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Health IT
NEWS.Direct!
Global Healthcare IT News, Research and Intelligence

Editorial Advisory Board
Dr Grant Fraser
Chief Medical Officer Medical Wizards Corporation

John Lightfoot
Chief Technology Officer MedVentive Inc.

CONTENTS
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Editorial
Cloud computing: Weathering the healthcare data storm Amoolya Moses

Health IT NEWS.Direct! is a global Healthcare Information Technology (Health IT) journal providing research, news, and business intelligence services. We publish several market research and strategic industry reports with key information for top management and decision makers in the healthcare technology industry. Health IT NEWS.Direct! is used by leading healthcare technology companies, hospitals, insurance companies, and media houses from around the globe.

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Review Article
Redefining healthcare communication on the cloud Damir Ljuboja

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Industry Perspectives
Cloud-based systems: Why they represent the future of patient care Jeff Surges

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Interview
Industry strives for interoperable cloud solution Chris Gough PwC foresees Indian cloud computing market to be $4 billion by 2015 Dr Rana Mehta, Rajesh Ranjan

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Editorial Team
Managing Editor Dr B M John Assistant Editor Amoolya Moses Research Analysts Dr Raghavendra Rao Dr Chinmaya Chigateri Design Veeresh Mathapati Abhilash A

Mini Reviews

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eHealth
eClinicalworks deploys EHR solutions at Ohio Orthopedic Center of Excellence

Partners and Alliances
Agfa and Dell partner to provide medical image management solution on the cloud

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INFORMATION
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Microsoft and GE Healthcare form novel IT company through JV

Products and Solutions
3M releases new ICD-10 financial analysis software and service

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Insights
IDC reports indicate an evolving HIE market Healthcare industry experts suggest strategies to address mobile device security and privacy threats H&HN survey illustrates IT utilization among 2012 ‘Most Wired Hospitals’

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Disclaimer
Views and opinions expressed in this publication are not necessarily those of iLogy. While every effort has been made to ensure accuracy of the information published in this edition, neither iLogy and its employees nor its information vendors accept responsibility for any errors or omissions. Further, iLogy and its information vendors do not take any responsibility for loss or damage incurred or suffered by any reader of this journal as a result of accepting any invitation/ offer published in this edition. iLogy reserves the right to use the information published herein in any manner whatsoever. No part of this publication may be reproduced in any form without the written permission of the publisher.

NEWS
Indian pharma giant, Piramal Healthcare buys USA’s Decision Resources Group Global perspectives on health IT from Harvard Medical School thought leader, Dr Blackford Middleton

July - September 2012

EDITORIAL
Cloud computing: Weathering the healthcare data storm
Amoolya Moses
Assistant Editor, Health IT NEWS.Direct!

In the recent decade, the healthcare industry has witnessed major transformations in its dependence on information technology for achieving efficient workflow, quality care, and efficient use of investments. Observing successes in other industries, healthcare has adopted these IT innovations and applied them to suit its needs. The frenzy to transform paper-based medical data into the more efficient electronic form, and the increased need to document and store data for future analysis has landed the industry with yet another dilemma of having to store and archive the exploding data volume. Innovations around managing large data sets and providing access without limiting it geographically or by devices have been addressed by cloud computing. The on-demand, SaaS offers both tangible and intangible benefits in the form of self-service ordering, large data storage, reduced maintenance, continuity of services in the event of a disaster, archiving, lower capital investment and enabling CIOs to enhance quality care with reduced costs. Taking the benefits of cloud to the next level, many feel that it can be leveraged to tackle Big Data, and in turn convert raw information into actionable data. Keeping alive the concept first visualized by Professor John McCarthy in the form of computer time-sharing during the early 1960s, cloud computing is now considered the next big thing in health information technology. In 2011 KLAS reported mixed responses for the acceptance of cloud technology in healthcare enterprises. Although 71% of providers had implemented or planned to implement the

