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          Security, Mobility and Interoperability: Critical Factors for Success with Brendan Downing, Partner, Falcon Consulting Group


Interview Conducted by: Parham Eftekhari, Co-Founder & EVP of Research, HTRAC Council


During this edition of Executive Perspective, we are meeting with Brendan Downing, partner of Falcon Consulting Group, a healthcare informatics consultancy, to talk about recent trends in the healthcare informatics industry and discuss issues that large healthcare provider organizations face when implementing and adopting EHR systems.

PE: Thanks for meeting me today, Brendan. Every time we meet, there seems to be a piece of new legislation or new ruling from the ONC and other regulatory bodies that rapidly shifts the focal point of the HIT industry. Where are we today and what should CIOs of large healthcare systems be focusing on right now?

BD: Thanks, Parham. It’s always a pleasure meeting with you. There are so many competing interests right now for CIOs of large healthcare organizations. Not only do they need to worry about adopting and implementing an EHR to meet Meaningful Use, they need to focus on other initiatives, such as integrating with state and local HIEs, staying on-top of the trends in mobile health (mHealth), incorporating ICD-10 into the framework of their organization, ensuring security policies and procedures are updated per the new proposed HIPAA omnibus rule, and figuring how to integrate their IT structure with newly acquired or merged hospitals. It’s no wonder that we have seen lots of turnover at the CIO rank this year. That being said, I think there are a few key areas of focus for 2013.

First and foremost is security. It is imperative for healthcare provider organizations to strengthen their policies and procedures to align with the new HIPAA proposed regulations, ensure that their systems are auditable, and data centers are secure. The last thing CIOs want is a leak of protected or confidential patient information.

Secondly, CIOs should focus on attesting for Meaningful Use. Whether an organization is in Stage 1 or Stage 2 of Meaningful Use, there are lots of dollars sitting on the table for healthcare providers to obtain and that should be a focus of any organization, especially after a large outlay in cost for EHR solutions. The most exciting component of Meaningful Use, at least to me, is the maturity of patient portals. By implementing a solid patient portal, CIOs have the ability to improve patient adoption and better compete with neighboring healthcare organizations. When discussing financial incentives, the buck doesn’t stop at Meaningful Use. Industry leading organizations are leveraging more advanced informatics and analytics to align with initiatives, such as Accountable Care Organizations (ACOs) and the Patient Centered Medical Home.  Such efforts necessitate an advanced IT environment and allow provider organizations to more strategically negotiate with healthcare payer organizations. 

Third, 2013 is the year of interoperability and information exchange. CIOs should ensure that any system they have can exchange data with other systems, both internally and externally of their enterprise. If a system cannot integrate  in a capacity which meets IHE standards, it is time to look for alternate solutions with vendors that care about interoperability. CIOs should be on the lookout for forging new partnerships with their local, state, or federal (if that’s going to happen anytime soon) HIEs that will add value to their patient populations, especially as they correlate to new ACOs. Finally, CIOs should focus on modernizing their EHR to incorporate patient population management and business analytics through optimization strategies with their vendors. Often times, healthcare organizations are a few releases behind or haven’t taken advantage of some of the best EHR vendor functionality. CIOs can incorporate these updates to create value for their staff and clinicians.

PE: Interesting. There is definitely a lot of competing interests. Falcon does a lot of work with improving the use of EHRs at your client sites, so what is the future of the EHR business?

BD: The focus of the last 5 years has been in rapid implementation. The need for electronic records, as prescribed by Meaningful Use, set forth a fury of new installs focused on giving providers electronic tools to better capture clinical data and streamline the revenue cycle processes. While these implementations have yielded great results, such as the amazing rate of physician adoption (over 50% nationwide), there will be a shift to patient population management and business analytics in the upcoming years. As the competitive landscape of healthcare shifts towards patient-driven care and a related reimbursement structure from payer organizations, those healthcare organizations that can band together in ACOs and manage patient populations through predictive analytics will rise to the top. EHRs also need to play a more active role in business analytics, and those organizations that take advantage of the immense amount of data found in EHRs will be able to implement better policies and procedures to increase their brand appeal to patients and improve the general quality of care. I know some attention has been focused on genometrics as of late, and it will be interesting how the cutting edge EHR vendors choose to adopt this is a tool for predictive analytics or patient identification.  

PE: Brendan, you speak with CIOs all over the country and help them with strategy work in deploying their EHR systems. So what is the CIOs biggest challenge for 2013 and how can they sleep easier this year?

BD: Great question, Parham. In my travels meeting with many of the nation’s top CIOs, I would say their biggest challenge for 2013 will be the prioritization of initiatives to best meet the overall business strategy of their organization, as well as, to stay ahead of the curve in a rapidly evolving industry. Most CIOs, as we talked about earlier, have so many competing objectives for this year, and determining what projects should their organization should tackle first is very difficult to determine. Many of the CIOs we work with have limited budgets, especially after procuring and implementing large enterprise EHR systems, so a lot of CIOs think the best thing to do is go after the low hanging fruit – maybe an ICD-10 implementation or attesting for MU. Falcon does a lot of strategic work with CIOs to help them determine what projects best fit in with their overall organization objectives and vision. For instance, a CIO in a rapidly growing health system where M&A activity has rattled his or her world, should focus on reigning in her IT infrastructure to focus on integrating existing systems or choosing one enterprise EHR. Aside from the budget restrictions, CIOs we work with often have a challenge finding and retaining good resources that can help them tackle initiatives independently, and that is where Falcon often comes in and helps our clients tackle strategic directives.

PE: Brendan, thanks for meeting with me today. In closing, what do you think the future of mobile health offerings will be?

BD: I was at the IHE conference last week in Chicago, and mHealth was amongst the most discussed topics. There was a projection that there will be over 300 million devices configured for mobile health exchange by 2017. That is an astonishing figure given how far we are away from that right now, but it makes total sense given our rapid transition to mobile in every other industry. As healthcare becomes more patient-centric, so will the way in which patients access their information via patient portals and tools to drive improved care decisions, such as regulating a chronic illness from the comforts of home. In order to meet those needs, healthcare providers and entrepreneurs will need to develop and deploy applications to facilitate provider/patient communication. One of my colleagues, who is a telehealth expert, thinks that the whole dynamic of the healthcare industry will change when patients can go outside of their geographic range to pursue better care through the facilitation of mobile devices. Good CIOs should pay attention to emerging mHealth vendors and should be prepared to implement some cutting-edge solutions that might make sense for their organization.  


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