place. Maybe we need a trusted entity that can be the traffic cop and authorize the flow of information and authorize access based on roles to say this person is granted access to this information for this purpose, for this period of time. There is some work in this area that is working to demonstrate how this could work. Ed pointed out that the report goes into all of this in detail, and it may seem daunting. He recommended that readers review the executive summary first and then dive into specific sections of the full report if there is interest to dig a little deeper.Ken, in closing out the podcast, asked Daniel to share any other issues he'd like to highlight or calls to action for the industry. Daniel responded by saying he is heartened by the interest of federal agencies and other organizations in doing work to solve the challenges around consent. Daniel expressed his hope this report will help support the work in this area. SOCI will be holding more webinars over the coming months to discuss consent and other issues and Daniel invited all listeners to get involved by attending some of these sessions which will be posted on either the NIC events or SOCI events pages.Ed added that these events aren't just work, but also have an aspect of fun, networking, and an opportunity to make connections outside of one's normal circles. Ken closed the episode by thanking Daniel for joining the Dish on Health IT podcast. Be sure to follow Stewards of Change Institute on Twitter and LinkedIn to stay up to date on this work.

Newsday – 2021 on Capitol Hill: A Health IT Update from CHIME's Mari Savickis

Play Episode Listen Later Dec 6, 2021 39:53 Transcription Available

December 6, 2021: Healthcare can't move forward without regulatory guidelines. Health IT leaders need to be in the know. https://www.linkedin.com/in/mari-savickis-42b9817/ (Mari Savickis), Vice President, Public Policy at https://chimecentral.org/ (CHIME) joins us today to discuss interoperability, de-identified data, 21st Century Cures, HIPAA, National Patient Identifier and cybersecurity. Plus the year that was in Washington, DC. HIPAA is so antiquated, but we adhere to it like it's the 10 Commandments. Is there any movement towards redoing it? Language prohibiting the HHS from developing a patient identification standard was removed from the House Labor bill for the 1st time in the Senate. And the FTC clarified their Health Breach Notification rule to include third-party applications that collect consumer's health information under privacy protections. Key Points: 00:00:00 - Intro 00:04:30 - Advocacy led by CHIME's public policy team resulted in https://www.congress.gov/bill/116th-congress/house-bill/7898 (HR 7898) law giving providers credit for cybersecurity best practices 00:09:00 - https://patientidnow.org/ (Patient ID Now) 00:25:00 - CHIME public policy launched the https://infoblockingcenter.org/ (InfoBlockingCenter.org) in 2021. A convenient site to find free resources, FAQs, articles, archived webinars, and cheat sheets to prepare you for compliance. 00:27:00 - All sectors are facing cybersecurity staffing shortages 00:27:30- 3 out of 4 hospitals operate without a designated security leader 00:31:30 - Cyber insurance has gone up by almost 50% Questions or comments? Please reach out to policy@chimecentral.org Stories: https://chimecentral.org/chime-applauds-federal-trade-commissions-actions-to-secure-consumer-health-data/ (CHIME Applauds Federal Trade Commission's Actions to Secure Consumer Health Data) https://chimecentral.org/survey-of-chime-and-aehis-membership-finds-widespread-cybersecurity-impacts-on-healthcare-need-for-more-government-support/ (Survey of CHIME and AEHIS Membership Finds Widespread Cybersecurity Impacts on Healthcare; Need for More Government Support) https://www.scmagazine.com/feature/leadership/attracting-retaining-healthcare-cisos-maybe-its-not-a-money-problem?mkt_tok=MTg4LVVOWi02NjAAAAGAo4u8i8iqAiGUONUvupwyrwgmJbvhbKMxVTkTwZRSoCMHN7yqps3a1mFTTQ3bSrWqWCUTfcS3Ejusk3Sv160bh1qrp_hwtuhfDgLA-Q (Attracting, retaining healthcare CISOs: Maybe it's not a money problem - SC Media)

21st Century Cures: What Song are People Singing?

Informatics in the Round

Play Episode Listen Later Nov 12, 2021 60:20

Hello and welcome to Informatics in the Round, a podcast designed to help everyone become a part of the dialog about topics in biomedical informatics. I'm Kevin Johnson, physician and informatics chair at Vanderbilt. @kbjohnsonmd on twitter, www.kevinbjohnsonmd.net on the web! ------------------- In this episode of Informatics in the Round, we get some follow-up information. A few episodes back, Dr. Trent Rosenbloom led a discussion about impending changes and a lot of national concern about a statutory response to information blocking that has resulted in patients having immediate access to clinical encounter summaries but also lab results. We were wrapped in anticipation of the fallout from implementing this change, and have eagerly awaited hearing from a patient and from Trent. So…. Here we are! Digging into the aftermath. The nuclear option, or tempest in a teapot? Trent is Professor of Biomedical Informatics, nursing, medicine and pediatrics. He directs the Vanderbilt patient portal, known as MyHealthatVanderbilt. MyHealth for short. He's also an avid runner, with his own marathon. Here's a link to his marathon: https://www.harpethhillsmarathon.com/ Sarah Bland is a regular guest on this podcast. By day, she's a senior project manager and all around funny person, but, as you've been learning and will hear more about today…she has layers. She's also at Vanderbilt. We were able to get a friend of Trent's, a geek, and a musician all in one in the form of Karl Kersey. Karl's band, Doonthebray, represents yet another form of music in Music City. And then there's Karl—He's low key, with a wonderful dry wit, and asks the hard questions. Trent didn't disappoint. He knows this stuff, and had great information to share both in response to questions we asked during the episode, and questions other listeners will undoubtedly be asking. https://www.facebook.com/doonthebrae ---------- By the way, tell a friend about the podcast. I'd love to get our listenership over 5K, and I need your help. If you have suggestions or ideas, hit me up on Twitter @kbjohnsonmd, or if think tweeting is for twits, email me at kevin1061@comcast.net. I love hearing from you!

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Newsday - CIOs Chat Health IT News in the Halls Of CHIME Fall Forum

Cancer Stories: The Art of Oncology

Play Episode Listen Later Nov 1, 2021 71:38

November 1, 2021: Newsday from the halls of CHIME Fall Forum 2021. Bill talks to Drex Deford from CrowdStrike, Colin Banas with Dr. First, Aaron Miri with Baptist Jacksonville, William Walders from Health First and Lee Milligan from Asante. No topic is left unspoken. Interoperability, supply chain, the first 100 days of a new CIO role, Epic, 21st Century Cures, current employee retention rates, the difference between an academic medical centre and an IDN (Integrated Delivery Network), cybersecurity, state federal partnerships, vaccination statistics and the pandemic. You won't want to miss this.Key Points:00:00:00 - Intro00:08:30 - I thought meaningful use stage two was going to knock things out of the park 00:16:10 - Labor is top of mind for CIOs. They're losing people. It's getting harder.00:35:50 - Florida operates as a family. Texas operates as a business. It's very different. 00:44:30 - You're going to be breached. So you just need to solve the problem really fast. 00:51:40 - Patients should have their information. They should be empowered. We want to empower people.