technology, patient data privacy and control were the two major factors for the surveyed hospitals’ staged and cautious approach to adoption. Analysts GBI Research finds that although cloud technology has reached the healthcare sector, it may just drift over developed economies, with North America, and in specific, the US having the lion’s share. The industry growth has been staked at 20.5% CAGR from 2010 to 2017. Despite global bigwigs like Merge Healthcare, Inc., Carestream Health, Inc. and CareCloud in the US, Agfa Healthcare of Belgium, and UK’s GE Healthcare contributing to this market section, no single vendor holds a share of more than 5%, making it fragmented. However, this sunny forecast can be slowed down by compliance with government policies, security concerns with hosting patient data, and interoperability. This issue of Health IT NEWS.Direct! outlines the various aspects of cloud computing in healthcare. With Damir Ljuboja from The University of Texas, Austin, discussing the hypothesis of the HealthCloud; Jeff Surges, CEO, Merge Healthcare gives us an overview of cloud computing from the perspective of storing and accessing imaging data. The issue also features industry perspectives on the various issues that plague the cloud computing industry in particular to the delivery of care and how these can be addressed. With this comprehensive outlook on the cloud, the team at Health IT NEWS.Direct! hopes that IT directors at healthcare facilities will be able to better manage the internal computing environments, while finding means to monitor and address the drawbacks in order to leverage the benefits of the technology to its optimum.

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REVIEW ARTICLE
Redefining healthcare communication on the cloud
To be a patient in the modern era of healthcare means to be submerged in a vast and expanding body of medical knowledge. Patients seek the expertise of multiple physicians, across specialties and between institutions, to ensure that they receive top-of-the-line care for their ailments. The plethora of medical knowledge easily overwhelms specialists and patients alike. Medical graduates are taught to know more and more about less and less. As a result, communication and understanding can become muffled in a sea of increasingly complex test results and an ever-expanding library of treatment options. With so much focus placed on details, it becomes difficult to visualize the big picture of patient care. Along with this fragmentation in healthcare delivery, barriers in communication, recordkeeping, and patient understanding forestall a unified and effective medical system. Changes driven by technological advancement and growing public sophistication, demand that this problem Damir Ljuboja The University of Texas at Austin Figure 1: Information flow on the cloud be addressed. The answer lies in the cloud.

Cloud computing, at its core, provides a network for shared resources, software, and information that is accessible on demand via the internet (Figure 1). Applied to healthcare on a wide scale, such a system could be the solution to many modern-day problems. While bits and pieces of present issues have been addressed by electronic medical records (EMR) and computerized physician order entry (CPOE), these solutions are local, at best. In a world of increasing specialization and patient privacy, simple communication is a breath of fresh air.

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The HealthCloud hypothesis
The solution I propose integrates key aspects of various international approaches to today’s pressing logistical problems in medical communication and compliance with novel ideas, to improve outcomes (Figure 2). The HealthCloud provides a multifaceted response to the issues of communication and recordkeeping, public access to reliable healthcare information, consulting, patient compliance, and hospital efficiency. Figure 2: HealthCloud physician-patient information exchange

HealthCloud could also provide support for patient selfmanagement of health by allowing them to gain a greater understanding of their ailments. On-demand consultations with an active board of physicians could provide real-time replies to medical enquiries. Chronic disease management programs operated by providers could bring together groups of people with similar conditions to provide support and advice. For the sickest patients, this collaboration can help them stay out of the hospital for longer than ever before. Patients could more readily assume the role of

With the goal of error reduction in mind, HealthCloud seeks to merge EMRs with electronic prescribing interfaces, such as CPOE, across providers (which would also decrease their cost of use). Improved software infrastructure and computerized alerts could prevent patients from receiving medications that may be harmful (due to interactions with other courses of treatment, for example). This could be effectively coupled with computerized decision support to guide clinicians toward safe and cost-effective treatments. An online system to track patients, their medications and treatments, referrals, and laboratory/imaging results would improve the organization of patient data across a fragmented medical landscape. The burden of documenting and submitting data to the online HealthCloud database could be lessened through the use of speech-to-text software. Such a system, if implemented, could improve the fail-safe measures in place on the physician’s side of the patient-doctor relationship and increase the efficiency of team-based medicine.

a principal caregiver and monitor their blood pressure, glucose levels, and other factors that increase the risk of complications. In order to accomplish this, HealthCloud could offer educational tutorials and medical tools that could be ordered and delivered to patients for a fee (e.g. a device to monitor blood pressure that reports directly to the patient’s record on the cloud). Reminders for scheduled appointments, medications, and other interventions could span across personal computers, mobile phones, and tablets. This integrated system of communication could lead to improved collaboration between doctors and patients.

Global communication
In the realm of recordkeeping, global approaches of particular note are the scannable Taiwanese Smart Cards, that contain individual medical histories, as well as the United Kingdom’s electronic medical records system, GP2GP This National Health .

