I'm about to head to the airport for my flight to Las Vegas and HIMSS12. As has become customary before each year's HIMSS conference, I sat down with H. Stephen Lieber, CEO of HIMSS, this past week to discuss the state of health IT and what to expect at the big event.

The timing of this interview was interesting. We spoke Wednesday morning at the new HIMSS office in downtown Chicago, one day after CMS Administrator Marilyn Tavenner told a gathering of American Medical Association leaders that federal officials were re-examining the Oct. 1, 2013, deadline for adopting ICD-10 coding, and one day before HHS Secretary Kathleen Sebelius made it official that there would be a delay.

Also one day after this interview, HIMSS announced that it has taken over the mHealth Summit from the Foundation of the National Institutes of Health. While Lieber talked extensively about mobile healthcare, he gave no hint that this news was coming.

Meanwhile, the whole health IT universe had been expecting HHS to release its proposed rules for Stage 2 of "meaningful use" of electronic health records this past week. That didn't happen. Monday is a federal holiday, so I don't think we will hear anything until at least Tuesday, which, coincidentally, happens to be the first day of the HIMSS conference. As if we don't have enough to keep us occupied in the next few days.

The recording is a little fuzzy. I'm not really sure what created the echo and the background noise, since we were in a dedicated interview room, one of the nice features at the new HIMSS digs. Radio interference perhaps? That happened to me a couple years ago in the old HIMSS office on East Ohio Street. Just pretend you're listening on AM radio or something.

Podcast details: Interview with HIMSS CEO Steve Lieber, February 15, 2012. MP3, stereo, 128 kbps, 31.9 MB, running time 34:51.

1:00 Logistics of HIMSS12 in Las Vegas after the venue change
2:00 Why the Venetian-Palazzo-Sands might work better than the Las Vegas Convention Center
2:55 Why the conference starts on Tuesday this year
3:25 Massive scale of the conference
5:25 Return of Cerner and Meditech and some first-time exhibitors
7:45 mHIMSS and HIT X.0
10:15 Twitter co-founder Biz Stone keynoting and the state of social media in healthcare
12:00 Accountable care and realignment of incentives
14:15 What might be in proposed rule for Stage 2 of meaningful use
17:20 Preview of HIMSS survey of hospital readiness for meaningful use
20:30 ICD-10 readiness
25:00 Greater public awareness of health IT but continuing difficulties in communicating the finer points of healthcare reform
27:50 Mobile healthcare
31:25 The growing importance of clinical analytics

Did you happen to catch my InformationWeek Healthcare story about how UPMC believes it has the roadmap in place to achieve true accountable care? Well, here's the rest of the story.

Last week, Nuance Communications invited me to Pittsburgh for a tour of the UPMC Center for Connected Medicine, an impressive, high-tech showcase on the 60th floor of the U.S. Steel Tower. There, I interviewed, among others, Rasu Shrestha, M.D., UPMC's vice president for medical information technology, medical director of interoperability & imaging informatics and division chief of radiology informatics. Here is that interview.

Podcast details: Interview with Rasu Shrestha, M.D., UPMC vice president for medical information technology, Feb. 7, 2012, at UPMC's Center for Connected Medicine. MP3, stereo, 128 kbps, 15.6 MB, running time 17:08.

1:10 "Clinical language understanding" and "bringing data to life"
3:05 Analytics beyond patient care
3:55 Computer-assisted coding
6:35 Business intelligence in the context of ACOs
7:45 UPMC striving to be an ACO
8:35 Aggregating data from payer and provider sides of the organization
10:30 Keeping medication lists up to date
11:45 Health information exchange among multiple vendor systems
13:00 What to watch for in the near future from UPMC
14:10 Overcoming cultural barriers to change

Patricia Mechael is the newly installed executive director of the mHealth Alliance, a joint effort of the United Nations Foundation, the Rockefeller Foundation and the Vodafone Foundation. The mHealth Alliance this week is joining with the Foundation of the National Institutes of Health to put on the third annual mHealth Summit in National Harbor, Md.

I first met Patty in 2008, at the mobile health week of the Rockefeller Foundation's Making the eHealth Connection conferences in bucolic Bellagio, Italy, when she was m-health advisor to the Earth Institute at Columbia University in New York, a post she continues to hold. I was impressed by her international credentials in applying mobility to public health.

