Healthcare Information and Management Systems Society (HIMSS): Annual Conference and Exhibition

LAS VEGAS – Plan for a dramatic loss of productivity and drop in revenue when anticipating the myriad changes that accompany rapid deployment of an electronic health record system.

"We thought volume would drop like a rock, 50% for the first 2 weeks, and then everybody would get used to the system, and volume would pop right back up. But that’s not what happened at all," Frank DiSanzo, chief information officer of the Saint Peter’s Healthcare System in New Brunswick, N.J., said at the Healthcare Information and Management Systems Society annual conference.

Patrice Wendling/Elsevier Global Medical News

When the system’s 478-bed acute care Saint Peter’s University Hospital and its 81 clinics switched to a single electronic health record (EHR) system, patient volume dropped 30% in the first month, another 16% in the second month, and another 5% in the third month. The losses were additive, and despite the urging of vendors to plan for this eventuality, the hospital was unprepared for the accompanying loss in revenue.

"You really have to plan for this on a cash-flow basis," said Mr. DiSanzo, also vice president for the health system.

The hospital, a "Marcus Welby–like" facility, as he described it, had involved a multidisciplinary, multispecialty project management team from the inception stage through optimization that included two part-time chief medical informatics officers and seven full-time IT members working 6 days a week.

Some staff threatened to quit if they couldn’t be involved in the 9-month project from the ground up, while others balked.

"Physician pushback is surprisingly strong, even among builders and superusers," he said.

The hospital created a smaller SWAT team of physicians, nurse informaticists, core IT staff, and superusers, all of whom were given carte blanche on decisions regarding work flow and patient flow. Each team was responsible for creating individual templates, with an emphasis on maintaining consistency within service lines and throughout the patient experience. Of the more than 1,200 templates created, only 300 were custom, he said.

Training was extensive, and rapid prototyping was used to get the project up and running quickly. Surprises were built into the system and potential scenarios tested using a board game approach and flash cards so responses and corrections could be programmed into the applications before going live. Patient visit cancellations were quickly anticipated, but what they didn’t count on was the myriad of tests often preordered for these visits.

"When we tried the board game approach and flash cards, we soon had a pile of cards of downstream orders that were never going to be cancelled because we had completely forgotten to build that in," Mr. DiSanzo said.

The hospital had modified the patient schedule for the launch, but still patients arrived who couldn’t be seen. Hospital leaders early on had wrestled over whether to notify patients about the EHR project, with two opposing camps emerging. One felt the hospital shouldn’t air its dirty laundry and that telling patients might just raise concerns, while the other felt that patients should be part of the process, Mr. DiSanzo said.

The full-disclosure camp won, and "I really think it was the right thing to do," he added. The hospital posted signs in all of its clinics and handed out cards during registration that detailed EHR benefits such as potential reduction in error, faster and more efficient care, and coordination with local pharmacies.

"The patients were really very good about it and were happy to see we were moving forward in an effort that they really thought was aimed completely at them, relative to providing them better care," he said. "That was a big win for us."

Mr. DiSanzo recalled that the new electronic charts looked great and made it easier to share information; however, clinicians and nurses were working longer hours entering the necessary data. Workers all received at least 12 hours of training, regardless of their role. Quick reference cards were created and "tips and tricks" were published daily, weekly, and monthly.

Still, there was a learning curve that took about 6 months to flatten out, Mr. DiSanzo observed. User age and familiarity with typing and computers were not necessarily factors. Commitment to the project was.

One of the biggest "operational nightmares" after the system went live was scanning the precipitous volume of paper that patients brought to a visit. In the past, these documents were easily slipped into the paper record, but now each had to be indexed, scanned, and retrieved. The time commitment needed to do this is huge, he said.

Another surprise was the mismatch that occurred between processes as mapped out for the EHR and what actually happened in the clinics. Nurses and physicians inevitably developed shortcuts relative to registering patients or shuffling visits to treat a more urgent case.

Mr. DiSanzo suggested that an unspoken schism between management’s expectations for EHR implementation and what really occurred in the clinics may also have contributed to the large drop in patient volume. When the volume really started to drop, the hospital worried that patients would go somewhere else, but that hasn’t happened.

In fact, billing has increased 22%, medication reconciliation and computerized physician order entry are both 100%, and patient volume is up 13% this year, even after accounting for other factors, he said.

The hospital is still wrestling with exactly what this means, but suspects that as staffers get more familiar with the EHR system, they’re finding new ways to increase their workflow or are having better patient encounters that result in patients following-up at other clinics within the system.

"Our culture isn’t cutting edge, bleeding edge, completely electronic," he said. "We’re like the nice friendly hospital down the block that you go to and receive this Marcus Welby kind of patient care; and, if we can do it, anybody can do it."

Mr. DiSanzo reported no relevant conflicts of interest.

LAS VEGAS – Plan for a dramatic loss of productivity and drop in revenue when anticipating the myriad changes that accompany rapid deployment of an electronic health record system.

"We thought volume would drop like a rock, 50% for the first 2 weeks, and then everybody would get used to the system, and volume would pop right back up. But that’s not what happened at all," Frank DiSanzo, chief information officer of the Saint Peter’s Healthcare System in New Brunswick, N.J., said at the Healthcare Information and Management Systems Society annual conference.

Patrice Wendling/Elsevier Global Medical News

When the system’s 478-bed acute care Saint Peter’s University Hospital and its 81 clinics switched to a single electronic health record (EHR) system, patient volume dropped 30% in the first month, another 16% in the second month, and another 5% in the third month. The losses were additive, and despite the urging of vendors to plan for this eventuality, the hospital was unprepared for the accompanying loss in revenue.

"You really have to plan for this on a cash-flow basis," said Mr. DiSanzo, also vice president for the health system.

The hospital, a "Marcus Welby–like" facility, as he described it, had involved a multidisciplinary, multispecialty project management team from the inception stage through optimization that included two part-time chief medical informatics officers and seven full-time IT members working 6 days a week.

Some staff threatened to quit if they couldn’t be involved in the 9-month project from the ground up, while others balked.

"Physician pushback is surprisingly strong, even among builders and superusers," he said.

The hospital created a smaller SWAT team of physicians, nurse informaticists, core IT staff, and superusers, all of whom were given carte blanche on decisions regarding work flow and patient flow. Each team was responsible for creating individual templates, with an emphasis on maintaining consistency within service lines and throughout the patient experience. Of the more than 1,200 templates created, only 300 were custom, he said.