Access Denied

Play Episode Listen Later Oct 25, 2021 30:04

A mother mourning the loss of her daughter discovers that she has lost something else important to her. TRANSCRIPT SPEAKER 1: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. SPEAKER 2: Welcome to JCO's Cancer Stories, The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. ELIZABETH CONROW: Access Denied, by Elizabeth Conrow. I lost my daughter, Amanda, in 2015. She was diagnosed with a brain tumor at age three and was in treatment for 2 and 1/2 years. Less than two weeks after she died, friends and family were getting on with their lives, but I was still in shock. I couldn't believe that Amanda was really gone. Early in the day, I looked at my kitchen table and tried to imagine her eating a bowl of rice, an unusual breakfast for a five-year-old. But that was Amanda. My eyes filled with tears as they rested on the empty chair. She was really gone. In that moment, standing in the kitchen, I struggled to remember every detail of who she was. It felt like the memory of her was slipping away. My heart beat quickened, and my mind raced with compulsive nagging thoughts. How tall was she the last time we were in the outpatient clinic? How much did she weigh? I realized I would never be able to put her on a scale again or mark her height on the cupboard door. I fear that this information would be lost forever, just like Amanda. I moved to my computer and started to log on to our hospital's online patient portal to see if I could find answers to my questions. How many times had I logged into this system looking for Amanda's test results or to message one of her doctors? How many times did it serve to confirm appointment times or remind me of medicine doses? I clicked the Sign In button, and my heart stopped. I couldn't get in. Instead of viewing her chart, I saw an alarming red stop sign and a message saying "access denied." I stared at the screen in disbelief. Just two weeks after losing my daughter, I faced yet another heartbreaking and unexpected loss. I no longer had access to Amanda's medical records. I no longer had a connection to her medical team and the hospital family I had grown to love and care for. Everything Amanda had been through for the last 2 and 1/2 years was gone. It was as if she never existed. She had vanished. I was caught off guard, deeply saddened, and utterly unprepared to have this connection to the hospital and this connection to Amanda ripped away. I was confused and embarrassed by my emotions. I certainly didn't need this access. But I was devastated that it had been taken away. I reached out to my daughter's oncologist to ask how and why the patient portal had been turned off. I let him know that it was really important to me to be able to view Amanda's records, at least for a time. It had never occurred to him that a parent might want to see this information again. He explained that it was a system designed safety measure that automatically turned off access to an account once a patient had died. I was the first parent to reach out to him with this question. Amanda's oncologist immediately contacted the online records office to reactivate her chart so I could search out answers to some of my questions. It brought me so much comfort to be able to go back in and revisit her medical journey. As I thanked her doctor, I shared with him how important it was to protect families from this type of trauma. I didn't want another family to experience this pain. He listened and helped put a manual reactivation system in place. Going forward when a child died, the online records office would manually reactivate each pediatric account individually. It wasn't a perfect solution, but it was a step in the right direction. It has been six years since Amanda's passing. I am now the bereavement coordinator at the same hospital where she received care. When I started in this role, I was surprised to learn of several families who, like me, had been denied access to their child's medical record. Hadn't the hospital resolved this issue years ago? I was frustrated that our institution hadn't found a better solution in the six years that passed. Last spring, as I followed up with bereaved families from our hospital, I had a conversation with a mother, Diane, that was hauntingly familiar and heartbreaking. Diane and I spoke on the phone shortly after the loss of her son, Evan. As we wrapped up our call, almost as an afterthought, she sheepishly asked about Evan's medical records being deactivated. I was immediately brought back to my kitchen table and the pain I felt when I experienced this secondary loss just two weeks after losing Amanda. I knew why Diane felt silly asking about this. And I deeply understood her need to log in. Diana explained that she was creating a record of everything Evan had been through, every transfusion, every chemo treatment, every inpatient and outpatient visit. And she could no longer complete that task. She shared her experience with me. I know for me, it was really difficult to wake up that very next morning, literally only about 12 hours since he died and not be able to look at it. Even though I know there had been no additional tests run since the last time I had checked, it was my morning routine to look at it. I would check it each morning, even before I got up. It had been that way for months while we were inpatient. First, looking at his ANC and counts, and then in the final month and a half, checking his bilirubin and liver numbers. There was always that hope that things were going to improve. This would be the day. So that first and subsequent time was just a blunt reminder that he was gone and there would be no more checking. I wanted to go back and look at his results, too. Oddly, I thought it would make me feel closer to him and closer to the routine I had while he was alive. Diane wanted to feel closer to her son. I wanted to feel closer to my daughter. Accessing a child's online medical portal is one way a parent begins to come to terms with this impossible loss. Snaman, et al, 2016, suggest that parents who are grieving significantly benefit from the creation and continuation of bonds with a child who has died. Revisiting a child's journey through the lens of the medical portal helps strengthen that bond. As I looked through Amanda's chart and remembered various times we visited the hospital, it helped me picture her more clearly. And it helped me feel a connection to her that I was deeply longing for. Looking through a child's medical record, while painful, can be part of healing and connection. In addition to creating bonds with a child who has died, the medical portal helps parents stay connected to the hospital and the medical team that cared for their child. According to additional research by Snaman, et al, 2016, bereaved parent's benefit from the ongoing support of a hospital throughout a time of grief. When a child dies, the secondary loss of the medical community can leave families feeling abandoned by those they have come to trust and depend on. Anyone who had taken care of Amanda felt like family to me. Sending messages to Amanda's medical team after she died provided a feeling of familiarity when everything else around me was spiraling out of control. A continuing connection with the medical team through the online portal can positively impact grief outcomes for bereaved parents. Accessing a child's medical record provides a grieving family with an easy way to communicate with, and ask lingering questions of the medical team. Access to medical records should not end when a child dies. The 21st Century Cures act acknowledges the need to provide patients with open notes and immediate access to medical information. As we implement real-time access for living patients, continuing access after a loss should also be considered essential. Dr. Alan Wolfelt, from the Center for Loss, discusses the need to say hello to one's grief and welcome it before saying goodbye to the person who died. In those early months, saying hello to grief meant reading through Amanda's medical records, communicating with her medical team, and uncovering every connection I had to her while she was alive. In some small way, logging into Amanda's medical portal and discovering that she was 42 inches tall and weighed 41.2 pounds brought me immeasurable comfort. As parents grieve the loss of a child, comfort and connection should be readily available without having access denied. SPEAKER 3: The guest on this podcast episode has no disclosures to declare. SPEAKER 4: Welcome to Cancer Stories, The Art of Oncology podcast series. With me today is Elizabeth Conrow, bereavement coordinator at the University of Rochester Medical Center and the author of Access Denied. Welcome to the program, Liz. ELIZABETH CONROW: Thank you so much for having me here. It's an honor to be here. SPEAKER 4: It is our pleasure. And first of all, let me start by saying I was very moved by the piece. And I'm so sorry that you lived through this experience. And really