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Cybersecurity, Telehealth and Big Tech Entrants are Top of Mind

Posted on November 22, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Unease over cybersecurity, optimism for the future of telehealth, and worries about the entry of big tech companies (like Apple, Amazon and Google) are the top three concerns for 2019 according to a recent survey of healthcare leaders released by the Center for Connected Medicine.

The Center for Connected Medicine (CCM), which is jointly operated by GE Healthcare, Nokia and UPMC, partnered with The Health Management Academy for the Top of Mind 2019 survey. Conducted in three parts, the research started with a survey of health system information officers in May 2018 to determine the top areas of health IT for 2019.

According to the CCM, key findings include:

  • Hackers and other cyber-criminals are stepping up their attacks on the health care industry, leading 87 percent of respondents to say they expect to increase spending on cybersecurity in 2019; no health system was expecting to decrease spending.
  • Health information technology (IT) leaders overwhelmingly expect government and commercial reimbursement to provide the majority of funding for telehealth services by 2022; internal funding and patient payments are expected to provide the majority of funding for telehealth in 2019.
  • 70 percent of responding executives said they were “somewhat concerned” about big tech companies, such as Apple, Amazon and Google, disrupting the health care market; 10 percent were “very concerned.”


Cybersecurity was the top concern from the 2018 survey so it is not surprising to see it on top of the list for 2019 – especially as the number of cyberattacks continues to increase each year. What is surprising is the level of confidence that executives have in their ability to recover from an attack.

According to the report:

  • Only 20% of respondents reported being “very confident” in their organization’s IT recovery and business continuity plans
  • 70% of respondents said they were “somewhat confident” in those plans

I’m not sure I would want to be at a healthcare organization that was only “somewhat confident” it could recover from a cyber attack.

For me, the survey highlights how much work we still have to do around cybersecurity in healthcare. It’s not just a matter of hardening HealthIT systems, that is only part of the solution. Healthcare organizations also need to implement robust security processes and ensure staff are properly educated.  The latter is particularly important as Phishing and spear-phishing were cited by 80% of Top-of-Mind survey respondents as the most common types of cyberattacks.

My colleague John Lynn recently wrote an article that dives deeper into cybersecurity.


One of the most interesting findings in the survey was the optimism healthcare executives have for telehealth.

“Telehealth represents a low percentage of total care delivery at all responding health systems, yet executives unanimously anticipate growth in the next three years as reimbursement increases and consumer demand picks up. All responding health systems report 10% or less of their organization’s total care delivery is currently provided through telehealth. However, all health systems expect an increase over the next three years, with 45% expecting a significant increase of 10% or more.”

According to the survey the biggest barrier to telehealth adoption is not the technology, but rather the lack of reimbursement.

Part of the optimism executives feel toward telehealth may have to do with the final 2019 Physician Fee Schedule and Quality Payment Program issued early in November 2019 by The Centers for Medicare & Medicaid Services (CMS). As of 1 January 2010, CMS will reimburse a number of telehealth and communication-technology based services:

  • Brief communication technology-based service, e.g. using phone or other telecommunications device to decide whether an office visit is needed
  • Remote evaluation of recorded video and/or images submitted by an established patient
  • Remote patient monitoring (CPT codes 99453, 99454, 99457)
  • Interprofessional Internet consultations (CPT codes 99451, 99452, 99446, 99447, 99448, 99449)

It is widely expected that CMS will continue to expand the reimbursement for communication technology enabled services in future years.

Entry of Big Tech Companies

Companies like Apple, Amazon, Google and Microsoft have each made significant healthcare-related announcements this past year and continue to push into the healthcare space. Their entry has executives concerned, according to the Top-of-Mind survey results.

“The biggest threat is if these companies get between us and the end consumer,” said one CEO in a written survey comment. “If there is a platform regulated and controlled by someone other than us – that makes us nervous. There are many places where some of these new platforms and conveniences can and will likely succeed – we haven’t been good in this space.”

What this CEO is referring to is the consumer-focus that these Big Tech companies have and how relentless they are at providing superior consumer experiences based on data as well as deep analytics. That is something traditional healthcare organizations have only just woken up to realize – that patients want the consumer-friendly conveniences they have become accustomed to from other industries like retail and banking.

