Podcasts about hies

On our Season 4 finale, we're joined by Holly Hurlburt, associate dean of the University College's Academic Enrichment Programs, to discuss the many high-impact experiences (HIEs) available to NC State students. HIEs are a fundamental part of an NC State education, helping students live out the latter half of our Think and Do motto. From traditional study-abroad opportunities and internships to Alternative Service Breaks and research, Pack members have many options to take what they have learned in the classroom and put it to use in the wider world — for their benefit and for the benefit of everyone around them. Hurlburt details the vital importance of these experiences and how Wolfpack donors and volunteers are helping make them possible. To learn more about HIEs and how you can empower NC State students to take part in them, visit go.ncsu.edu/experiences. If you would like to hear even more stories of Wolfpack success, subscribe to the NC State Philanthropy Podcast today via Apple Podcasts, Spotify, Stitcher or Podbean. Please leave a comment and rating as well to let us know how we're doing. Thanks for listening, and as always, go Pack! Transcript available here.

Steve Heard, Chief Innovation Officer at J2 Interactive, presents a strategy in this interview for dealing with new forms of data known as Social Determinants of Health (SDoH) and how traditional HIEs can evolve to help organizations exploit this data.Heard points out that SDoH has the strongest impacts on people who are poor, isolated, or otherwise marginalized, but that those populations have impacts on the health of everybody else. He therefore urges policy-makers not to "abandon" these people or ignore the needs indicated by the data.Learn more about J2 Interactive: https://www.j2interactive.com/Health IT Community: https://www.healthcareittoday.com/

On this special episode host Dr. Nick recorded live at HIMSS25 with Lou LaRocca, President & CEO J2 Interactive and Sean Kennedy, Head of Product, HealthShare, InterSystems. Interoperability collaborators Intersystems and J2 share insights on payer-provider opportunity to reduce admin burden and ease patient access; interoperability with community-based organizations (CBOs); and HIEs growing and establishing CIE frameworks. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

This podcast episode is part of a series focused on the critical issue of the opioid epidemic, and how healthcare IT and health information exchanges (HIEs) can bridge interoperability gaps. Explore how HealtheConnections is enhancing data exchange and interoperability to tackle opioid treatment and prevention. The podcast provides a look into the innovative use of emerging technologies, addresses regulatory impacts, and highlights the role of community data in reshaping behavioral healthcare.Things You'll Learn:The vital role of HIEs in Central New York's healthcare ecosystem. Key technologies used by HealtheConnections for supporting interoperability and opioid treatment programs. Emerging trends and technologies expected to impact the interoperability landscape in the next 3-5 years. How regulatory changes to 42 CFR Part 2 are affecting HIEs and their stakeholders. Methods used by HealtheConnections to support local health departments in monitoring and reporting opioid overdoses. Real-world examples of innovative processes enhancing overdose tracking and prevention. The impact of community data on person-centered care in behavioral healthcare. How HL7v2 feeds and other technologies are improving interoperability at Helio Health. MODERATOR: Bill Cioffi MPPA, CHCIO, ITILClient Partnership Executive, Nordic Healthcare Bill is a seasoned healthcare IT executive and the Client Partnership Executive at Nordic Healthcare, where he focuses on strengthening client relationships, expanding portfolios, and driving strategic growth. With over 15 years of experience in healthcare IT leadership and 25+ years in IT infrastructure and operations, he has a proven track record of leading digital transformation initiatives.GUEST: Elizabeth AmatoPresident and CEO, HealtheConnections A 16-year veteran of the health IT field, with focused expertise in program development and design, advocacy, research, and source funding. For the past 12 years, she has held various leadership positions in the New York state HIE space, including the past 3 years serving as the Chief Operating Officer at NY's second largest HIE, HealtheConnections. As of January 1st she assumed the role of President & CEO at HealtheConnections. Elizabeth is a passionate advocate for improving the health of communities through HIE, data-centric technology, and clinical-community partnerships. GUEST: Liana ProsonicAssociate VP, Finance and Compliance Liana is a certified public accountant (CPA) and worked for 8 years in public accounting before transitioning to management accounting in 2016. They worked as Director of Accounting Operations at Loretto, a long-term post-acute care provider, for 5 years, and moved into a new role as Director of Finance and Compliance at HealtheConnnections, a HIE, in 2021. In their current role as AVP of Finance and Compliance at HealtheConnections they oversee the financial operations and compliance program. They also teach accounting as an adjunct professor at York College of Pennsylvania. GUEST: Corey ZeiglerCIO, Helio Health Corey has been with Helio Health for about 5 years. They are a large substance use and behavioral health organization with 70 different locations throughout Central New York spanning from Albany in the eastern side to Rochester on the western side, down to the Pennsylvania border to the south and almost to Canada in the North. Their services include inpatient, outpatient, residential, affordable housing, homelessness and a lot of the health and human services functions in New York State.The CHIME Opioid Task Force (OTF) was launched in early 2018 with a simple mission: to turn the tide on the opioid epidemic using the knowledge and expertise of the nation's healthcare IT leaders. While our mission is simple, achieving it is not. Opioid addictin is a complex disease that requires long-term, if not lifetime, care from well-informed clinicians who are supported with easy-to-use and reliable tools.

What are the best HIEs doing? Join radio host Jim Tate on this special episode from a recent virtual event with Manifest MedEx CEO Erica Galvez, and J2 Interactive CTO Mickey Yalon as they discuss the latest advancements in Interoperability. Jim, Erica, and Mickey discuss new industry standards and regulations, how HIEs are becoming a critical component in the public health space, HIEs getting more involved with CBOs, the promise of FHIR, and better serving payer. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

This episode of Quality Matters features highlights from the NCQA Health Innovation Summit panel discussion on data interoperability, held on November 1st in Nashville. Moderated by Arcadia's Aneesh Chopra, the panel explored how to make health data accessible and usable for improving patient care. Panelists (Laura McCrary of KONZA, Dr. Marc Overhage of Elevance Health and Abdul Shaikh of AWS) emphasize interoperability is critical for quality reporting, care coordination and closing care gaps. Emphasizing trust as the cornerstone of data exchange frameworks such as TEFCA, panelists outline the need for alignment between payers, providers and technology organizations to ensure better health outcomes.  The panel unpacks technical and operational challenges surrounding interoperability, such as integrating fragmented data sources and transforming raw reports into insight practitioners can use at the point of care. Panelists compare HIEs and QHINs to highways, illustrating how these systems enable cross-border data sharing. But delivering actionable information, rather than overwhelming clinicians with reports, remains a challenge. Solutions such as Bulk FHIR and cloud-based technologies are highlighted as promising ways to help data reach its best, highest use. The discussion closes with an appeal for greater collaboration and participation in initiatives like the NCQA Bulk FHIR Quality Coalition to test modern quality measures. As Laura McCrary points out, the interoperability challenge isn't just technological—it's cultural and contractual. By aligning incentives and fostering trust between stakeholders, health care can evolve from fragmentation to seamless, person-centered care.  Key Quote: "Bringing data together for a particular patient so we have a comprehensive view for clinical care, quality assessment, predictive modeling, whatever it might be–it's still the golden ring that I'm trying to get to.We have standards and that's great, and those continue to improve.It's pretty amazing the volume of data and the number of people that we're able to access and share data between payers, providers, other participants in the healthcare ecosystem."Marc Overhage, MD Time Stamps:(2:55) Data exchange is all about trust.(4:38) QHINs are the superhighways of health data exchange. HIEs are the on- and off-ramp.(5:25) QHINs were created to work around geographic limitations of HIEs.(6:12) QHINs' challenge is providing information in a way that practitioners can use.(7:21 ) To understand where data exchange can go wrong, focus on the interfaces between steps.(9:12) Data exchange agreements often require legal expertise as much as technical expertise.(11:13) The industry faces a big binary choice about how to organize quality information.(12:46) Bulk fire and cloud computing are a powerful combination.(14:31) Join the Bulk FHIR Quality Coalition.Links:Bulk FHIR Quality CoalitionQuality Matters Ep: 07Quality Matters Ep: 08Connect with Aneesh ChopraConnect with Laura McCraryConnect with Marc OverhageConnect with Abdul Shaikh 

Join us as Joseph Valente, founder of Trade Mastermind, shares his journey from tradesman to businessman with Jonathan Moorhouse from HIES; HIES is a leading consumer protection organisation covering the installation of home energy products. What You'll Learn:

On this episode of Quality Matters, we explore the growing importance of Health Information Exchanges (HIEs) and Qualified Health Information Networks (QHINs) with Laura McCrary, President and CEO of KONZA National Network. Laura discusses the pivotal role these systems play in quality care, enabling the secure and efficient sharing of medical records across diverse networks. By advancing the digitalization and interoperability of health data, these networks enhance patient safety and care coordination.We explore how integrating claims data with clinical data enhances quality, underscoring the critical importance of trusted networks for data exchange. Laura dispels common myths surrounding HIEs and QHINs, while offering practical tips for health care organizations curious about connecting to these essential systems.Additionally, we examine national efforts to expand connectivity and ensure that all health care organizations are part of a growing, robust data infrastructure. This episode serves as a handy guide for how to leverage HIEs and QHINs to participate in more capable and coordinated health care ecosystem.Key Quote: “There is a lot more information available. It really is both a blessing and a curse. In the past, there was no information available for the doctor. Now there's so much. The first problem was how did we actually move the data from Florida, say, to New York? It's been solved through QHINs. As we solve one problem, we've created a new one, which is there's too much information available. We've got to address this new problem.”-Laura McCrary, Ed.DTime Stamps:(01:48) Challenges and Change in Data Exchange(03:48) Myths and Realities of HIEs and QHINs(07:35) Connecting Different Kinds of Data(10:27) Dimensions of Trust(14:29) Reducing Burden with Digital Measurement(16:06) Future of HIEs and QHINs--Links:NCQA resources on digital qualityLearn about KONZAConnect with Laura

Before Guidewell DCMG implemented the Prisma AI service from eClinicalWorks, intake on a patient could take two days when the office was busy. Why this long? Guidewell operates in Florida and many patients come from out-of-state and their records are scattered among various HIEs and other healthcare organizations. Obtaining the records, reading them, and entering summaries into Guidewell's own EHR was labor-intensive. Prisma AI and the Sunoh AI Medical Scribe have dramatically altered the patient visit for patient and physician alike. Prisma AI creates a summary of patient records focused on the specialty of the physician: “the good parts,” according to Lalith Samaraweera, Director of Clinical Informatics & Business Intelligence at Guidewell. Learn more about Guidewell DCMG: http://dc-fl.com/ Learn more about eClinicalWorks: https://www.eclinicalworks.com/ Health IT Community: https://www.healthcareittoday.com/

In the new episode of the Future of Psychiatry podcast technology, including artificial intelligence  and health information exchanges  are reshaping the landscape of mental wellness. HIEs, designed to collect and share health data, aim to enhance care continuity despite facing challenges such as underutilization and interoperability issues. AI offers personalized health insights by analyzing data, but ethical considerations like privacy and bias must be addressed. Additionally, the episode highlighted the complexities of personalized care, emphasizing the importance of collaboration and patient-centric approaches. As technology continues to evolve, embracing innovation offers the opportunity to create a more connected and informed future for mental health care.Host: Bruce Bassi MDMore resources, including a full transcript, can be found at our podcast website: https://www.telepsychhealth.com/futurepsychiatrypodcast/We are always looking to grow and learn more about the field of tech and mental health. If you have an idea for the show, want to suggest a guest, or have a suggestion, please feel to message us through our website's contact page. If you want to support the show, please like on Facebook, and follow us on Instagram, and Tiktok and subscribe on Youtube.As always, the content is for educational purposes and is not medical advice. If you are having a medical or psychiatric emergency please contact 911.

