After enjoying HIMSS13 last week, I am writing one blog per day this week reviewing the sessions which I thought were most insightful. This is the fifth and final blog in the series.

Today I am going to cover some quick hitters. The week at HIMSS is so full of great education sessions that it is impossible to attend them all. It is also difficult to adequately review every session I attended, but I wanted to share some key takeaways from several sessions I attended:

Session 47: Implementing Patient Engagement and Care Coordination Technologies for Improved Outcomes

Ed Martinez, senior vice president and CIO at Miami Children’s Hospital, framed the complexities of implementing health IT by saying,

“Implementing technology is hard, but changing the way people think is harder.”

Miami Children’s Hospital has had great success in implementing care coordination technologies and Mr. Martinez discussed three key aspects:

  1. Technology must be leveraged
  2. Data must be integrated
  3. Patient engagement must be continuous, including pre care, point-of-care, and post care.

And as a final aspect, Mr. Martinez added that his salary bonus, and everyone’s bonus at Miami Children’s Hospital, is tied to patient satisfaction. Click here for the slides.

Session 77. Lessons/Insights from a Pioneer ACO's Journey to Value-Based Care

Banner Healthcare is a Pioneer ACO, which is different from a Medicare shared-savings ACO. Banner partners with Aetna in implementing their ACO model.

ACOs have often been called the new HMOs, but it was pointed out that there is a major difference – HMOs had a lack of data, while a properly implemented ACO should be data rich. And it is the use of the data that can make ACOs much more successful than the HMOs.

However, electronic data itself is not sufficient for success. If the electronic data is unstructured without utilizing proper coding, the data is much less valuable. Semantic interoperability is key. Click here for the slides.

Session 93. Update on OCR's Health Information Privacy Enforcement and Audit Program

The Office for Civil Rights (OCR) delivered a presentation on HIPAA rules and HITECH Breach notifications. The theme of the day was that privacy and security should be a plus, not a barrier. The analogy made was that rules are “guideposts, not speed bumps.”

The goal of the OCR is to have balance in the policy. They want the data to be accessible, but in a secure way. For details on the enforcement program or the audit program, the slides can be viewed here.

Session 112. Extra-Sensitive PHI: Appropriate Sharing using Data Segmentation for Privacy

the topic of extra-sensitive patient health information (phi) was discussed in this presentation. my understanding of extra-sensitive phi prior to this presentation was primarily at the document level. for example, the ccd document for a hollywood actor would be tagged with a confidentiality level of "very confidential," and as a result it could only be accessed by the properly authenticated personnel.

the idea of a granular approach for extra-sensitive phi was discussed. for example, if a person has a history of drug abuse and doesn’t want that specific sensitive information shared, the clinical application would need to display all the patient data except for the drug abuse history. the "russian doll" approach to privacy metadata was proposed. essentially, there would be metadata to signify whether a document could be opened, then more metadata to decide whether a section could be viewed, then more metadata to decide if a specific test within that section could viewed, and so. just like russian dolls. for more details, download the slides here.

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