HIMSS Annual Meeting 2015

CHICAGO – For Margaret Mary Health in Batesville, Ind., partnerships were central to the formation of its community-wide patient portal.

In 2012, the hospital launched a portal that combines the records and information of multiple health providers in southeast Indiana and surrounding areas into a single system that patients can access. The approach departs from a standard portal model in which each physician practice has its own portal and patients must assess their health information from multiple sources, according to Dr. Jeffrey Hatcher, a Batesville ob.gyn and medical staff liaison for Margaret Mary Health.

“The whole goal of electronic records was to consolidate and centralize and streamline health care records,” Dr. Hatcher said in an interview. “In a lot of ways, what we’re doing is just building on that process. We’ve eliminated the need for all of those individual portals and connected the patients and their physicians to the health information exchange (HIE). Those practices feed the information through the HIE into the patient’s chart.”

Margaret Mary began efforts to design its portal in early 2011. The hospital partnered with NoMoreClipboard, a company that offers patient engagement tools to health providers, and HealthBridge, a nonprofit corporation that supports health information technology adoption and health information exchange (HIE). The timing was perfect, Dr. Hatcher said, because NoMoreClipboard and Indiana Health Information Technology Inc. (IHIT) had just received a joint $1.5 million grant from the Office of the National Coordinator for Health Information Technology (ONC) to develop, deploy, and pilot test solutions that enable patients to access electronic health information exchange data.

Despite a knowledgeable design team, the road to Margaret Mary’s united provider portal was strewn with bumps and obstacles, Dr. Hatcher said at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS). Developers encountered skepticism from some health providers and received push back from electronic health record (EHR) vendors.

The vendors’ “excitement to participate and help us develop this was not as great because it basically took the place of their product,” Dr. Hatcher said in an interview. “It’s a really slow process to get them to cooperate. They’re just not willing to move things along at a pace that’s rapid enough.”

Dr. Hatcher’s team worked to gain the trust of each participant. One key was ensuring that each provider was comfortable with what medical information would be released and when, and what type of sensitive information should be withheld and for how long, he said. Portal developers also had to create policies for the system and take into account the various data access rules of patients’ home states – including Indiana, Ohio, and Kentucky.

There were privacy issues as well. While the hospital serves a regional population of 70,000, it is situated in the rural community of Batesville, a town of 7,000. Residents in the small community historically have passed down identical first and last names for several generations leading to four or five people in the community with the same name, according to a case study on the project by NoMoreClipboard.

To address the situation, development experts created standards-based policies to securely match consumers with their data, and once authenticated, transport those data into patients’ personal health record.

Since the portal launched in 2012, 18,000 patients have accepted their access codes and about 5,000 patient have used the portal, Dr. Hatcher said. Because the portal links to HealthBridge, patients are able to get data from across the continuum of care, whether or not they receive the care at Margaret Mary. HealthBridge serves southwest Ohio, southeast Indiana and northern Kentucky. Additionally, several Cincinnati hospitals have authorized sharing their HIE data with Margaret Mary patients who use the portal.

No hard numbers on the portal’s impact yet exist, but providers have noted an increase in productivity and a rise in patient satisfaction, Dr. Hatcher said.

“When you look at the care perspective, it’s changed the dynamics of the conversations we’re having,” he said. “When patients get data, we can point them to trusted websites and they can come in prepared. The follow-up appointment becomes more of a discussion and not a lab review. Now you’re spending [more] time planning care.”

Dr. Hatcher encourages other physicians and health systems to participate in such patient engagement efforts, especially as Stage 3 of meaningful use approaches. The Centers for Medicare & Medicaid Services has proposed that all physicians and hospitals meet Stage 3 meaningful use requirements beginning in 2018. The proposed rule also calls for 25% of patients to access their data, although it allows for third-party providers to access a patient’s account as a means of satisfying the requirement.

“As we begin this heath care–sharing process, it’s really important to have patients in a position where they’re more educated about the process that’s going on with them,” Dr. Hatcher said in an interview. “The more you educate your patients, the more it helps them embrace what you’re trying to do. It’ll be hard to meet the upcoming meaningful use measures if you don’t have patients engaged in their health care plan.”

Health providers interested in creating a similar patient portal should review what other health systems have done in the past and build on their ideas, Dr. Hatcher added.

“You’ve got to have the enthusiasm of your medical staff,” he said. “You’ve got to have the support of your organization, and you have to have a vision. Know what you want before you start. If you do that, then you’re well on your way.”

[email protected]

On Twitter @legal_med

CHICAGO – For Margaret Mary Health in Batesville, Ind., partnerships were central to the formation of its community-wide patient portal.

In 2012, the hospital launched a portal that combines the records and information of multiple health providers in southeast Indiana and surrounding areas into a single system that patients can access. The approach departs from a standard portal model in which each physician practice has its own portal and patients must assess their health information from multiple sources, according to Dr. Jeffrey Hatcher, a Batesville ob.gyn and medical staff liaison for Margaret Mary Health.

“The whole goal of electronic records was to consolidate and centralize and streamline health care records,” Dr. Hatcher said in an interview. “In a lot of ways, what we’re doing is just building on that process. We’ve eliminated the need for all of those individual portals and connected the patients and their physicians to the health information exchange (HIE). Those practices feed the information through the HIE into the patient’s chart.”

Margaret Mary began efforts to design its portal in early 2011. The hospital partnered with NoMoreClipboard, a company that offers patient engagement tools to health providers, and HealthBridge, a nonprofit corporation that supports health information technology adoption and health information exchange (HIE). The timing was perfect, Dr. Hatcher said, because NoMoreClipboard and Indiana Health Information Technology Inc. (IHIT) had just received a joint $1.5 million grant from the Office of the National Coordinator for Health Information Technology (ONC) to develop, deploy, and pilot test solutions that enable patients to access electronic health information exchange data.

