CIO Survey: FHIR is a Potential Game Changer, Blockchain Overhyped | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CIO Survey: FHIR is a Potential Game Changer, Blockchain Overhyped

January 23, 2018
by Heather Landi
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When it comes to IT innovation at healthcare organizations, change is happening at a very uneven pace and hospitals and health systems are approaching it in different ways, a new report finds. While a handfl of surveyed CIOs said their organizations are aggressively moving foward with formalized IT innovation efforts, other organizations are not putting more structure at all behind IT innovation right now, according to a report from Impact Advisors.

Impact Advisors surveyed College of Healthcare Information Management Executives (CHIME) CIO members to examine the current state of providers’ IT innovation efforts and to better understand future efforts. The results, provided in the report “IT Innovation Efforts at Hospitals and Health Systems,” underscores some important realities in the market right now about providers’ efforts to expand and formalize IT innovation internally.

As the report notes, traditionally, IT innovation at hospitals and health systems has been fairly ad-hoc and small in scale, often narrowly targeted on a specific problem or use case. However, given the increasingly competitive health delivery landscape, the report notes that there is no growing interest among some provider organizations to expand, and formalize, internal IT innovation efforts.

One of the key report findings is that change is happening at a very uneven pace, and there is significant divergence among hospitals and health systems in terms of plans for IT innovation. Only 14 percent of CIOs said their organization has established a dedicated IT Innovation Center. Just one-third of all CIOs said their organization has an “internal committee/working group that meets regularly about IT innovation.” Less than 20 percent have a defined portion of their IT budget formally dedicated to innovation and only 12 percent have hosted internal contests or competitions focused on IT innovation.

“At one end of the spectrum, a handful of industry leaders are putting structure and discipline behind innovation efforts, established dedicated IT ‘Innovation Centers’ and forming strategic partnerships with a variety of stakeholders, including IT vendors from other industries,” the report authors wrote. “At the same time, other hospitals and health systems are not thinking about IT innovation at all, focusing instead on just keeping up with cumbersome regulatory requirements, increasingly sophisticated cyber threats and general market uncertainty.”

Many CIOs indicated they are looking externally to drive IT innovation. Thirty-six percent of CIOs cited partnerships with enterprise electronic health record (EHR) vendors, while a quarter of CIOs said their organizations have formed partnerships focused on innovation with a healthcare IT startup. Twenty—three percent cited a partnership with a health IT vendor other than an EHR vendor, and 16 percent cited a partnership with an IT vendor from outside healthcare. Overall, close to two-thirds of respondents indicated their organizations have established strategic partnerships focused on IT innovation with at least one identified stakeholder, and more than a third cited at least two of the stakeholders.

Gauging CIOs’ perspectives on emerging technologies, HL7’s FHIR (Fast Healthcare Interoperability Resources) was seen as the technology with the most potential to make a tangible, positive impact in the next two years (chosen by half of CIO respondents). Only 16 percent cited natural language processing, 14 percent cited cloud computing and 12 percent cited machine learning.

Conversely, CIOs view blockchain as the most overhyped emerging technology (cited by 48 percent of respondents). Cloud computing also was viewed as overhyped by 23 percent of CIOs.

When CIOs were asked which area of IT innovation was their highest priority, the top response was “increasing internal operational efficiencies,” which was cite by almost half of CIOs. However, the survey takes a closer look at CIOs with the most structure currently in place around IT innovation (those organizations that have established a dedicated IT Innovation Center), and, among those CIOs, the most common response about top priorities was “enhancing the consumer/patient experience.”  That was cited by 27 percent of all CIOs as a top priority, followed by driving knowledge and discovery (14 percent).

CIO respondents also identified a number of challenges that represent significant barriers to being able to drive more IT innovation within their organization. More than two-thirds of CIOs (68 percent) said other priorities are currently more important and 59 percent cited resource capacity as a significant barrier. Funding is also viewed as a significant barrier to IT innovation, cited by 55 percent of CIOs. As the report notes, only a quarter of CIOs cited “lack of governance/structure to support innovation” as a barrier, which perhaps underscores the fact that many formalized IT innovation efforts are still in the early stages.

Thirty-four percent of CIOs also identified “lack of formal sponsorship from operational leaders” as a barrier, and 27 percent cited “resource skills” as a top challenge.

The survey also asked CIOs about future plans, and the results indicate that IT leaders are sharply divided about their plans for driving IT innovation moving forward. Over the next two years, 43 percent of CIOs said they plan to form new strategic partnerships focused on IT innovation, and 36 percent plan to create more structure internally. Other responses indicated plans to increase the number of internal staff focused on IT innovation, increasing the share of the budget dedicated to innovation, and investing in one or more healthcare IT startup companies.