She was chosen in September to lead the mHealth Alliance, and joined just a few weeks ago. I interviewed her by phone last week in anticipation of the mHealth Summit. This is the result. (I'll have a companion piece in MobiHealthNews in the next day or two.)

Podcast details: Interview with Patricia Mechael, executive director of mHealth Alliance. Recorded Dec. 1, 2011. MP3, mono, 64 kbps, 5.1 MB. Running time 11:05
0:40 Roots in Bellagio meetings
1:30 mHealth Summit
2:05 Vision for mHealth Alliance and mHealth Summit
3:50 Legacy of Bellagio
4:45 Global reach of mobile phones
6:45 Multiple communication channels to account for literacy differences
7:25 Smartphones in global health
8:20 Separating hype from reality in low-resource environments

Did you miss Eric Dishman's keynote address Tuesday at the Medical Group Management Association's annual conference in Las Vegas? That's OK, because I secured a few minutes with Dishman, director of health innovation and policy at Intel, immediately after his talk, and the results are right here.

This podcast, recorded in the somewhat noisy press room at the Las Vegas Convention Center, is a companion piece of sorts to my coverage in MobiHealthNews on Thursday, so I hope you have a chance to check out both.

Podcast details: Intel's Eric Dishman on connected care management, recorded Oct. 26, 2011, at MGMA annual conference in Las Vegas. MP3, mono, 64 kbps, 5.2 MB. Running time 11:08.

0:30 Virtual care coordination in nontraditional settings
1:05 Overlap/collaboration with Care Innovations joint venture
2:10 Prototype device for monitoring symptoms of Parkinson's patients
4:00 Home monitoring of "classic" chronic diseases
4:55 Tracking behavioral changes for prevention and early detection
6:05 Realizing the potential of mobile health
6:55 Care coordination and health reform
8:30 ACOs and payment for quality
9:35 Intel's future providing "strategic blueprints" for healthcare
10:20 How to share ideas with him

In part two of my series from month's IBM Exchange 2011, my guest is IBM Distinguished Engineer Scott Schumacher. In this lively podcast, Schumacher discusses Watson, disease management and the concept of the "clinical hub," which envisions bringing together clinical decision support and case management.

As with my previous podcast with IBM's Lorraine Fernandes, I set my mic too low. I boosted the level during editing, but that introduced more background noise than I'd like. Schumacher mostly comes through nice and clear, though.

Podcast details: Interview with IBM Distinguished Engineer Scott Schumacher, recorded Sept. 14, 2011, in Chicago. MP3, stereo, 128 kbps, 13.2 MB. Running time 14:25.

0:30 What the IBM Exchange is
1:38 The "clinical hub"
2:30 Population analytics and individual patient analysis
4:20 Applying Watson intelligence and other medical knowledge
5:40 Target customers for clinical hub
7:10 Technical challenges
8:15 Potential for the technology
9:00 Video/image mining
10:00 Plans for testing and deployment
11:35 Mining of clinical notes and patient history
12:30 Incorporation of genomics and predictive treatment plans

From the Department of Procrastination comes part one of a two-part podcast series from last month's IBM Exchange 2011, an event the vendor put on to display its wares in health information exchange. The two-day conference took place in Chicago, home of the former Initiate Systems, which IBM acquired in early 2010. Here, I talk with Lorraine Fernandes, global healthcare ambassador for IBM (yes, that's really her title), about how HIE enables healthcare reform and improved public and population health. (In part two, which I'll post later this week, I discuss Watson with IBM's Scott Schumacher.)

As usual, I had a minor technical glitch. Since it was a local event, I schlepped my bag downtown and set up a mixing board with two mics. I didn't notice until the very end that I had my mic set way too low. I tried to fix that during editing, but raising the level just introduces more background noise. Ah, at least Lorraine's words are clear.

Podcast details: Interview with IBM Global Healthcare Ambassador Lorraine Fernandes, recorded Sept. 14, 2011, in Chicago. MP3, stereo, 128 kbps, 22.0 MB. Running time 23:50.

