Dec 11 2008

World Healthcare Innovation and Technology Congress Day 3 Wrap-up and Summary

Category: HealthTim @ 9:27 am

The final day of the World Healthcare Innovation and Technology Congress began with a bag, Scott McNealy from Sun discussing how Open Source works for healthcare. McNealy’s presentation was incredibly entertaining; equal parts insightful information and stand-up comedy. Here is a sampling of quotes from McNealy:

  • We must go digital. Just look doctors handwriting and you’ll see, we must go digital.
  • Open Source is a very old concept that we’ve been doing since 1982. If I can go a little Al Gore here, we invented Open Source.
  • Public key encryption schemes are the best option. If you have a secret in your code, it will be discovered and breached. Humans cannot keep a secret. What if the Trojan horse was made of glass? Would they have let it in?
  • When I hear “enterprise license agreement,” I think, “The first hit of heroin is free.”
  • Technology has the shelf life of a banana; it will be outdated before you can roll it out.

McNealy’s message centered around the very real impact Open Source is having on the market and how that success can be brought to healthcare. Sun has spent $26 Billion on research and development and is currently involved in the creation of the Nationwide Health Information Network (NHIN).

Open Source has tremendous advantages including avoiding “format rot” in archiving information. What happens 20 years from now when someone needs to open a document created in a proprietary tool like MS Word? Or better yet, how does one render a document created in the Wang system? With Open Source you can bundle the files with the rendering agent.

In a nutshell, McNealy says there are 7 reasons to be open

  1. Lower barriers to entry
  2. Increased security
  3. Faster procurement
  4. Lower cost
  5. Better quality code
  6. Open standards last longer
  7. Lower barriers to exit

As a recovering developer, his comments on better code peaked my curiosity. Basically, developers are very protective of their reputations and releasing code into an open environment for the scrutiny of other codes ensures the code is top-notch. Open Source code tends to be written cleaner and documented thoroughly; coders are opening their robes and exposing themselves to the world. They want to look good.

My favorite comments dealt with the privacy question and how it works the same in the Open Source world. First, “Somebody a long time ago someone said you don’t have privacy, get over it. Oh wait, that was me.”  And the second quote, dealt with what is perceived now as a secure delivery system, the US Post Office. “You take an 8 x 11 piece of paper, stuff it in a folded paper envelope, seal it with spit, write unblinded information in the outside in the to and from areas, give it to the Federal Government for a couple of days, stick it into a tin box, all with the hopes that it will get there.” Yet somehow we worry about the level of encryption used on networks or go so far as to print everything and take them out of the secure networks to set them on a desk.

In closing, McNealy had one more comment on healthcare that resonated around the room, “There is only one industry more screwed-up than computers and that’s healthcare. You kill everyone eventually, I know you are working on it.”

I found more in that 30 minutes of Scott McNealy then I’ve found in entire conferences. I’m very appreciative of him and his taking the time to speak with us.

Next up, was a presentation on Direct Practice Medicine by Scott Shreeve and Jordan Schlain, two physicians who are delivering healthcare differently. Their belief is it’s not always about the throughput, it’s not always about speed, it’s about relationships. The business model involves seeing considerably less patients to avoid the “hamster wheel” syndrome of running faster and faster but not getting anywhere. Their patients subscribe to their clinic and have 24/7 access to physicians who actually know them and spend time getting to really know them. To pay for the services, subscribers increase decidable in their health insurance and use the money saved to pay the monthly access fee.

What I found intriguing was the level of detail in the understanding of the patient and access to care provided with their model. I’m not a physician, but I suspect most physicians enter practice to get to know and improve the lives of their patients. Somewhere along the line we have deviated into short episodes of disparate care that may be causing more harm then good. Having said that, I wonder what happens to patients who need care beyond what is being delivered in this manner, but I do like the concept. I’m going to watch the continued expansion of this model in the future and you can go to currenthealth.md to learn more.

Unfortunately, after this session, I had to be off to the airport and a return to the real world. However, on the way back, I take a couple of learning with me from the congress

  1. Healthcare is in the midst of a fundamental transformation that is being driven by customers, globalization, economic factors, and an unprecedented influx of technology
  2. Social networking on online communication have a central place in healthcare, both in the delivery of care and the support of the care process not to mention uniting the growing army of reformers who are finding support and ideas in the community.
  3. We still have a long way to go.

