Another information packed day at the conference.  Brian Behlendorf of NHIN Connect, Fishetti & Tastrom on VA's Innovations program, Dr. Howard Hays on IHS' Meaningful Use efforts, Jim Hebsleb of CMU with an update on the study of the open source VistA community, Rob Kolodner of OHT and Collaborative Transformations spoke of VistA (and HIT) in a changing world.

The 'keynote' for today was by Roger Baker, CIO of the VA (Scott Cragg also joined him).  He has been in the position for just over a year and provided the group with an update on his initiatives, philosophy and the status on a number of fronts.  I jotted down a few notes as well:

• VA IT Budget is $4B
• He has spent time looking at the development process
  • One myth he found was that 'centralization' was what killed VistA innovation -- he felt stagnation had occurred long before
  • In order to improve things, he's started a number of initiatives
    • Customer Forward Development = moving developers back into the clinical facilities
    • Sandbox environments
    • Innovation Initiatives (see Fishetti and Tastrom's discussion)
• Private Sector is catching-up
  • VA will consider COTS where it makes sense
  • COTS will surpass VistA in 5-15 years
• VA has other things to offer -- its research in health care improvement adds huge value
• ... on the IAC Report:
  • There was good and bad
  • He appreciated the input
  • ... and welcomes reasoned, thought out opinions
  • Sept 1 is the deadline for input, he is targeting Dec 1 as the deadline for a plan to reach a decision.  He suggested that is probably aggressive and may slip
• He acknowledged the problem w/ the FOIA process and FTP site.  Scott Cragg has the authority to get it fixed.

Today was the first day of the VistA Community Meeting, hosted at George Mason University (go Patriots!) in Fairfax, Virginia.  Participants were treated to presentations on several ongoing implementations (India and Puerto Rico) as well as provocative talks by Phillip Longman (Best Case Anywhere) and Ed Meagher (IAC chair of the VistA Modernization Committee).

I presented an update on the various projects and releases currently available here on Medsphere.org:

Today was the fist day of the 20th VistA Community Meeting (VCM) in Tempe, Az.

Edmund Billings was given the opportunity to speak on the topic of VistA strategy, partnering with the client and Meaningful Use.  I think it is fair to say his presentation was well received and generated a good discussion within the audience.

Jon Tai and I presented an update on Medsphere.org and the various open source projects and releases.  The big announcement of the day was the release of FM Projection -- a technology that allows us to project FileMan structures into SQL structures (not replication or conversion) for querying via standard tools.  A recording the presentation was captured and is available:

Medsphere.org: Released

20th VCM, Tempe Az.

A core benefit of electronic health records (EHRs) is the ability to capture data related to patient care and then sift through that data for patterns and trends. Searchable data is a necessity for generating best practices and improving existing workflows. Of course, the benefits to a single hospital are greatly expanded when data is collected among several facilities, including clinics. Regional health information exchanges (HIEs) enable administrators, care providers, and other personnel to make decisions with a knowledge of what works, thereby improving patient care.

Join us for the monthly community call to hear about how to create an HIE. Come prepared to talk about past experiences and share questions about future projects.

What: Creating a Health Information Exchange

• Welcome (Edmund Billings - Medsphere)
• The Importance of HIEs in Achieving Meaningful Use (Edmund Billings)
• What is an HIE? (Kelley Malott - Vangent)
• Best Practices in Creating an HIE (Kelley Malott)
• Roadblocks: What you should be aware of (Kelley Malott)
• A Practical HIE Example (Kelley Malott, Bernie Thuman, Eric Pupo - Vangent)
• What does CCHIT mean to an open source HIE? (Eric Pupo)
• HIE Funding sources (Kelley Malott)
• Q&A

Work group/Project Updates:

• Behavioral Health WG (Debbie Daspit, Medsphere)
• OpenVista/GT.M Integration Project (Jon Tai, Medsphere)
• CCR/CCD Gateway Project (George Lilly; Fay Struble, Medsphere)

When: October 29, 12:30 - 2pm Pacific
Where: Dial-in: (888) 506-8565 // Participant Code: 6597197
Web conference: http://medsphere.com/infinite/

Slides: CCR_CCD_Update_20091029.pdf, Ecosystem Community Call_20091029.pdf

Speakers

Edmund Billings, Medsphere's chief medical officer, was a pioneer in the development of electronic medical records (EMR) and is a seasoned healthcare information technology (IT) entrepreneur.

Kelley Malott, DHS Biodefense and Civilian Health Business Development Director for Vangent Healthcare Solutions, has over a decade of healthcare, business development and sales experience.

Bernie Thuman is vice president and chief technology officer for Vangent Healthcare Solutions and has more than 25 years experience in the information technology and services industry.

Eric Pupo is the principal of health information technology at Vangent Healthcare Solutions, where he is engaged in work at the Office of the National Coordinator for Health Information Technology (ONCHIT) as part of the Federal Health Architecture (FHA) program.