Despite a knowledgeable design team, the road to Margaret Mary’s united provider portal was strewn with bumps and obstacles, Dr. Hatcher said at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS). Developers encountered skepticism from some health providers and received push back from electronic health record (EHR) vendors.

The vendors’ “excitement to participate and help us develop this was not as great because it basically took the place of their product,” Dr. Hatcher said in an interview. “It’s a really slow process to get them to cooperate. They’re just not willing to move things along at a pace that’s rapid enough.”

Dr. Hatcher’s team worked to gain the trust of each participant. One key was ensuring that each provider was comfortable with what medical information would be released and when, and what type of sensitive information should be withheld and for how long, he said. Portal developers also had to create policies for the system and take into account the various data access rules of patients’ home states – including Indiana, Ohio, and Kentucky.

There were privacy issues as well. While the hospital serves a regional population of 70,000, it is situated in the rural community of Batesville, a town of 7,000. Residents in the small community historically have passed down identical first and last names for several generations leading to four or five people in the community with the same name, according to a case study on the project by NoMoreClipboard.

To address the situation, development experts created standards-based policies to securely match consumers with their data, and once authenticated, transport those data into patients’ personal health record.

Since the portal launched in 2012, 18,000 patients have accepted their access codes and about 5,000 patient have used the portal, Dr. Hatcher said. Because the portal links to HealthBridge, patients are able to get data from across the continuum of care, whether or not they receive the care at Margaret Mary. HealthBridge serves southwest Ohio, southeast Indiana and northern Kentucky. Additionally, several Cincinnati hospitals have authorized sharing their HIE data with Margaret Mary patients who use the portal.

No hard numbers on the portal’s impact yet exist, but providers have noted an increase in productivity and a rise in patient satisfaction, Dr. Hatcher said.

“When you look at the care perspective, it’s changed the dynamics of the conversations we’re having,” he said. “When patients get data, we can point them to trusted websites and they can come in prepared. The follow-up appointment becomes more of a discussion and not a lab review. Now you’re spending [more] time planning care.”

Dr. Hatcher encourages other physicians and health systems to participate in such patient engagement efforts, especially as Stage 3 of meaningful use approaches. The Centers for Medicare & Medicaid Services has proposed that all physicians and hospitals meet Stage 3 meaningful use requirements beginning in 2018. The proposed rule also calls for 25% of patients to access their data, although it allows for third-party providers to access a patient’s account as a means of satisfying the requirement.

“As we begin this heath care–sharing process, it’s really important to have patients in a position where they’re more educated about the process that’s going on with them,” Dr. Hatcher said in an interview. “The more you educate your patients, the more it helps them embrace what you’re trying to do. It’ll be hard to meet the upcoming meaningful use measures if you don’t have patients engaged in their health care plan.”

Health providers interested in creating a similar patient portal should review what other health systems have done in the past and build on their ideas, Dr. Hatcher added.

“You’ve got to have the enthusiasm of your medical staff,” he said. “You’ve got to have the support of your organization, and you have to have a vision. Know what you want before you start. If you do that, then you’re well on your way.”

[email protected]

On Twitter @legal_med

CHICAGO – For Margaret Mary Health in Batesville, Ind., partnerships were central to the formation of its community-wide patient portal.

In 2012, the hospital launched a portal that combines the records and information of multiple health providers in southeast Indiana and surrounding areas into a single system that patients can access. The approach departs from a standard portal model in which each physician practice has its own portal and patients must assess their health information from multiple sources, according to Dr. Jeffrey Hatcher, a Batesville ob.gyn and medical staff liaison for Margaret Mary Health.

“The whole goal of electronic records was to consolidate and centralize and streamline health care records,” Dr. Hatcher said in an interview. “In a lot of ways, what we’re doing is just building on that process. We’ve eliminated the need for all of those individual portals and connected the patients and their physicians to the health information exchange (HIE). Those practices feed the information through the HIE into the patient’s chart.”

Margaret Mary began efforts to design its portal in early 2011. The hospital partnered with NoMoreClipboard, a company that offers patient engagement tools to health providers, and HealthBridge, a nonprofit corporation that supports health information technology adoption and health information exchange (HIE). The timing was perfect, Dr. Hatcher said, because NoMoreClipboard and Indiana Health Information Technology Inc. (IHIT) had just received a joint $1.5 million grant from the Office of the National Coordinator for Health Information Technology (ONC) to develop, deploy, and pilot test solutions that enable patients to access electronic health information exchange data.

Despite a knowledgeable design team, the road to Margaret Mary’s united provider portal was strewn with bumps and obstacles, Dr. Hatcher said at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS). Developers encountered skepticism from some health providers and received push back from electronic health record (EHR) vendors.

The vendors’ “excitement to participate and help us develop this was not as great because it basically took the place of their product,” Dr. Hatcher said in an interview. “It’s a really slow process to get them to cooperate. They’re just not willing to move things along at a pace that’s rapid enough.”

Dr. Hatcher’s team worked to gain the trust of each participant. One key was ensuring that each provider was comfortable with what medical information would be released and when, and what type of sensitive information should be withheld and for how long, he said. Portal developers also had to create policies for the system and take into account the various data access rules of patients’ home states – including Indiana, Ohio, and Kentucky.

There were privacy issues as well. While the hospital serves a regional population of 70,000, it is situated in the rural community of Batesville, a town of 7,000. Residents in the small community historically have passed down identical first and last names for several generations leading to four or five people in the community with the same name, according to a case study on the project by NoMoreClipboard.

To address the situation, development experts created standards-based policies to securely match consumers with their data, and once authenticated, transport those data into patients’ personal health record.