However, one-third of CIOs (34 percent) said their organization has no plans to take any of the actions listed in the survey question over the next 24 months.

The report authors conclude that the uneven pace of change could lead to further separation in the health delivery market. “Provider organizations that are able to put structure behind IT innovation and set up the right strategic partnerships will get access to technology sooner, learn faster and have many more market leading opportunities with digital health than provider organizations that struggle with IT innovation,” the report authors state.

What’s more, the report authors contend that successful IT innovation requires organizational commitment, experienced leadership, a defined methodology and the right partnerships. “Starting now is essential for keeping up with industry leaders and gaining access to emerging technologies,” the report states.

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CommonWell Officials: Carequality Connection Now “Generally Available” for Members

November 16, 2018
by Rajiv Leventhal, Managing Editor
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CommonWell’s executive director said this latest step “breaks down another interoperability barrier”

Connection capabilities to the Carequality framework, by members of the CommonWell Health Alliance, are now “generally available,” according to officials who made an announcement today.

CommonWell, a trade association providing a vendor-neutral platform and interoperability services for its members, announced in August that it had started a limited roll-out of live bidirectional data sharing with an initial set of CommonWell members and providers and other Carequality Interoperability Framework adopters. This marked a key step in a collaborative effort to increase health IT connectivity across the country by enabling CommonWell subscribers to engage in health data exchange through directed queries with Carequality-enabled providers, and vice versa.

In just the first two weeks of a few CommonWell-enabled providers being connected, Jitin Asnaani, CommonWell Health Alliance executive director, said there were more than 4,000 documents bilaterally exchanged with Carequality-enabled providers.

Since then, by leveraging the technological infrastructure built by CommonWell service provider Change Healthcare, members Cerner and Greenway Health successfully completed a focused rollout of the connection with a handful of their provider clients, who have been exchanging data daily with Carequality-enabled providers, officials stated today.

Now, since the connection went live in July, officials noted  that CommonWell-enabled providers have bilaterally exchanged more than 200,000 documents with Carequality-enabled providers locally and nationwide.

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Advancements in Healthcare: Interoperability, Data Exchange, and More

Micky Tripathi, President and Chief Executive Officer of the Massachusetts eHealth Collaborative, is one of the most well-informed and well-respected healthcare IT leaders in the U.S. Tripathi has...

“We are proud to break down yet another barrier to interoperability by making this much-anticipated connection available to our members and their clients,” Asnaani said in a statement today. “This increased connectivity will serve to empower providers with access to patient health data critical to their healthcare decision-making.”

In December 2016, CommonWell and Carequality, an initiative of The Sequoia Project, announced connectivity and collaboration efforts with the aim of providing additional health data sharing options for stakeholders. Officials said that the immediate focus of the work between Carequality and CommonWell would be on extending providers’ ability to request and retrieve medical records electronically from other providers. In the past two years, teams at both organizations have been working to establish that connectivity.

Together, CommonWell members and Carequality participants represent more than 90 percent of the acute EHR market and nearly 60 percent of the ambulatory EHR market. More than 15,000 hospitals, clinics, and other healthcare organizations have been actively deployed under the Carequality framework or CommonWell network.

Carequality is a national-level, consensus-built, common interoperability framework to enable exchange between and among health data sharing networks. It brings together electronic health record (EHR) vendors, record locator service (RLS) providers and other types of existing networks from the private sector and government, to determine technical and policy agreements to enable data to flow between and among networks and platforms.

CommonWell Health Alliance operates a health data sharing network that enables interoperability using a suite of services aiming to simplify cross-vendor nationwide data exchange. Services include patient ID management, advanced record location, and query/retrieve broker services, allowing a single query to retrieve multiple records for a patient from member systems.

Following the August announcement of the limited bi-directional data sharing capabilities, Micky Tripathi, Ph.D., president and CEO of the Massachusetts eHealth Collaborative said, “This is the ‘golden spike’ moment, connecting the two big railroads, like when AT&T and Verizon finally got connected. This is building that bridge.” Tripathi, who also directly observes and participates in conversations with Carequality and CommonWell, added, “It will take a while for all of the production sites and different vendors to get up and running. That will probably take a couple of years. But you have to have the bridge to connect them to begin.”

