2014 Health IT Change Agents

These influential individuals and organizations are leading the charge for positive change in health IT.

Compiled by Ken Congdon, Editor In Chief

There’s no denying it. The U.S. healthcare system is in dire need of repair. Health IT will be a huge part of the solution, but it must constantly evolve to meet the needs of the market, providers, and patients. That’s where a select group of individuals and organizations comes in. These visionaries push the boundaries of what can be done with health IT and lead the charge for positive change. We call these influential few Health IT Change Agents.

Over a two-week period, we asked our readers to nominate individuals and organizations that they believe are true champions for health IT progress. The response we received was overwhelming. Our editorial staff spent days carefully reviewing each nomination and narrowed the list down based on a series of carefully selected criteria.

From our perspective, the following traits exemplify a Health IT Change Agent:

• They must push conventional health IT boundaries, challenge the status quo, lead the charge for positive change through health IT, and be highly influential.
• They must have a clear vision and effectively communicate this vision with others.
• They must be knowledgeable about health IT and lead by example.

With these characteristics in mind, we decided to recognize the following individuals and organizations as our inaugural class of Health IT Change Agents. All nominations we received were worthy of such a distinction, but this group proved to be the cream of the crop. Their efforts are making an undeniable impact on our industry, and health providers and vendors alike should stop and take notice.

A True HIE Champion

Mark Jacobs, CIO, Delaware Health Information Network (DHIN)

We simply couldn’t ignore the accomplishments of Mark Jacobs. He was our most-nominated candidate — a testament to the number of people he has influenced. Jacobs’ health IT career has spanned more than 30 years and includes high-ranking positions at Wellspan Health System, Lancaster Health Alliance, and Wyoming Valley Health System, to name a few. However, his most recent (and arguably most notable) contribution to the world of health IT has come in his role as CIO of the Delaware Health Information Network (DHIN).

The DHIN was the country’s first operational statewide HIE, and as the organization’s first CIO, Jacobs has been a true champion and visionary in the area of HIE adoption, execution, and sustainability. He has not only been instrumental at ensuring the DHIN has the proper technical infrastructure in place, Jacobs has also helped the HIE achieve universal adoption of its user base (nearly 100 percent of the hospitals in the state of Delaware and most physicians are connected to and use the DHIN). According to his nominators, Jacobs accomplishes this feat by “getting in the trenches” and interacting with all stakeholders (e.g., providers, payers, vendors) to create a daily workflow and value proposition that works for everyone.

Jacobs’ sphere of influence isn’t limited to Delaware. He is determined to spread his philosophy for a successful HIE both nationally and internationally. He is working closely with the ONC and HHS to develop a national policy to further HIE. He has been involved with the national HIMSS Health Information Exchange spotlight. Jacobs has also authored several articles and white papers on HIE, including “Ensuring Privacy and Security of Health Information in Pennsylvania” and “Building a Sustainable Model for Health Information Exchange.” Finally, Jacobs has provided testimony to the Senate Communications and Technology Committee promoting broader adoption and sharing of electronic patient records in Pennsylvania. These are but a few of the efforts that make Mark Jacobs a leading voice in the area of HIE.

A Rebel For Entrepreneurial Healthcare

Jonathan Bush, President and CEO, athenahealth

When it comes to larger-than- life personalities in the field of health IT, they don’t get much bigger than Jonathan Bush. The guy is outspoken, charismatic, and he’s just everywhere. It’s hard to think of a 2014 health IT conference or event where Bush wasn’t a featured keynote speaker. In addition, Bush released his provocative new book, Where Does It Hurt? An Entrepreneur’s Guide To Fixing Health Care, earlier this year to critical acclaim. However, it’s not just the fact that Bush is in the public eye (a lot), there’s substance in what he has to say, and he’s beginning to open enough eyes to start a healthcare revolution.

Like many, Bush is passionate about fixing the U.S. healthcare system. However, to Bush, the answer doesn’t lie in legislation or bureaucracy. Instead he promotes a free market healthcare system that gives entrepreneurs more freedom to develop solutions to the problems that plague our industry and patients (i.e., consumers) more control over their care. Bush calls for disruption to the status quo through new business models, payment models, and technologies, and this philosophy guides the way he runs athenahealth. According to Bush, injecting more competition and a profit motive into the delivery of healthcare will do more to improve the quality and reduce the cost of care than 100 new (well-intended) government regulations ever could. Furthermore, he believes that a free market environment will spur healthcare innovation and motivate Americans to demand more from their providers while accepting more responsibility for their own wellness. This is Bush’s vision to building a flourishing healthcare marketplace, and his passion and influence have the industry listening.