Point-of-Care Partners (POCP) Dish on Health IT hosts, Pooja Babbrah and Jocelyn Keegan welcome special guest Laura McCrary, President and CEO (Chief Executive Officer) of KONZA National Network. KONZA was recently designated as one of the first five Qualified Health Information Networks, or QHINS (Qualified Health Information Networks), to participate in the Trusted Exchange Framework and Common Agreement (TEFCA)Laura McCrary speaks with hosts about: Why KONZA pursued QHIN statusInsight into the QHIN processHow KONZA's status as a Health Information network since 2010 forms their approach as a QHINKONZA's initial Membership mix, and What's new or surprising in the TEFCA Common Agreement version twoBefore digging into the meat of the episode, Jocelyn Keegan introduced herself briefly as the payer practice lead at POCP, program manager of HL7 Da Vinci Project and devotee to positive change building and getting stuff done in healthcare IT. She added that her focus at POCP is on interoperability, prior authorization and the convergence of where technology, strategy, product development and standards come together.Jocelyn ended her introduction by saying that she has had the honor of seeing Laura McCrary present on several occasions and that her pragmatic approach is refreshing and that she is looking forward to hearing how KONZA will be building on their already vibrant HIE (Health Information Exchange) footprint as a QHIN. Next Laura introduced herself sharing that she has been working on interoperability strategy in Kansas and then expanding to nationwide over the last 4 decades. She started her career as a special education history teacher. Early in her career she realized that while these children were in her care, she should have some basic information about medications or conditions so she could be informed and able to ensure everyone was well cared for. Of course, nobody shared medical records with teachers and parents didn't have access to their kid's patient records either. Making sure special education teachers or at the very least the school nurse could access necessary clinical information at the point of care became a passion of hers which led to an early success in her career which was working with the University of Kansas Medical Center setting up one of the first telemedicine programs in the public-school systems. Because of this work, since the early 2000's, elementary kids in Kansas City, KS inner-city public-school systems have had access to basic health and telemedicine services. The telemedicine project helped Laura realize that technology really could bridge access gaps if we built and employed a robust technology infrastructure.When asked about KONZA's mission and reasons for becoming a QHIN, Laura shared that the name “KONZA” is named after a Kansas prairie that is one of the most beautiful prairies in the nation. The way KONZA originated in Kansas around 2010 is a bit different than how other HIEs started. Most states at that time received federal funding through the American Recovery and Reinvestment Act to establish health information exchanges.Kansas was different in that instead of standing up a state-sponsored exchange, they actually encouraged a private-public partnership and opened the floor for any organization who wanted to do business as a health information exchange in Kansas could so as long as they meet a set of very rigorous accreditation requirements, which included some pretty innovative ideas for that time.For example, one of the things that was required was that the health information exchange needed to share all information with patients. As early as 2012, Kansas HIEs were required to have a personal health record for patients where they could access any data that was in the health information exchange. QHINS must also do this by offering “individual access services” and KONZA has already been doing this for over a decade. In addition to sharing data with patients, Kansas also required data sharing of HIPAA (Health Insurance Portability and Accountability) approved treatment, payment, and healthcare operations data with payers as it relates to their members.  Laura continued by sharing that today, 4 exchanges do business in Kansas, and they all work together as well as connect to other exchanges. KONZA also expanded to be able to serve patients across state lines as Kansas residents cross over into Missouri quite often to consume healthcare. Because of this history and background, Laura shared that becoming a QHIN was a natural progression and a way to support their mission to make sure all participants have access to their own or their patient's data. Pooja asked Laura about the process of becoming a QHIN. Pooja acknowledged the stringent requirements for QHINs and mentioned challenges discussed at the ONC Annual meeting in December.Laura shared KONZA's experience, saying they initially thought it would be like Kansas certification requirements. However, the application process involved demonstrating sustainability, financial viability, high trust certification for security, and proper information sharing using IHE protocols. KONZA became a candidate QHIN in February of the previous year, requiring the development of a project plan addressing technology conformance testing and demonstrating business viability.Laura emphasized the challenge of meeting high-level requirements, including safety, security, project management, and board governance. Notably, QHINs must have 51% of their Board of Directors as members, ensuring those participating in the network make decisions about the business model. KONZA reached 49% and welcomed a new member from a public health organization in January. The ongoing process involves meeting the remaining requirements to become a fully certified QHIN.Laura said the process of becoming a QHIN is a continuous work in progress. While they successfully crossed the finish line and are in production, she emphasized the need for ongoing changes to advance interoperability and data sharing. Laura highlighted the importance of QHINs working together as colleagues and federal leadership setting expectations for the national network. After four decades of working on the project, she expressed great satisfaction with the current state of progress.Pooja inquired about the impact of the diverse functional areas of the first group of QHIN designees on their operations. She expressed curiosity on behalf of Point of Care Partners, highlighting KONZA's background as a health information exchange in Kansas and seeking insights into how this background influenced KONZA's role as a QHIN.Laura responded by emphasizing the significance of diversity among QHINs as a valuable asset. She expressed excitement about the potential for innovative solutions to emerge from the diverse backgrounds of QHINs, enabling a departure from a one-size-fits-all approach. Laura expected the development of exciting and innovative solutions unique to each QHIN's diverse background.Pooja then invited Jocelyn to share her thoughts. Jocelyn expressed appreciation for Laura's insights, noting that knowing more about Laura's background made sense. She highlighted the importance of Laura's background in approaching long-term transformation. Jocelyn commended the incremental progress and permanent change advocated in the industry, aligning with Laura's pragmatic approach.Jocelyn acknowledged the mix of QHINs as fascinating and emphasized the importance of meeting people where they are. She recognized the relay race nature of the journey, with December marking the start of a new phase. Jocelyn predicted the challenge of creating compelling business cases and exploring the evolving business model for QHINs. She expressed interest in seeing the progress reports as end users transition from the HIE world to the TEFCA world.Laura emphasized the importance of KONZA serving as the QHIN for Health Information Exchanges (HIEs) and growing out of the HIE space. She expressed the belief that onboarding HIEs to their QHIN is crucial for expanding access to a broader set of data, benefiting patient care. Laura highlighted the critical role HIEs play in meeting the healthcare needs of communities, states, and regions.To ease this onboarding process, KONZA actively reached out to HIEs. Laura shared her personal commitment by mentioning that she had personally spoken with every HIE in the last six months. Additionally, KONZA planned to initiate HIE office hours to engage with HIEs and discuss the onboarding process to the QHIN. Laura conveyed a strong sense of responsibility, stating that if HIEs were not successfully onboarded to QHINs, she would personally feel like they had failed. She recognized the significant value and commitment HIEs have provided to their communities and stressed the importance of building upon their established connections and capabilities.Jocelyn initiated a discussion on expanding endpoints and the role of payers in TEFCA. She acknowledged Laura's insight into the base requirement in Kansas that involved having payers at the table, filling gaps in understanding about payer participation in national programs. Jocelyn expressed interest in understanding the implications of active payer participation, especially with recent rules requiring payers to provide data to providers.Laura provided a comprehensive response, highlighting the common inclusion of payers in HIE networks and the evolving landscape outlined in TEFCA requirements. She emphasized that recent rules, including prior authorization, point towards increased payer participation in the QHIN model. Laura praised ONC's efforts and leadership, acknowledging the challenge of absorbing the vast amount of information released.Laura discussed the significance of two specific SOPs (Standard Operating Procedure) dropped on Friday related to delegation of authority and healthcare operations. She encouraged stakeholders to focus on these documents, emphasizing the critical role they play in bringing clinical and claims data together. Laura outlined the historical challenge of integrating clinical and claims data, noting that TEFCA offers an opportunity to bridge this gap.Notably, Laura highlighted the requirement for payers participating in the QHIN model to provide adjudicated claims. She acknowledged that while this transformation may take time, conversations with payers indicated openness to sharing crucial data that providers might not have. Laura expressed excitement about the groundwork laid in the SOPs, anticipating an amazing transformation in healthcare. She encouraged innovative companies to explore the delegation of authority, foreseeing its profound impact on healthcare transformation.Pooja highlighted the collaboration between CMS and ONC in recent rule drops and mentioned the inclusion of FHIR (Fast Healthcare Interoperability Resource) in the latest regulations. Jocelyn asked for comments on this, pointing out varying levels of maturity in QHINs' FHIR programs. She emphasized the shift towards API (Application Programming Interface) and codified data over documents, aiming for automation and reducing human involvement. Jocelyn expressed interest in Laura's perspective, considering the existing collaborations and partnerships.Laura explained the importance of EHRs (Electronic Health Records) being FHIR-enabled for effective data sharing with QHINs. She clarified that while QHINs can be FHIR-enabled, the critical factor is whether EHR vendors support FHIR. Laura highlighted the necessity for EHR systems to have FHIR endpoints and publish them in the RCE (Recognized Coordinating Entity) directory for effective data retrieval. She stressed that both FHIR endpoints and resources are crucial for successful data exchange. Regarding facilitated FHIR, Laura expressed excitement about its implementation by the end of Q1. She mentioned the role of facilitated FHIR in responding to payers and highlighted the importance of the healthcare operations SOP. Laura also discussed the bulk FHIR initiative by NCQA, expressing enthusiasm for participation. She emphasized the significance of FHIR in sharing minimum necessary data, addressing the challenges posed by lengthy patient care documents. Laura underscored FHIR's role in providing relevant information to physicians and caregivers based on their specific needs.Pooja, the host, moves to the closing segment, asking cohost Jocelyn and guest Laura for final messages or calls to action. Jocelyn commends Laura on FHIR progress and highlights the importance of maturity and bulk FHIR for automation. She mentions an upcoming Da Vinci Community Roundtable discussion on the clinical data exchange FHIR guide and encourages engagement with Laura for early participation in payer use cases.Laura emphasized the profound opportunities with QHINs, including potential in public health and COVID response. Laura invites those interested in discussing the future of healthcare data and transforming patient care to reach out via LinkedIn, email, or to call her. Pooja expressed gratitude to guest, Laura McCrary for joining The Dish on Health IT and to listeners for tuning in. 

Prof. Emeritus Datuk Dr. Zakariah Abdul Rashid membincangkan pertumbuhan pendapatan isi rumah Malaysia pada 2022 (1.9%) dan peningkatan kemiskinan mutlak (6.2%) dengan menyentuh berkaitan projek rintis gaji progresif, menekankan kebolehpercayaan majikan dan kesaksamaan dalam kenaikan gaji berdasarkan produktiviti, dengan penekanan pada kajian impak sebelum menjadikannya mandatori.

Prof. Emeritus Datuk Dr. Zakariah Abdul Rashid membincangkan pertumbuhan pendapatan isi rumah Malaysia pada 2022 (1.9%) dan peningkatan kemiskinan mutlak (6.2%) dengan menyentuh berkaitan projek rintis gaji progresif, menekankan kebolehpercayaan majikan dan kesaksamaan dalam kenaikan gaji berdasarkan produktiviti, dengan penekanan pada kajian impak sebelum menjadikannya mandatori.

Civitas Networks for Health is a non-profit consortium that brings together a broad community of organizations interested in health data exchange. Many members are HIEs, but a number of other organizations in health care including community organizations are members as well. Civitas started only two and half years ago, but already have 165 members spread across the country. In this short video, CEO Lisa Bari describes the most interesting aspects of Civitas's recent conference. She said that people coming out of COVID-related isolation were eager to join workshops so that organizations such as HIEs, quality improvement organizations, and data collaboratives could achieve common goals.  That was on full display at the conference as each of these organizations connected and learned the unique approaches organizations we're taking across the country. Of course, we couldn't pass up the chance to hear Bari's thoughts on Trusted Exchange Framework and Common Agreement (TEFCA) and QHINs, the importance of both state and national efforts to improve interoperability, and how health data utilities (HDUs) are expanding and drawing in both public and private organizations. Learn more about Civitas Networks for Health: https://www.civitasforhealth.org/ Health IT Community: https://www.healthcareittoday.com/

Paul L Wilder, Executive Director of the CommonWell Health Alliance and Liz Buckle, Director of Product, discuss CommonWell's vision, achievements, and plans for the future.  Plus, Wilder shares what he was hearing about the Trusted Exchange Framework and Common Agreement (TEFCA) at the HIMSS 2023 annual conference and offers up a few takeaways.  Buckle also shares her experience at the Interop Showcase and details of the recent CommonWell FHIR Connectathon where CommonWell members leveraged FHIR to improve interoperability. FHIR, the API for automated data sharing, is mature and being adopted. This more recent standard makes trust automatable as well. To describe the current situation in health care, Wilder asked us to imagine if a retailer had to call your bank every time you made a credit card purchase. Wilder also dove into his experience with HIEs and how connectivity is key to public health and in preparation for future pandemics or other emergencies.  Buckle shared her experience from working for a founding member of CommonWell to becoming a full time employee in her role as Director of Product.  She aptly pointed out the importance of ensuring women and other diverse voices are in these efforts for the simple reason that we are all consumers of healthcare. She also pointed out how encouraging it was to see an even split of men and women in a meeting with candidate QHINs and federal partners. Wilder added that it is usually the mothers who carry the burden of tracking and managing health journeys for their family. The mom is the one who knows how hard it is to access elusive data and how important data sharing is. Learn more about CommonWell Health Alliance: https://www.commonwellalliance.org/ Find more great health IT content: https://www.healthcareittoday.com/

Overall, Coach Durden is in his 35th season as a head coach. This past year the Lady Wolves achieved a 23 and 5 record before being eliminated in the "Elite Eight" of the 6A state tournament. Durden's Lady Wolves have played in ten of the past fourteen state championship games, while winning the state titles in 2020, 2019, 2018, 2017, 2015, 2011, 2010 and 2009. Tim Slater is in his 3rd year at Grayson high school as Head Girls Basketball coach. He coached Lanier High school girls basketball team to the GHSA state championship in 2018-19. Coach Nichole Dixon is head girls basketball coach at Holy Innocents Episcopal School in Atlanta, GA. She has led her HIES program to 2 GHSA state championships and 2 Atlanta Tip-off Coach of the Year Awards --- Support this podcast: https://podcasters.spotify.com/pod/show/kevin-furtado/support

This week we hear from Angie Bass, Chief Strategy Officer with Velatura Public Benefit Corporation, an industry leader in providing HIT and HIE consulting, development, implementation and operation services across the nation. Angie offers insight on Health Data Utilities (HDUs), the differences between HDUs and HIEs, and why it's the next step towards interoperability and better public health. 

Jason Joseph, Chief Digital and Information Officer of Corewell Health, reviews the growing trend of the payer/provider model of care, HIEs, and the benefits of agile methodology.

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!

Geoff Fallon, VP of Clinical and Business Applications at MaineHealth, explores regional Health Information Exchanges and his experience migrating to the cloud.

