Neil Versel's Healthcare IT Podcasts (podcasts)
Direct download: Thomas_Laur_-_SAP.mp3
Category:podcasts -- posted at: 12:56am CDT

In a sidebar to the September cover story I did for Healthcare IT News, I reviewed some of the work of Scot Silverstein, M.D., who has long been chronicling problems with EHRs and other health IT systems. Unfortunately, he wasn't available for an interview in time for that report, but he was last week, so I got him for a new podcast.

Silverstein, a professor of health informatics at Drexel University in Philadelphia, considers EHRs to be experimental and, sometimes, less safe than paper records and would like to see health IT subjected to the same kind of quality controls as aerospace software or medical devices. "Suboptimal system design could lead even careful users to make mistakes," Silverstein said in this interview.

During this podcast, we refer to a couple of pages that I promise links to, so here they are. Silverstein writes regularly for the Health Care Renewal blog, a site founded by Roy Poses, M.D., a Brown University internist who runs the Foundation for Integrity in Research and Medicine. His definitions of good health IT and bad health IT appear on his Drexel Web page.

Podcast details: Scot Silverstein, M.D., on health IT safety risks. MP3, mono, 128 kbps, 33.8 MB. running time 36:59.

1:10 How this interest came about
3:05 His blogging
3:45 His 11 points demonstrating why he believes the FDA should be concerned about health IT risks
5:00 IOM, FDA and ECRI Institute statements on health IT safety
5:50 Comparing EHRs to medical devices and pharmaceuticals
8:35 Lack of safety testing in health IT
9:25 Issues with EHR certification
10:00 Safety validation of software
10:35 EHR's role in Texas Health Presbyterian Hospital's initial discharge of Ebola patient
11:50 EHR failure causing medical harm to a close relative
13:10 Poor design vs. poor implementation
14:35 Who should regulate?
15:55 Billions already spent on EHRs
16:45 Threat of litigation
17:40 "Postmarket surveillance" of "medical meta-devices"
18:50 EHRs now more like "command and control" systems
19:30 Movement to slow down Meaningful Use
20:17 Safety issues with interoperability
21:40 Importance of usability
22:30 His role at Drexel
24:18 "Critical thinking always, or your patient's dead"
25:05 Lack of health/medical experience among "disruptors"
29:30 Training informatics professionals and leaders
31:15 Concept vs. reality of "experimental" technology
32:50 Advice for evaluating health IT
33:55 Guardians of the status quo
35:10 Health IT "bubble"
36:10 Good health IT vs. bad health IT

Direct download: Scot_Silverstein.mp3
Category:podcasts -- posted at: 1:44am CDT

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. "Tee" Green III about this, I decided to take it a step further.

In all my years of covering health IT, I've never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn't have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for "retail health"
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

Direct download: 140908_Tee_Green_-_Greenway_Health.mp3
Category:podcasts -- posted at: 2:55pm CDT

Yesterday, Grand Rounds, a San Francisco-based startup that makes an "outcomes management platform" for large employer groups, introduced Office Visits, an online service that helps consumers find "quality" physicians close to home. I've long been skeptical of any claims of healthcare quality or any listing of "best" physicians or hospitals, so I invited Grand Rounds co-founder and CEO Owen Tripp on for a podcast to explain what his company is doing.

He told me that a proprietary algorithm helps Grand Rounds "recommend with confidence" the top physicians among the 520,000 medical specialists the company graded nationwide, based on numerous publicly available data sources and some self-reporting. Of those more than half a million specialists, only about 30,000 meet the company's criteria for recommendation, which shows, at the very least, that Grand Rounds is highly selective.

Based on this interview, I think the product has a lot of potential. It's nice to see ratings based on outcomes data and not squishy criteria like "he is a great doctor," as parodied in The Onion this week ("Physician Shoots Off A Few Adderall Prescriptions To Improve Yelp Rating").

At about 18:30, the conversation reminds me of another recent podcast, with University of Rochester neurologist Dr. Ray Dorsey. It turns out that Dorsey is among the 1,000 or so medical advisors to Grand Rounds.


