2015 Health IT Change Agents

Our inaugural class of Health IT Change Agents set a high bar, but this year’s class can more than hold its own when it comes to driving positive change and advancing health IT.

We spend a lot of time at Health IT Outcomes covering what’s wrong with the industry. EHR implementation failures, ICD-10 transition breakdowns, and multi-million-dollar breaches affecting hundreds of thousands of people are just a few of the more unpleasant stories we’ve written about this year.

In the face of these failings, we’re fortunate to have healthcare’s versions of Don Quixote, nameless hidalgos setting out to undo wrongs and bring justice to the healthcare world. But, unlike the ingenious gentleman of La Mancha, our heroes are not conquered, forced to lay down their arms and cease their acts. No, fortunately for the healthcare industry, our visionaries continue to 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.

Following up on the success of last year, we asked Health IT Outcomes readers which individuals and organizations they thought should make up the second class of Health IT Change Agents. Our editorial staff sorted through the many nominations, carefully reviewing each until we had narrowed the list to the final 15. We used the following criteria to determine this year’s selections:

• 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 to others; and
• They must be knowledgeable about health IT and lead by example.

With these criteria in mind, we are proud to present the Health IT Change Agents Class of 2015. 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.

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Leading Cleveland’s HIT Charge

David Kaelber, MD, PHD, MPH, CMIO, The MetroHealth System

As CMIO of The MetroHealth System in Cleveland, Dr. David Kaelber oversees the 45-employee Center for Health Informatics and Patient Engagement. Under Kaelber’s charge, the Center is responsible for developing and implementing all of MetroHealth’s clinical informatics and patient engagement technology activities, as well as leading system- wide personal health record, health information exchange, and Meaningful Use (MU) efforts.

Kaelber helped MetroHealth become the nation’s first safetynet/ public healthcare system with Epic EHR to achieve the Health Information Management and System Society’s electronic medical record adoption model Stage 7 in both the ambulatory and hospital settings. Kaelber has also led numerous inpatient and outpatient initiatives designed to use electronic data to improve patient care, manage care transitions, and enhance patient engagement.

One such initiative involved assembling a team to develop alerts for all CDC Advisory Committee on Immunization Practices recommended pediatric and adult immunizations. Under this program, when alerts identified patients overdue for immunizations, reminders were sent to patients via text and voice messages, postcards, and PHRs. As a result, MetroHealth realized a significant increase in all immunization rates — including a 245 percent increase in Herpes Zoster immunizations.

Kaelber has successfully led MetroHealth’s overall PHR efforts. Nearly 40 percent of MetroHealth’s patient population has signed up for and is using the healthcare system’s EHR-tethered PHR. This has generated hundreds of thousands of dollars in savings from improved operational efficiencies, such as the ability to selfschedule visits, as well as patient communication efficiencies, such as the ability to view lab and imaging results and immunizations, renew medications, and send messages to their healthcare team.

In addition to leading its MU program, which has brought more than $30 million to MetroHealth, Kaelber also leads its EHRbased HIE efforts that have led to more than 1.5 million documents being exchanged. Finally, under Kaelber’s direction, Metro- Health became the nation’s first healthcare system to develop an automated vaccine adverse event detection and reporting system, integrated with the EHR. In its first year of operation, this Electronic Support for Public Health system led to a 30-fold increase in vaccine adverse events reported to the CDC.

Among the first group of physicians to achieve board-certification in clinical informatics, Kaelber is eager to share his unique expertise as evidenced by his nearly 150 clinical informatics-related peer review publications, abstracts, and national conference presentations. Additionally, he has given more than 50 clinical informatics-related invited talks at EHR meetings and grand rounds around the country.

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A True Physician Advocate

Dr. Linda Girgis, FAAFP, Physician and Practice Owner, Girgis Family Medicine LLC

Our most-nominated Health IT Change Agent, Dr. Linda Girgis, is a board certified family physician in South River, NJ, who has been in private practice since 2001. Girgis is currently affiliated with St. Peter’s University Hospital and Raritan Bay Hospital and is passionate about teaching medical students and residents from Drexel University and the University of Medicine and Dentistry of New Jersey.