 Afternoon, passion Creek. What a great day to be a part of this community. Amen. Exciting times ahead and as we prepare tonight for the word, let's take a look at Exodus chapter three. But Moses asked God, who am I that I should go to Pharaoh and that I should bring the Israelites out of Egypt? He answered, I will certainly be with you and this will be the sign to you that I am the one who sent you. When you bring the people out of, You will all worship God at this mountain. Then Moses asks, God, if I go to the Israelites and I say to them, the God of your ancestors has sent me to you, and they ask me, what is his name? What should I tell them? God replied to Moses, I am who I am. This is what you are To say to the Israelites I am has sent me to. Amen. Thank you Ron so much. If you guys can open your Bibles to that. In Exodus chapter three, we're just doing like a six part series on the life of Moses. And so, and leading up to, uh, when we we're finished, we're gonna be actually in the new place and we have a whole nother series we're really excited about as we start in the junior high. Uh, but Pastor Caleb, I thought did a phenomenal job last week. We learned, uh, many things, but one of the things in Exodus two is Moses, he did the right thing for all the wrong in all the wrong. , right? And so he was bothered by the oppression of his people. And so we see that he took matters into his own hands. He struck the Egyptian, hid him under the sand. And I don't, it seems kind of in the text, he wasn't particularly remorseful or guilty until he got caught. Uh, the next day, uh, the, uh, the Israelites were saying you were the one who murdered this Egyptian. And so what he does, kind of what all of us would do, he bottles up that shame and he runs away and he runs to the. So now we're back into the story where Moses' dreams are dashed. This royalty he was in the house of the Pharaoh, is now a refugee Moses, which actually means to be drawn out by water. This significant imagery of water is now stuck in a dry and barren desert. Everything his life thought was going to be is completely opposite. Now, what does he do? We actually learned in Acts chapter seven that Moses was in the wilderness here for 40 years, and at the 40 year mark, Moses noticed something out of the ordinary. Look at it mean. Look at it with me. In verse one of chapter three, it says, meanwhile, Moses was shepherding the flock of his father-in-law jet. The priest of Midian, he led the flock to the far side of the wilderness and came to Horrib the mountain of God. By the way, later, Horeb is also the same phrase for Sinai, which is where Moses gets the 10 Commandments. We'll probably talk more about that later in a few, uh, messages. Why does he say hob sometimes than Sinai and other, but it's pretty significant. Verse two, then an angel of the Lord appeared to him in a flame of fire within a. As Moses looked, he saw that the bush was on fire but was not consumed. We first need to give Moses props for noticing, right? Like most of us, especially today, we are so focused on getting attention that we never give enough space to give attention. Especially in our economy and our world of attention grabbing with social media. How many of us are even at a spot like Pastor Caleb said to practice last week? Silence and solitude. If Moses wasn't practicing silence and solitude, maybe he would've never seen this bush and maybe this story wouldn't have happened. Look at verse three. So Moses thought I must go over and look at this remarkable. Why isn't the bush burning up now? Scholars have long debated the significance of the burning bush. Lemme give you a few theories of what people think the bush and the fire represent. Uh, the first one is the bush is Israel and the fire is the oppression of Egypt. And so bush, uh, what's interesting too about Israel, that it's a very. Israel has always kind of mentioned as just common people. There's nothing particularly amazing about them, just that God chose them, which by the way, amen. Nothing particularly great about you, but God loves you and that's what makes you so great. All right, so the bush is Israel, and what's interesting here is the fire, which would normally do wet to a bush, completely dissipate it. Instead, the bush is still living. And it's a picture. Some scholars point to the fact that although Israel is in the midst of slavery and oppression with seemingly no way out, they're still strong despite being enslaved, despite them wanting to kill all of the sons, they're still here. Another example though of the bush. The bush equals God's imminence and the fire equals God's transcendence. These are big theological terms. Let me explain. Imminence simply means that God isn't just high in the sky. He is with us. He's present with his people in the most ordinary of circumstances in the most ordinary of ways. If you hear Christmas Eve, we talked about how Jesus is fully. Right. He is imminent. He is with us. You would assume God is in this special place up in a high tower, but instead his presence is with us even in the midst of something as common as a bush, but also the transcendence. The transcendence points to the power and holiness of God. So the fire is something altogether, not like we're used to. God is not someone to be trifled with. He may be in the ordinary, but do not. He is not like us. He is not even just extraordinary. He is holy other than us, which again, kind of points to Jesus. He is fully man. God's imminent with us, but also he is still. Jesus is fully God worthy of our worship and praise on his holy other than us. One more theory. That. I think, by the way, this is like the main reason why it's the bush and the fire. But one more that I think is really interesting. Uh, pastor Caleb has me in, not really, but getting me into more and more, uh, where is he? A Greek Orthodox art . Oh, he's fixing his guitar. I call them out the worst time. Yo. Okay, so he has me looking into Greek Orthodox art more, which is weird. Don't do it. But what's pretty fascinating is Mary, there's a picture of Mary and she is painted as if. Fully consumed, not consumed, but surrounded by fire. And so the bush equals Mary's womb and the fire equals the presence of Jesus. And isn't that amazing like a bush? Mary is just an ordinary woman, but extraordinarily used by God. And in the God of the Old Testament as we read, God is so holy and unlike us, typically, if you encounter God, you die at the spot, and yet God in His grace doesn't consume. Mary is preserved and Mary is used for the story of God. Anyways, that'll preach, but let's keep going. Verse four, it says, when the Lord saw that he had gone over to look, look at that he noticed. He's responding to Moses's attention. God called out to him from the bush, Moses, Moses. You see this throughout the Bible when they say the phrase multiple times, it's to get someone's attention, but it's also affectionate. If you see like Jesus, he always says, Peter, Peter, it. It's actually a sign of love and a, it's almost like saying, Hey, look in my eyes. And so Moses replies, here I am. He answered, do not come closer. He said, remove the sandals from your feet for the place where you're standing is holy ground. So then he continued. I am the God of your father, the God of Abraham, the God of Isaac, and the God of. Now you have to recognize this is news to Moses. Moses has been an identity crisis. He was born a Hebrew, but raised in Egyptian. So when a God appears the God and says, Hey, I'm the God of your fathers, he must be thinking, which one? I don't know who I am the God of Pharaoh. Or the God of Abraham, the, the story of those, uh, of, of that lineage. He doesn't know who his dad really is. And so God here is already giving him an assurance of who he is. No, your father is the God of Abraham, the God of Isaac, and the God of Jacob. And so Moses hit his face because he was afraid to look at God. This is to insinuate how powerful in the presence of God in this moment was, was overwhelming. So then the Lord said, I ob observed the misery of my people in. And I've heard them crying out because of their oppressors. I know about their sufferings, and I've come down to rescue them from the power of the Egyptians and to bring them from that land to a good and spacious land. A land flowing with milk and honey, the territory of the Canaanites, Hittites, Amorites, parasites, HIEs, and Jes. So because the Israelites cry for help has come to me, and I've also seen the way the Egyptians are oppressing. Therefore go, I am sending you to Pharaoh so that you may lead my people, the Israelites out of Egypt. So first we have to see this passage says more about God than it does about Moses. First of all, God didn't pick Moses because he's perfect. It's not like Moses all of a sudden because he was in the desert for 40 years as this perfect human being. Instead, we see here that God's just a God of grace, and in his gracious choosing, he chooses Moses. Also, we see God doesn't have to. God is right for just not intervening because God is God. He doesn't need us. He doesn't owe us anything. And so the fact we even read in the Old Testament that he's calling them my people, that he feels their, their, their cries and, and wants to come down. This is a personal God. This is a God that nobody had ever heard of, especially in the ancient Near East. No one imagined a God like this who's so extremely personal. But also we have to see here in this text, God doesn't need any of us. He is wholly self. We're about to see in verse 14. He has that phrase, I am. I am who I am, Yahweh, which means this. In his kindness, God is inviting Moses. Look, verse 10, therefore go. He's inviting Moses to have a part to play, not because he needs Moses, but because in his grace he decides to use him. And that can be the same for you and me. God does not need us, but in his grace, he invites. To be a part of his mission, but I do want to, so there's, I, we can literally talk for eternity about God and his character and what we even see just in this passage. But I also want us to use this moment to, to what does this mean for the life of Moses now? Now, quickly, it's likely Moses was never expecting a word from God, and there's three reasons why, uh, should be on the screen. Number one, he's a murderer. Right, so God is holy. We are not, and and God in his holiness cannot be approached, especially by someone who as sinned so much that he murdered someone. So Moses is carrying around this shame, and so he is not imagining God coming and intervening. The second reason is the last time God spoke was 400 years prior. Anybody else noticed the significance of the 400 year gap of silence? Where else did that?  between the old and the New Testament, right? When Jesus was introduced, when, when the angel came down and said, I've become to bring good news, there was a 400 year gap of silence. We also have it here. And so the last time God spoke to his people was to Jacob to go to Egypt, and that one day they will be rescued and sent to the promised land. But now that's been 400 years. So Moses doesn't know anyone who knows anyone who heard a word from God. So he's not expecting it. And number three, he's in the middle of nowhere. Midian is a desert in the ancient Near East Place meant something. I actually think we can do a great service to us if we begin to recognize the significance of a place. I think one reason why our souls are so distraught and disconnected is we never stay somewhere long enough. , right? There's something beautiful about planting roots and just being who you are with the people who are around you, whatever those, whoever those neighbors are. But anyways, he says he names his son in Exodus two. He's, he names his son, gosh. And gosh, literally means I am a foreigner in a foreign land. What's Moses saying here? Saying, I'm lost? My son represents this season of life, and in this season, nobody knows who I am and I don't know where. So he is thinking, God won't speak to me. He has no home. Moses has no security. Moses has no identity, and by this point he is in a deep identity crisis. In fact, one could argue he just has given up to even figure out who he is. Is Moses like pastor Caleb mentioned last week. Is he an Egyptian or a Hebrew? Is he special? Or is he just a shepherd? Is he a deliverer or is he just a murderer? Is Moses chosen by God or just forgotten by God? And I imagine you are well acquainted with this type of crisis. And I know , I know I am right, but this crisis is way too important for us to brush off and distract ourselves. And I think that's the grace that Moses had getting to the desert. He had nothing to distract himself and now he had to encounter God. Now, the world today, we'll call this identity crisis, but here's what the crisis really is. Write this down. The crisis of knowing self and knowing God, these are two equally important crises, that for some of us, it's why we are so disintegrated, so depressed, and so. There's been a lot of theologians throughout history who have claimed that these two things are the most important tasks to partake in the journey, to partake in, uh, for us to really live out what God has called us to German theologian, a meister I Eckhart, he said the following, he says, no one can know God, who does not first know himself. Sounds a little new agey, doesn't it? What's going on here? No, we need to know ourself. How about the 15th century Spanish nun, St. Teresa of Avila, where we get a lot of our stage theory of the Christian life from? She says, almost all problems in the spiritual life stem from a lack of self knowledge. Now, let me give you one more person, which may most people, if you, if you're a theology nerd in the room, you would never guess he would say such a thing. Reform theologian, John Calvin. He said the following, our wisdom consists almost entirely of two parts. The knowledge of God and of ourselves. He actually goes on to say, but as these are connected together by many ties, it is not easy to determine which of the two precedes and gives birth to the other. So in other words, do you try to know yourself first or you try to know God first? And John Calvin says, yes, it is a journey that goes together hand. And so this journey, this process is what I would call is the egoic journey, the journey of the ego, figuring out who you are and what God's called you to. So there are stages if you, if you're around passion Greek, you know, we love this stuff. But there seems to be throughout the biblical text, throughout just life in general, there seems to be stages of your journey in figuring out who you are. And in so doing, also figuring out who God is. Now, most of us begin here at stage one, which is the conceited. This is the blessing of being young, by the way, cuz you don't know any better. You're just ignorant and you think you're awesome. , God will fix that. But anyways, concede itself. What happens when you're conceited is a simple reality and it's okay. Life hasn't beat you up enough. And so there's still something in you that says, I can figure it out. I have the power. Just give me the control. And in God's patie, You'll see throughout the Bible, God uses conceited people for some pretty extraordinary things. Now, he beats out that conceit, but he uses them. Think of the story of Joseph in his arrogance, tells his brothers about how great he is and how they're going to worship and serve him. One day he's conceited. That was not the point of the vision, but God still used them. Moses in his conceit, saw the Israelites hurting and he thought, I'll take care of this. Let me just kill. Conceited, and this is what happens. And here's what, what. Here's different ways you can figure out if you're conceited. And it's okay. There's grace in this room. Let me just say quickly. This has been a lot of my life. All right, so the conceit itself finds identity in one of three ways, or possibly all three. First off is performance. So some of us, we think I'm great because of what I do. Right, so you'll see this a lot in the sports world, in the career world, right? I'm just really good at this specific task, and let me just say, it's great to have pride in what you're doing. I think that's totally fine, but you cannot base your worth off of what you're doing. See the difference there. What's hard though is some of us we're so good at what we do. It's a pretty good idol. You're pretty satisfied for a while because you work hard and you get paid. The second way that the conceit itself finds its identity is in possessions. I'm great. Maybe not for what I do, but I'm great because of what I have. Some of you have won the lottery, like literally, if you have talked to me, we're trying to get a church building. You know what? But possessions wise, right? You find your hope and satisfaction on the things that you own, right? You actually compare your worth and value by comparing what items you have versus what items they. This is all good and dandy until that no longer works, right? Or the third one is popularity. I think some of us have actually never graduated from high school, right? All of life is who's at the popular table. So I'm great because of what others think of me. Social media has taken that and cranked it up to a hundred. You can now people say your value is based off how many people follow. Like I have people, I have a YouTube channel, been slaving over it for six years. I have this, it's a steady amount of subscribers, but oh, the judgment. When I tell people how many subs they have, they go, oh, hmm, okay, and move on. And you're like, no, I'm worth more than what you think. You know, like this is a thing. Popularity, the conceited self runs to this. And the reality is is Moses could actually run to at least several of these popularity. He was in the Pharaoh's home possessions. He was in the Pharaoh's house. And so this probably helped, you know, boost his ego, but by the grace of God, and here's what happens. If God is so gracious to you, God will meet you at a moment where you have been completely stripped of all your arrogance and conceit. God does this many different ways. I think one way, God, we as a church went through the Book of Ecclesiastes last year and I, and I think that's a huge way God can grace you with a sense of exhaust. You're just exhausted. Like possessions. Just they, they never satisfy performance. There's always somebody better popularity. I'm never enough. And so the chase isn't fulfilling, and so if you're here for the Ecclesiastes series, you just kind of say, heaven, it's useless. You have it all and you still need more. Or God can grace you, not with exhaustion, but with embarrassment. There's maybe a moment where you are publicly humili. You lose everything, someone takes over the spotlight. Or like Moses, you take it a step too far and wind up murdering someone and having to run away. So Moses was the conceit itself, and he ran away embarrassed and ashamed. And after the beat down, if you and I are given the Grace Long enough, what typically happens is we now enter into the desert of the defeat. Your wounds have stacked up against you. Your opportunities have slipped away from your fingertips. Those relationships were not based on love, but on a contract on performance. And you are now left alone. And if I can be honest, I am much more acquainted with this one in more recent. And as I wrestle with this text and as I've been praying about us getting victory over the defeat itself, I have to acknowledge moving on from here does not happen quickly, nor does it happen easily. Let me give you some examples. What does it mean to be the defeat itself? Maybe you're in the room thinking, is this who I am? Well, here's how you can know. The defeat itself finds its identities in one of three ways. One is victim. , right? You live your whole life. If others knew how hard I had it, your, your identity is your illness, right? You just tell everyone how bad you have it, and that's how you find hope. You're defeated. Your hope isn't in victory. It's in being a victim. The second thing is vengeance. The defeated self thinks, okay, if I can just make them feel the pain that they made me feel, then I'll be. So you're living really an operation of defeat. You're bitter, you're looking to the past, not to the future. And this next one honestly, is a word that I haven't heard until recently and I'm hearing a lot of psychologists, experts, uh, mention. It's, is voyeurism. Voyeurism at its most basic element is just finding pleasure and watching others do what you can never do or what you would never be brave enough to do. Not, it's worse. Voyeurism can be uh, things like watching things online, but it's also just in being a fan of, of, of a football team. And your whole life is just about that cuz you can't find victory. So you just watch others do victory while you sit on the couch. That's the defeat itself. And to be honest, I know that we get so annoyed with, with young men being so conce. But I think some of us, we just put them to the defeated realm and we just leave 'em alone. Men, we, we need to have a journey to go towards, right? It's not a victory that many teenagers can't even think of what life could look like, and so many have committed suicide. So many have no future because we have made sure to tell them how terrible this world is, how terrible they are, and then we wonder why we're in the mess. So, so many men, and I'm speaking to that just cuz I'm a man if you didn't know. Um, voyeurism is a huge, huge thing that men are running to. They've raised their white flag and they just wanna watch somebody else be victorious for them. Now Moses, he, he had a lot of emotions to process in the desert, right? Victimhood, maybe thinking, man, they don't understand why I did that. Right? I murdered that guy because I wanted to save them, but now they were mad at me, right? Vengeance. Man, I need a man. Look what the Egyptians have done to me. Look what those Israelites have done to me. But they don't know, right? And they're stuck. And we're honest with ourselves. You and I are well acquainted with this cycle of being conceited and then being defeated and then having enough self illusion we are conceited again, and then we get defeated all the more. And the reality is, is without God, you are either conceded or. But God can step in sometimes in a burning bush moment and flip things around. What's what's fascinating is today, technically it's on Tuesday, but today is our seven year anniversary as a church.  and, um, it is entirely not gone the way that I planned at all on the five year vision board or the 10, or even the two. And so the ver the first few years and some of you in the room you were there, um, I, I would say I was clearly the conceited self. And the reality is, is, uh, church planning book I read last year has said that. I think every single church planner is conceited or else they would be too wise to not plant a church. Uh, but we're so arrogant we think, no, we can do it. Okay. The stats are 90% failed. Yeah, but I'm like, the 1%, you know, I'm the greatest, so let's do it. And so God in his grace somehow does that. And so this journey of planning a church has been humiliating. It has been slow, so slow, way slower than I thought. And um, for the first few years, I would just give myself a pep.  or I go to Disneyland, , and then we would move forward. But eventually that exhaustion and that embarrassment got to me. And as I look back at my life, like I I, I had this moment where I looked at Jordan and I said, look, the more effort I put in doesn't equal more success. And that's frustrating, right? I try harder, but get almost the very same or even less results. What do I. . So the last few years has really, I know some of you're like, Trey, you, you're too vulnerable. Whatever. The last few years has like broken me like, um, it's been hard. I think it's hard for all of us. I'm only sharing this because I want to identify with the story, Moses, and hopefully it's helpful to you. But I think what, what I've noticed is I've kind of shifted from conceit itself to defeat itself, and it is very, very hard to lead when you are defeated. Man. I even think about last year I went from like full of energy to just fighting for any amount of energy. And so I found out about this thing called coffee and I was like, whoa, this is how humans actually exist. This makes sense to me now. And then I found out about monsters and I was like, wow, like how did I get through college without these drugs? Uh, and so, but I went from. So much energy to like needing substances to push me forward. I went from clarity. You would, if you would ask me ever, like, what's your five year, 10 year plan? What? Oh, I would have all the answers. I went through a season where I was confused. I don't know. I just know my Bible's right, so let's just keep reading it. One more. The, the biggest thing I found from going conceited to defeated, um,  in the first few years, I, I loved my sermons. Like I would watch him again and go, why aren't more people listening? You know, like, come on. Did you hear that rhyme? You know, And now, like I despise them. And every week I walk down and go, what am I supposed to be? An artistic, like graphic designer? You know? Like, I'm just like, what is my purpose in life? And, and what's been so helpful, and this all has a purpose besides like making sure you never look at me like a strong leader ever again. But part of this is recognizing this is the journey of the Christian life. This is a part of. I read Hebrews, uh, 10 through 12 this morning, and in it he says, no. Listen. Listen. God disciplines, those he loves, like God in his mercy actually makes life hard on you because he's teaching you this thing called faith and perseverance and humility. And even like for me, man, two years ago, I would've said a sermon on identity would've made that would've made me. Quit struggling. You know, like I would always make fun of people like, you know, the friends who say, I just need to go across the world to find myself. I'm like, that's not gonna help. You know, like, you're right there, you know? But now I'm like, I kinda get it. Like, anybody got a ticket? Let's go to Malaysia. I don't know, let's figure something out. You know? And this struggle, like the dark fog of the unknown. And, and I hesitate to say this, but I, I really do feel like we're entering into a new season as a church and in my own life, and it's very exciting. And now I, I believe clarity is coming back and opportunity and favor in ways we've never seen before. But, but what, what I've learned, and I think what Moses is interacting with here, is you cannot skip the desert. The reality is, is God will keep you in the desert as long as he needs because he loves you. Here's the good. God's deliverance is imminent. When you accept, you are limited. This was the burning bush moment for Moses. God had to wait until Moses was at this beautiful crossroads of knowing. Man, I can't do it all by myself, but man, I still wanna do something good. H, how do I, I need God or else I can't. Well, I need to do something. See, Moses had to get to the end of himself so that he had the eyes to see God. Look at verse 11. This is how God now introduces himself. So, so he says, Moses, ask God, who am I? Who am I that I should go to Pharaoh, and that I should bring the Israelites out of? Look how he answers. He says, I will certainly be with you. That's all you need to know that I'm with you, and this will be the sign to you just to comfort him. I'm the one who sent you. When you bring the people out of Egypt, you will all worship God at this mountain. You know this mountain? You keep walking around for 40 years. There's a purpose I've been, this feels useless. But this mountain here was always here for the future. You just never understood it until now. This is the sign, the very fact where you're sitting, standing, I'm gonna give you the 10 commandments in the law, verse 13. Then Moses asked if I go to the Israelites. So he is still kind of like that defeated itself. Like, okay, uh, well what about this? What about that? So now he says, if I go to the Israelites and say to them, the God of your ancestors will send me to you, and they ask, well, what's his name? What should I tell them? These are the most two simple questions we always ask. Who am I? And God, who are you? So God, in his grace answers, God replied to him saying, I am who I am. This is what you are to say. The Israelites I am has sent you this. This name means Yahweh. This is He always was. He always is. He will forever will be. Don't worry, he has this in his hands.  look at the two gifts, even just in 11th through 14 that Moses has given. Number one, Moses is given the gift of a limited self, not conceited, not defeated, just limited. See, God doesn't call him up to be strong and mighty. Again, that's exactly what the conceited self wants to hear. But also notice God doesn't like cast him out for failing to live up to God's standards. That's what the defeat itself expects to. Instead, he's saying, Moses like, who am I? God is saying, Moses, you're limited, but you're anointed. You're limited, but you have my presence, so it's gonna be good. Other passages say, I am who I am. Other people translate as I, I will be who I will be. You just watch. You just wait and see. And that's the second thing He, he's given the grace of a covenant God. So who am I? I'm. God, who are you? God's a covenant loving, faithful God. Time and time again, God is saying, I will be with you. Moses says, but what about this? He says, I am with you. I will go before you. I am your power. I am who you need me to be, but God, who are you? I'm the God of mercy. I'm the God of faithful, never-ending. Love. Love. And this is where the egoic journey eventually leads us to. It eventually leads. These are the two questions I want us as our response time to think about, to pray to meditate, maybe kind of just spend some time with God is this first question, will you accept who you have actually become? Now to the conceit itself, you're not as great as you think . Just accept who you really are to the defeat itself. Hey, actually, God's doing a lot more in your life than you. You're just limited. You're one human and that's actually such a grace. I want you to wrestle with that question this week. Will you ex, will you accept who you have actually become? This is especially true for those of us on the back half of life. The saying goes, young people are only nice cuz they keep thinking one day they'll be nice. Right? They have expectation. They'll actually. Will you accept who you've actually become? Will you get really honest the things that have been done to you? Will you just accept that? Realize this is always, this trauma is a part of my story. James K. Smith, he wrote a book, wait, it's, it wasn't that great, but he had a line in there that I thought was so good, talking about the grace of just recognizing who you are and being okay. It's not on the screen, but I put it on my notes this afternoon cause I think it's so good. It says, grace is not a time machine. Grace is not a reset button. I think that's what we want. We come to church cuz we don't like who we become. So we want the reset. It says no Grace is something even more unbelievable. It's restoration. It is reconciliation of, and despite our histories of animos. Grace isn't an undoing, it is overcoming. Isn't that interesting? When Jesus rose again on the third day, he still had the scars. See, when we talk about come to Christ, come to the cross, come to His grace, we're not saying we reset everything that's ever happened in your life. But the reality is, is there is a resurrection that. The pain is now being resurrected into something beautiful. The brokenness is being resurrected into something powerful. This wandering by Mount Ho for 40 years is now being resurrected to where this is the very place where people will encounter God and the ethics of all of Israel will be set throughout all eternity. What he does is God isn't looking to reset, to ignore. No. He is taking all your pain and all your hopes and dreams, and what he wants to do is for you to come to the end of your. Clinging to the cross of Christ, receive him, surrender to him, trust him, and in his power. What he does is he takes your history, he takes your pain, he takes your sin, and and the very things he used to struggle with, the things that you hate about yourself now through the resurrection, gives you a grace to be a source of love to those people who you once were. You now have greater empathy. You now have greater patience and love and purpose and courage. This is all according to his plan. The second question you have to wrestle with, that you have to get honest with is will you surrender to who God actually is? Man, God is way more personal than you've ever imagined. Look at the text. God is way more holy than you'd ever expect, but God is so much more loving than you could ever hope for. Will you surrender? Will you surrender to him, Phil led, just to kind of just sit there. Will you actually accept who you've actually become and will you surrender to who God actually is? What we're gonna do this week in your together groups? We're gonna put forth, we're trying to think through what's a practice here that can help you kind of have a burning bush moment And just thinking through the daily examine. It's a, most of this just go on the, on the group guide on the website, but quickly it's an exercise where you just review your day and you say, okay, where's all the bad stuff? What was all the gracious stuff? And, and just thank God for it. And we wanna do is actually, as you start groups again, this week, pastor Caleb's done a great job of doing a a decade by decade. What, what we wanna invite you to do is to, to look at your life a and and to ask for the spirit's guidance and get honest and accept your past failure, decade by decade. Writing him down, but then recognizing and accepting God's grace throughout all of that decade by decade and giving thanks to him. I'm really encouraged for us to do that, but again, I want us to, Which question are you wrestling with most? Will you accept who you've actually become? Cuz God doesn't want to work with your idealized self. He wants to impact and work with your real self. And will you surrender to who God actually is? Way more loving than you'd ever imagined. Way more gracious, personal, holy. And it's that intersection. We can have a burning bush moment that sets. Towards a purpose and mission for the rest of our life.

