Neil Versel's Healthcare IT Podcasts
CHICAGO—It's becoming a tradition, sitting down with athenahealth Chairman, CEO and President Jonathan Bush for a podcast during the annual HIMSS conference. If you missed the original in 2007 or the sequel in 2008, you missed a whole lot of fun. If you happened to catch either or both of those, you know you're in for some more entertainment, and perhaps even some enlightenment. We get awfully intellectual this time.

By the way, this one is rated PG-13 for language, but the kiddies wouldn't understand the topic anyway. Enjoy.

Podcast details: Interview with athenahealth's Jonathan Bush at HIMSS09. MP3, stereo, 64 kbps, 16.6 MB, running time 36:11
1:45 Thoughts on "meaningful use"
2:25 Maybe accelerate PQRI?
3:30 Why EHR implementation has failed so far
4:40 David Ricardo and physician transcription
4:35 Let primary care physicians be the disruptive force
5:30 Lessons from "House"
6:15 Rethinking medicine
6:50 Micromanagement by the government and thoughts on scope of practice
7:50 Practice models that work
9:05 Data that help manage populations
10:05 Lobbying in Washington and qualifying for stimulus money
11:15 Medicare audits
11:30 HIMSS membership and "defensive" business management
13:00 Software-enabled service vs. software vs. ASP vs. software as a service
14:30 Examples of software-enabled services
16:45 Why standalone software is dying
17:15 Uninstalls of other products
18:15 How the stimulus has affected the company
21:20 "Aggressive stance" of Medicare
21:40 Many things happening at once
22:40 Unintended consequences of government actions
24:50 Entitlement spending and end-of-life care
28:30 Potential similar problems with stimulus and a return of the "plutonium sneakers."
29:20 Decision-makers who have never run a practice
30:00 Hopes for David Blumenthal as national coordinator
30:30 Thoughts on comparative effectiveness studies
31:20 Concerns of HIT industry: "Don’t make what I’ve been doing for years illegal."
31:50 Different needs for different doctors
32:35 New standards on data mining and patient privacy
34:20 The example of General Motors

Direct download: Jonathan_Bush_HIMSS09.MP3
Category: podcasts -- posted at: 12:21 AM
Comments[0]

CHICAGO—For the second year in a row, I had a long, detailed chat with HIMSS CEO Steve Lieber before the start of his organization’s annual conference. This time, I was able to meet him in his downtown Chicago office last week since the 2009 conference is a home game for both of us.

Clearly, the focus of the HIMSS conference and of this podcast was on the economic stimulus that will send billions of dollars into the health IT sector next decade, but there is plenty else going on in healthcare technology and in the economy as a whole. Enjoy the podcast—and don’t be surprised to see a small army of Epic Systems employees at the conference. The company is busing nearly 800 people down from Verona, Wis., less than three hours away.

Podcast details: Interview with HIMSS CEO Steve Lieber on the 2009 HIMSS conference, recorded April 1, 2009. MP3, 64 mbps, 25.5 MB, running time 55:47.

0:20 Immediacy of health IT with passage of ARRA
1:20 Healthcare vs. the economy in general
2:15 Timing of the stimulus money
3:45 Thoughts on "meaningful use"
5:25 Input from HIMSS membership on shaping regulations
7:00 Upfront expenses for back-end stimulus payoff
7:40 Shifting of priorities
8:30 Financing issues
9:03 The Illinois example: Paying down Medicaid backlog with non-IT stimulus funding
10:50 Current leadership vacuum at HHS
11:35 Interagency committees formed within federal government
12:15 Thoughts on David Blumenthal
13:05 Thoughts on John Glaser
13:40 Why President Obama might have made the change at ONC
15:20 First hospitals reaching Stage 7 on HIMSS Analytics EMR Adoption Model
16:15 State of EMR adoption as it relates to ARRA incentives
17:15 EMRs for physicians
18:24 Watch vendors for clues on physician adoption
19:00 Change in the environment with ARRA
19:50 Other cultural barriers to adoption
20:45 HIMSS will provide case studies and how-tos on adoption for physician offices.
21:30 Workflow change
23:18 Changes to HIPAA and consumer attitudes toward data confidentiality
25:25 Treating healthcare data like financial data
25:55 Certification of health IT
27:25 Standards and the work of HITSP
29:10 How to improve HITSP process
30:10 Certification and favoritism
31:40 Why it would be a mistake to replace CCHIT and HITSP
32:30 Relationship between HIMSS and CCHIT
34:00 Complaints about CCHIT
34:43 Assessment of certification to date
36:12 Tying practice management and EHR software together
37:25 Relationships between ambulatory and hospital data
37:37 Stark EHR exemption
38:40 Medicare e-prescribing incentive
40:15 Expectations for attendance at HIMSS conference
42:20 Economic impact on exhibitors
42:05 Meditech and Cerner skipping conference
44:15 Estimate that conference will generate $4 billion in HIT buying
45:20 Effect of Chicago location
46:30 Healthcare hub in Chicago and Midwest
47:35 New conference programs related to the stimulus
48:25 Transition from Robert Kolodner to Blumenthal
49:30 Creating "different worlds" within the conference
50:30 Meeting with CBO and expectations for actual HIT spending
51:15 Education at HIMSS conference
51:50 Interoperability
52:30 Some drop-off on consumer focus because of magnitude of stimulus
53:15 Partnerships between enterprise and ambulatory vendors
53:30 Keynote speaker Alan Greenspan and "irrational exuberance"

Direct download: Steve_Lieber_-_HIMSS_09.MP3
Category: podcasts -- posted at: 8:01 AM
Comments[0]

As regular readers know, I was fortunate enough to be invited by the Rockefeller Foundation to Bellagio, Italy, last week for the third of four weeks in a series of conferences called Making the eHealth Connection. The goal was for a small group of technology and healthcare informatics leaders to come up with actionable ideas to use IT to improve the health of people in the developing world.

The week I was there focused on electronic health records and mobile health.

While I was in Bellagio, I interviewed Judith Rodin, Ph.D., president of the Rockefeller Foundation (and former president of the University of Pennsylvania), and Ariel Pablos-Méndez, M.D., managing director of the Rockefeller Foundation and the head of health programs. Unfortunately, there was an echo in the room that found its way onto the recording. And unfortunately the battery ran out of my recorder before I got done chatting with Dr. Pablos.