interested in knowing how you transformed your personal grief into now, your profession. ELIZABETH CONROW: Sure. Well, it's definitely been a process. Obviously, as a family, we never thought we would be down this road. I never thought I would have a child who had cancer. I never thought that I would have to go through the grief of losing a child and then comforting my own family, and my husband, and those around us through that experience. And I can tell you that for the first couple of years, I really didn't feel equipped to do anything. I felt like I lost my confidence in anything that I had an ability to do prior to this. Simple things like making a meal for someone who was sick became way too overwhelming to even consider doing. So it was definitely a process of years. But when the opportunity came up to work at Golisano Children's Hospital, the same place where Amanda had been cared for, the timing was right. And I knew that it was a great step to take and a way to honor Amanda's life, and really in some way, offer just a little bit of support and comfort to bereaved families, because I understood a little bit of what maybe they were going through. So it just seemed like a really good fit and a really good match for my experience at that point and a way to help and honor Amanda. SPEAKER 4: Let's start by talking a little bit about Amanda. Tell us a little bit about her and her story. ELIZABETH CONROW: Sure. Amanda is one of five children. So she was the fourth of the five. Very silly, loved to wrestle with daddy, had the biggest blue eyes that anyone had ever seen. She was just a delight and a joy. And when she was 3 and 1/2, she was diagnosed with a brain tumor. And we were in the hospital for a number of days. She had surgery and a full resection. And we were told that if after a resection and radiation it never came back, that we would be good. But that if it came back, it would likely be terminal. So we knew at the outset that this was-- we're not dealing with a cold or a headache. We're dealing with something pretty serious. So she went through the surgery beautifully. She went through all of her radiation treatments. We did a clinical trial of chemotherapy. And six months from when she was diagnosed, we really felt like we did well. She did amazing. And we were ready to walk away from everything and just celebrate really, kind of getting through this. And her very first follow-up scan two weeks after she was done with treatment-- her doctor, Dr. Koronas, called us and let us know the very devastating news that the tumor had returned, and it was all in her brain and down her spine and too many places to count. So six months from diagnosis, we knew that this was not going to end well. And we kind of had to struggle to prepare for that, as well as to recognize that in that moment, she was still Amanda. And she was still doing really well. But we knew that time would be limited. And so we had actually a very good year and a half with her, as much as you can say that. She went through additional radiation treatments. And we continued to try other chemotherapies to do what we could. But ultimately, in February of 2015, surrounded by her family in our home she passed away. And we then had a whole new struggle with grief and really, coming to terms with a new life and a devastating loss. But she was a joy. And she was a joy throughout it. So it was not all terrible. SPEAKER 4: She sounds like an extraordinarily little girl. And in your essay, you start by telling us that just after she died, I think a few days or weeks, you're thinking about her, and you want to access her medical record through the portal that you had gotten used to using all the time. And then as you're logging in, you get the signal that says "access denied." And that triggered a tremendous wave of grief for you or something. Tell us a little bit about that and what you did with that. ELIZABETH CONROW: Sure. I think I didn't realize at the time that I was really just trying to hang on to who she was, that I was trying to connect with her in some way. I mean, it was just two weeks after she had died. And I just-- I wanted access to see, what did she weigh? Goodness, if I could recreate her in the form of a stuffed animal, how long would she be? How much would she weigh? And when I went to log in, it was a horribly devastating loss. It really felt like all of the sudden, I knew in my mind she was gone, but logging into this wealth of information that contained all of her blood counts and numbers and information that we had access so often, to all of a sudden have that gone. It was just a punch in the gut reminder that she truly was gone and that her records had disappeared. And she just wasn't here. And I wasn't prepared for that. I really thought that I'd be able to go in and find the things I wanted to find and have peace about that. It was shocking to me. And I remember feeling so embarrassed like, how can I call her doctor and say, I lost this access and I really need it? When she's not here, there's no reason. I don't need it. He's going to think I'm crazy. But it was important enough to me that I reached out to him. And I said, you've got to help me. How can I still access this? SPEAKER 4: So what happened next? ELIZABETH CONROW: So he-- actually, I was pretty surprised. I was the first parent he said, that had ever reached out to him with this issue. And I thought, how is that possible? How is that possible? And I'm guessing other parents had experienced it, but didn't know what to do, didn't know where to turn. And he was very compassionate. And he reached out to our online medical team, our portal team, and tried to figure out a way to reactivate the account for me. And got that done very quickly. And I said, well, it's not enough that it's been reactivated for me. No other parent can go through this. We have to come up with a plan. And so he really did work very hard with our team here to come up with something that would hopefully fix the problem. And it did. I know many families then, had their access turned back on manually, through a manual process that they put in place here. But I know that in the last six years, there have been several families who went to log in and had this experience. And unless you've been there and unless you've been the parent on the end of losing a child and then going in and having more taken away that you didn't expect, you don't understand the pain of that. And so I think the driving force behind me really wanting to write this article was to say, I know that this isn't just my institution. I know this is happening across hospitals. I know that when a child dies, this access is turned off. And that really hurts families. And if there's a way to bring attention to that and say, hey, we can do better, we need to. SPEAKER 4: Now that you have this perspective, I know that you have actually developed some training for oncology fellows and staff to train them a bit to talk with bereaved parents. What are some of the lessons that you want people to learn? ELIZABETH CONROW: That's a great question. I'm working with another doctor here. It's an advanced communication training where we're helping young doctors share bad news for the first time. And it's amazing to me how afraid people are to approach the bereaved. And I guess, having been through it, I see now how poorly we really do bereavement and how afraid we are to kind of approach someone who's lost a child and just wrap our arms around them and say, I'm so sorry. I'm here with you. Everybody wants to fix it. And there's no fix. And people don't want to approach a bereaved parent and bring up their child, because they don't want to make them sad. And what many people realize is that our children are always on our mind. You're not reminding us of anything we're not already thinking about. I was pretty surprised after losing Amanda that someone could be on my mind all the time-- all the time when they're not here anymore. You know, you think about people here and there, time to time, people in your life. But once she was gone, she was right at the front of my mind and still is, every moment of every day. And so if you see a bereaved person, it's OK to mention their child's name. I actually-- I go to the dentist. And the woman who cleans my teeth, every single time I go, will mention Amanda. And I know it's intentional. And I know it's because she wants me to know that she cares. And so those kinds of simple acts that people do as a way of recognizing and honoring the child whose passed means so much to a bereaved parent. SPEAKER 4: Just listening to you and the emotion in your voice, I imagine it must have been difficult in a way to go back to the same place where Amanda was treated and now, work with the staff and the clinicians who treated her. Tell us a little bit about how you've managed those relationships? ELIZABETH CONROW: One of the things I've learned, and that's partly through the role I have now in supporting other bereaved parents is that everyone grieves