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

 

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

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

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

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