Health IT NEWS.Direct! journal by iLogy iLogy

Health IT NEWS.Direct! Global Healthcare IT News, Research and Intelligence

Editorial Advisory Board Dr Grant Fraser Chief Medical Officer Medical Wizards Corporation

CONTENTS

John Lightfoot Chief Technology Officer MedVentive Inc.

Health IT NEWS.Direct! is a global Healthcare Information Technology (Health IT) journal providing research, news, and business intelligence services. We publish several market research and strategic industry reports with key information for top management and decision makers in the healthcare technology industry. Health IT NEWS.Direct! is used by leading healthcare technology companies, hospitals, insurance companies, and media houses from around the globe.

10 Designed and Published on behalf of Health IT NEWS.Direct! by iLogy Healthcare Solutions

Editorial Cloud computing: Weathering the healthcare data storm Amoolya Moses

Review Article Redefining healthcare communication on the cloud Damir Ljuboja

Industry Perspectives Cloud-based

systems:

Why

they

represent the future of patient care Jeff Surges

Interview Industry strives for interoperable cloud solution Chris Gough PwC foresees Indian cloud computing market to be $4 billion by 2015 Dr Rana Mehta, Rajesh Ranjan

Editorial Team Managing Editor Dr B M John Assistant Editor Amoolya Moses Research Analysts Dr Raghavendra Rao Dr Chinmaya Chigateri Design Veeresh Mathapati Abhilash A

Mini Reviews

eHealth eClinicalworks deploys EHR solutions at Ohio Orthopedic Center of Excellence

Partners and Alliances

Agfa and Dell partner to provide medical image management solution on the cloud

INFORMATION

Products and Solutions

For contributions, author guidelines, and comments: editor@healthitnewsdirect.com

For advertisements and reprints:

Microsoft and GE Healthcare form novel IT company through JV

3M releases new ICD-10 financial analysis software and service

sales@healthitnewsdirect.com

Insights

IDC reports indicate an evolving HIE

Healthcare industry experts suggest

Editorial process: www.healthitnewsdirect.com/?page_id=7

iLogy reserves the right to use the information published herein in any manner whatsoever. No part of this publication may be reproduced in any form without the written permission of the publisher.

strategies to address mobile device security and privacy threats

Disclaimer Views and opinions expressed in this publication are not necessarily those of iLogy. While every effort has been made to ensure accuracy of the information published in this edition, neither iLogy and its employees nor its information vendors accept responsibility for any errors or omissions. Further, iLogy and its information vendors do not take any responsibility for loss or damage incurred or suffered by any reader of this journal as a result of accepting any invitation/ offer published in this edition.

market

21 24 25

H&HN survey illustrates IT utilization among 2012 ‘Most Wired Hospitals’

NEWS Indian pharma giant, Piramal Healthcare buys USA’s Decision Resources Group Global perspectives on health IT from Harvard Medical School thought leader, Dr Blackford Middleton

July - September 2012

EDITORIAL Cloud computing: Weathering the healthcare data storm Amoolya Moses Assistant Editor, Health IT NEWS.Direct!

In the recent decade, the healthcare industry has witnessed major

technology, patient data privacy and control were the two major

transformations in its dependence on information technology for

factors for the surveyed hospitals’ staged and cautious approach

achieving efficient workflow, quality care, and efficient use of

to adoption. Analysts GBI Research finds that although cloud

investments. Observing successes in other industries, healthcare

technology has reached the healthcare sector, it may just drift

has adopted these IT innovations and applied them to suit its

over developed economies, with North America, and in specific,

needs.

the US having the lion’s share. The industry growth has been staked at 20.5% CAGR from 2010 to 2017. Despite global

The frenzy to transform paper-based medical data into the more

bigwigs like Merge Healthcare, Inc., Carestream Health, Inc. and

efficient electronic form, and the increased need to document

CareCloud in the US, Agfa Healthcare of Belgium, and UK’s GE

and store data for future analysis has landed the industry with

Healthcare contributing to this market section, no single vendor

yet another dilemma of having to store and archive the exploding

holds a share of more than 5%, making it fragmented. However,

data volume. Innovations around managing large data sets and

this sunny forecast can be slowed down by compliance with

providing access without limiting it geographically or by devices

government policies, security concerns with hosting patient data,

have been addressed by cloud computing. The on-demand,

and interoperability.

SaaS offers both tangible and intangible benefits in the form of self-service ordering, large data storage, reduced maintenance,

This issue of Health IT NEWS.Direct! outlines the various aspects

continuity of services in the event of a disaster, archiving, lower

of cloud computing in healthcare. With Damir Ljuboja from The

capital investment and enabling CIOs to enhance quality care with

University of Texas, Austin, discussing the hypothesis of the

reduced costs. Taking the benefits of cloud to the next level, many

HealthCloud; Jeff Surges, CEO, Merge Healthcare gives us an

feel that it can be leveraged to tackle Big Data, and in turn convert

overview of cloud computing from the perspective of storing

raw information into actionable data.

and accessing imaging data. The issue also features industry perspectives on the various issues that plague the cloud

Keeping alive the concept first visualized by Professor John

computing industry in particular to the delivery of care and how

McCarthy in the form of computer time-sharing during the early

these can be addressed.

1960s, cloud computing is now considered the next big thing in With this comprehensive outlook on the cloud, the team at Health

health information technology.

IT NEWS.Direct! hopes that IT directors at healthcare facilities will In 2011 KLAS reported mixed responses for the acceptance

be able to better manage the internal computing environments,

of cloud technology in healthcare enterprises. Although 71%

while finding means to monitor and address the drawbacks in

of providers had implemented or planned to implement the

order to leverage the benefits of the technology to its optimum.

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REVIEW ARTICLE Redefining healthcare communication on the cloud To be a patient in the modern era of healthcare means to be submerged in a vast and expanding body of medical knowledge. Patients seek the expertise of multiple physicians, across specialties and between institutions, to ensure that they receive top-of-the-line care for their ailments. The plethora of medical knowledge easily overwhelms specialists and patients alike. Medical graduates are taught to know more and more about less and less. As a result, communication and understanding can become muffled in a sea of increasingly complex test results and an ever-expanding library of treatment options. With so much focus placed on details, it becomes difficult to visualize the big picture of patient care. Along with this fragmentation in healthcare delivery, barriers in communication, recordkeeping, and patient understanding forestall a unified and effective medical system. Changes driven by technological advancement and growing public sophistication, demand that this problem Damir Ljuboja

be addressed. The answer lies in the cloud.

The University of Texas at Austin Figure 1: Information flow on the cloud

Cloud computing, at its core, provides a network for shared resources, software, and information that is accessible on demand via the internet (Figure 1). Applied to healthcare on a wide scale, such a system could be the solution to many modern-day problems. While bits and pieces of present issues have been addressed by electronic medical records (EMR) and computerized physician order entry (CPOE), these solutions are local, at best. In a world of increasing specialization and patient privacy, simple communication is a breath of fresh air.

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July - September 2012

The HealthCloud hypothesis

HealthCloud could also provide support for patient self-

The solution I propose integrates key aspects of various

understanding of their ailments. On-demand consultations with an

international approaches to today’s pressing logistical problems

active board of physicians could provide real-time replies to medical

in medical communication and compliance with novel ideas,

enquiries. Chronic disease management programs operated

to improve outcomes (Figure 2). The HealthCloud provides

by providers could bring together groups of people with similar

a multifaceted response to the issues of communication and

conditions to provide support and advice. For the sickest patients,

recordkeeping, public access to reliable healthcare information,

this collaboration can help them stay out of the hospital for longer

consulting, patient compliance, and hospital efficiency.

than ever before. Patients could more readily assume the role of

management of health by allowing them to gain a greater

Figure 2: HealthCloud physician-patient information exchange

With the goal of error reduction in mind, HealthCloud seeks to

a principal caregiver and monitor their blood pressure, glucose

merge EMRs with electronic prescribing interfaces, such as

levels, and other factors that increase the risk of complications.

CPOE, across providers (which would also decrease their cost

In order to accomplish this, HealthCloud could offer educational

of use). Improved software infrastructure and computerized alerts

tutorials and medical tools that could be ordered and delivered

could prevent patients from receiving medications that may be

to patients for a fee (e.g. a device to monitor blood pressure that

harmful (due to interactions with other courses of treatment, for

reports directly to the patient’s record on the cloud). Reminders

example). This could be effectively coupled with computerized

for scheduled appointments, medications, and other interventions

decision support to guide clinicians toward safe and cost-effective

could span across personal computers, mobile phones, and

treatments. An online system to track patients, their medications

tablets. This integrated system of communication could lead to

and treatments, referrals, and laboratory/imaging results would

improved collaboration between doctors and patients.

improve the organization of patient data across a fragmented medical landscape. The burden of documenting and submitting

Global communication

data to the online HealthCloud database could be lessened through the use of speech-to-text software. Such a system, if

In the realm of recordkeeping, global approaches of particular

implemented, could improve the fail-safe measures in place on

note are the scannable Taiwanese Smart Cards, that contain

the physician’s side of the patient-doctor relationship and increase

individual medical histories, as well as the United Kingdom’s

the efficiency of team-based medicine.

electronic medical records system, GP2GP. This National Health

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Public information flow

Service Connecting for Health (NHS CFH) project enables the automatic (but still physical) transfer of individual health records between the approximately 9,000 general practitioner practices in

The accessibility of accurate information is of concern. Corporate

the UK when a patient chooses to switch providers. EMRs that

marketing geared at highlighting the advantages of products has

automatically transfer between systems across the internet are

measureable impact on the exactitude and quality of medical

a rarity. In 2008, just 20% of clinicians in the United States were

information available through internet search engines. In order to

using EMRs and few of these recordkeeping systems were able

combat this problem, HealthCloud could feature a consultation

to directly communicate with each other, even within the same

interface that links patient computers and mobile phones to a

hospital system. Just 4% of doctors were using state-of-the-art,

managing team of physicians via a patient portal. This system

fully functional EMR systems.

could allow for the back-and-forth exchange of messages and/

or chat between the two parties in isolation from the external data HealthCloud consolidates all these approaches in order to maximize

made available by medical companies (Figure 3). In doing so,

efficiency. The proposed system calls for encrypted, standardized

accurate information could quickly and readily flow into the hands

patient records to be kept on hospital, insurer, private provider, or

of the public.

government servers, which can be accessible via the internet when needed by physicians or the patient. If implemented on national or

HealthCloud’s consultation interface could provide answers to

global levels, this could greatly improve communication between

questions or concerns that patients forget to mention during

providers from different specialties, institutions, or even nations

appointments. A 2002 International Health Policy Survey by the

and lead to a reduction in redundant and repetitious testing.