Podcast details: Interview with Owen Tripp, co-founder and CEO of Grand Rounds. MP3, stereo, 128 kbps, 23.8 MB, running time 26:04.

1:00 "Safety" vs. good outcomes
2:20 "Downright terrifying" facts about choosing doctors
4:15 Story behind Grand Rounds
5:30 Algorithm for measuring physician quality that he says has shown about a 40 percent lower rate of mortality on common cardiac procedures
7:10 Data sources, including some self-reporting
8:35 Care coordination services Grand Rounds provides for patients
9:50 Why the direct-to-consumer market is so difficult in healthcare
12:00 Care teams
14:00 Availability and scope of service
16:15 When patients should travel for care and when they should not
18:15 Elements of telemedicine
19:35 Importance of asynchronous communication
21:45 Target market and why he sees the $200 fee as a bargain for patients
23:35 Managing patient records and other data
24:35 Company goals

Direct download: Owen_Tripp_-_Grand_Rounds.mp3
Category:podcasts -- posted at: 3:54pm CDT

It's time for my annual podcast interview with HIMSS President and CEO Steve Lieber, this time from the Orange County Convention Center in Orlando, Fla., on the day before the official opening of the 2014 HIMSS Conference, rather than in his Chicago office a week or so in advance.

Lieber reiterated HIMSS' position that the federal government should extend the attestation period for Meaningful Use Stage 2 by one year. I wasn't there, but today at the CIO Forum, one of the preconference educational symposia, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be an announcement on Stage 2 flexibility, possibly Thursday morning at a joint ONC-CMS town hall. That session will feature CMS Administrator Marilyn Tavenner and new national health IT coordinator Karen DiSalvo, M.D. I've never heard either of them speak, and now I'm excited to be covering that session.

We also discussed other aspects of healthcare reform, trends in health IT and expectations for HIMSS14. Of note, on Monday morning, HIMSS and two other organizations will announce a new initiative on "personal connected health."

Near the end, I reference the podcast I did last week with Dr. Ray Dorsey about remote care for Parkinson's patients. For easy reference, here's the link.

This is, I believe, the seventh consecutive year I have done a podcast with Lieber at or just before the annual HIMSS conference. Another interview that has become somewhat of a tradition won't happen this time, as Athenahealth CEO Jonathan Bush is not making the trip to Orlando this year.

Podcast details: Interview with HIMSS President and CEO Steve Lieber, Feb. 23, 2014, at HIMSS14 in Orlando, Fla. MP3, stereo, 128 kbps, 36.2 MB. Running time 39:35.

0:40 "It's time to execute."
1:40 Challenges for small hospitals and small practices
3:10 New ONC EHR certification proposal and continued questions about Meaningful Use Stage 2
5:00 Prioritizing with multiple healthcare reform initiatives underway, including proposed SGR repeal
6:30 Surviving ICD-10 transition
7:35 HIMSS' position on MU2 timelines
9:05 Remember "macro objective" of Meaningful Use
10:00 Letter to CMS from organizations not including HIMSS calling for what he says are "very vague" changes to MU2 criteria
11:40 Things in MU2 causing providers fits
13:05 Fewer EHR vendors certified for 2014, but more HIMSS exhibitors
15:00 What this means for providers who bought products certified to 2011 standards
17:20 Progress on Meaningful Use so far
21:00 Looking toward Stage 3
22:42 What healthcare.gov struggles might mean for health IT
25:35 Other aspects of the Affordable Care Act being lost in the public debate
27:10 Political considerations related to health IT
29:40 Patient engagement and new HIMSS exhibitors
32:20 Why healthcare spending and provider shortage forecasts don't account for efficiency gains made from technology and innovation
35:10 Demographic challenges for healthcare
35:45 Shift from hospitals to ambulatory and home care and consolidation of provider organizations

Direct download: Steve_Lieber_-_HIMSS14.mp3
Category:podcasts -- posted at: 11:12pm CDT

Two months ago, I interviewed neurologist Ray Dorsey, M.D., co-director of the Center for Human Experimental Therapeutics at the University of Rochester, for a story I wrote based on a study he led. He had a lot of interesting things to say and, unlike so many other physicians, was aware of multiple system atrophy, the disease that killed my dad in 2012, so I decided to have him on for a podcast to describe how he is using off-the-shelf telehealth technology to expand access to care, improve patient satisfaction and reduce costs.