I want to thank the organizers of the congress for their hard work in putting together an event that was both informative and entertaining. One suggestion, in the future, you audience members are very tech savvy. Give them tables and outlets so they can document and report on the event, look-up resources being discussed, and possibly participate in events online.  Beyond that suggestion, I look forward to next year’s conference.

For more on the congress, try these:

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Dec 10 2008

World Healthcare Innovation and Technology Congress – Day 2 Wrap-Up

Category: HealthTim @ 10:28 am

Day 2 of the World Healthcare Innovation and Technology Congress started early with a 7:00 AM breakfast sponsored by Alcatel-Lucent. Early morning meetings are usually rough, but many of us were from other time zones and we were less than talkative. They probably needed stronger coffee and an IV drip to get the group going. The main message from Alcatel-Lucent talk; the network is in the path of care. This has many meanings, but it echoed the general theme of the entire conference.

Next up was the opening keynote address from Microsoft’s Peter Neupert focused on consumer driven healthcare changes on how online communities are creating new points of care. The disparate communications between the patients, care providers, and family and friends cause significant stress on the patients and producing negative outcomes. Online communities can deliver the same message to all concerned with the patient and ease this stress. Neupert’s message, it’s not about the technology, but the outcomes we are trying to enable. Agreed. Just not sure I want to go to the Microsoft Hospital. Probably needs to be rebooted every twelve patients…

Another interesting point was the discussion about using all this data we are collecting on patient treatment and outcomes to create logic and assist the physician in the care of the patient. While this is not a new concept, it was a good reminder of the benefits of EMRs and true interoperability, the utilization of data to improve outcomes. Let’s face it, there is too much to know to be able to handle all situations a care provider may encounter.

Frank Torti of the FDA challenged my thinking and made me look at the role of the FDA in a different light. Torti is a scientist and discussed the infusion of science into an agency that regulates products accounting for 25% of all consumer spending. The challenges to the FDA are growing due to overseas manufacturing of drugs, medical devices and food, bio-terrorism, and the accelerated change in technology. To keep up with these challenges, the FDA is turning more to science and three principles: partner more and smarter, maintain a core of scientific expertise, and be preemptive with their scientific strategy.

Next was a demonstration of “cutting-edge” technologies. The first was a merging of video conferencing and translators from LifeLinks. Their system was impressive, but the most entertaining part of the demo was seeing a member of the audience who recognized and reacquainted herself with one of the interpreters. From that point on, the demo bordered on being more of a dating service, but seeing the interface work in that fashion proved to be an effective illustration of its success. The second demo was an impressive data informatics and business intelligence tool by MedE Financial. However, I’m still left wondering, how do we get good data into systems do perform this type of analysis. We need to remove human error as much as possible.

After lunch, we broke into three executive tracks involving 4 presentations. The first I attended was on a clinical intelligence system for providers that demonstrated an intuitive and powerful tool that could be quite useful. The second was a demonstration from the Social Security Administration and their efforts with the NHIN and finding ways to process claims in hours instead of months.

Next came the two highlight presentations of the day; Consumers at the Center with Greg Matthews of Humana and Second Life and Virtual Worlds with GT Sweeney.

I had the pleasure of meeting Greg Matthews first via Twitter on day 1 of the conference. He was part of the 5 or 6 of us who were live tweeting during the event and building our own little network. When Greg realized his breakout session was in the “big room,” he put out a call to Twitter group to attend his session.

Greg and Humana are working on strange (for an insurance company) and wonderful uses of technology and social networking to improve their customer’s health. From the Free Wheeling bike program (freewheelinwaytogo.com) featured in this year’s presidential conventions to the new efforts with Exer-games, his team of innovators pushed my thinking and challenged me to figure out better ways to reach-out and engage our customers. For more on Greg’s team and their programs, check out their blog crumpleitup.com. The name says it all.

The SecondLife demo was also strong and my favorite part was watching the virtual presenter from London take over the show, talk to us from a podium, display his slides, and even gesture to the slides all within SecondLife. One can always benefit from a live demonstration of technology in action and despite the challenges, live demos are the best way to go. The possibilities for community development and personal interaction were racing through my mind.

