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ONC Roundup: Senior Leadership Changes Spark Questions

July 17, 2018
by Rajiv Leventhal
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The Office of the National Coordinator for Health IT (ONC) has continued to experience changes within its upper leadership, leading some folks to again ponder what the health IT agency’s role will be moving forward.

Last week it was reported that Genevieve Morris, who has been detailed to the U.S. Department of Veterans Affairs (VA) from her position as ONC’s principal deputy national coordinator, will move over full time to lead the newly establishment VA Office of Electronic Health Record Modernization (OEHRM). Morris will head OEHRM, which was launched in June, and will manage the preparation, deployment and maintenance of VA’s new electronic healthcare record system and the health IT tools dependent upon it. 

With Morris departing, questions will arise about who at ONC is spearheading ONC’s TEFCA initiative, the agency’s plan to jolt the sluggish pace of progress on interoperability between providers. Morris was previously active in TEFCA discussions, showing an ability to answer stakeholder questions at a high level while also discussing its potential future impact.

But Morris leaving isn’t the only shakeup within ONC’s senior executive department. John Fleming, M.D., the deputy assistant secretary for health technology reform, has been nominated to assistant secretary of commerce for economic development. In late June, U.S. Sen. John Kennedy (R-La.) applauded the Trump Administration for nominating Fleming for the position. “I can think of no better candidate than Dr. Fleming for the role of assistant secretary of commerce for economic development,” said Kennedy at the time. Fleming will have a hearing on his nomination this week.

Fleming, a former Congressman and a practicing family physician for nearly 40 years, was hired last March to take on a new role at ONC— deputy assistant secretary for health technology reform. Earlier this year, at the HIMSS18 conference in Las Vegas, Fleming said that relieving clinician burden through health IT was his main area of focus. Having been a practicing provider for so long, along with being an early adopter of EHRs in the 1990s, this focus area seemed like a natural fit for Fleming.

As such, in Politico’s July 16 morning eHealth newsletter, it was pondered that with these changes—coupled with CMS moving more aggressively into interoperability issues, with strong data sharing proposals in recent rule releases—is ONC “fading away” as a department within HHS? To this question, ONC spokesperson Peter Ashkenaz rebuffed those claims, telling Politico that ONC is very much involved “with TEFCA, the data sharing rule, the definition of ‘open APIs without special effort,’ and an Aug. 6-8 interoperability forum.”

ONC’s 2019 budget could get cut by up to 37 percent, as suggested by the White House, though a recent House Appropriations Committee draft bill proposed a less severe budget cut (a 29-percent decrease) for the health IT agency.

 

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Nemours Children’s Health’s New CEO: “The Most Exciting Time in Healthcare”

October 12, 2018
by Mark Hagland
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Nemours Children’s Health’s new CEO, R. Lawrence Moss, spoke with Healthcare Informatics about the opportunities and challenges facing children’s healthcare providers

On June 5, the Nemours Children’s Health System, based in Wilmington, Delaware, and with care locations in the Delaware Valley region and Florida, announced that R. Lawrence Moss, M.D., had been named the organization’s next president and CEO. An announcement posted to the organization’s website stated that “The Board of Directors of the Nemours Foundation today announced Dr. R. Lawrence Moss has been selected to succeed Dr. David Bailey as the President and CEO of Nemours Children’s Health System. Dr. Moss will begin his tenure October 1, 2018. Dr. Moss, a renowned pediatric surgeon, biomedical researcher, educator, and health system executive. He is internationally recognized for leadership in healthcare quality and safety, including service as a founding director for developing quality standards for pediatric surgery nationally. He is also known for with tremendous achievements in academic health centers, national hospital associations, and government organizations accountable to the public. He joins Nemours after serving seven years as Surgeon-in-Chief at Nationwide Children’s Hospital in Columbus, Ohio, and the E. Thomas Boles Jr., Professor of Surgery at The Ohio State University College of Medicine.”

The announcement went on to say that "Dr. Moss brings unique experiences as a physician leader in academic health centers, and he embodies the character of Nemours, a health system dedicated to continuous learning and improvement," said Brian Anderson, Chairman of the Board of Directors of the Nemours Foundation. "In addition to his clinical roles, he brings invaluable perspective and expertise in the development and execution of value-based care focused on the overall health of children through collaboration with payers and government agencies. The Board is pleased that Dr. Moss will continue fulfilling our mission to meet the needs of children, families, and the communities we serve."


R. Lawrence Moss, M.D.

"The President and CEO role at Nemours represents a wonderful opportunity to lead an institution that embodies the values I hold as most important to the future of American healthcare," Dr. Moss said in a statement included in the June 5 announcement. "With a focus on creating health over treating disease, efficient care delivery and an alignment of the success of the medical center with the health of the population it serves, I believe that Nemours is in an optimal stage of development to offer the next leader the opportunity to catalyze a quantum step forward."

