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A Healthcare Alliance's New Voice on the Federal HIT Standards Committee

March 23, 2013
by Mark Hagland
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Keith Figlioli of the Premier healthcare alliance shares his perspectives on his involvement with the HIT Standards Committee, and his shifting perspectives on healthcare IT’s evolution

Earlier this month, Keith Figlioli, senior vice president of healthcare informatics for the Charlotte-based Premier healthcare alliance, was named a new member of the federal HIT Standards Committee, one of the committees charged with supporting health IT automation progress by the Office of the National Coordinator for Health IT (ONC). On March 1, Figlioli became one of 15 new or continuing members of the committee, whose membership includes distinguished representatives from the hospital, medical group, pharmaceutical, policy, and consulting spheres. The appointment of Figlioli and the other new and continuing members to the committee was announced by Health and Human Services (HHS) Secretary Kathleen Sebelius in a press release. In a statement included in the press release, Farzad Mostashari, M.D., National Coordinator for Health Information Technology, said, “The role the Policy and Standards Committees play in helping guide the nation’s health IT policy is immeasurable. HHS relies on their input and guidance because of each member’s broad and diverse perspectives that have been informed by their real-world experience.”

Figlioli, who has been with Premier since September 2009, will help to lead a panel discussion during the Healthcare Informatics Executive Summit in May in San Francisco on the topic, “How Will Population Health and Analytics Support ACOs, Bundled Payments and the Medical Home?” He has also been extremely busy on a number of other fronts, including helping to lead the introduction of the new PremierConnect platform, which integrates the alliance’s new safety app on the organization’s big data platform. In a March 5 press release announcing the release of the new platform, Figlioli said in a statement, “With advancing technology, evolving healthcare demands and regulatory pressures, comes the opportunity to re-imagine how care is delivered. A real-time surveillance platform that predictively identifies variances can help eliminate waste and unnecessary costs, and improve outcomes—all by quickly getting accurate information to the right people at the right time.”

Figlioli spoke recently with HCI Editor-in-Chief Mark Hagland regarding his appointment to the HIT Standards Committee and his perspectives on the progress of the meaningful use process under the Health Information Technology for Economic and Clinical Health (HITECH) Act more broadly. Below are excerpts from that interview.

What was the process around your appointment to the HIT Standards Committee? Did you submit your name to ONC, or did they solicit your participation?

A little bit of both was involved. They do have a solicitation process, but overall, the process involved a little bit of both. But I obviously had an EHR [electronic health record] background—I used to be at Eclipsys, before Premier [Figlioli served in several different positions at the Atlanta-based Eclipsys Corporation, now a part of the Chicago-based Allscripts, from March 2003 through August 2009, ultimately as senior vice president, enterprise solutions, at Eclipsys, from February 2009-August 2009], and saw firsthand what was taking place from a vendor standpoint, and also, per my position at Premier, we touch pretty much interact with 40 percent of the healthcare market nationwide. So the fit seemed a good one.

Keith Figlioli

What was your reaction to the news of the appointment?

It’s quite an honor, obviously, and I’m very personally excited. And one of the buzz factors that came out of HIMSS13 is that we’re about to enter the post-EHR phase, and the government is realizing that, too—and if you look at the people who have been added, how we end up shaping regs and meaningful use, etc., will obviously be determinative in what goes on going forward in the industry.

What will be your goal in serving on the committee?

To represent Premier and our members. We touch 40 percent of the healthcare market, and I’m popping in and out of the executive suites of these member organizations who are advocating every day; so my hope is to bring the broader alliance lens to this, beyond the provider-to-provider mindset. This gives it more of a national point of view, rather than just one region’s or provider’s lens. And that’s my goal; I’ve got a duty to the organization.

What’s your sense of the ONC’s mindset right now?

Well, I haven’t been in my first meeting yet, but it’s interesting: all of us can critique from afar, but to be actively involved in the dialogue is different. And all of us at Premier have a strong sense of what we’re hoping for, though this is our first immersion at the level of technical standards. My perception from afar right now is that I think they’re reassessing the assumptions that came into this from the start—the assumption at the beginning of this that the EHR was the panacea. And with the Affordable Care Act and other federal initiatives, the whole foundation of this may need to be reassessed. I saw some coverage of Farzad [Mostashari] saying he’s reassessing this more fundamentally and looking at the post-EHR world. And that’s exactly what I want to find out. What exactly is that guiding set of assumptions? Because it will determine where we go from here. And I’ve been in this space for a long time, and my own assumptions in this space have so fundamentally shifted over the last few years.

How have your assumptions fundamentally changed about the current evolution of healthcare information technology?

When you work for an EMR/EHR vendor, that’s your world; and that was my lens. And when I moved over to Premier and started having all sorts of c-level discussions, my perspective shifted from the EHR being everything to its being a key fundamental facilitator among others.  And [internal healthcare system reform] proving very difficult in terms of getting people aligned, changing the payment system, getting inpatient people to think like outpatient people—it all involves very deep change management stuff. And just because you have the technology, doesn’t mean you know how to use it.

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