The Health IT Guru

Dr. John Halamka, CIO, CareGroup Health System and Harvard Medical School

Dr. John Halamka is like the E.F. Hutton of the health IT industry — when he talks, people listen. Dr. Halamka has so many titles and sits on so many boards (e.g., CIO of CareGroup Health System and Harvard Medical School, Chairman of NEHEN, CEO of the MA-SHARE RHIO, Chair of HITSP, etc.), it’s hard to believe he has time to sleep let alone author new posts for his influential blog, Life As A Healthcare CIO. Yet the leadership and vision he brings to each of these roles have made him somewhat of a folk hero in health IT circles. Hospital CIOs across the country use Dr. Halamka as their measuring stick, and IT vendors seek his input on how to make their products more valuable in clinical settings. Over the years, Dr. Halamka has provided valuable insight on everything from Meaningful Use and EHR interoperability (citing his own best-of-suite EHR at CareGroup Health System as a use case) to viable clinical applications for iPhones, iPads, and Google Glass. Beyond his own blog, Halamka is also a regular guest author for many health IT-focused publications and speaks frequently at industry conferences and events — all in the interest of helping the healthcare industry effectively implement IT to improve care and outcomes.

The mHealth Maven

Dr. Eric Topol, Cardiologist, Researcher, Author

Dr. Eric Topol has been involved with wireless medicine and mHealth since its inception and has arguably done more than anyone to bring the capabilities and benefits of these technologies to the forefront of the American consciousness. He was the first physician to serve on CardioNet’s Medical Advisory Board in 1999, the first dedicated wireless medicine company that performs real-time ECG remote, continuous rhythm monitoring. In 2007 he joined the Board of Sotera Wireless that has developed the first continuous noninvasive blood pressure monitoring device, which also captures all vital signs. He led the first trial with the GE Vscan device, a pocket high-resolution, mobile ultrasound imaging device, introduced in the US in 2010 and is currently leading clinical trials of heart rhythm and heart failure monitoring wireless devices.

At the 2009 International Wireless CTIA meeting, Dr. Topol gave the keynote address on wireless health, the first time this topic has ever been the subject of a CTIA plenary session. In addition, in early 2010 he gave a wireless medicine presentation at the Consumer Electronic Show. In 2011, Dr. Topol published his critically acclaimed book, The Creative Destruction Of Medicine. The book focuses on how personal digital technology allows doctors to see a full, continuously updated picture of each patient, helping them care for each patient individually and in real time. Dr. Topol has also appeared on several popular television programs to demonstrate the value of mHealth technology, including The Doctors, NBC’s Rock Center, and The Colbert Report.

The Artist Advancing Patient Rights

Regina Holliday, Artist, Speaker, Founder of The Walking Gallery

Unlike others who made our 2014 Health IT Change Agent list, Regina Holliday is not a doctor, hospital CIO, or vendor executive. Instead, Holliday’s influence in the health IT industry is much more a product of cruel fate and her unquenchable desire to make a difference in the lives of patients and their families.

Regina’s beloved husband, Fred, died of kidney cancer in 2009. Throughout his treatment, Regina became increasingly frustrated by the inefficiency and lack of compassion that permeated the U.S. healthcare system. At one point, Regina asked to see her husband’s medical records so that she could research his condition and care, and they could make more informed decisions together. She was told that Fred’s medical records would cost 73 cents per page and would only be available after a 21-day wait. Fred passed away before Regina received his medical records.

As part of the grieving process, Regina started painting murals that illustrated her and Fred’s ordeal with our broken healthcare system. She quickly realized that she was not alone. In 2010, she started painting other people’s healthcare stories using a unique object as a canvas — the backs of business jackets. That’s when The Walking Gallery was born. The Walking Gallery is a medical advocacy movement where individuals wear patient narrative paintings on business jackets in the interest of promoting patient rights. To date, there are nearly 300 members of The Walking Gallery (I am proud to be one of them). Many of the works focus on providing patients with ownership of the health data. In addition to painting, Regina has become a renowned speaker in the area of patient rights. Regina’s been called the “Rosa Parks of healthcare,” and you’re bound to see her painting and/or speaking at health IT conferences across the country accompanied by several of her disciples proudly displaying her art on their backs.