1:00 Global problem of public health
1:45 Renewed focus on population health
3:00 Early successes and a search for better models
4:00 Private HIE in competitive U.S. markets
5:00 "Lowest common denominator" of EHR
6:30 Barriers to HIE
7:00 Building trust with consumers
11:30 Engaging people in the healthcare system
12:30 HIE for care coordination
13:30 Planning and executing ACO plans
15:15 Experiments in healthcare reform
16:00 Explaining healthcare innovations to the general public
18:05 Home monitoring for preventing hospital readmissions
19:45 IBM analytics, including Watson
21:10 Addressing continued physician resistance
22:30 Healthcare and American competitiveness

Back in June, I covered the Wisconsin Technology Network's Digital Healthcare Conference in Madison. That conference featured a panel with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner, Judy Murphy, vice president of information services at Aurora Health Care in Milwaukee, and Epic Systems CEO Judy Faulkner, based in nearby Verona, Wis.

The panel discussed the question, "Is meaningful use a floor or a ceiling?" as I reported for WTN News. The conference also featured several sessions on how business intelligence and health information exchange can support Accountable Care Organizations.

A month later, I saw Shaffer again at AMDIS Physician-Computer Connection meeting in Ojai, Calif. There, she presented preliminary data from Gartner's annual survey of CMIOs. After the conference ended, I got a chance to sit down with Shaffer for this podcast. Since the fog and clouds finally lifted on the final day, we decided to record this outdoors at the beautiful Ojai Valley Inn, which is why you will hear some birds and other (human) creatures in the background. We don't care, it was too nice to sit indoors.

We mostly discussed how HIE can support ACOs, but we also touched on meaningful use and health reform in this lively interview. Enjoy.

Podcast details: Interview with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner. Recorded July 15, 2011, in Ojai, Calif. MP3, mono, 64 kbps, 7.9 MB. Running time 17:14.

1:35 ACO as a business model and a fundamental change in the needs of patients (chronic disease)
3:00 Interoperability for care coordination 3:50 Will ACO model be better than disease management as it exists today?
4:50 Nature of proposed rules
7:30 Importance of innovation because "meeting the metrics is average."
9:05 Is meaningful use a floor or a ceiling? Is an ACO a floor or a ceiling?
10:46 Ambulatory services growing faster than hospital services
12:38 "Oligopolies" in healthcare building interoperability and continuums of care
14:40 How far can you go with interoperability in this changing healthcare climate?
15:19 Targeted panel management rather than population health

Why are physicians still resisting EMRs? Maybe it's because systems aren't easy to use and lack interoperability. That's the hypothesis of Rick Kneipper, co-founder and chief strategy officer of Anthelio Healthcare Solutions, a Dallas-based business process services firm that until February was known as PHNS.

In my latest podcast, Kneipper joins me to discuss the shortcomings of current EMRs and current EMR policy, and offers his remedies for the problems. Give it a listen, then share your thoughts, too.

Podcast details: Interview with Rick Kneipper, co-founder and chief strategy officer, Anthelio. MP3, mono, 64 mbps, 12.7 MB. Running time 27:50

1:05 Why he thinks current EHRs aren’t meeting their promise of improving safety, quality and efficiency of healthcare
2:00 Money for meaningful use is starting to flow
2:30 Lack of interoperability in lower levels of in HIMSS Analytics EMR Adoption Model
3:35 Similar problems in meaningful use standards
4:15 No “silver bullet”
5:15 Per PCAST report, many EMRs create electronic versions of patient charts
6:25 Systems for creating billing documentation, not for improving care
7:05 Anthelio’s approach on workflow
7:55 Why aren’t we reengineering workflows?
9:10 Process doesn’t end when EMR goes “live”
10:05 Ultimate objective of meaningful use
10:43 Some physicians are just doing it for the money
12:15 Limitations of certification
12:45 Waiting on Stage 2 requirements
14:20 Caveat emptor and the rush to book revenue
15:33 Interoperability missing from Stage 1
16:00 Physician engagement in EMR selection
18:55 Usefulness of EMR data
20:45 Clinical decision support in MU
23:00 Patient safety compared to aviation safety
25:00 Public apathy toward patient safety
26:20 Advice to vendor community

In 2009, after 25 years of moving "Toward an Electronic Patient Record" (TEPR), the Medical Records Institute disbanded and its founder, Peter Waegemann, shifted his focus to mobile healthcare by creating the mHealth Initiative.

