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

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"