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Service Connecting for Health (NHS CFH) project enables the automatic (but still physical) transfer of individual health records between the approximately 9,000 general practitioner practices in the UK when a patient chooses to switch providers. EMRs that
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Public information flow
The accessibility of accurate information is of concern. Corporate marketing geared at highlighting the advantages of products has measureable impact on the exactitude and quality of medical information available through internet search engines. In order to combat this problem, HealthCloud could feature a consultation interface that links patient computers and mobile phones to a managing team of physicians via a patient portal. This system could allow for the back-and-forth exchange of messages and/ or chat between the two parties in isolation from the external data made available by medical companies (Figure 3). In doing so, accurate information could quickly and readily flow into the hands of the public. HealthCloud’s consultation interface could provide answers to questions or concerns that patients forget to mention during appointments. A 2002 International Health Policy Survey by the Commonwealth Fund has found that 31% of sick adults in the US leave a doctor’s office without getting crucial questions answered and 39% do not abide by the physician’s advice because of this.3 In an earlier study, 51% of patients surveyed thought that their primary care physicians had excellent or very good knowledge about their medical history, and 36% felt that they had excellent or very good knowledge of their biggest worries.4 By linking the inquirers to their electronic medical records, each case could be uniquely considered by the physician team and patients would have a means of filling in the gaps into their understanding.

automatically transfer between systems across the internet are a rarity. In 2008, just 20% of clinicians in the United States were using EMRs and few of these recordkeeping systems were able to directly communicate with each other, even within the same hospital system. Just 4% of doctors were using state-of-the-art, fully functional EMR systems.
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HealthCloud consolidates all these approaches in order to maximize efficiency. The proposed system calls for encrypted, standardized patient records to be kept on hospital, insurer, private provider, or government servers, which can be accessible via the internet when needed by physicians or the patient. If implemented on national or global levels, this could greatly improve communication between providers from different specialties, institutions, or even nations and lead to a reduction in redundant and repetitious testing. This system would be disaster-proof because of online access and information back-up on redundant servers. Natural disasters that level cities such as the 2005 Katrina hurricane in New Orleans or the 2004 Indian Ocean Tsunami would not destroy medical histories and cause a disruption in care. Residents who endure these catastrophes could travel to neighboring cities or countries and find their medical histories readily accessible. Figure 3: HealthCloud public access model

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Virtual primary care consultation
Additionally, the HealthCloud could act as a facilitating tool in family medicine. By integrating an online system that considers symptoms in a similar fashion as the WebMD interface, the cloud could generate possible diagnoses and, moving one step further, refer the user to a local specialist (with patient consent). This would also allow for the identification of high-risk groups of chronic or infectious diseases and facilitate appropriate responses by health organizations. Outbreaks could be identified more easily and accurately than ever before. In order to make this system more financially feasible, computerized algorithms could be employed on the cloud, which consider symptom input to generate potential courses of action. Common questions could be grouped together in order to minimize the workload undertaken by the managing body of physicians.

were available to primary care physicians just 51%-77% of the time four weeks after a discharge, because of which the quality of care was compromised in about 25% of follow-up visits.7 On the part of the consumer, the subjectivity of symptoms input remains the biggest concern. Many patients tend to downplay the significance of the pain they are experiencing, while others in the same circumstances amplify it. This could skew the diagnoses made by the virtual physician team and impact prescribed courses of action. A possible way of combating this would be to use the online system as a way of merely categorizing the types of health complaints users submit before referring them to a primary care physician. In this way, the online team would act as an initial evaluation checkpoint whose conclusions are forwarded to a local physician.

Increased patient compliance
As suggested in Figure 2, the dissemination of dosage information and medication reminders to patients’ mobile devices and computers would increase the likelihood of compliance. Many patients tend to cease a course of treatment as soon as they begin to feel better. This is known to result in multidrug resistant organisms and contributes to the prevalence of disorders that are difficult to manage, including certain sexually transmitted diseases and multi-drug-resistant tuberculosis. This aspect of the HealthCloud could also automatically suggest cross-conditional treatment that providers may overlook, such as eye exams for diabetes patients, by identifying target groups based on their medications and previous appointments.