From WEDI's National Conference this past October in Washington DC, Civitas Networks for Health's CEO Lisa Bari hosts an engaging panel on the power of Health Information Exchanges with Nichole Sweeney, General Counsel and Chief Privacy Officer for CRISP and Elizabeth Killingsworth. General Counsel and Chief Privacy Officer for Manifest Medex.    Learn more about HIEs and Civitas Networks for Health at https://www.civitasforhealth.org/

When you go to see a doctor, nurse practitioner, physical therapist, or one of many other healthcare professionals, your health information is typically stored in a secure electronic patient chart. This allows for the collection of comprehensive health information and continuity of care for each patient. However, pharmacists in community pharmacies typically do not have access to this information and rely heavily on prescription fill histories. With the advanced training pharmacists receive today, can this critical information be shared with pharmacists in a way that protects private health information while also enhancing the services that a pharmacist is trained to provide? In this episode of DISRxUPT, Dr. Cathy Kuhn, manager of clinical programs for Custom Health, joins us to discuss how health information exchanges (HIEs) may be a solution that provides pharmacists with all the health information needed to provide advanced clinical services, including chronic disease state management, test-to-treat services, and many others. Listen as we discuss how HIEs can enhance the role of the pharmacist as part of the interprofessional care team for patients.

For the 43rd episode of the CIO podcast hosted by Healthcare IT Today, we sat down with Henry Vynalek, Director of HIE & IT Operations at Ohio Health Information Partnership. This time we're diving into the world of HIEs! We look at what the IT stack looks like for an HIE. Next we discuss the […]

Identity management is one of the top problems HIEs face today. There are numerous complications that happen when you try to ensure the identity of a patient. To better address identity management at SCHIO, Dan Chavez, Executive Director of SCHIO (Santa Cruz Health Information Organization), turned to Verato. We had a chance to catch up with Chavez at the DirectTrust and Civitas conference to learn more about this decision. Learn more about SCHIO: https://www.santacruzhie.org/ Find more great healthcare IT content: https://www.healthcareittoday.com/

In this episode, Melanie sits down with Lee Barrett, Executive Director and CEO of EHNAC, a national healthcare accreditation organization. Previously, he was the President and CEO and sat on the board of directors at HealthEC, a consulting and solutions provider of products for ACOs, Population Health, HIEs, web portals, EMR and transactional platforming. As a health IT and security guru, Lee has plenty of thoughtful perspectives to share on data privacy, cyber security and tech innovation in the healthcare space. He explains how we've come a long way as an industry in providing a level of support and assurance for stakeholders, and why stakeholder trust is the name of the game in the industry today. Lee also shares his perspective on what's on the horizon for the future of the industry, including in areas like telehealth, medical devices and cryptocurrencies.

This episode features Brandon Neiswender, VP & Chief Strategy Officer at CRISP Shared Services (CSS). Here, he discusses CSS, a nonprofit support organization that provides technology infrastructure for HIEs, the evolution of HIEs, his focus on health equity, and more.