differently. And I know there are some parents who, the first time they come back to the hospital, it's really, really hard for them. And it's almost like a PTSD moment. For me, I appreciated and cared about all of the medical staff so much that coming back here to me, was a need. I needed to get back here and find a way to connect with these doctors and nurses and the people who cared for Amanda so beautifully while she was here. In those first months of grief, I showed up at the hospital-- I remember there was one day I showed up, and I felt so lost. But I just needed to see those nurses and give them a hug. And I felt awkward and out of place, because suddenly, I'm here and she's not with me. But I just needed to be in a place where she had been and a place that meant so much to us. So coming back here for me, certainly had its hard moments. And there have been challenges with it. But it's been a place of comfort. And being able to talk about Amanda with other parents has really been a gift for me, because it's not an opportunity you have all the time, especially six years later to talk about the child who died. So it's been a gift. SPEAKER 4: What is it like for you to be with other parents now who are going through what you experienced? How does your experience of loss influence your role as a counselor for a newly bereaved parents? ELIZABETH CONROW: I do a lot of listening. I do a lot of listening. And there are some parents who I'll call and follow up with and check in on. And they're good. And they don't need anything. And to be honest, I think when we first lost Amanda, if someone called me and I had never met them before, I might say I'm good. I don't really need any support right now. I've got my family. But there are some parents who I will call, and they will talk to me for 45 minutes. And they will cry. And they will say, you're the first person I've been able to talk to about this, because you understand and you've been through it. And so I'm able just to listen. And when they say things that they think are crazy, I wandered into my son's room and I slept in his bed last night, I say, I understand that. I once found Amanda's socks in a travel bag. And when I found them, I pulled them out and I slept with her socks. So there are things that people think are crazy that I'm able to help them normalize some of those feelings and understand that it's OK. SPEAKER 4: I don't think it's crazy at all. You speak with such knowledge and also such empathy. I wonder if you can help us also understand how you see the clinicians now-- the doctors and nurses who are actually are caring for these patients-- how you see them react to the death of a patient and how they maintain their relationships with what the parents once the kids are gone? ELIZABETH CONROW: It's been very interesting, I guess you could say to be on the other side of this, right? I was on the parents side before, where I was able to receive kind of the love and comfort and support of those who cared for Amanda. And I was able to see them showing up at the funeral and the ways that they would reach out and send notes and cards. But now, being on this side working with many of those same people, I've been really struck, even during our weekly meetings when they talk about different cases and different families and the losses that they've had, how significantly it does impact them, and how much those families and those children really do mean to them. And you know, I've often sat there now wondering, well, what did they say about my family? What did they say about us? And not a conversation I can go back to and sit in on. But I'm just struck by how much they really do care and how much it extends beyond this just being a job for most of-- all of them. SPEAKER 4: Yeah, in your role now, in your professional role, what kind of changes have you implemented in the way clinicians and parents communicate, or the way the system communicates with parents? ELIZABETH CONROW: At our hospital where I work, we have probably around 80 or 90 losses a year. And I came into this and said, I can support these families. And I can follow up with 80 or 90 families in a reasonable manner. But really, we need more parents doing this. We need to expand kind of what we're doing. So I've been trying to work toward implementing a mentoring program of sorts, where bereaved parents who are a few years out in their grief can come alongside newly bereaved parents and really support them, one on one for a year or a year and a half to help them get through that time, so that it isn't just me. And as great as I am, I really know that we can do much, much better by parents if we expand kind of the support network that we have. So I've been trying to grow some of our bereaved parent base. And those who can give input on some of the things we're doing-- because I know bereaved parents have so much wisdom and so much they can share from their own experiences. SPEAKER 4: You sound like a force. I wonder, have you connected with other hospitals, other teams? Or is your-- are you concentrated on your hospital and your community? ELIZABETH CONROW: The greatest support to me, actually has been St. Jude. They have such a fantastic program. Their bereavement, their parent support is really outstanding. Actually, just this week, I was able to sit in on one of their parent mentor trainings to kind of learn, well, how do you train your people, and what do you do? And so that was fantastic. So I'm really grateful-- grateful for their support. So they've been really wonderful. SPEAKER 4: I imagine Amanda's passing really affected your entire family and the other kids. Can you tell us a little bit about how all the other kids dealt with their grief? ELIZABETH CONROW: Sure. I know at the time when Amanda was diagnosed, my oldest was 9, and my youngest was 9 months. So everybody was pretty little. And they went through that at a really young age. And then when she passed, my oldest was 11 and my youngest was 3. So they were still little. And they had been through what I consider to be significant trauma in those early years. And when things first happened, I mean, I had a therapist describe it to me as a children's mobile that hangs over their bed you know, that once it becomes imbalanced, it just tips on its side. And that's the way things felt at home for quite a while. You know, just nothing felt right and things felt out of order. But kids are so resilient and so forward looking. And my kids really did beautifully through it. And I had someone tell me, well, kids are going to revisit grief. And they're going to come back to it from time to time. And it'll surprise you. And I will say, that's so true. You know, I would think everything was going along OK and everyone was coping well. And then, my daughter Jessica, who was closest in age to Amanda, would come down at 10 o'clock at night in tears because she was thinking about her sister. And that would catch me a little bit off guard. And my oldest just went away to college. And she's now 18. And she's had some conversations with me lately just about everything they went through and really revisiting some of her feelings about it all. And so they don't really get over it. But helping them to kind of process it and work through it and really, just talk about her. We talk about her constantly. She's a part of everything we do. We still make her a birthday cake. So we just keep her memory alive and celebrate her life together. But grief for kids is certainly different, and it doesn't end. But they are definitely forward looking and really can handle more than I think sometimes we give them credit for. SPEAKER 4: And your husband and you I hear have also been involved in some activities to talk about this publicly or teach others. What was that like for you as parents? ELIZABETH CONROW: There are a few things that we've really wanted to help move forward in terms of childhood cancer awareness and things that people can do to really help bereaved parents. And I think there's just so much that people don't know or understand. Many people don't realize how underfunded childhood cancer is. So it just means a lot to us to be able to kind of get that message out now. SPEAKER 4: I imagine there's so much work to do. And as we've had this great opportunity to chat about Amanda to remember her, to think about your experience and the amazing work you seem to be doing-- are there any final comments that you want to share with our listeners? ELIZABETH CONROW: It's an honor for me to really share this experience. And that bereaved parents need support, and they need to know that people care and remember, even as time goes on. So just take good care of those who know who are grieving. And love one another. SPEAKER 4: Thank you so much. This is Liz Conrow, author of Access Denied, published in Journal of Clinical Oncology. Thank you very much. Until next time. SPEAKER 1: Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all of the shows at podcast.asco.org. [MUSIC PLAYING]