The study focused on Parkinson's disease, as does a new study Dorsey is leading through http://connect.parkinson.org, but Dorsey sees this technology as promising for treating autism and Alzheimer's disease as well.

We, of course, discussed cross-state licensure holding back wider use of remote care, a subject that is very much in the news right now. In fact, Health Data Management just published a story I wrote about, in part, the launch of the Alliance for Connected Care. This group, headed by three former senators and including CVS Caremark, Walgreens, Verizon Communications, WellPoint, Welch Allyn, Cardinal Health and telehealth companies HealthSpot, Teladoc, Doctor on Demand, MDLive and GE-Intel Care Innovations, is advocating for regulatory changes to expand remote care.

Podcast details: Interview with University of Rochester neurologist Ray Dorsey, M.D. MP3, mono, 128 kbps, 16.3 MB. Running time 17:54.

1:30         Telehealth to expand access to care for people with chronic diseases

2:00         Shocking numbers about Medicare beneficiaries with Parkinson's who don't have a regular neurologist

2:45         Lack of reimbursement for telehealth even though it costs substantially less than in-person visits

3:38         Incentives to provide care in "high-cost, relatively unsafe environments"

3:58         Insurers "are never going to lead the way" in terms of innovation

4:40         Previous study funded by PatientsLikeMe, the Verizon Foundation and Medtronic funded his study

5:40         Findings of that study, and advantages of remote care

6:25         Telehealth to increase access to care, improve patient satisfaction and reduce costs

6:50         New study on "virtual house calls" about to launch in collaboration with Patient-Centered Outcomes Research Institute (PCORI)

7:37         Low-cost, off-the-shelf technology

9:45         Registering for PCORI study

10:40       Cross-state licensure issues, including new Alliance for Connected Care

12:10       Parameters and goals for new Connect.Parkinson study

13:35       How technology is creating care opportunities for "anyone, anywhere"

14:10       Dealing with the newly insured and with special-needs patients

15:50       Savings from preventing falls and other dangerous conditions

16:10       Enrollment for Connect.Parkinson

16:42       About the Center for Human Experimental Therapeutics

 

Direct download: Ray_Dorsey_140218.mp3
Category:podcasts -- posted at: 3:36am CDT

Two weeks ago, I picked apart a terribly misleading, ideologically steeped Fox News story that wrongly linked the initial failure of the healthcare.gov Affordable Care Act insurance exchange to the Meaningful Use EHR incentive program. Among my many criticisms was the reporter's apparent confusion between an actual EHR and My Medical Records, the untethered PHR offered by MMRGlobal.

In that post, I said, "I haven’t seen a whole lot of evidence that MMRGlobal isn't much more than a patent troll."

Bob Lorsch, CEO of that company, posted in the comments that I should put my money where my mouth is and interview him. (I had interviewed Lorsch before, but never wrote a story because of my longstanding policy of not paying attention to untethered PHRs since none that I know of has gained any market traction, despite years of hype.)

As this podcast demonstrates, I took Lorsch up on his offer. It was at times contentious, in part because I challenged many of his statements in the Fox story and to me, and in part because he challenged some of mine.

He asked me a pointed question, whether I still thought he was a patent troll. Based on the fact that MMR actually earned patents on a product it actively markets and didn't just purchase someone else's patents for the point of suing others, it's hard to conclude that he is a patent troll.

Investopedia defines patent troll as:

"A derogatory term used to describe people or companies that misuse patents as a business strategy. A patent troll obtains the patents being sold at auctions by bankrupt companies attempting to liquidate their assets, or by doing just enough research to prove they had the idea first. They can then launch lawsuits against infringing companies, or simply hold the patent without planning to practise the idea in an attempt to keep other companies productivity at a standstill."

By that definition, MMR is not. I still don't think an untethered PHR is a good business model, a belief supported by the fact that publicly traded MMR is a penny stock, currently trading at less than 3 cents per share. I have said that patient engagement, called for on a small scale by Meaningful Use Stage 2 rules, could change the landscape for PHRs—with a better chance in pediatrics than for adult populations—but it certainly will take a few years.