Interoperability. Let's just review a few key points that probably everybody listening knows but certainly bear repeating because they matter. I don't want to dig into the technical or regulatory details of interoperability. That is above my pay grade. But I want to talk about the really important stuff that maybe doesn't get talked about a whole lot because you say the word interoperability and it's like the magic word that transports the unwary into the land of shadow and smoke and mist. It's like a self-published YA (young adult) novel half the time. But let's start here: First of all, consider that a lot of healthcare these days is conceived of as a scattering of micro-moments. It's not even like we think of patients one at a time. We think about patients one ICD-10 code at a time. And we think about those ICD-10 codes in 20-minute increments whenever a patient happens to show up in clinic. The average Medicare patient these days sees five specialists and more than one PCP a lot of times. So, we're not only breaking that patient down into codes per minute or something, but this is further broken down by clinician or practice. Now consider that everybody knows—and when I say everybody knows, I mean it's inarguable at this point—health happens at the whole-patient level, at the whole-person level, more accurately. It happens at the community level: 80% of patient outcomes are going to derive from what that patient does when they leave the office and whether they are able to and health literate enough to construct a reconciled treatment plan for themselves from the bits and pieces of information they've received scattered all over the place. You know in Star Trek when someone gets into the transporter to beam down to a planet and their whole body splinters into a gazillion little pieces? That's how our healthcare industry treats patients. They are frozen in that moment and rarely, if ever, become whole on the other side. So, when we talk about interoperability, what we're really talking about is a means to an end. What we are discussing is creating the ability to treat the whole patient or—Heaven forbid!—consider the whole community because we have enough data that we can accurately and adequately see the whole picture. We are able to avoid prescribing a treatment that is dangerous to the patient, inefficient, duplicative, or low quality—which is what happens over and over again. It's no amazing surprise that our healthcare industry wastes $1 in $4 we spend and doesn't net outcomes that are great in almost any respect when compared to other countries. Let me say this more bluntly, as if that wasn't already pretty blunt: If I don't know relevant and important details about my patient, then I cannot consistently deliver care that is high quality, safe, or cost conscious due to service duplication or uncoordinated care. I mean, how is anybody supposed to deliver evidence-based care when a lot of evidence may or may not be missing? So basically, without interoperability piping in the right patient information, I cannot succeed in any risk-based arrangement, right? If care provided is consistently lower quality, uncoordinated, unsafe, or inefficient, how am I supposed to optimize my care delivery? Said another way, interoperability is essential for anybody who wants to succeed in a value-based arrangement. I need all the data on my patients, and I need it in a way that I can separate the signal from the noise. Of course, getting 40 pages of duplicative SOAP (subjective, objective, assessment, and plan) notes that are semi-accurate and that no one bothers to look at is just unhelpful. Quick counterpoint: FFS (fee for service) loves siloed data. You know how much money everybody talks about could be saved if we eliminate duplicative services? Well, that's how much some fee-for-service health system is gonna lose if you make it easy for clinicians to see that the patient already got that CAT scan. So, in sum, interoperability is essential to high-quality, safe, and efficient care. A mark of a health system or provider practice who is really committed to patient outcomes is going to be their commitment to share data. The world has moved from a “Hey, you're permitted to share data if you really want to” to a “You are obligated to share your data.” And right now, I am loosely quoting Micky Tripathi, PhD, MPP, who is the ONC's (Office of the National Coordinator for Health Information Technology) national coordinator and also the guy in charge of TEFCA (Trusted Exchange Framework and Common Agreement) and implementing the provisions against information blocking that was in the Cures Act Final Rule last year. In this healthcare podcast, I am speaking with the perfect person about interoperability, and that would be Lisa Bari, who is the CEO of Civitas Networks for Health, which is a national collaborative working to improve interoperability in this country to improve health. Since interoperability is a huge topic, what I wanted to understand from Lisa most particularly are: Who are the current roster of players in the interoperability space? Like, what is going on there? Lisa told me that there are four main groups of interoperability folks—EHR (electronic health record) systems; APIs (application programming interfaces); HIEs (health information exchanges), both profit and nonprofit; and then others like clearinghouses, etc—which we talk about in some detail in this episode. We also discussed Larry Ellison's bold proclamation that Cerner is going to build one national medical records database. It's almost like Larry made it through the “welcome to the healthcare briefing” packet that his team gave him and immediately concluded that the interoperability problem is a technology problem, not a business case, fee-for-service, workflow, no universal ID, human, organizational, or government problem. Lisa adds some fidelity there.  Also, TEFCA … we talk about what it is and what it's not. Short version: It's a framework so that no one can say they won't share data lest they get in trouble in some way. At the same time, it's not gonna solve, as Lisa puts it, “the last mile of interoperability,” meaning it's not going to put the right information in the right clinician's hands at the right time. It just governs getting data from one organization to another organization but kinda has nothing to do with the clinical workflow, so to speak. The Civitas Networks for Health annual conference, by the way, is coming up on August 21-24 if you are interested in going.  You can learn more at civitasforhealth.org.  Lisa Bari, MBA, MPH, is the inaugural CEO of Civitas Networks for Health, a national nonprofit member- and mission-driven organization that was previously known as the Network for Regional Health Improvement and the Strategic Health Information Exchange Collaborative. Civitas counts over 100 multi-stakeholder-governed regional health improvement collaboratives and health information exchanges as members and creates national opportunities for education and community building between its members, policy makers, and business partners. Their upcoming conference (August 21-24, 2022, in San Antonio or via livestream) focuses on the theme of data collaboratives and information exchanges creating the critical infrastructure for health equity. Previously, Lisa was the health IT and interoperability lead at the CMS Innovation Center, working on primary care innovation model policy, and additionally has a background in health IT marketing and strategy. She holds an MBA from Purdue University and a Master of Public Health in health policy from the Harvard TH Chan School of Public Health and serves on the boards of directors of HealthCare Access Maryland and the Zorya Foundation.  06:30 How does value-based care depend on interoperability? 07:38 Why is it really important to exchange information at the right time with the right purpose? 08:00 What is one of the easiest low-hanging fruit to achieve in value-based care? 09:42 What are the four kinds of companies getting into the interoperability space? 11:51 “As we know, there's sort of technical interoperability … and then there's semantic interoperability.” 12:59 Where are we right now with EHR basic interoperability? 15:33 Who should ACOs hire to get the right data at the right time? 17:00 Why is it important to delineate the different types of HIE? 22:09 What can ACOs assure with interoperability? 22:59 Is the demand among ACOs for interoperability there? 24:04 “If you're in value-based care, you better care about what's happening outside of the healthcare setting.” 24:36 EP108 with Chris Klomp.26:25 “Every couple of years, someone talks about creating the ultimate database to rule them all. … It hasn't happened yet, and I don't think it's going to happen.” 26:56 “The difficult thing about healthcare data … interoperability … is an organizational and a governance problem.” 28:49 “You've gotta start with the incentives … and then you do have to say … ‘We are not gonna hoard any more data.'” 29:10 What is TEFCA, and how does it fit into this interoperability conversation? 32:17 “I think partners are trying to solve for value and outcomes.” You can learn more at civitasforhealth.org.  @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth How does value-based care depend on interoperability? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth Why is it really important to exchange information at the right time with the right purpose? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth What is one of the easiest low-hanging fruit to achieve in value-based care? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth What are the four kinds of companies getting into the interoperability space? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “As we know, there's sort of technical interoperability … and then there's semantic interoperability.” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth Where are we right now with EHR basic interoperability? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth Who should ACOs hire to get the right data at the right time? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth Why is it important to delineate the different types of HIE? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth What can ACOs assure with interoperability? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth Is the demand among ACOs for interoperability there? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “If you're in value-based care, you better care about what's happening outside of the healthcare setting.” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “Every couple of years, someone talks about creating the ultimate database to rule them all. … It hasn't happened yet, and I don't think it's going to happen.” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “The difficult thing about healthcare data … interoperability … is an organizational and a governance problem.” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “You've gotta start with the incentives … and then you do have to say … ‘We are not gonna hoard any more data.'” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth What is TEFCA, and how does it fit into this interoperability conversation? @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth “I think partners are trying to solve for value and outcomes.” @lisabari of @civitas4health discusses #interoperability on our #healthcarepodcast. #healthcare #podcast #digitalhealth   Recent past interviews: Click a guest's name for their latest RHV episode! Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas, David Muhlestein, David Scheinker, Ali Ucar, Dr Carly Eckert, Jeb Dunkelberger (EP360), Dan O'Neill, Dr Wayne Jenkins, Liliana Petrova, Ge Bai, Nikhil Krishnan, Shawn Rhodes, Pramod John (EP353), Pramod John (EP352), Dr Eric Bricker

John Kansky, president and CEO of Indiana Health Information Exchange, discusses how statewide and regional exchanges have evolved during the pandemic – and predicts where they're headed next.

Ken Kleinberg, Practice Lead of Innovative Technologies at Point-of-Care Partners (POCP), and host of The Dish on Health IT kicked off the episode by welcoming co-host Jocelyn Keegan and our special guest, Gabriela Pelin, Chief Innovation Officer with Avaneer Health. This episode will feature a discussion on how Avaneer Health is establishing a trusted network to streamline health care processes, the technology they're using that significantly includes blockchain and the vision they have for the industry. Ken explains that he first met the folks at Avaneer, a couple of HIMSS conferences ago and he's been excited about the work they're pioneering ever since.Jocelyn Keegan, Payer Practice Lead at POCP introduced herself explaining that she is a devoted change agent focused on getting stuff built and done for real. She went on to say that her focus, at POCP is on interoperability, prior authorizations, and the convergence of where tech standards and product strategy happens. Jocelyn also conveyed that she is the program manager for Da Vinci Project, which is probably one of the most expansive FHIR accelerators to date. Jocelyn explained that she is excited to hear from Gabriela and the work that Avaneer is doing, especially with the introduction of technologies like blockchain into the space. Guest, Gabriela Pelin thanked Ken and Jocelyn for having her on and expressed excitement to be part of the podcast. She began introducing herself explaining that her career seemed to constantly land her in the middle of transformation or innovation. Gabriela went on to say that luckily, over the past three and a half years, she stumbled over blockchain technology. She discovered that blockchain is a fascinating technology that enables people to work together. Her drive for innovation was immediately stoked and she was propelled to understand it. She went on to explain that Avaneer has many people at the table from very influential payers and providers who are all very interested in how to make progress in applying blockchain in healthcare. Ken then asked Gabriela to give a high-level overview of Avaneer health, their founders, participants, targeted use cases, and the network being established. He explained that he thinks most listeners will likely be wondering if Avaneer is like a clearing house or other entity already out there.Gabriela explained that the founders of Avaneer talked for a long time with founding network members about the purpose of the work, why the network needed blockchain and what about the industry needed to change. Each discussion brought them back to wanting to improve the patient experience and outcomes because each person either has been, will be or have a loved one that is a patient and that it was imperative to improve the overall experience and outcomes because all people deserve better. Gabriela went on to explain that the health care market is notorious for discrepancy in interests between the different players in the market, and they don't necessarily naturally work together to solve broader, industry problems. Avaneer wanted to create a network that would allow these stakeholders to come together to fix these issues for all patients and their families. Avaneer wants to reimagine the industry, and all of the steps in the back-office administration and care delivery so that we can accelerate healthcare, Gabriela explained that this is how they came up with the idea of connect once and consume many solutions, many use cases and connect direct. Moving forward, Avaneer wants payers, providers, pharmacies, clearing houses, really anyone needing to exchange clinical and administrative data to be part of this all-inclusive network so that everybody can connect directly, and we can make a difference for people.Ken then asked for Gabriela to list founders and members, and to describe some of the use cases Avaneer is tackling first.Gabriela explained that Avaneer has payers like, Anthem, Aetna, CVS, and HCSC. Those organizations are considered visionaries in terms of the different projects they take on to move the market and make a difference for their members. Cleveland clinic, known for its innovation in the industry, is also a member. She explained that Avaneer members so far are early adopters and that there are also members from the financial and broader technology industries participating like PNC Bank and IBM. The participation of these non-healthcare companies brings a different point of view and an important balance throughout the journey. Gabriela closed her commentary about members by affirming that it's good to have a diversified group since Avaneer wants to be all inclusive,Gabriela then went on to explain the initial use cases Avaneer is tackling. Coverage and eligibility data is one of the first things Avaneer will be tackling to make sure that all parties have access to a patient's coverage information, information related to services performed by whom and when and that everyone has access to the same copy of the same information. Gabriela explained that if everybody's on the same page and the communication is direct, then you can cut steps between what is your eligibility, what are your benefits, and here is the payment from the insurance company. Avaneer believes this can be accomplished, even if it's a difficult process, by using blockchain. Ken turned the floor over to Jocelyn to comment on her thoughts about what Avaneer is trying to accomplish. Jocelyn expressed excitement about the network and the use of blockchain. She explained that through her work with Da Vinci and in her projects at POCP, she's recognized that the claims database is the only place considered a source of truth and there isn't currently a lot of transparency with the patient and the provider about what a patient's specific benefits are at a specific point in time. Jocelyn then asked Gabriela to talk about what this kind of transparency would look like in the real world for payers, providers, and patients and to explain what these initial Avaneer projects really look like. Gabriela stated that the work is still new but that the technology stack has been deployed. Avaneer founding members are focused on completing the technology stack and getting a few applications running this year. Once that goal is met, Avaneer wants to open the network to the market. Ken asked for more details about the technology Avaneer is using whether blockchain, FHIR or cloud. Gabriela explained that the industry has been moving towards the cloud at a steady pace even if it's only really picked up steam over the last couple years. The core Avaneer architecture is cloud-based as a basic layer and network management layered over to ensure its scalable and increased traffic can be routed over time. Additionally, the information that can be allowed or should be disallowed based on HIPAA rules must be programmed in based on roles network members will assign to their employees. Blockchain as a service is the other part that allows members to build on basic blockchain but ensures that everyone has agreed to the same process. She observed that Avaneer is learning from the work of Da Vinci regarding how to get multiple stakeholders to agree to a joint process. The discussion moved to talk about FHIR, the HL7 Accelerator program and other standards development happening and how more stakeholders seem to be coming together to collaborate and contribute to standards development to solve these bigger more complex issues which is ultimately going to move the industry forward. Ken then shifted the conversation back to TEFCA and other organizations like Carequality, the eHealth Exchange, CommonWell and asked Gabriela to describe how Avaneer compares or fits in with these initiatives. Gabriela explicated that they are appreciative that the industry has made progress with the initiatives Ken named and that Avaneer sees them as supporting the traditional point to point connection. This approach enables one transaction between willing parties, whereas Avaneer is trying to solve for this problem of payers and providers constantly having to review every single solution that they want to implement on their system. So Avaneer is building this network to allow one connection to consume many services. This would allow members to essentially review security and other connection considerations once and then perform transactions or use solutions as needed. Gabriela reminded Ken and Jocelyn that they are still in the stage or proving their approach works.Ken followed up by asking whether Avaneer is considering becoming a QHIN under TEFCA. Gabriela said that Avaneer met with ONC. And that during those discussions it became clear that HIEs are using technology from 20+ years ago and Avaneer wants the opportunity to build new solutions from scratch instead of patchworking into already old and deteriorating technology systems. Jocelyn then asked Gabriela how she would want listeners to the podcast to get involved or figure out how to align with Avaneer or adopt something like blockchain. Basically what actions could listeners take to take bigger leaps in leveraging new technologies? Gabriela responded by explaining that Avaneer is happy to talk to organizations and offer practical advice but for the time being they are very much heads down trying to prove the network is viable. Once they are past the proof point, Avaneer will be in a better position to work more closely with stakeholders on how they can join and move forward. In closing, Ken asked what Gabriela would like the industry to know or if she had any final message that they want to send out. Gabriela responded by asking the industry keep an open mind on blockchain. She explained that she recognizes not everybody is there yet. She and the people at Avaneer really believe that blockchain is a technology that is going to help healthcare. She explained that it must be said that blockchain doesn't belong in every single use case. But she asked that the industry keep an open mind and be willing to help explore the possibilities on this journey. Ken then thanked Okay Gabriela and Jocelyn for being on the podcast and reminded listeners they can find past episodes on all podcast platforms and the POCP website and that videos of the conversations are posted on the POCP YouTube channel.  

