Who Will Change the Course of Health Information Technology?

MDNG Pediatrics, July 2007, Volume 5, Issue 7

Health information technology (IT) is evolving rapidly. Big changes are on the way, including pay for performance (P4P), ePrescribing, ubiquitous electronic health records (EHRs), and computerized...

Health information technology (IT) is evolving rapidly. Big changes are on the way, including pay for performance (P4P), ePrescribing, ubiquitous electronic health records (EHRs), and computerized physician order entry (CPOE), interoperable patient data that can move from provider to provider effortlessly over high-speed Internet connections, and a new breed of personal health record that will scour the Internet for patient-centric health information. Who will guide this process? The individuals on this list are likely to have a major influence over the direction of healthcare IT over the next few years.

Steve Ballmer

Who: CEO of Microsoft Corporation

Why: Microsoft is committed to entering the health IT arena. Ballmer recently told Health Informatics, “We’re very serious about health, not just providing doctors with a word processor, but also very interested in the business of health, and we’re very committed to it.” Microsoft recently acquired Azyxxi, a health IT company that aggregates clinical information across disparate platforms. Microsoft has also unveiled its Connected Health Framework, which is a schema for permitting the interoperability of patient data across systems. Microsoft may also be interested in the home health market and medical devices that facilitate information transfer between patients at home and physicians, offices, or hospitals.

Craig R. Barrett

Who: Chairman of the Board, Intel Corporation

Why: Barrett is a member of the highly influential American Health Information Community (AHIC). As Chairman of Intel, Barrett has been outspoken in his criticism of American healthcare for being too expensive, too inefficient, and too error-prone. He has called for wider adoption of IT to lower costs and improve quality in healthcare. Significantly, Intel has joined with BP America, Cardinal Health, Wal-Mart, and other partners to fund a non-profit institute to develop a personal health record (PHR), named Dossia. Dossia, according to a December 6, 2006 press release, will be an independent system that will “give individuals access to complete medical information whenever and wherever they need it.” Dossia may revolutionize the PHR market because it is not only a repository for personal health data, but also an aggregator of personal health data that can gather health information from various sources and store it within secured databases.

David W. Bates, MD

Who: Medical Director of Clinical and Quality Analysis, Partners Healthcare System

Why: Dr. Bates has played a pivotal part in academic health informatics, championing the role of EHRs and computerized decision support in improving patient safety. He serves on the Executive Committee of the Center of Information Technology Leadership at Partners Healthcare System. He is co-director of the Program in Clinical Effectiveness at the Harvard School of Public Health and Board Chair for the American Medical Informatics Association. His influential research covers such areas as prevention of adverse drug events, improving clinical effectiveness, and implementation of clinical guidelines through the adoption of EHRs and decision support.

Adam Bosworth

Who: Vice President of Google, Head of Google Health

Why: Bosworth, one of the pioneers of XML technology, is Vice President of Engineering at Google and now heads Google Health. Google wields immense influence and power in IT, and while the company’s exact strategy in the health IT space may still be evolving, it is clear that healthcare is too big for Google to ignore. Google may choose to be a provider of medical information (competing with WebMD), a purveyor of PHRs (as alluded to in this Google Blog post), or an aggregator of personal health information. Bosworth is committed to improving the quality and relevance of health information searches in Google. Refer to our May 2007 Cover Story, “Are you Googleable?” for more information on Google.

Carolyn Clancy, MD

Who: Director, Agency for Healthcare Research and Quality (AHRQ)

Why: Dr. Clancy heads the influential AHRQ, which has become the government vehicle for distributing grants for the development of health IT infrastructure. Most government money available to offset the cost of purchasing health IT has been funneled through AHRQ. AHRQ has been pivotal in developing strategies and funding research that addresses how health IT can make healthcare safer and more efficient.

Stanley Crane

Who: Chief Technology Offi cer at Allscripts

Why: Crane is a mathematician who has led teams that created software for electronic medical records (EMRs), ePrescribing, physician education, and Web-based medication sales. He is at the center of National ePrescribing Patient Safety Initiative (NEPSI) efforts to provide every physician in the US with free ePrescribing software (eRXnow). It allows physicians to prescribe electronically through the SureScripts Network and access benefit information through the RxHub network.

Suzanne F. Delbanco, PhD

Who: Executive Director, Leapfrog Group

Why: Delbanco leads the highly influential Leapfrog Group, which seeks to mobilize the purchasing power of large employers to create breakthroughs in the safety and cost effectiveness of American healthcare. The Leapfrog Group has established an initial agenda of “Four Leaps,” hospital quality and safety practices that include CPOE, evidence-based hospital referrals (referring patients to hospitals with the most and best experience in treating specific disease entities), staffing of ICUs with specialty trained intensivists, and implementing 30 National Quality Forum-endorsed safe practices.