As the discussion around HITECH and Meaningful Use continues to evolve, we need to focus on how organizations will reach the goals of adoption and improved quality.

Please join us for the second in a series of community calls focused on changes and updates to the Meaningful Use clauses of HITECH and ARRA.

This call would be useful to any facility interested in understanding the details and requirements of the Meaningful Use language and how their organization and patients might profit from implementing the necessary processes and systems.

• What: Meaningful Use: Adoption, Quality and Analysis
• • Updates from ONC on Meaningful Use Criteria
  • Use and Adoption Objectives
  • • A review of the 2011 measurement criteria
    • Use case: 10% of all orders (any type directly entered by authorizing provider through CPOE)
  • Quality Improvement Objectives
  • • A review of the 2011 measurement criteria
    • Use case: % eligible surgical patients who receive VTE prophylaxis
  • Analysis Objectives
  • • A review of the 2011 measurement criteria
    • Use case: Stratify reports by gender, insurance type, primary language, race, ethnicity
• Demonstration of Voice Recognition (Dragon)
• • Discussion of use and workflow
• Clinical Transformation WG Update & Status
• Open Source Project Updates
• • GT.M Integration
  • CCR/CCD Gateway
    

When: August 27, 12:30 - 2pm Pacific
Where: Dial-in: (888) 506-8565 // Participant Code: 1302465
Web conference: http://medsphere.com/infinite/

Slides: Ecosystem Community Call - 20090827.pdf, CCR-CCD-Update-090827.pdf

Information technology is clearly necessary but not sufficient to attain Meaningful Use.  Success also requires leadership at all levels, knowledge of best practices, implementation of content that supports best practices, and direct incorporation of practices into clinical workflow. A genuine understanding of improved outcomes demands re-evaluation and measurement over time.

While some healthcare organizations have achieved these improved outcomes, the level of effort and cost required varies far and wide.  In the spirit of open source collaboration, Medsphere believes the community should work together to find the most efficient path to meaningful use and better medicine.

Medsphere has focused on these and similar topics for some time and feels that our research and findings can inform community discussion and provide a starting point from which to achieve crucial Meaningful Use goals.

What: Partnering for Meaningful Use
- What is “Meaningful Use”? - Edmund Billings, CMO, Medsphere
   - What is needed to attain “Use”? - Edmund Billings
   - How best to get there? - Mary Lawrence Staley-Sirois, President, Resurgence Consulting
   - Proposed Meaningful Use Program -  Edmund Billings
   - Questions & Discussion - Edmund Billings
- OpenVista/GT.M Integration Project Update
- CCR Gateway Project Update

When: July 30, 12:30 - 2pm Pacific
Where: Dial-in: (888) 506-8565 // Participant Code: 1302465
Web conference: http://medsphere.com/infinite/

Slides: Ecosystem Community Call - 20090730.pdf, CCR-CCD-Update-090730.pdf

Medication Reconciliation is not a new topic, but the time might be right to review where it has been and where it is going. Join us on May's community call to discuss the past, present and future, best practice in the enterprise and beyond -- especially as it relates to meaningful use and ePrescribing.

What: Medication Reconciliation Redux

• Medication Reconciliation Today
• • Historical view
  • Joint Commission's current recommendations
• Best Practices in the Enterprise
• • Intake
  • Transfer
  • Discharge
• Reconciliation across the care continuum
• • What happens after discharge?
  • Meaningful Use and ePrescribing
• Clinical Transformation WG Update
• Open Project Update
• • OpenVista/GT.M
  • CCD/CCR

When: May 28, 12:30 - 2pm Pacific
Where: Dial-in: (888) 346-3950 // Participant Code: 1302465
Web conference: http://www.medsphere.com/infinite/

Slides: Ecosystem Community Call - 20090528.pdf, CCR-CCD-Update-090521.pdf

(recording starts a few minutes into the presentation due to a scheduling error -- our apologies)

This month's community call is part two in a series on Clinical Transformation. The presentations will highlight how Clinical Transformation affects outcomes AND the bottom-line of health care organizations. The presentation will provide a proof point on how Clinical Transformation has a direct Return on Investment (ROI) for both the patient and the provider organization.

This topic is both clinical and administrative in nature and will likely be useful to physicians, nurses and others interested in outcomes, as well as health care CIOs, CFOs and administrators.

Please feel free to forward this invitation to any colleagues or associates who you believe would find this topic of interest or would like to participate in the discussion.

What: Clinical Transformation (Part II)
- Clinical Transformation
    - a Blueprint
    - in Practice
- Transformation Working Group Update
    - Review of status
    - Framework for Planning
    - Discussion
- Open Project Updates
    - OpenVista/GT.M Integration
    - CCD/CCR collaboration
- Medsphere.org: Tip of the month

When: March 26, 12:30 - 2pm Pacific
Where: Dial-in: (888) 346-3950 // Participant Code: 1302465
Web conference: http://www.medsphere.com/infinite/

Slides: Ecosystem Community Call - 20090326.pdf