- Registran lecheros del Valle del Yaqui baja producción, y negativo panorama por la sequía y alza en insumos. - Tiene el HIES fuertes protocolos de seguridad, aseguró su director tras el intento de robo de una recién nacida. - Decomisa la SSPM más de 50 armas blancas, con ello se evitó la comisión de uno o varios delitos. Acompáñanos en la segunda edición de Las Noticias con Susana Arana y Joel Gutiérrez, Diana Sambrano con el pronóstico del tiempo y Poncho Inzunza con los deportes.

When it comes to HIEs, every one is so different. They often have different missions and many states have multiple HIEs trying to approach the problem from different directions. In Arkansas, they're lucky to have one HIE for the whole state which is focused on helping patients. They leverage things like ADT notifications, real-time alerting, and have created real partnerships with payers to make a difference in their state. To learn more about their success, I sat down with Anne Santifer, Executive Director at AR State Health Alliance for Records Exchange (SHARE), right after her presentation at HIMSS 2022. We asked Santifer to share about their statewide HIE collaboration with ADT notifications that she presented on stage. She also shared about how their long-standing partnership with Secure Exchange Solutions worked and the impact that it was having on end users. Learn more about Secure Exchange Solutions: https://www.secureexsolutions.com/ Find more great Health IT content: https://www.healthcareittoday.com/

The interoperability and information-blocking rules have imposed new regulations and requirements on health information exchanges (HIEs). How are HIEs responding to these new regulations in a space they have been in for decades? In this episode of our special series on interoperability, hear from Dan Paoletti, CEO of the Ohio Health Information Partnership. Dan and Epstein Becker Green attorneys Allen Killworth and Nivedita Patel discuss the role of HIEs in the interoperability landscape and the impact of the information-blocking rules on HIEs. Visit our site for more information and related resources: https://www.ebglaw.com/dhc37. Subscribe for email notifications: https://www.ebglaw.com/subscribe. Visit: http://diagnosinghealthcare.com. The EMPLOYMENT LAW THIS WEEK® and DIAGNOSING HEALTH CARE podcasts are presented by Epstein Becker & Green, P.C. All rights are reserved. This audio recording includes information about legal issues and legal developments. Such materials are for informational purposes only and may not reflect the most current legal developments. These informational materials are not intended, and should not be taken, as legal advice on any particular set of facts or circumstances, and these materials are not a substitute for the advice of competent counsel. The content reflects the personal views and opinions of the participants. No attorney-client relationship has been created by this audio recording. This audio recording may be considered attorney advertising in some jurisdictions under the applicable law and ethical rules. The determination of the need for legal services and the choice of a lawyer are extremely important decisions and should not be based solely upon advertisements or self-proclaimed expertise. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.

Health Information Exchanges (HIEs) are improving the quality of their data as a way to further increase their value. Higher quality data from HIEs helps healthcare organizations see their region more clearly, allowing them to allocate their resources in the areas that need it. Healthcare IT Today sat down with key executives from Healthix (an HIE), J2 Interactive and CareCom to learn more about their collaboration to improve the quality of data through semantic interoperability. Learn more about CareCom: http://www.carecom.com/ Find more great health IT content: https://www.healthcareittoday.com/

Jaime Bland, DNP, RN, CEO of CyncHealth, explains how doctors in Nebraska and Iowa now are able to exchange certain types of social health data on their states' HIEs, and what it could mean for improving patient outcomes.  

Petra und Stefan Hies sind seit 41 Jahren Handwerker, Augenoptiker und Brillen-Designer aus Leidenschaft. Ihr Credo ist es, Menschen in ihrer Vielfalt und Individualität zu erkennen, und sie dabei zu unterstützen ihren eigenen Weg zu gehen. Sei es in der Ausbildung, in der Beratung ihrer Kunden oder dabei, individuelle Begabungen zu erkennen.In der heutigen Episode sprechen wir über:die Entwicklung von Hies Optik seit der Übernahme vor 15 Jahren über Kooperationen in der Modewelt, wie zum Beispiel während der Berlin Fashion Week und in New Yorkdie eigene Meisterwerkstatt, wo sie sogar Einzelanfertigungen herstellen (USP)wie wichtig es ihnen ist, die Einzigartigkeit jedes Menschen mit ihren Brillenkreationen  zu unterstreichen neue Technologien, und warum sie sich gegen Brillen aus 3D-Druck entschieden habenihre Vertriebswege, zwei Geschäfte und einen neuen Online-ShopNachhaltigkeit, die eine große Rolle im Unternehmen spieltdie größte Herausforderung war bislang, während der Corona-Zeit mit der Abhängigkeit von nicht mehr funktionierenden Lieferketten umzugehendie größten Erfolge sind vielen kleine Erfolge, wie zum Beispiel Menschen zu helfen, die Welt besser zu sehenTipps: einzigartig bleiben, Persönlichkeiten unterstützen statt zu deformieren, einmal mehr aufzustehen als man hinfälltund vieles Spannende mehr.Es lohnt sich reinzuhören.Hier geht's zu den ShownotesWOMEN IN FASHION MENTORINGMöchtest auch Du mit Deinen vorhandenen Potenzialen, Fähigkeiten und Kenntnissen Deine unverwechselbare Marke im Fashion- und Lifestyle-Segment aufbauen? Ich helfe Dir gerne bei der Gründung Deiner eigenen Marke, und biete Dir meine Erfahrungen, meine Plattform, und den Zugang zu meinem exklusiven Netzwerk.TRIFF JETZT DEINE ENTSCHEIDUNG und vereinbare Dein kostenfreies Vorgespräch mit mir. Vielen Dank für Deine Treue!Herzlichst,Sibel Brozathttps://womeninfashion.de/www.linkedin.com/womeninfashion.dewww.instagram.com/womeninfashion.dewww.facebook.com/womeninfashion.deTelegram Gruppenchat

Details:Luigi Leblanc joins us for a discussion right at the intersection of public health and technology. How can we optimize use of technology, how is technology being used for niche services, how are programs changing to drive reimbursement for these? Find out the answers to these and more in this episode of RevDive!Interviewee:    Luigi Leblanc, VP of Technology at Zane Networks Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.Sponsored by: ABILITY NetworkFor more information on critical RCM updates, be sure to follow RevDive on our social channels:- Website - Facebook - LinkedIn - Twitter - YouTube

All data is not created equal. In fact, there is data out there that's incredibly valuable, but not being used. Understanding how data shapes strategies and business models can be one of the most important keys to success that a healthcare entrepreneur can access. On our latest Executive Briefing, we talk to a new panel featuring Francesco Lucarelli, Chief Commercial Officer and Partner at HCB Health, Chuck Hazzard, VP of Wearables and Integrations at Heads Up Health, and Sara Badahman, CEO and Founder of HIPAAtrek. We discussed everything from interoperability to health information exchange (HIEs) to help identify data that can build strategies and tactics which any innovator can deploy in their commercialization process. It doesn't matter if you're a startup entrepreneur or a corporate innovator, there's gold here - and you just might uncover a bit of wisdom and insight that gives you the edge you need to push your innovation forward. Come and listen to this week's episode! Here are the show highlights:  What you need to do in order to find success (2:34) Why you should never “go it alone” (5:52) This is why we identify the need before jumping to technology(7:58) Is it a “you” problem or an industry problem? (9:02) Data validation of business models (16:48) Healthcare and the rule of three (28:59)   Guest Bios  Francesco Lucarelli is Chief Commercial Officer and Partner at HCB Health, a full-service marketing agency focused on giving life-changing medicines a voice. If you'd like to get in touch with Francesco after the show or learn more about HCB Health you can go to their website HCBHealth.com, email him at francesco.lucarelli@hcbhealth.com, or find him on linked in at Francesco Lucarelli. Chuck Hazzard is VP of Wearables and Integrations at Heads Up Health, a health data analytics company that aggregates lifestyle data to enable healthcare clinics to generate presentations and graphs that increase patient engagement and trust while growing top-line revenue. If you'd like to get in touch with Chuck after the show, or learn more about Heads Up Health, you can go to their website at HeadsUpHealth.com, email him at chuck@headsuphealth.com, or find him on LinkedIn at Chuck Hazzard. Sarah Badahman is the CEO and Founder of HIPAAtrek, a one-stop-shop cloud-based platform that streamlines an organization's compliance program and allows it to create, manage and maintain its compliance processes from start to finish. If you'd like to get in touch with Sarah after the show, or learn more about HIPAAtrek, you can go to their website at HIPAAtrek.com, email her at at sarah@hipaatrek.com, or find her on LinkedIn at Sarah Badahman, CHPSE.

Jonathon Feit, co-founder and CEO of Beyond Lucid Technologies & Consulting joins The Dish on Health IT hosts, Ken Kleinberg, Pooja Babbrah and special guest host Ed Daniels to talk about the role of emergency services (EMS) in the healthcare ecosystem now and in the future and how EMS fits into healthcare's interoperability journey. The hosts, Ken Kleinberg and Pooja Babbrah briefly introduced themselves. Guest host, Ed Daniels introduced himself by saying that the majority of his career has been spent on interoperability, data exchange and HIEs. Ed was a volunteer firefighter for 14 years and is currently working on the development of a multi-stakeholder collaborative on eConsent which is why this discussion was of particular interest to him. Jonathon then introduced himself explaining that he is not a field practitioner or first responder. He shared that he joined the military after September 11, 2001 but discovered that his Tourette's syndrome disqualified him from service, which led him to find another way to serve. He decided to leverage his skills as a technologist to solve problems related to data exchange to support EMS and first responders. Beyond Lucid, the company Jonathon co-founded is focused on solving these issues. Right now, Beyond Lucid spends half of their day in the world of Fast Healthcare Interoperability Resources (FHIR), EMS, critical care both ground and air, the other half of the day is in the world of electronic health records (EHRs) focusing on things like patient matching. Beyond Lucid is currently running the Oregon Portable Orders for Life Sustaining Treatment (POLST) registry from a technology standpoint and are branching into pediatrics and medical complexities. What Jonathon finds interesting about this work is identifying what field providers do and what they need. Using end of life medical orders as an example, Jonathon pointed out that there is really a 0% margin of error. If someone has indicated in their records that they don't want to be resuscitated but first responders are unaware of these records, the patient's wishes may not be followed. Another aspect of data exchange from the field to health systems so that data captured in the field can be incorporated into the patient's record fast enough for it to be useful in how the patient is cared for in the emergency room (ER). The future of Beyond Lucid is focused on car crashes, winning a patent on a system to gather crash intelligence about the passengers such as number of passengers, whether children are in the car, or special medical needs of passengers such as hemophilia. There are mission critical pieces of data that need to be exchanged in real-time. What prompted Jonathon to reach out to Point-of-Care Partners initially was the episode of the Dish on Health IT about social determinants of health (SDOH) because it highlighted patient data that helped look at patients as people. SDOH is important to providing holistic care. Host, Ken Kleinberg asked for a little more context of how EMS fits in the overall healthcare ecosystem, asking specifically about how EMS has historically been billed separately from other healthcare services as transport. Mr Feit explained that yes, it's true that EMS is billed as transport is many places but it's a yes with an asterisk because things are changing due to COVID. He explained that you really have to look more broadly to federal laws and how EMS is regarded. For example, up until the last 18 months, CMS regarded EMS as a supplier to healthcare, not a provider. This impacts not only how services are billed but related to interoperability rules as well.  Meaningful use doesn't apply to EMS which is a big problem because EMS uses a different data set that falls under the department of transportation and not Health and Human Services (HHS). He added that EMS is the most expensive taxi ride you'll ever take. With the exception of one value-based care experiment happening now, EMS services are generally billed on a per mile basis and the rate is cost adjusted based on the experience level of the driver and the severity of the patient. EMS is emerging as a central part of safety net care in rural spaces where there aren't enough doctors to serve the population and the fact that it's a service available 24/7. Viewing EMS as a provider is a critical distinction that's starting to change. Ed agreed with how Jonathon characterized the current view of EMS in healthcare generally and in regulation. Ed explained that historically, ambulances were intended to just get the patient into the hospital as soon as possible but it's changed drastically over the years with life-saving services being performed on site and in transit. Ambulances are no longer just transport but definitely a provider situation. It's time for a change in how this type of care is provided and being billed and reimbursed.Ken observed that it would be a real problem if the patient was charged in hospital for how far they were pushed in a wheelchair from their room to get a test. Ken then asked Pooja if there was a parallel between how pharmacists have transitioned to be part of the care team as opposed to an adjunct service. Pooja responded that she does see some parallels and mentioned reading a CMS blog post by Chiquita Brooks-LaSure and other CMS leaders that discussed the Center for Medicare and Medicaid Innovation (Innovation Center) which explored 50 alternative payment models to fee for service. While only a handful were considered successful, the ones that had some success had mandates to back them up. Pooja added that she thinks that just as the payment model in pharmacy is being revisited, the payment and reimbursement model for EMS should be re-examined as well. Ed added that another scenario where the pay for transport model for EMS just doesn't make sense is when a patient maybe just needs to get emergency care at home but doesn't need to be transported to the hospital. The current reimbursement structure doesn't allow for this. Jonathon pointed out that there is currently an “allergy” in the mobile medical arena to good data. He went on to clarify that when you mention CMS, where they have extremely wonky geeks who are truly good at their job, people forget they need fuel for their work, they need data. Jonathon went onto explain that when creating mandates versus voluntary guidance, you really need not just data but good data to back that up and see what is working and what's not. Right now, entering in information about a patient encounter by EMS staff isn't a priority because there isn't an understanding of how good data could transform things for the better. EMS has so much catching-up to do. Jonathon added that this lack of good data problem isn't unique to EMS by any means but it's an issue that needs to be tackled for us to see real change. Jonathon explained that part of the reason he reached out to Point-of-Care Partners was because he felt we provide a breadth of perspective to these issues in healthcare that reflects the bigger picture. He added that when docs talk to other docs or nurses and EMS techs to talk to Fire fighters, they aren't hearing from outside their environment to gain that broader perspective and close the gaps in understanding about their role in the ecosystem. He continued to say that we need to make the case why it's so important to get good data into the system and for that data to be fluid across environments. Ken interjected and said that now that the now we're getting into the interoperability part of the conversation, he wanted to ask about the system that's generally used by EMS called The National Emergency Medical Services Information System (NEMSIS) and asked if it was connected to EHRs.Jonathon responded that NEMSIS is separate and therefore and unequal data set maintained through the National Highway Safety Administration. It has a rich history of tracking data for car crashes and heart attacks while driving which Jonathon admitted was a gross over-simplification. There is a way for NEMSIS to connect to EHRs but there hasn't been education and discussion from the federal level down to the state, county and regional level on why the data and connecting to EHRs matters. Beyond Lucid was awarded a project in California back in 2015 to build the bridge between NEMSIS using HL7 standards like CCD. Beyond Lucid completed a gap analysis to understand what it would take to go from one to the other. What they found was an 85% overlap between what was required in the EMS system and the HL7 CCD. The 15% gap fell largely in 3 buckets including family history, past encounters and mental health which is very similar to SDOH. There are efforts to plug this hole with real-time data. Jonathon added that there are other efforts giving an example the largest fire service in Southern Denver, Colorado which was the first to send real-time data to Sentara health system in 2018 which shows it can be done, however, Jonathon added that health systems and EMS aren't doing a good job of talking with each other about their respective needs. Ken asked Jonathon to talk about Beyond Lucid being one, if not the first EMS IT vendor to join the Commonwell Health Alliance and whether they are now getting some SDOH data from HIEs. Jonathon explained that about 2 years ago at the National Association of State EMS officials, there was an outcry for SDOH and contextual data. Up until then this demand was mostly at the local level. Beyond Lucid volunteered to be the vendor to make this possible and develop a superset of data and has announced this capability to populate SDOH data for 911 calls. This project made a lightbulb go off for those involved on why this data should be a separate data set when it really should be integrated in the overall record. Jonathon explained that strong ID is really important because especially when you're looking at end of life orders, you want to make sure you're looking at the right patient. Unfortunately, a lot of initiatives required affirmative permission from he patient to look them up but the problem is that this doesn't work in the back of an ambulance. Ultimately the trust framework is critical but right now there is so much dirty data. Jonathon went on to say that now that FHIR V4 has been balloted and approved and Carequality/Sequoia was awarded the trust framework project, it seems progress is being made and EMS is finally at the table. Ken asked Pooja to provide her perspective on how EMS might use SDOH and eConsent and advanced care directives. Pooja shared that when you think about the knowledge first responders gain about a patient's living situation and environmental challenges, it makes sense that they could contribute valuable SDOH data that could be used downstream. It's about time the industry start looking at how the data going into EMS systems can be shared along the care continuum. Jonathon interjected that it's also important for police to have access to some of this information and that Beyond Lucid has helped create a database of medically complex children so police know if they are interacting with someone that perhaps is non-verbal so can't explain their situation or who can't follow verbal commands. Without this information Police encounters can end tragically. Encounter data really needs to flow throughout healthcare and also community services. Ken re-focused the conversation on eConsent. Ed shared that he is working on an initiative now on how to get electronic informed consent and advanced directives. It's a very complicated question and there isn't one answer. Ken began to close out the podcast by asking Jonathon if there was any last topic he'd like to cover suggesting perhaps something about COVID and vaccines since Jonathon had mentioned this in conversations prior to the podcast. Jonathon responded that he knows vaccines can be controversial and really he isn't talking about vaccinations per se but it's important to talk about interoperability and data quality and that for many years vaccination registries didn't talk to each other or couldn't be accessed by providers. This is important in the context of when you're planning to hold someone to account on getting vaccinated and proving they've been vaccinated. Jonathon posed the question that shouldn't there be a single source of truth rather than asking people to hold onto a little card? If we get the smart people in the room to solve these problems, we can make so much progress. Pooja added that in her role on the NCPDP board, they've had many conversations about how to use existing standards to create a central source of truth. Pooja explained that she's glad we were able to have this important discussion. 