An Ambassador For ACO Attainability

Dr. Farzad Mostashari, Founder and CEO, Aledade, Inc. and former National Coordinator For Health IT

In health IT circles, Dr. Farzad Mostashari needs no introduction. This bow-tie-sporting medical maven spent nearly three years as the National Coordinator for Health IT, where he arguably ushered in some of the most impactful elements of the Meaningful Use program. One of the qualities that sets Dr. Mostashari apart from other national coordinators is the fact that he always looks at heath IT through the lens of the provider first. He is determined to uncover and alleviate the challenges associated with health IT adoption and help providers realize the operational and clinical value technology can deliver as quickly as possible. Dr. Mostashari brings this approach to his latest venture as founder and CEO of Aledade, Inc. as well.

Dr. Mostashari has always been a proponent of ACOs (accountable care organizations) and their ability to improve patient care coordination. Many independent physicians practices share his beliefs but have a hard time making the organizational and technological investments necessary to form an ACO. Dr. Mostashari created Aledade to provide independent primary-care physicians with the support they need to successfully transition to ACOs. Through his observations, Dr. Mostashari believes that underinvesting in the ACO and population health management infrastructure is one of the main reasons why many ACOs fail. Therefore, through Aledade, Dr. Mostashari aims to provide practices with the critical elements necessary for an ACO transformation (e.g., analytics software, data warehousing, EHR interfaces, ACO-specific hires and licenses, etc.) up front. The firm’s business model is to be compensated on the back end through a percentage of the savings it generates for its clients. Aledade received more than $4.5 million in initial seed funding and is poised to help impact ACO growth.

A Patient Experience Evangelist

Dr. Bridget Duffy, Chief Medical Officer, Vocera Communications

Whether it’s defining the components of an optimal healing environment or developing technological innovations that improve communication between physicians and patients, Dr. Bridget Duffy has spent more than 20 years focused on improving the overall healthcare experience of patients. Dr. Duffy served as the first chief experience officer in the country at the Cleveland Clinic from 2006 to 2009. During her tenure, she introduced several administrative changes at the clinic, such as creating institute-level experience officers and organizing patient and family advisory councils.

Following her work at the Cleveland Clinic, Dr. Duffy founded and served as CEO of ExperiaHealth, a company that helped healthcare providers improve staff and patient loyalty through innovative communication technologies that restore human connection in healthcare. In this role, Dr. Duffy worked with healthcare organizations to develop patient experience strategy, map the gaps in the healthcare experience, create experience standards of care, engage physicians in experience improvement, and build a culture that sustains a commitment to patient experience improvement.

ExperiaHealth was acquired by Vocera Communications in 2013 where Dr. Duffy continues her quest to improve the patient experience as CMO of the organization. She is steadfast in her dedication to restoring humanity to healthcare by using the right mix of communication technologies to return doctors and nurses to the patient bedside. Dr. Duffy frequently speaks in the U.S. and Canada on the importance of patient, family, and staff experience in healthcare. Her presentations often focus on how communication tools can improve care coordination, patient engagement and satisfaction, and clinical outcomes.

The e-Patient Poster Boy

Dave deBronkart, Cancer Survivor, Blogger, Speaker, Author

Widely known as “e-Patient Dave,” deBronkart is a pioneer in the area of Participatory Medicine — a model where patients become potent agents in creating and managing their health in partnership with physicians. deBronkart began to focus on altering the balance of power in healthcare after surviving Stage IV, Grade 4 renal cell carcinoma (kidney cancer). To deBronkart, an e-patient is empowered, engaged, equipped, and enabled. Dave is actively involved in opening health information directly to patients and creating a new dynamic regarding how information is delivered, accessed, and used by individuals. This is revolutionizing the relationship between patient and provider, which in turn will impact insurance, careers, quality of life, and the distribution of finances across the entire spectrum of healthcare. deBronkart is as known for coining the phrase “Gimme my damn data,” as he is dedicated to educating the industry on the e-patient movement. He’s a prolific speaker on the topic and even testified in Washington for patient access to the medical record under Meaningful Use. He also published Let Patients Help: A Patient Engagement Handbook last year to provide physicians and patients with a road map for how to create tighter partnerships with one another.