TEPR had grown into a rather substantial event, peaking at 3,800 attendees in 2004, when newly appointed national health IT coordinator Dr. David Brailer was the featured speaker. But attendance and vendor square footage rapidly declined after that, as much of the action in the realm of EMRs either moved to medical specialty societies or the huge HIMSS conference.

Taking a more content-driven than vendor-driven approach, the mHealth Initiative has tried its hand at conferences since last year. (I spoke and served on a panel at the organization’s 2nd mHealth Networking Conference last fall.) A week ago, the group held its third such event in that paradise for lovers of jet noise, Rosemont, Ill., and I sat down with Waegemann to record this podcast.

Podcast details: Interview with Peter Waegemann, chairman and founder of the mHealth Initiative. Recorded March 31, 2011, at the mHealth Initiative’s 3rd Networking Conference in Rosemont, Ill. MP3, mono, 64 kbps, 6.0 MB. Running time 26:02.

0:20     Transition from e-health to m-health after 25 years of running TEPR
1:50    "Total paradigm shift" for documenting and accessing information at the point of care
2:20     No country he’s seen has a complete, effective EMR yet
2:40    Movement from an industrial society to an “information society” of knowledge workers
4:40    Beyond voice communications
6:20    Behavior change in healthcare and adapting to technology
7:20    Lack of connectivity among mobile devices and shortcomings in current technology
8:55    The politics of standards for m-health devices and systems
10:40    Always “five years away”
11:20    Searching for the iPhone of home monitoring
12:00    iPad’s role in healthcare and its shortcomings
13:00    Apps
14:20    EMR vendors discovering mobile devices
15:25    Distinctions between wired health, wireless health and connected health
15:50    “Three pillars” of m-health
16:40     “Communication-enhanced healthcare”
17:35    Better care for less money
19:05    Cell phones in hospitals
20:30    Integration issues
21:00    Patients and younger physicians driving change
22:00    “Unified communications”
22:42    Payment for home monitoring
24:30    European approaches to m-health

The 2011 HIMSS conference gets underway this weekend in Orlando, Fla. For the fifth year in a row, I interviewed HIMSS President and CEO H. Steven Lieber to preview the annual conference.

Check Health Data Management's HIMSS microsite Friday and MobiHealthNews next week for write-ups of parts of this interview, but this is the only place you can hear the whole thing. 

The audio is pretty clear, but you may hear faint music in the background. The recorder seems to have picked up some radio interference. That’s not entirely unexpected in a downtown Chicago office building, namely HIMSS headquarters at 230 E. Ohio St. Ah, well. Enjoy the podcast, and I'll see you in Orlando.

Podcast details: Interview with HIMSS CEO Steve Lieber. MP3, stereo, 128 kbps, 30.6 MB. Running time 33:26

0:30 Attendance "well in excess of 30,000"
1:00 Increasing interest in health IT because of meaningful use
1:35 ICD-10 and 5010 somewhat “sidelined” but still important
2:40 The march toward meaningful use
3:00 25 percent of membership already at Stage 1 meaningful use
4:20 "Uncertainty" about future stages replacing confusion about what Stage 1 meaningful use is
5:15 Questions about whether early Stage 1 attestation shortens the timeline for Stage 2
6:00 Efforts by some new members of Congress to repeal or cut funding to HITECH
7:30 Questions about meaningful use he hears from HIMSS members
8:40 Balancing meaningful use with 5010 and ICD-10 compliance efforts
12:00 Incentives from private payers
12:40 Quality vs. cost savings
14:00 Public perception of healthcare reform
16:10 PPACA hasn’t had time to make an impact yet
16:55 Expectations for David Blumenthal’s HIMSS keynote and politicization of health IT
19:10 Speculation about next national coordinator?
21:25 New, parallel HIT X.0 conference-within-a-conference
24:30 Mobile and wireless technology at HIMSS and in healthcare
27:10 Hype cycle in mobile apps
28:10 Home care and telehealth reimbursement
30:00 Technology and ACOs
31:00 Berwick speaking at HIMSS this year after several previous attempts to get him