We also take a while getting into the discussion about IT, but I still think it’s an interesting interview.

Podcast details: Interview with Judith Rodin, Ph.D., and Ariel Pablos-Méndez, M.D., of the Rockefeller Foundation. Recorded July 29, 2008, in Bellagio, Italy. MP3, mono, 64 kbps, 14.5 MB, running time 31:41.

1:05 Rationale behind the conferences
1:55 Harnessing the beneficial aspects of globalization to fix the negative effects
2:50 Why e-health in the developing world?
5:00 Affordability, accessibility and quality of care
5:28 "Leapfrog" strategy for bringing technology to underserved areas
6:50 Market opportunities from public-private partnerships, even in poor countries
8:02 E-health as a remedy to globalization of diseases
10:30 Bold, actionable ideas
12:22 "Game-changing ideas" from previous Bellagio conferences
13:15 Welcome to Dr. Ariel Pablos-Méndez
14:05 The foundation’s current attempt to strengthen health systems and long history of creating global programs
15:15 Breaking down the silos of health programs in developing countries
16:05 Worldwide concerns go beyond HIV/AIDS
16:40 Problems with access to care, and the role of telemedicine
17:10 Problems with affordability and efficiency
18:20 Good health at low cost
19:15 Theory that the future will be about more health for the money rather than more money for health
19:45 Current Rockefeller Foundation health programs: access
20:35 Role of the private sector in health systems in developing countries
22:45 E-health in the developing world
23:50 Challenges and opportunities in e-health
24:55 Interoperability issues with legacy systems
26:20 Technology transfer from U.S. institutions to Africa before legacy systems become a problem
27:34 Why the timing is right for IT and for these conferences
28:10 Needs: collaboration, agenda setting, capacity building, evidence, applications
30:00 Bold ideas: British NHS and a system in Sao Paolo, Brazil, sharing code with South Africa and developing a framework strategy for e-health

 

Direct download: Rockefeller_ehealth.mp3
Category: podcasts -- posted at: 3:46 AM
Comments[0]

I love the annual Association of Medical Directors of Information Systems (AMDIS) Physician-Computer Connection. It's a chance to hear some of the smartest people and most accomplished people in healthcare, namely medical informaticists, in a small, informal setting. This year's event, held last week in beautiful, laid-back Ojai, Calif., featured an appearance by Robert Kolodner, M.D., the national coordinator for health information technology.

After Dr. Kolodner's presentation—more of a Q&A with his peers in medical informatics—he graciously sat down for an audio interview with me. Here is the result.

Podcast details: Robert Kolodner, M.D., on the national health IT strategy. Recorded July 16, 2008, in Ojai, Calif. MP3, stereo, 64 kbps, 14.3 MB, running time 31:24.

0:40 Background on national health IT strategic plan toward interoperable electronic health records
3:35 Goals of the plan
4:08 Distinction between "health" and "healthcare"
5:25 Explanation of "patient centeredness"
6:20 Physicians’ role in promoting patient centeredness
7:30 IT’s role
8:50 Population health
10:40 Why physicians should care about national IT strategy
12:55 Making the issue personal
13:35 Financial incentives for technology adoption
14:37 Incremental advances
16:18 Medicare e-prescribing incentives as one step in a series of improvements
17:30 Convincing healthcare organizations to cooperate
18:08 Greater public awareness about electronic health information
18:32 Privacy and security concerns, and coming framework
20:50 Convincing doctors to share data
22:10 Trial National Health Implementation Network implementations
22:55 Where physician IT leaders can make a difference
24:06 AHIC successor
25:25 Complexity of healthcare in the U.S. and abroad
27:18 Profound workflow changes from IT and maximizing skills of healthcare professionals
29:06 Possible effects of 2009 administration change
30:15 Health IT’s fundamental role in healthcare reform

Direct download: Kolodner-AMDIS.mp3
Category: podcasts -- posted at: 6:03 AM
Comments[0]

The just-completed Towards an Electronic Patient Record (TEPR) conference featured the unveiling of the TEPR Cell Phone Project, an eight-month effort to study and prove the efficacy of the mobile phone as a hub of interoperability in healthcare. (You can read my Digital HealthCare & Productivity story about the project here.)

The Medical Records Institute, which puts on TEPR, is partnering with AllOne Health Group, a Wilkes-Barre, Pa.-based health and wellness services provider, to conduct this test of bottom-up, consumer-controlled health information exchange. The study begins June 1, and results will be released at TEPR 2009 next February.

During Monday’s TEPR Cell Phone Project press conference, I peppered AllOne executives with some tough questions about their plans, and was not shy about voicing my skepticism about personal health records. In a rare show of tact on my part, I did so without offending anyone. In fact, Frank Avignone, director of business and sales development for AllOne Health subsidiary AllOne Mobile, agreed to join me the following day to record this podcast.

Podcast details: Interview with Frank Avignone, director of business and sales development, AllOne Mobile, about the TEPR Cell Phone Interoperability Project. Recorded May 20, 2008. MP3, mono, 64 kbps, 10.8 MB. Running time 23:37

0:54 Background on the company and its technology
2:00 Interoperability study
3:30 Metrics being measured
4:00 Convergence of Dossia, Google Health and Microsoft Health Vault, and the subtle differences
5:50 Technology behind AllOne Mobile Health
6:49 Phone requirements and registration process
8:25 Continuity of Care Record
8:50 Why consumers might accept this technology
10:25 Data input options
11:50 Provider access to data
12:37 Workflow considerations
14:10 Pragmatic approach to uptake
14:35 Logistics of the study
16:25 Study participants
17:30 Mobile phone carriers
19:30 ROI for end users
21:00 Marketing strategy
22:18 Study goals

Direct download: Frank_Avignone.MP3
Category: podcasts -- posted at: 12:42 AM
Comments[0]

For me, the highlight of HIMSS ’07 was my podcast interview with Jonathan Bush of athenahealth. It was so much fun, he agreed to sit down with me again at this year’s HIMSS conference. I’m hoping this can become a regular occurrence. We get full of ourselves at several points and get way off topic at times, but it was taped on the last morning of HIMSS and everyone’s a little loopy by then. Even the technical glitch—my microphone being off for a few seconds—didn’t affect the outcome, other than to provide a good laugh or three.