Since the portal launched in 2012, 18,000 patients have accepted their access codes and about 5,000 patient have used the portal, Dr. Hatcher said. Because the portal links to HealthBridge, patients are able to get data from across the continuum of care, whether or not they receive the care at Margaret Mary. HealthBridge serves southwest Ohio, southeast Indiana and northern Kentucky. Additionally, several Cincinnati hospitals have authorized sharing their HIE data with Margaret Mary patients who use the portal.

No hard numbers on the portal’s impact yet exist, but providers have noted an increase in productivity and a rise in patient satisfaction, Dr. Hatcher said.

“When you look at the care perspective, it’s changed the dynamics of the conversations we’re having,” he said. “When patients get data, we can point them to trusted websites and they can come in prepared. The follow-up appointment becomes more of a discussion and not a lab review. Now you’re spending [more] time planning care.”

Dr. Hatcher encourages other physicians and health systems to participate in such patient engagement efforts, especially as Stage 3 of meaningful use approaches. The Centers for Medicare & Medicaid Services has proposed that all physicians and hospitals meet Stage 3 meaningful use requirements beginning in 2018. The proposed rule also calls for 25% of patients to access their data, although it allows for third-party providers to access a patient’s account as a means of satisfying the requirement.

“As we begin this heath care–sharing process, it’s really important to have patients in a position where they’re more educated about the process that’s going on with them,” Dr. Hatcher said in an interview. “The more you educate your patients, the more it helps them embrace what you’re trying to do. It’ll be hard to meet the upcoming meaningful use measures if you don’t have patients engaged in their health care plan.”

Health providers interested in creating a similar patient portal should review what other health systems have done in the past and build on their ideas, Dr. Hatcher added.

“You’ve got to have the enthusiasm of your medical staff,” he said. “You’ve got to have the support of your organization, and you have to have a vision. Know what you want before you start. If you do that, then you’re well on your way.”

[email protected]

On Twitter @legal_med

CHICAGO – In 2013, Mission Health in North Carolina launched Mission Health Partners, a physician-led accountable care organization of independent physicians, hospitals, and other health providers that focuses on reduced costs, more efficient care, and population health.

But the road to developing Mission Health Partners ACO was not without its challenges, said Dr. Robert Fields, Mission Health Partners ACO quality committee chair and quality director for Mission Medical Associates.

To form a strong organization, physician leaders and administrators first had to gain stakeholder buy-in, build a population health infrastructure, and identify physician champions to support the approach, Dr. Fields said during the annual meeting of the Healthcare Information and Management Systems Society.

In a video interview, Dr. Fields discusses how the Mission Health Partners ACO was formed and how leaders overcame obstacles along the way. Dr. Fields also shares guidance for other doctors who are interested in developing such models. 

[email protected]

On Twitter @legal_med

CHICAGO – In 2013, Mission Health in North Carolina launched Mission Health Partners, a physician-led accountable care organization of independent physicians, hospitals, and other health providers that focuses on reduced costs, more efficient care, and population health.

But the road to developing Mission Health Partners ACO was not without its challenges, said Dr. Robert Fields, Mission Health Partners ACO quality committee chair and quality director for Mission Medical Associates.

To form a strong organization, physician leaders and administrators first had to gain stakeholder buy-in, build a population health infrastructure, and identify physician champions to support the approach, Dr. Fields said during the annual meeting of the Healthcare Information and Management Systems Society.

In a video interview, Dr. Fields discusses how the Mission Health Partners ACO was formed and how leaders overcame obstacles along the way. Dr. Fields also shares guidance for other doctors who are interested in developing such models. 

[email protected]

On Twitter @legal_med

CHICAGO – In 2013, Mission Health in North Carolina launched Mission Health Partners, a physician-led accountable care organization of independent physicians, hospitals, and other health providers that focuses on reduced costs, more efficient care, and population health.

But the road to developing Mission Health Partners ACO was not without its challenges, said Dr. Robert Fields, Mission Health Partners ACO quality committee chair and quality director for Mission Medical Associates.

To form a strong organization, physician leaders and administrators first had to gain stakeholder buy-in, build a population health infrastructure, and identify physician champions to support the approach, Dr. Fields said during the annual meeting of the Healthcare Information and Management Systems Society.

In a video interview, Dr. Fields discusses how the Mission Health Partners ACO was formed and how leaders overcame obstacles along the way. Dr. Fields also shares guidance for other doctors who are interested in developing such models. 

[email protected]

On Twitter @legal_med

CHICAGO – Bundled care payments are a hot topic among physicians as the Centers for Medicare and Medicaid Services continues to roll out its bundled payment pilot program.

But does the method really improve quality and enhance care delivery?

Physician leaders with the Arkansas Health Care Payment Improvement Initiative may have the answer. Arkansas was the first to implement a statewide payment reform initiative that rewards doctors for quality care and enables them to access data about overall care quality delivered during a set time period.

Dr. William Golden, medical director of the Arkansas Division of Medical Services, Department of Human Services, spoke about the initiative and its impact at the annual meeting of the Healthcare Information and Management Systems Society.

The initiative was launched in 2011 and includes partnerships between the Arkansas Department of Human Services, Arkansas Blue Cross and Blue Shield, and QualChoice of Arkansas.

The program enables physicians to share in the savings or excess costs of an episode, depending on their performance for each episode. For some episodes, health providers submit information through the billing system’s provider portal, a HIPAA-compliant online tool that collects data about overall care and performance. The portal allows hospitals, physicians, and other providers to submit a set of quality metrics data that will to be tied to the initiative’s financial incentives.

The tool also allows doctors designated as principal accountable providers to access reports about their average quality, costs, and utilization for care episodes.

