HIMSS: Moving From Stimulus Hope To Real Health-Care IT Projects

If there was a dominant theme at this year's Healthcare Information and Management Systems Society (HIMSS) conference in Chicago, it was undoubtedly the federal stimulus--what the American Recovery and Reinvestment Act means for those with a health-care IT stake, and what they can do to capitalize on the opportunities it presents.

In keynotes and high-level presentations from the likes of actor Dennis Quaid, former Federal Reserve chairman Alan Greenspan and Kaiser Foundation Health Plan Chairman and CEO George Halvorson, HIMSS attendees heard the arguments that have since the Obama campaign and far earlier been so often repeated as to appear rote. In essence, American health care needs fixing on a number of levels and technology and should include the widespread adoption of electronic medical records (EMRs) as part of a national health information system.

The stimulus appropriations specific to EMRs--some $19 billion in incentive payments for physicians and hospitals that can demonstrate "meaningful use" of an EMR--are a catalyst for those efforts.

The stimulus "lowers the financial hurdle, undoubtedly," said Dr. George Taylor Jr., vice president of Health IT Programs at Northrop Grumman. "So the next piece is, how do you solve the problem of every doctor--trained in different places, with different styles and different preferences--with an EMR that's designed for one? How do you get past that? The important money is years out, so now is the time to get out there."

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While that nebulous "meaningful use" concept still hasn't been defined by the Department of Health and Human Services, the tone at HIMSS was "don't wait around."

Some sources expressed concern that back-end infrastructure, from storage capabilities to broadband, wasn't being accounted for--that is, that the stimulus money would benefit EMR adoption but not what was necessary to support it in the long term. Others had faith that the stimulus will do what it's supposed to: save health-care organizations enough money to spend on better, more efficient systems overall.

"There's enough money in that if they do it right, the cost savings in there will be enough to do those things," said Richard Howe, vice president of business development at Healthcare Informatics Associates, Bainbridge Island, Wash. "The stimulus package is adamant about standards--without that, you have nothing."

Various conversations between Channelweb and VARs, vendors, health-care CIOs and other industry experts throughout the conference painted the same picture: It is time to get past the initial excitement over the stimulus and anticipate what needs to be done next, whether "meaningful use" is defined or not.

"Everyone is on the stimulus bandwagon," said Jason Fradin, vice president of marketing and communications at InfoLogix, a Hatboro, Pa.-based solution provider. "But it's really nothing new to us."

Fradin's suggestion--that mainstream interest in EMRs and health-care IT was shining a light on something most folks inside of health IT have been doing for ages--wasn't exactly unique.

Nor was the thought that there are enough clues about "meaningful use" in the basic needs of a back-end infrastructure to support EMRs--namely, that an EMR needs to be easy to use and able to store, secure, regulate, share and sort data.

"A lot of the folks here have great [EMR] systems," said Scott Storrer, president and CEO of MEDivision, which makes payer software and management solutions designed to support EMRs. "But they can't do anything with the data. We're waiting for the stimulus to get a little bit more definition like everybody, but not a lot of people seem to be asking what the ecosystem is going to look like after that happens."

NEXT: The Struggle To Support EMRs

The infrastructure to support EMRs is the big question--and the big opportunity. With all the data floating around, HIMSS attendees buzzed, how do you manage it effectively?

"The American Recovery and Reinvestment Act certainly created a lot of interest. The dust is settling right now and we're trying to learn a bit more," said William "Buddy" Gillespie, vice president and CTO for WellSpan Health, a network of physicians, hospitals and clinics in Pennsylvania and Maryland. "Sustainability is the word. The infrastructure is sometimes forgotten, and it needs to be stable, expandable and scalable to protect the integrity of the system and the data."

"It's that piece that's often the last thing considered," added Rick Dallamann, marquee accounts manager at Syracuse, N.Y.-based solution provider CXtec. "That's why we're trying to stay two, three, four years ahead of where the industry is so we can meet it as it happens."

If interoperability is to be achieved, sources agreed, operability needs to happen first.

"We've described the content but beyond that, we need a way to transport it from place to place," said Dr. John Halamka, CIO of CareGroup Health System and CIO and dean for technology at Harvard Medical School.

"Health care is ultimately local," Halamka said. "When we start with the notion of a nationwide health information exchange, we start with cities and towns. But to answer it in a quizzical way, there's too much data and not enough wisdom. We're going to get even more data--just think, you can get 10,000 data points on every patient and look at it all. You'll never sleep again! So there needs to a way to separate the wheat from the chaff and tell you what you need to know. Infrastructure has to get in there. Here's a set of rules--best practices, alerts, reminders. Here are the tests you need. There's going to be an investment in automated Web services to build into EMRs and HIE [health information exchanges] on top of the data."

Rob Israel, CIO of John C. Lincoln Health Network in Arizona, said there's a lot good in the stimulus but EMRs are not going to become a huge, mainstream priority for physicians until incentive payments became penalties.

"You won't see EMR until there's forced usage," Israel said. "The government put a big carrot out there but is right now using a pencil for a stick. That's a big problem."

Israel, who uses Lumension security products through Lincoln Health Network, said the secure data exchange remained his biggest concern.

"There's only so much you can know about what's coming into your system," he said. "With an EMR, that's a huge amount of data. No one notices IT until it goes down, so keeping it seamless is the biggest challenge for any CIO. If anything, this may help us a bit with budget, but in the end, if there's room in the budget for a bone saw or a redundant server, bone saw wins, you know?"

NEXT: Channel Takeaways

Vendors and distributors alike have spent the past two months fine-tuning training programs for VARs on how to capture stimulus dollars, from health care to transportation to energy.

Distributor Avnet Technology Solutions four years ago launched Avnet HealthPath University, vertical-specific training for VARs to better equip them with knowledge and understanding of health-care environments and the ways in which they could get involved without being clinical giants like the McKessons, Cerners and GEs of the world.

"There are funding opportunities in all areas," said David Hutchinson, HealthPath Practice Leader at Avnet Technology Solutions, Americas. "But there aren't many hospitals built to support that kind of growth in [EMRs]."

HealthPath had already seen steady popularity, said Tony Vottima, Avnet's vice president of business development, but what was especially resonating with VARs was the hands-on experience and the inclusion of doctors to act as consultants for resellers when they made sales calls.

"That gives them instant credibility," Vottima said.

Credibility is often the hardest part of a VAR's health-care sell. More often that not, it's learning who to approach.

"The CIO is not the end user," said Hutchinson. "The nurses, and people like radiology, the lab, facilities, finance--they all have unique systems and they make buying decisions."

"We try to load them with info as much as possible," said Greg Davidson, senior health-care business development manager at Panasonic. "I do a lot of Webinars, and a lot of in-person training. Health care is complex, and they need door-openers, something to show they understand a health-care workflow. Hopefully, with the training, reseller ABC goes to a customer and the customer mentions something and light bulbs go off."