Podcast details: Interview with Jonathan Bush, president and CEO of athenahealth, recorded Feb. 28, 2008, in Orlando, Fla. MP3, mono, 64 kbps, 18.9 MB, running time 41:17.

0:35 The cult of Mr. HIStalk
1:25 Is Cerner pulling out of HIMSS?
2:25 Disruptive technologies
2:50 Why software is dead
4:25 Why other companies still sell software
6:30 The "dead zone" around the Orange County Convention Center
8:15 Chief athenista Todd Park and future plans for the company
10:15 athena’s lingo
12:10 Success of eClinicalWorks based on selling software
14:10 Google Health, the next Segway?
16:05 Google Health vs. Microsoft HealthVault and other PHRs
18:00 Why existing PHRs are not much better than Microsoft Word
19:00 How athenahealth could help with PHRs
20:40 PHRs need something to do
21:15 Could Google give doctors leverage with health plans?
23:55 Trust issues
24:45 Risk vs. reward for sharing health information
26:05 athena’s API for linking to PHRs
27:25 Why e-commerce works in other industries
28:35 What doctors need
29:25 Carrot vs. stick: cash, options or control
31:10 Opportunity for doctors to take back disease management from payers
33:00 How to reach physician practices
33:40 Targeting smaller practices
34:55 Opportunities with enterprise customers
36:15 Partnership with Eclipsys and the seeds of RHIOs
39:40 Slight technical glitch, and concluding remarks

Direct download: Jonathan_Bush_-_HIMSS_08.MP3
Category: podcasts -- posted at: 2:36 PM
Comments[0]

ORLANDO, Fla.—Here’s a podcast that’s been a year in the making. Actually, it was a year plus an hour and a half. Last year in New Orleans, I had a lively, hour-long conversation with HIMSS President and CEO Steve Lieber that was supposed to be for a podcast, but the recording didn’t work.

On Saturday, I showed up at the appointed hour for another sit-down with Lieber, and realized I’d forgotten my recorder back at my hotel, so we rescheduled for about 90 minutes later. Well, the third time was a charm, and the result is this podcast, a lively, half-hour-long conversation with Steve Lieber, just ahead of the opening of the annual HIMSS conference.

Podcast details: Interview with Steve Lieber at HIMSS ’08. MP3, mono, 64kbps, 13.8 MB. Running time 30:10.

0:30 Expected attendance of 27,000+
1:15 Greater attention on technology in healthcare
1:45 Growth on clinical side
2:50 More interest from non-IT executives
4:00 E-prescribing as an example of IT crossing disciplines
5:45 Multiple opportunites for improvements in prescribing and medication administration
6:30 Continuing problems with access to capital
8:50 Prospects for Medicare payment reform
10:07 Health IT in the presidential campaign
11:15 Health IT debate remains largely nonpartisan.
12:40 Progress among private payers in reimbursement for quality
14:00 More focus on disease management than quality per se
14:40 Slow adoption of personal health records
15:42 Suitability of PHRs for chronically ill
17:30 Kids may be first major PHR constituency in general population.
18:05 Google, Microsoft and Revolution Health in healthcare and HIMSS keynotes from Eric Schmidt and Steve Case
20:00 Movement toward home health
20:40 HIMSS strategic interest in medical devices
21:40 HIMSS branching out as an association
22:30 Interoperability of financial and administrative information
23:10 Working for universal set of quality measures
23:35 Globalization of HIMSS
26:00 Standardization beyond the U.S., e.g., Snomed
27:00 Highlights of HIMSS conference: Interoperability Showcase
28:00 Public meetings at HIMSS, including AHIC
29:03 International registration

Direct download: Steve_Lieber_-_HIMSS_08.MP3
Category: podcasts -- posted at: 1:15 PM
Comments[0]

From the Department of Better Late Than Never comes this podcast with Nick Jacobs, CEO of Windber Medical Center in Windber, Pa., who's well known in some circles for being perhaps the first hospital chief in the country to write his own blog.

Nick's Blog has been around since May 2005, and Jacobs also contributes to Hospital Impact and to the World Health Care Blog. Paul Levy at Beth Israel Deaconess Medical Center in Boston has been writing his blog since August 2006. (I've got them both beat, as my blog dates to May 2004. But I am not going to brag until I get the kind of traffic that HIStalk does. That blog, which I've heard referred to as the "National Enquirer of health IT," recently passed 1 million visitors. I'm still looking up at 30,000.)

Speaking of historical records, I've been sitting on this podcast since September, when Jacobs was in Chicago for the third Healthcare Blogging & Social Media Summit way back in September. I've got an even older recording in the podcast pipeline, and who knows when I'll get to that? I did write about Jacobs in Digital HealthCare & Productivity in early October, but now you can hear what he's all about.

Podcast details: Interview with Nick Jacobs, CEO of Windber (Pa.) Medical Center. MP3, mono, 64 kbps, 9 MB. Running time 19:34.

0:49 Genesis of the blog
2:02 How blogging helps a small hospital compete with larger hospitals
2:50 His message
3:45 Early blog posts and how he started taking more risks
4:50 Motivating employees via the blog
5:40 Keeping local mass media honest
6:40 The global reach of the Internet: “You can never be a prophet in your own home town.�
8:00 Why other hospital CEOs don’t blog
9:20 Being the first to take the plunge
10:00 Why healthcare is so slow to turn to IT
10:40 Windber’s cancer research for the military
11:30 National recognition and local indifference: “reverse urban snobbery�
12:30 Transparency in healthcare
13:45 Flaws in public reporting requirements
15:30 High tech at small hospitals
16:20 Using the Internet to build a reputation
17:30 Market challenges for a small hospital
18:04 The future and his passion for change in healthcare

Direct download: Nick_Jacobs.MP3
Category: podcasts -- posted at: 11:49 PM
Comments[0]

SAN FRANCISCO--Dr. David Brailer is a very popular man these days. Having $700 million of Other People’s Money to invest, as his company, Health Evolution Partners does, tends to do that. At the Health 2.0 Conference today, it took an hour and 15 minutes for him to fend off the suitors and finally sit down with me for this brief but lively podcast about his new venture and about the current state of health information technology in America. I think it was worth the wait.

(Everyone else is blogging this event live. I can’t keep up, so thought I’d try something different.)