Commonwealth Fund has found that 31% of sick adults in the US leave a doctor’s office without getting crucial questions answered

This system would be disaster-proof because of online access

and 39% do not abide by the physician’s advice because of this.3

and information back-up on redundant servers. Natural disasters

In an earlier study, 51% of patients surveyed thought that their

that level cities such as the 2005 Katrina hurricane in New Orleans

primary care physicians had excellent or very good knowledge

or the 2004 Indian Ocean Tsunami would not destroy medical

about their medical history, and 36% felt that they had excellent

histories and cause a disruption in care. Residents who endure

or very good knowledge of their biggest worries.4 By linking the

these catastrophes could travel to neighboring cities or countries

inquirers to their electronic medical records, each case could be

and find their medical histories readily accessible.

uniquely considered by the physician team and patients would have a means of filling in the gaps into their understanding.

Figure 3: HealthCloud public access model

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REVIEW ARTICLE

July - September 2012

Virtual primary care consultation

were available to primary care physicians just 51%-77% of the time

Additionally, the HealthCloud could act as a facilitating tool in

was compromised in about 25% of follow-up visits.7

four weeks after a discharge, because of which the quality of care

family medicine. By integrating an online system that considers symptoms in a similar fashion as the WebMD interface, the cloud

On the part of the consumer, the subjectivity of symptoms input

could generate possible diagnoses and, moving one step further,

remains the biggest concern. Many patients tend to downplay the

refer the user to a local specialist (with patient consent). This would

significance of the pain they are experiencing, while others in the

also allow for the identification of high-risk groups of chronic or

same circumstances amplify it. This could skew the diagnoses

infectious diseases and facilitate appropriate responses by health

made by the virtual physician team and impact prescribed courses

organizations. Outbreaks could be identified more easily and

of action. A possible way of combating this would be to use the

accurately than ever before. In order to make this system more

online system as a way of merely categorizing the types of health

financially feasible, computerized algorithms could be employed

complaints users submit before referring them to a primary care

on the cloud, which consider symptom input to generate potential

physician. In this way, the online team would act as an initial

courses of action. Common questions could be grouped together

evaluation checkpoint whose conclusions are forwarded to a local

in order to minimize the workload undertaken by the managing

physician.

body of physicians.

Security

Increased patient compliance

HealthCloud, like any online system, is not without its share of

As suggested in Figure 2, the dissemination of dosage information

security concerns. Issues of identity management, physical

and medication reminders to patients’ mobile devices and

accessibility of data servers, availability of access to the network,

computers would increase the likelihood of compliance. Many

and patient privacy are of significant importance.

patients tend to cease a course of treatment as soon as they begin to feel better. This is known to result in multidrug resistant

Commercial companies developing medical record services

organisms and contributes to the prevalence of disorders that

assure the public that their data will be stored in encrypted

are difficult to manage, including certain sexually transmitted

databases with privacy measures entirely in the control of the

diseases and multi-drug-resistant tuberculosis. This aspect of the

individual. The same concept applies to HealthCloud. Patients

HealthCloud could also automatically suggest cross-conditional

in the system will be indentified by an assigned numerical code,

treatment that providers may overlook, such as eye exams for

and to ensure the strictest confidentiality, the code will only be

diabetes patients, by identifying target groups based on their

made obtainable to the individual. Access to the cloud will be

medications and previous appointments.

freely available to anyone with an email address and approved numerical code. Thus, any type of internet access confers

Improved provider efficiency

theoretical access to HealthCloud. Those who live without internet

Provider efficiency is another area of medicine that HealthCloud

in public libraries.

could reach the cloud at their doctors’ offices, internet cafes, or

is designed to improve. CPOE systems alone have been noted to reduce serious medication-related errors by 55%.5 Improvements

Access control will entail the input of several personal identifiers,

in decision support software led to an 83% reduction in the overall

including name, date of birth, and a government-assigned code,

rate for medication errors.6

such as social security number, in combination with a selfassignment pin and password to enter the cloud. The patient will

HealthCloud’s integration of these two systems (as depicted in

not be referred to by name in any of the online records and no

Figure 1), along with a prescription fail-safe algorithm, allows

identity-compromising information shall be placed on the servers.

for their combined efforts in the prevention of medication errors. This online system could reference patient EMRs on the cloud

As a back-up, records identifying which numerical code belongs

when doctors attempt to prescribe new medicines and verify the

to a particular user shall exist on private servers in the HealthCloud

compatibility of the drug in question with the patient’s current

infrastructure. These servers will not be connected to the internet

ailments, particularly those outside of the provider’s specialty,

and are a precautionary measure in case users lose their numerical

and medications.

identifiers. Documented access to these private files shall only be granted to a limited number of employees with high-level

In addition to order entry support, the HealthCloud is designed to

clearance. Thus, the system shall avoid using federated identity

increase the availability of patient discharge summaries by linking

management and will instead rely on single sign on through

them to the individual’s EMR. A 2007 study found that summaries

patient portals.

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July - September 2012

Fraud is another user concern, but could be avoided by requiring an

be prepared for unexpected spikes in demand or other sudden

email and verifiable form of government identification (depending

increases in bandwidth requirements.

on country of residence) upon user sign-up.

Conclusion

Scalability

Health information technology stands at the precipice of change.

The goals of HealthCloud are rooted in granting equal access

The demands of an international public on an increasingly isolated

to a wide user pool. In order to accomplish this, the system’s

body of physicians, stress the fabric of medical care. The solution

functionality must be made plausible on a grand level. Vertical

lies in organization and communication. The HealthCloud, albeit

expansion through the addition of hard drives, servers, and

not infallible, proposes a novel paradigm of healthcare delivery

central processing units will enable the cloud to accommodate

on the cloud.

an increasing number of virtual machines by adding resources within the same logical unit to increase capacity. Horizontally, the

References

addition of clustering solutions and access points, in combination

01. GP2GP: why it’s needed. NHS Connecting for Health. http://www.

with multiple load balancers (server farms), will design the system

connectingforhealth.nhs.uk/systemsandservices/gpsupport/gp2gp/

in such a way as to handle and distribute heavy traffic, optimally.

needed/index_html?url=http://www.connectingforhealth.nhs.uk/

To prevent possible complications, software clutter will be kept

programmes/gp2gp/. Last accessed August 31, 2012.

at a minimum and an appropriate amount of caching will be

02. DesRoches CM, Campbell EM, Rao SR, et al. (2008). Electronic Health

maintained. This will allow for the maximum scalability factor and

Records in Ambulatory Care - A National Survey of Physicians. N Engl

therefore lead to improved performance. Although the process for

J Med. 359(1):50-60.

scaling up is dynamic, the aforementioned approach will allow for

03. Blendon RJ, Schoen C, DesRoches C, Osborn R, Zapert K. Common

maximum theoretical growth under ideal conditions.

concerns amid diverse systems: health care experiences in five countries. Health Aff (Millwood). 2003;22(3):106-121.

Sustainability

04. Lee TH, Mongan JJ. Chaos. In: Chaos and Organization in Health Care.

In order to be permanent, a system must promise longevity.

05. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician

HealthCloud maintains its functional integrity through the

order entry and a team intervention on prevention of serious medication

Cambridge, MA: MIT Press; 2009:18.

incorporation of weekly data save points. This ensures that patient

errors. JAMA. 1998;280(15):1311-6.

records are constantly backed-up in case of emergency failure or

06. Bates DW, Miller EB, Cullen DJ, et al. Patient Risk Factors for Adverse Drug

an infrastructural breach. Redundant servers aid in this effort by

Events in Hospitalized Patients. Arch Intern Med.1999;159(21):2553-

assuming control of the cloud during primary server(s) failures.

2560.

Often, primary and secondary servers are both functional and

07. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW.

share duties to increase overall throughput. In the event that one

Deficits in communication and information transfer between hospital-

fails, the redundant assumes full command until the primary is

based and primary care physicians: implications for patient safety and

repaired and brought back online. In this way, HealthCloud would

continuity of care. JAMA. 2007 Feb 28;297(8):831-41.

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July - September 2012

INDUSTRY PERSPECTIVES Cloud-based systems: Why they represent the future of patient care I’ve been in the healthcare IT industry for more than 20 years. During that time, I’ve seen my share of trends, fads, buzzwords and hot topics, but if I had to pick the one trend I think will change the way healthcare providers do business and share information, I would absolutely pick the cloud. Cloud-based systems can do more than just give providers the ability to store and share data more easily. It can give the entire healthcare community (including patients) the power to communicate more freely and actually talk to each other as never before. This article will explain why I feel that way. Imaging has always appealed to me. In my opinion, it’s the most important part of an electronic health record. When a patient goes to the doctor, the first thing he or she asks is, “Where’s your X-ray?” However, the average file size of your basic medical image is about 5 gigabytes (GB). In healthcare, that is an extremely large file. You can’t e-mail that as an Jeff Surges

attachment, and storage of such files requires staggering amounts of server space that

CEO

need to be updated constantly. However, you or I can easily download approximately the

Merge Healthcare

same size of the file every day on YouTube or Netflix. That’s what we do. In fact, I like to say that Merge Healthcare is the YouTube or Netflix of healthcare. In 1999 I co-founded a company called Extended Care Information Network (ECIN). At that time we did not use the term cloud, but we knew that we needed to help our customers discharge planning in a more cost effective way that made it easier to share information. At that time we touted the benefits of SaaS, but many of the basic principles and benefits of today’s cloud-based solutions remain the same – and more than ever, they represent the future.