I stand by my original statement that the Fox News story did health IT a huge disservice by latching onto one problem and trying to tie it to an unrelated issue simply because it fits an ideological narrative. As for MMR, well, take a listen and then judge for yourself. It's a long podcast, but I went through the trouble of breaking it down by discussion point so you can skip around as necessary.

Podcast details: Interview with Bob Lorsch, CEO of MMRGlobal, recorded Oct. 18, 2013. MP3, mono, 128 bps, 49.5 MB, running time 54:07

2:03        About My Medical Records

3:26        Why he believes his product is better than traditional EHRs

5:00        My skepticism of untethered PHRs

6:28        Lorsch's interview with HIStalk from February

6:40        MMR's user base

8:00        Why he thinks MMR could facilitate health information exchange

9:40        Health information exchanges vs. health insurance exchanges

10:15     Patient-centered HIE as an alternative to multiple patient portals

12:20     Physician trust of patient-supplied data, and other workflow issues

15:05     Emergency use case

15:50     How MMR is different from other PHRs

16:32     "Last mile" of connectivity

18:17     His assertion in Fox story that patients lose control of health information and privacy under ACA, despite HIPAA

24:15     MMR carries cyber liability insurance

25:00     Scope of MMR's patents

26:45     "Likely" infringement of patents

27:45     Lawsuits and licensing

29:30     Patent troll?

31:10     Negotiations with WebMD and others

33:00     MMR's reputation

35:00     "We build and sell what we have intellectual property rights to."

36:25     Other vendors ignoring patients?

36:50     Standardization in health IT

38:38     MMR's low stock price

39:20     Patient engagement boosting PHR use?

42:00     Interest from WellPoint

42:48     Payers building trust with PHRs

44:18     Other features of MMR's PHR

46:45     Segmentation of sensitive parts of medical records

49:08     Putting me on the spot

50:35     His objective in asserting patent rights

51:15     MMR's issue with Walgreens

52:25     Revenue sharing vs. licensing

Direct download: Bob_Lorsch_interview.mp3
Category:podcasts -- posted at: 1:43am CDT

Once again, as has become custom, I sat down with HIMSS CEO Steve Lieber at the organization's Chicago headquarters the week before the annual HIMSS conference to discuss the conference as well as important trends and issues in the health IT industry. I did the interview Monday.

Here it is late Friday and I'm finally getting around to posting the interview, but it's still in plenty of time for you to listen before you get on your flight to New Orleans for HIMSS13, which starts Monday but which really gets going with pre-conference activities on Sunday. At the very least, you have time to download the podcast and listen on the plane or even in the car on the way to the airport. As a bonus, the audio quality is better than usual.

Podcast details: Interview with HIMSS CEO Steve Lieber about HIMSS13 and the state of health IT. Recorded Feb. 25, 2013, at HIMSS HQ in Chicago. MP3, stereo, 128 kbps, 46.0 MB. Running time: 50:17.

1:00        Industry growth and industry consolidation
2:50        mHIMSS
3:45        Why Dr. Eric Topol is keynoting
6:00        New Orleans as a HIMSS venue
6:50        Changes at HIMSS13, including integration of HIT X.0 into the main conference
8:55        Focus on the patient experience
9:35        Global Health Forum and other "conferences within a conference"
13:00     Criticisms of meaningful use, EHRs and health IT in general
17:00     Progress in the last five years
20:45     Healthcare reform, including payment reform
22:30     Why private payers haven't demanded EHR usage since meaningful use came along
23:50     Payers and data
26:28     Potential for delay of 2015 penalties for not meeting meaningful use
29:15     Benefits of EHRs
30:40     Progress on interoperability between EHRs and medical devices
32:52     Efficiency gains from health IT
35:27     Home-based monitoring in the framework of accountable care
36:55     Consumerism in healthcare
39:40     Accelerating pace of change
41:10     Entrepreneurs, free markets and the economics of healthcare
43:25     Informed, empowered patients and consumer outreach
46:30     Fundamental change in care delivery

Direct download: Steve_Lieber_HIMSS13.mp3
Category:podcasts -- posted at: 5:00pm CDT

Did you happen to catch my story in MobiHealthNews on Thursday about Carrie Handley, the IT consultant-turned-cancer patient? She got frustrated with first a misdiagnosis and then the hassle of lugging around a binder full of paper records that she had to go to multiple sites to collect to assure continuity of care during her treatment and surgeries. So Handley digitized all her records.