These two sessions are why I came here; they illustrate and demonstrate what is possible to stretch our thinking. The event provided me the ability to connect virtually and face-to-face with like-minded individuals who share my interests and deal with the same pains. When you think about it, this really is a massive dating service helping you to find sole-mates who share your interests…

My day concluded with a presentation on the international perspective of healthcare and the global economy. I found two key messages in this talk. First, Denmark has built a very slick and comprehensive health information network and it is being used. They average 4.5 million messages a month from a country of 5.5 million. The second lesson spoke of the challenges in universal healthcare in a global and moving marketplace. It’s great when you have universal healthcare in your country, but what happens when you cross boarders into someone else’s universal system? Add to the mix medical tourism and there could be a steep price in the future.

After 11 straight hours of sitting, listening, tweeting, and taking notes, my back told me it was time to go. I’ll have to watch today’s closing address on the CD-ROM that I’m ordering. Overall day 2 of the World Healthcare Innovation and Technology Congress was a smashing success and well worth my time. I only wish there were more people here to listen to these presentations and share the growing excitement.

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Dec 09 2008

World Healthcare Innovation and Technology Congress – Day 1 Wrap-Up

Category: HealthTim @ 8:44 am

The first day of the World Healthcare Innovation and Technology Congress provided abundant information and gave a glimmer of hope to those of us trying desperately to improve healthcare through the infusion of IT.

I arrived at the conference after the opening keynote address and and entered the conference during a presentation called: How the Current Economic Challenges are Changing the Future of Innovation Investment. Understanding where the business opportunities are in healthcare and specifically where venture capitalists are seeing opportunities, is a telling case as to where things will be heading in our industry.

The first question, is there still VC money out there was answered with a qualified yes; there is money, but it is more discerning in the selection process. What was interesting to me was the amount of individual investments seems to be increasing. If you have a good concept and business model, you will not only be funded, but will likely find more funding then prior efforts. Part of the higher awards may be a by-product of the recommendation for “more realistic” timelines in business models.

Other learning from the presentation, treatment will continue to dominate attention over prevention because the aging population, blockbuster drugs are still out there and even incremental improvements can create tremendous opportunities in drugs, personalized drugs will grown in importance, and 1/3 of all prescriptions are not fulfilled and many patients do not follow the regiment prescribed.

Next, I went to a panel presentation called: Moving Connectivity Across the Healthcare Spectrum: Contemporary Approaches to Collaboration Management and Web 2.0 Technologies

One theme: In social networking, the individual is seen as a node and the tools are designed to connect nodes together. This makes sense, but lacks the personal feeling that is the true driver in social networking, but it helps from an IT perspective. I believe it is that individual’s need to connect is what drives nodes to other nodes. It was also suggested that social networking can be used in medical education to allow students to “experience” health events by following patients who are using social networking to cope with their care. Interesting….

The key message here was, patients are feeling increasingly empowered to access their patient information and the greater liability may come from those who are NOT embracing these technologies. Sharing medical information with patients is no longer an option, but a requirement.

Next was the highlight of Day 1: Newt Gingrich. Newt is a politician and politicians, the good ones, always seem to give excellent presentations. Newt is a good politician.

Favorite Newtisms:

  • I worked very hard to defeat John Kerry because he was left of Kennedy and I was afraid he would nationalize the banks
  • The Bush stimulus package is just dumb. It’s like giving a teenager amphetamines so they could get even crazier before they crash
  • It will be virtually impossible for Obama to make health a real priority. It will take 6-9 months just to sort through the wreckage.
  • We are in a great time of discontinuity in world. It is not a time of marginal change

You get the idea. Bottom line, we are in a mess, but things are moving forward. Expecting fundamental and instantaneous change is not realistic and will likely cause more problems then solutions.

The final presentation was from the iRobot company showing how in-house robots could be used to reestablish physician house calls with a 21st century twist. Your doctor is giving you an examination via robotics, video, audio, and health monitoring tools. Interesting, but a bit creepy. The best quote from the presenter when displaying an elderly woman smiling at a robot in her home, “Some people find this image disturbing.” The times they are a-changing.

The evening reception proved to be very interesting as well. As fate would have it, a physician from University of Oklahoma sat at my table and we struck-up a conversation. Being both an employee and a fan of the University of Texas, I opened with 45-35. For those of you who don’t know, OU is in the national championship even though UT defeated them. I guess this is another example of how IT can make a mess of things.

Once we moved on, we had a very interesting discussion about the challenges facing both our institutions and in the end, I think we are going to work together to help them start working on their own physician portal. Funny how things work out.