Training was extensive, and rapid prototyping was used to get the project up and running quickly. Surprises were built into the system and potential scenarios tested using a board game approach and flash cards so responses and corrections could be programmed into the applications before going live. Patient visit cancellations were quickly anticipated, but what they didn’t count on was the myriad of tests often preordered for these visits.

"When we tried the board game approach and flash cards, we soon had a pile of cards of downstream orders that were never going to be cancelled because we had completely forgotten to build that in," Mr. DiSanzo said.

The hospital had modified the patient schedule for the launch, but still patients arrived who couldn’t be seen. Hospital leaders early on had wrestled over whether to notify patients about the EHR project, with two opposing camps emerging. One felt the hospital shouldn’t air its dirty laundry and that telling patients might just raise concerns, while the other felt that patients should be part of the process, Mr. DiSanzo said.

The full-disclosure camp won, and "I really think it was the right thing to do," he added. The hospital posted signs in all of its clinics and handed out cards during registration that detailed EHR benefits such as potential reduction in error, faster and more efficient care, and coordination with local pharmacies.

"The patients were really very good about it and were happy to see we were moving forward in an effort that they really thought was aimed completely at them, relative to providing them better care," he said. "That was a big win for us."

Mr. DiSanzo recalled that the new electronic charts looked great and made it easier to share information; however, clinicians and nurses were working longer hours entering the necessary data. Workers all received at least 12 hours of training, regardless of their role. Quick reference cards were created and "tips and tricks" were published daily, weekly, and monthly.

Still, there was a learning curve that took about 6 months to flatten out, Mr. DiSanzo observed. User age and familiarity with typing and computers were not necessarily factors. Commitment to the project was.

One of the biggest "operational nightmares" after the system went live was scanning the precipitous volume of paper that patients brought to a visit. In the past, these documents were easily slipped into the paper record, but now each had to be indexed, scanned, and retrieved. The time commitment needed to do this is huge, he said.

Another surprise was the mismatch that occurred between processes as mapped out for the EHR and what actually happened in the clinics. Nurses and physicians inevitably developed shortcuts relative to registering patients or shuffling visits to treat a more urgent case.

Mr. DiSanzo suggested that an unspoken schism between management’s expectations for EHR implementation and what really occurred in the clinics may also have contributed to the large drop in patient volume. When the volume really started to drop, the hospital worried that patients would go somewhere else, but that hasn’t happened.

In fact, billing has increased 22%, medication reconciliation and computerized physician order entry are both 100%, and patient volume is up 13% this year, even after accounting for other factors, he said.

The hospital is still wrestling with exactly what this means, but suspects that as staffers get more familiar with the EHR system, they’re finding new ways to increase their workflow or are having better patient encounters that result in patients following-up at other clinics within the system.

"Our culture isn’t cutting edge, bleeding edge, completely electronic," he said. "We’re like the nice friendly hospital down the block that you go to and receive this Marcus Welby kind of patient care; and, if we can do it, anybody can do it."

Mr. DiSanzo reported no relevant conflicts of interest.

LAS VEGAS – Plan for a dramatic loss of productivity and drop in revenue when anticipating the myriad changes that accompany rapid deployment of an electronic health record system.

"We thought volume would drop like a rock, 50% for the first 2 weeks, and then everybody would get used to the system, and volume would pop right back up. But that’s not what happened at all," Frank DiSanzo, chief information officer of the Saint Peter’s Healthcare System in New Brunswick, N.J., said at the Healthcare Information and Management Systems Society annual conference.

Patrice Wendling/Elsevier Global Medical News

When the system’s 478-bed acute care Saint Peter’s University Hospital and its 81 clinics switched to a single electronic health record (EHR) system, patient volume dropped 30% in the first month, another 16% in the second month, and another 5% in the third month. The losses were additive, and despite the urging of vendors to plan for this eventuality, the hospital was unprepared for the accompanying loss in revenue.

"You really have to plan for this on a cash-flow basis," said Mr. DiSanzo, also vice president for the health system.

The hospital, a "Marcus Welby–like" facility, as he described it, had involved a multidisciplinary, multispecialty project management team from the inception stage through optimization that included two part-time chief medical informatics officers and seven full-time IT members working 6 days a week.

Some staff threatened to quit if they couldn’t be involved in the 9-month project from the ground up, while others balked.

"Physician pushback is surprisingly strong, even among builders and superusers," he said.

The hospital created a smaller SWAT team of physicians, nurse informaticists, core IT staff, and superusers, all of whom were given carte blanche on decisions regarding work flow and patient flow. Each team was responsible for creating individual templates, with an emphasis on maintaining consistency within service lines and throughout the patient experience. Of the more than 1,200 templates created, only 300 were custom, he said.

Training was extensive, and rapid prototyping was used to get the project up and running quickly. Surprises were built into the system and potential scenarios tested using a board game approach and flash cards so responses and corrections could be programmed into the applications before going live. Patient visit cancellations were quickly anticipated, but what they didn’t count on was the myriad of tests often preordered for these visits.

"When we tried the board game approach and flash cards, we soon had a pile of cards of downstream orders that were never going to be cancelled because we had completely forgotten to build that in," Mr. DiSanzo said.

The hospital had modified the patient schedule for the launch, but still patients arrived who couldn’t be seen. Hospital leaders early on had wrestled over whether to notify patients about the EHR project, with two opposing camps emerging. One felt the hospital shouldn’t air its dirty laundry and that telling patients might just raise concerns, while the other felt that patients should be part of the process, Mr. DiSanzo said.

The full-disclosure camp won, and "I really think it was the right thing to do," he added. The hospital posted signs in all of its clinics and handed out cards during registration that detailed EHR benefits such as potential reduction in error, faster and more efficient care, and coordination with local pharmacies.

"The patients were really very good about it and were happy to see we were moving forward in an effort that they really thought was aimed completely at them, relative to providing them better care," he said. "That was a big win for us."

Mr. DiSanzo recalled that the new electronic charts looked great and made it easier to share information; however, clinicians and nurses were working longer hours entering the necessary data. Workers all received at least 12 hours of training, regardless of their role. Quick reference cards were created and "tips and tricks" were published daily, weekly, and monthly.

Still, there was a learning curve that took about 6 months to flatten out, Mr. DiSanzo observed. User age and familiarity with typing and computers were not necessarily factors. Commitment to the project was.

One of the biggest "operational nightmares" after the system went live was scanning the precipitous volume of paper that patients brought to a visit. In the past, these documents were easily slipped into the paper record, but now each had to be indexed, scanned, and retrieved. The time commitment needed to do this is huge, he said.