Top-of-Mind Conference

In a few weeks CCM will be hosting healthcare leaders from around the country at their annual Top-of-Mind conference. I’m really excited to attend the event and learn first-hand how leaders plan to address their concerns in 2019. Stay tuned.

Healthcare Interoperability is Solved … But What Does That Really Mean? – #HITExpo Insights

Posted on June 12, 2018 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the best parts of the new community we created at the Health IT Expo conference is the way attendees at the conference and those in the broader healthcare IT community engage on Twitter using the #HITExpo hashtag before, during, and after the event.  It’s a treasure trove of insights, ideas, practical innovations, and amazing people.  Don’t forget that last part since social media platforms are great at connecting people even if they are usually in the news for other reasons.

A great example of some great knowledge sharing that happened on the #HITExpo hashtag came from Don Lee (@dflee30) who runs #HCBiz, a long time podcast which he recorded live from Health IT Expo.  After the event, Don offered his thoughts on what he thought was the most important conversation about “Solving Interoperability” that came from the conference.  You can read his thoughts on Twitter or we’ve compiled all 23 tweets for easy reading below (A Big Thanks to Thread Reader for making this easy).

As shared by Don Lee:

1/ Finally working through all my notes from the #HITExpo. The most important conversation to me was the one about “solving interoperability” with @RasuShrestha@PaulMBlack and @techguy.

2/ Rasu told the story of what UPMC accomplished using DBMotion. How it enabled the flow of data amongst the many hospitals, clinics and docs in their very large system. #hitexpo

3/ John challenged him a bit and said: it sounds like you’re saying that you’ve solved #interoperability. Is that what you’re telling us? #hitexpo

4/ Rasu explained in more detail that they had done the hard work of establishing syntactic interop amongst the various systems they dealt with (I.e. they can physically move the data from one system to another and put it in a proper place). #hitexpo

5/ He went on and explained how they had then done the hard work of establishing semantic interoperability amongst the many systems they deal with. That means now all the data could be moved, put in its proper place, AND they knew what it meant. #hitexpo

6/ Syntactic interop isn’t very useful in and of itself. You have data but it’s not mastered and not yet useable in analytics. #hitexpo

7/ Semantic interop is the mastering of the data in such a way that you are confident you can use it in analytics, ML, AI, etc. Now you can, say, find the most recent BP for a patient pop regardless of which EMR in your system it originated. And have confidence in it. #hitexpo

8/ Semantic interop is closely related to the concept of #DataFidelity that @BigDataCXO talks about. It’s the quality of data for a purpose. And it’s very hard work. #hitexpo

9/ In the end, @RasuShrestha’s answer was that UPMC had done all of that hard work and therefore had made huge strides in solving interop within their system. He said “I’m not flying the mission accomplished banner just yet”. #hitexpo

10/ Then @PaulMBlack – CEO at @Allscripts – said that @RasuShrestha was being modest and that they had in fact “Solved interoperability.”

I think he’s right and that’s what this tweet storm is about. Coincidentally, it’s a matter of semantics. #hitexpo

11/ I think Rasu dialed it back a bit because he knew that people would hear that and think it means something different. #hitexpo

12/ The overall industry conversation tends to be about ubiquitous, semantic interop where all data is available everywhere and everyone knows what it means. I believe Rasu was saying that they hadn’t achieved that. And that makes sense… because it’s impossible. #hitexpo

13/ @GraceCordovano asked the perfect question and I wish there had been a whole session dedicated to answering it: (paraphrasing) What’s the difference between your institutional definition of interop and what the patients are talking about? #hitexpo

14/ The answer to that question is the crux of our issue. The thing patients want and need is for everyone who cares for them to be on the same page. Interop is very relevant to that issue, obviously, but there’s a lot of friction and it goes way beyond tech. #hitexpo

15/ Also, despite common misconception, no other industry has solved this either. Sure, my credit card works in Europe and Asia and gets back to my bank in the US, but that’s just a use case. There is no ubiquitous semantic interop between JP Morgan Chase and HSBC.

16/ There are lots of use cases that work in healthcare too. E-Prescribing, claims processing and all the related HIPAA transactions, etc. #hitexpo

17/ Also worth noting… Canada has single payer system and they also don’t have clinical interoperability.

This is not a problem unique to healthcare nor the US. #hitexpo

18/ So healthcare needs to pick its use cases and do the hard work. That’s what Rasu described on stage. That’s what Paul was saying has been accomplished. They are both right. And you can do it too. #hitexpo

19/ So good news: #interoperability is solved in #healthcare.