At the end of the first day, I was very glad I came to the conference. To find time to think, I decided to do what must be done in DC; I went to talk to Abe. Even without the cold temperature, I always get goose bumps.

Lincoln Memorial

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Nov 20 2008

HIMSS Virtual Conference Day 2 Wrap-Up

Category: HealthTim @ 9:55 pm

Today, I attended Day 2 of the HIMSS Virtual Conference & Expo. This was the final day of the conference and had a slightly shorter agenda than yesterday.

For me, the highlight of today’s presentations was one from Dr. Albert Villarin called Clinical Decision Support in the Trauma Center: A Practical Guide to Clinical, Administrative and Quality Informatics. The talk centered around an impressive use of technology to improve efficiencies and care in a busy Philadelphia trauma center. As a recovering programmer, I was intrigued to discover they were using Cold Fusion 8 as their primary development language. Apparently, reports of Cold Fusion’s demise were greatly exaggerated.

At the end of the conference, a couple of things stuck-out in my mind. First, the integration of process improvement techniques through healthcare information technology (IT) continues to make significant gains in clinical operations. I’m seeing more use of data analysis for the purpose of improving processes and producing better clinical outcomes. My biggest frustration in IT is when IT is used for IT’s sake; not to make significant process improvements. Thankfully, we are seeing more evidence of the “proper” use of technology.

The second major learning for me was the use of Web 2.0 tools that surrounded and augmented the conference, but were not actually part of the conference. HIMSS had a Twitter account and used Twitter to promote and connect attendees during sessions. Personally, I met many others who shared my interests in HIT and Web 2.0 through the use of Twitter. While the conference structure had a “lounge,” the purpose of the lounge seemed more about sales and not so much about networking. Tweeting on Twitter afforded me the opportunity to talk to others about presentations while they were occurring. In a typical conference setting, that type of cross-talk would be frowned upon. Here, it proved to be very beneficial.

For the next virtual conference, I believe HIMSS should explore adding more Web 2.0 features into their conference structure and encourage more of these connections. When establishing my profile, there were opportunities to enter an Instant Messaging ID, but who uses IM anymore? What if the conference took place in Second Life and had actual speaking avatars and meeting rooms? That would be interesting. Perhaps we could leverage professional profiles in LinkedIn to create your vCard as a way of connecting individuals. They could encourage using Twitter in lieu of the Q&A sessions. Perhaps contests could be established to promote use of these and other tools. After all, how can one learn the benefits of emerging technologies unless there is a meaningful purpose to use them?

I found a lot of value in the conference and look forward to the next one in June. I also hope HIMSS will be open to extending the networking capabilities and would be happy to do my part to help.

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Nov 20 2008

HIMSS Virtual Conference and Expo Day 1 Wrap-Up

Category: HealthTim @ 9:40 am

Yesterday, I attended the first day of the HIMSS Virtual Conference & Expo. HIMSS is the Healthcare Information Management & Systems Society and they describe themselves this way:

The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry’s membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.

I’ve been a member of HIMSS for the past couple of years, attended the HIMSS conference in 2006, and received my CPHIMS (Certified Professional in Healthcare Information and Management Systems) certification in May of 2007. Suffice it to say, I believe in this organization and the role they play in healthcare IT.

My background includes spending time in many industries; always in an IT capacity. However, my current position is my first experience in healthcare and HIMSS has played a key role in my education and understanding of the challenges and opportunities within the healthcare industry. As we all know, finding the time for professional development and the budget for travel is becoming an increasing challenge. So, how does a professional find the time and the money to attend training? We attend virtually.

HIMSS offers a virtual conference to their members. The interface is slick and prompted my 17-year-old to say, “Cool” when he first saw it.

Of course, once you get past the glitz of the interface, it all boils down to the presentations which are delivered via WebEx. Let’s face it; a conference is only as good as the presenters and their materials. Fortunately, there were many quality presentations on Day 1, but the highlight was: “Smart Citizens, Smarter Patients: A Primer on Social Media and the Wisdom of Patients” by Jane Sarasohn-Kahn (www.healthpopuli.com). This presentation provided a wealth of information and gave me renewed hope that Web 2.0 and patient-focused care will ultimately improve both the care of patients and promote healthy living.

Now, I’m off to attend Day 2 and perhaps drop-by the vendor area. I’ll post a more complete update later today. If you attend the conference, let me know what sessions you found most useful and I’ll be sure to checkout any good presentations I missed.

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