Girgis has been a physician’s advocate on the topics of user experience and usability related to EHRs. She’s a thought leader, an outspoken advocate for physicians remaining in the healthcare dialogue, and a constant bridge builder between patients and healthcare providers (HCPs), making sure that innovation keeps trust and engagement as core principles of the point of care. She humanizes HIT for consumers and physicians, and educates thousands with her reach.

Girgis is a blogger for SERMO, Physician’s Weekly, and Library of Medicine where she is now amongst their featured physicians. Additionally, she is a guest columnist for Med- CityNews and Health IT Outcomes, and has been interviewed by U.S. News, NPR’s Marketplace, and the NBC Nightly News. Girgis also released two books — Inside Our Broken Healthcare System and The War on Doctors: And the Destruction of US Healthcare. Both books include as part of their theme the need for repairing our healthcare system, as well as advocating patient-centric care and fighting to keep private practices from being taken over by third parties, namely insurance companies and the government.

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The Nation’s HIT Champion

Karen DeSalvo, Acting Assistant Secretary for Health, National Coordinator for Health Information Technology, and Director of the Office of the National Coordinator for Health Information Technology

Dr. Karen DeSalvo is a physician who has focused her career on improving access to affordable, highquality care for all people, especially vulnerable populations. She has done this through direct patient care, medical education, policy and administrative roles, research, and public service.

In her role as acting assistant secretary for health, DeSalvo oversees 12 core public health offices, 10 regional health offices across the nation, and 10 presidential and secretarial advisory committees. As the national coordinator for health information technology, DeSalvo sets high-level policy and the strategic direction of the office, including efforts related to interoperability.

The role suits DeSalvo well as she is a long-time advocate of real interoperability, working tirelessly to put in place the structure that will allow the sharing of data leading to better outcomes. Additionally, DeSalvo leveraged her HIT/public health knowledge to assist with the emergency response to the Ebola outbreak.

Before joining the U.S. Department of Health and Human Services, she was health commissioner for the City of New Orleans and senior health policy advisor to New Orleans mayor Mitchell Landrieu. She is credited with transforming New Orleans’ outmoded health department to one that achieved national accreditation and restored healthcare to devastated areas of the city, including leading the establishment of a public hospital.

Following Hurricane Katrina, DeSalvo helped build an innovative and award-winning system of neighborhood-based primary care and mental health services for lowincome, uninsured, and other vulnerable individuals that boasts a sophisticated health IT infrastructure.

DeSalvo served as president of the Louisiana Health Care Quality Forum, the state’s leader for the health information exchange, and the National Association of Chiefs of General Internal Medicine. She has also served on the boards of the National Association of County and City Health Officials and the Society of General Internal Medicine.

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An IT Visionary

Dr. Joseph Kvedar, VP, Connected Health at Partners HealthCare

Dr. Joseph Kvedar is vice president of Connected Health at Partners HealthCare and was formerly the director of the Center for Connected Health, an organization he also founded. Moreover, he is a recognized visionary in his field.

The Center for Connected Health creates and studies models for healthcare delivery that move care into the daily lives of patients. Leveraging information and consumer technologies, the Center helps providers and patients manage chronic conditions, maintain health and wellness, and improve adherence, engagement, and clinical outcomes. The Center is a division of Partners HealthCare, founded by Brigham and Women’s and Massachusetts General Hospitals.

Under Kvedar’s direction, the Center developed a connected health technology platform that supports its clinical programs and inspired the launch of the first connected health employee benefit, adopted by EMC Corporation. In 2010, he cofounded the personal health technology company Healthrageous, where he is chair of the scientific advisory board.

Kvedar grew and formalized the Center’s consulting services, which provide product evaluations, feasibility trials, reviews, and counsel to companies seeking to enter the market. Through research, innovation, clinical programs, and consulting services, the Center has become a catalyst in the shift to connected healthcare.

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Growing HIE In Georgia

Tara Broxton Cramer, Executive Director, Georgia Regional Academic HIE

Tara Broxton Cramer was named executive director of the Georgia Regional Academic Community Health Information Exchange in November 2011. She was previously executive director of the East Georgia Health Cooperative, a rural health network.