The issues: Where to house all the data – and who manages it all? Every year, countless dollars and hours are spent archiving diagnostic images. A single image can need as much as two gigabytes or more for storage, with regulations requiring these image data to be stored for years. Traditional methods of image and data archiving are now giving way to an exciting new advance in healthcare technology: cloud-based image storage and sharing, which has been proven to help healthcare stakeholders collaborate, improve the delivery of care, and reduce its cost. Without the accessibility and scalability of the cloud, C-suite executives face the unenviable task of managing terabytes or even petabytes of imaging data, which can mean real inefficiencies that have proven to escalate IT costs. A cloud-based solution can help providers create a complete patient record that can eliminate inefficiencies, such as patient-borne CDs and duplicate scans that expose patients to radiation, and enable faster collaboration. This new efficiency is catching on quickly with a variety of users across the nation. By 2015, it is expected that cloud storage will account for more than 35% of the six petabytes of new studies annually captured in vendor neutral archives (VNAs). Along with images, providers continue to bring in more corresponding studies, which then grow in size once they are stored, as they are updated and modified. In addition,

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these studies and images need be managed and organized. As

leave his or her office, walk or drive over to the lab or office where

data warehouses grow and grow, additional staffing and training

the image is located, and view it there. In all these cases, time to

within hospitals and health networks are required, just to keep

treatment is delayed significantly.

track of everything and problem-solve. This type of training is not a one-time expense, but rather an ongoing cost to stay on top of

Duplicate scans

system updates. Hardware must be purchased and maintained. Continued investment is needed for basics such as memory,

Finally, duplicative scans and tests are an increasing cost issue.

speed and updated operating systems, to name but a few. Finally,

Annual healthcare costs of as much as $100 billion have been

healthcare data may be managed on private networks that are

attributed to diagnostic imaging tests. Of these, an estimated

often times inaccessible from other platforms.

35% are of duplicates. This is the equivalent of $35 billion in unnecessary costs. Time and money can be spent just on locating

Then, there are basic housekeeping issues, such as reports

a crucial image, as opposed to simply going to a cloud-based

and worksheets, which have to be filled out manually for each

solution where images are stored securely and in one place.

patient. In many settings, a provider has to make the effort to match up a specific report with a specific image on CD, or even

For example, a patient may go in for a procedure and need

video cassette. The paperwork can pile up fast. A provider may

imaging work done. A radiologist, instead of being able to access

have his or her own style for dictating reports, so uniformity can

a single HIE for this patient’s complete set of images, may be

also become a real issue. Finally, the increasing amount of paper

forced instead to play detective and hunt down these images,

archives in addition to data warehousing can create storage and

which may be stored in a variety of different formats in several

management problems. The likelihood of misfiled or misplaced

different places. It’s easier just to order a new scan, but this is

reports can grow, which may require further staff to manage and

exactly how costs absolutely add up over time.

organize the growing reams of paper. In fact, it is estimated that a single-clinician practice spends, on Through our daily dealings with providers and other customers,

average, about $17,000 a year associated with traditional methods

it has become clear to us that the current system is becoming

of exchanging patients’ health information.

more and more unwieldy and does not serve the best interest of patients. Just the cost of servers to house all these data can easily

The cloud: A game-changer

balloon to an unsustainable level.

In a cloud-based storage system, images are securely stored in

Image sharing

multiple locations. They are accessible anytime and anywhere, via

The simple task of image sharing in a timely manner has

grow, providers and managers can simply add capacity to the cloud

become a real issue of cost and efficiencies within healthcare

as opposed to adding onsite storage hardware, management, and

delivery. The most glaring example is the CD. Even in today’s

bandwidth. That way, managers are only paying for the capacity

technologically advanced world, patients continue to bring any

they actually need. In a cloud-based infrastructure, images and

vital images corresponding with their care to the hospital on a

data remain secure and meet all regulatory requirements.

a standard web-based browser. As health systems’ storage needs

CD, which may cause frustration among in-house specialists and referring physicians if they are ever lost or damaged while being

Furthermore, physicians and specialists can also share images

transported from one place to another. There are times when a

worldwide through the cloud, and in many cases, such a service

CD is unreadable, which may cause a delay in care. In many

is free. Image sharing offers an easy-to-use and efficient means

cases, providers and specialists still rely on the video cassette

of quick image sharing, which result in faster diagnoses and

and corresponding players to view critical images.

treatment for patients. Efficiencies are greatly increased.

A provider may be unable to share an image quickly with a

Examples of efficiency

colleague or specialist due to incompatible viewing systems, resulting in a loss of efficiencies. If several providers need to

A cloud-based system can also marry reports to images and keep

view the same image and exchange critical information relating

them all in one place, which can solve many filing and storage

to care for that patient, such a process can take days or even

issues. Once these images are on the cloud, it can be viewed

weeks, because they are unable to view images simultaneously

by everyone and does not necessitate the need to burn them on

from different locations. They cannot share images over a mobile

a CD. This would be important if a patient changes his or her

device. If a provider needs to view an image, and that image is only

physician. When a patient goes to a provider for follow-up, he or

stored on a CD in a single place, then he or she needs to physically

she can pull out these images quickly, instead of having to rely on

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July - September 2012

Issues of security

memory or ordering a duplicate scan. All these time efficiencies definitely lead to better patient care, as they decrease the time patients need to spend in the hospital.

When considering whether to implement cloud-based storage and image sharing, hospital and health network executives need

Emergency rooms and trauma centers can also potentially benefit.

to make sure such an infrastructure is absolutely 100% secure.

Doctors can receive and review images from trauma centers in

It’s a noteworthy issue. Recent surveys have shown that 91%

outlying areas long before patients who have suffered an accident

of physicians feel open-access systems designed for sharing

arrive, providing extra time to process, prepare a diagnosis, and

medical images can be beneficial to patients; however, 70% are

get ready to treat. Also, the burdensome process of transferring

worried about the security aspect. When selecting a cloud storage

and importing a CD with an incoming trauma patient can now

system, decision makers should choose a system that features

become a thing of the past. Unnecessary steps are eliminated in

the following, so that the security of images, and corresponding

the process, such as duplicative scans. More educated decisions

studies and reports are paramount: •• Extensive experience with applications, healthcare providers,

on whether a patient transfer is necessary can be made, because physicians are able to view the patients’ images ahead of time

and patients

•• Physical and application security

to determine if he or she is not in a critical enough state for the

•• Compliance with HITECH, HIPAA, and other federal

transfer to be necessary.

policies

•• Highly available and technically innovative datacenter

Emergency room doctors like such a system because it helps them better manage patient flow, and the staff greatly appreciates

environment

•• Datacenters distributed geographically to ensure disaster

the cloud’s ability to help them make decisions more quickly.

recovery following a major event

•• Presence of a technical network operating center and full-time

Switching to cloud-based systems also creates greater staffing efficiencies, through improved flexibility in how hospitals staff their

year-round staff for managing any data loss or crises

services. IT specialists would no longer be needed to help with the uploading, reading (and in some cases, locating) of CDs.

The benefits of cloud-based solutions continue to evolve, allowing

Through cloud-based solutions, costs in that area can be reduced

hospitals and health networks to remain responsive to change

and resources diverted to more value-added IT projects. Finally,

across the healthcare continuum, which can undoubtedly lead

hospitals can save money on the number of contracts needed for

to greater efficiencies, reduced costs, and ultimately better

maintenance and archiving. These are hard costs that managers

patient outcomes. Better patient outcomes are why I got into the

can realize right away just from switching to the cloud.

healthcare industry in the first place.

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Health IT NEWS.Direct!

July - September 2012

INTERVIEW Industry strives for interoperable cloud solution Q: We have observed that the adoption of cloud computing among healthcare providers has increased. In your opinion, are there processes or technologies that healthcare organizations still use off the cloud that you think should migrate into the cloud? A: Today, many organizations are struggling with the exponential growth of the data that they need to store, secure, and maintain. The situation is a bit more dire in healthcare than in other industries due to data retention requirements. Depending on who you ask, data storage requirements in healthcare are doubling every 12-24 months, with medical imaging as the largest contributor to this trend. For some organizations, more than 50% of overall storage capacity is dedicated to medical imaging. Chris Gough

This application domain is ripe for migration to the cloud. We are starting to see the

Lead Healthcare,

beginnings of this with cloud-based vendor neutral archives (VNA), where image archives

Cloud Computing Architect,

can be hosted on the cloud, abstracting away the specifics of a given vendor’s PACS solution.

Intel

This can provide a healthcare organization with greater flexibility to switch PACS vendors as solution offerings and business needs change over time. Perhaps most importantly, scaling the infrastructure to support the ever growing set of data is accommodated by the cloud platform; which was designed and optimized for scale from the beginning. Q: Can you please provide an example as to how cloud computing has made a significant impact in a healthcare organization? A: South Florida Medicine is a multi-specialty practice that was experiencing several challenges related to the rapid growth of their business. They decided to centralize their practice management platform across their multiple locations using a software-as-a-service (SaaS) solution offered by CareCloud. This decision resulted in significant positive impact for their organization: •• It is now easier for them to scale/grow because they no longer need to manage the hardware and software associated with their practice management solution.

•• As new practices are added to the organization, they can be integrated very quickly; simply given access to the centralized, cloud-based solution.

•• South Florida Medicine can leverage expertise of external organizations. For example, to take advantage of cutting-edge security capabilities and best practices that allow them to better keep sensitive information secure and satisfy regulatory requirements. Together, these benefits can enable healthcare organizations like South Florida Medicine to focus on improving patient care, or growth rather than on ’keeping the lights on.’ Q: In the healthcare industry, which is the most preferred service model that vendors adopt: software-as-service, platform-as-service, or infrastructure-asservice models? A: Software-as-service (SaaS) is by far the most heavily adopted cloud service model in the healthcare industry, and I expect this will continue to be the case for the foreseeable future. Infrastructure-as-a-service (IaaS) is getting some traction in large healthcare

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INTERVIEW

July - September 2012

enterprise organizations that are building private clouds. This is an

both inside and outside of healthcare. Intel has a long history of

evolutionary step that enables these organizations to realize some

promoting and creating open, interoperable, standards-based

of the benefits of cloud while still getting good return on existing

solutions, and I believe this will be required to maximize the long-

datacenter investments. Both platform-as-a-service (PaaS) and

term, sustained success of cloud computing.

