Doctors Love iPads. What Does it Mean? What Does it Mean?

After attending the largest annual health IT conference of the year — HIMSS 11 –  John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”

Doctors love iPads…not surprising? But, how might you explain this?

There are at least two different possibilities:

  • Coincidence Theory
  • Conspiracy Theory

The Coincidence Theory

So doctors want to access EHR software through the iPad…what’s the big deal?

Apple has built a great new hardware platform with the iPad. There’s nothing else like it in the marketplace.  While other companies are building competing tablets, Apple’s has been the only viable option in the market for over a year.

Getting DIRECTly to the Point: The Role of the Direct Project in Fast-Tracking Health IT Interoperability

By Rich Elmore and Arien Malec. Rich Elmore is the Direct Project Communication Workgroup leader and Vice President, Strategic Initiatives at Allscripts.  Arien Malec is ONC’s Coordinator, Direct Project and Coordinator, S&I Framework.

A patient’s health records are no longer confined to a doctor’s office, shelved inside a dusty file cabinet. With the advent of the Nationwide Health Information Network, a framework of standards, services and policies that allow health practitioners to securely exchange health data, medical records digitized to be easily shared between doctor’s offices, hospitals, benefit providers, government agencies and other health organizations, all across America.

This health information exchange is dramatically enhanced by the Direct Project. Launched in March 2010, the Direct Project was created to enable a simple, direct, secure and scalable way for participants to send authenticated, encrypted health information to known, trusted recipients over the Internet in support of Stage 1 Meaningful Use requirements. The Direct Project has more than 200 participants from over 60 different organizations. These participants include EHR and PHR vendors, medical organizations, systems integrators, integrated delivery networks, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology vendors.

Comments to ONC: PCAST HIT Report Becomes a Political Piñata

The PCAST Report on Health IT has become a political piñata. 

Early Feedback on PCAST 

Like many of my colleagues, I was taken aback by the release of the Report in early December 2010 — I didn’t know quite what to make of it. Response in the first week of release was: 
  • Limited. The first commentaries were primarily by technical and/or clinical bloggers. The mainstream HIT world had remarkably little initial reaction to the Report. 
  • Respectful of the imprimatur of “The President’s” Report and noting some of the big names associated with the report (e.g., Google’s Eric Schmidt and Microsoft’s Craig Mundie.)
  • Focused on technical and/or clinical perspectives around two broad themes.
    • The vision is on target:  “extraordinary”, “breathtakingly innovative”.
    • These guys didn’t do all their technical homework. The range varies, but the message is consistent. 

Today’s POV on PCAST 

What  a difference a six weeks makes. 

Summarizing Early PCAST HIT Critiques: “Brilliant, but they didn’t do all their technical homework.”

Last week PCAST (The President’s Council of Advisors on Science and Technology) issued a major report — “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward”. 

The reviews are filtering in and I’m seeing two major themes: 

  1. The vision is on target:  “extraordinary”, “breathtakingly innovative”.
  2. These guys didn’t do all their technical homework. The range varies, but the message is consistent. 

Here are some early critiques of the PCAST report. Let the debate continue!

Digital Medical Office of the Future Conference. Las Vegas, Sept. 9-10


Healthcare providers face critical choices in selecting and implementing Electronic Health Records (EHRs). In addition, physicians and hospitals will need to develop the capacity to exchange clinical information in order to meet Meaningful Use requirements. This program will offer detailed and practical information on EHR selection and implementation, as well as strategies for creating a sustainable health information exchange (HIE). The program also features sessions on legal/regulatory issues, clinical platforms and applications as well as strategies for optimizing workflow in order to accelerate clinical transformation.

Distinguished Speakers Include:

Steve Adams, Executive Vice President, Collaborative Care, Alere & President, Clinical Groupware Collaborative
Mark R. Anderson, FHIMSS, CPHIMS, CEO & Healthcare IT Futurist, AC Group, Inc.
Beverly Bell, RN, MHA, CPHIMS, FHIMSS, Partner, Clinical Implementation Practice Director, CSC Healthcare Group
Soma Bulusu, MS, CIO, Marin General Hospital
Proteus Duxbury, Managing Consultant, PA Consulting Group
Andrew Ganti, MSIE, Principal, Workflow IT Solutions
Kennedy Ganti, MD, Virtua Lumberton Family Physicians & Chair, New Jersey Health Information Technology Commission
Arthur Gasch, Founder, Medical Strategic Planning, Inc. & Author of Successfully Choosing Your EMR: 15 Crucial Decisions (Wiley Press)
David C. Kibbe, MD MBA, Senior Advisor, American Academy of Family Physicians & Principal, The Kibbe Group LLC
Vince Kuraitis, JD, MBA, Principal, Better Health Technologies, LLC
Arien Malec, Coordinator, NHIN Direct, Office of the National Coordinator for Health Information Technology
Debbie Newman, MBA, CPHIMS, Director of Process Improvement, Licking Memorial Health Systems
Gordon Norman, MD, MBA, EVP & Chief Innovation Officer, Alere
Keith Parker, Regional Extension Center, Nevada
Deborah Smith, PhD, Chief Strategic Planning and Quality Officer, Alaska Native Tribal Health Consortium
Carlos Vigil, DO, Internal Medicine Physician & CEO, United Hospitalist Group

