ORLANDO -- Deputy National Coordinator for Health IT Farzad Mostashari kicked off the Office of the National Coordinator for Health IT Town Hall at the annual Healthcare Information and Management Systems Society conference on Tuesday by applauding National Coordinator for Health IT David Blumenthal's work in shepherding federal health IT efforts.
He said Blumenthal, who will leave his post as the country's health IT chief to return to academia in April, "set us on the path we're on."
Mostashari said, "We have a plan, we have a strategy," adding, "We together have to carry the ball forward." He said, "There is momentum. We are on the right track." However, Mostashari acknowledged, "Boy, there's a lot of work to do."
He noted that while about 47,000 primary care providers who collectively treat about 70 million Americans have signed up to participate in regional extension centers, "it's not enough to sign people up. We've got to get them to meaningful use."
When it comes to the health IT work force, Mostashari noted that 84 community colleges will graduate 3,400 health IT professionals this spring. However, he said the industry still needs "many, many more."
Mostashari told attendees that every state is at least in the planning stage of state health information exchanges and that 75% have received programmatic approval of their plans. There is "a lot of work to do yet," he said, noting that states face tremendous barriers in terms of financing and budgets.
According to Mostashari, the next phase of electronic health record adoption is bound to be challenging, as the country moves from the early adopters to provider groups with fewer resources that need the adoption process to "be easier and simpler."
He warned that there will be heightened privacy and security concerns in the near future. "We have to step up our game," Mostashari said.
He acknowledged that health care reform, ICD-10, HIPAA 5010 and other issues are competing for health care providers' attention.
Still, Mostashari remains positive. "We can do it. We can do it. It's just hard. It's not impossible. It's just hard," he said.
To be successful, Mostashari said ONC must continue with the principles that have guided the agency's work thus far, including:
- Ensuring a transparent and open process;
- Keeping an eye on the prize;
- Keeping feet on the ground;
- Using the market; and
- Putting patients at the center.
Addressing Health Care Providers' Concerns
After Mostashari's speech, ONC staff members and CMS' Tony Trenkle took the stage to answer a variety of questions submitted via note cards by HIMSS attendees.
One of the most common concerns cited by health care providers at this year's conference is the timeline for Stage 2 of the meaningful use program.
Mostashari said, "We hear you. We understand." He said ONC is committed to working with the health care industry to find an appropriate solution. "We want people to succeed," he said.
One audience member asked whether the federal government would delay or extend the meaningful use program, adding, "My CIO thinks you will."
Trenkle, director of the CMS Office of e-Health Standards and Services, answered with a concise "No." Mostashari noted that it's possible that there might be certain adjustments, such as to the timeline for Stage 2, but that the program will continue as planned.
When asked about REC enrollment, Mat Kendall, director of ONC's Office of Provider Adoption Support, said most of the country's 62 RECs are on track to meet their enrollment goals. However, he noted that enrollment is not how ONC plans to measure the success of RECs. Instead, officials plan to measure success in terms of the number of health care providers who become meaningful users.
Another audience member questioned why the timelines of the meaningful use program and Medicare's electronic prescribing program are not aligned. Under the meaningful use program, incentive payments begin in 2011 and penalties kick in starting in 2015. However, under the e-prescribing program, incentive payments began in 2009, and health care providers who do not e-prescribe by 2012 will face penalties.
Trenkle noted that the timelines for the penalties were legislatively mandated and not determined by CMS. He said, "You can thank your friends on the Hill for that, not CMS."
Creators of Satirical Health IT Websites Unveiled
Offering some welcome levity to a jam-packed conference that mostly tackles serious issues, the individuals behind two satirical websites that have been poking fun at the health IT industry for nearly three years finally revealed themselves at a HIMSS press conference on Tuesday.