IaaS are compelling service models for healthcare organizations that have software development operations. Large enterprise

In order to help make this vision a reality, Intel works very closely

organizations are taking a pragmatic, phased approach to cloud

with an organization called the Open Data Center Alliance (ODCA),

adoption with ’Test & Dev’ as the typical phase-1 environment

serving as the technical advisor. This organization comprises

that uses IaaS or PaaS in a multi-phase cloud adoption strategy.

more than 300 enterprise organizations around the world that are dedicated to speeding up the migration to cloud computing.

I should mention, however, that the life sciences industry is an early

The ODCA identifies key enterprise use cases and requirements

adopter of IaaS, and uses this service model quite extensively

for cloud, and works with the vendor community to ensure that

for research and development. This is due to the fact that this

emerging solutions address these requirements. In addition, the

industry is not as heavily regulated as the payer/provider space

ODCA collaborates closely with industry standards bodies to make

and because typical applications/workloads lend themselves very

sure that these use cases and requirements can be addressed in

well to the ’pay-as-you-go’ model offered by large public cloud

an open, interoperable, standards-based manner.

providers. Q: Please add a note on the estimated market scenario Q: What are the newer trends that we could be witnessing

expected in 2020 for cloud computing in the healthcare

with respect to cloud computing in healthcare?

domain.

A: Today, the largest obstacle to cloud adoption in healthcare is

A: We are already seeing a ’cloud first’ approach for smaller

security and privacy. This is due, in part, to the highly regulated

companies and start-ups that don’t see a value proposition in

nature of the industry. Intel is working very diligently with McAfee

building their own datacenter from the ground up. In this timeframe,

and a host of other partners to ensure that cloud environments are

healthcare enterprise organizations will be taking the same

just as secure as their in-house enterprise IT counterparts. Over

approach. Hosting and maintaining applications on-premises will

the next several years, you will see security come to be viewed as a

start to become the exception rather than the rule.

significant benefit of adopting cloud solutions rather than a barrier to entry. Even today, for many healthcare organizations (especially

As open, interoperable cloud solutions emerge, there will be many

organizations that lack a large, dedicated IT staff), there are many

key benefits for healthcare organizations: •• Lower cost

security benefits that can be realized by moving to a well-managed

•• Ability to select best in class solution components from

cloud environment.

multiple vendors

•• Less complex and more feature rich-solutions for high

Q: We are again in a situation where we observe a large number of distributed and competing cloud platforms that

availability and disaster recovery, spanning multiple

organizations are using. This situation, similar to those

datacenters and geographic regions

faced in legacy, in-house systems has the same challenge of limited interoperability among them. How do you think we

However, the highly-distributed nature of future cloud solutions

will be resolving this challenge in the future?

will also introduce some new challenges. For example, I suspect that data sovereignty issues associated with cross-border flow

A: Yes, we are seeing vendor lock-in reemerge as a top IT concern

of sensitive information will come to the fore. As a result, there

with the emergence of cloud. In order to solve this problem, what is

will be an increasing need for solutions that can restrict data and

needed is a set of open, interoperable standards that can support

application execution to approved geographic regions to ensure

the key use cases and requirements of enterprise IT departments,

patient privacy and regulatory compliance.

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Health IT NEWS.Direct!

July - September 2012

PwC foresees Indian cloud computing market to be $4 billion by 2015 Q: The benefits of cloud computing is being propagated across the industry. What are the factors that a healthcare organization needs to keep in mind before adoption? A: It’s very important for the healthcare fraternity to know what the function of IT is in healthcare: cutting cost or providing better value to the business. This will determine what types of applications need to be moved to cloud, what type of SLAs to be ensured, and what type of security mechanism to be kept in place. Patient data privacy would be critical for hospitals planning to get on cloud. Then there is data integration, where there is a definite need to create a strategy for syncing the data, i.e., data residing in various clouds need to be integrated with the data in the company. Dr Rana Mehta Leader Healthcare

Q: What are the drivers for the adoption of cloud technology in healthcare?

PwC India A: The use of the cloud technology brings with it several benefits and these are same for cloud adoption across the healthcare sector as well. These are driving the uptake of cloud in the healthcare sector: •• For a large unorganized sector, with small hospitals for whom it is not viable to install in-house hardware and software, cloud solutions are very cost effective.

•• It is difficult to find qualified staff for maintenance and up-gradation of IT systems which can be taken care of automatically by cloud technology.

•• It is useful in increasing a number of multi-location chain of hospitals because scalability is easier with cloud.

•• It facilitates reduced capex on building ones own IT assets, as IT cost is managed as operational cost on ‘pay per use’ basis.

•• It helps remove cost and complexities of managing sophisticated IT infrastructure in-house, which requires huge capital cost to plan for the peak capacity and skilled

Rajesh Ranjan

manpower to maintain it.

Leader Emerging Technologies PwC India

Q: Could cloud be the answer to Big Data in healthcare? Do you feel the two can be incorporated for an advantage? A: Definitely! This is a trend to keep a watch on, as cloud-based analytics is already in the market. However Big Data is more core to business than IT, and integrating it with cloud will be a big leap. Q: Data security, interoperability, and regulatory compliance have been identified as the road bumps to widespread adoption of cloud in healthcare. How can a healthcare organization overcome these issues with the use of cloud? A: The regulatory need of privacy and security of the patient record should be a key concern before adopting cloud services. However this can be tackled through proper need assessment and transition planning that will help the healthcare organizations to take the right decisions.

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INTERVIEW

July - September 2012

Cloud interoperability standards are evolving by consortiums

services. Most of their offerings are similar in nature; however,

of standards and definitions. Currently there is a lack of cloud

they can be differentiated on the basis of offerings for large and

interoperability standards understanding between the cloud

small enterprises and some also specialize in specific industry

providers and platform. However, since healthcare has established

domains.

standards of HL7 and DICOM protocols, this will continue to be a Q: What stake does the Indian market have in cloud

functional protocol residing on top of the cloud platform.

computing? Q: Will there come a time when cloud technology will be advocated by the government for implementation?

A: The Indian cloud computing market is currently at 900 million USD and is projected to grow up to 4 billion USD by 2015. The

A: Definitely yes! This is a great opportunity for state governments

growth potential in the areas such as IaaS and SaaS are huge

to extend the reach and provide better heath-related services.

and the Indian SMBs including healthcare players are poised to

Cloud can be used to implement HIS, which will uniquely identify

move directly to the cloud to reduce cost on infrastructure and

a patient and store its health records across all government

manpower to manage applications in-house.

hospitals in any state. Our firm is already advising some of the state governments on this.

Q: What is the future for cloud technology in healthcare?

Q: Who are the major cloud players? What are the key

A: The future of cloud will be about integrating patient information

differentiators?

across the healthcare providers and payers, and adopting CRM and analytics services on cloud. It will also have great potential

A: There are big MNCs like Google, Amazon, Microsoft as well

for government adoption so as to meet the goal of ‘healthcare

as Indian names like Tata, Reliance who provide cloud-based

for all’.

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Health IT NEWS.Direct!

July - September 2012

eHEALTH eClinicalworks deploys EHR solutions at Ohio Orthopedic Center of Excellence In an attempt to increase the efficiency and reduce the time lag

correctional health centers, regional extension centers, and the

in delivering services, Ohio Orthopedic Center of Excellence has

U.S. Department of Health (DoD). The vendor’s solutions are

chosen eClinicalWorks, an ambulatory clinical solution provider,

certified by the Certification Commission for Health Information

for its electronic health record (EHR) solution to be used by 59

Technology (CCHIT) Office of the National Coordinator –

providers, located at various regions.

Authorized Testing and Certification Body (ONC-ATCB; 2011-12), and Child Health (2008 and 2011-12). Reporting revenues of over

Established in 1965, Upper Arlington, Ohio-based Ohio

$200 million for 2011, the company has been featured in Inc.

Orthopedic Center of Excellence offers an array of services

5000 list of the fastest-growing companies by revenue, and in

such as spine surgery, total joint replacement, hand surgery,

the 2011 vendor assessment report on US ambulatory EMR/EHR

ambulatory surgery, sports medicine, and digital imaging. The

for midsize and large practices by International Data Corporation

Center zeroed in on eClinicalWorks for an EHR system in view of

(IDC), a market research company.

the company’s ability to facilitate the provider in complying with the ‘meaningful use’ criteria, aid in R&D, and streamline reporting

Significantly driven by the meaningful use incentives, researchers

by using a fully integrated platform.

from Harvard and the University of California at San Francisco (UCSF) have noted that despite the increased rate of EHR

Customized for over 50 specialties and sub-specialties, the

use (90% and 71%), functionalities to achieve meaningful use

EMR will be licensed by the orthopedic center for the following

have been utilized to a minimum (2% and 30%, respectively).

components:

Also reporting increased acceptance, athenahealth’s recently

•• Unified EMR/PM: Embedded with quality measure and

released annual Physician Sentiment Index (PSI) findings differ

registry reporting, and e-prescribing, it enables physicians to

on the benefits provided by EHRs. From 2011 to 2012, the survey

seamlessly communicate with peers, access patient-related

found that the number of respondents relating the electronic

information, and also qualify for ‘meaningful use’ incentives.

record to better care delivery not only dropped, but a greater

Integrated with a practice management (PM) system, it aids

association was made to the worsening of patient care. Apart

in achieving optimized workflow from the time of patient

from this, a majority of physicians (44%) felt that EHRs were built

admission until billing.

not keeping the physician in mind, and achieving meaningful

•• eClinicalWorks Patient Portal: Allows patients and

use is a burden (75%). For physicians who choose to differ, as

physicians to exchange various information such as lab

of April 2012, CMS has paid more than $5 billion in incentives

reports, reminders, educational material, medical history,

to 94,097 providers, and there are currently more than 132,000

appointment schedules, paying bills, refill prescriptions via

primary care providers working towards achieving meaningful

a secure network, anytime, and anywhere.

use.