Another surprise was the mismatch that occurred between processes as mapped out for the EHR and what actually happened in the clinics. Nurses and physicians inevitably developed shortcuts relative to registering patients or shuffling visits to treat a more urgent case.

Mr. DiSanzo suggested that an unspoken schism between management’s expectations for EHR implementation and what really occurred in the clinics may also have contributed to the large drop in patient volume. When the volume really started to drop, the hospital worried that patients would go somewhere else, but that hasn’t happened.

In fact, billing has increased 22%, medication reconciliation and computerized physician order entry are both 100%, and patient volume is up 13% this year, even after accounting for other factors, he said.

The hospital is still wrestling with exactly what this means, but suspects that as staffers get more familiar with the EHR system, they’re finding new ways to increase their workflow or are having better patient encounters that result in patients following-up at other clinics within the system.

"Our culture isn’t cutting edge, bleeding edge, completely electronic," he said. "We’re like the nice friendly hospital down the block that you go to and receive this Marcus Welby kind of patient care; and, if we can do it, anybody can do it."

Mr. DiSanzo reported no relevant conflicts of interest.

LAS VEGAS – Patients want to be able to review their test results online, even before they discuss them with their doctor.

A Mayo Clinic survey of 1,972 patients reported that 61% were very likely and 30% somewhat likely to view test results prior to having such discussions.

"This may pose interpretation challenges for patients, especially when complicated medical terminology is used or a difficult diagnosis, such as cancer, is revealed," Dr. Mark Parkulo said in an interview. "Providers are justifiably concerned about this, but the survey also emphasizes the importance patients place on the interpretation of the results by their provider."

Overall, 28% of patients reported that it was somewhat important and 35% very important for their physician or health provider to see the results first, while 33% said it was somewhat important and 42% very important to be able to communicate with their doctor about the results.

"I think this should reassure providers that most patients value the providers’ counsel and will seek their input prior to making a decision," said Dr. Parkulo, an internist who chairs the e-health policy work group at Mayo Clinic, Jacksonville, Fla.

Visitors to MayoClinic.org were invited to participate in the survey in October 2010. Patients in the hematology and medical oncology departments at Mayo’s Rochester, Minn., clinic and primary care patients at the Florida clinic also were asked to complete a paper survey. Roughly half of the patients were Mayo Clinic employees.

Respondents had a high level of interest in viewing laboratory data and clinical notes online via a secure portal, Dr. Parkulo reported at the HIMSS12 annual conference.

In all, 70% reported being very interested and 20% somewhat interested in using a Mayo Clinic website to view their test results. Similarly, 69% were very interested and 21% somewhat interested in using the site to view clinical and provider notes.

Respondents varied in how soon they expect test results to be available online, with 38% wanting access to results as soon as results are known, 29% within several hours, 27% within a day or two, and 3% within a week, Dr. Parkulo noted. A total of 3% percent responded "don’t know/no opinion."

For pathology and radiology results, 48% preferred that the provider contact them with the results prior to being able to view them online; however, 35% wanted the results posted online, even if the results had not been reviewed and no matter what the results were.

"These findings should be taken into consideration during website/portal development, as online access to personal medical information expands," Dr. Parkulo recommended.

A total of 44% of respondents reported having a serious medical diagnosis.

Most survey respondents (44%) were aged 50-64 years, 29% were 30-49, 22% were 65 or older, and just 5% were aged 18-29 years.

The majority of respondents were female (72%) and white (91%).

Although 60% of all respondents reported going online daily, 82% of non-Mayo employees and 64% of all respondents had never used the clinic’s website to view laboratory test results.

Dr. Parkulo said the Mayo Clinic has spent a great deal of time discussing online issues with physicians and used the patient survey in developing its current policy. Laboratory testing is released online as soon as it is posted in the electronic medical record. Later this year, they plan on releasing radiology and pathology results after a delay of 48 hours to allow for provider review, and releasing provider notes as soon as they are available, with a disclaimer when applicable that will inform patients that the notes have not been authenticated.

"Clearly this represents a change in practice for many staff members and some have legitimate concerns about creating anxiety for patients and patients’ abilities to interpret complicated medical tests," he said. "However, patients are mostly positive concerning the ease and rapid access to their information."

Dr. Parkulo and his coauthors reported no relevant conflicts of interest.

LAS VEGAS – Patients want to be able to review their test results online, even before they discuss them with their doctor.

A Mayo Clinic survey of 1,972 patients reported that 61% were very likely and 30% somewhat likely to view test results prior to having such discussions.

"This may pose interpretation challenges for patients, especially when complicated medical terminology is used or a difficult diagnosis, such as cancer, is revealed," Dr. Mark Parkulo said in an interview. "Providers are justifiably concerned about this, but the survey also emphasizes the importance patients place on the interpretation of the results by their provider."

Overall, 28% of patients reported that it was somewhat important and 35% very important for their physician or health provider to see the results first, while 33% said it was somewhat important and 42% very important to be able to communicate with their doctor about the results.

"I think this should reassure providers that most patients value the providers’ counsel and will seek their input prior to making a decision," said Dr. Parkulo, an internist who chairs the e-health policy work group at Mayo Clinic, Jacksonville, Fla.

Visitors to MayoClinic.org were invited to participate in the survey in October 2010. Patients in the hematology and medical oncology departments at Mayo’s Rochester, Minn., clinic and primary care patients at the Florida clinic also were asked to complete a paper survey. Roughly half of the patients were Mayo Clinic employees.

Respondents had a high level of interest in viewing laboratory data and clinical notes online via a secure portal, Dr. Parkulo reported at the HIMSS12 annual conference.

In all, 70% reported being very interested and 20% somewhat interested in using a Mayo Clinic website to view their test results. Similarly, 69% were very interested and 21% somewhat interested in using the site to view clinical and provider notes.

Respondents varied in how soon they expect test results to be available online, with 38% wanting access to results as soon as results are known, 29% within several hours, 27% within a day or two, and 3% within a week, Dr. Parkulo noted. A total of 3% percent responded "don’t know/no opinion."

For pathology and radiology results, 48% preferred that the provider contact them with the results prior to being able to view them online; however, 35% wanted the results posted online, even if the results had not been reviewed and no matter what the results were.

"These findings should be taken into consideration during website/portal development, as online access to personal medical information expands," Dr. Parkulo recommended.

A total of 44% of respondents reported having a serious medical diagnosis.