One key element in this progression is that currently, EHR giant Epic is not a member of CommonWell, despite other major EHR vendors pushing Epic in that direction. “Because sharing among Epic customers is already universal, when CommonWell connects to Carequality, the entire Epic base will become available, creating instant value for most areas of the country,” a recent KLAS report on interoperability stated.

Interestingly, Tripathi noted in August that once there is “general availability” of the data sharing services for all Carequality and CommonWell members, the competition factor will become less important. “It makes both networks more valuable,” Tripathi said at the time.

It appears as if that “general availability” time has now come. “Thanks to the CommonWell-Carequality connection, our patients can have access to their medical records regardless of the EHR a health care facility uses,” said David Callecod, president and CEO of Lafayette General Health, a Cerner client located in Lafayette, La. “When data is made readily available, providers can make diagnostic and treatment decisions more quickly, and patients can recover sooner. Better data means better communication with our patients and providers, better care and better outcomes. This is a very powerful tool!”

Officials also noted that with the connection officially in production, additional CommonWell members, including Brightree, Evident and MEDITECH, are in the process of subscribing to the connection and taking it live with their provider clients.


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Advancements in Healthcare: Interoperability, Data Exchange, and More

Tuesday, December 4, 2018 | 3:00 p.m. ET, 2:00 p.m. CT

Micky Tripathi, President and Chief Executive Officer of the Massachusetts eHealth Collaborative, is one of the most well-informed and well-respected healthcare IT leaders in the U.S. Tripathi has an inside look at the most significant interoperability trends that are happening nationwide and will discuss varying interoperability and data exchange efforts fit together in the bigger picture of U.S. healthcare.

Tripathi will also discuss the future of data exchange, advancements of standards such as FHIR, the reality of information blocking challenges, and more in this latest Healthcare Informatics webinar, which gives a high-level view on the many market forces that impacting nationwide interoperability.

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Epic Lowers App Orchard Program Fees, Introduces New Low-Cost Tier

November 1, 2018
by Heather Landi, Associate Editor
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Verona, Wis.-based Epic plans to lower program fees for health IT developers participating in its App Orchard program, and will launch a new entry-level program tier, called Nursery.

Epic announced the App Orchard updates at its App Orchard conference last week at its Verona headquarters, according to reporting from Politico published Oct. 26.

In an email statement, Brett Gann, App Orchard director, confirmed the company is reducing and simplifying the costs associated with participating in the app developer program. The three tiers of the program will see program fee reductions ranging from 33 to 80 percent as part of the update, Gann said.

Epic launched its App Orchard in 2017 as an online marketplace for third-party developers with 13 applications.

To date, more than 350 companies in the healthcare industry participate in Epic’s app developer program, where they have access to hundreds of application programming interfaces (APIs), documentation, testing tools, individual technical support, training, conferences, and integration with the Epic community, Gann said,

Gann also said the program updates announced last week at the annual App Orchard Conference in Verona will “engage a broader community of developers and increase access to APIs through simplified and reduced costs.”

The updates will help drive healthcare innovation as interested developers have the opportunity to build on top of Epic’s health record platform, using emerging industry standards such as FHIR (Fast Healthcare Interoperability Resources), Gann said.

Epic also announced a new program tier, Nursery, that will enable early-stage startups to enroll in the app developer program to access Epic’s public API documentation, tutorials, and sandboxes. Early-stage startups also will have access to FHIR, SMART on FHIR, and CDS Hooks, Gann said.

Enrolling in the Nursery program tier will cost participants $100 per year, Gann said, and when a company is prepared to go to market with its product, it may graduate to one of the other three tiers.

Nursery members will have access to Epic’s FHIR sandboxes, classroom and online learning opportunities, and the ability to engage with the online community of Epic, health system, and vendor developers and experts.

In addition to the program fee reductions, as part of the update, Epic will offer new program benefits to participants in the other three tiers, such as additional training opportunities, developer events, support services, sandboxes, and program accounts.

Gann also said Epic has simplified the pricing model for API-based integrations, eliminating the minimum fees, and reducing the cap. “It’s our expectation these updates will be a price reduction for nearly all program members,” he said.

Some developers, particularly smaller developers, have complained in the past that the fees to participate in the vendor app store are too steep.

Earlier this year, Politico reported the experiences of Rick Freeman, CEO of Interopion. Freeman told Politico that a family planning questionnaire app he developed for HHS’s Office of Population Health could have cost him up to $750,000 to run on Epic or Cerner for a year.

As reported by Politico in its October 26 report, in response to the program updates, Freeman said he is “very happy with the changes.”

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