Podcast details: Interview with Dr. David Brailer on Health Evolution Partners and progress in health IT. MP3, mono, 64 kbps, 4.5 MB. Running time 9:53.

0:34 Investment strategy
1:05 Surprise since he started the fund
1:40 About the company
2:25 Why he’s not looking at biotechnology
2:55 Health 2.0
3:35 Investing through venture partners
3:45 Assessment of national health IT adoption
4:35 Health IT hasn’t become politicized
5:05 Tough issues still unsettled
6:13 RHIOs
6:50 Shakeout in health IT (and interruption from siren outside the window)
7:50 Advice to people involved in RHIOs
8:08 Personal health records and consumerism

Direct download: Brailer.MP3
Category: podcasts -- posted at: 3:40 PM
Comments[0]

I guess technically this isn't really a podcast, or at least not my podcast, since I'm not in this at all. But I'm pretty sure it's a worldwide Internet exclusive, U.S. National Coordinator for Health Information Technology Dr. Robert Kolodner's keynote address to the MedInfo 2007 conference on Aug. 23 in Brisbane, Australia. Kolodner's office even asked me for a copy.
 
I wanted to plug my recorder into the sound board. The sound techs there told me don't bother, they'd burn me a CD of the speech. So here you have it, a pristine recording, ripped from that CD. (Please, no flames from BitTorrent purists who believe that there's no such thing as a "pristine mp3" file.) I've uploaded it in stereo and at 128 kbps, double my normal, mono podcast rate.
 
I'm not going to bother with detailed podcast info for this one, since it took me almost a month to get this posted in the first place, but I'll link once again to the story I wrote from Brisbane about Kolodner's remarks and my interview with him. As a special bonus, I've included Kolodner's presentation slides so you can follow along at home.
 
I'll also say that the "cuddling a koala" he refers to in the first minute is exactly what I'm doing in the picture in my Sept. 9 post. That was from Lone Pine Koala Sanctuary on the outskirts of Brisbane, if you're ever in the neighborhood. Good thing Brisbane is in Queensland, because apparently it's illegal to touch a koala in the Australia state of Victoria.
 
I have a couple more podcasts in the pipeline, so check this space later this week.
 
Podcast details: Keynote speech by Dr. Robert Kolodner to MedInfo 2007, Aug. 23, 2007, in Brisbane, Australia. MP3, stereo, 128 kbps, 43.5 MB. Running time 47:30.

Presentation slides (PDF, 2.4 MB)
Direct download: Kolodner-MedInfo.mp3
Category: podcasts -- posted at: 1:30 PM
Comments[0]

Right before America effectively shut down for an Independence Day that fell on a Wednesday and surely prompted some very long weekends, the Centers for Medicare and Medicaid Services proposed some modifications to various Medicare payment and provider eligibility rules. Among the proposals is a plan to remove computer-generated faxing from the CMS definition of electronic prescribing. alter the Medicare Part D electronic prescribing regulations.

This move is bound to make some e-prescribing advocates very happy, particularly on the pharmacy side and among the patient-safety crowd. Case in point is Rick Ratliff, chief operating officer of e-prescribing connectivity network SureScripts, who joins me for this podcast to discuss the CMS proposal and the future of e-prescribing.

Podcast details: Interview with SureScripts COO Rick Ratliff on proposed Medicare Part D e-prescribing regulations. MP3, 64 kbps, 10.2 MB, running time 22:14.

1:00 What SureScripts does
2:08 Fax exemption in existing rule
3:07 What CMS is proposing
4:02 Impact of the proposed change
4:26 What vendors might have to do
5:37 Lack of financial incentives in Medicare e-prescribing rules
6:35 Why it's a "potentially enormous" change
7:45 Two-way communication in e-prescribing
8:35 Savings from efficiency gains
9:33 Private payers following the lead of CMS
10:00 True electronic prescribing vs. electronic faxing
11:30 Public comment period for the proposal
12:43 What SureScripts might tell CMS
13:22 How to encourage physicians to adopt e-prescribing
15:02 Physician attitudes toward patient suggestions
16:45 The tipping point
17:50 Is this a competitive battleground for pharmacies?
18:37 How retail pharmacies view e-prescribing
19:30 Effect of e-prescribing on patient and physician expectations
20:07 New SureScripts technology to report back to physicians on fill rates
21:25 E-prescribing effect on healthcare quality

Direct download: SureScripts-Ratliff.MP3
Category: podcasts -- posted at: 12:22 PM
Comments[0]

Last month, I blogged about the "personal" nature of electronic health records in France, based on a blog post by American-born, Paris-based health IT consultant Denise Silber. Well, Denise read my post and e-mailed me, or maybe it was I who sent the link to her. I've been in Vegas the last three days and the memory is a bit fuzzy at this stage. A few e-mails later, I had her on the phone for this podcast. Enjoy.

Podcast details: HIT consultant Denise Silber on European initiatives. MP3, mono, 64 kbps, 10.3 MB, running time 22:36

1:00 Background on her e-health consulting and marketing work
2:40 France's "personal medical record"
3:40 Fears of Big Brother on both sides of the Atlantic and French data privacy laws
4:25 Patient control of records in France
5:15 HIPAA confusion in the U.S.
6:00 Conflicts between French law and European standards for physicians, and patient concealment of personal health information
6:55 Usage and costs of French health system, including electronic insurance cards
8:25 Differences between French system and other European health systems
9:42 Physician use of EMRs and computers in France
10:25 Current status of French EMR projects
11:47 Standards
12:28 Purpose of the French PMR
13:05 Accuracy and quality of consumer health information
14:45 Physician shortage in France
15:47 HON Code
16:47 New organization for health information improvement in France
18:45 Consumerism in healthcare and transparency
21:10 Other forms of information accreditation

Direct download: Denise_Silber.MP3
Category: podcasts -- posted at: 11:00 AM
Comments[0]

This podcast pretty much covers the entire field. Dr. David Kibbe, senior advisor to the Center for Health Information Technology of the American Academy of Family Physicians, weighs in on health IT in primary care, consumerism, data standards, value-based healthcare purchasing and national IT policy, among many topics we cover in just over half an hour. We recorded this at the 2007 TEPR conference in Dallas last week.