Security
HealthCloud, like any online system, is not without its share of security concerns. Issues of identity management, physical accessibility of data servers, availability of access to the network, and patient privacy are of significant importance. Commercial companies developing medical record services assure the public that their data will be stored in encrypted databases with privacy measures entirely in the control of the individual. The same concept applies to HealthCloud. Patients in the system will be indentified by an assigned numerical code, and to ensure the strictest confidentiality, the code will only be made obtainable to the individual. Access to the cloud will be freely available to anyone with an email address and approved numerical code. Thus, any type of internet access confers theoretical access to HealthCloud. Those who live without internet could reach the cloud at their doctors’ offices, internet cafes, or in public libraries. Access control will entail the input of several personal identifiers, including name, date of birth, and a government-assigned code, such as social security number, in combination with a selfassignment pin and password to enter the cloud. The patient will not be referred to by name in any of the online records and no identity-compromising information shall be placed on the servers. As a back-up, records identifying which numerical code belongs to a particular user shall exist on private servers in the HealthCloud infrastructure. These servers will not be connected to the internet and are a precautionary measure in case users lose their numerical identifiers. Documented access to these private files shall only be granted to a limited number of employees with high-level clearance. Thus, the system shall avoid using federated identity management and will instead rely on single sign on through patient portals.

Improved provider efficiency
Provider efficiency is another area of medicine that HealthCloud is designed to improve. CPOE systems alone have been noted to reduce serious medication-related errors by 55%.5 Improvements in decision support software led to an 83% reduction in the overall rate for medication errors.6 HealthCloud’s integration of these two systems (as depicted in Figure 1), along with a prescription fail-safe algorithm, allows for their combined efforts in the prevention of medication errors. This online system could reference patient EMRs on the cloud when doctors attempt to prescribe new medicines and verify the compatibility of the drug in question with the patient’s current ailments, particularly those outside of the provider’s specialty, and medications. In addition to order entry support, the HealthCloud is designed to increase the availability of patient discharge summaries by linking them to the individual’s EMR. A 2007 study found that summaries

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Fraud is another user concern, but could be avoided by requiring an email and verifiable form of government identification (depending on country of residence) upon user sign-up.

be prepared for unexpected spikes in demand or other sudden increases in bandwidth requirements.

Scalability
The goals of HealthCloud are rooted in granting equal access to a wide user pool. In order to accomplish this, the system’s functionality must be made plausible on a grand level. Vertical expansion through the addition of hard drives, servers, and central processing units will enable the cloud to accommodate an increasing number of virtual machines by adding resources within the same logical unit to increase capacity. Horizontally, the addition of clustering solutions and access points, in combination with multiple load balancers (server farms), will design the system in such a way as to handle and distribute heavy traffic, optimally. To prevent possible complications, software clutter will be kept at a minimum and an appropriate amount of caching will be maintained. This will allow for the maximum scalability factor and therefore lead to improved performance. Although the process for scaling up is dynamic, the aforementioned approach will allow for maximum theoretical growth under ideal conditions.

Conclusion
Health information technology stands at the precipice of change. The demands of an international public on an increasingly isolated body of physicians, stress the fabric of medical care. The solution lies in organization and communication. The HealthCloud, albeit not infallible, proposes a novel paradigm of healthcare delivery on the cloud. References
01. GP2GP: why it’s needed. NHS Connecting for Health. http://www. connectingforhealth.nhs.uk/systemsandservices/gpsupport/gp2gp/ needed/index_html?url=http://www.connectingforhealth.nhs.uk/ programmes/gp2gp/. Last accessed August 31, 2012. 02. DesRoches CM, Campbell EM, Rao SR, et al. (2008). Electronic Health Records in Ambulatory Care - A National Survey of Physicians. N Engl J Med. 359(1):50-60. 03. Blendon RJ, Schoen C, DesRoches C, Osborn R, Zapert K. Common concerns amid diverse systems: health care experiences in five countries. Health Aff (Millwood). 2003;22(3):106-121. 04. Lee TH, Mongan JJ. Chaos. In: Chaos and Organization in Health Care. Cambridge, MA: MIT Press; 2009:18. 05. Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280(15):1311-6. 06. Bates DW, Miller EB, Cullen DJ, et al. Patient Risk Factors for Adverse Drug Events in Hospitalized Patients. Arch Intern Med.1999;159(21):25532560. 07. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P Baker DW. , Deficits in communication and information transfer between hospitalbased and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007 Feb 28;297(8):831-41.