This week we speak with WEDI's Privacy and Security Workgroup Co-Chairs, Marilyn Zigmund Luke from AHIP and Tina Grande from the Healthcare Leadership Council. The workgroup meets monthly to identify and work towards resolution on all implementation issues related to securing, and protecting health information across the industry.. They facilitate the review of privacy and security beyond HIPAA/HITECH in the growing areas of EHR, HIEs, HIX's and interoperability.    Interested in joining WEDI and/or a workgroup? Visit wedi.org

July 26, 2021: It's Newsday with Ed Ricks, CEO, Director of Healthcare at Sirius Healthcare. A Gartner CIO report shows that IT spending is expected to increase for cyber, analytics and cloud. McKinsey reports that telehealth utilization has stabilized at levels 38X higher than before the pandemic. Why are states against easing licensing for telemedicine? Does it make sense? Walmart Health is getting licensed in 37 states to offer telehealth. What does that mean for the industry? Truveta Grows to More Than 15% of US patient care. HIEs are exploding globally. Why the exponential growth? And in hospital telehealth is not an oxymoron. During COVID, the benefits of it were obvious. However, what happens after COVID? Key Points:Don't look at it as a cybersecurity problem. Look at it as a risk management problem. [00:06:45] Behavioral health is currently the highest percentage of telehealth visits [00:21:45] Some of the most important work within our industry is around the USCDI [00:29:55] The more data the better. There's no doubt about it. [00:36:25] Sirius HealthcareStories:Gartner CIO report: IT spending expected to increase for cyber, analytics, cloud - Healthcare IT NewsIt's '​​all about protecting local physicians from competition': Why states are against easing licensing for telemedicine - BeckersWalmart Health is Gearing up to Offer Telehealth across the Country - Business InsiderTelehealth: A quarter-trillion-dollar post-COVID-19 reality? - McKinseyIn Hospital Telehealth is not an Oxymoron. Here's Why - Healthcare Pitt StopUnified Data: The Key to HIE Success -  Healthcare IT TodayTruveta Grows to More Than 15% of U.S. Patient Care with New Members, Closing Series A Funding with Nearly $100 Million

The HITECH Act, part of the broad American Recovery and Reinvestment Act of 2009, ushered in major changes for health care's information and informatics landscape. The legislation may best be known for "meaningful use" requirements attached to hospital and/or physician funding to support the adoption of electronic health records (EHRs).The law also greatly boosted health information exchanges, or networks that share clinical information across different health care settings.On today's episode of A Health Podyssey, Dr. Julia Adler-Milstein, director of the Center for Clinical Informatics and Improvement Research at the University of California San Francisco, joins Health Affairs Editor-in-Chief Alan Weil to discuss a survey of health information exchange organizations she and colleagues published in the May 2021 issue of Health Affairs. The survey reveals a level of maturity in the field of health information exchange, but a few critical issues continue to threaten the ability to achieve the potential and promise of EHRs. Listen to Alan Weil interview Julia Adler-Milstein on the evolution of health information exchange organizations, TEFCA, and health data governance.Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts

The work of Health Information Exchanges (HIEs) is vast and diverse, from SDoH to public health/pandemic response and so much more. This week, Matthew welcomes Lisa Bari, CEO of the Strategic Health Information Exchange Collaborative  (SHIEC), a national collaborative representing more than 81 health information exchanges (HIEs). SHIEC member HIEs serve 95% of the United States population.  What is an HIE? How do they differ from state to state and why are so many people, including Dr. Donald Rucker, former National Coordinator for Health IT, feel HIEs are game changers in health data exchange? Sign up for WEDI 2021, our annual springtime showcase of health IT education, best practices and emerging trends. Use the code PODCAST for 20% off our already affordable registration rates. The can't miss event of the spring is coming, May 14 and 17 (Pre-Conference) and May 18-20 (Main Conference). Register at wedi.org

Is October 2022 on your calendar yet? Beyond being my birthday month, it is also when the Information Blocking rule goes to the next set of data, unstructured data.FTAAs of April 5, 2021, healthcare providers, certified health IT developers, and health information exchanges (HIEs) needed to abide by the information blocking regulations. Yet, Tripathi wants healthcare organizations to look at the larger picture, with several compliance dates on the horizon within the next 18 months.In 18 months, the floodgates will open, making healthcare organizations responsible for sharing that structured data as well as some unstructured data, presenting a bigger challenge, Tripathi said.-------Wouldn't it be great if we didn't fight this or procrastinate but rather build out the framework and establish a core set of partners who use the data on behalf of our patients and community to further health goals?A man can dream.#cio #cmio #healthIT #healthcare #chime #himss #interoperabilityhttps://ehrintelligence.com/news/amp/onc-leader-tripathi-offers-tips-for-interoperability-rule-success

The CyberPHIx Roundup is your quick source for keeping up with the latest cybersecurity news, trends and industry leading practices, specifically for the healthcare industry. In this episode, our host Brian Selfridge highlights the following topics trending in healthcare cybersecurity this week: The House passed an amendment to the HITECH Act that provides OCR enforcement safe harbors for adoption of security best practices including NIST and HITRUST OCR guidance issued for HIEs and disclosures of PHI to public health authorities during the pandemic NSA cybersecurity advisory about cloud attack techniques that are successfully bypassing standard access controls A new FBI ransomware advisory for the DopplePaymer ransomware strain NSA's guidance for addressing attacks targeting outdated encryption protocols including SSL and TLS NIST released cybersecurity standard for PACS and radiology systems The latest updates on the groundbreaking SolarWinds attack and related recommendations for healthcare entities

On this year-end episode of The Dish on Health IT podcast, host Gary Austin and co-hosts Ken Kleinberg, Pooja Babbrah and Jocelyn Keegan discuss prognostications on the year ahead in the areas of COVID-19, technology innovation, health data, and price transparency. Gary begins the episode by addressing the elephant in the room: the ongoing impact of COVID-19. He asks Pooja to open the discussion by giving her thoughts on the impact of the healthcare vertical COVID-19 is going to have in 2021. Pooja says COVID-19 is going to impact a lot of things, starting off with the vaccine. For the vaccines that are beginning to roll out, two different doses are needed for it to be effective. Tracking immunizations will be tricky for HIEs. Who has received the first dose? The second? Adherence will be critical. We need to make sure those who received the first dose of the vaccine also receive the second dose. Even the payers and pharmacies are going to be impacted by COVID-19 not just with the vaccine, but with how people are seeing their doctors. Pooja references past The Dish on Health IT podcasts that covered telehealth, the expanding role of pharmacists such as giving vaccinations, and the opportunity to better include community pharmacists in efforts, which all will remain relevant moving into the new year.Jocelyn agrees with Pooja in saying we need to drive volume in this market to the most suitable place that can best serve a patient and have the right tools and connectivity to make sure that data is comprehensively gathered. Jocelyn does see two things we will have to grapple with when moving into the new year. The first is the impact of profits and loss from a provider organization standpoint. There is massive loss happening for those in the direct line of care. She thinks when we look at 2021, it will be about leveraging the tools in front of us and taking advantage of the new technology that is being laid down. The second issue at hand will be impacts of market readiness. We wanted these rules to be put in place and then the rules were put in place. Will delays on these rules slow us down when we were at a point in time when we could have had a perfect storm to push through a lot of technology change? How fast do we allow ourselves to move? How much do we acknowledge what our provider teams are dealing with?Ken believes the vaccine will be key. He recently read an article that correlated the degree of someone's education with their willingness to take the vaccine. If you had an advanced degree, you would be most likely to want to take the vaccine. The less education a person had, the less likely they were willing to take it. There are big trust and education factors here that payers, providers, IT vendors – all of us really – need to take responsibility in helping with that. Gary moves the discussion to the next topic: health technology, specifically telehealth, FHIR APIs and health information exchanges (HIEs). What are your thoughts as to where these technologies are going in 2021? Ken notes that all three of these technologies have something in common and that is that they are connecting stakeholders together. We've experimented and piloted. We've had our successes and less so over the last two decades, but now we are seeing these technologies come together and become mainstream. This could be due to leadership, regulations, relaxation of regulations (in the case of telehealth), or simply the need to fight the pandemic. Once data starts to flow, we will be able to run advanced analytics with more varied data sources. This can inform decision support, risk stratification, analysis of social determinants of health, precision health and so forth. Ken is particularly excited about the promise of natural language processing and AI machine learning. Pooja agrees with Ken in saying these technologies are essentially connecting people together and sharing more information, which brings up trust. We are starting to open up more data. We have HIPAA which spans across our business entities. What will happen when we open up data to the patient? Patients having trust in applications will be critical for them in getting their information. Then comes the issue of who the patients are willing to share the information with. eConsent plays a huge role in this. Who are patients going to share the data with? Do they understand that when they share their record, it will essentially share their entire patient record? Is that something they want to do? Moving into 2021, trust and eConsent will be a huge focus. Jocelyn points out that if a problem is big enough, we can make the existing artificial barriers disappear. She goes on to explain that people have been leveraging tools that are available to them. When you're in the middle of a pandemic, it is about what tools are there that are being underutilized such as the HIE. She goes on to address new technologies and the unleashing of data by using APIs predominantly through FHIR. The pandemic has clearly shown how important these projects are and will allow stakeholders to progress towards more real work in the upcoming quarters. Payer and provider rules continue to get dropped. Jocelyn feels the work around FHIR and APIs is truly a nonpartisan topic. We are seeing universal agreement and will continue to push forward. Gary moves to the next topic, which is health data. What do you see happening with health care data in 2021? Jocelyn sees a couple of things happening here. First, payers and EHRs, around the information blocking rule, are mastering their information in a way that they haven't had to before; being able to comprehend where their clinical and claims data are. What's most interesting is the scope of data that's under regulation and having people meet those initial regulations. Secondly, we are realizing this is real. There are the people who are getting their house in order and then there are people who are trying to just check the box to get through this set of regulations. Ken notes that terminology and code set management have been important to providers and now to payers as well. Payers will need to get a handle on the clinical data they have and share it. Ken says some may only do the bare minimum while others will use this as a business advantage.  Jocelyn hopes that the next round of USCDI addresses some of the deficits in the payer-based data. Pooja adds that while we often talk about clinical and claims data, we need to also be thinking about pharmacy data. With USCDI 2.0, we need to start thinking about those stakeholders who haven't been involved like pharmacies. To have clinical, claims and pharmacy data together would be a very powerful thing.Gary asks Pooja to address price transparency. Pooja says that real time benefit check feels old hat now since it has been in the market for five years. With consumer-facing, there are implementation guides in place, and we are starting to see some PBMs pick those up and start to look at it. The biggest thing though is the final rules that dropped a couple weeks back for the payers and providers. Pooja thinks that's where we're going to see a lot of traction in 2021. Payers and providers need to be looking at this as a way to give themselves a market advantage. There is a long way to go, but it all comes down to freeing data and putting more opportunity in the consumers' hands. To find the care they need at a price they can afford it.  Ken says that consumers can play a very important role with price transparency. He wonders how we educate the consumers to operate in the proper vector. The more information you provide them, in an easily-digestible way, can make a difference. Ken believes these final rules can be used as a market differentiator that could lead to stronger consumer loyalty. Gary asks Jocelyn to discuss accelerators in terms of price transparency. Jocelyn says the name of the game with price transparency is that it needs to be patient-focused. It's about information equity, having the same information as my provider, which requires all the players to be involved. Jocelyn thinks that if we look across the board, that's the sentiment of what's happening. That's the foreseeing function we see coming out of these rules is make the data available so that we can have the innovation we need to get to a well-educated consumer. The final topic relates to the new administration. Gary first asks Jocelyn where she sees CMS and ONC going? She predicts that we can expect public health to get some money to actually do real work. Since this is a non-partisan topic, she also expects regulations to continue to come through. Jocelyn is confident that with the work coming out of the ONC and CMS teams around regulations and the work we are seeing come out of cross collaborations, we are making real meaningful progress in helping our consumers. Pooja adds that with CMS, we are still waiting on a final rule for the consumer-facing real time benefit check transaction. These topics seem to have bi-partisan support, so she does not see many changes in these focus areas. Ken gives his final thoughts. He thinks 2021 is going to be one of the most intense years in decades for health plans, providers, and IT vendors as they start to tackle all the game changing open API regulations that are going to require them to share data. Jocelyn thinks we have never been better positioned to impact change. We are in a unique situation with the move toward FHIR and APIs. It is rare to be able to fundamentally change how an industry works. That's what we're doing. Pooja closes by saying she thinks this pandemic has opened our eyes to everything that is wrong. The CMS and ONC rules were coming out just as we were going on lockdown. It makes you wonder, if we had these rules in place just on our own without being forced to do it, how much of this heartache and struggle we are going through now could have been avoided? Pooja was frustrated to see the rules get delayed. We are in the middle of a pandemic. We should not be slowing things down; we should be speeding them up. 