During the payment initiative’s first phase, insurers introduced five episodes of care, including upper respiratory infections, total hip and knee replacements, congestive heart failure, attention deficit/hyperactivity disorder, and perinatal.

In a video interview, Dr. Golden discusses the initiative, the road to build its design, and how the program has affected physicians and patients.

[email protected]

On Twitter @legal_med

CHICAGO – Bundled care payments are a hot topic among physicians as the Centers for Medicare and Medicaid Services continues to roll out its bundled payment pilot program.

But does the method really improve quality and enhance care delivery?

Physician leaders with the Arkansas Health Care Payment Improvement Initiative may have the answer. Arkansas was the first to implement a statewide payment reform initiative that rewards doctors for quality care and enables them to access data about overall care quality delivered during a set time period.

Dr. William Golden, medical director of the Arkansas Division of Medical Services, Department of Human Services, spoke about the initiative and its impact at the annual meeting of the Healthcare Information and Management Systems Society.

The initiative was launched in 2011 and includes partnerships between the Arkansas Department of Human Services, Arkansas Blue Cross and Blue Shield, and QualChoice of Arkansas.

The program enables physicians to share in the savings or excess costs of an episode, depending on their performance for each episode. For some episodes, health providers submit information through the billing system’s provider portal, a HIPAA-compliant online tool that collects data about overall care and performance. The portal allows hospitals, physicians, and other providers to submit a set of quality metrics data that will to be tied to the initiative’s financial incentives.

The tool also allows doctors designated as principal accountable providers to access reports about their average quality, costs, and utilization for care episodes.

During the payment initiative’s first phase, insurers introduced five episodes of care, including upper respiratory infections, total hip and knee replacements, congestive heart failure, attention deficit/hyperactivity disorder, and perinatal.

In a video interview, Dr. Golden discusses the initiative, the road to build its design, and how the program has affected physicians and patients.

[email protected]

On Twitter @legal_med

CHICAGO – Bundled care payments are a hot topic among physicians as the Centers for Medicare and Medicaid Services continues to roll out its bundled payment pilot program.

But does the method really improve quality and enhance care delivery?

Physician leaders with the Arkansas Health Care Payment Improvement Initiative may have the answer. Arkansas was the first to implement a statewide payment reform initiative that rewards doctors for quality care and enables them to access data about overall care quality delivered during a set time period.

Dr. William Golden, medical director of the Arkansas Division of Medical Services, Department of Human Services, spoke about the initiative and its impact at the annual meeting of the Healthcare Information and Management Systems Society.

The initiative was launched in 2011 and includes partnerships between the Arkansas Department of Human Services, Arkansas Blue Cross and Blue Shield, and QualChoice of Arkansas.

The program enables physicians to share in the savings or excess costs of an episode, depending on their performance for each episode. For some episodes, health providers submit information through the billing system’s provider portal, a HIPAA-compliant online tool that collects data about overall care and performance. The portal allows hospitals, physicians, and other providers to submit a set of quality metrics data that will to be tied to the initiative’s financial incentives.

The tool also allows doctors designated as principal accountable providers to access reports about their average quality, costs, and utilization for care episodes.

During the payment initiative’s first phase, insurers introduced five episodes of care, including upper respiratory infections, total hip and knee replacements, congestive heart failure, attention deficit/hyperactivity disorder, and perinatal.

In a video interview, Dr. Golden discusses the initiative, the road to build its design, and how the program has affected physicians and patients.

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

AGA Resources
AGA has collaborated with leading organizations to provide you with various resources to help ensure your smooth transition to ICD-10. Visit our ICD-10 Resource Center at www.gastro.org/practice-management/coding/icd10 to learn more

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

AGA Resources
AGA has collaborated with leading organizations to provide you with various resources to help ensure your smooth transition to ICD-10. Visit our ICD-10 Resource Center at www.gastro.org/practice-management/coding/icd10 to learn more

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

AGA Resources
AGA has collaborated with leading organizations to provide you with various resources to help ensure your smooth transition to ICD-10. Visit our ICD-10 Resource Center at www.gastro.org/practice-management/coding/icd10 to learn more

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

[email protected]

On Twitter @legal_med

CHICAGO – Between now and the Oct. 1 ICD-10 transition, physicians should examine their past claims, reduce backlogs, and develop contingency plans to address unforeseen challenges, Betty Gomez said at the annual meeting of the Healthcare Information and Management Systems Society.

Physicians “think about Oct 1, 2015, and we think, ‘OK, all of my [preparations] are done. Great,’ ” said Ms. Gomez, a regulatory strategy consultant based in Louisville, Ky. But “Oct. 1 really marks the beginning of you ‘operationalizing’ your work and living in an ICD-10 world. It doesn’t stop there. It’s just the first milestone.”

Alicia Gallegos/Frontline Medical News

Over the next 6 months, physicians should assess their coding systems and ensure they are fully prepared to work efficiently when ICD-10 goes live, Ms. Gomez said. A first step is getting a handle on the number of pending and denied claims. If an excess of pending claims exist, work immediately to lessen that excess.

“With the transition, there are going to be unforeseen obstacles and challenges,” she said. “You don’t want to have a pile and then be piling on top of that.”

Ms. Gomez recommended creating ways to monitor performance and develop thresholds for success. Benchmarks can help determine what success looks like and what issues should trigger concern. As Oct. 1 approaches, have a checklist in place to ensure all necessary tasks are completed. Questions might include: Do I have a response team or designated staff member in place to address potential problems that arise on or after Oct. 1.? Are staff members educated on when to use ICD-9 and when to use ICD-10 codes after the transition?

“You need to make sure you can continue to use both ICD-9 and ICD-10 codes, based on date of service or date of discharge,” Ms. Gomez said. “Verification is so important. You can never go wrong with making sure everything is in order.”