university art apple speaker simple loss hospitals ptsd journal goodness revisiting accessing oncology oddly anc asco access denied clinical oncology rochester medical center jco music playing cancer stories golisano children transcript speaker century cures asco podcast network

EP 88: The Cures Act, Chart Notes and Missing Patients

Nobody Told Me That! with Teresa Duncan

Play Episode Listen Later Oct 20, 2021 57:32

Another insurance nerd joins me on the podcast! Rick Garofolo of Practice Mechanics teaches me about the Cures Act - part of me wishes I didn't know anything about it. BUT it's important and we need to be compliant when it goes into effect. We also discussed some hot topics from his classes at the recent American Association of Dental Office Management's Annual Conference. You may be surprised to learn how you should be tracking inactive patients. We talk about chart notes. I hope you get as excited as we did!

missing patients american association coding chart chew annual conference cures act century cures dental office management

The Many Hats of the CIO with Brian Sterud of Faith Regional Health Services

Play Episode Listen Later Sep 10, 2021 29:24

September 10, 2021: Brian Sterud wears many hats at Faith Regional Health. He's the VP of IT, the CIO and the CISO. In smaller health systems everyone has to muck in. How do they cover it all? How do they manage their time and stay current? Every health system is prepared for a 24 hours or less security risk. But after that, things get complicated. How would a smaller organization handle 30 days? 40 days? What's the biggest learning from having the ERP suite in the cloud? Can you get to the level of customization that you want? What kind of things can you do to improve clinician experience? What's it like to do a comprehensive network upgrade with Aruba? How has that helped security and operations? And what kinds of technology priorities are on the agenda for the next 24 months?Key Points:We can be really nimble because of the multiple hats we wear [00:06:20] There's always something more that you can do in regards to security risks [00:11:30] Take a hard look at endpoint protection and DLP and where that sits within your organization [00:24:30] How do you stay up with Price Transparency and 21st Century Cures? [00:24:44] How do you maintain excellent office culture? [00:26:05] Faith Regional Health

API-Driven Claims Adjudication, Brought to you By 21st Century Cures

The DownEast Emergency Medicine Podcast

Play Episode Listen Later Aug 25, 2021 9:46

Would this project have been done without the 21st Century Cures Act?FTAAnthem, Humana and SS&C Technologies have entered into a joint venture named DomaniRx to develop a claims adjudication and pharmacy benefits manager cloud platform, according to documents filed by SS&C Technologies with the Securities and Exchange Commission.PBMs receive and store massive amounts of data in their function of claims adjudication. The use of an Application Programming Interface, or API, allows applications to talk to each other for a faster, seamless process.In December 2020, CMS proposed the Interoperability and Patient Access final rule, which became final on May 1. It is aimed at removing silos of information that prevent patient data exchange and promotes interoperability throughout the healthcare system.Starting July 1, payers were required to give patients access to their data through "open" APIs, subject to the provision of HIPAA. Medicaid, CHIP and individual market Qualified Health Plans payers needed to build, implement and maintain APIs that enabled provider access to their patients' data. They were also required to streamline the prior authorization process.AHIP pushed back against the rule earlier this year, saying it was hastily constructed, requiring insurers to build these technologies without the necessary instructions.-----I don't imagine it would have, but I'm curious what you think.#healthcare #healthIT #cio #cmio #chime #himsshttps://www.healthcarefinancenews.com/news/anthem-and-humana-enter-multi-million-agreement-ssc-api-cloud-platform

driven chip claims 21st century api medicaid humana ss apis cms securities hipaa exchange commission interoperability health it pbms patient access adjudication century cures act ahip application programming interface century cures

OMG, TMI! What does open notes mean for you and your patients?

Play Episode Listen Later Jun 24, 2021 13:41

The 21st Century CURES act has mandated that starting on April 5th, 2021 patient notes (with a few very narrow exceptions) must be easily available to patients via their patient portal. How did this come about, and what does it mean for us? Click Here for full show notes This lecture was presented at the 2021 Maine Medical Center Winter Symposium. For more information on the symposium click here. Sam Wood, MD

patients md sam wood opennotes century cures

Podcast from Washington: The All of Us Research Program

The NACCHO Podcast Series

Play Episode Listen Later Jun 24, 2021 15:01

In this week's episode of Podcast from Washington, NACCHO government affairs team members Ian Goldstein and Adriane Casalotti discuss the proposal for the 21st Century Cures 2.0 discussion draft released by Reps. Diana DeGette (D-CO) and Fred Upton (R-MI). They discuss the public health provisions in the bill and its chances of passage. They also discuss the FY2022 appropriations process, as Congress breaks for July 4 recess. Later in the program, Ian Goldstein speaks with Craig Braquet about the All of Us Research Program, which seeks to break down barriers that exist in medical research studies by expanding the diversity in research and clinical trials to include individuals with disabilities. They discuss the importance of people with disabilities' participation in the program.

washington congress reps research programs fy2022 us research program century cures naccho

CHIME Summer Forum Recap - 7 ONC Coordinators and Aaron Miri

Digital Health Unfiltered

Play Episode Listen Later Jun 24, 2021 17:43

What do we learn about the future of interoperability and data sharing when seven former National Coordinators for health IT covering four administrations are on stage together.Micky Tripathi, Biden AdministrationDon Rucker Trump AdministrationVindell Washington Obama AdministrationKaren Desalvo - Obama AdministrationFarzad Mostashari - Obama AdministrationDavid Blumenthal - Obama AdministrationRob Kolodner - Bush AdministrationThe primary thing we learn is the continuity of the strategy across administrations. Karen Desalvo summed it up well when she said "And it's just important. I think for the audience to understand that the theme here is that we build on each other's work. And we try to do that in a very nonpartisan way, because that gives the industry a lot more certainty about where the future's going to go."21st Century Cures wasn't a fluke, it was a continuation of a strategy that frees the data from silos in order to bring advances to the patients when they need them. To give them actionable data and agency over that data in pursuit of health. To give them choice in their health decisions and to provide clinicians with powerful tools to make them more effective in the delivery of care.Mistakes have been made on the journey, but the direction remains the same across the last two decades of work by the ONC national coordinators. #healthcare #healthIT #chime #himss #cio #cmio

mistakes forum coordinators chime miri health it onc karen desalvo century cures national coordinators