Bad news: It’s a ton of work and everyone needs to do it.

More bad news: You have to keep doing it forever (it breaks, new partners, new sources, new data to care about, etc). #hitexpo

19/ Some day there will be patient mediated exchange that solves the patient side of the problem and does it in a way that works for everyone. Maybe on a #blockchain. Maybe something else. But it’s 10+ years away. #hitexpo

20/ In the meantime my recommendation to clinical orgs – support your regional #HIE. Even UPMC’s very good solution only works for data sources they know about. Your patients are getting care outside your system and in a growing # of clinical and community based settings. #hitexpo

21/ the regional #HIE is the only near-term solution that even remotely resembles semantic, ubiquitous #interoperability in #healthcare.

22/ My recommendation to patients: You have to take matters into your own hands for now. Use consumer tools like Apple health records and even Dropbox like @ShahidNShah suggested in another #hitexpo session. Also, tell your clinicians to support and use the regional #HIE.

23/ So that got long. I’ll end it here. What do you think?

P.S. the #hitexpo was very good. You should check it out in 2019.

A big thank you to Don Lee for sharing these perspectives and diving in much deeper than we can do in 45 minutes on stage. This is what makes the Health IT Expo community special. People with deep understanding of a problem fleshing out the realities of the problem so we can better understand how to address them. Plus, the sharing happens year round as opposed to just at a few days at the conference.

Speaking of which, what do you think of Don’s thoughts above? Is he right? Is there something he’s missing? Is there more depth to this conversation that we need to understand? Share your thoughts, ideas, insights, and perspectives in the comments or on social media using the #HITExpo hashtag.

UPMC Plans $2B Investment To Build “Digitally-Based” Specialty Hospitals

Posted on November 20, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

The University of Pittsburgh Medical Center has announced plans to spend $2 billion to build three new specialty hospitals with a digital focus. Its plans include building the UPMC Heart and Transplant Hospital, UPMC Hillman Cancer Hospital and UPMC Vision and Rehabilitation Hospital. UPMC already runs the existing specialty hospitals, Magee-Womens Hospital, Western in Psychiatric Institute and Clinic and Children’s Hospital of Pittsburgh.

UPMC is already one of the largest integrated health delivery networks in the United States. It’s $13 billion system includes more than 25 hospitals, a 3-million-member health plan and 3,600 physicians. If its new specialty centers actually represent a new breed of digital-first hospital, and help it further dominate its region, this could only add to its already-outsized clout.

So what is a “digitally-based” hospital, and what makes it different than, say, other hospitals well along the EMR adoption curve? After all, virtually every hospital today relies on a backbone of health IT applications, manages patient clinical data in an EMR and stores and stores and shares imagines in digital form.   Some are still struggling to integrate or replace legacy technologies, while others are adopting cutting-edge platforms, but going digital is mission-critical for everyone these days.

What’s interesting about UPMC’s plans, however, is that the new hospitals will be designed as digitally-based facilities from day one. UPMC is working with Microsoft to design these “digital hospitals of the future,” building on the two entities’ existing research collaboration with Microsoft and its Azure cloud platform.

The Azure relationship dates back to February of this year, when UPMC struck a deal with Microsoft to do some joint technology research. The agreement builds on both UPMC’s fairly impressive record of tech innovation and Microsoft’s healthcare AI capabilities, genomics and machine learning capabilities. For example, in working with Microsoft, UPMC gets access to Microsoft’s health chat bot technology, which is being deployed elsewhere to help patient self-triage before they interact with the doctor for a video visit.

I’d love to offer you specific information on how these new digitally-oriented will be designed, and more importantly how the functioning will differ from otherwise-wired hospitals that didn’t start out that way, but I don’t think the two partners are ready to spill the beans. Clearly, they’re going to tell you all of this is the new hotness, but nobody’s provided me with any examples of how this will truly improve on existing models of digital hospital technology. I just don’t think they’re that far along with the project yet.

Obviously, UPMC isn’t spending $2 billion lightly, so its leadership must believe the new digital model will offer a big payoff. I hope they know something we don’t about the ROI potential for this effort. It seems likely that if nothing else, that technology investment alone won’t drive that big a rate of return. Clearly, other major factors are in play here.