As the organization’s website notes, “Nemours is an internationally recognized children's health system that owns and operates the two free-standing children’s hospitals: the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., and Nemours Children's Hospital in Orlando, Fla., along with outpatient facilities in five states, delivering pediatric primary, specialty and urgent care. Nemours also powers the world’s most-visited website for information on the health of children and teens, KidsHealth.org, and offers on-demand, online video patient visits through Nemours CareConnect. Nemours ReadingBrightstart.org is a program dedicated to preventing reading failure in young children, grounded in Nemours’ understanding that child health and learning are inextricably linked, and that reading level is a strong predictor of adult health.”

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On October 1, Dr. Moss officially joined the organization, replacing David Bailey, M.D., who retired following 12 years as Nemours’ CEO. On October 11, during a break in a one-day conference presented by the Nemours organization entitled “Pediatric Moneyball: Technology, Consumerism & Population Health,” focused on the opportunities and challenges facing our healthcare system, our communities, and our society in caring for children and improving their health and wellness, Dr. Moss, along with Gina Altieri, senior vice president and chief of strategy integration at Nemours, sat down to speak with Healthcare Informatics Editor-in-Chief Mark Hagland regarding their perspectives on the landscape around children’s healthcare in the present moment. Below are excerpts from that interview.

Strategic planning has never involved higher stakes than it does these days at children’s hospitals operating in the United States. Can you speak to this moment in U.S. healthcare? How does it strike you right now?

R. Lawrence Moss, M.D.: I’ve been doing this for a long time, and I have to say that this is the most exciting time in healthcare at any time in my career. I think it’s fantastic, because we have the opportunity to address and fix the two biggest problems I’ve seen in my career. We have the opportunity to align the finances of the system with the health of the patient; it’s been totally backwards. When a child needs more treatment, the system benefits. But finally, we have society’s attention and focus on, how do we create a situation where the child stays healthy, the family wins, and the system wins? Dr. Bailey, my predecessor, said it so well this morning, that health is so much more than healthcare. And we can be more than we’ve been; and we aspire to do that.

Children’s hospitals are facing payment challenges as never before. What do you see as the keys to their survival in the current reimbursement environment?

Dr. Moss: First of all, as children’s hospitals, we need to do a better job of articulating our value to society. We bring enormous value to society, and a lot of folks don’t know that. And we’ve got to get better at telling that story; it’s the greatest story in the world. Secondly, we need to more effectively partner with our government partners, because 60 percent of the children whose healthcare is funded, it’s funded through the government. Third, we need to be able to use the massive advances in technology to bring HC to the patient, in the way that the patient and family needs.

Gina Altieri: I agree that technology can enable a lot of the collaboration—even as our last panel was talking about how we get to where the children are, and partner with others, and bring the provider to the family that might be in a rural area, and might not have easy access to care, for example.


Gina Altieri

We’ve been so health system-centric, rather than patient- or family-centric, until recently, as a U.S. healthcare system.

Altieri: Yes, we shifted from provider-centric to consumer-centric, in developing [KidsHealth.org and the Nemours CareConnect]. We did that with design thinking, and we really did partner with families early on. We had our providers, families, and technical people early on, to understand their needs.

Moss: A really interesting thing I learned a really interesting thing at dinner last night, talking to a strategic consultant over dinner. He showed some data about the use of smartphones—that those are actually disproportionately used by the most disadvantaged parts of society.

Altieri: And it’s a misconception that disadvantaged people don’t use technology.

How do you look at technology, at the investment involved, and what can be achieved with it?

Moss: I look at it as a tool to achieve what we want to achieve. Innovation being the intersection between science and humanity, what Walter Isaacson said this morning [journalist, author, biographer and historian Walter Isaacson had delivered a presentation to the Pediatric Moneyball audience on Thursday morning]. It’s wonderful to have the technology, but unless we have the humanity to know how to use it, we won’t advance. What Nemours brings to the table, and the people in this organization bring to the table, is the ability to understand and care about what children really need.

Altieri: From a budget or investment perspective, we did recognize 20 or so years ago that this cost of investing in this technology was an investment in our future, and that we needed to look at this as a long-term investment. And we’re far beyond initial investment in an EMR, for example.

Moss: We’re cognizant of the investment, and it’s well worth it.

And you and your colleagues have achieved significant improvement in patient and family satisfaction, through the technology-facilitated advances you’ve made at Nemours.

Yes, we’re very proud of our patient and family satisfaction.

And how does the investment in and development of technology, for telehealth and other purposes, support the shift into value-based healthcare?