Initially, she transported the information on a USB drive, but that got lost in a doctor's lab coat. Then, her son brought over an iPad. The tablet provided the right balance of portability and shareability. In this interview, Handley, a resident of Waterloo, Ontario (you know, the home of BlackBerry maker Research in Motion), describes the process and shares her thoughts in general on mobility in healthcare.

We wouldn't have connected if she hadn't read my tribute to my dad last month. After reading Handley's story in the e-mail she sent me, I knew we had to do this podcast to help spread the idea that communication can help foster the kind of patient-centric care that eluded my dad, that initially eluded her and that probably eludes millions of people every year.

This Sunday is Father's Day. I miss my dad terribly. But I take comfort in knowing that I'm doing a small part to raise awareness of multiple system atrophy (MSA) -- the rare neurodegenerative disease that killed him -- and perhaps advancing the cause of patient safety ever so slightly.

Podcast details: Interview with health IT consultant and cancer survivor Carrie Handley about mobility in healthcare. MP3, mono, 128 kbps, 26.7 MB. Running time 29:13.

Direct download: Carrie_Handley.mp3
Category:podcasts -- posted at: 12:17am CDT

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

Direct download: Steve_Lieber_Feb_2012.mp3
Category:podcasts -- posted at: 4:01pm CDT

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

Direct download: Rasu_Shrestha_-_UPMC.mp3
Category:podcasts -- posted at: 8:23am CDT

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

Direct download: Patty_Mechael.mp3
Category:podcasts -- posted at: 2:11pm CDT

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

Direct download: Eric_Dishman_MGMA_11.mp3
Category:podcasts -- posted at: 12:50am CDT

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

Direct download: IBM_Scott_Schumacher.mp3
Category:podcasts -- posted at: 3:50pm CDT

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

Direct download: IBM_Lorraine_Fernandes.mp3
Category:podcasts -- posted at: 12:48am CDT

Gartner's Vi Shaffer on HIE, ACOs and meaningful use

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

Direct download: Vi_Shaffer_AMDIS_2011.mp3
Category:podcasts -- posted at: 12:12pm CDT

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

Direct download: Rick_Kneipper_-_Anthelio.mp3
Category:podcasts -- posted at: 3:26pm CDT

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

Direct download: Peter_Waegemann.mp3
Category:podcasts -- posted at: 12:17am CDT

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

 

Direct download: Steve_Lieber_-_HIMSS11.MP3
Category:podcasts -- posted at: 9:37pm CDT

One of the more interesting figures in health IT is Evan Steele, the outspoken CEO of ambulatory EMR vendor SRSsoft. For years, Steele pushed his Montvale, N.J.-based company’s “hybrid” EMR as a product that won't slow down "high-performance" physicians. After passage of the American Recovery and Reinvestment Act in 2009, Steele openly boasted that his customers—mostly specialists—were prepared not to receive bonuses for "meaningful use," a program he believes is skewed toward primary care.

Recently though, Steele has shifted his stance. SRSsoft has rebranded "hybrid" EMR as SRS EHR and now is seeking certification so customers can qualify for the federal incentive program. What makes Steele tick and what led to his change of heart? This podcast provides some answers.

I apologize for the audio quality. I was using a new telephone recording device, and clearly don’t have the settings right. I edited this on an airplane, and the recording was tolerable. Just listen with a bunch of background noise and it’ll be fine. :)

Podcast details: Interview with Evan Steele, CEO of SRSsoft. MP3, stereo, 128 kbps, 27.8 MB. Running time 28:22.