In terms of financial preparation, discuss with the practice’s top payers what kind of contingency plans are needed to ensure their revenue remains sufficient after Oct. 1, said F. Phil Cartagena Jr., ICD-10 program manager for Partners Healthcare System in Boston. The general recommendation is that practices have a minimum of 3 months of cash flow on hand, Mr. Cartagena said in an interview. However, it’s beneficial for practices to work out agreements in which payers match or partially match physicians’ current monthly run rate during the transition. Such arrangements can help mitigate claim denials that take time to be adjudicated, thus delaying cash flow.

“Your business isn’t going to change,” Mr. Cartagena said. “The patients that you’re seeing and the things that you are doing aren’t going to radically change, but if the ability to properly account for them and get paid for them changes, you don’t want it to have a major impact to your bottom line.”

Mr. Cartagena also suggested that physicians start more extensive patient documentation now, rather than waiting until ICD-10. As most physicians know, the nearly fivefold increase in the number of codes also requires more specific documentation than did ICD-9.

“The more specific that you can be, the better it is, whether it matters for actually coding the record correctly, or if it’s for stratifying your patient mix or having a better understanding clinically of how the diagnoses of your patient population break down,” he said. “It all comes back to the more information you have on the patients, the better they can be coded, and the better information you get at the end of all of it to understand your mix.”

[email protected]

On Twitter @legal_med

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

[email protected]

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

[email protected]

CHICAGO – Health care data theft represents a far greater threat than theft of credit card, financial, and banking information.

The reasons are simple: stolen health care records have a longer shelf life and offer a higher payout on the black market, James Trainor, deputy assistant director of the Federal Bureau of Investigation’s Cyber Division, said at the annual meeting of the Healthcare Information Management Systems Society.

Patrice Wendling/Frontline Medical News

When credit cards are stolen it’s pretty easy to identify the information on cyber crime forums and compensate for loss, so the value of that stolen credit card or bank record has a certain shelf life. For health care records, it’s harder to identify where those stolen records may end up and as such it creates a greater challenge for law enforcement.

The opportunity to exploit and monetize stolen health care data for various forms of fraud such as identity, Medicaid, tax, medical device, and pharmaceutical fraud increases the value at which they can be sold online.

“Actually, it’s one of the primary reasons why criminal organizations go after health care records,” Mr. Trainor said.

Not surprisingly, the FBI rates health care data theft as a Tier 1 priority, capable of causing “catastrophic or severe harm.”

And the problem is growing. Two years ago, a significant cyber intrusion occurred every 2 weeks; now it happens every 2-3 days.

“The pace is growing rapidly, the volume of data that’s being [stolen] is substantially increasing, and it just requires a much more robust response across the U.S. government and private sector,” said Mr. Trainor, who helped investigate the December 2014 Sony cyber attack.

Some of the unique challenges to the health care sector are the use of legacy computer systems, “bring your own device” policies, and increased volume of data following the transition to electronic health records, and stolen protected health information isn’t readily discovered, he said. The range, size, and capability of IT infrastructure varies dramatically as do the funding and resources needed to keep up with the rapidly changing IT field.

Other challenges include video conferencing systems, digital video systems used for consultations and remote procedures, and Internet-connected medical devices such as insulin pumps, pacemakers, and MRI machines, said Kevin Hemsley, a project manager at the Idaho National Laboratory supporting the Department of Homeland Security’s Industrial Control Systems Computer Emergency Response Team.

Patrice Wendling/Frontline Medical News

While providers love the ability to use the Internet to control and monitor devices, ingrained security mechanisms can be minimal. This makes for low-hanging fruit for thieves who can enter the system and even lock up an otherwise safe device.

Mr. Hemsley noted that a 2014 report by the Internet security and training firm SANS found that 33% of malicious traffic passed through or was transmitted from VPN applications and devices versus 16% from firewalls, 7% from routers, and 3% from enterprise network controllers.

“One of the messages here is to look at cyber security as being more than HIPPA, it’s patient safety,” he said.

Both experts advised physicians and other health care providers to update their privacy and security software frequently. Available resources include the FBI’s 24-hour CyWatch (855-292-3937/[email protected]), Cyber Task Force (with 56 local field offices), and for individuals, the Internet Crime Complaint Center (www.ic3.gov).

Speedy communication with officials following a data breech is important not just to get the institution’s system back up and running, but it allows officials to identify data footprints left by hackers before they are destroyed, Mr. Trainor said.

In two of the three recent high profile health care cyber attacks involving Community Health Systems (4.5 million accounts), Anthem Blue Cross Blue Shield (78 million records), and Premera Blue Cross (11 million consumers), the institutions contacted the FBI, but in one unnamed case, the FBI had to make the call, he pointed out.

[email protected]

CHICAGO – A majority of health providers use some form of mobile technology to engage patients, but only half have experienced improved care coordination or cost savings from doing so.

The new data comes from a study presented April 14 at the annual meeting of the Healthcare Information and Management Systems Society. The survey of 238 health providers found 90% of respondents use at least one type of mobile device to engage patients. Fifty-one percent indicated the technology affected their ability to greatly impact or coordinate patient care, while another 41% reported they had not experienced a strong impact on care coordination.

Alicia Gallegos/Frontline Medical News

Similarly, 54% of respondents reported they achieved cost savings based on mobile technology use, while 42% were unsure about the effect on cost savings, and 3% said the technology had not yielded cost savings.

The most common mobile technology used was app-enabled patient portals (73%). At least half of respondents reported using telehealth services (62%) or text messaging (57%) with patients.

About one-third indicated a high degree of effectiveness in engaging patients using app-enabled patient portals, while 27% reported the same using telehealth services, such as video consults. Apps, such as prescribing apps, were least likely to engage patients.