Sustainability
In order to be permanent, a system must promise longevity. HealthCloud maintains its functional integrity through the incorporation of weekly data save points. This ensures that patient records are constantly backed-up in case of emergency failure or an infrastructural breach. Redundant servers aid in this effort by assuming control of the cloud during primary server(s) failures. Often, primary and secondary servers are both functional and share duties to increase overall throughput. In the event that one fails, the redundant assumes full command until the primary is repaired and brought back online. In this way, HealthCloud would

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INDUSTRY PERSPECTIVES
Cloud-based systems: Why they represent the future of patient care
I’ve been in the healthcare IT industry for more than 20 years. During that time, I’ve seen my share of trends, fads, buzzwords and hot topics, but if I had to pick the one trend I think will change the way healthcare providers do business and share information, I would absolutely pick the cloud. Cloud-based systems can do more than just give providers the ability to store and share data more easily. It can give the entire healthcare community (including patients) the power to communicate more freely and actually talk to each other as never before. This article will explain why I feel that way. Imaging has always appealed to me. In my opinion, it’s the most important part of an electronic health record. When a patient goes to the doctor, the first thing he or she asks is, “Where’s your X-ray?” However, the average file size of your basic medical image is about 5 gigabytes (GB). In healthcare, that is an extremely large file. You can’t e-mail that as an Jeff Surges CEO Merge Healthcare attachment, and storage of such files requires staggering amounts of server space that need to be updated constantly. However, you or I can easily download approximately the same size of the file every day on YouTube or Netflix. That’s what we do. In fact, I like to say that Merge Healthcare is the YouTube or Netflix of healthcare. In 1999 I co-founded a company called Extended Care Information Network (ECIN). At that time we did not use the term cloud, but we knew that we needed to help our customers discharge planning in a more cost effective way that made it easier to share information. At that time we touted the benefits of SaaS, but many of the basic principles and benefits of today’s cloud-based solutions remain the same – and more than ever, they represent the future.

The issues: Where to house all the data – and who manages it all?
Every year, countless dollars and hours are spent archiving diagnostic images. A single image can need as much as two gigabytes or more for storage, with regulations requiring these image data to be stored for years. Traditional methods of image and data archiving are now giving way to an exciting new advance in healthcare technology: cloud-based image storage and sharing, which has been proven to help healthcare stakeholders collaborate, improve the delivery of care, and reduce its cost. Without the accessibility and scalability of the cloud, C-suite executives face the unenviable task of managing terabytes or even petabytes of imaging data, which can mean real inefficiencies that have proven to escalate IT costs. A cloud-based solution can help providers create a complete patient record that can eliminate inefficiencies, such as patient-borne CDs and duplicate scans that expose patients to radiation, and enable faster collaboration. This new efficiency is catching on quickly with a variety of users across the nation. By 2015, it is expected that cloud storage will account for more than 35% of the six petabytes of new studies annually captured in vendor neutral archives (VNAs). Along with images, providers continue to bring in more corresponding studies, which then grow in size once they are stored, as they are updated and modified. In addition,

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these studies and images need be managed and organized. As data warehouses grow and grow, additional staffing and training within hospitals and health networks are required, just to keep track of everything and problem-solve. This type of training is not a one-time expense, but rather an ongoing cost to stay on top of system updates. Hardware must be purchased and maintained. Continued investment is needed for basics such as memory, speed and updated operating systems, to name but a few. Finally, healthcare data may be managed on private networks that are often times inaccessible from other platforms. Then, there are basic housekeeping issues, such as reports and worksheets, which have to be filled out manually for each patient. In many settings, a provider has to make the effort to match up a specific report with a specific image on CD, or even video cassette. The paperwork can pile up fast. A provider may have his or her own style for dictating reports, so uniformity can also become a real issue. Finally, the increasing amount of paper archives in addition to data warehousing can create storage and management problems. The likelihood of misfiled or misplaced reports can grow, which may require further staff to manage and organize the growing reams of paper.

leave his or her office, walk or drive over to the lab or office where the image is located, and view it there. In all these cases, time to treatment is delayed significantly.