0:57 "Hybrid" EMR and physician productivity
1:40 Change in direction for the company with certification
2:15 What has and hasn’t changed with the product itself
3:10 Still targeting "high-performance" physicians
5:25 Why he says SRS EHR won’t slow physicians down
6:40 Documentation options
7:30 Why he believes Stage 1 meaningful use is skewed toward primary care
9:40 Changes in final regulations that focus on specialists
10:35 Why SRS is seeking certification now
13:00 Differences between SRS and other vendors
14:00 Physician confusion about meaningful use
15:40 "Unnatural" elements for specialists in meaningful use
16:30 Innovation being "sapped" from marketplace
17:00 Gamble of the stimulus
18:15 How SRS is innovating within the confines of the new rules
20:00 Expectations for HIMSS11
22:05 What SRS gets out of going to HIMSS
23:30 SRS’ niche among large, enterprise systems vendors
26:20 Message for HIMSS attendees

 

Direct download: Evan_Steele_SRSsoft.MP3
Category:podcasts -- posted at: 8:48pm CDT

At the Mobile Health Summit in Washington, D.C., in November, I had a chance to meet Don Jones, vice president of health and life sciences at Qualcomm, for the first time since July 2008, when were both at the m-health week of the Making the eHealth Connection series in Bellagio, Italy. As a founding board member of the West Wireless Health Institute and chairman of the Wireless-Life Sciences Alliance, Jones is a key player in wireless and mobile health both in the U.S. and abroad. In this podcast, we chatted about Qualcomm's interest in this industry, the progress and potential of m-health and what to look for in the future.

Podcast details: Interview with Don Jones, VP of health and life sciences at Qualcomm. Recorded Nov. 10, 2010, at Mobile Health Summit in Washington, D.C. MP3, stereo, 128 kbps, 32 MB, running time: 34:58.

0:30        Qualcomm’s history in wireless healthcare
1:00        Founding of West Wireless Health Institute and Wireless-Life Sciences Alliance
3:30        Global focus of mHealth Summit and needs in different parts of the world
4:40        Progress in developing countries
5:35        Qualcomm’s partnerships, including master’s program at Scripps Research Institute
6:40        Role of mobile/wireless in EHRs and “meaningful use”
7:50        Quest Diagnostics empowering consumers with app for reporting test results
9:00        Auto-population of patient records and medication reminders
10:25     Consumers embarrassing doctors by adopting technology first
11:15     Physician adoption of PDAs, smartphones and now iPads because they save time
13:05     What the iPad is missing, and the future of touch-screen tablets
14:30     Infection control with mobile devices
15:15     Low-cost imaging technologies replacing the stethoscope
16:40     Possible regulation of smartphones and apps as medical devices
18:30     Safety risks in healthcare without technology
19:45     Thought leadership at mHealth Summit
20:25     Orange and GE Healthcare’s city-wide, cloud-based PACS in Paris
23:00     Mobile/wireless in the context of health reform
25:10     Health delivery reform vs. health insurance reform
27:30     EMRs and incentive payments
28:50     Reimbursement/payment for wireless technologies
31:00     Building a competitive environment in healthcare
32:05     Progress to expect in the next year
33:20     Likely product launches in early 2011
34:05     Operator-driven medical devices

 


Direct download: Don_Jones_mHealth_Summit.MP3
Category:podcasts -- posted at: 12:37am CDT

Nearly two months ago, I was honored to be a participant in the closing panel session at the mHealth Initiative’s 2nd mHealth Networking Conference in San Diego. I happened to record the audio of that session directly off the sound board. I present that recording here.

Other participants on the panel, which addressed hype vs. reality in mobile healthcare, were: C. Peter Waegemann, mHealth Initiative founder; John Mattison, M.D., CMIO of Kaiser Permanente; and Paulanne Balch, M.D., physician lead for KP Health Connect messaging.

You should know my gravelly, hesitating voice by now. The man with the German accent is Waegemann and the other male voice is Mattison's. Obviously, the female voice belongs to Balch, though mHealth Initiative President Claudia Tessier makes a couple of appearances.

Podcast details: Panel discussion from mHealth Initiative 2nd Networking Conference on hype vs. reality, featuring Neil Versel, Peter Waegemann, Paulanne Balch, M.D., and John Mattison, M.D. Recorded Sept. 9, 2010. MP3, stereo, 128 kbps, 77.6 MB, running time 1:21:26.