Podcast details: Interview with Dr. David Kibbe at 2007 TEPR conference. MP3, mono, 64kbps, 16 MB, running time 35:090:40 Background on AAFP's Center for Health IT and what he's doing.
1:40 Personal health records and mobilization of personal health information
2:10 Continuity of Care Record
4:11 Continuity of Care Document and Clinical Document Architecture
5:25 CCR, PHRs and the Internet 6:20 Growth in CCR interest
7:00 PHRs based on XML
7:40 Google's healthcare plans
8:55 Reliability of health information on the Internet
10:00 Consumers having access to the same information as health professionals
10:45
Revolution Health
11:50 Web information and the physician/patient relationship
12:45 Higher expectations among patients
13:45 Consumerism and retail health clinics
15:00 AAFP's involvement in retail clinics
16:28 Concept of the medical home
18:00 Health information and the elderly
19:12 Model of information homes in other service industries
20:20 Asynchronous communication to help manage patient care
20:46 Reimbursement problems with asynchronous care
21:20 Employers becoming more aware of value in healthcare
22:15 Advice to major healthcare purchasers
23:00 When major changes might happen
23:45 Framing the national debate
25:15 Stark exemption and primary care
26:57 AAFP advice to small practices on the Stark exemption
28:40 Awareness of Stark exemption
30:30 Awareness of the benefits of EHRs
31:42 Certification
33:57 Are products improving because of certification?

 

Direct download: Kibbe.MP3
Category: podcasts -- posted at: 11:30 AM
Comments[0]

WASHINGTON�As co-chair of the State Alliance for e-Health, Tennessee Gov. Phil Bredesen has been heavily involved in the health IT policy debate. He's also frustrated with the slow progress of technology adoption that's holding back gains in quality and efficiency (read "cost savings" from a governor's perspective). And Monday at the World Health Care Congress, he was not afraid to share his thoughts, as this short audio clip demonstrates.

Podcast details: Tennessee Gov. Phil Bredesen on health IT adoption, recorded April 23, 2007, in Washington, D.C. MP3, mono, 64 kbps, 2.1 MB, running time 4:31.

Direct download: Bredesen.MP3
Category: podcasts -- posted at: 3:07 PM
Comments[0]

WASHINGTON—Live from the World Health Care Congress, here's an interview with Dr. Bill Bria, chief medical information officer of Shriners Hospitals for Children and president of the Association of Medical Directors of Information Systems. We talk about the increasing importance of CMIOs as hospitals align their IT strategies with overall institutional goals, including quality improvement, and we discuss the similar growth of AMDIS. Bria also plugs the annual AMDIS Physician-Computer Connection, which is OK with me since I've been shameless in plugging my article in Red Herring.

Podcast details: Interview with Dr. Bill Bria on CMIOs and medical informatics. Recorded April 23, 2007, in Washington, D.C. MP3, 64kbps, 8.6 MB, running time 18:56.

 

Direct download: Bria.MP3
Category: podcasts -- posted at: 11:55 AM
Comments[0]

NEW ORLEANS—As promised, here's my particularly lively podcast with Jonathan Bush, president and CEO of athenahealth. I could tell you some of the highlights, but the details below ought to be teaser enough. Enjoy.

Podcast details: Interview with Jonathan Bush, president and CEO of athenahealth, recorded at HIMSS'07 in New Orleans. MP3, mono, 64 kbps, 11.8 MB, running time 25:45.

2:12 HIMSS traffic
2:50 HIT interest in ambulatory care/Stark changes
4:05 "Battle of the Thunderdome" at the nexus of health IT
5:00 Personal health records
7:10 Role of government in health IT
7:56 Role of hospitals in promoting HIT adoption
9:25 Movement of money in healthcare supply chain
11:00 athenahealth's relationship with Eclipsys
11:50 athenahealth's business model
12:45 Plutonium shoes and the value of "free"
15:40 athenaClinicals and financial guarantees
16:55 Physicians and data entry
19:08 Office/workflow management as a supply chain
20:30 athena's scanning/data-entry operation
21:20 Delivering results
22:45 Outlook for the industry
24:45 The "athena model"

Direct download: Jonathan_Bush_-_athenahealth.MP3
Category: podcasts -- posted at: 6:48 PM
Comments[0]

NEW ORLEANS—Since time of the essence this week, I'm keeping this post short.

This is a fairly short, off-the-cuff interview with Dave Garets, president and CEO of HIMSS Analytics, kind of a teaser for Garets' "Riffing on the Issues" session on Tuesday with Partners HealthCare CIO John Glaser at the annual HIMSS conference.

Of note, HIMSS Analytics is announing Tuesday that it is expanding its research of hospital IT capabilities into Canada, but you heard it here first. But that's not all you'll get out of this podcast. Garets gives his take on the state of the health IT industry, circa February 2007.

If I had more time, I'd include a detailed description of the contents of this podcast, but since I have deadlines to meet tonight, I'm going to pass. Click here to listen.

More recordings to come later this week.

Podcast details: Interview with HIMSS Analytics CEO Dave Garets. MP3, mono, 64 kbps, 5.9 mb, running time 12:56.

Direct download: Dave_Garets.MP3
Category: podcasts -- posted at: 10:23 PM
Comments[0]

From the Department of Better Late than Never comes this podcast, recorded two weeks ago, in advance of the first-ever Healthcare Blogging Summit, which was held Dec. 11 in Washington, D.C. But thanks to my crazy schedule, this interview was not posted until Dec. 15 in a Florida hotel room. Most of the information is still relevant. Promise.

In this interview, Dmitriy Kruglyak, creator of the Medical Blog Network, a healthcare-focused publication in a blog format, talks with me about the growth of blogging in healthcare and explains his current project, the HealthTrain Manifesto. Essentially, it’s a statement of integrity guidelines for the highly unstructured world of grass-roots healthcare media.