Promoting Internal Innovation to Drive Healthcare Efficiency

Posted on June 1, 2017 I Written By

The following is a guest blog post by Peyman S. Zand, Partner, Pivot Point Consulting, a Vaco Company.

Technical innovation in healthcare has historically been viewed through the lens of disruption. As tech adoption in the industry matures, perceptions on the origin of innovation are evolving as well. Healthcare leadership teams are increasingly leaning on feedback from the front lines of care delivery to identify ways to eliminate waste and drive greater efficiency. Rather than leaving innovation up to third parties, many health organizations are formalizing programs to advance innovation within their own facilities.

There are two schools of thought on healthcare innovation. Some argue that the market’s unique challenges can only be understood by those in the field, leaving outside influencers destined to fail. Others view innovation success in outside markets as an opportunity for healthcare stakeholders to learn from the wins and losses of more technically progressive industries. By mimicking other industries’ approach to promoting innovation (as opposed to their byproducts) in our hospitals and health systems, healthcare can draw from the best of both worlds. What we know is that the process in which innovation is adopted is very similar in all industries. However, the types of innovations and specific models can and should be tailored to the healthcare industry.

Innovation in Healthcare: Three Examples at a  Glance

There are several examples of health organizations successfully forging a path to institutionalized innovation. University of Pittsburg Medical Center (UPMC), Intermountain Healthcare and Mayo Clinic have pioneered innovation programs that merge internal clinical expertise with technical innovators from vertical markets in and outside healthcare. This article highlights some of the ways these progressive organizations have achieved success.

Innovation at UPMC

UPMC Enterprises boasts a 200-person staff managed by top provider and payer executives at UPMC. The innovation team is presently engaged in more than a dozen commercial partnerships, including support for Vivify Health’s chronic care telehealth solutions, medCPU’s real-time decision support solutions and Health Catalyst’s data warehousing and analytics solutions. Each project is focused on the goal of improving patient outcomes. The innovation group was recently rumored to be partnering with Microsoft on machine learning initiatives and the results may have a profound impact on how we use technology in care delivery.

UPMC Enterprises supports entrepreneurs—both internal individuals and established companies—with capital, technical resources, partner networks, recruiting and marketing assistance to support innovation. Dedicated focus in the following areas lends structure to the innovation program:

  • Translational science
  • Improving outcomes
  • Infrastructure and efficiency
  • Consumer engagement

All profits generated from investments are reinvested to support further research and innovation.

Innovation at Intermountain Healthcare

Like UPMC, Intermountain’s Healthcare Transformation Lab supports innovation in the areas of telehealth and natural language processing (NLP), among others. Like most providers, one of Intermountain’s primary goals is controlling costs. The group’s self-developed NLP program is designed to help identify high-risk patients ahead of catastrophic events using data stored in free-text documents. Telehealth innovations let patients self-triage to the right level of care to incentivize use of the least expensive form of care available. Intermountain’s ProComp solution offers its providers on-the-spot transparency about the cost of instruments, drugs and devices they use. That innovation alone net the health system roughly $80 million in reduced costs between 2013 and 2015.

Most of Intermountain’s innovation initiatives are physician led or co-led. The program strives for small innovations in day-to-day work, supported by a suite of innovation support services and resource centers. Selected innovations from outside startups are supported by the company’s Healthbox Accelerator program involvement, while internal innovations are managed by the Intermountain Foundry. Intermountain offers online innovation idea submissions to promote easy participation. The health organization’s $35 million Innovation Fund supports innovations through formalized investment criteria and trustee governance resources. It is important to note that Intermountain Healthcare is interested in all aspects of innovation including supply chain and other non-clinical related projects.

Innovation at Mayo Clinic

Mayo Clinic’s Center for Innovation (CFI) brings in innovation best practices from both healthcare and non-healthcare backgrounds to drive new ideas. The innovation team’s external advisory council is comprised of both designers and physicians to drive innovation and efficiency in care delivery. The CFI features a Multidisciplinary Design Clinic that invites patients into the innovation process as well.