Most survey respondents (44%) were aged 50-64 years, 29% were 30-49, 22% were 65 or older, and just 5% were aged 18-29 years.

The majority of respondents were female (72%) and white (91%).

Although 60% of all respondents reported going online daily, 82% of non-Mayo employees and 64% of all respondents had never used the clinic’s website to view laboratory test results.

Dr. Parkulo said the Mayo Clinic has spent a great deal of time discussing online issues with physicians and used the patient survey in developing its current policy. Laboratory testing is released online as soon as it is posted in the electronic medical record. Later this year, they plan on releasing radiology and pathology results after a delay of 48 hours to allow for provider review, and releasing provider notes as soon as they are available, with a disclaimer when applicable that will inform patients that the notes have not been authenticated.

"Clearly this represents a change in practice for many staff members and some have legitimate concerns about creating anxiety for patients and patients’ abilities to interpret complicated medical tests," he said. "However, patients are mostly positive concerning the ease and rapid access to their information."

Dr. Parkulo and his coauthors reported no relevant conflicts of interest.

LAS VEGAS – Patients want to be able to review their test results online, even before they discuss them with their doctor.

A Mayo Clinic survey of 1,972 patients reported that 61% were very likely and 30% somewhat likely to view test results prior to having such discussions.

"This may pose interpretation challenges for patients, especially when complicated medical terminology is used or a difficult diagnosis, such as cancer, is revealed," Dr. Mark Parkulo said in an interview. "Providers are justifiably concerned about this, but the survey also emphasizes the importance patients place on the interpretation of the results by their provider."

Overall, 28% of patients reported that it was somewhat important and 35% very important for their physician or health provider to see the results first, while 33% said it was somewhat important and 42% very important to be able to communicate with their doctor about the results.

"I think this should reassure providers that most patients value the providers’ counsel and will seek their input prior to making a decision," said Dr. Parkulo, an internist who chairs the e-health policy work group at Mayo Clinic, Jacksonville, Fla.

Visitors to MayoClinic.org were invited to participate in the survey in October 2010. Patients in the hematology and medical oncology departments at Mayo’s Rochester, Minn., clinic and primary care patients at the Florida clinic also were asked to complete a paper survey. Roughly half of the patients were Mayo Clinic employees.

Respondents had a high level of interest in viewing laboratory data and clinical notes online via a secure portal, Dr. Parkulo reported at the HIMSS12 annual conference.

In all, 70% reported being very interested and 20% somewhat interested in using a Mayo Clinic website to view their test results. Similarly, 69% were very interested and 21% somewhat interested in using the site to view clinical and provider notes.

Respondents varied in how soon they expect test results to be available online, with 38% wanting access to results as soon as results are known, 29% within several hours, 27% within a day or two, and 3% within a week, Dr. Parkulo noted. A total of 3% percent responded "don’t know/no opinion."

For pathology and radiology results, 48% preferred that the provider contact them with the results prior to being able to view them online; however, 35% wanted the results posted online, even if the results had not been reviewed and no matter what the results were.

"These findings should be taken into consideration during website/portal development, as online access to personal medical information expands," Dr. Parkulo recommended.

A total of 44% of respondents reported having a serious medical diagnosis.

Most survey respondents (44%) were aged 50-64 years, 29% were 30-49, 22% were 65 or older, and just 5% were aged 18-29 years.

The majority of respondents were female (72%) and white (91%).

Although 60% of all respondents reported going online daily, 82% of non-Mayo employees and 64% of all respondents had never used the clinic’s website to view laboratory test results.

Dr. Parkulo said the Mayo Clinic has spent a great deal of time discussing online issues with physicians and used the patient survey in developing its current policy. Laboratory testing is released online as soon as it is posted in the electronic medical record. Later this year, they plan on releasing radiology and pathology results after a delay of 48 hours to allow for provider review, and releasing provider notes as soon as they are available, with a disclaimer when applicable that will inform patients that the notes have not been authenticated.

"Clearly this represents a change in practice for many staff members and some have legitimate concerns about creating anxiety for patients and patients’ abilities to interpret complicated medical tests," he said. "However, patients are mostly positive concerning the ease and rapid access to their information."

Dr. Parkulo and his coauthors reported no relevant conflicts of interest.

LAS VEGAS – For the first time in years, financial constraints have been replaced as the most significant barrier to health IT implementation in the 23rd annual HIMSS Leadership Survey.

Instead, 22% of respondents cited IT staffing as their greatest challenge, up from 17% last year. Inadequate financial support was the top barrier to IT implementation last year for 18% of respondents, falling to 14% this year.

"Meaningful use regulations/incentives are creating an opportunity for health care [providers] to receive funding for IT adoption, and therefore more financial resources are being allocated to health IT in order to attain these financial incentives," HIMSS [Healthcare Information and Management Systems Society] president and chief executive officer H. Stephen Lieber said in an interview.

But the rapid adoption of health IT by so many organizations is placing a strain on staffing. Nearly two-thirds (61%) of respondents said they will hire more IT staff in the next year, with the greatest need in the area of clinical application support (43%).

The HIMSS survey is based on feedback from 302 health IT professionals, largely chief information officers and IT directors, representing more than 600 hospitals throughout the United States.

Achieving meaningful use was identified by 38% of respondents as the top IT priority to be addressed at their organization over the next 2 years. This is a notable decline from last year when 49% of respondents cited the federal meaningful use electronic health record (EHR) incentive program as their top IT priority.

This year’s number two IT priority was a focus on clinical systems such as computerized practitioner order entry, EHRs, or e-prescribing (15%), followed by leveraging information (13%).

Federal Incentives

Implementing International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10) continues to be the top financial IT focus for 67% of respondents. The next closest item, upgrading the patient billing system, polled at just 6%.

"Federal initiatives continue to drive the IT decisions made by health care organizations," Mr. Lieber said.

The recent decision by the Health and Human Services department (HHS) to postpone the Oct. 1, 2013, deadline for ICD-10 implementation reverberated throughout the annual HIMSS conference, where the survey was released. Mr. Lieber pointed out that the statement from HHS Secretary Kathleen Sebelius stated that the ICD-10 deadline would be extended for "certain providers."

"I interpret ‘certain’ to mean that it may not be extended for all," he said, adding that no further clarification has been issued by HHS.

Regardless, institutions have spent considerable time and money on the federal initiatives. So far, 26% of respondents said their organization has attested to stage 1 meaningful use and were preparing to meet stage 2 requirements. In addition, 89% of respondents are on track to complete the ICD-10 conversion by the original deadline.