Cramer is leading the charge for interoperability in rural southeast Georgia. Her HIE encompasses 11 sites, spans one million patients, and grew roughly 450 percent in six months and 638 percent in 10 months. That may not sound like a lot compared to other HIEs until you realize the population for the Augusta, Macon, and Savannah, GA, areas combined is only about 420,000 people.

Cramer sits on the User Group Committee of the Georgia Health Information Network and is a member of the both the Technology Committee and the Pediatric Asthma Committee for the Pediatric Healthcare Improvement Coalition. She is a former secretary of the board for the National Cooperative of Health Networks and co-chaired its 2011 annual conference. She received the organization’s New and Emerging Leader Award in 2009.

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Bringing Vital IT To Healthcare’s Tiniest Patients

Dr. Brian Jacobs, VP, CMIO, and CIO, Children’s National Health System

Dr. Brian Jacobs is a professor of pediatrics at George Washington University and VP, CMIO, CIO, and a critical care faculty member at Children’s National Health System. Additionally, Jacobs oversees the Bear Institute — the first pediatric health IT institute in the nation — a close collaboration with Cerner Corporation. He serves on the Bear Institute Steering Committee, which determines and approves all strategies, initiatives, resource allocations, proposals, roadmap changes, and innovation team projects. Jacobs is also the executive director of the Center for Pediatric Informatics and oversees the Children’s IQ Network, a pediatric health information exchange in the Washington, D.C. metropolitan region.

With more than 20 years of healthcare experience, Jacobs is an advocate for using IT as a lever to streamline workflows, improve operations, and deliver quality care. He plays a leading role in developing organizational informatics and technology in care delivery, education, and research.

Jacobs works to ensure that the management of Children’s National’s IT systems aligns with its strategic clinical and technology objectives, while allowing its clinicians to remain focused on advancing the health and well-being of children. The Bear Institute has emerged as a model of pediatric excellence by uncovering new ways to deliver improved health outcomes through joint development. It cultivates a foundation of innovation, technological advancement, and quality results.

Jacobs played a key role in leading the Children’s National-Cerner collaboration to accomplish multiple objectives. As of June 2015, these accomplishments include the construction of a state-of-the-art Innovation and Learning Center, collectively saving 1,100 end users 420 hours per day from reduced log-in times, increasing electronic prescriptions by 32 percent, and enabling more than 600 unique users to send more than 4,000 texts and place over 5,000 calls per day via iPhones.

Today, the Bear Institute continues to push boundaries as it designs IT innovations to help improve pediatric outcomes beyond the medical center and into population health and research, and with Jacob’s help it has seen an ambulatory EHR rollout to seven regional outpatient clinics, 17 hospital clinics, and across 52 specialties and subspecialties, as well as advanced analytics and population health registries.

Jacobs has authored numerous journal articles, book chapters, abstracts, and scientific presentations and frequently shares his knowledge and vision in the pediatric space as a guest lecturer at conferences, leadership forums, and hospitals, including the Annual National Patient Safety Foundation Patient Safety Congress, the Pediatric Critical Care Colloquium, and the HIMSS Annual Conference & Virtual Conference.

In addition, Jacobs shares his extensive knowledge and more than 20 years of experience in health IT in a variety of industry leadership roles. He is a fellow of the American Academy of Pediatrics and the American College of Critical Care Medicine. He also is a member of the Society for Pediatric Research, the Association of Medical Directors of Information Services, past Chairman of the HIMSS/ AMDIS Physician Community and member of the HIMSS Board of Directors.

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Bringing Innovation to Radiology

Shannon Werb, CIO, vRad (Virtual Radiologic)

Shannon Werb was selected, in part, because of his effort to develop innovative analytics solutions that help radiology groups and imaging service lines drive more value and innovation in the radically changing healthcare environment. Appointed vRad CIO in September 2013, Werb is responsible for all aspects of vRad’s technology platforms and data assets, as well as overseeing all IT operations. Additionally, he works with hospital and radiology group clients to develop innovative ways to leverage data and technology to improve patient care and operational efficiency in an era of outcome-driven healthcare.

Evidence-based medicine and complete transparency into quality and economic performance will be requirements in the new healthcare environment, and Werb believes radiology must use analytics tools to measure and document its own quality and performance in order to provide value. More importantly, radiology must communicate these insights in order to be seen as a strategic partner that deserves a seat at the table.