Duplicate scans
Finally, duplicative scans and tests are an increasing cost issue. Annual healthcare costs of as much as $100 billion have been attributed to diagnostic imaging tests. Of these, an estimated 35% are of duplicates. This is the equivalent of $35 billion in unnecessary costs. Time and money can be spent just on locating a crucial image, as opposed to simply going to a cloud-based solution where images are stored securely and in one place. For example, a patient may go in for a procedure and need imaging work done. A radiologist, instead of being able to access a single HIE for this patient’s complete set of images, may be forced instead to play detective and hunt down these images, which may be stored in a variety of different formats in several different places. It’s easier just to order a new scan, but this is exactly how costs absolutely add up over time. In fact, it is estimated that a single-clinician practice spends, on

Through our daily dealings with providers and other customers, it has become clear to us that the current system is becoming more and more unwieldy and does not serve the best interest of patients. Just the cost of servers to house all these data can easily balloon to an unsustainable level.

average, about $17,000 a year associated with traditional methods of exchanging patients’ health information.

The cloud: A game-changer
In a cloud-based storage system, images are securely stored in multiple locations. They are accessible anytime and anywhere, via a standard web-based browser. As health systems’ storage needs grow, providers and managers can simply add capacity to the cloud as opposed to adding onsite storage hardware, management, and bandwidth. That way, managers are only paying for the capacity they actually need. In a cloud-based infrastructure, images and data remain secure and meet all regulatory requirements. Furthermore, physicians and specialists can also share images worldwide through the cloud, and in many cases, such a service is free. Image sharing offers an easy-to-use and efficient means of quick image sharing, which result in faster diagnoses and treatment for patients. Efficiencies are greatly increased.

Image sharing
The simple task of image sharing in a timely manner has become a real issue of cost and efficiencies within healthcare delivery. The most glaring example is the CD. Even in today’s technologically advanced world, patients continue to bring any vital images corresponding with their care to the hospital on a CD, which may cause frustration among in-house specialists and referring physicians if they are ever lost or damaged while being transported from one place to another. There are times when a CD is unreadable, which may cause a delay in care. In many cases, providers and specialists still rely on the video cassette and corresponding players to view critical images. A provider may be unable to share an image quickly with a colleague or specialist due to incompatible viewing systems, resulting in a loss of efficiencies. If several providers need to view the same image and exchange critical information relating to care for that patient, such a process can take days or even weeks, because they are unable to view images simultaneously from different locations. They cannot share images over a mobile device. If a provider needs to view an image, and that image is only stored on a CD in a single place, then he or she needs to physically

Examples of efficiency
A cloud-based system can also marry reports to images and keep them all in one place, which can solve many filing and storage issues. Once these images are on the cloud, it can be viewed by everyone and does not necessitate the need to burn them on a CD. This would be important if a patient changes his or her physician. When a patient goes to a provider for follow-up, he or she can pull out these images quickly, instead of having to rely on

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memory or ordering a duplicate scan. All these time efficiencies definitely lead to better patient care, as they decrease the time patients need to spend in the hospital. Emergency rooms and trauma centers can also potentially benefit. Doctors can receive and review images from trauma centers in outlying areas long before patients who have suffered an accident arrive, providing extra time to process, prepare a diagnosis, and get ready to treat. Also, the burdensome process of transferring and importing a CD with an incoming trauma patient can now become a thing of the past. Unnecessary steps are eliminated in the process, such as duplicative scans. More educated decisions on whether a patient transfer is necessary can be made, because physicians are able to view the patients’ images ahead of time to determine if he or she is not in a critical enough state for the transfer to be necessary. Emergency room doctors like such a system because it helps them better manage patient flow, and the staff greatly appreciates the cloud’s ability to help them make decisions more quickly. Switching to cloud-based systems also creates greater staffing efficiencies, through improved flexibility in how hospitals staff their services. IT specialists would no longer be needed to help with the uploading, reading (and in some cases, locating) of CDs. Through cloud-based solutions, costs in that area can be reduced and resources diverted to more value-added IT projects. Finally, hospitals can save money on the number of contracts needed for maintenance and archiving. These are hard costs that managers can realize right away just from switching to the cloud.