Although 43% of respondents could not say how much their institution had invested in converting to ICD-10, 29% said it was less than $1 million, 15% between $1 million and $4 million, and 4% spent $5 million or more.

Only 5% of respondents indicated that their organization made no additional investment in order to achieve stage 1 meaningful use. One-third reported they will invest less than $1 million, 27% between $1 million and $4 million, and 29% at least $5 million.

Those investments, however, are expected to pay off. A full 23% anticipate they will receive $2 million to $3 million, while 13% expect no less than $10 million in incentives.

IT Security Breaches Continue

The report notes that IT security breaches continue to plague health care organization, although the reduction in violations from 26% last year to 22% this year, suggests efforts to secure patient information are working.

Compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations and Centers for Medicare and Medicaid Services security audits are the top security concerns (34%). This displaces an internal breach of security (32%), which had been the primary security concern for the past several years. One-third of respondents (32%) also expressed concern that their organization’s security systems were inadequate.

"What this shows is that health IT executives continue to hold this as an area of critical importance and diligence," Mr. Lieber said.

Notably, only 6% of respondents expressed concern about the organization’s ability to secure information on mobile devices.

With regard to IT infrastructure priorities, mobile devices were a priority for 18% of organizations, just behind servers/virtual servers at 19%, which was also the top response in 2011. Virtual desktops/laptops and security systems were each identified by 16% of respondents as their primary infrastructure goal. Cloud computing and telemedicine were not on the radar of many organizations, polling at just 3% and 2%, respectively.

When asked to select areas where IT could have the most impact on patient care, the leading answer was once again improving clinical and quality outcomes (38%), followed by reducing medical errors/improving patient safety (22%), and standardization of clinical care using evidence-based medicine (16%).

LAS VEGAS – For the first time in years, financial constraints have been replaced as the most significant barrier to health IT implementation in the 23rd annual HIMSS Leadership Survey.

Instead, 22% of respondents cited IT staffing as their greatest challenge, up from 17% last year. Inadequate financial support was the top barrier to IT implementation last year for 18% of respondents, falling to 14% this year.

"Meaningful use regulations/incentives are creating an opportunity for health care [providers] to receive funding for IT adoption, and therefore more financial resources are being allocated to health IT in order to attain these financial incentives," HIMSS [Healthcare Information and Management Systems Society] president and chief executive officer H. Stephen Lieber said in an interview.

But the rapid adoption of health IT by so many organizations is placing a strain on staffing. Nearly two-thirds (61%) of respondents said they will hire more IT staff in the next year, with the greatest need in the area of clinical application support (43%).

The HIMSS survey is based on feedback from 302 health IT professionals, largely chief information officers and IT directors, representing more than 600 hospitals throughout the United States.

Achieving meaningful use was identified by 38% of respondents as the top IT priority to be addressed at their organization over the next 2 years. This is a notable decline from last year when 49% of respondents cited the federal meaningful use electronic health record (EHR) incentive program as their top IT priority.

This year’s number two IT priority was a focus on clinical systems such as computerized practitioner order entry, EHRs, or e-prescribing (15%), followed by leveraging information (13%).

Federal Incentives

Implementing International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10) continues to be the top financial IT focus for 67% of respondents. The next closest item, upgrading the patient billing system, polled at just 6%.

"Federal initiatives continue to drive the IT decisions made by health care organizations," Mr. Lieber said.

The recent decision by the Health and Human Services department (HHS) to postpone the Oct. 1, 2013, deadline for ICD-10 implementation reverberated throughout the annual HIMSS conference, where the survey was released. Mr. Lieber pointed out that the statement from HHS Secretary Kathleen Sebelius stated that the ICD-10 deadline would be extended for "certain providers."

"I interpret ‘certain’ to mean that it may not be extended for all," he said, adding that no further clarification has been issued by HHS.

Regardless, institutions have spent considerable time and money on the federal initiatives. So far, 26% of respondents said their organization has attested to stage 1 meaningful use and were preparing to meet stage 2 requirements. In addition, 89% of respondents are on track to complete the ICD-10 conversion by the original deadline.

Although 43% of respondents could not say how much their institution had invested in converting to ICD-10, 29% said it was less than $1 million, 15% between $1 million and $4 million, and 4% spent $5 million or more.

Only 5% of respondents indicated that their organization made no additional investment in order to achieve stage 1 meaningful use. One-third reported they will invest less than $1 million, 27% between $1 million and $4 million, and 29% at least $5 million.

Those investments, however, are expected to pay off. A full 23% anticipate they will receive $2 million to $3 million, while 13% expect no less than $10 million in incentives.

IT Security Breaches Continue

The report notes that IT security breaches continue to plague health care organization, although the reduction in violations from 26% last year to 22% this year, suggests efforts to secure patient information are working.

Compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations and Centers for Medicare and Medicaid Services security audits are the top security concerns (34%). This displaces an internal breach of security (32%), which had been the primary security concern for the past several years. One-third of respondents (32%) also expressed concern that their organization’s security systems were inadequate.

"What this shows is that health IT executives continue to hold this as an area of critical importance and diligence," Mr. Lieber said.

Notably, only 6% of respondents expressed concern about the organization’s ability to secure information on mobile devices.

With regard to IT infrastructure priorities, mobile devices were a priority for 18% of organizations, just behind servers/virtual servers at 19%, which was also the top response in 2011. Virtual desktops/laptops and security systems were each identified by 16% of respondents as their primary infrastructure goal. Cloud computing and telemedicine were not on the radar of many organizations, polling at just 3% and 2%, respectively.

When asked to select areas where IT could have the most impact on patient care, the leading answer was once again improving clinical and quality outcomes (38%), followed by reducing medical errors/improving patient safety (22%), and standardization of clinical care using evidence-based medicine (16%).

LAS VEGAS – For the first time in years, financial constraints have been replaced as the most significant barrier to health IT implementation in the 23rd annual HIMSS Leadership Survey.

Instead, 22% of respondents cited IT staffing as their greatest challenge, up from 17% last year. Inadequate financial support was the top barrier to IT implementation last year for 18% of respondents, falling to 14% this year.

"Meaningful use regulations/incentives are creating an opportunity for health care [providers] to receive funding for IT adoption, and therefore more financial resources are being allocated to health IT in order to attain these financial incentives," HIMSS [Healthcare Information and Management Systems Society] president and chief executive officer H. Stephen Lieber said in an interview.