Werb has also brokered strategic partnerships with disruptive technology companies in the areas of natural language processing, artificial intelligence, and deep/machine learning to solve well-understood clinical challenges and make vRad’s radiologists more effective as physicians so they provide strategic value to referring physicians who care for patients.

As a recognized healthcare IT authority, advisor, and evangelist, Werb has extensive experience leading organizations and successfully developing innovative enterprise solutions for medical personnel that improve clinical processes and the patient experience. He writes a column for AXIS Imaging News about HIT and imaging analytics and has authored numerous white papers and journal publications on subjects including the value of radiology analytics, vendor-neutral archiving, next-generation PACS, cloud-based solutions, and enterprise content management.

Werb is an accomplished speaker and author and has garnered recognition in numerous global awards, including Frost & Sullivan’s North American Visionary Innovation Award in Medical Imaging Analytics (2014), InformationWeek Elite 100 (2014 and 2015), IHS Research — Independent VNA Market Leader (2012/2013), KLAS — VNA Market Leadership in the United Kingdom (2013), and Frost & Sullivan’s 2011 Product Leadership and 2012 Market Leadership Awards in Enterprise Imaging Informatics (2011/2012).

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Social Media #HITChampion

Dr. Geeta Nayyar, CMO and CIO, Femwell Group Health

Dr. Geeta Nayyar is currently chief medical and innovation officer at Femwell Group Health. Previously, she was AT&T’s first CMIO, where she guided the development of the company’s ForHealthSM program and overall mHealth strategy.

In addition to her work at Femwell, Nayyar is a physician executive, public speaker, author, and social media leader focusing on healthcare innovation, mobility, and cloud health IT solutions. She is committed to improving efficiencies in healthcare enterprises, leveraging the power of health IT and bolstering the reach and effectiveness of health promotion and disease awareness programs.

She has been named one of the “Top 26 smartest people in Health IT” by Becker’s Report, one of the “Top 25 Minority Healthcare Executives” by Modern Healthcare, and one of the “Top 12 Powerful Women Voices in Healthcare Innovation and on Twitter” by MedCityNews. In addition, Nayyar is a prolific blogger and has been asked to share her thoughts with The Washington Post, The Huffington Post, CNN, and ABC News.

Nayyar has made a science of blending healthcare and social media, working hard to amass more than 11,500 Twitter followers. She feels social media is absolutely healthy and necessary for the healthcare conversation and has written, “Doctors, as respected members of society, are also highly revered for their opinions when they are shared socially, which is even more reason to help boost the conversation and meet consumers where they want to share and discuss. Social media is also a vehicle that helps to scale both bad and good healthcare information. Point is: The dialog is happening, and it’s happening in a transparent and dynamic way.”

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An HIT Friend In The Federal Government

Gail Kalbfleisch, Director, Federal Health Architecture, U.S. Department of Health and Human Services

Gail Kalbfleisch joined the Federal Health Architecture (FHA) in February 2014. Since then, she has redefined the vision of FHA to incorporate four key elements that are needed within the federal health IT space: Capture (architect federal HIT), Analyze (identify gaps in HIE approaches in order to guide decision making in programmatic and strategic initiatives and processes, Design (promote, oversee, coach, and pilot potential shared services), and Communicate (facilitate information sharing to convene best approaches).

In addition, Kalbfleisch has worked with FHA’s federal partners to identify priority focus areas that support their agency’s efforts to securely and effectively exchange health information with other exchange partners. She has also reached out beyond the federal community to establish partnerships with the IT industry in order to share lessons learned and best practices from both the public and private sectors — effectively minimizing redundancy in efforts to achieve interoperability and reducing financial risks.

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Advancing HIT In Western Pennsylvania

Dr. Rasu Shrestha, MBA, Chief Innovation Officer, UPMC and Executive VP, UPMC Enterprises

Dr. Rasu Shrestha, in his role as chief innovation officer for UPMC, helps drive innovation strategy with the goal of transforming of the organization into a more patient-focused and economically sustainable system.

His team at the UPMC Technology Development Center works to solve healthcare challenges by leveraging UPMC’s technology expertise in creative ways. Through strategic partnerships, joint development agreements, and investments in start-ups, Shrestha champions the development, implementation, and commercialization of these innovations.