•• eClinicalMessenger®: Uses voice-over-internet protocol (VoIP) technology to promote the sharing of data between

Frost & Sullivan, in a 2011 report, has predicted the US market

provider and patient via voice messages and SMS texts.

to shoot up to $6.5 billion in 2012, a steep increase from $973.2

•• Enterprise Business Optimizer (eBO ): A financial and

million of 2009. Furthermore, anticipating a $8.3 billion US market

clinical analytics tool.

share by 2016, Millennium Research Group has reported over 750 companies that have entered into the market space in a matter

The solution’s suite also includes eClinicalWorks Electronic Health

of two years, offering solutions that have some form of EMR

eXchange (eEHX), eClinicalWorks P2P, and eClinicalMobile .

features. In addition, an estimated average 12% per annum rate

in growth through 2016 has questioned the long-term viability of Headquartered at Westborough, MA and operating at New York

these products in the market. Also suggesting increased market

City, Pleasanton, Chicago, and Alpharetta, eClinicalWorks caters

saturation in the near future, Frost analysts opine that vendor

to more than 370,000 medical professionals, 180,000 providers,

displacements will become a natural effect of changes in provider

in physician groups, health centers, hospitals and communities,

management and ownership.

www.healthitnewsdirect.com

July - September 2012

PARTNERS AND ALLIANCES Agfa and Dell partner to provide medical image management solution on the cloud Round Rock, TX’s Dell will provide its cloud platform to host

The cloud-based portfolio, by simplifying image archival

its clinical archive portfolio and Greenville, SC-based Agfa

and management, allows healthcare providers to focus their

HealthCare’s Imaging Clinical Information System (ICIS). This

investments on supporting care, strategic services, and technology

partnership has been inked in an attempt to enable offsite

development, and its cost predictability helps increase return on

expansion, facilitating access to archived information, and provide

investment.

comprehensive electronic medical records (EMR) that supports the management of images.

Apart from Agfa, Dell has inked similar deals with Siemens Healthcare, and NextGen Healthcare and Puerto Rico Hospital

Agfa, a part of Agfa-Gevaert Group, among its many deliverables,

Supply, enabling the presence of healthcare solutions on the

focuses on including medical images into EMRs, in accordance

cloud. Dell, through its cloud-hosted clinical archives, supports

with an imaging strategy that outlines both the clinical role of better

data in more than 800 clinics, 5 billion diagnostic imaging objects,

health outcomes, as well as the business role of streamlining

and over 72 million clinical studies.

operations and facilitating insurance reimbursements. Its suite of solutions under this vertical, which are included in the current

Healthcare data constitutes 30% of the global data, according to

collaboration, include ICIS, a workflow-centric clinical platform

a 2008 survey by Ponemon Institute, an education and research

that enables a longitudinal imaging record, IMPAX Data Center,

organization. More recently, BridgeHead Software, a provider

a scalable enterprise-wide or regional imaging management

of healthcare data storage management solutions, found that

solution, and XERO Technology Viewer, a web 2.0-based platform

63% of the surveyed providers attributed this increasing volume

that enables real-time image access. Although ICIS was already

of healthcare data primarily to imaging information. In order to

accessible on private clouds at client data centers, its current

address this, healthcare organizations are deploying disaster

availability as a completely managed service on the cloud,

recovery and data archival tools for effective information

extends the choices of clinical information system for providers,

management. Disaster recovery has also been mandated by

simplifies image viewing, management, and archiving, facilitating

Health Insurance Portability and Accountability Act (HIPAA)

the establishment of an image-enabled EMR.

Security. A data management survey by BridgeHead has found disaster recovery as a top area of interest for healthcare

According to the agreement, Agfa HealthCare’s US clients can also

IT investments, with 55% planning to have it as one of their

access Dell Cloud Clinical Archive, a solution to retrieve archived

top 3 investment areas. In support of data management, the

information at times of system downtime or natural calamity, and

industry has taken to cloud computing technology, which offers

Dell Cloud Clinical Recovery, which acts as a secondary archive to

healthcare organizations a centralized means to store, exchange

an existing onsite archive, allowing disaster recovery and business

and retrieve medical images, while enabling archiving and

continuity.

disaster recovery.

www.healthitnewsdirect.com

Health IT NEWS.Direct!

July - September 2012

Microsoft and GE Healthcare form novel IT company through JV •• Microsoft’s know-how in creating ecosystems and platforms,

The shift from sporadic individual patient care to continuous population management has given rise to the need for greater

and solutions including

insight into care delivery, integrated care processes, and the

»» Microsoft Vergence: single sign-on, context management

engaging of patient experiences. These in turn mandate a transition

software »» Microsoft Amalga: health intelligence platform for the

towards new payment models that require the providers to connect disparate silos of care and integrate data. In an attempt to address

enterprise

this need, IT giants GE Healthcare and Microsoft Corporation have

»» Microsoft expreSSO: single sign-on solution for the

entered into a 50-50 joint venture to form a new company called

enterprise •• GE Healthcare, its experience in administrative and clinical

Caradigm™, which is aimed at providing the healthcare fraternity

workflow solutions including

with real-time intelligence that it can use to enhance the quality of healthcare rendered and patient experience.

»» GE Healthcare eHealth Information Exchange: health information exchange

The idea which was incepted in December 2011, has now reached

»» Qualibria Quality Management Solution: clinical decision

completion following the establishment of a firm set of goals, and

support application

steered by a strong leadership team to enable the company to achieve its outcomes. The leadership team for the new company

Through this collaborative effort, GE Healthcare and Microsoft

has been established by constituting a team of executives from GE

hope to address pressing concerns of the healthcare sector,

Healthcare, Microsoft, Care Innovations (an Intel and GE company),

such as healthcare-associated infections and chronic disease

and Philips Healthcare. Michael Simpson is spearheading the new

management, and global challenges to quality care, including

establishment as CEO, Neal Singh as CTO, Lauren Salata as CFO,

access to patient-critical information and healthcare costs. This,

and Michael Willingham as regulatory affairs and quality assurance

they plan to achieve by focusing on interoperability of health

executive. Obtaining regulatory approvals from the initial list of

systems, accountability and performance of healthcare delivery

countries, the company is located at City Center Bellevue, Bellevue,

systems at all levels of care and in every country.

WA, and operates from Andover, MA; Salt Lake City, UT; Chevy Chase, MD; with centers across the globe as well.

In support of GE chairman and CEO, Jeffrey R Immelt’s belief in the potential of the combination of leading companies with

Through this new venture, Caradigm intends on developing

complementary capabilities to meet a common vision, GE

and marketing collaborative clinical applications and an open,

Healthcare embarked on a previous JV with Intel Corporation for

interoperable healthcare intelligence platform, which aims to

the establishment of Care Innovations LLC. The combining of

improve population health management systems, thereby

Intel’s Digital Health Group and GE Healthcare’s Home Health

reducing costs and enhancing outcomes of care delivery. The new

business, Care Innovations was incepted in January 2011 to cater

company will serve as a platform for software vendors to develop

to home health monitoring and the telehealth sector.

customized and demand-driven solutions for the industry, and leverage and connect these applications to Microsoft HealthVault,

For Microsoft, many analysts consider this move as an exit from

which will remain with Microsoft as a cloud-based service.

the clinical market, except for HealthVault, with the previous sell-off of its Amalga HIS to Orion Health in 2011. This is augmented by

Caradigm will also host collaborative clinical applications directed

the conditions in this JV, wherein Microsoft contributes through

towards achieving the long-term goal of developing a healthcare

its intellectual property, and the rest of the business is handled

performance management suite aimed at better population health

by GE. Although, Microsoft has held onto to HealthVault in this

management. Backed by a common vision of a connected,

JV, analysts, Chilmark Research, wait to see whether it can be

patient-centered health system, the parent companies bring to

converted into revenue generating sustainable business for the

the table complementary expertise:

company, or ends like the recently closed Google Health.

www.healthitnewsdirect.com

July - September 2012

PRODUCTS AND SOLUTIONS 3M releases new ICD-10 financial analysis software and service 3M Health Information Systems, a provider of health IT solutions

tool was chosen, in 2011 by CMS, to assist in the conversion of

and services, has announced the inclusion of an analysis tool and

applications, systems, and reports from ICD-9 to ICD-10. It was

consulting services into its International Classification of Diseases

also licensed to Medicare Administrative Contractors (MACs) and

– Revision 10 (ICD-10) transition planning solutions suite. This

carriers, and Fiscal Intermediaries (FIs). 3M’s association with

has been designed to assist providers in estimating the ICD-10

CMS goes way back to 1995, when the company was contracted

transition’s financial impact on each, diagnosis related group

to provide ICD-10 General Equivalence Mappings (GEMs),

(DRG), hospital department, and on an organization as a whole.

Procedure Coding System (PCS), and the initial conversion of MS-DRGs to ICD-10.