Podcast details: Dmitriy Kruglyak, creator of the Medical Blog Network and HealthTrain Manifesto. MP3, mono, 64 kbps, 15.6 MB, running time 34:11.0:50 Explanation of the Medical Blog Network
2:35 Healthcare Blogging Summit
3:40 Blogging’s effect on consumers and on healthcare organizations
5:20 The changing dynamics of information dissemination
5:51 Grass-roots transparency and how to respond to it
6:36 Speakers at the summit
8:47 Harnessing the power of the Web and new concepts on the Internet
11:25 Growth of individuals publishing information online
12:52 Power of blogging in other industries
13:45 Transformation of the role of traditional media
14:28 Blogging’s growth in healthcare
16:50 Evolution of the Internet in healthcare
18:37 HealthTrain Manifesto
19:21 Roots of it in ClueTrain Manifesto (late 1990s) for conversational media
20:51 How healthcare is different from other subject matter
22:13 HON Code and other earlier e-health standards more for top-down media
23:05 Holes that HealthTrain attempts to fill
24:21 Credibility of health information
25:10 The 18 concepts of the HealthTrain Manifesto
27:19 Survey of healthcare bloggers re: anonymity
29:48 More on how healthcare organizations should operate in new era of transparency
30:47 Support for HealthTrain Manifesto
33:00 Where to read manifesto and list of supporters

Direct download: HealthTrain.MP3
Category: podcasts -- posted at: 9:37 AM
Comments[0]

A new name on the healthcare scene is Sage Software, which entered the market in September with its $565 million purchase of Emdeon Practice Services from Emdeon Corp. Who is Sage Software and what are the company's plans for the Intergy brand name? At last week's Radiological Society of North America meeting in Chicago, I sat down with Paul Stinson, Sage's senior vice president of healthcare, to find out.

Audio quality isn't the best because a lot of ambient noise made its way into the interview booths in the press room, but I don't think it's worse than listening to AM radio.

Podcast details: Interview with Paul Stinson, senior vice president of healthcare for Sage Software, Nov. 27, 2006. MP3, 64kbps, 11.6 MB, running time 25:23.

0:40 Background on acquisition and on Sage
1:30 Sage’s history in accounting software
2:40 Intergy’s history in radiology and imaging
3:35 Sage’s market share
4:00 View of radiology market as part of bigger healthcare picture
5:30 Growth potential in EHR and size of customer base
6:37 Target market
8:00 Division of product line between Intergy and Medware
9:24 Assessment of market for smallest practices
11:45 Effect of Stark exemption on the market
13:37 Effect of CCHIT certification on the market
15:24 Evolution of market in next two years
17:25 Continuing relationship with WebMD
18:16 Growing interest in PHRs and providing information to patients
19:08 Physicians warming to sharing scheduling information online
20:55 Online communication with patients and e-prescribing
22:53 Patient safety improvements and malpractice insurance rates
23:40 Privacy and security issues

Direct download: Sage_Software_-_RSNA.mp3
Category: podcasts -- posted at: 7:41 PM
Comments[3]

At the recent Medical Group Management Association annual conference in Las Vegas, I sat down with Malcolm Costello, vice president of marketing for Kryptiq Corp., a healthcare communication and integration company in Portland, Ore. We talked about secure messaging and other means of electronic communication that are helping to improve healthcare workflows and link providers to patients.

I was surprisingly alert for 9:30 in the morning, when we recorded this, and the sound quality is better than normal because I used an actual hand-held microphone rather than the built-in mic on my digital recorder. What a concept!

Podcast details: Interview with Malcolm Costello, VP marketing, Kryptiq Corp., recorded Oct. 24, 2006 at MGMA annual conference in Las Vegas. MP3, 64 kbps, 9.0 MB, running time 19:41.

00:22 What Kryptiq does
01:20 Online communications as a way to interest physicians in IT
02:25 Michigan State case study on messaging
03:15 Memorial-Hermann case study on prescription refills
04:15 Nursing burnout from administrative inefficiency
05:05 Coordination of care from electronic messaging
06:27 Standards in messaging vs. standards in EHR
07:30 Different formats of physician portals
08:40 Where messaging fits in the RHIO discussion
09:24 No good, sustainable financial model for RHIOs
10:00 Peer-to-peer messaging is a better idea
10:58 E-mail works other industries as a standardized platform
11:53 Potential of smart medical devices and other future communication technologies
14:02 E-mail for disease management
14:55 Integration of inputs from patients
16:15 Outlook for interoperability in the future
18:25 Adoption without standardization

Direct download: Malcolm_Costello_-_Kryptiq.MP3
Category: podcasts -- posted at: 12:31 AM
Comments[1]

What was supposed to be a journalists' roundtable with Intel Chairman Craig Barrett and Wal-Mart Stores Executive Vice President Linda Dillman turned into an exclusive interview for me when other invited reporters failed to show. Their loss is my gain—and yours.

I now have a podcast with two of the most powerful business people in America, on the subject of large healthcare purchasers demanding technology-driven quality from the people who provide health services to their employees. It continues on the theme that Barrett spoke on during his keynote address to the Third Health Information Technology Summit in Washington last month, which I reported on here. This interview took place shortly after the speech.

Podcast details: Exclusive interview with Intel Chairman Craig Barrett and Wal-Mart SVP Linda Dillman, Washington, D.C., Sept. 26, 2006. MP3, mono, 64 kbps, 13.9 MB, running time 30:23.

00:40 Barrett's interest in healthcare
01:05 Pilot programs to promote IT and quality
01:30 Purchasing power of large employers
01:58 Wal-Mart's $4 co-pay for generic drugs
03:20 Completeness of personal health records
04:33 Lack of price information for consumers
05:30 Cost shifting in healthcare
06:00 Wal-Mart's IT investment
06:40 Looking at the big picture
07:30 Getting a broad coalition involved
08:10 Debate vs. actions, cost shifting
09:10 Consumers ultimately pay the bills
09:40 Opportunity in the health system and incentives for healthcare to modernize
10:35 Current insurance at companies
10:55 Wal-Mart will be requiring quality
11:40 How to show transparency
12:25 Feedback from employees
13:40 Employees are savvy business`people
14:15 Duplication in the system
14:50 Medical liability and access to information
16:40 Systemwide quality should be overriding issue
18:00 What creates quality problems?
18:35 IT's role in alleviating the nursing shortage
19:45 Opinion of Kolodner
20:20 Barrett on AHIC and the slow pace of reform
22:15 Every other industry has adopted technology
22:50 Framing the debate over who pays
23:35 Quality tolerance in other industries
23:50 Roles of various stakeholders
24:35 "Forcing function" of change
26:18 Private payers are middlemen responding to the rules.
27:00 How to put pressure on suppliers
27:35 Purchasers have been passive for too long
28:36 How long until purchasing changes start showing results?
28:53 American competitiveness
Direct download: Barrett-Dillman_podcast.mp3
Category: podcasts -- posted at: 4:17 PM
Comments[0]

As promised, here's the podcast of the delivered by outgoing CMS administrator Mark McClellan, M.D., at last week's Third Health Information Technology Summit in Washington.

