07 May DHC 2008: Electronic data management a top CIO concern
Madison, Wis. – The 2008 Digital Healthcare Conference kicked off Wednesday with a look at personal health records, but it is the myriad of data management issues surrounding clinical electronic health records that many attendees are focused on.
The conference draws chief information officers from healthcare organizations throughout Wisconsin and national speakers who are engaged with the increasingly complex issues surrounding medical informatics.
Many Wisconsin healthcare CIOs are in the process of implementing electronic medical records from companies like Epic Systems and McKesson, but the task of optimizing and managing the patient data contained within those records is only beginning.
One of those issues is the forthcoming integration of patient genetic information with patient EMRs, a development that has been forecast since researchers announced they had cracked the human genome.
John Glaser, vice president and CIO of the Boston-based Partners Healthcare, and an advocate of integrating information from genetic tests with EMRs, will speak on the information technology infrastructure that will be needed to support and secure genetic information.
Glaser, who is working to establish such an infrastructure at Partners, told WTN that genetic testing is something that the most engaged healthcare consumers already are demanding. As a result, CIOs may in the near future need to make the business case for the integration of the genome in EMRs.
David Lundal, vice president and CIO of SSM Integrated Healthcare, is in the middle of an implementation of Epic Systems EMR software. Lundal said customers of Epic software have been informed of the coming integration at recent Epic user group conferences.
Lundal has a friend who runs a software company that serves genetic researchers, and genomics has long been a professional interest. Now that he has the responsibility for managing EMRs, he expects that integrating new functionality will be a constant part of his thought process.
“I expect to be in this [healthcare IT] field for a long time, so I suspect at some point I’ll be dealing with it,” Lundal said.
Business intelligence
The integration of the human genome and EMRs is one of several IT management issues being explored at DHC. Several presentations will offers strategies on how to deal with the pending data explosion brought on by healthcare IT, while others will explore how to leverage it for business advantage.
Business intelligence in the healthcare space, the kind that provides clear metrics that can be used to drive better decision-making, is the subject of one program. It will be led by John Hansmann, a regional manager for Intermountain Healthcare. Intermountain a Utah-based nonprofit organization that has linked BI to both clinical and business operations.
Reed Eichner, vice president and CIO for the Healthcare Information Management Systems Society, is in the early stages of a BI roll out. He said the organization has begun to see some of the fruits of its BI project in several departments, including finance and accounting for the development of critical dashboards for board members. The HIMSS education department, and corporate relations and membership departments, also have benefited from new analytics capabilities, Eichner said.
“The metrics that drive the business include things like membership stats,” he explained. “We have several different types of membership at HIMSS, including individuals, corporate members, and a newly developed one called organizational affiliates, which is aimed specifically at hospitals and hospital groups.”
Eichner said providing financial statistics that are driving the organization, and also offering some value-based statistics that are used in conjunction with statistics to recruit and retain corporate members, helps corporate membership drives. These drives are aimed at getting companies like IBM to sign up as corporate members, and displaying the value of benefits that HIMSS provides to corporate members is part of the value proposition that can be used in combination with analytics.
AT DHC, Eichner is interested in hearing about case studies at other organizations to see what “trials and tribulations” they might have gone through with their BI rollouts, and the benefits they are gaining.
Kerra Guffey, CIO of Meriter Hospital of Madison, is new to both Meriter and Madison. DHC offers her a chance to network in her new environment, learn what other CIOs are doing about issues that also are on her plate, and focus on substance like virtualization, disaster recovery planning, and policies and processes.
With virtualization, Meriter is trying to consolidate the amount of equipment [servers] sitting in its data center, better leverage investments its hardware technology, and reduce the need for power and cooling.
“Our organization, like so many, is moving toward virtualization, and you can do that on so many fronts,” she said. “We also have some major initiatives around our data center and disaster recovery, and we’re looking at some of our policies to update those.
“I also think this is really beneficial to me – because I’m new to the community – to network with my peers both in healthcare and vendors that I work with.”
Personal matters
The conference kicked off Wednesday with sessions on public-private partnerships and personal health records. PMRs, which are not to be confused with electronic medical records maintained by healthcare organizations, would be managed by healthcare consumers. They have generated some controversy due to privacy concerns, with physicians and researchers like Harvard Medical School’s Kenneth Mandle and Isaac Kohane calling for HIPAA medical privacy rules to be extended to PHRs.
Erik Phelps, a partner in Michael Best & Friedrich, said HIPAA is an imperfect law to protect patient privacy because certain information can be shared with patient consent, and it does not allow a private right of action. Those exceptions sound nefarious, he said, but they are necessary for the orderly functioning of healthcare systems and their components that share patient data on tests and radiology images and the like.
“An individual, with some exceptions, cannot pursue remedies under HIPAA,” he explained. “While it has industry-level value in that it creates best practices for the protection of information, making it less likely there will be breaches, it’s not the kind of law that will solve an individual’s problems.”
Phelps said there are other federal statutes generally related to information storage that may be a better vehicle for individuals because they do, in certain instances, allow for a private right of action where an individual can sue for their damages. They include the Electronic Communications and Privacy Act, and a component of it called the Stored Communications Act, and the Computer Fraud and Abuse Act.
Privacy concerns have not prevented high-tech powerhouses like Google and Microsoft from applying significant human and financial resources to the development of PHRs.
In Wisconsin, one of their most enthusiastic advocates is Patti Brennan, a professor in the College of Engineering at the University of Wisconsin-Madison. Brennan has an interesting perspective on data privacy and ownership, asserting that PHR data should be thought of in terms of liquidity. She used the example of having money but loaning it to a bank for its use through various accounts, while still retaining the right to use the money. “I do not believe the patient owns that data,” she said. “I believe that [data] is an institutional asset.”
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