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Report from World Healthcare Innovation & Technology Congress

November 10, 2010
by David Raths
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CIOs begin work on health IT underpinnings of accountable care organizations

“The future is already here – it's just not evenly distributed.”

Louise Liang, M.D., a retired Kaiser Permanente executive, used this quote of science fiction writer William Gibson to launch her Nov. 8 presentation at the World Healthcare Innovation & Technology Congress in Washington, D.C.

Liang, the former senior vice president for quality and clinical systems support, was making a point about the workflow and quality improvements Kaiser is already seeing from its $4 billion investment in health IT called KP HealthConnect. She has even edited “Connected for Health,” a 240-page book about Kaiser’s effort to use electronic health records (EHR) to transform care delivery.

The Gibson quote was fitting, because in the audience were chief information officers and chief medical information officers of health organizations looking at vastly different near-term futures. Some, such as Thomas Smith, CIO of four-hospital NorthShore University Health System in Evanston, Ill., talked about all the work they have already done on the first stage of meaningful use. Smith has established a meaningful use governance structure, assigning to specific executives ownership of each measure. They are charged with making the organizational changes necessary to comply with federal requirements. Smith said he hopes to begin the formal 90-day reporting period in January and submit attestation documentation to the Centers for Medicare & Medicaid Services (CMS) in April.

Tom Smith

At the other end of the spectrum was the CIO of a group of small rehabilitation hospitals that is ineligible for incentives. He laughingly called it “meaningless use” as he talked about his efforts to find an affordable EHR to serve his organization.

In between are CIOs and CMIOs of midsize organizations who don’t have the luxury of an integrated health system such as Kaiser or Geisinger Health System, and who must convince independent community physicians that partnering on health IT makes sense. They have made some progress on Stage 1, but have more work to do to catch up with NorthShore.

Some conference attendees seem to have shifted their focus a bit from the Health Information Technology for Economic and Clinical Health (HITECH) Act to the implications of the health reform act.

Several speakers mentioned that whether or not Republicans in Congress slow provisions of the law, their organizations will move toward accountable care organization (ACO) models anyway, because it makes business sense to do so. Several presentations dealt with envisioning the health IT underpinnings of a high-functioning ACO. “It is definitely not too early to start thinking about the infrastructure you will need in an ACO model,” said Mike Cummens, M.D., associate chief medical officer of Marshfield Clinic, the largest private group medical practice in Wisconsin with 775 physicians.