But the rapid adoption of health IT by so many organizations is placing a strain on staffing. Nearly two-thirds (61%) of respondents said they will hire more IT staff in the next year, with the greatest need in the area of clinical application support (43%).

The HIMSS survey is based on feedback from 302 health IT professionals, largely chief information officers and IT directors, representing more than 600 hospitals throughout the United States.

Achieving meaningful use was identified by 38% of respondents as the top IT priority to be addressed at their organization over the next 2 years. This is a notable decline from last year when 49% of respondents cited the federal meaningful use electronic health record (EHR) incentive program as their top IT priority.

This year’s number two IT priority was a focus on clinical systems such as computerized practitioner order entry, EHRs, or e-prescribing (15%), followed by leveraging information (13%).

Federal Incentives

Implementing International Classification of Diseases, 10th edition diagnosis and procedure codes (ICD-10) continues to be the top financial IT focus for 67% of respondents. The next closest item, upgrading the patient billing system, polled at just 6%.

"Federal initiatives continue to drive the IT decisions made by health care organizations," Mr. Lieber said.

The recent decision by the Health and Human Services department (HHS) to postpone the Oct. 1, 2013, deadline for ICD-10 implementation reverberated throughout the annual HIMSS conference, where the survey was released. Mr. Lieber pointed out that the statement from HHS Secretary Kathleen Sebelius stated that the ICD-10 deadline would be extended for "certain providers."

"I interpret ‘certain’ to mean that it may not be extended for all," he said, adding that no further clarification has been issued by HHS.

Regardless, institutions have spent considerable time and money on the federal initiatives. So far, 26% of respondents said their organization has attested to stage 1 meaningful use and were preparing to meet stage 2 requirements. In addition, 89% of respondents are on track to complete the ICD-10 conversion by the original deadline.

Although 43% of respondents could not say how much their institution had invested in converting to ICD-10, 29% said it was less than $1 million, 15% between $1 million and $4 million, and 4% spent $5 million or more.

Only 5% of respondents indicated that their organization made no additional investment in order to achieve stage 1 meaningful use. One-third reported they will invest less than $1 million, 27% between $1 million and $4 million, and 29% at least $5 million.

Those investments, however, are expected to pay off. A full 23% anticipate they will receive $2 million to $3 million, while 13% expect no less than $10 million in incentives.

IT Security Breaches Continue

The report notes that IT security breaches continue to plague health care organization, although the reduction in violations from 26% last year to 22% this year, suggests efforts to secure patient information are working.

Compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations and Centers for Medicare and Medicaid Services security audits are the top security concerns (34%). This displaces an internal breach of security (32%), which had been the primary security concern for the past several years. One-third of respondents (32%) also expressed concern that their organization’s security systems were inadequate.

"What this shows is that health IT executives continue to hold this as an area of critical importance and diligence," Mr. Lieber said.

Notably, only 6% of respondents expressed concern about the organization’s ability to secure information on mobile devices.

With regard to IT infrastructure priorities, mobile devices were a priority for 18% of organizations, just behind servers/virtual servers at 19%, which was also the top response in 2011. Virtual desktops/laptops and security systems were each identified by 16% of respondents as their primary infrastructure goal. Cloud computing and telemedicine were not on the radar of many organizations, polling at just 3% and 2%, respectively.

When asked to select areas where IT could have the most impact on patient care, the leading answer was once again improving clinical and quality outcomes (38%), followed by reducing medical errors/improving patient safety (22%), and standardization of clinical care using evidence-based medicine (16%).

UPDATED Feb. 24 to include information publication of the proposed federal regulations.

LAS VEGAS – Proposed stage 2 federal regulations for the meaningful use of electronic health records will require more effort from health care providers, but also promises to provide them with more flexibility.

"The main message is that we’ve stayed the course," Dr. Farzad Mostashari, national coordinator for health information technology, said at the HIMSS12 annual conference, where the regulations were previewed.

Patrice Wendling/Elsevier Global Medical News

Much of what providers will see in stage 2 will be familiar because Dr. Mostashari’s organization, the Office of the National Coordinator for Health Information Technology (ONC), largely adopted the recommendations of the health information technology policy and standards advisory committees, he said.

The proposed regulation were published late in the day Feb. 23 in the Federal Register; comments must be filed by 5 pm ET on Apr. 23. Stage 2 of the meaningful use pro­gram will not start, however, until Janu­ary 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

The proposed regulation has been sent to the Office of the Federal Register and should be published officially within days. Once published, the clock will start ticking on a 60-day public comment period. Stage 2 of the meaningful use program will not start, however, until January 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

There is a big push in the stage 2 regulations toward standards-based data exchange and interoperability, Dr. Mostashari said.

"We can’t wait 5 years to get standards-based exchange in this world," he added.

Specifically, in order to receive the federal incentive payment under Medicare or Medicaid, meaningful users will be required to use direct project protocols for secure e-mail, although they can instead opt for information-exchange certification through the SOAP (simple object access protocol) approach. For the first time, there is a single standard for transferring laboratory results, as well as messaging standards for public health, and standards for vocabulary.

To demonstrate compliance with data exchange requirements in stage 2, meaningful users will have to actually exchange data across organizational or vendor boundaries; a test exchange will not suffice, Dr. Mostashari emphasized. To that end, a summary of care must be sent to a recipient outside the meaningful user’s organization for more than 10% of referrals and transitions of care.

Under the proposed regulations, stage 2 also will put more emphasis on patient engagement. For physicians, it will no longer be enough merely to provide patients with access to their EHRs. At least 10% will have to access, download, or transmit the information to a third party. Also, more than half of patients must be provided with access to a summary of their treatment within 4 days.

Overall, the stage 2 regulations propose 17 core objectives plus 3 of 5 new menu objectives for eligible health care providers, and 16 core objectives plus 2 of 4 new menu items for hospitals. One menu objective includes the proposal that more than 40% of diagnostic medical scans and images be accessible through certified EHR technology, Centers for Medicare and Medicaid Services policy analyst Travis Broome said at the meeting. The electronic reporting of data to a cancer or specialty registry is also a new menu item.

Although stage 2 will further improve the meaningful use of EHRs, Dr. Mostashari said that the ONC also takes very seriously President Obama’s executive order that government agencies reduce regulatory burdens.

"In many parts, throughout both [regulations], we have done whatever we can to increase the flexibility and to reduce the burdens of these regulations," he said.