Telehealth services and app-enabled patient portals also were the top technologies for future investment, said Jennifer Horowitz, HIMSS senior director for research.

Physicians and other health providers “are starting to see some really good traction with these types of technologies so they’re planning on moving forward with them in the future,” she said. “Organizations are starting out on their journey, and they need to continue on that journey to make sure these are effective technologies for their patients.”

Only 8% of respondents reported that all data captured by mobile devices was integrated into their electronic health record system (EHR). Another 6% said at least three-quarters of data was integrated; a third (32%) said no mobile data was integrated into their EHR.

“That leaves a really wide road to opportunity for health care organizations to make sure they’re creating a strategy to integrate that data into their environment,” Ms. Horowitz said.

Respondents noted that telehealth interventions had the greatest impact on care coordination, particularly in radiology and neurology.

When it comes to saving money, respondents reported the primary cost savers were mobile-enhanced preventive care, wellness management, and disease surveillance.

For physicians, the survey results highlight the importance of utilizing mobile technology as they adapt to changing health care rules and new models of care delivery, David A. Collins, HIMSS senior director of health information systems said in an interview.

“To align themselves with the demands of the health care system – the value-based system, the [accountable care organization concept] – technology is a tool to be leveraged to achieve those cost savings,” Mr. Collins said in an interview. “Its a lot cheaper to issue $800 worth of equipment to a patient than it is to have them readmitted and lose thousands of dollars” in subsequent care.

The 2015 HIMSS Mobile Technology Study analyzed responses from health care executives, physicians, health providers, and IT specialists between Jan. 15, 2015, and Feb. 13, 2015. The respondents worked for hospitals, medical practices, health systems, and other health care entities, such as academic medical centers and emergency services providers.

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On Twitter @legal_med

CHICAGO – A majority of health providers use some form of mobile technology to engage patients, but only half have experienced improved care coordination or cost savings from doing so.

The new data comes from a study presented April 14 at the annual meeting of the Healthcare Information and Management Systems Society. The survey of 238 health providers found 90% of respondents use at least one type of mobile device to engage patients. Fifty-one percent indicated the technology affected their ability to greatly impact or coordinate patient care, while another 41% reported they had not experienced a strong impact on care coordination.

Alicia Gallegos/Frontline Medical News

Similarly, 54% of respondents reported they achieved cost savings based on mobile technology use, while 42% were unsure about the effect on cost savings, and 3% said the technology had not yielded cost savings.

The most common mobile technology used was app-enabled patient portals (73%). At least half of respondents reported using telehealth services (62%) or text messaging (57%) with patients.

About one-third indicated a high degree of effectiveness in engaging patients using app-enabled patient portals, while 27% reported the same using telehealth services, such as video consults. Apps, such as prescribing apps, were least likely to engage patients.

Telehealth services and app-enabled patient portals also were the top technologies for future investment, said Jennifer Horowitz, HIMSS senior director for research.

Physicians and other health providers “are starting to see some really good traction with these types of technologies so they’re planning on moving forward with them in the future,” she said. “Organizations are starting out on their journey, and they need to continue on that journey to make sure these are effective technologies for their patients.”

Only 8% of respondents reported that all data captured by mobile devices was integrated into their electronic health record system (EHR). Another 6% said at least three-quarters of data was integrated; a third (32%) said no mobile data was integrated into their EHR.

“That leaves a really wide road to opportunity for health care organizations to make sure they’re creating a strategy to integrate that data into their environment,” Ms. Horowitz said.

Respondents noted that telehealth interventions had the greatest impact on care coordination, particularly in radiology and neurology.

When it comes to saving money, respondents reported the primary cost savers were mobile-enhanced preventive care, wellness management, and disease surveillance.

For physicians, the survey results highlight the importance of utilizing mobile technology as they adapt to changing health care rules and new models of care delivery, David A. Collins, HIMSS senior director of health information systems said in an interview.

“To align themselves with the demands of the health care system – the value-based system, the [accountable care organization concept] – technology is a tool to be leveraged to achieve those cost savings,” Mr. Collins said in an interview. “Its a lot cheaper to issue $800 worth of equipment to a patient than it is to have them readmitted and lose thousands of dollars” in subsequent care.

The 2015 HIMSS Mobile Technology Study analyzed responses from health care executives, physicians, health providers, and IT specialists between Jan. 15, 2015, and Feb. 13, 2015. The respondents worked for hospitals, medical practices, health systems, and other health care entities, such as academic medical centers and emergency services providers.

[email protected]


On Twitter @legal_med

CHICAGO – A majority of health providers use some form of mobile technology to engage patients, but only half have experienced improved care coordination or cost savings from doing so.

The new data comes from a study presented April 14 at the annual meeting of the Healthcare Information and Management Systems Society. The survey of 238 health providers found 90% of respondents use at least one type of mobile device to engage patients. Fifty-one percent indicated the technology affected their ability to greatly impact or coordinate patient care, while another 41% reported they had not experienced a strong impact on care coordination.

Alicia Gallegos/Frontline Medical News

Similarly, 54% of respondents reported they achieved cost savings based on mobile technology use, while 42% were unsure about the effect on cost savings, and 3% said the technology had not yielded cost savings.

The most common mobile technology used was app-enabled patient portals (73%). At least half of respondents reported using telehealth services (62%) or text messaging (57%) with patients.

About one-third indicated a high degree of effectiveness in engaging patients using app-enabled patient portals, while 27% reported the same using telehealth services, such as video consults. Apps, such as prescribing apps, were least likely to engage patients.

Telehealth services and app-enabled patient portals also were the top technologies for future investment, said Jennifer Horowitz, HIMSS senior director for research.