Offered as a component of ICD-10 code translation tool, the financial impact analysis tool evaluates ICD 9-derived DRG claims

Apart from 3M, many vendors such as Healthcare Information

along with the base payment rate of an organization, and details

and Management Systems Society (HIMSS) and Jvion, CSC,

the probable reimbursement that could be derived if the same

and Edifecs have come up with ICD-10 financial impact analysis

DRGs were generated from ICD-10 codes. The financial impact

solutions to aid providers in making the transition.

tool also detects the DRGs that will remain as is and those that The U.S. Department of Health and Human Services (HHS) has

will change.

proposed a ruling mandating the healthcare industry to shift from ICD-10 financial impact analysis consulting service, includes

ICD-9 to ICD-10 by October 1, 2014. Regarded as a massive

executive-level reports, onsite record review, data analysis,

task, the implementation of ICD-10 is said to affect almost every

and education to enable providers make informed decisions

operational system and process of the providers’ revenue cycle

on educational requirements, and operational and personnel

and payors’ administrative procedures.

enhancements. Services are also provided for improving clinical documentation, along with a web-based curriculum, the ICD-10

While gearing up for the switch in the coding systems, several

Education Program.

concerns related to planning, implementation and cost associated with the process, dearth of skilled coders and trained staff, and

According to 3M, by evaluating the financial impact, healthcare

reduction in overall productivity daunt the healthcare fraternity,

organizations can review contracts, project receivables, and

according to a recent article published in the journal Perspectives

incorporate training programs and enhancement of documentation

in Health Information Management. Although the migration to ICD-

where they are most required. With this, Ray Terrill, the senior vice

10 may initially offer many challenges, it is anticipated to provide

president at 3M believes that they can transform the transition to

significant benefits over a period of time. The research article finds

ICD-10 as a strategic advantage by purging probable oversight

ICD-10 to reduce cost as it allows for improved cost analyses

and risks.

and data integrity, enhanced monitoring of health outcomes, and reduced fraud and abuse. With the requirement of better

The latest addition adds to Salt Lake City, UT-based 3M Health

documentation, according to Milliman, a consulting and actuarial

Information Systems’ wide array of ICD-10 transition solutions and

organization, the new coding system will result in more precise

services that help clients enhance documentation and coding,

coding and payments in return.

identify potential risks, map and convert systems, translate codes, and educate employees. For more than 30 years, the company

In conclusion, it has been suggested that healthcare entities

has been catering to over 5,000 hospitals, globally, through more

can successfully make this transition by understanding both, the

than 100 coding experts. With more than 15 years of expertise in

challenges, benefits, and related costs of implementation, and

managing ICD-10 products and services, 3M’s code translation

choosing an appropriate adoption strategy.

www.healthitnewsdirect.com

Health IT NEWS.Direct!

July - September 2012

INSIGHTS IDC reports indicate an evolving HIE market IDC Health Insights finds the health information exchange (HIE)

and analytical technology, apart from just offering primary HIE

market landscape to be evolving, through two market reports

technology, in an attempt to cater to technical and business

that have analyzed HIE vendors. Sixteen vendors providing HIE

demands of accountable care. In addition, the HIE market is

platforms, including tools for development, educational and

expected to witness a dramatic change over the coming 12 to 18

professional services, an extensive partner network, and published

months, with the entrance of dominant vendors into the market,

APIs; and 10 vendors for packaged solutions were evaluated

which is flooded with small, private companies.

through these two studies. While the study finds platform designs advancing over time The ‘IDC MarketScape: U.S. Health Information Exchange

(mostly through self-development) to satisfy the requirements of

Packaged Solutions 2012 Vendor Assessment’ study finds the HIE

clients and alliances in the ecosystem, the packaged solutions

market to be fragmented, with vendors offering products of varied

will be developed to cater to specific requirements. The latter are

origins, including composite applications, integration engine

expected to lower the risks posed by uncertain project timelines,

platforms, clinical messaging, portals, managed network services,

scope, and costs.

and information management. It was also seen that the enterprise industry forms the fastest growing market, in account of its ability

The HIE market, despite many challenges, has witnessed

to support collaborative care and demonstrate meaningful use.

remarkable growth (an excess of 40%) in 2011, according to a 2012 Clinmark Research report. In concurrence with the present

Released consequently, the ‘IDC MarketScape: U.S. Health

report, Clinmark finds the enterprise market as a major contributor,

Information

Vendor

and the HITECH Act and statewide HIE contracts as minor

Assessment’ found that the HIE market continues to evolve

factors supporting this growth. Healthcare organizations have

as the attention is shifting towards the conversion of data into

been turning towards HIE implementation, not only for complying

‘actionable information’ for collaborative care or accountable

with meaningful use, but responding to pending reimbursement

care initiatives, from enabling connectivity for data exchange and

changes, and shifting from pay-for-services to pay-for-outcomes

using technology meaningfully. As a consequence of this shift,

model. The new reimbursement models would require healthcare

additional vendor consolidations have been reported. This has

organizations to better manage patient care and operations across

been demonstrated by seven MnAs and the emergence of new

the continuum of care. Amidst the diverse EHR environment,

vendors, like telecommunication and payor organizations, since a

providers are increasingly adopting HIE technology in an effort to

2010 analysis by IDC. In view of such activities, the HIE packaged

access data in EHR silos across the community.

Exchange

Platform

Solutions

2012

solutions study proposes a dynamic market with continuous change seen in the competitive and technical scenario. The study

Black Book, a market research company, in their recent survey,

also reports a major role played by platform-as-a-service in the

also finds evolving reimbursement models and the push to prepare

HIE market; as vendors consider building a strategic collaborative

for accountable care organizations as major reasons (85%) for

ecosystem with other companies.

HIE adoption. Further, the research also indicates healthcare organizations’ HIE spending to grow significantly by 2014, as

Lynne A Dunbrack, Program Director, IDC, finds the IT demands,

indicated by 8 out of 10 provider participants.

due to changing reimbursement and care delivery models, and health information organizations, to be too big to be fulfilled by a

With the healthcare industry quickly entering into the post-EHR era,

single company. Both surveys show that, vendors are acquiring,

Clinmark finds that the value of patient data is in a HIE-supported

partnering, or developing collaborative care, patient engagement,

network, and not in disparate EHR data silos.

www.healthitnewsdirect.com

INSIGHTS

July - September 2012

Healthcare industry experts suggest strategies to address mobile device security and privacy threats Wireless communication devices are being adopted increasingly

established models for defining a way forward on mobility and

in the healthcare industry. A 2012 Dell SecureWorks report finds 2

security concerns. The plan, upon considering the needs and

of 5 US clinicians utilizing tablets or smart phones during patient

important sections of the organization, should give an insight

encounters. Although mobile devices offer several benefits, it

into the areas of opportunity, costs, and expected investment.

brings with it privacy and security risks, with 65% of data breaches

•• Risk assessment: Comprises of recognizing, and assessing

occurring on laptops and mobile phones, and 57% because of

the risks. The procedure plays a pivotal role while switching

theft. These have been cited as chief hindrances for mHealth

between various ownership models or smart phone platforms,

adoption by 41% specialists and one-third primary caregivers.

and complying by security and privacy enforcement laws.

With this, it is imperative for healthcare providers to develop risk

•• Security assessment: Manual and automated approaches

assessment and mitigation plans to tackle security and privacy

of testing should be applied to analyze the security and

threats posed by mobile devices, and avoid penalties, tarnished

compliance risk imposed by an application, connected

reputation, and financial loss. According to the report, the cost for

systems, and flow of data between application and system. •• Data encryption and protection for PHI by availing access to

recovering data following breach involving mobile devices is $258. Below is the compilation of suggestions made by the healthcare

only authorized users.

fraternity, for managing security and privacy with mobile devices. NCCIC, a U.S. Department of Homeland Security (DHS)-led center

Apart from these, below are a few best practices suggested by

overlooking nation-wide cyber and communications operations,

various industry leaders, which has been consolidated by ID

advocates a layered security mode for securing mobile devices:

Experts, a data breach solution provider.

•• Acquire medical devices with fine-grained and well

•• Providers should consider and mitigate risks involved with the use of personal devices for work-related purposes,

documented security functionalities, which are safe to configure on networks

and facilitate benefits of these devices found lacking in the

•• Incorporate ongoing support for vendors to update antivirus,

organization. •• With theft and loss of devices being top healthcare data

patch, and firmware in the purchase vehicle. Enforcing safe, effective and legal software and patch upgrading regulations.

breaches, geolocation tracking software, a low-cost insurance

•• Have a practical approach for managing network monitoring

policy, has been suggested as a useful approach to trace and clean data present in devices.

and intrusion detection techniques, external-facing firewalls,

•• In cases of theft or loss of mobile devices, remote wiping

and internal network segmentation that contain the devices •• Forbid unauthorized users via access control lists (ACL),

methods need to be used to brick the whole device, rather

and unsecured and/or unrecognized devices, through

than just deleting the encrypted corporate data, as most of

the enforcement of stringent laws, from accessing health

the personal data stored in the devices have a backup on

information network (HIN)

the cloud.

•• Frame guidelines for periodic review, management, and

•• USB locks can be installed to prevent unauthorized transfer

•• Leverage the principle of least authority in determining the

•• Encryption is necessary.

auditing of network configurations upon change of network

of data.

•• Introduction of ’bring-your-own-device’ (BYOD) and mobile

accounts that require access to particular medical device components, instead of the complete network

devices renders electronic PHI vulnerable to data breaches;

•• Password protect personal health information (PHI)

hence, organizations should implement cyber liability

•• Ensure secure communication channels by encrypting and

insurance as a part of data breach response strategy. •• While upgrading BYOD, users must ensure that all private

authenticating both ends of the channel

and sensitive information are successfully deleted from old

In an attempt to ensure secure mobile computing, Dell

devices that go offline. •• Ensure technical safeguards such as data segmentation,

SecureWorks, provider of information security services, suggests the following steps to healthcare organizations:

encryption, access controls, VPN software remote, data

•• Develop a guidepost: Involves the evaluation of different

erasure, etc. are installed in mobile devices before use at a

modes employed to secure mobile devices, and utilization of

www.healthitnewsdirect.com

setting.

Health IT NEWS.Direct!