Extormity -- a satirical electronic health record vendor with a tag line of "Expensive, Exasperating, Exhaustive" -- and SEEDIE -- a fake health IT standards organization known as the Society for Exorbitantly Expensive and Difficult to Implement EHRs -- are the brainchild of executives from Medical Informatics Engineering, or MIE, and NoMoreClipboard.com.
In a white paper, called "The Extormity Manifesto Contrasting Views of Health Care IT," the vendor explains that "several late-night brainstorming sessions aided by grain-based, creativity-enhancing beverages yielded an unlikely idea designed to shed light on the shortcomings of the bad actors in the vendor community -- the creation of a fictional EHR company that embodies the expensive, inflexible, arrogant and unseemly side of health care IT."
NoMoreClipboard.com President Jeff Donnell -- whose alter ego Extormity CEO Brantley Whittington has been featured in previous iHealthBeat columns -- said he wanted to "come up with a creative way to shine light" on the fact "that there are questionable vendors out there" without naming names.
Donnell said that health care providers' most common complaints about EHR adoption concern cost and having to change their workflow to fit the system. He combined those complaints -- extortion and conformity -- to come up with the name of the fake EHR vendor.
On the certification side, Donnell said that MIE spent a lot of time, money and resources to become one of the first vendors to receive certification in 2006 from the Certification Commission for Health IT. But it started to hear complaints about companies that received certification but then deployed products that were very different from what received that seal of approval. SEEDIE was launched in response to those complaints.
The sites instantly attracted attention from the health IT news and blog community. Within its first month, the Extormity website attracted 40,000 visitors, Donnell said. He added that the visitors really represented "the who's who in health care," including everyone from hospitals and health systems to the federal government to the very vendors the site makes fun of.
Through the use of fake news releases that play on current health IT events, the satirical websites have managed to stay relevant since their 2008 launch.
Visitors spent an average of eight minutes on the Extormity website, with some spending up to 45 minutes. In some ways, the real vendor was envious of the attention its fake company was receiving, Donnell said.
"We have tapped into a very deep, rich pervasive vein of discontent that is out there," he said.
While the spoof started as an outlet to parody companies that were giving the industry a bad name, it also became a way to guide MIE and NoMoreClipboard, Donnell explained. He said that in meetings, executives often will say, "What would Extormity do? And, we'll do the opposite," or at times, "That sounds a little Extormity" when they felt the vendor might be moving in the wrong direction.
So why did they decide to come clean? And, why now?
Donnell said that when he and his colleagues launched Extormity in 2008, they weren't sure when and how they would reveal that they were behind it. He said that it has "been an internal debate for some time" and that there were times when the executives thought maybe they shouldn't reveal themselves at all.
However, Donnell said, "We wanted to take the opportunity to connect the dots." With billions of dollars in meaningful use incentive payments at stake, the vendor wanted "to make physicians aware of affordable, sensible, minimally invasive EHR and [personal health record] alternatives," he said.
Donnell said that he and his colleagues always viewed the annual HIMSS conference as "the ideal venue" for the big reveal but that they weren't ready to come clean until this year.
When the HIMSS vice president of education contacted Extormity about three weeks ago to see if it would be willing to participate in the conference, Donnell said he and his colleagues "felt like this was the right time, the appropriate time."
Now that MIE and NoMoreClipboard have revealed that they are behind the ever-popular satirical websites, executives expect to see a spike in business.
Donnell noted that even if a small percentage of the hundreds of thousands of visitors to the fake sites decide to take a look at the vendor's actual products and a small percentage of those people select their products, it will have a positive financial impact.
But Donnell and his colleagues aren't done with Extormity and SEEDIE yet. Donnell said, "As long as there is something to lampoon, we'll lampoon," adding, "We don't see that ending any time soon."
In fact, Extormity CEO Brantley Whittington is scheduled to speak at the HIT X.0 Conference on Thursday. During his session, Whittington will discuss how his company "combines the principles of extortion and conformity to extract revenues from hospitals and physicians who pay dearly for its propriety EHR solutions," according to a release.
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