For example, the proposed rules allow group reporting of quality measures within a practice, instead of just individual reporting by physicians. Also, physicians and other health care providers can meet meaningful use requirements by using a complete EHR, a modular EHR, or a combination of modular EHRs.

Uptake of EHR technology has been good, but in an effort to further spur adoption, the Department of Health and Human Services announced last December that physicians who started efforts to participate in the Medicare EHR incentive program in 2011 would not have to meet stage 2 requirements until 2014, a full year later than originally planned.

"If there’s one thing that we’ve all learned, it’s that to truly make meaningful use of meaningful use, it takes time," Dr. Mostashari said.

He reported no conflicts of interest.

UPDATED Feb. 24 to include information publication of the proposed federal regulations.

LAS VEGAS – Proposed stage 2 federal regulations for the meaningful use of electronic health records will require more effort from health care providers, but also promises to provide them with more flexibility.

"The main message is that we’ve stayed the course," Dr. Farzad Mostashari, national coordinator for health information technology, said at the HIMSS12 annual conference, where the regulations were previewed.

Patrice Wendling/Elsevier Global Medical News

Much of what providers will see in stage 2 will be familiar because Dr. Mostashari’s organization, the Office of the National Coordinator for Health Information Technology (ONC), largely adopted the recommendations of the health information technology policy and standards advisory committees, he said.

The proposed regulation were published late in the day Feb. 23 in the Federal Register; comments must be filed by 5 pm ET on Apr. 23. Stage 2 of the meaningful use pro­gram will not start, however, until Janu­ary 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

The proposed regulation has been sent to the Office of the Federal Register and should be published officially within days. Once published, the clock will start ticking on a 60-day public comment period. Stage 2 of the meaningful use program will not start, however, until January 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

There is a big push in the stage 2 regulations toward standards-based data exchange and interoperability, Dr. Mostashari said.

"We can’t wait 5 years to get standards-based exchange in this world," he added.

Specifically, in order to receive the federal incentive payment under Medicare or Medicaid, meaningful users will be required to use direct project protocols for secure e-mail, although they can instead opt for information-exchange certification through the SOAP (simple object access protocol) approach. For the first time, there is a single standard for transferring laboratory results, as well as messaging standards for public health, and standards for vocabulary.

To demonstrate compliance with data exchange requirements in stage 2, meaningful users will have to actually exchange data across organizational or vendor boundaries; a test exchange will not suffice, Dr. Mostashari emphasized. To that end, a summary of care must be sent to a recipient outside the meaningful user’s organization for more than 10% of referrals and transitions of care.

Under the proposed regulations, stage 2 also will put more emphasis on patient engagement. For physicians, it will no longer be enough merely to provide patients with access to their EHRs. At least 10% will have to access, download, or transmit the information to a third party. Also, more than half of patients must be provided with access to a summary of their treatment within 4 days.

Overall, the stage 2 regulations propose 17 core objectives plus 3 of 5 new menu objectives for eligible health care providers, and 16 core objectives plus 2 of 4 new menu items for hospitals. One menu objective includes the proposal that more than 40% of diagnostic medical scans and images be accessible through certified EHR technology, Centers for Medicare and Medicaid Services policy analyst Travis Broome said at the meeting. The electronic reporting of data to a cancer or specialty registry is also a new menu item.

Although stage 2 will further improve the meaningful use of EHRs, Dr. Mostashari said that the ONC also takes very seriously President Obama’s executive order that government agencies reduce regulatory burdens.

"In many parts, throughout both [regulations], we have done whatever we can to increase the flexibility and to reduce the burdens of these regulations," he said.

For example, the proposed rules allow group reporting of quality measures within a practice, instead of just individual reporting by physicians. Also, physicians and other health care providers can meet meaningful use requirements by using a complete EHR, a modular EHR, or a combination of modular EHRs.

Uptake of EHR technology has been good, but in an effort to further spur adoption, the Department of Health and Human Services announced last December that physicians who started efforts to participate in the Medicare EHR incentive program in 2011 would not have to meet stage 2 requirements until 2014, a full year later than originally planned.

"If there’s one thing that we’ve all learned, it’s that to truly make meaningful use of meaningful use, it takes time," Dr. Mostashari said.

He reported no conflicts of interest.

UPDATED Feb. 24 to include information publication of the proposed federal regulations.

LAS VEGAS – Proposed stage 2 federal regulations for the meaningful use of electronic health records will require more effort from health care providers, but also promises to provide them with more flexibility.

"The main message is that we’ve stayed the course," Dr. Farzad Mostashari, national coordinator for health information technology, said at the HIMSS12 annual conference, where the regulations were previewed.

Patrice Wendling/Elsevier Global Medical News

Much of what providers will see in stage 2 will be familiar because Dr. Mostashari’s organization, the Office of the National Coordinator for Health Information Technology (ONC), largely adopted the recommendations of the health information technology policy and standards advisory committees, he said.

The proposed regulation were published late in the day Feb. 23 in the Federal Register; comments must be filed by 5 pm ET on Apr. 23. Stage 2 of the meaningful use pro­gram will not start, however, until Janu­ary 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

The proposed regulation has been sent to the Office of the Federal Register and should be published officially within days. Once published, the clock will start ticking on a 60-day public comment period. Stage 2 of the meaningful use program will not start, however, until January 2014 for physicians and other eligible health care providers, and October 2013 for hospitals.

There is a big push in the stage 2 regulations toward standards-based data exchange and interoperability, Dr. Mostashari said.

"We can’t wait 5 years to get standards-based exchange in this world," he added.

Specifically, in order to receive the federal incentive payment under Medicare or Medicaid, meaningful users will be required to use direct project protocols for secure e-mail, although they can instead opt for information-exchange certification through the SOAP (simple object access protocol) approach. For the first time, there is a single standard for transferring laboratory results, as well as messaging standards for public health, and standards for vocabulary.

To demonstrate compliance with data exchange requirements in stage 2, meaningful users will have to actually exchange data across organizational or vendor boundaries; a test exchange will not suffice, Dr. Mostashari emphasized. To that end, a summary of care must be sent to a recipient outside the meaningful user’s organization for more than 10% of referrals and transitions of care.

Under the proposed regulations, stage 2 also will put more emphasis on patient engagement. For physicians, it will no longer be enough merely to provide patients with access to their EHRs. At least 10% will have to access, download, or transmit the information to a third party. Also, more than half of patients must be provided with access to a summary of their treatment within 4 days.