21st Century Cures, and the Patient Portal

Play Episode Listen Later Jun 24, 2021 20:30

21st Century Cures Act is already making waves. But the most impactful change is yet to come: the API provisions go live next year. Will this put patients in the driver's seat for sharing data, and jumpstart health entrepreneurship? Nick and Sudipto make the case.

patients portal 21st century api century cures act century cures

Pink Sheet Podcast: Emergent On Capitol Hill, Second Cures Bill, US FDA’s Public Sponsor Rebuke

Pharma Intelligence Podcasts

Play Episode Listen Later May 21, 2021 34:41

Pink Sheet reporters and editors discuss Emergent BioSolutions’ congressional appearance, plans for the next 21st Century Cures bill, and the FDA’s statement on the clinical trials for CytoDyn’s investigational COVID-19 therapy.

covid-19 public fda capitol hill cures rebuke emergent us fda pink sheets century cures

Next in Health IT with Andrew Rosenberg, M.D.

Play Episode Listen Later May 19, 2021 50:08

May 19, 2021: In healthcare, a significant portion of the workforce have to be on site. How do leaders of today support and manage flexible, hybrid and remote work? Our guest today is Andrew Rosenberg, CIO at Michigan Medicine who shares his insights on virtual care, 21st Century Cures, innovation, information blocking, telehealth and the cloud. How do we take the lessons of virtual care and continue to really shift the paradigm, not just with care at home, but how do we improve capacity in our tertiary hospitals and improve patient engagement in clinics? Are we at a point now where technology is driving the business strategy? Or are we still at a point where technology serves the business strategy and therefore the business strategy dictates the technology? What about application modernization and how it relates to cybersecurity and business continuity? Have we entered a new era in our cyber journey? And do you build your own technology products or buy them from vendors? There's a reason for both.Key Points:As a moderator it's essentially impossible via Zoom or Teams to spark a fun and educational debate versus doing it in person [00:04:20]Ambulatory care always had a relatively low volume of virtual visits. The peak in 2020 was 70-80% being virtual but it’s gone back down to 20%. [00:29:03]Patients love telehealth. They don't have to drive and wait around to be literally seen for two minutes. [00:35:05]It's not about information blocking. It’s about interoperability and availability. [00:37:25]The typical person does not understand the depth of their medical data. They seek a trusted professional to help them. [00:38:45]The pursuit of healthcare is constantly trying to shift from things that we deem as inefficient to more patient centric, more humane and less expensive [00:25:20]Michigan Medicine

21st Century Cures: Curing our Anxiety or Causing It?

Informatics in the Round

Play Episode Listen Later May 15, 2021 66:39

Our third episode of this year covers a very important, timely, and relevant topic. Every so often the Federal government passes landmark legislation. We’re going to see what’s happening at Vanderbilt, which is a microcosm of what’s happening in your world as a result of 21st Century Cures and the specific actions it is requiring to stop information blocking. Huh? Yea, we’ll get into what that means. We have Dr. Trent Rosenbloom, an expert in biomedical informatics and especially technologies that are used by patients to manage their health information. Trent’s been at the forefront of this issue and has way more than one podcast to share with us. We might well have him back in a few months to discuss how this is going in more detail. Trent is joined by Sarah Bland, one of the very insightful and quick witted people I have the pleasure of working with on this podcast from time to time. Thanks, Sarah, as always. Although the masks she was wearing on our zoom recording were next-level weird. You’ll see those pics on our podbean-based website for Informatics in the Round, on our Facebook site, on Twitter, on Instagram, and maybe soon even on TikTok! One thing I love about Nashville—Music City as it’s often called—is that you can find a fantastic singer or songwriter almost everywhere you look. This episode is no exception! Will Comstock, one of the amazing, affable, and always professional administrative staff in my department, is also a wonderful musician and songwriter and blessed this show with his voice and his creativity. He also, by the way, shared an important piece of personal insight, from which part of the opening clip was snipped.

tiktok anxiety federal 21st century causing vanderbilt yea curing informatics century cures

How Far We've Come: 400 Episodes and a Look Back at Healthcare IT

Play Episode Listen Later May 7, 2021 52:01

May 7, 2021: Today is a very special episode. It’s our 400th show. How far have we come in healthcare IT over the last three and a half years? Tess Kellogg, Director of Marketing at This Week in Health IT joins Bill to celebrate the insights of our incredible community of contributors including David Bensema on telehealth, Dale Sanders on architecture, David Chou on ransomware, Tressa Springmann on Apple Health, David Muntz on handling talent shortage in IT and Ed Marx on life, death and everything in between. You’ll also get a behind the scenes look at building up a podcast from 28 downloads to over 250,000 in one year alone. What were the conversations in 2018, 2019 and 2020? The pandemic was tragic in so many ways. And yet for healthcare it seemed like it shocked the system in a way that it needed to. The healthcare industry has achieved things over the past 12 months that were never thought possible. Key Points:There’s no way the average American can understand pricing and what they're getting themselves into when they walk into the hospital [00:17:25] 2018 will be known as the high water mark for reimbursement for healthcare [00:22:10] 2019 was “Grow to Greatness” [00:22:24] 2020 was all about clear focus which led to digital transformation [00:32:30] What the pandemic really catalyzed in healthcare was external pressure [00:37:50] 2021 is about 21st Century Cures, information blocking, AI and machine learning [00:40:50]

covid-19 american director marketing ai leadership digital innovation diversity healthcare security artificial intelligence greatness cloud analytics look back customer experience cio telehealth regulatory emerging technologies interoperability health it apple health david chou century cures dale sanders

A Discussion with Kevin Manemann from Providence on Tech in Healthcare

Play Episode Listen Later Apr 16, 2021 56:58

April 16, 2021: The patient experience changed dramatically during COVID. Workflows had to adjust and change as part of that. We asked Kevin Manemann, Chief Executive Southern California at Providence, what expectations do patients now have? What are the most impactful steps you can take to meet those expectations? What home care technologies are emerging as critical? Can we sustain telehealth? Has the covered lives business grown for Providence? What does a CIN look like in Southern California? What are the technologies, the communication platforms and the data that you need to bring together? How do you move seamlessly from multiple EMR platforms to just one? What is the complexity of delivering on bundled payments and what are some of the strategies to approach that? Plus learn more about Providence St. Joseph Health’s “Own It” program and how it has impacted the organization.Key Points:When COVID hit, within 2 weeks we had 8,000 providers set up on telehealth [00:04:15] Have we finally gotten rid of clipboards? [00:06:21] About 20 to 30% of care that is provided is unnecessary [00:11:50] Text technology adds to a seamless patient experience [00:20:15] What value will 21st Century Cures create for patients and providers? [00:25:20] If we could monitor diabetic patients and intervene in the moments of concern, more times than not you could figure out what to do without them having to come into the emergency room [00:26:32] The administration that we have now really needs to put pressure on EMR vendors to open up [00:35:00] Providence