July - September 2012

•• It is imperative for employees to shut down the laptops

preserving and promoting brand confidence among its

completely as opposed to leaving them in sleep mode, when

customers. •• Conducting risk audition and assessment on new technologies

unattended, to ensure efficient encryption of the device. •• Staff should be educated against leaving data unencrypted

prior to installation is an important step that should be followed

while at rest or transit, switching off security settings, failing

by the providers. Providers need to develop applications after

to inform incidents of theft or loss, and downloading free

consulting with the privacy, legal, and compliance teams in

software/applications from unauthorized sites containing

order to eliminate future problems.

malware. •• With the growing use of mobile devices in the healthcare

With mobile devices offering a novel platform to support enhanced

industry, it is necessary to have a data management policy

patient care, and reduced costs, implementation of policies and

for securing PHI.

solutions to tackle security and privacy concerns becomes vital

•• Companies gathering, exchanging, or storing any personal

for healthcare organizations to establish a competitive edge by

data need to maintain transparency with user consent for

keeping abreast with latest technology advancements.

www.healthitnewsdirect.com

INSIGHTS

July - September 2012

H&HN survey illustrates IT utilization among 2012 ‘Most Wired Hospitals’ Hospitals & Health Networks (H&HN), a publication of the American

medical centers also mentioned that CPOE systems are used for

Hospital Association (AHA), has announced more than 200 Most

entering all lab, radiology and medication orders at inpatient and

Wired hospitals, based on a survey that analyzed IT utilization

emergency departments, and alerting care givers on common

at healthcare organizations across four areas: infrastructure,

prescribing mistakes. The use of CPOE has been advocated by

business and administrative management, clinical integration

the EHR Incentive Program as a means of meaningfully employing

(ambulatory/physician/patient/community), and clinical safety and

IT at a healthcare setting. With government regulations fueling the

quality (outpatient/inpatient hospital).

adoption, the worldwide market for CPOE has been anticipated to reach US$1.5 billion by 2018, according to Global Industry

H&HN, in cooperation with McKesson Corporation, CareTech

Analysts; with the US represented as the largest regional industry,

Solutions, AT&T, the College of Healthcare Information

and expected to emerge as the fastest growing market.

Management Executives (CHIME), and AHA, conducted the survey on 1,570 hospitals (~27% of US hospitals); of which, 662

Social media: Moving a step forward in improving patient

completed the survey. The survey results provide an insight into

experience, over 25% of the Most Wired hospitals are providing

the types of technology used by these Most Wired hospitals and

the facility to interact with physicians through chats and

the rationale behind this recognition.

messages. Almost half are also using social media as a means of communicating with patients during a crisis (Figure 1).

Patient care

This will benefit many social media enthusiasts, who account

Including the existing methods of improving patient care, the

for one-third of the 1,000 US consumers utilizing this mode

survey has found that tech savvy hospitals are venturing into the

of communication for looking up medical data, tracing and

latest in what technology and media can offer for connecting

exchanging information related to clinical symptoms, and

with patients; improving not only care quality, but also patient

expressing their views about treatments, health plans, physicians,

satisfaction.

etc (PricewaterhouseCoopers). Analysts at PwC opine that with social media transforming the healthcare fraternity’s means of

Clinical decision support tools: Most Wired providers, according

interaction, healthcare organizations may miss out on engaging

to the survey, have implemented clinical decision support systems

patients by not leveraging the potential of this medium of

for enabling real-time data access, and keeping a tab on drug

communication.

allergies and interactions to reduce errors and duplication of Figure 1: Social media outlets used by the Most Wired hospitals

data. In addition, 63% of these hospitals have in place alert systems that guide them in complying by CMS-mandated quality measures. While, 100% of the most wired hospitals employ drug interaction and drug allergy alert tools, 91%, and 88% of the total respondents use them, respectively. Similarly, a higher usage of clinical decision support for high priority hospital conditions, and drug formula checks was noted in these hospitals (96% and 97%), when compared to all those surveyed (74% and 84%). The ability of decision support tools, such as e-prescribing and e-learning competency, in improving quality care, patient satisfaction, referrals, testing, readmissions and compliance to guidelines, and lowering hospital stay and errors has also been indicated in a whitepaper by Elsevier. Estimations of Frost & Sullivan have indicated that the market for decision support will reach $364.1 million in 2016. Computerized provider order entry (COPE): The survey also found that the utilization of CPOE has aided the organizations in enhancing care quality and lowering expenditure. One of the

www.healthitnewsdirect.com

Health IT NEWS.Direct!

July - September 2012

Data privacy and security

Wired hospitals, as apposed to 58% of all survey respondents,

Protecting sensitive patient data is a major challenge faced by

fix any IT-related problems before it negatively impacts the end-user

the US healthcare system. In an effort to overcome this challenge

experience. The different strategies employed by the organizations

the survey found that the most-wired hospitals are more prepared

are shown in Figure 2. Performance monitoring is found to result

with annual tests and risk assessment, and sophisticated data

in increased efficiencies, care delivery, and treatment outcomes.

proactively monitor infrastructure and application performance to

protection tools (Table 1). Figure 2: Methods used for monitoring healthcare IT performance Table 1: Risk assessment and testing results of the survey Methods conducted

All survey respondents (%)

Most Wired hospitals (%)

Risk analysis to detect gaps in compliance and vulnerabilities in security

Penetration testing to detect vulnerabilities in security

Wireless security assessment

Risk assessment of social media networks/public internet use

Among the types of security measures, access controls (biometrics, smart cards and key cards) and intrusion detection systems where the most widely employed for authorized users among both the Most Wired hospitals (94% and 93%, respectively) and other survey respondents (85% and 77%, respectively). Mandated for meaningful use of technology, recent supporting research from a 2011 HIMSS survey suggests that 74% of the respondents conduct risk analysis for estimating potential threat to patient health information. According to the results of a 2011

For monitoring the performance of the organization, 90% of the

Healthcare IT News survey, security measures commonly used

Most Wired hospitals use performance enhancement scorecards,

by the participants include role-based control methods, followed

and workforce management tools, when compared to 73% and

by multi-factor authentication for identity proofing, in-house

72% of all the survey respondents, respectively. Further, automated

background checks, knowledge-based authentication, and

patient flow systems (74% and 57%, respectively), and web-based,

access controls.

real-time operational budget against financial modeling, budget forecasting and expense monitoring (72% and 53%, respectively)

In response to the current survey results, Linda Reed, vice president

are also being adopted by the Most Wired hospitals, and all survey

and CIO of Atlantic Health System, states that although tools are

participants.

vital for maintaining privacy and security of data, they perform only half of the job; the rest can be accomplished by creating in people,

Conclusion

a sense of importance, awareness, and vigilance in safeguarding

According to Rich Umbdenstock, President and CEO, AHA, the

personal health information (PHI).

survey results not only identify the role of IT in enhancing patient

Real-time performance monitoring

safety and care delivery, but also in increasing hospital efficiency.

With the extensive utilization of IT in care delivery, it becomes

is witnessing lately, it is imperative for IT systems to be robust

essential for healthcare set-ups to have real-time data on the

in providing physicians and executives with actionable, real-time

performance of the systems. The benefits that the technology offers

data and support evidence-based care.

In order to cope with the changes that the healthcare industry

can be reversed in episodes of network inaccessibility or system slow-down, which can pose a threat to patients. In an effort to avert

The healthcare industry, from the past two years, has been

such unnecessary risks, the survey found that 75% of the Most

focusing on enhancing care quality, efficiencies, in order to

www.healthitnewsdirect.com

INSIGHTS

July - September 2012

comply with national regulations through the use of clinical

Chief Medical Information Officer, Heartland Health, St. Joseph,

applications like COPE, health information exchange (HIE), and

opines that access to knowledge and information through patient

clinical decision support tools. However, the Most Wired hospitals

engagement, actionable alerts, evidence-based care, real-time

have taken their focus to the next level by using IT for not merely

decision support at bed side, and population health management

adhering to the law, but to also meet the organizations’ definition

dashboards is now the center of interest. He further interestingly

of ’meaningful use’. This definition, although diverse across

states a shift in attitude from “‘Why are you making me do this?’

the organizations, is focused on value and data. Joe Boyce,

to ‘Can it do that?’”

www.healthitnewsdirect.com

Health IT NEWS.Direct!

July - September 2012

NEWS Indian pharma giant, Piramal Healthcare buys USA’s Decision Resources Group Piramal Healthcare Ltd has completed the acquisition of Decision

years, starting from 2006. With regard to the current acquisition,

Resources Group (DRG) for an approximate amount of US $635

Peter Hoenigsberg said that Piramal’s participation in DRG will

million. Piramal Healthcare has decided to operate DRG as an

help boost data provided in emerging markets, which has been

autonomous business with its headquarters retained at Burlington,

proven as the primary avenues of growth in the pharmaceutical

MA. The leadership will continue to be driven by Peter Hoenigsberg,

markets.

CEO, DRG, and its existing senior management team. The acquirer, Piramal Healthcare is ranked 5th among the 10 top Massachusetts-based DRG, a global provider of healthcare data

pharmaceutical contract manufacturers across the world, and has

and analysis, is made up of a portfolio of companies that offer

115 issued patents and 395 pending applications across the world.

insights and information that is of high value to organizations in

The company has placed a larger impetus on its already prevailing

the healthcare sector to enable them to make knowledgeable

acquisition activity towards acquiring global growth businesses

and informed decisions. The company has a strong team of

that would help achieve sustainable returns, since the 2010 sale of

400 employees and leverages a network of 125,000 healthcare

its domestic formulations business to Abbott Laboratories for US

professionals across the world to provide analytics services for

$3.72 billion. The DRG buy follows the acquisition of the molecular

pharmaceutical, medical devices, financial, managed care and

imaging R&D portfolio of Bayer Pharma AG in April of this year and

biotechnology industries. With its focus directed towards the

the injectible anesthetic products businesses of Bharat Serums

biopharma, medical technologies, and market access businesses,

and Vaccines Limited in 2010.

DRG has a portfolio of brands offering services that concentrate According to a business consulting and advisory company, Grant

on the various aspects of healthcare: •• Arlington Medical Resources (AMR): provides market

Thornton, 2011 witnessed 59 M&A deals in the pharma, healthcare

intelligence for the diagnostic imaging and pharmaceutical

and biotech domains in India. The deals were valued at a total of

industries

US$ 2.1 billion and accounted for 5% of all the M&A activities that

•• BioTrends Research Group: offers market research to

took place across various industry sectors (Table 1).

