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Looking Back and Looking Forward: Marion Ball’s Perspectives on the Future of Healthcare and Healthcare IT

March 10, 2014
by Mark Hagland
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Marion Ball shares her perspectives on where healthcare has been—and needs to go

Among those attending HIMSS14, the annual conference of the Chicago-based Health Information and Management Systems Society, in Orlando, Florida, the last week in February, some have a broader historical perspective on the events and discussions than others. One who had a comprehensive historical perspective on all the happenings at HIMSS14 was Marion Ball, Ed.D., senior advisor and research industry specialist in healthcare informatics at IBM Research.

The Baltimore-based Ball has spent 40 years in healthcare and healthcare IT positions, including serving for years as a hospital CIO. She is a member of the Institute of Medicine, and serves on a variety of boards, including the Board of Regents of the National Library of Medicine, the International Medical Informatics Association (IMIA), and the American Medical Informatics Association (AMIA), and the American Health Information Management Association (AHIMA) foundation, and has co-chaired the HIMSS board. Also a member of the editorial advisory board of Healthcare Informatics, Dr. Ball spoke recently with HCI Editor-in-Chief Mark Hagland regarding her perspectives on where healthcare and healthcare IT have been, and where they’re going. Below are excerpts from that interview.

You recently received an award from HIMSS. Please tell me about that.

Every year, they recognize a few people who have attended HIMSS for the past 30 years. Four of us got this award, called the “Life Member Award 2013”: in 2013, I had been a member for 30 years. These are people who have made contributions. I was lucky three years ago, when HIMSS celebrated “50 in 50”—they celebrated the most influential people in healthcare, during HIMSS’ first half-century, and I was honored as one of the most influential IT contributors to the field in the past 50 years. What happened was that they picked ten people in five different decades, who had made contributions, and I was one of the ones picked for the 1990s. That in a way was a much more prestigious award than this one; but it’s just nice to be recognized. And I’ve been fortunate to have served twice on the HIMSS board—the first time, in the early 1990s, as we were transitioning from being a personal membership society in the American Hospital Association, and then again about five years ago.

Marion Ball, Ed.D.

What did you think about the issues discussed at this year’s HIMSS Conference?

Well, at the very beginning of HIMSS, it really was the management engineers who started this thing. And I was one of the ones saying, you’ve got to get the clinical people involved—I wanted to make sure the nurses, physicians, and other clinicians would be involved, not just the management engineers and the IT people. Cindy Spur, who’s a nurse, a senior person at Partners, came into the picture. She and I worked very diligently, and were able to get the board to approve the notion of HIMSS growing into the whole clinical world.

That’s so obvious now.

Yes, of course! But in the very early days, the management engineers initially were reticent, but we were able to make it possible for the clinicians to play a role in HIMSS. And over time, many things came about, for example, the whole TIGER [Technology Initiative Guiding Education Reform] Initiative. It is becoming clear that we need to infuse clinician education—for nurses, physicians, and pharmacists—with IT education and training. And at the very beginning, David Brailer didn’t see that we needed the nurses involved as foot soldiers in transforming healthcare. So that’s how TIGER was born. And we said, we’ve got to get these two worlds together, education and application.

And two-and-a-half years ago, with wonderful support from Steve [H. Stephen Lieber, HIMSS’ president and CEO], Carla Smith [executive vice president, HIMSS], and Joyce Sensemeier, [M.S., RN-BC, HIMSS’ vice president, informatics], TIGER was established as a 501c3 organization, under the umbrella of HIMSS agreed to support TIGER until it might become self-sustaining. And Sally Schlak until recently served as an excellent leader as the TIGER executive director. She has just been hired by Cerner. We will miss her! HIMSS is going to have to decide how to work together with TIGER now, and whether to continue to financially support TIGER or not.

For the future, the whole push in trying to transform healthcare is around clinical transformation, and it’s really all about what happens at the point of care. If the clinician and the consumer are not in sync with each other, that’s a problem. We are working on a research project on adherence, related to the point of care. The bottom line is that 40-60 percent of patients don’t understand exactly what their physicians have told them, and you wonder why people end up in EDs! And we’re working in a chronic disease clinic, mostly with diabetic patients. And we recorded and checked what the physician is actually saying to the patient. And is it being understood by the patient? And then we have the patient go to a little kiosk, and ask them five questions, for example, let us make an appointment with the eye doctor and the foot doctor; and the patient says, I didn’t hear that! But what he told them was, you need to see an ophthalmologist and a podiatrist.


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