CFI staff found it was essential to show physicians data that demonstrated known problems and how proposed innovations could make a difference to their patients. They emphasize temporary changes, or “rapid prototyping,” to garner physician buy-in. Mayo’s CFI promotes employee involvement in innovative design through its Culture & Competency of Innovation platform, which features weekly meetings, institution-wide classes, lunch discussion groups and an annual symposium. Mayo’s innovation efforts include these additional physician-led platforms:

  • Mayo Clinic Connection—supporting shared physician experience
  • Prediction and Prevention
  • Wellness—promoting patient education
  • Destination Mayo Clinic—focused on improving patient experience

While these innovation examples represent large healthcare organizations, fostering innovation does not require a big budget. Mayo Clinic’s “think big, start small, move fast” approach to innovation illustrates a common thread among successful innovation programs. Here are practical strategies to advance innovation in healthcare, regardless of organizational size or budget.

Four Steps to Implementing an Innovation Program in Your Organization

Innovation doesn’t have to be grandiose or expensive. Organizations can start small. Begin by opening a companywide dialogue on innovation and launching a simple, online idea submission process to engage personnel in your organization. The most important part of this process is educating your teams to understand how to evaluate new innovations against a relatively pre-defined set of criteria.  For example, are you trying to improve patient safety, quality of care, reduce cost, increase patient or physician satisfaction, etc.

Another key element of successful innovation is encouraging collaboration and participation across a wide variety of stakeholders. Cross-functional teams bring multifaceted perspectives to the problem-solving process. Strive for incremental gains in facilitating opportunities for cross-department collaboration in your organization. This is particularly important for the implementation step.

Measure success using performance metrics where clinical efficiencies are concerned. Physician satisfaction, while difficult to quantify, can also pose big wins. You can expect some failures, but stack the odds by learning from other departments, organizations and industries to avoid making the same mistakes.

To work, innovation must happen often and organically. Dedicate funding, establish cross-department teams and build a formal process for vetting internal ideas. Consider offering staff incentives to drive engagement. Not all ideas will succeed. Identify metrics that will help determine ROI (not all ROIs are measured in dollars) on pilot programs so you can weed out initiatives that aren’t delivering early on to protect resources. Also, keep in mind that you can improve these innovations at each iteration.  Make the process iterative and roll out the initiatives quickly. If it fails, shut the process down quickly and move on. If it is successful, improve it for the next iteration and scale it quickly to maximize the benefits.

Whether you’re cross-pollinating internal teams to promote innovation, building partnerships with other organizations or leveraging technology to better connect providers and patients, healthcare’s ability to successfully collaborate is vital to advancing innovation in healthcare.

About Peyman S. Zand
Peyman S. Zand is a Partner at Pivot Point Consulting, a Vaco company, where he is responsible for strategic services solving healthcare clients’ complex challenges. Currently serving as interim regional CIO for Tenet Healthcare, Zand was previously a member of the University of North Carolina Healthcare System, leading Strategy, Governance, and Program/Project Management. He oversaw major initiatives including system-wide EHR implementation, regulatory programs, and physician practice rollouts. Prior to UNC, Zand formed the Applied Vision Group, a firm dedicated to assisting healthcare organizations with strategic planning, governance, and program and project management for key initiatives.

Zand holds a Bachelor’s of Science in Computational Mathematics and Engineering from Michigan State University, and a Master of Business Administration from the University of Michigan.

The B2B Vendors are Coming! The B2B Vendors are Coming!

Posted on March 10, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

It’s been a couple of weeks since the annual HIMSS conference wrapped up for 2017 and I’m just starting to emerge from the HIMSS-Haze of sleep deprivation. I doff my hat to those that recovered more quickly.

As usual there was too much to take in at HIMSS17. The keynotes were fantastic, the sessions educational and the exhibit hall had a buzz about it that was absent from last year’s event. Although the main take-away from HIMSS17 seems to be the emergence of Artificial Intelligence, I believe something else emerged from the event – something that may have far greater ramifications for HealthIT in the short term.

For me the big story at HIMSS17 was the arrival of mainstream IT companies. I have been going to HIMSS for 10 years now and I can honestly say this year was the first time that non-traditional healthcare IT vendors were a noticeable force. SAP, IBM (Watson), Intel, Google, Salesforce, Samsung and Microsoft were just a few of the B2B vendors who had large booths in the HIMSS17 exhibit hall.

Salesforce was particularly noteworthy. They made a big splash with their super-sized booth this year. It was easily five times the size of the one they had at HIMSS16 and featured a fun “cloud viewer” at its center along with a large theatre for demonstrations.