0:00 Intro (Waegemann)
0:45 Hype around untethered PHRs (Versel)
2:40 PHRs and projections for future (Mattison)
5:50 Why there’s hype (Versel)
7:15 Consumer perspective on connectivity (Balch)
8:15 “Mind-blowing” applications in m-health (Waegemann)
8:50 iPhone replacing the stethoscope (Versel)
9:45 M-health as the “horseless carriage” (Balch)
10:25 What problem m-health addresses and what’s missing (Mattison)
12:10 Power of text messaging (Versel)
12:55 Patients texting during exams (Balch)
13:35 Audience question: What’s next after m-health
13:55 M-health is an enabler (Waegemann)
15:15 Too much unfiltered information (Mattison)
16:55 Movement to a knowledge-based society (Waegemann)
18:00 Machine-data interactions, escalated to experts as needed (Mattison)
19:00 Vision of personalized shopping experiences to choose healthy food (Balch)
19:45 Evolution of information sharing in healthcare (Waegemann)
21:40 How computers have changed teaching to focus on heuristics (Mattison)
23:15 Understanding context (Versel)
24:10 How m-health will change health information management (Waegemann)
24:35 The evolution of transcription and HIM (Claudia Tessier)
26:30 Changes in how information is collected (Balch, Mattison)
27:30 What you can’t find on the Internet (Mattison)
28:15 Audience comment: The future will favor those who can integrate information
28:55 Different types of information processing (Mattison)
29:30 Audience question: Where does consumer trust come from in healthcare?
31:25 Loss of collegiality due to EHRs and text messaging (Mattison)
33:45 Trusted entities (Mattison)
35:40 Generational differences in trust of doctors (Versel)
37:40 Lessons from early adopters (Balch)
39:25 Migration away from direct social contact (Mattison)
41:00 Systems for patients to describe their conditions (Waegemann)
41:50 Clinical Document Architecture to handle structured and unstructured data (Mattison)
44:35 Gaming for better health (Balch/Mattison)
45:50 Audience question: How much leadership does Kaiser show in this area?
46:30 Aneesh Chopra’s visit to KP’s Garfield Center (Mattison)
48:20 Can other organizations close the digital divide? (Waegemann/Mattison)
49:45 Kaiser looking at open-source technology (Mattison)
50:25 Power of text messaging and social networking (Balch)
50:50 Encouraging healthy behavior through information (Waegemann)
51:40 Embracing basic mobile technologies (Versel)
53:25 Mobile is changing economics of healthcare (Mattison)
54:30 Consumers equating more care with better care (Versel)
55:30 Technology vs. cultural attitudes (Mattison)
56:15 Audience comment: Fee-for-service model needs to change
56:40 Kaiser vs. fee-for-service model (Mattison)
58:20 Audience question: What is boundary between health/fitness and clinical/therapeutic apps?
59:25 Standards for evidence-based medicine (Mattison)
1:02:15 Audience question: How do you accelerate cycle time for discovery?
1:02:35 EHR as an observational, enrollment and tracking tool (Mattison)
1:04:00 Consumers will drive app acceptance (Balch)
1:04:20 User interfaces (Waegemann)
1:04:55 No comment (Mattison)
1:05:10 Audience question: Will mobile widen digital divide between healthcare and “enemies” of population health?
1:07:05 Who is custodian of individual data? (Mattison)
1:08:20 Knowing consumer preferences (Balch)
1:08:40 Wish list for m-health (all panelists and some audience members)
1:20:10 “Journey” of mobile health (Waegemann)</span>

Direct download: mHealth_Initiative_panel.MP3
Category:podcasts -- posted at: 3:33pm CDT

Last Thursday, for the fourth consecutive year, I sat down with HIMSS CEO H. Stephen Lieber for an interview ahead of the opening of the annual HIMSS conference. For the third consecutive year, the recording actually worked. And for the second consecutive year, I went to HIMSS headquarters in downtown Chicago for the interview, rather than waiting for the conference itself. Unfortunately, the HVAC system in the conference room was rather noisy, so there is some background noise. Still, the voices come through loud and clear.

I wrote a story based on this interview in Monday's FierceHealthIT, but here is the world premiere of the full recording.