Platinum Sponsor: Ingenix
Silver Sponsors: AC Group, Inc., Medical Strategic Planning, Inc., NextGen Healthcare
Bronze Sponsors: Cerner Ambulatory, EHS


For additional information, please contact TCBI:
Ph: 310-265-2570               Email:

Is HITECH Working? #6: HITECH and Health Reform Objectives are Synergistic

by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA


….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA).

We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle:

Realizing the full potential of health IT depends in no small measure on changing the health care system’s overall payment incentives so that providers benefit from improving the quality and efficiency of the services they provide. Only then will they be motivated to take full advantage of the power of electronic health records. Dr. David Blumenthal,  New England Journal of Medicine, April 9, 2009

Is HITECH Working? #4: While most attention has been focused on demand side incentives (will doctors and hospitals buy EHRs?), the supply (vendor) side of HIT is already transforming.

by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA

Most of the press coverage and attention to HITECH has been to the “buy” side of the market:  The central question here has been: “Will doctors and hospitals buy and use EHR technology?”

Meanwhile — and much more quietly — the sell (vendor) side of the EHR market is already dramatically different than it was a year ago. We observe change occurring at at least three levels:

  1. HITECH as Policy Change
  2. HITECH as Mindset Change
  3. HITECH as Technology/Business Model Change

Is HITECH Working? #1: Hospitals are grumbling but are playing in the game; success is not guaranteed.


by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA 

The rationale for hospitals having to play in the HITECH game is straightforward: the financial carrots through 2015 are helpful, and the financial sticks after 2015 will be very painful.

We’ll discuss:

  • Financial Impacts on Hospitals
  • Survey Data Showing Hospitals Will Play
  • Why Success is Not Guaranteed

Financial Impacts on Hospitals

Even prior to HITECH, most hospital executives already had passed the threshold decision and concluded that they need to implement EHR technology. Thus, the issue for most hospitals isn’t “whether” to implement EHR technology, but “when”, “at what cost”, and “how”.

A Compendium of Perspectives on the HITECH Certification NPRM

Just the Facts 

Certification Programs NPRM (Notice of Proposed Rulemaking)

Health IT, U. S. Department of Health and Human Services; March 2, 2010

Certification NPRM




Bookmarked version of Certification NPRM (much easier to navigate)

U. S. Department of Health and Human Services; March 2, 2010

Via OCCAM Practice Management blog, March 3, 2010


Commentary and Analysis


Proposed EHR Certification Rule Changes Game

HDM Breaking News; March 2, 2010

“The rule mentions the Certification Commission for Health Information Technology, but does not grant it any grandfather status…. So, while CCHIT appears to be able to continue its operations under the proposed temporary certification program, its future isn’t clear in the proposed permanent program.”


Certification NPRM: A Statement from Alisa Ray, Executive Director, Certification Commission for Health Information Technology (CCHIT)

EHR Decisions; March 3, 2010

“…we feel confident about our prospects of becoming accredited…. We feel confident about the future, and we look forward to the opportunity to continue playing a role in accelerating the adoption of health IT.


 Why Rush Vendor Certification of EHR Technologies?

The Health Care Blog; March 08, 2010

“David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don’t think this is a good idea…this recently-announced two-stage EHR technology certification plan bears all the marks of a hastily drawn up blueprint that, if rushed into production, could easily collapse of its own bureaucratic weight.”


HIT Leaders React to Proposed EHR Testing and Compliance Rule

HealthLeaders Media; March 4, 2010

  • “They got it exactly right.” Simeon Schwartz, MD, president and CEO of WestMed Medical Group.
  • “It’s going to be interesting to see how much the vendors got out ahead of this and how much they’ve hedged their bets” Eric Saff, CIO of John Muir Health
  • “…no matter where you are in the chain of this market, you can in fact certify those modules as opposed to waiting until you meet complete meaningful use to be certified. So I think that’s great. I think that’s really considerate of the ONC.” Luigi Leblanc of Solink