•• Decision Resources: specialize in research on the

Table 1: Noteworthy biopharma and healthcare MnA of 2011

small-midsized pharmaceutical companies

emerging developments, market potential, and trends in the pharmaceutical industry

Acquirer

Acquiree

Deal value (in US$ millions)

Deal type

Fortis Healthcare Ltd

Super Religare Laboratories

174.57

Majority stake

Max India Ltd

Max Healthcare Institute Ltd

30.43

Increasing stake

Aventis Pharma Ltd

Universal Medicare Pvt Ltd (Distribution and marketing of neutraceuticals)

114

Acquisition

Serum Institute of India Ltd

Orchid Chemicals & Pharmaceuticals Ltd

1.43

Strategic stake

Vivimed Labs Ltd

Uquifa SA

Acquisition

•• Fingertip Formulary: formulary database on commercial, Medicare, Medicaid and PBM plans, etc. in the US

•• HealthLeaders-InterStudy: provides analyses reports on

health plans, healthcare markets in specific geographical regions, and managed Medicaid and Medicare plans

•• Manhattan Research: healthcare advisory and market research firm

•• PharmaStrat: providing market research and consulting

in the areas of organized customer and reimbursement for biopharmaceutical manufacturers

•• Millennium Research Group: provides focused strategic information on pharmaceutical, medical devices, and biotechnology industries •• Pinsonault: delivers solutions for business and training

specific to managed markets in the biotech and pharmaceutical industries

With the current buy, the chairman of Piramal, Ajay Piramal has expressed that Piramal’s focus and approach has been cemented

From its projects, DRG reported US $160 million in revenues for

in investing in businesses with strong intellectual property in the

2012, and have been reporting a CAGR of 20% for the past 5

healthcare industry.

www.healthitnewsdirect.com

NEWS

July - September 2012

Global perspectives on health IT from Harvard Medical School thought leader, Dr Blackford Middleton Press release Blackford Middleton to deliver keynote at HIMSS AsiaPac12

during the conference, reaching out to key target audiences. The

Conference and Exhibition about clinical decision support and

HIMSS AsiaPac12 will include:

knowledge sharing The Four Conferences in One comprises of HIT X.0, mHIMSS July 10, 2012 Singapore: The HIMSS AsiaPac12 Conference

(Mobile Health), Standards and interoperability, and Care in the

and Exhibition (www.himssasiapac.org/12) in Singapore will begin

Community. In order to promote the understanding of the reality

with a keynote address by Dr. Blackford Middleton, Corporate

of ageing in countries undergoing marked demographic changes,

Director, Clinical Informatics Research & Development, Partners

the Care in the Community track will focus on the myriad social

HealthCare System, Clinical Informatics R&D Harvard Medical

and cultural differences in people’s experiences of ageing and

School, Brigham & Women’s Hospital in Boston. Dr. Middleton will

health and helps to identify strategic opportunities for appropriate

describe research and development efforts at Partners HealthCare

technologies and services for the ageing population.

System and Harvard Medical School focusing on clinical decision support (CDS) and knowledge sharing. Highlights will be drawn

The Symposia Programme, which includes the Clinicians IT

from the multi-national CDS Consortium.

Leadership Symposium, Nursing Informatics Symposium, and radio-frequency identification (RFID) & real-time location system

Focusing on the central theme of ‘linking people, potential

(RTLS) in Healthcare Symposium.

and progress’, the HIMSS AsiaPac12 will connect people and information in new ways that increase patient care and safety,

The Interoperability Showcase, providing an important opportunity

reduce healthcare costs and improve quality of care across the

for participants to come together with purchasers of clinical

continuum of care in Asia Pacific. This new and unique annual

technologies to show that interoperable clinical solutions are not

conference will focus on the information technology (IT) needs

far off in the future.

of healthcare providers and services during the three day-event to be held from September 17-19 at the Marina Bay Sands in

The Exhibition will showcase hundreds of products and services for

Singapore.

healthcare IT needs. Attendees will experience live demonstrations, technology updates, new products and services in the healthcare

“HIMSS AsiaPac12 Conference is crucial for IT healthcare providers

IT industry.

throughout the Asia Pacific region. No other organization offers the type of IT healthcare information and services that contribute to

At the HIMSS AsiaPac12, the distinctive expertise of the speakers,

improving the quality and safety of patient care all in one three-

the in-depth sessions, and the large exhibition will give attendees

day event. I am privileged to be a part of this conference,” Dr.

exclusive information that will focus on the ‘Continuum of Care’ of

Middleton said.

information flow for homecare and acute care.

The HIMSS AsiaPac12 will gather global healthcare leaders

About HIMSS

and professionals who will be sharing technological advances and innovative best practices for the industry. At the start of the

HIMSS is a cause-based, not-for-profit organization exclusively

conference on 18 September, Mr. Gan Kim Yong, Minister for Health

focused on providing global leadership for the optimal use of

for the Republic of Singapore, will give an opening address as our

information technology (IT) and management systems for the

guest-of-honour. Dr. Charles Sawyer (MD, FACP), Associate Chief

betterment of healthcare. Founded 51 years ago, HIMSS and

Health Information Officer for the Geisinger Health System, will

its related organizations are headquartered in Chicago with

give the closing keynote, in which he will present some of the tools

additional offices in the United States, Europe and Asia. HIMSS

and data routinely utilized by Geisinger to deliver reliable, high

represents more than 44,000 individual members, of which

quality medical care to the population we serve. Specific examples

more than two thirds work in healthcare provider, governmental

will be provided emphasizing improvements in the quality / cost

and not-for-profit organizations. HIMSS also includes over 570

relationship and improved clinical outcomes.

corporate members and more than 170 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems.

A number of education sessions and symposia will be available

www.healthitnewsdirect.com

Health IT NEWS.Direct!

July - September 2012

HIMSS frames and leads healthcare practices and public policy

For media enquiries and interviews, please contact:

through its content expertise, professional development, research

Florence Fang

initiatives, and media vehicles designed to promote information

Flame Communications

and management systemsâ&#x20AC;&#x2122; contributions to improving the quality,

Tel : (65) 6259 3193

safety, access, and cost-effectiveness of patient care.

Email : florence@flamecomms.com

To learn more about HIMSS and to find out how to join us and our

Yvonne Lim

members in advancing our cause, please visit our website at www.

Manager, Marketing & Communications

himssasiapac.org.

HIMSS Asia Pacific Tel : +(65) 6664 1184

For more information about HIMSS AsiaPac12, please visit www.

Email : ylim@himss.org

himssasiapac.org/12.

www.healthitnewsdirect.com

July - September 2012

EVENTS Health 2.0 Europe Fall 2012

HIMSS AsiaPac12 Organizer: HIMSS

Organizer: Health 2.0

Date: September 17 - 19, 2012

Date: November 6 - 7, 2012

Location: Singapore

Location: Berlin, Germany

Link: www.himssasiapac.org/12/home/index.aspx

Link: www.health2con.com/events/conferences/europe-fall-2012

iHT2 Health IT Summit in New York Organizer: Institute for Health Technology Transformation

The 8th Annual World Healthcare Innovation & Technology Congress

Date: September 19 - 20, 2012

Organizer: World Congress

Location: New York City, NY

Date: November 7 - 9, 2012

Link: http://ihealthtran.com/newyorkhome.html

Location: Arlington, VA Link: www.worldcongress.com/events/HL12010

13th International Conference (IHIC)

HL7

Interoperability

Organizer: HL7

The 9th Annual American Health Care Congress (AHCC)

Date: September 27 - 28, 2012

Organizer: World Congress

Location: Vienna, Austria

Date: November 12 - 13, 2012

Link: http://ihic2012.hl7.at

Location: Anaheim, CA Link:

IEEE International Conference on Bioinformatics and Biomedicine (BIBM 2012)

http://worldcongress.com/events/HR12005/index.

cfm?confCode=HR12005

Date: October 4 - 7, 2012

International Telemedicine Conference 2012: Telemedicon 12

Location: Philadelphia, PA

Organizer: Telemedicine Society of India

Link: www.ischool.drexel.edu/ieeebibm/bibm12

Date: Novenber 29 - December 1, 2012

Organizer: IEEE

Location: Coimbatore, India

2012 HIMSS Summit of the Southeast

Link: www.telemedicon12.com/default.aspx

Organizer: HIMSS Tennessee Chapter Date: October 16, 2012

2012 mHealth Summit

Location: Nashville, TN

Organizer: mHIMSS

Link: www.tnhimss.org/events

Date: December 3 - 5, 2012 Location: Washington, D.C.

HIMAA 2012 National Conference

Link: www.mhealthsummit.org/index.php

Organizer: Health Information Management Association of Australia Limited (HIMAA)

iHT2 Health IT Summit in Austin

Date: October 29 - 31, 2012

Organizer: Institute for Health Technology Transformation

Location: Queensland, Australia

Date: December 5 - 6, 2012

Link: http://himaa2.org.au/conference

Location: Austin, TX Link: http://ihealthtran.com/austinhome.html

Second International Conference on Advances of Information & Communication The Privacy & Security Forum Organizer: Healthcare IT News and HIMSS Technology in Health Care – ICTHC 2012 Organizer: The Association of Computer Electronics and

Date: December 12 -13, 2012

Electrical Engineers (ACEEE)

Location: Boston, MA

Date: November 1 - 2, 2012

Link: www.healthprivacyforum.com

Location: Kuala Lumpur, Malaysia Link: http://icthc.theides.org/2012/index.htm

www.healthitnewsdirect.com

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• HIT X.0

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This annual Conference & Exhibition will

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17–19 SEPTEMBER 2012 MARINA BAy SANDS WWW.HIMSSASIAPAC.ORG/12

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Opening address by Guest-of-Honour Mr GAN Kim Yong Minister for Health, Republic of Singapore

Opening Keynote by Dr Blackford MIDDletON Corporate Director, Clinical Informatics Research & Development, Partners HealthCare System, Harvard Medical School, Brigham & Women’s Hospital

closing Keynote by Dr charles sAWYer MD, FACP Associate Chief Health Information Officer Geisinger Health System

transforming healthcare through IT ™