Overall, the stage 2 regulations propose 17 core objectives plus 3 of 5 new menu objectives for eligible health care providers, and 16 core objectives plus 2 of 4 new menu items for hospitals. One menu objective includes the proposal that more than 40% of diagnostic medical scans and images be accessible through certified EHR technology, Centers for Medicare and Medicaid Services policy analyst Travis Broome said at the meeting. The electronic reporting of data to a cancer or specialty registry is also a new menu item.

Although stage 2 will further improve the meaningful use of EHRs, Dr. Mostashari said that the ONC also takes very seriously President Obama’s executive order that government agencies reduce regulatory burdens.

"In many parts, throughout both [regulations], we have done whatever we can to increase the flexibility and to reduce the burdens of these regulations," he said.

For example, the proposed rules allow group reporting of quality measures within a practice, instead of just individual reporting by physicians. Also, physicians and other health care providers can meet meaningful use requirements by using a complete EHR, a modular EHR, or a combination of modular EHRs.

Uptake of EHR technology has been good, but in an effort to further spur adoption, the Department of Health and Human Services announced last December that physicians who started efforts to participate in the Medicare EHR incentive program in 2011 would not have to meet stage 2 requirements until 2014, a full year later than originally planned.

"If there’s one thing that we’ve all learned, it’s that to truly make meaningful use of meaningful use, it takes time," Dr. Mostashari said.

He reported no conflicts of interest.

LAS VEGAS – Merging the American Medical Association’s physician community portal with that of AT&T should provide physicians with a broader array of health information technology solutions, particularly for the physician on the go.

"[Physicians] will have access to tools such as electronic prescribing, registries, electronic medical records, and also sophisticated analytic and population-health tools that will come from the AT&T side," Dr. Steven Stack, chair-elect of the AMA board of trustees, said in an interview at this meeting after the announcement was made.

 The AMA’s AMAGINE physician community portal has focused on providing small- and mid-sized physician groups with access to affordable IT technology, while the AT&T Healthcare Community Online portal focused on integrated and larger health care systems. The decision to have AT&T own and operate the combined platform was a natural progression for both groups as they sought to provide a broader suite of services, and should appear seamless to users since both portals are hosted by Covisint, Dr. Stack said.

Smartphone usage among physicians is thought to be about 84%, while tablet usage is thought to be about 50%.

Keeping the mobile physician securely connected will be a large part of the new platform, but patients should also benefit through AT&T’s mobile patient care applications, Randall Porter, assistant vice president of AT&T ForHealth, said in an interview. For example, AT&T has an application specifically for diabetes patients that uses a smartphone in combination with the patient’s glucometer to provide real-time feedback about how to manage their disease.

"The physician would be brought into the loop through the integration of the data into the [electronic medical record] through the portal capability," Mr. Porter said.

Neither AMA nor AT&T would discuss the financial terms of the deal, but Mr. Porter said that existing contractual obligations and bundles will be honored for the roughly 6,000 physician/physician groups using the AMA AMAGINE portal. Future pricing should remain competitive, given the evolving nature of the market, he added.

Dr. Stack said the AMA will remain involved in the platform to provide expertise from the physician and patient point of view.

LAS VEGAS – Merging the American Medical Association’s physician community portal with that of AT&T should provide physicians with a broader array of health information technology solutions, particularly for the physician on the go.

"[Physicians] will have access to tools such as electronic prescribing, registries, electronic medical records, and also sophisticated analytic and population-health tools that will come from the AT&T side," Dr. Steven Stack, chair-elect of the AMA board of trustees, said in an interview at this meeting after the announcement was made.

 The AMA’s AMAGINE physician community portal has focused on providing small- and mid-sized physician groups with access to affordable IT technology, while the AT&T Healthcare Community Online portal focused on integrated and larger health care systems. The decision to have AT&T own and operate the combined platform was a natural progression for both groups as they sought to provide a broader suite of services, and should appear seamless to users since both portals are hosted by Covisint, Dr. Stack said.

Smartphone usage among physicians is thought to be about 84%, while tablet usage is thought to be about 50%.

Keeping the mobile physician securely connected will be a large part of the new platform, but patients should also benefit through AT&T’s mobile patient care applications, Randall Porter, assistant vice president of AT&T ForHealth, said in an interview. For example, AT&T has an application specifically for diabetes patients that uses a smartphone in combination with the patient’s glucometer to provide real-time feedback about how to manage their disease.

"The physician would be brought into the loop through the integration of the data into the [electronic medical record] through the portal capability," Mr. Porter said.

Neither AMA nor AT&T would discuss the financial terms of the deal, but Mr. Porter said that existing contractual obligations and bundles will be honored for the roughly 6,000 physician/physician groups using the AMA AMAGINE portal. Future pricing should remain competitive, given the evolving nature of the market, he added.

Dr. Stack said the AMA will remain involved in the platform to provide expertise from the physician and patient point of view.

LAS VEGAS – Merging the American Medical Association’s physician community portal with that of AT&T should provide physicians with a broader array of health information technology solutions, particularly for the physician on the go.

"[Physicians] will have access to tools such as electronic prescribing, registries, electronic medical records, and also sophisticated analytic and population-health tools that will come from the AT&T side," Dr. Steven Stack, chair-elect of the AMA board of trustees, said in an interview at this meeting after the announcement was made.

 The AMA’s AMAGINE physician community portal has focused on providing small- and mid-sized physician groups with access to affordable IT technology, while the AT&T Healthcare Community Online portal focused on integrated and larger health care systems. The decision to have AT&T own and operate the combined platform was a natural progression for both groups as they sought to provide a broader suite of services, and should appear seamless to users since both portals are hosted by Covisint, Dr. Stack said.

Smartphone usage among physicians is thought to be about 84%, while tablet usage is thought to be about 50%.

Keeping the mobile physician securely connected will be a large part of the new platform, but patients should also benefit through AT&T’s mobile patient care applications, Randall Porter, assistant vice president of AT&T ForHealth, said in an interview. For example, AT&T has an application specifically for diabetes patients that uses a smartphone in combination with the patient’s glucometer to provide real-time feedback about how to manage their disease.

"The physician would be brought into the loop through the integration of the data into the [electronic medical record] through the portal capability," Mr. Porter said.

Neither AMA nor AT&T would discuss the financial terms of the deal, but Mr. Porter said that existing contractual obligations and bundles will be honored for the roughly 6,000 physician/physician groups using the AMA AMAGINE portal. Future pricing should remain competitive, given the evolving nature of the market, he added.

Dr. Stack said the AMA will remain involved in the platform to provide expertise from the physician and patient point of view.