He previously served as vice president of medical information technology and medical director of interoperability and imaging informatics at UPMC. A frequent speaker at national and international healthcare and technology conferences, Shrestha has been recognized by InformationWeek as one of the “Top 20 Health IT Leaders Driving Change” and as a “Top Healthcare Innovator.”

Shrestha spoke at HIMSS15 about semantic data harmonization at UPMC, noting that for the first time in all of medicine, “We’ve harmonized all mappable data codes across healthcare,” an accomplishment that is a foundational component to push true interoperability forward.

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The Healthcare IT Guy

Shahid Shah, CEO, Netspective Communications and Health IT Blogger

Known as “The Healthcare IT Guy” across the Internet, Shahid Shah is a well-known healthcare IT thought leader in and technology strategy consultant to many federal agencies. He is also winner of Federal Computer Week’s “Fed 100” award given to IT experts who have made a big impact in the government.

Shah has designed and built multiple clinical solutions during his almost 20-year career and helped design and deploy the American Red Cross’s EHR across thousands of sites. He’s also built several Web-based EMRs now in use by hundreds of physicians, designed large groupware and collaboration sites in use by thousands, and advanced clinical interfaces for medical devices and hospitals.

Shah runs three blogs, including healthcareguy.com, on which he provides insights on how to apply technology in healthcare.

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Marrying HIT And Informaticists

Doug Fridsma, MD, PHD, President and CEO, American Medical Informatics Association

As president and CEO of American Medical Informatics Association (AMIA), Dr. Doug Fridsma is highly regarded in both the informatics and healthcare communities. This is in large part a result of his role leading AMIA’s 5,000 members to advance research, assess the impact of health innovation, and advance the field of informatics.

Fridsma joined AMIA last November, bringing with him experience in both academic and government settings where he worked tirelessly to advance health IT. Prior to his role with AMIA, Fridsma spent four years in the Office of the National Coordinator (ONC) for Health Information Technology, most recently as its chief science officer.

While with the ONC, Fridsma coordinated health IT investments across the Department of Defense, the Department of Veterans Affairs, and the Social Security Administration by using the Federal Health Architecture (FHA) system. He also created the Standards and Implementation (SI) Framework, a community-driven platform accelerating the development of national, consensus-based standards.

Through the SI Framework he led the development of national standards for electronic patient care summary reports, laboratory reporting, and secure email information exchange. Additionally, Fridsma is credited with accelerating the development and implementation of HIT standards to support MU and establishing a community of more than 3,000 participants interested in solving health IT problems.

Prior to ONC, he was associate professor and director of academic programs at the Department of Biomedical Informatics, Arizona State University/University of Arizona and taught as an adjunct professor, University of Arizona Medical School and had a clinical practice at the Mayo Clinic. Of note, Dr. Fridsma was also an assistant professor, University of Pittsburgh, in the Departments of Medicine and Biomedical Informatics.

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Self-Described Data Geek Serves As Patient Champion

Susannah Fox, CTO, U.S. Department of Health and Human Services

Susannah Fox likes to help people navigate health and technology, a quality that has served her well since being named CTO of the U.S. Department of Health and Human Services in May. Prior to joining HHS, Fox was the entrepreneur in residence at the Robert Wood Johnson Foundation, responsible for providing input into and strategy for the Foundation’s priorities and writing articles and blog posts exploring new ideas in healthcare.

Fox had big shoes to fill in taking over for Bryan Sivak, who retired in April after creating the HHS IDEA Lab, HHS Buyers Club, and the agency’s Innovator-in-Residence and Entrepreneur-in- Residence programs. This didn’t deter Fox, who listed three goals she set for the agency that made her anxious to begin.

The first was to support and expand the “data liberaciÓn” work that Todd Park, the first CTO of HHS, sparked. Second was to nurture the entrepreneurial spirit that Sivak and his IDEA Lab team ignited across all 11 HHS operating divisions. And the third was to shine a spotlight on the role that citizens play in strengthening the health of our country.

These weren’t just idle words for Fox, who put her money where her mouth was and has spent the first five months of her tenure urging those responsible for healthcare innovation to focus on the patient. She has constantly called for providing patients access to their EHR data easily and continues the movement toward giving patients a greater voice in federal policies.