On this episode of The Dish on Health IT, hosts Pooja Babbrah, Jocelyn Keegan, Ken Kleinberg and Gary Austin discuss key takeaways from the annual ONC Tech Forum. The discussion highlights key areas covered at the conference such as Fast Healthcare Interoperability Resources (FHIR), Health Information Exchanges (HIEs), Public Health, United States Core Data for Interoperability (USCDI), Lab orders and results, and Social Determinants of Health (SDOH)Gary kicks off the discussion with a baseball theme and asks everyone to give their game (conference) highlights. Jocelyn first commends the ONC team for providing a positive, interactive online experience for participants. It was the next best thing to meeting in person. As for the content, the message of the day was FHIR and the urgency to make it work. Jocelyn brings up that those who are perceived as information blocking will also start to be targeted. Ultimately, she likes the synergy happening between CMS and ONC, there is uniformity among the sessions around moving forward.Ken's favorite session discussed healthcare systems in other parts of the world. He says there are certain aspects of healthcare that we do exceptionally well, and there are other areas where other countries do things better. Ken also listened in on a session highlighting the challenges facing labs, especially concerning inefficiencies with the exchange of results.Pooja observes that the overall theme of the conference seemed to reflect a pent-up consumer demand for a better healthcare system. She attended sessions she considered to be “off the beaten path,” such as long-term care. Pooja notes it's the specialty groups that feel like what is being done today does not meet their needs. When we look at the goal of supporting value-based care, we need to be thinking about everyone on the healthcare spectrum. How do we bring those other marginalized groups into the fold as well?Gary asks Jocelyn how fast is FHIR's fastball. Jocelyn says it's still too early to tell as FHIR is still maturing as a standard. However, she notes that it has been fantastic to watch real-world examples and leadership unfold in the meantime. More now than ever, it is evident as to why unleashing this data is so important. We are no longer tolerating inefficiencies like we have in the past. Jocelyn praises those on the frontlines using FHIR who come back and evangelize how they are leveraging it. Gary asks Ken what role HIEs will play in all of this. Ken mentions that HIEs vary considerably in their success, size, and scope. Some HIEs have started to work together, which is a very good thing. There are around 100 significant HIEs in the country now, much less than just a couple years ago. They've had to have some sort of sustainability in who they are working with. The providers have been key in clinical data. It's not quite clear what payer involvement looks like with HIEs. Ken says some payers claim that HIEs aren't fully focused on their needs. He thinks that is something that will probably change. HIEs will serve both payers and providers more equally than in the past.Pooja says HIEs can bring the longitudinal patient view. HIEs can take data from different sources and bring them together in a patient record as opposed to just bits and pieces sitting everywhere. We have the potential to reach more groups using HIEs during COVID that you couldn't normally reach with an EHR. Pooja agrees that we are down to a smaller group of HIEs, but the ones who are out there are doing innovative things and figuring out their new role in the environment. Gary asks how we can get payers more engaged with the HIEs. Jocelyn thinks the people who have focused on use cases and real business problems are the ones who will be viewed as a trusted partner when situations like a hurricane or pandemic arises. Payers will be more likely to wire in with HIEs when they are solving real business problems.Jocelyn hopes there are real, meaningful dollars put in place, so public health has an equal footing when it comes to implementation guides. Population health is complicated because there are so many endpoints. She hopes what we take out of this is that we need to seriously invest in our infrastructure for public health, then we all will win. Ken adds that on some issues, states are going to do things their own way, but when it comes to a pandemic, we need a more national approach. We are on our third attempt at a nationwide exchange, which is still, realistically, several years away. There may be some successes with the current HIE structure, yet in some areas like public health, it has proven to be inadequate. ONC is starting to fund some of these areas.Gary asks if there is any movement on a national patient identifier. Pooja mentions that ONC recently held listening sessions on universal patient identifier and a national patient identifier. She notes we are waiting to see if congress passes legislation to allow research on it. Pooja thinks we should look to other industries, outside of healthcare, who are doing this today, such as the financial industry. Other questions also arise concerning privacy and security. How do we share necessary information in a secure manner? Gary asks Jocelyn what she heard at the conference about USCDI. Jocelyn says the team at ONC recognizes there needs to be more frequent updates and ways for the public to impact what's in USCDI. There is a path forward to include ways for people to submit new ideas and to rely less on big annual/bi-annual updates. This becomes important as the expanse of people participating in the FHIR community gets larger and other stakeholders get engaged. The introduction of this new process to be able to expand and advance USCDI independent of the big turn of the wheel, is important for those who are implementing in the market. Gary asks Ken what he heard about labs. Ken notes key challenges like terminology and distributing results. For example, physicians may be ordering what they think is a certain lab test when they are actually getting another because the names are so similar, a capitalized letter could mean the difference between two tests. Then, you also have the challenge of distributing results. Public health often does not get results for a week or more after the results are known. The test results pass through many different places, which can sometimes also result in lost information.Pooja's final remarks talk about players on the bench, those who are waiting to get into the game. This is everyone outside of the main groups, including long-term care facilities, pharmacies, specialty providers, labs, or social determinants of health. She says that if we don't invest in these groups, we will not be able to accomplish what we are trying to achieve.Jocelyn is starting to see the work from the past several years produce itself in meaningful ways. She appreciated hearing from those on the frontlines who are using the tools at hand. Our healthcare system has unique challenges due to both our economic and political landscape, but there are plenty of opportunities for us to continue to lead around things like APIs and FHIR.

The discussion continues with guest, Dr. Tim Pletcher, Executive Director of the Michigan Health Information Network Shared Services (MiHIN) joins The Dish on Health IT panel of senior consultants, Gary Austin, Jocelyn Keegan and Ken Kleinberg to discuss the role of Health Information Exchanges in healthcare, their role in the response to COVID-19 and what role they can serve in the future once TEFCA is finalized.  Part 2 of the discussion jumps in with how MiHIN responded to COVID-19 by creating a separate group to serve public health needs during the crisis. MiHIN also created a telehealth service to better serve patients and support stay at home orders. Dr. Pletcher explained they acceleration the connections with labs and expressed his desire for results to be sent back via API instead of batch files to expedite results availability. Data links and analytics have taken on a whole new role during this time. MiHIN has taken on a support role which may have pumped the brakes on some innovation projects but there has been opportunity to increase the priority of other projects that could directly positively impact the pandemic response. Jocelyn explained why its so important to meet people where they are in order to make progress. This time is also a time for these simulated barriers to drop. She asked Dr. Pletcher how MiHIN is dealing with perceived security issues when working with innovation projects or partnering with new stakeholders. Dr. Pletcher responded by saying that their biggest challenge right now are Quest and Labcorp because they don't like to share data but this will be resolved through government intervention. The issues generally are not technical issues but business issues with one partner either not wanting to share data or restricting how the data can be used. The group went on to discuss how dropping the rules to facilitate the use of telehealth more readily will be a huge driver for change and innovation and hopefully the rules will remain suspended because patients should have more access via telehealth even over state lines. The conversation moved to data blocking with Gary pointing out EHRs are usually the ones getting the finger pointed at them for data blocking. Dr. Pletcher expressed that Epic or Cerner have never blocked or withheld data in Michigan so he doesn't know who it really is doing the data blocking. Will the US do more around pandemic surveillance like Taiwan and South Korea? Will HIEs support something like? Ken pointed out that some people don't want to be tracked in this way and will opt out or avoid it, however, if it's the only way a person is allowed to get into a ball game or something, they likely will. Dr. Pletcher explained that opt-in and opt-out is an archaic concept. There is a much better framework which would allow patients to express a more granular desire of how they want their data to be used. Doctors have choices too and when patients consent to receive treatment, physician choices come into play. The group highlighted where there are similarities between the financial and healthcare industries related to security and data access until the complexities of healthcare ends the similarities with identity being a major hurdle. With the explosion of patient apps, there is also a trust factor the that comes into play as far as understanding what data that can be obtained from patients apps can be trusted and whether they will look at HIEs as the consolidator of data vs going to Payers.        

Guest, Dr. Tim Pletcher, Executive Director of the Michigan Health Information Network Shared Services (MiHIN) joins The Dish on Health IT panel of senior consultants, Gary Austin, Jocelyn Keegan and Ken Kleinberg to discuss the role of Health Information Exchanges in healthcare, their role in the response to COVID-19 and what role they can serve in the future once TEFCA is finalized.  Gary Austin kicked off the episode by having Ken and Jocelyn give their perspective on HIEs. Ken went on to provide a primer on the history of HIEs and their varying role depending on the model before going on to mention that the Trusted Exchange Framework and Common Agreement (TEFCA) may change the ecosystem once finalized. Dr. Pletcher explained that the MiHIN Group is comprised of 3 companies: MiHIN,  Velatura & Interoperability Institute. Each company serves a specific purpose. Velatura was created to stay aware of what is happening at the national level and to operate nationally. The Interoperability Institute is a research and development group staffed by interns who are the next generation of Health IT professionals. HIEs were compared to public commons, like parks and good roads and bridges that people want to have but don't necessarily want to pay for. Dr. Pletcher pointed out that many HIEs were created prematurely before EHR standards and adoption was where it needed to be for valuable data exchange. Ultimately the value model for MiHIN is based on use cases that are then driven to mass adoption.    The value lies primarily with the government and health insurance companies so payers primarily pay for MiHIN service so providers are incentivized to improve data quality while being subsidized to change their workflow to do so. What's the difference between the successful HIE vs struggling models? Dr. Pletcher pointed out that it's centered around the value the HIE is bringing to each stakeholder and building upon it over time while following the money. Jocelyn added that solving real problems and talking about the elephants in the room to deal with barriers head-on is crucial. She offered that having MiHIN join the HL7 Da Vinci Project is hastening progress. There is an opportunity for HIEs to reinvent themselves as more flexible API standards are developed and take advantage of fielded codifiable exchange tools to get things into real production environments and take out custom codes and massive production efforts. The team continued to discuss the financial model of HIEs and how they may evolve post-COVID-19. Will there be more government funding after COVID-19 calms down? Maybe, but there are a lot of people in need and the general funds at the state level are tapped. There may be some federal programs that look toward automation to cut down on some of he manual processes that are still eating up resources. There may be other non-government revenue streams that open up either with employers or by offering telehealth services at the HIE level. Jocelyn pointed out that while streamlining and making data liquid in general (whether through HIEs or just better adoption of APIs in general) is a money saver for health systems and payers,  patients also win through getting better, more informed care and ultimately leading to better outcomes. Part 2 of this conversation is coming soon!  

Health Information Exchanges (HIEs) play a critical role in improving the continuity of patient care across healthcare entities and geographies. HIEs often operate behind the scenes to coordinate the secure sharing of information across healthcare entities. Organizations considering using or interfacing with a Health Information Exchange (HIE) will benefit by listening to this Podcast discussion about security and privacy trends with Nick VanDuyne, Executive Director at NY Care Information Gateway and Meditology's Brian Selfridge.   As the manager of a regional health information gateway partnered with the state of New York, Nick gives us an insider view of risk management security issues and approaches including: Key questions to ask in evaluating HIE or Regional Health Information Organizations (RHIOs). Specifically, how to evaluate the security and privacy controls of the entity. Challenges faced by the “big data” aspect of an HIE or RHIO and security approaches to address them.  As well as methods for reconciling the security and privacy expectations of a wide range of disparate stakeholders that share and use health data (hospitals, state agencies, and others). The use of security certifications in providing demonstrable assurance of security controls to your members and business partners. An insider view of the inherent security strengths or vulnerabilities of healthcare data communication protocols like HL7, DICOM and newer HIE-specific protocols such as DIRECT. Opinions about emerging technologies and security considerations for the next wave of innovations poised to hit the healthcare market.