Altieri: Yes, and in addition to improving the experience for families, we recognized that we really did need to come up with alternatives that were less costly. We did surveying and found that 60 percent of families would have gone to the ED without the telehealth.

What do you see as your biggest challenges and opportunities in the next few years?

Moss: I prefer to talk about opportunities. The opportunities are to play a major leadership role in what children’s healthcare looks like tomorrow in this country. We are a multiple state organization; our patients come from the most disadvantaged and the most privileged backgrounds. We are a microcosm of the country, and when we get it right, it will be important.

 


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NLM’s Flatley Brennan to Receive AMIA’s Morris Collen Award

October 11, 2018
by David Raths, Contributing Editor
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She spearheaded efforts on including patient-generated data in EHRs

Patricia Flatley Brennan, R.N., Ph.D., director of the National Library of Medicine, will be awarded the 2018 Morris F. Collen Award of Excellence by the American College of Medical Informatics (ACMI).

The award is given each year at the AMIA Symposium in honor of Morris F. Collen, a pioneer in the field of medical informatics at Kaiser Permanente. It is presented to an individual whose personal commitment and dedication to medical informatics has made a lasting impression on the field. 

Brennan is widely recognized for her abilities to repurpose commercial technologies to improve the safety and effectiveness of health service delivery systems, according to AMIA.  She developed a first of its kind technology-based home care service for persons living with AIDS in the 1980s. She also worked to develop home care technologies to support elder caregivers, people recovering from cardiac surgery and patients with chronic heart disease. Her work had a profound impact on future development of technologies used for in-home chronic illness management.

She also spearheaded the biomedical informatics efforts that led to the federal requirement that electronic health records systems must safely and effectively include patient-generated and patient-sourced data. Patient access to information is now a core part of the CMS EHR incentive program.

Brennan has been elected to the American Academy of Nursing, the American College of Medical Informatics, the National Academy of Medicine, and the New York Academy of Medicine. She has also been honored with the AMIA Leadership Award and the AMIA Virginia K. Saba Award.

 

 

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Why A.I. Will Never Replace Recruiters

September 12, 2018
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AI can be a great tool, but recruiters aren’t going away

I remember fear settling in like a big dark cloud when I opened my search practice in 2005 with all the dire predictions of how the Internet and all the online hiring websites were going to put recruiters out of business. Many articles were written on the demise of the recruiter as Monster.com would literally scare us out of business.

Then came other job opening aggregators like Indeed.com, ZipRecruiter and a whole host of other websites chasing HR gold as if there was a switch they could simply flip to eliminate the human touch that recruiters bring to the table with engaging candidates, only to be replaced by a text message alert or an email notification of all the new jobs that were now open. The only thing they were missing were qualified applicants.

These predictions never came true and all the prognosticators simply forgot what recruiters actually do every day that their technologies will never replace. CIOs need to remember the critical nature of hiring leaders and team members for key roles in their organization. Candidates need to be vetted and coached to listen to an opportunity to join your team when we call the candidates. You have to remember:

  • We talk with people. Yes, we use a cell phone, or now a VOIP phone, and actually engage in a dialogue with candidates about opportunities. It’s a novel approach—I get it.
  • We engage with people that will never look on those job posting sites because they are not looking for a new job. Period.
  • We contact passive candidates that up until our call were never going to leave their job because they are so focused on the now that they don’t even think about looking on a website for a job they are not even interested in.
  • We help clients and candidates come together on the right offer and provide two-way communication during the hiring process, so each party has a deep understanding of the other party’s point of view. Online sites—well you get the picture…
  • We hammer out the details of relocation packages with our clients and the candidates and their families to make sure the move is done smoothly to allow the family to begin their transition to a new city. It’s the personal touch that matters here because we are dealing with people’s lives.

Fast forward: The next wave of artificial intelligence (AI) products for hiring are cropping up everywhere and we are hearing similar calls for recruiters to give up and retreat as the latest algorithm and data analytics tools are able to speed up the hiring process supplanting recruiters. Within seconds, these tools are touting they can determine who the perfect candidates are based on the analytics and machine learning tools designed for hiring. Guess what? It won’t happen.

AI can be a great tool, but it falls dreadfully short of meeting hiring managers' expectations. It won’t wave a magic wand suddenly making hiring enjoyable and much quicker with the same quality as the work performed by most search firms. I’ve been in technology in some form or fashion for a very long time. I love technology and what technology can do to speed up productivity and actionable data I can use every day in the work we do. It’s awesome!

But to be clear, I’m not going away. I have seen this movie before and I am fairly certain I can tell you how it ends. The work recruiters do to find and recruit great talent is something humans must do.

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