Going Beyond "Checking the Box" for Policy Adherence

Play Episode Listen Later Apr 6, 2021 40:20

On this episode of The Dish on Health IT, Alix Goss vice president and senior consultant at Imprado joins our hosts Ken Kleinberg, Pooja Babbrah and Jocelyn Keegan to talk historical policy and standards milestones, how they brought us to where we are today and why it's important for the industry to go above and beyond the mentality of just checking the box for policy adherence in order to gain a competitive advantage and achieve better patient outcomes. Kens asks Alix to give us a breakdown of how we got to where we are today in health IT. Alix kicks off the podcast by explaining that for several decades, we've been trying to address improved affordability and outcomes in our healthcare system. It's about the right data at the right time for the right patient and in the right format. In 1996, under the Health Insurance Portability and Accountability Act, we set off on a journey that forced us to be on a trajectory, as a nation, in our information exchange for administrative simplification. Think of that as governing, or establishing, pharmacy and medical standards along the way, in the 1999 to 2003 timeframe.Then, we rolled up our sleeves and tried to make all of that work only to realize we really needed to bring clinical aspects into it too. We started working on the American Health Information Community (AHIC) under the Bush administration, which helped us figure out what clinical data exchange needed to look like. A lot of the work was memorialized under the Health Information Technology and Economic and Clinical Health Act (HITECH) of 2009. Shortly after, we got the Affordable Care Act. Then came the Medicare Access and CHIP Reauthorization Act of 2015, which established a robust Quality Payment Program, changing the way Medicare rewards for clinical value over volume. Most recently, our journey continued with the 21st Century Cures Act in 2016, which promotes and funds the acceleration of research and drug and medical device development. In the end, HIPAA gave us administration simplification and now 21st Century Cures is bookending decades of progress and forcing us into this intersection of clinical administrative data all around the patient.Ken asks Alix if she believes Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) and rated standards are innovative. She responds with a question. What is your definition of innovation? If you're in other industries you're probably thinking, yeah, not so much. But for healthcare, we're so complex with the variability of all the data elements. Our current transaction evolution to adopt FHIR will provide us with greater flexibility throughout the entire process. Alix thinks FHIR is the way we're going to bridge a great deal of problems, but she does not necessarily see electronic data interchange (EDI) going away. It's gotten into the DNA of our architectures and our business decisions. It's the way we do things. We like to adopt new standards, but where we always fall short is doing the cultural transformation of workflows as opposed to sometimes just having a “check the box” mentality.Jocelyn, who has extensive FHIR Accelerator experience, notes it is no longer just about the rules or the laws that have gone into effect, it really has to do with if we're not figuring out how to make value-based care work, what is our alternative? What will push people to make the shift? The pandemic further exposed current weaknesses in our ability to exchange clinical data, to let us roll out vaccines at scale across our public health infrastructure. There could not be a more compelling business case for why it's so imperative for everyone to start picking up existing tools and implementing. As data starts to free and more players implement, those that don't react or those that have the “check the box” mentality are going to put themselves in a significant competitive disadvantage in the coming years.Pooja has examined these issues from a patient, CARIN Alliance perspective. She is concerned with how we make it easier for patients to access and share their data. FHIR APIs finally get us to that point where it's easier for patients to download their data. We're getting to the point, thanks to some of the recent technology and standards, where it is easier for patients and consumers to download their information and to do searches on price transparency. Ken moves the conversation to payers. He asks Alix if this stakeholder group is embracing change or just “checking the box”. Alix says it is a very mixed landscape out there as far as opinions and corresponding strategies. There are some who are only going to come along when the axe (aka penalties) comes down. Then there are others who are pushing the envelope and pulling folks along. Alix thinks there is a landscape in the payer community that feels overburdened and has its own compliance fatigue. She believes there is also skepticism around what might change. That skepticism coupled with longer term trust dynamics in the payer-provider community plus the sustainability themes for payers (rapidly changing business models) has caused them to start considering things with different lenses that they've never had to before. Past approaches have trained the industry to wait for regulations and incentives to create movement, meaning there is far more “check the box” mentality than anything. Alix is optimistic though, especially under the FHIR Accelerator community, that there is a group of thought leaders who are leaning in and trying to drive a stronger course forward for us all.Ken asks Jocelyn what her comments are about payers being burdened. She notes it is a fair point and that there a couple of factors at play here. To Alix's point, there's a lot of entrenched operational support and infrastructure in place that's been running to support EDI for a number of years, and there has been minimal effort in doing clinical data exchange with payers. Because of the historical combative relationship between payers and providers, we haven't seen much progression yet. However, with the Da Vinci Project, we get to see daily how those relationships are changing. Payers who leverage modern APIs will transform their organizations, how they work and how they view their relationships with provider partners. They will be the ones who come through the curve faster.Pooja notes we are essentially flipping the entire model payers are operating under today. They're not used to opening up their data to others. It's the same in the PBM space. On the pharmacy side, we're not quite there yet but how do we make it easier for data to be shared? How do we make it easier for patients to access their data?Pooja also brings up that payers are having to meet interoperability, patient access and price transparency rules, which is a lot. She has a feeling payers might default to just “checking the box” because they will all be in a rush to meet what's in place today. The point is though, we need people to be thinking outside of “checking the box”. Where can they focus? What are the specific use cases that they could look to in order to achieve a market advantage? Pooja thinks that's where payers need to be paying attention.Alix comments that we're not just transforming standards, we're transforming culture. How does a patient become informed? We have an educational foundation here of using technology to interpret information in collaboration with someone's payers, providers, benefit plans and their family's budget. That's how we stitch this all together. However, to Pooja's point, the history of payers and the cultural transformation is one of our shortcomings in implementation efforts that we've undertaken in the last 30 years.Ken asks Alix how she sees the new federal administration playing out over the next few years. Alix says public infrastructure has been duct taped together and underfunded for decades. The work people have done at a local and state level in partnership with the Centers for Disease Control and Prevention (CDC) has been amazing. It is also amazing how the commercial sector relies on registry and public health information. So many use the data, yet very few people help support the public health infrastructure. So, Alix thinks we are going to see a lot of transformation in the public health space (for the good). Having a new national coordinator like Micky Tripathi is going to really help leverage implementation efforts and take us to the next round of progress. Additionally, Alix does see FHIR as a key factor in bridging a number of issues out there, but she's not expecting a hard left turn in this next administration.Ken asks Alix for her final thoughts. Alix stresses for people to get educated and involved in standards development, both policy and technology standards. If you can't play at the national level directly, you can always offer your public comment on proposed rulemaking. We all have experiences to share and we all should exercise our voice to strengthen our nation's trajectory and agility to respond to all the amazing technology and medical advances that are yet to come. So if you can't get involved directly, tap into the expertise of the folks at Point-of-Care Partners or Imprado because they can inject that knowledge and add your story to their library of perspectives from which we influence.