Kevin Hutchinson

Who: President and CEO of SureScripts®

Why: Kevin Hutchinson is a member of the AHIC and is CEO of SureScripts, which, as the network that electronically connects physicians and clinicians to pharmacies and makes ePrescribing practical, has been key to the recent success of ePrescribing in the US. SureScripts is one of the partners with Allscripts in the NEPSI free ePrescribing project.

David C. Kibbe MD, MBA

Who: Principal, The Kibbe Group, LLC

Why: Dr. Kibbe is the founding director of the Center for Health Information Technology for the American Academy of Family Physicians, where he serves as a senior advisor. Now he is a health IT consultant with the Kibbe Group and is one of the co-developers of the Continuity of Care Record (CCR), which allows the interoperable exchange of patient information between providers and across platforms and EHR vendors. Kibbe is an influential health IT strategist and visionary who has the creativity to build new solutions to old problems in health IT.

Robert M. Kolodner MD

Who: National Coordinator for Health Information Technology

Why: Dr. Kolodner previously served as Chief Health Informatics Officer for the VA Health System; and in 2006 replaced Dr. David Brailer in the pivotal position of National Coordinator for Health Information Technology. The Office of the National Coordinator (ONC) is charged with developing and implementing a strategy to move healthcare into the IT age. Kolodner plans to follow the aggressive agenda set by Brailer to push the development of interoperable standards in health IT, push for the National Health Information Network (NHIN), and continue to push for physicians and hospitals to adopt EHRs.

Mark Leavitt

Who: Chairman, Certifi cation Commission on Health IT (CCHIT)

Why: Leavitt is the driving force behind the CCHIT. CCHIT was formed to operationalize Dr. David Brailer’s idea that the certification of EHRs would speed adoption by physicians and other healthcare professionals. In 2006, CCHIT completed its first round of certifi cation of ambulatory EHRs and in 2007 will begin certifying inpatient EHRs. Key to the process of certification are issues of functionality, privacy, security, and interoperability. Both inpatient and outpatient EHRs must be certified in a juried testing process. CCHIT workgroups establish both criteria and scripts for testing the EHRs, which infl uences vendor development through a “roadmap” process that delineates what functionality will be tested annually over the next three testing cycles.

Michael O. Leavitt

Who: Secretary of the Department of Health and Human Services (HHS)

Why: Leavitt wields enormous power over healthcare expenditures through the huge Medicare and Medicaid programs. His budget accounts for nearly 25% of federal expenditures and has 67,000 employees. According to the HHS website, Leavitt is “intensely focused on making healthcare more transparent in quality and price...” Leavitt has committed the HHS and Centers for Medicare and Medicaid Services (CMS; www.cms.hhs.gov) to using health IT to lower healthcare costs and reduce medical errors. Leavitt is a strong proponent of P4P as a tool to reduce healthcare costs. On the HHS site, Leavitt indicates his intention “to link all health records through an interoperable system that protects privacy as it connects patients, providers and payers, resulting in fewer medical mistakes, less hassle, lower costs and better health.” Leavitt also serves as Chair of AHIC. Through the HHS, Leavitt is responsible for major initiatives in health IT, including AHIC, ONC, government P4P, and the National Health InformationNetwork (NHIN).

Steven Lieber

Who: President and CEO of Health Information Management Systems Society (HIMSS)

Why: Lieber leads HIMSS, a powerful organization that now has more than 15,000 individual members and more than 240 corporate members that employ more than 1,000,000 workers. The winter annual meeting of HIMSS has emerged as the most important industry trade show where deals are made and new products rolled out. HIMSS has extended its reach and influence beyond vendors and now attracts clinicians, CMOs (Chief Marketing Officers), CIOs (Chief Information Offi cers), CNOs (Chief Networking Offi cers), and CMIOs (Chief Medical Informatics Officers) to its hugely successful annual meetings. Not only has HIMSS emerged as a vendor trade organization, but also as an organization that has significant efforts in education, professional development, and health IT advocacy.

Neal Patterson

Who: CEO of Cerner Corporation

Why: Patterson is the influential leader of Cerner Corporation, arguably the most successful developer of EHRs and CPOE. Cerner continues to grow at a rapid pace and has signifi cant market penetration in both the US and internationally. In my opinion, Cerner has set the bar high for inpatient EHRs.

William Yasnoff, MD, PhD

Who: Managing Partner, National Health Information Infrastructure (NHII) Advisors

Why: Dr. Yasnoff is the former National Health Information Infrastructure Director for HHS. He has had considerable influence in molding the strategy behind the NHIN and now is a healthcare consultant and founder

of a new venture called eHealthtrust. eHealthtrust is a new idea in EHRs that proposes to store patient data in protected health data banks, allowing patients to access their records but also making the data available for research and public health uses on a limited de-identified basis.

Daniel B. Hier, MD, MBA, is Professor of Neurology and Rehabilitation at the University of Illinois at Chicago, where he is Physician Practice Director for the Neuroscience Center. He is the Physician Editor of MDNG: Neurology Edition and Associate Editor for Education for AAN.com for the American Academy of Neurology. He serves as Vice Chair for the EHR Workgroup for the AAN.