McClellan, who is stepping down in mid-October after heading Medicare for two years, spoke immediately after Robert Kolodner, M.D., gave his first public comments since being named interim national health IT coordinator the previous week. Again, the moderator who hosts the Q&A portion is John Glaser, vice president and chief information officer of Partners HealthCare, Boston.

Podcast details: Mark McClellan, M.D., Third HIT Summit, Sept. 25, 2006, Washington, D.C. MP3, mono, 64 kbps, 17.0 MB, running time 37:19.

Direct download: McClellan_HIT_Summit_9-25-06.mp3
Category: podcasts -- posted at: 11:42 PM
Comments[0]

WASHINGTON--I've got nearly pristine audio of the first public comments of Robert Kolodner, M.D., after he was named interim national coordinator for health information technology. The speech was recorded live Monday in Washington, at the Third National Health IT Summit.

I also have audio from outgoing CMS administrator Mark McClellan, M.D., who spoke immediately after Kolodner. I will post that recording later in the week.

The moderator for the Q&A whom you hear at the end of Kolodner's address is John Glaser, vice president and chief information officer of Partners HealthCare, Boston.

Podcast details: Robert Kolodner, M.D., Third National HIT Summit, Sept. 25, 2006, Washington, D.C. MP3, mono, 64 kbps, 14.4 MB. Running time 31:25.

Direct download: Kolodner_HIT_Summit_9-23-06.mp3
Category: podcasts -- posted at: 1:16 AM
Comments[0]

HOUSTON--As an esteemed member of the Fourth Estate, it pains me to say this, but many of my colleagues just don't get it.

Although I have been covering healthcare issues for 5½ years now and health IT for 4½ years, I feel like I don't belong at the annual Association of Health Care Journalists conference, which is going on here this weekend. Saturday in particular was a complete waste of my time, as there was not one session on the agenda that I found relevant to the work I do. There is too much of a focus on clinical and consumer issues and little that someone in the non-scientific trade press would care about.

The lunchtime keynote speaker on Saturday, acting Food and Drug Administration Commissioner Andrew von Eschenbach, M.D., just got nominated to the job on a permanent basis, and thus chose not to speak about any policy or his regulatory philosophy until the Senate has a chance to hold hearings. I walked out before his speech ended, and I was not the only one who was disappointed.

What was more disheartening, though, was the session that I personally moderated Friday morning on issues related to health IT. You can hear the audio here.

The panel, consisting of Sam Karp of the California HealthCare Foundation; Certification Commission for Health Information Technology Chairman Mark Leavitt, M.D.; and Linda Dimitropoulos of RTI International; went well. But attendance was sparse. I counted 19 people in the room, but that included publicists for two of the panelists, plus an editor from a techie magazine.

Given the fact that conference registration was close to 350 and that there were only four other sessions going on at the time, I was disappointed. Health correspondent from metropolitan daily papers mostly stayed away. This tells me that the average health correspondent does not understand the significance of IT, even though the session was entitled, "IT: Its promise for changing health care." Reporters continue to write about how the American health system is broken, but they ignore one of the most obvious cures.

On Friday, we were lucky enough to have Agency for Healthcare Research and Quality Director Carolyn Clancy, M.D., for a press conference and a keynote address. Privately, Clancy told me that she shares my concern that the mainstream press does not understand the role of IT in healthcare reform. Publicly during her speech, she implored the journalists present to help inform the public about how electronic health records can improve outcomes and save money.

Later, more than one fellow AHCJ member told me they found Clancy's speech uninspiring. The technology message apparently went over everyone's head. No wonder there is little consumer pressure on healthcare providers to change their ways.

Despite being a shy person, I've always been a bit of an anti-establishment rabble-rouser when I feel like something is wrong, so during Saturday's AHCJ membership meeting, I voiced my disappointment about the fact I found most of the program irrelevant to what I do. I also mentioned that I doubted value of my membership.

At the risk of sounding pompous, I get the sense that they need me more than I need them.

Listen to the podcast and tell me I'm not crazy. It's a long session and a big file, but I think it's worth it. Too bad my colleagues in the health media don't seem to agree with me.

Podcast details: "IT: Its promise for changing health care." Association of Health Care Journalists annual meeting, March 17, 2006, Houston. MP3, mono, 64 kbps, 35.2 MB, running time 1:16:58.

Direct download: AHCJ_Health_IT_panel_64kbps.mp3
Category: podcasts -- posted at: 11:07 PM
Comments[0]

The folks at Trinity Health in Novi, Mich., are in the midst of a massive rollout of health information technology that eventually will cover 24 hospitals in seven states--and have the third-largest clinical data repository in the nation, behind only the Department of Veterans Affairs and Kaiser Permanente. Called Project Genesis, the effort has not been widely publicized (not for lack of trying--I pitched the story to a couple of editors last year and was turned down).

While meeting last week with Narendra Kini, M.D., Trinity Health's executive vice president for clinical and physician services, I decided to turn the recorder on and let him explain Project Genesis for the masses (or at least the few hundred people who will find this page). This podcast is the result.

Podcast details: MP3, mono, 64 kbps, 5.7 MB, running time 12:30.

Direct download: Kini-Trinity_Health.mp3
Category: podcasts -- posted at: 1:01 PM
Comments[0]

Meet the Bloggers event at HIMSS 2006, Feb. 12, 2006. MP3, mono, 64 kbps, 6.5 MB, running time 14:16.
Direct download: Meet_the_Bloggers.MP3
Category: podcasts -- posted at: 9:31 AM
Comments[0]

This is my interview with Misys Healthcare Systems CEO Tom Skelton about consolidation among health IT vendors. We recorded it on Feb. 1, the day Misys announced its acquisition of Payerpath and the day after the president’s State of the Union address, and we refer to the events of "today" and "last night" in the podcast. I waited a week to post it because I used the interview for a story that ran in this week’s Health-IT World. Never bite the hand that feeds you!