Salesforce, however, didn’t stop there. They also threw a HUGE party over at Pointe Orlando on Tuesday night. At one point, the party had a line of eager attendees that snaked out the front of the facility. Their party rivaled that of several large EHR vendors.

IBM was also back at HIMSS after an extended absence. Their “organic booth” was always busy with people curious to learn more about IBM Watson – particularly after the keynote given by CEO Ginni Rometty on Day 1.

So what does the arrival of mainstream B2B vendors mean for healthcare?

Consolidation. The EHR gold rush is over and yet companies like SAP and Salesforce are still electing to invest in healthcare. Why would they do that at a time when government incentive money has all but dried up? I believe it’s because they smell consolidation and optimization opportunities. These B2B players have large war chests and as HealthIT companies begin to struggle, they will be knights in shining armor waiting to swoop in.

More Consumer Technologies. One of the big trends in healthcare right now is consumerism. There is a drive by healthcare organizations to adopt consumer-centric technologies and workflows to service patients better. Patients are seeking providers that offer the conveniences that they are used to as consumers: online appointment booking, mobile chat, real-time price quotes, etc. Companies like Google, Samsung, IBM and Microsoft already have technologies that work well in the consumer world. With growing demand in healthcare it’s only natural that they are investing.

Standards. Maybe I’m just being optimistic, but when companies like TSYS (a very large financial transaction processor) show up at HIMSS for the first time, one can only hope that standards and interoperability will soon follow. After all, if cut-throat banks can agree on a common way to share information with each other, surely the same can happen in healthcare.

Cognitive Computing. Google, IBM, Microsoft and Intel have all made big bets on cognitive computing. I’m willing to bet that their investments in this area dwarf anything that a HealthIT company has made – including Epic and Cerner. IBM and Microsoft in particular have been aggressively seeking partners to work with them on health applications for Artificial Intelligence. Just ahead of HIMSS17, Microsoft and UPMC Enterprises announced that they would be working together to “create new products aimed at transforming care delivery”.

I’m very excited by the arrival of these B2B technology vendors. I think it signals the start of a maturation phase in the HealthIT industry, one in which consolidation and collaboration break down legacy silos. At the very least, traditional HealthIT companies like Cerner, Epic, athenahealth and NextGen will now have to step up their game in order to fend off these large, well-funded entrants.

Exciting times!

Dr. Rasu Shrestha Helps Injured Passenger Enroute to #HIMSS16

Posted on March 1, 2016 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

One of the most interesting aspects of HIMSS are the stories that emerge during the conference. There are the “macro” stories like the announcements of new joint ventures and there are the “micro” stories of individual triumphs.

I love the personal stories that I hear/over-hear at HIMSS. Over the years I find that I remember these personal tales more vividly than I do the product announcements. Yesterday on #HIMSS16 Day 1, I heard the most incredible story in my nine years of attending the conference.
Rasu Shrestha
Rasu Shrestha MD MBA @RasuShrestha, Chief Innovation Officer at UPMC and Executive Vice President at UPMC Enterprises shared with me how he treated an injured passenger on his flight to Las Vegas for #HIMSS16.

Shortly after taking off from Pittsburgh airport, a straight-out-of-TV request came over the plane’s PA system: “Is there a medical doctor on board? If so, please identify yourself to the crew.” As with all other flights to Las Vegas this week, the plane was filled with fellow HIMSS attendees, but only Dr. Shrestha identified himself as an MD. He was quickly brought to an unconscious passenger in the aisle near the back of the plane.

The fallen man had collapsed on the way to the restroom and had hit his head on one of the foot rests, causing a gash on his forehead. When Dr. Shrestha arrived the man was bleeding profusely. After quickly assessing the situation, he sprang into action. Using only the plane’s first aid kit, Dr. Shrestha staunched the bleeding but the man remained unconscious. At this point two nurses who happened to be on board, came to help Dr. Shrestha and together they managed to stabilize the injured man.

“Had they had a suture kit on board I would have dressed his head injury right there on the plane” said Shrestha, “It was clear to me he needed stitches.”

The impromptu care team did so well that the man was able to complete the flight to Las Vegas without an emergency landing. Paramedics met the plane on arrival and took the injured man to a local hospital. He is recovering nicely. In recognition for his good deed, all the passengers and flight crew gave Dr. Shrestha an enthusiastic round of applause.