Fox committed to change healthcare’s reality and put patients at the center and has delivered in a big way. She continues her crusade to reduce the burden of healthcare processes, is leading the charge to speed up government procurement processes, and is still one of the biggest champions of open data.

Not happy to rest on her laurels, Fox is building her work at the Pew Research Center on using social media to manage the nation’s health at HHS. She believes that connecting documents via Google combined with connecting people through social media will provide much-needed access to information and, in the process, create the ePatient — a person both empowered and engaged.

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Creating A Culture Of Innovation

Ed Marx, Executive Vice President, The Advisory Board Company and CIO, NYC Health & Hospitals Corporation (HHC)

Ed Marx, a regular blogger for HIStalk, is one of health IT’s leading voices. Marx has been applying his passion for leveraging technology to enhance the patient and provider experience at The Advisory Board Company since being hired there in April. Marx previously served as SVP and CIO of Texas Health Resources in Arlington, one of the largest faith-based, nonprofit healthcare delivery systems in the United States and the largest in North Texas in the number of patients served.

It was at Texas Health Resources that Marx received the 2013 HIMSS Enterprise Davies Award, which recognizes the use of health IT and EHRs to improve healthcare delivery and patient safety and achieve a demonstrated return on investment. He was also the recipient of HIMSS’ 2013 John E. Gall Jr. CIO of the Year Award, which recognizes health IT executives who have made significant contributions to their organizations and demonstrated innovative leadership through effective use of technology.

Marx’s primary focus in his current role is the implementation of the Epic EMR at HHC — the largest implementation of Epic in public health. HHC is an 11-hospital, $7.5-billion health system with many additional outpatient, and the EMR implementation is expected to go live at the first facility in April 2016. This is all part of HHC’s mission of being a world- class institution despite being a public health institution.

The Epic implementation is no small undertaking, but Marx is not one to shy away from daunting tasks, as his record of progressive IT utilization proves. The presenter of the 2013 John E. Gall Jr. CIO of the Year award noted that Marx’s unique leadership style and approach to IT management, combined with his commitment to supporting the value of healthcare IT and promoting its effectiveness as a strategic asset, set him apart from the rest of the field.

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Providing Nurses A Voice In HIT

Elizabeth Casey Halley, RN, Principal, Center for Transforming Health at MITRE

A clinical informaticist with more than 25 years of experience in health IT, Elizabeth Casey Halley, MBA, RN, FHIMSS, is a principal in the Center for Transforming Health (CTH) of the MITRE Corporation, a federally funded research and development center. She is respected throughout the health community for her knowledge of health IT interoperability standards and their potential to improve the delivery of healthcare services.

Her role at CTH requires her to serve as liaison to key stakeholders in the private and public sectors on both customer programs and MITRE-sponsored health-related research. For her efforts, Halley was presented with the MITRE Program Recognition Award of Distinction for enabling healthcare transformation.

Halley plays a key role in numerous national health IT initiatives that impact her community and the country. In addition, she is a member-elect of the Health Information Management Systems Society (HIMSS) Board of Directors, outgoing chair of the HIMSS Nursing Informatics Committee, member of the Technology Informatics Guiding Education Reform Initiative Foundation Board, and member of the INOVA Loudoun Healthcare, Inc. Board of Directors.

Halley currently supports CMS in its efforts to set up a comprehensive, electronic, distributable, and authoritative source for patient assessment data and associated health IT standards. In addition to using standardized data for quality improvement, standardization will enable interoperable EHRs to improve person-centric care and healthcare delivery throughout the care continuum.

She has championed health IT collaboration efforts to develop and adopt health IT information exchange standards across federal agencies and the private sector, including the Consolidated Health Informatics initiative within the Department of Health and Human Services Office of the National Coordinator for Health Information Technology, responsible for establishing consensus standards for exchanging EHR and public health information.

Halley has spoken to national audiences and authored numerous articles on nursing informatics and health IT including “Improving the Past through Standards and Interoperability” and “Nurses Exchanging Information: Advancing a Nurses Understanding of Electronic Health Records (EHR) Standards and Interoperability.” She has represented the Nursing Informatics Community in a variety of health IT forums, including with members of the Congressional Nursing Caucus.