Physicians and other health providers “are starting to see some really good traction with these types of technologies so they’re planning on moving forward with them in the future,” she said. “Organizations are starting out on their journey, and they need to continue on that journey to make sure these are effective technologies for their patients.”

Only 8% of respondents reported that all data captured by mobile devices was integrated into their electronic health record system (EHR). Another 6% said at least three-quarters of data was integrated; a third (32%) said no mobile data was integrated into their EHR.

“That leaves a really wide road to opportunity for health care organizations to make sure they’re creating a strategy to integrate that data into their environment,” Ms. Horowitz said.

Respondents noted that telehealth interventions had the greatest impact on care coordination, particularly in radiology and neurology.

When it comes to saving money, respondents reported the primary cost savers were mobile-enhanced preventive care, wellness management, and disease surveillance.

For physicians, the survey results highlight the importance of utilizing mobile technology as they adapt to changing health care rules and new models of care delivery, David A. Collins, HIMSS senior director of health information systems said in an interview.

“To align themselves with the demands of the health care system – the value-based system, the [accountable care organization concept] – technology is a tool to be leveraged to achieve those cost savings,” Mr. Collins said in an interview. “Its a lot cheaper to issue $800 worth of equipment to a patient than it is to have them readmitted and lose thousands of dollars” in subsequent care.

The 2015 HIMSS Mobile Technology Study analyzed responses from health care executives, physicians, health providers, and IT specialists between Jan. 15, 2015, and Feb. 13, 2015. The respondents worked for hospitals, medical practices, health systems, and other health care entities, such as academic medical centers and emergency services providers.

[email protected]


On Twitter @legal_med

CHICAGO – The federal government’s Shared Nationwide Interoperability Roadmap lays out a grand vision for a single health IT ecosystem, but will it be able to enforce its own standards or be able to meaningfully incorporate the flood of patient-provided data in an era of Fitbits and Apple watches?

Those were just a few of the concerns heard by the officials from the Office of the National Coordinator for Health Information Technology (ONC) at the annual meeting of the Healthcare Information and Management Systems Society.

Patrice Wendling/Frontline Medical News

During a listening session on the Roadmap, one attendee called for oversight and a transparent process to handle complaints much like the airline industry has for lost luggage, observing that providers already have a hard time getting industry to recognize and “play ball” with each other.

Rules of engagement and governance are one of the core building blocks of the Roadmap, with the ONC establishing a governance framework with rules of the road and identifying a mechanism to recognize organizations that comply with that framework. That could be thought of as a mechanism for advancing some accountability, but it’s important to remember that participation in that process will be voluntary, according to Erica Galvez, interoperability portfolio manager at ONC.

“So unless that’s tied to other policy levers ... or other enforcement authorities, ONC, given its current authority, has quite a few limitations on its ability to actually affect the type of enforcement you’re alluding to,” she added.

The ONC does have proposals for in-field surveillance of products and additional transparency requirements associated with products, said Steven Posnack, director of the ONC Office of Standards and Technology. Still, the ONC doesn’t necessarily have all the “arrows and quivers” needed to affect the enforcement and accountability some would like, he acknowledged.

Patrice Wendling/Frontline Medical News

Core technical standards and functions designed to help achieve the Roadmap’s 3-, 6-, and 10-year milestones include consistent data formats and semantics; consistent, secure transport techniques; standard, secure services; accurate patient identity matching; and reliable resource location.

One physician attendee called for standardizing the standards themselves, noting that there are more than 150 terminologies in use, each with its own idiosyncrasies. One approach may be to follow the example set by global IT organizations like Facebook, LinkedIn, and Yahoo, which converged on using the Web standards as a means to have persistent, authoritative URIs (uniform resource identifiers) that can be shared globally, he suggested to a round of applause.

Another attendee called for future drafts of the Roadmap to address an increasing trend among biopharmaceutical companies to create their own portals or mobile apps for a specific therapy, which requires providers to download multiple infrastructures to support various therapies.

Still another attendee artfully asked that Departments of Defense and Veterans Affairs medical records be incorporated into the proposed nationwide IT system to ensure meaningful longitudinal care for veterans.

There was little audience discussion about the Roadmap’s other core building blocks of a common clinical data set or privacy and security. Concerns about medical device interoperability, however, were raised from the floor and have been echoed in the public comments received by the ONC, Ms. Galvez said.

She stressed that the Roadmap is a shared plan that attempts to capture both public and private sector activities.

“We’re not going to achieve interoperability at the scale we are attempting with government action alone,” Ms. Galvez said. “In looking at some of the early public comments, I will say I have not seen as many commitments from folks as I would really like to see. I’d really like to see organizations coming forward and saying ‘There’s a call to action in this space, we think there’s something we can do about that, and here’s what we’re willing to do.’ ”

The public comment period on the Roadmap officially closed April 3, but comments on the ONC’s 2015 Interoperability Standards Advisory will be accepted through May 1.

[email protected]

CHICAGO – The federal government’s Shared Nationwide Interoperability Roadmap lays out a grand vision for a single health IT ecosystem, but will it be able to enforce its own standards or be able to meaningfully incorporate the flood of patient-provided data in an era of Fitbits and Apple watches?

Those were just a few of the concerns heard by the officials from the Office of the National Coordinator for Health Information Technology (ONC) at the annual meeting of the Healthcare Information and Management Systems Society.

Patrice Wendling/Frontline Medical News

During a listening session on the Roadmap, one attendee called for oversight and a transparent process to handle complaints much like the airline industry has for lost luggage, observing that providers already have a hard time getting industry to recognize and “play ball” with each other.

Rules of engagement and governance are one of the core building blocks of the Roadmap, with the ONC establishing a governance framework with rules of the road and identifying a mechanism to recognize organizations that comply with that framework. That could be thought of as a mechanism for advancing some accountability, but it’s important to remember that participation in that process will be voluntary, according to Erica Galvez, interoperability portfolio manager at ONC.