As Dr. Shrestha finished his story, it was easy to see how moved he was by this gesture from his fellow passengers – most of whom are part of the Pittsburgh healthcare community.

For me, this is likely going to be the most memorable story of #HIMSS16 – or any HIMSS for that matter…and we’re only on Day 1!

UPMC Kicks Off Mobility Program

Posted on July 1, 2014 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

If you’re going to look at how physicians use health IT in hospitals, it doesn’t hurt to go to doctors at the University of Pittsburgh Medical Center, a $10 billion collosus with a history of HIT innovation. UPMC spans 21 hospitals and employs more than 3,500 physicians, and it’s smack in the middle of a mobile rollout.

Recently, Intel Health & Life Sciences blogger Ben Wilson reached to three UPMC doctors responsible for substantial health IT work, including Dr. Rasu Shrestha, Vice President of Medical Information for all of UPMC, Dr. Oscar Marroquin, a cardiologist responsible for clinical analytics and new care model initiatives, and Dr. Shivdev Rao, an academic cardiologist.

We don’t have space to recap all of the stuff Wilson captured in his interview, but here’s a few ideas worth taking away from the doctors’ responses:

Healthcare organizations are “data rich and information poor”: UPMC, for its part, has 5.4 petabytes of data on hand, and that store of data is doubling every 18 months. According to Dr. Shrestha, hospitals must find ways to find patterns and condense data in a useful, intelligent, actionable manner, such as figuring out whether there are specific times you must alert clinicians, and determine whether there are specific sensors tracking to specific types of metrics that are important from a HIM perspective.

Mobility has had a positive impact on patient care:  These doctors are enthusiastic about the benefits of mobility.  Dr. Marroquin notes that not only do mobile devices put patient care information at his finger tips and allow for intelligent solutions, it also allows him to share information with patients, making it easier to explain why he’s doing a give test or treatment.

BYOD can work if sensitive information is protected:  UPMC has been supporting varied mobile devices that physicians bring into its facilities, but has struggled with security and access. Dr. Shrestha notes that he and his colleagues have been very careful to evaluate all of the devices and different operating systems, making sure data doesn’t reside on a mobile device without some form of security.

On the self-promotion front, Wilson asks the doctors about a pilot  project (an Intel and Microsoft effort dubbed Convergence) in which clinicians use Surface tablets powered by Windows 8. Given that this is an Intel blog, you won’t be surprised to read that Dr. Shrestha is quite happy with the Surface tablet, particularly the form factor which allows doctors to flip the screen over and actually show patients trends.

Regardless, it’s interesting to hear from doctors who are gradually changing how they practice due to mobile tech. Clearly, UPMC has solved neither its big data problems nor phone/tablet security issues completely, but it seems that its management is deeply engaged in addressing these issues.

Meanwhile, it will be interesting to see how far Convergence gets. Right now, Convergence just involves giving heart doctors at UPMC’s Presbyterian Hospital a couple dozen Microsoft Surface Pro 3 tablets, but HIT leaders plan to eventually roll out 2,000 of the tablets.

EMRs Can Create New Malpractice Problems

Posted on October 9, 2013 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

In theory, EMRs have the capacity to improve patient care and avoid medical errors, but they also stand the chance of creating errors of their own, so users shouldn’t expect EMRs to lower their malpractice premiums, according to a story reported in FierceEMR.

In fact, the story suggests, EMRs can create new problems and make it harder to defend against lawsuits arising from some EMR-related problems, including the following, FierceEMR notes:

  • Disabled clinical decision support alerts that, if used, could have caught a problem
  • Auto complete functions that fill in data incorrectly
  • Sharing of passwords, so that physicians look like they’re viewing the chart when they really aren’t or in more than one place at the same time
  • Sloppy documentation, such as data entered incorrectly

What’s more, EMRs create audit trails which make it easier for plaintiff’s attorneys to find errors in care. And on top of that, legal costs for “e-discovery” — the collection of evidence from electronic systems — can raise the expense of a legal battle further, FierceEMR says.

Here’s an example of a situation in which an EMR-based error can create serious legal exposure. In one case lodged against the  University of Pittsburgh Medical Center, a 62-year old man died due to otherwise treatable bleeding in the brain because an intubation failed.