The quality of recordings made from the telephone line varies quite a bit, and the sound has not been the best on my two most recent podcasts, including this one. I went shopping on eBay recently and I’m expecting to get better recordings in person at HIMSS next week with the audio equipment I picked up.

Podcast details:

Interview with Misys Healthcare Systems CEO Tom Skelton on HIT industry consolidation. MP3, mono, 64kbps, 5.9 MB, running time 12:53

  • 0:00 Introduction
  • 0:40 Misys acquisition of Payerpath
  • 1:10 Payerpath’s fit within current Misys operations
  • 3:20 Data capture and data mining for clinical improvement
  • 4:55 Standards and certification for ambulatory EHRs
  • 7:02 Consolidation in health IT industry
  • 9:40 Impact of consolidation on customers
  • 11:08 What potential customers should consider
  • 12:08 Skelton’s "elevator speech" about Misys
  • Direct download: Skelton-Misys.MP3
    Category: podcasts -- posted at: 11:08 AM
    Comments[0]

    William Yasnoff, M.D., former National Health Information Infrastructure director in the Department of Health and Human Services, has created a new business model for community-wide health information exchange, which he calls the eHealthTrust. Now a private healthcare consultant in Arlington, Va., Yasnoff recently landed its first eHealthTrust customer, the Louisville Health Information Exchange. In this podcast, he explains the concept and discusses a current request for proposals for the Louisville project.

    Podcast details:

    Interview with William Yasnoff, M.D., on the "eHealthTrust" concept. MP3, mono, 64kbps, 21 MB, running time 45:59.

  • 0:00 Introduction
  • 0:50 Issues with building National Health Information Network
  • 4:45 Winning stakeholder cooperation
  • 6:20 HIPAA and patient ownership of medical records
  • 7:20 Financial sustainability of regional health networks
  • 9:48 Business case for the eHealthTrust
  • 10:40 An untapped source of revenue
  • 11:45 Consumer awareness of EHRs
  • 13:10 Public trust and consumer access to their own health information
  • 15:10 Why there should be centralized health databases
  • 17:55 Usability of search functions in an eHealthTrust
  • 19:30 Financial consequences of decentralization
  • 22:25 Components of an eHealthTrust
  • 23:30 Security and operational considerations
  • 26:35 Explanation of eHealthTrust business model
  • 31:25 Participation of Medicare/Medicaid/uninsured patients
  • 34:50 Louisville Health Information Exchange
  • 37:15 Services offered to patients
  • 41:13 Louisville contract bidding process
  • 45:18 For more information
  • Direct download: Yasnoff.MP3
    Category: podcasts -- posted at: 4:27 PM
    Comments[0]

    Podcast details: MP3, stereo, 128 kbps, 11.6 MB, running time 12:39

    This is a very special interview I did with Sam Bierstock, M.D., a health IT consultant with IBM, but perhaps better known as the harmonica-playing leader of Dr. Sam and the Managed Care Blues Band (a.k.a. Dr. Sam and the Frivolous Action Blues Band).

    He and keyboard player John Melnick have combined to write and perform "Before You Go," a special musical tribute to the thinning ranks of veterans of World War II.

    Dr. Sam discusses the motivation behind the song and the incredible response there has been since he posted it for free access at www.beforeyougo.us a little more than a month ago. As of Friday, the site was being accessed at the astounding rate of 50,000 times a day.

    He requests that people pass along the link to any World War II veterans they know. As the grandson of a living WWII vet, I am happy to oblige.

    I apologize for the echo when I speak, as I had to convert the original MP3 file to WAV format in order to edit in a clip of the song, then re-convert the finished product to MP3. Sound quality always suffers in the MP3-to-WAV translation.

    And now back to our regularly scheduled programming.

    Direct download: Dr_Sam_podcast.MP3
    Category: podcasts -- posted at: 5:22 PM
    Comments[0]

    Interview with Fred Trotter, GPL Medicine proponent, on "free" and other open-source software for healthcare. MP3, mono, 64kbps, 18.5 MB, running time 40:27.

  • 0:55 Definition of GPL software
  • 2:30 Definition and discussion of "free" software
  • 5:25 Why he believes GPL is the only "morally acceptable" license in medicine
  • 6:35 GPL vs. proprietary licenses
  • 10:35 Making money with GPL licenses
  • 11:45 Critical nature of medical software
  • 13:15 Software keeping up with changes in the law
  • 16:05 "Vendor lock-in" for customers
  • 19:40 Trotter's experience in healthcare programming
  • 21:35 Three important GPL projects: FreeMed, OpenEMR and ClearHealth
  • 23:10 VistA
  • 24:30 VistA-Office EHR
  • 29:20 How VistA-Office might change the EHR market
  • 33:30 Problems with hybrid electronic/paper record systems
  • 34:50 GPL allows users to improve software
  • 36:20 Why VistA improved VA healthcare
  • 38:40 Fixing the broken healthcare system

  • Direct download: Fred_Trotter_interview.mp3
    Category: podcasts -- posted at: 10:03 PM
    Comments[0]

    Interview with Girish Kumar, founder and vice president of sales and marketing, eClinicalWorks, re: personal health records. MP3, mono, 64kbps, 9.3 MB, running time 20:18
    Direct download: Kumar-eclinicalworks.MP3
    Category: podcasts -- posted at: 2:02 PM
    Comments[0]

    Interview with Jordan Glogau, chief technology officer, Preferred Health Resources re: Hurricane Katrina assistance

    MP3, mono, 64kbps, 6.5 MB, running time 14:16

    1:05 Explanation of plan

    2:45 Open-source software

    3:10 Standards

    3:45 Rude interruption by Call Waiting beep

    4:40 Power of the Internet to solve problems

    5:45 Disease surveillance

    7:25 HIPAA

    9:10 Urgency of situation

    10:40 Interest from others in health IT

    11:35 Quick deployment of technology

    12:20 How to get in touch

    13:30 Call for action

    Direct download: Glogau-Katrina_response.MP3
    Category: podcasts -- posted at: 11:24 PM
    Comments[0]

    Interview with Stephen Hau, founder and vice president of marketing and development, PatientKeeper. MP3, mono, 64kbps, 11.7 MB running time 25:39
    Direct download: Hau_interview.mp3
    Category: podcasts -- posted at: 2:15 PM
    Comments[0]