Podcast details: Interview with HIMSS CEO H. Stephen Lieber on the 2010 HIMSS conference, recorded Feb. 18, 2010. MP3, stereo, 128 kbps, 31.7 MB, running time 34:36.

1:00 State of the HIT industry a year after ARRA
2:20 HIMSS10 registration patterns
5:00 Types of vendors exhibiting this year
6:30 Mobile applications
8:20 HIPAA, 5010 and ICD-10
10:15 Health IT's role in healthcare reform 13:45
Health IT alone can't fix healthcare
15:40 Getting the word to physician practices about meaningful use
17:55 Hospital-based physicians and meaningful use
19:15 Pressure to achieve meaningful use
20:15 Why HIMSS doesn't support weakening of requirements
21:40 Health IT workforce issues
25:10 Hiring IT professionals laid off from other industries
26:40 The future of certification
30:00 Clinical decision support comes of age
31:55 Focus of the 2010 conference

Direct download: Steve_Lieber_02-18-10.MP3
Category:podcasts -- posted at: 12:10am CDT

Jeff Margolis, founder, chairman and CEO of The TriZetto Group, has written a book, called "The Information Cure." In it, Margolis discusses his vision for "integrated healthcare management," the combination of information technology and process improvement on both the administrative and clinical sides of healthcare to change deeply ingrained behaviors.

We recorded this way back on Sept. 10, the day after President Obama pitched his healthcare bill to a joint session of Congress, and I unfortunately sat on this recording for more than four months. The legislation may have changed considerably since then—and may be headed for the trash heap anyway—but the problems plaguing healthcare in the U.S. persist. Thus, I present this podcast, still as fresh as the day it was made.

Podcast details: Interview with Jeff Margolis of The TriZetto Group. MP3, stereo, 64 kbps, 16.4 MB, running time 35:54

0:25 Integrated healthcare management
2:05 Health reform and quality of care
3:20 The book’s consumer focus
4:40 Collection of massive amounts of administrative data
5:25 Fragmentation of data
6:20 Payers managing "healthcare supply chain"
7:15 Using information to identify "value-based benefits"
8:00 Consumers and cost, prevention and chronic diseases
9:20 Physicians and "value-based reimbursement"
11:10 Slow diffusion of information in healthcare
12:05 Physicians clueless about what things cost patients
13:50 Price transparency to consumers
14:30 Real-time claims adjudication/eligibility checking
15:50 Thoughts on the stimulus
17:15 Avoiding "digital silos"
19:10 No single, right answer in health reform
20:30 Assembling "virtual supply chains," like Amazon
21:30 EHRs in the big picture
22:20 Patient as the aggregator
24:15 Vision for new eligibility transactions
26:15 Data enabling physician cash flow
27:50 Role of personal health records
28:30 His definitions of EMR, EHR, PHR
30:10 Why EHR vendors are "overreaching"
31:05 Organizing principles of health information exchange
33:05 Patients vs. consumers
34:45 Takeaway message of the book

Direct download: Jeff_Margolis_-_TriZetto_091009.mp3
Category:podcasts -- posted at: 4:30pm CDT

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: 11:21pm CDT

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: 7:01am CDT

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: 2:46am CDT

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: 5:03am CDT

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: 11:42pm CDT

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: 1:36pm CDT

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: 12:15pm CDT

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: 10:49pm CDT

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: 2:40pm CDT

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: 12:30pm CDT

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: 11:22am CDT

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: 10:00am CDT

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: 10:30am CDT

WASHINGTONâ��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: 2:07pm CDT

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: 10:55am CDT

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: 5:48pm CDT

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: 9:23pm CDT

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: 8:37am CDT

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: 6:41pm CDT

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: 11:31pm CDT

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: 3:17pm CDT

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: 10:42pm CDT

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: 12:16am CDT

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: 10:07pm CDT

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: 12:01pm CDT

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: 8:31am CDT

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: 10:08am CDT

    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: 3:27pm CDT

    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: 4:22pm CDT

    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: 9:03pm CDT

    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: 1:02pm CDT

    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: 10:24pm CDT

    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: 1:15pm CDT