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Maximizing EHR Potential, MyChart, and Interoperability with Epic VP of Patient Experience

Play Episode Listen Later Apr 2, 2021 46:45

April 2, 2021: Patients relied heavily on virtual tools to connect with providers throughout the pandemic. A single click to a doctor is the holy grail. So is having access and control over your data. Our guest today is Sean Bina, VP of Access and Patient Experience for Epic. What role does MyChart play in this virtual care world? How is Epic working with the innovation community to optimise patient experience? What is their role in the vaccination effort? How has Epic been working with clients to streamline vaccine scheduling? What about interoperability? How can healthcare information be connected across health systems, retail pharmacies and statewide registries? Sean and Bill also dive deep into remote monitoring, telehealth, 21st Century Cures, MyChart Care Companion, Epic Health Research Network and the Vaccine Credential Initiative.Key Points:The hurdles for becoming a MyChart user are much fewer and easier to get over than ever before [00:07:40] In a study around remote monitoring of their hypertensive patients, Oschner saw a 40% increase in the number of patients that were meeting their goals. That’s a huge reduction in readmissions. [00:13:20] As the FHIR standard continues to develop and grow it's becoming even easier for Epic to make connections to third parties and other vendors [00:17:35] Epic is helping to establish privacy standards to make sure the goal of 21st Century Cures is achieved [00:24:35] EpicMyChartMyChart Bedside Epic Health Research Network

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Leading on Innovation and Quality Care in a Pandemic with CIO Ed Kopetsky of Stanford Children's

Play Episode Listen Later Feb 12, 2021 48:35

February 12, 2021: Ed Kopetsky, CIO for Stanford Children’s Health joins us. Ed is a CIO of the Year. He is a lifetime achievement award winner. He talks about what distinguishes a great CIO from a good one. The organizing principle during the pandemic is safety and speed. How do you determine what projects to do moving forward? What are the biggest challenges facing pediatric health in California today? What’s it like to work in the inspiring community of Silicon Valley? What’s the deal with the transparency rule and 21st Century Cures compliance? And learn about Ed’s incredible work on the Opioid task force made up of leading edge clinicians in addiction medicine.Key Points:Children's hospitals have really gone retail [00:04:35]There's no flu season this year because of our isolation, not bringing people into clinics and using virtual care. So safety wise and quality wise, that's been a significant advancement. [00:14:55] Great CIO's have great networks [00:23:50] Children's hospitals are kind of like Switzerland. They have to partner with everybody. [00:34:45] Addiction is not an acute illness. It's a chronic lifelong illness. [00:44:00] When COVID hit, mental health went to the wayside again. Our overdose mortality rate is up 50%. [00:44:45] Stanford Children’s Health

What 2021 Will Bring to Healthcare with Children's Hospital CIO Theresa Meadows

Play Episode Listen Later Feb 3, 2021 37:16

February 3, 2021: Artificial intelligence, chatbots, machine learning, remote work, price transparency, leveraging the cloud and 2021 technology priorities. Join today’s conversation with Theresa Meadows, CIO for Cook Children's Healthcare System. Children's hospitals are unique in that their interoperability strategy has to be REALLY good. What does it look like? What kinds of regulatory things must be considered? What does a children's integrated delivery network (IDN) look like? Do these health systems rely on their EHR? Or do they use a third party? What about homegrown data solutions? The topic of work culture is huge in 2021. How do you manage productivity with a remote workforce? Key Points:IT projects are never over. They are living breathing entities that last forever. [00:09:50] Cook Children’s two IT goals: 1. To enable our patients to be more mobile. 2. To enable our employees to be more mobile and more agile in their work. [00:19:35] 21st Century Cures and price transparency [00:25:55] The technology priorities for 2021 are mobile and digital [00:19:00] There are a lot of repetitive things that we do in IT that RPA is perfect for. E.g. password creation and password termination. [00:33:10] Cook Children's Healthcare System

Vaccine Credential Initiative is a Proof Point for a decade of Interoperability Iniatives

Play Episode Listen Later Jan 15, 2021 10:34

Start the clock. The Vaccine Credential Initiative (VCI) will show how far we've come with interoperability.Rewind three years. The idea that Cerner and Epic would participate in anything together, at least anything that was more than just a CYA announcement would be unheard of. Now they are both in on VCI.More on VCI.-----FTAParticipating organizations will agree to offer individuals with digital access to their vaccination records using the open, interoperable SMART Health Cards specification based on W3C Verifiable Credential and HL7 FHIR standards, according to VCI.------This will be a great test. The urgency created by the pandemic, coupled with the progress on interoperability fueled by FHIR and 21st Century Cures are coming together. Now we get to see what can happen when all players have a shared will to make something happen.The speed and proliferation of a solution will tell us if we are on the right path and give us a metric by which to measure all future interoperability efforts by these players.

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Optimizing Health IT to Improve Health System Performance - Rand Corporation

Play Episode Listen Later Nov 13, 2020 48:13

November 13, 2020: It’s been about a decade since the passing of the HITECH Act when we as a country decided to invest many billions of dollars into our health IT infrastructure. So it’s the perfect time to look back and see how things are going. Bob Rudin of the Rand Corporation, a nonprofit think tank, shares their research. The working paper is called “Optimizing Health IT to Improve Health System Performance.” They interviewed executives from 24 health systems around the country. We see all kinds of efficiencies in every industry, why isn’t it happening in healthcare? What’s going on? What’s the problem? Are we getting value from all the new technology? If not, why not? How can we do better? What about distribution? How do we get apps out to the masses? How do we get the clinicians to adopt them? And with so many mergers happening, is there a secret sauce?Key Points:Looking at health IT in the context of health systems and how we're trying to use it to improve performance [00:05:25] There's now industry consensus that it’s better for a health system to be on one electronic health record rather than on more. There’s so many efficiencies you gain from doing that. [00:11:25] The 10 year foundation has been laid but it was 5 years ago when the 21st Century Cures was signed into law that we really saw the first seeds [00:34:05] Can we all agree that evidence-based medicine makes the most sense? The answer to that is not always. [00:43:45] "Optimizing health IT to improve health system performance"

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Healthcare in the 21st Century with Aneesh Chopra