A Surgical Innovator

Dr. Atul Gawande, General and Endocrine Surgeon at Brigham and Women’s Hospital, Professor, and Author

Dr. Atul Gawande is a well-respected thought leader not only in the healthcare industry, but popular culture as well. In fact, Time recognized him as one of the 100 most influential thinkers in 2010. Dr. Gawande is probably best known for his work in the area of healthcare process improvement — particularly his leadership in the creation of a standard surgical checklist that has led to marked improvement in surgical outcomes and been heralded as “the biggest clinical invention in thirty years” by The Independent. This methodology is outlined in his New York Times bestseller, The Checklist Manifesto.

In addition, Dr. Gawande is a leading advocate for healthcare technology and effective use of health data in clinical settings. For example, Dr. Gawande is the chair of Lifebox, an organization intent on preventing unsafe surgeries globally by ensuring that life-saving technologies, such as pulse oximeters, are provided to low-income countries. He has also been a popular keynote speaker in the health IT conference circuit as of late, sharing his thoughts on the positive impact effective data analytics technology can have not only on surgical decisions but also on overall clinical care and patient outcomes. According to Dr. Gawande, the key is not simply gathering the data but making it scalable, actionable, and accessible.

A Visionary For Coordinated Community Health

Tess Coody-Anders, CEO, Resolute Health

Tess Coody-Anders says that healthcare is about serving the “Chief Health Officer Mom” — the mother who has to dedicate tremendous amounts of time to quarterbacking the medical care of her children and aging parents. It is this belief that fuels Coody-Anders’ leadership at Resolute Health, an innovative new provider organization in the Tenet Healthcare network.

Resolute is built around the concept of improving population health. However, unlike other health systems that build their population health models around anchor hospitals, Resolute built community and population health programs first. The provider only recently opened its 128-bed hospital in June.

Resolute Health’s vision is manifest in its 56-acre “wellness campus” that includes not just the hospital but clinics, outpatient facilities, a fitness center, health-oriented restaurants, walking trails, and an integrative medicine center as well. To Coody- Anders, it’s not enough for a provider to simply help a patient get healthy. It must also provide individuals with the tools and knowledge to stay well.

The Resolute Health facility is not only designed to provide a one-stop shop for healthcare in the community, but also to facilitate care coordination between providers. For example, all providers in the Resolute Health network and the hospital are on a single EMR. Furthermore, the provider equips its patients with encrypted smartcards that house their personal health records. Any clinician in the Resolute Health network can access and update patient health records with a simple swipe of these smartcards.

A Leading Voice For HIT In Ohio

Dr. Stephen Beck, CMIO, Mercy Health

As CMIO, Dr. Stephen Beck has helped Ohio-based Mercy Health leverage technology and clinical information systems that drive performance improvement for long-term success. Drawing on his expertise, Mercy Health has been rolling out an ambitious health IT strategy that began with a successful five-year EHR implementation across its 24 hospitals. The effort has extended to deployment of embedded clinical decision support tools, HL7 Infobutton capability, and evidence-based order sets to drive CPOE (computerized physician order entry) adoption and standardized evidence-based practices at the point of care.

Dr. Beck’s leadership has united physicians and other providers toward a common goal, and Mercy Health has achieved significant adoption of new technology among its 1,900 ambulatory and inpatient physicians as a direct result. Due in large part to his efforts, Mercy Health was named a 2014 “Most Wired” Hospital by Hospitals & Health Networks. The provider was also named one of the Top 15 Health Systems in the Nation by Truven Health Analytics.

On a national level, Dr. Beck was one of the first physicians to be recognized by HIMSS as a Certified Professional in Health Information and Management Systems (CPHIMS). He has been actively involved for many years in content review for the HIMSS National Conference and was chairman of the National Professional Practice Task Force for HIMSS. Dr. Beck has also been honored as a Fellow by both HIMSS and the American College of Physicians.

An International Force For HIT Transformation

Sumit Nagpal, President and CEO, Alere Accountable Care Solutions (formerly Wellogic)

Sumit Nagpal has been viewed as a pioneer in the health IT space ever since he founded Wellogic (one of the first HIE vendors) back in 1992. Wellogic was the first HIE infrastructure to connect to the NHIN (National Health Information Network), and the company has since been acquired by Alere and is now known as Alere Accountable Care Solutions.