UPMC’s policy is that when a patient is a difficult intubation case, that must be noted directly in the EMR, which then displays a bright yellow banner nothing the problems at the top of the record. However, “difficult intubation” was not noted in his chart.  When his breathing tubes were later removed, he could not continue to breathe on his own. Attempts to re-intubate him failed, and he died.

As if that wasn’t bad enough, the defense alleges that after the patient’s death, a QA official from UPMC accessed the system and retroactively entered data labeling the deceased as a difficult intubaton. When that didn’t create the yellow banner, the defense claims, the official retracted the “diff intub” entry. Unfortunately for him, all of his actions were logged by the system.

The bottom line is that as it becomes apparent that EMRs come with their own set of safety issues, malpractice insurers who once offered premium discounts to those who use EMRs are dropping the idea. EMRs certainly have the potential to offer improved safety in some instances, but human error isn’t going away completely no matter what fixes EMRs offer.

UPMC Sinks $100MM Into Big Data

Posted on November 6, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

The University of Pittsburgh Medical Center has announced plans to spend $100 million over five years to create a massive data warehouse, a move which puts it well at the forefront of hospital “big data” efforts.

According to Information Week, UPMC’s data warehouse will bring together clinical, financial, administrative, genomic  and other information. The health system has targeted more than 200 data sources across the Medical Center, UPMC Health Plan and other affiliates.

I’ll let Information Week describe the technical set-up:

To collect, store, manage, and analyze the information maintained in the data warehouse, UPMC will use the Oracle Exadata Database Machine, a high-performance database platform; IBM’s Cognos software for business intelligence and financial management; Informatica’s data integration platform; and dbMotion’s SOA-based interoperability platform that integrates patient records from healthcare organizations and health information exchanges. These tools will manage the 3.2 petabytes of data that flows across UPMC’s business divisions.

As to how UPMC plans to use these tools, they’re hoping to do all of the things you might imagine, including genomically-tailored prescribing, population analytics and sophisticated tracking of individual patient data to make predictions about possible risks.

As I see it, UPMC’s efforts highlight both the importance of big data efforts and the downside in making the investment.

On the one hand, you’ve got the benefits. For example, patients will clearly see better outcomes if doctors can use top-drawer analytical tools to predict how treatments will work or know well in advance if a patient’s condition is about to go south.  And hospitals will clearly run better if execs get insights into issues that cross clinical and administrative boundaries, such as ED or OR utilization.

On the other, you’ve got the reality that big data projects are prohibitively expensive for all but the best-funded of healthcare organizations, and probably won’t produce returns on investment for several years at best.  Average community hospitals won’t be consolidating and analyzing their data this way anytime soon.

UPMC Kicks Off Competitive HIE

Posted on July 5, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or

The University of Pittsburgh Medical Center has kicked off a new HIE connecting its properties with other health systems in western Pennsylvania.  The project, which should bring together access to more than 7 million patient records, goes into direct competition with that being launched by major state health insurer Highmark Inc.

UPMC’s HIE, ClinicalConnect, brings together its facilities with clinicians at Butler Health System, Heritage Valley Health System, Altoona Regional Health System, Armstrong County Memorial Hospital, Excela Health, Jefferson Regional Medical Center, St. Claire Hospital and Washington Hospital. While reports don’t describe how ClinicalConnect is being funded, you’ve gotta believe the $9 billion UPMC is fronting a lot of cash.

This move sets up an interesting competitive situation on the state, a fairly unusual one given that it’s built around an HIE.

Right now, UPMC is the 2,000 pound gorilla of western PA. Meanwhile, $14.6 billion Highmark is one of the dominant health insurers in the state. And now they’re going head to head on the HIE front. Mean ol’ Highmark has publicly announced its intention to build a system with UPMC’s bitter rival West Penn Allegheny Health, and as part of its plans, expects to launch a statewide HIE that could conceivably bypass UPMC’s regional effort.

When asked by a reporter whether the two HIEs can work together, their spokespeople basically said “Humph!” and denied that anyone cared about competition.  Oh yeah, we definitely believe that.

What interests me about this hoo-haw is that it both organizations seem to see their HIE as critical to their delivery network development efforts. While it makes perfect sense, it hasn’t been a big theme in HIE discussions to date. (My sense is that most hospital CIOs have seen HIEs as plumbing rather than a value-add.)

Interesting stuff here. I’m eager to see what happens next.