“So unless that’s tied to other policy levers ... or other enforcement authorities, ONC, given its current authority, has quite a few limitations on its ability to actually affect the type of enforcement you’re alluding to,” she added.

The ONC does have proposals for in-field surveillance of products and additional transparency requirements associated with products, said Steven Posnack, director of the ONC Office of Standards and Technology. Still, the ONC doesn’t necessarily have all the “arrows and quivers” needed to affect the enforcement and accountability some would like, he acknowledged.

Patrice Wendling/Frontline Medical News

Core technical standards and functions designed to help achieve the Roadmap’s 3-, 6-, and 10-year milestones include consistent data formats and semantics; consistent, secure transport techniques; standard, secure services; accurate patient identity matching; and reliable resource location.

One physician attendee called for standardizing the standards themselves, noting that there are more than 150 terminologies in use, each with its own idiosyncrasies. One approach may be to follow the example set by global IT organizations like Facebook, LinkedIn, and Yahoo, which converged on using the Web standards as a means to have persistent, authoritative URIs (uniform resource identifiers) that can be shared globally, he suggested to a round of applause.

Another attendee called for future drafts of the Roadmap to address an increasing trend among biopharmaceutical companies to create their own portals or mobile apps for a specific therapy, which requires providers to download multiple infrastructures to support various therapies.

Still another attendee artfully asked that Departments of Defense and Veterans Affairs medical records be incorporated into the proposed nationwide IT system to ensure meaningful longitudinal care for veterans.

There was little audience discussion about the Roadmap’s other core building blocks of a common clinical data set or privacy and security. Concerns about medical device interoperability, however, were raised from the floor and have been echoed in the public comments received by the ONC, Ms. Galvez said.

She stressed that the Roadmap is a shared plan that attempts to capture both public and private sector activities.

“We’re not going to achieve interoperability at the scale we are attempting with government action alone,” Ms. Galvez said. “In looking at some of the early public comments, I will say I have not seen as many commitments from folks as I would really like to see. I’d really like to see organizations coming forward and saying ‘There’s a call to action in this space, we think there’s something we can do about that, and here’s what we’re willing to do.’ ”

The public comment period on the Roadmap officially closed April 3, but comments on the ONC’s 2015 Interoperability Standards Advisory will be accepted through May 1.

[email protected]

CHICAGO – The federal government’s Shared Nationwide Interoperability Roadmap lays out a grand vision for a single health IT ecosystem, but will it be able to enforce its own standards or be able to meaningfully incorporate the flood of patient-provided data in an era of Fitbits and Apple watches?

Those were just a few of the concerns heard by the officials from the Office of the National Coordinator for Health Information Technology (ONC) at the annual meeting of the Healthcare Information and Management Systems Society.

Patrice Wendling/Frontline Medical News

During a listening session on the Roadmap, one attendee called for oversight and a transparent process to handle complaints much like the airline industry has for lost luggage, observing that providers already have a hard time getting industry to recognize and “play ball” with each other.

Rules of engagement and governance are one of the core building blocks of the Roadmap, with the ONC establishing a governance framework with rules of the road and identifying a mechanism to recognize organizations that comply with that framework. That could be thought of as a mechanism for advancing some accountability, but it’s important to remember that participation in that process will be voluntary, according to Erica Galvez, interoperability portfolio manager at ONC.

“So unless that’s tied to other policy levers ... or other enforcement authorities, ONC, given its current authority, has quite a few limitations on its ability to actually affect the type of enforcement you’re alluding to,” she added.

The ONC does have proposals for in-field surveillance of products and additional transparency requirements associated with products, said Steven Posnack, director of the ONC Office of Standards and Technology. Still, the ONC doesn’t necessarily have all the “arrows and quivers” needed to affect the enforcement and accountability some would like, he acknowledged.

Patrice Wendling/Frontline Medical News

Core technical standards and functions designed to help achieve the Roadmap’s 3-, 6-, and 10-year milestones include consistent data formats and semantics; consistent, secure transport techniques; standard, secure services; accurate patient identity matching; and reliable resource location.

One physician attendee called for standardizing the standards themselves, noting that there are more than 150 terminologies in use, each with its own idiosyncrasies. One approach may be to follow the example set by global IT organizations like Facebook, LinkedIn, and Yahoo, which converged on using the Web standards as a means to have persistent, authoritative URIs (uniform resource identifiers) that can be shared globally, he suggested to a round of applause.

Another attendee called for future drafts of the Roadmap to address an increasing trend among biopharmaceutical companies to create their own portals or mobile apps for a specific therapy, which requires providers to download multiple infrastructures to support various therapies.

Still another attendee artfully asked that Departments of Defense and Veterans Affairs medical records be incorporated into the proposed nationwide IT system to ensure meaningful longitudinal care for veterans.

There was little audience discussion about the Roadmap’s other core building blocks of a common clinical data set or privacy and security. Concerns about medical device interoperability, however, were raised from the floor and have been echoed in the public comments received by the ONC, Ms. Galvez said.

She stressed that the Roadmap is a shared plan that attempts to capture both public and private sector activities.

“We’re not going to achieve interoperability at the scale we are attempting with government action alone,” Ms. Galvez said. “In looking at some of the early public comments, I will say I have not seen as many commitments from folks as I would really like to see. I’d really like to see organizations coming forward and saying ‘There’s a call to action in this space, we think there’s something we can do about that, and here’s what we’re willing to do.’ ”

The public comment period on the Roadmap officially closed April 3, but comments on the ONC’s 2015 Interoperability Standards Advisory will be accepted through May 1.

[email protected]