Nagpal concentrates on identifying the root cause of healthcare issues throughout systems and then supports the creation of systemic change to create better clinical outcomes in areas such as population health. His efforts and best practices are internationally recognized.

For example, Nagpal is currently overseeing the redirection of the healthcare system in the city of Leeds in the United Kingdom (NHS). He is strategically overseeing and supporting the implementation of various chronic disease management programs in the UK in order to improve the overall health of the population while supporting the reduction of costs to the NHS. To this end, he has created technology systems to aid large populations in improving outcomes that can be used worldwide.

Nurturing A Culture Of HIT Innovation

Intermountain Healthcare

Despite its ongoing (and public) challenges in regards to Meaningful Use attestation (largely self-imposed out of concern for maintaining patient safety during its transition from a homegrown EHR to a Cerner platform), Intermountain Healthcare has a long history as a provider on the cutting-edge of health IT adoption and care quality improvement. For example, the provider has been using computers for clinical decision support since the 1950s and leveraged EHRs in some form since the 1970s. Intermountain also conducted some of the first studies on healthcare quality, utilization, and efficiency in the 1980s.

Intermountain continues to build on its reputation for health IT innovation. The provider recently implemented an enterprisewide telehealth platform to support its patient-centered shared accountability model. Rather than maintaining several department-level telehealth solutions, Intermountain has made telehealth part of the system’s technology infrastructure. The resulting service is called Intermountain TeleHealth Services e Visit. The solution is browser-based, allowing patients to enter a URL, click a button, complete the necessary forms, and begin a virtual doctor’s visit.

Finally, late last year, Intermountain opened its Healthcare Transformation Lab — a designated facility where Intermountain employees can work together with IT vendors to develop new technology prototypes to improve patient care and outcomes. One of the first innovations to come out of the lab is a handwashing sensor that can be worn like a watch by hospital physicians, nurses, and other caregivers to reinforce proper hand hygiene to reduce infections. The lab also has worked with clinicians to develop a “life detector” that alerts caregivers of changes to patients’ vital signs, in or out of medical facilities.

Enhancing Early Detection And Intervention

St. Joseph Mercy Oakland

In March of this year, St. Joseph Mercy Oakland opened its new $135 million South Patient Tower. The facility is unique because a technology infrastructure known as The Intelligent Care System was incorporated into the design of the building. A central component of The Intelligent Care System is an early warning detection solution called Visensia by OBS Medical. The system monitors patients to detect early warning signs and alerts clinicians to intervene before a critical event occurs. Visensia tracks patient conditions using a software algorithm that evaluates five key vital signs (blood pressure, pulse rate, respiratory rate, pulse oximetry, and temperature) and calculates a single value (index score) that reflects a patient’s hemodynamic wellness. Traditionally, clinicians would evaluate these individual data points manually and often not in reference to one another.

A pilot program of the solution showed a 34.5 percent reduction on patient mortality, a 50 percent reduction in “code blue” rates, and a 5.3 percent reduction in average patient length of stay. The next phase of the solution will be to provide all patients in the South Patient Tower with a mobile device to wear on their wrist that will capture all of these vital signs automatically throughout the day and upload them to Visensia. These sensors will reduce the number of times clinicians need to interrupt patients to collect these vitals.

Driving Health IT Education

HIMSS (Healthcare Information and Management Systems Society)

When it comes to health IT associations, there’s HIMSS and then there’s everyone else. HIMSS boasts more than 52,000 individual members, of which more than two-thirds represent healthcare provider, government, and not-for-profit organizations.

HIMSS is focused on providing the industry with ongoing education and information on how better healthcare can be achieved through effective application of IT. This effort culminates every year at the HIMSS Annual Conference that attracted a record-breaking 38,000 attendees in 2014. However, HIMSS is much more than just a once-a-year gala event. Through HIMSS Analytics, the organization provides research, market intelligence, and analytical expertise to support the decision-making processes of healthcare providers and vendors alike. Finally, HIMSS delivers its health IT education to the masses through HIMSS media — the association’s publishing arm that includes such titles as Healthcare IT News, Government Health IT, and mHealth News.