Issues of security
When considering whether to implement cloud-based storage and image sharing, hospital and health network executives need to make sure such an infrastructure is absolutely 100% secure. It’s a noteworthy issue. Recent surveys have shown that 91% of physicians feel open-access systems designed for sharing medical images can be beneficial to patients; however, 70% are worried about the security aspect. When selecting a cloud storage system, decision makers should choose a system that features the following, so that the security of images, and corresponding studies and reports are paramount: • Extensive experience with applications, healthcare providers, and patients • Physical and application security policies

• Compliance with HITECH, HIPAA, and other federal • Highly available and technically innovative datacenter environment • Datacenters distributed geographically to ensure disaster recovery following a major event • Presence of a technical network operating center and full-time year-round staff for managing any data loss or crises

The benefits of cloud-based solutions continue to evolve, allowing hospitals and health networks to remain responsive to change across the healthcare continuum, which can undoubtedly lead to greater efficiencies, reduced costs, and ultimately better patient outcomes. Better patient outcomes are why I got into the healthcare industry in the first place.

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INTERVIEW
Industry strives for interoperable cloud solution
Q: We have observed that the adoption of cloud computing among healthcare providers has increased. In your opinion, are there processes or technologies that healthcare organizations still use off the cloud that you think should migrate into the cloud? A: Today, many organizations are struggling with the exponential growth of the data that they need to store, secure, and maintain. The situation is a bit more dire in healthcare than in other industries due to data retention requirements. Depending on who you ask, data storage requirements in healthcare are doubling every 12-24 months, with medical imaging as the largest contributor to this trend. For some organizations, more than 50% of overall storage capacity is dedicated to medical imaging. Chris Gough Lead Healthcare, Cloud Computing Architect, Intel This application domain is ripe for migration to the cloud. We are starting to see the beginnings of this with cloud-based vendor neutral archives (VNA), where image archives can be hosted on the cloud, abstracting away the specifics of a given vendor’s PACS solution. This can provide a healthcare organization with greater flexibility to switch PACS vendors as solution offerings and business needs change over time. Perhaps most importantly, scaling the infrastructure to support the ever growing set of data is accommodated by the cloud platform; which was designed and optimized for scale from the beginning. Q: Can you please provide an example as to how cloud computing has made a significant impact in a healthcare organization? A: South Florida Medicine is a multi-specialty practice that was experiencing several challenges related to the rapid growth of their business. They decided to centralize their practice management platform across their multiple locations using a software-as-a-service (SaaS) solution offered by CareCloud. This decision resulted in significant positive impact for their organization: • It is now easier for them to scale/grow because they no longer need to manage the hardware and software associated with their practice management solution. simply given access to the centralized, cloud-based solution. • As new practices are added to the organization, they can be integrated very quickly; • South Florida Medicine can leverage expertise of external organizations. For example, to take advantage of cutting-edge security capabilities and best practices that allow them to better keep sensitive information secure and satisfy regulatory requirements. Together, these benefits can enable healthcare organizations like South Florida Medicine to focus on improving patient care, or growth rather than on ’keeping the lights on.’ Q: In the healthcare industry, which is the most preferred service model that vendors adopt: software-as-service, platform-as-service, or infrastructure-asservice models? A: Software-as-service (SaaS) is by far the most heavily adopted cloud service model in the healthcare industry, and I expect this will continue to be the case for the foreseeable future. Infrastructure-as-a-service (IaaS) is getting some traction in large healthcare

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INTERVIEW

enterprise organizations that are building private clouds. This is an evolutionary step that enables these organizations to realize some of the benefits of cloud while still getting good return on existing datacenter investments. Both platform-as-a-service (PaaS) and IaaS are compelling service models for healthcare organizations that have software development operations. Large enterprise organizations are taking a pragmatic, phased approach to cloud adoption with ’Test & Dev’ as the typical phase-1 environment that uses IaaS or PaaS in a multi-phase cloud adoption strategy. I should mention, however, that the life sciences industry is an early adopter of IaaS, and uses this service model quite extensively for research and development. This is due to the fact that this industry is not as heavily regulated as the payer/provider space and because typical applications/workloads lend themselves very well to the ’pay-as-you-go’ model offered by large public cloud providers.

both inside and outside of healthcare. Intel has a long history of promoting and creating open, interoperable, standards-based solutions, and I believe this will be required to maximize the longterm, sustained success of cloud computing. In order to help make this vision a reality, Intel works very closely with an organization called the Open Data Center Alliance (ODCA), serving as the technical advisor. This organization comprises more than 300 enterprise organizations around the world that are dedicated to speeding up the migration to cloud computing. The ODCA identifies key enterprise use cases and requirements for cloud, and works with the vendor community to ensure that emerging solutions address these requirements. In addition, the ODCA collaborates closely with industry standards bodies to make sure that these use cases and requirements can be addressed in an open, interoperable, standards-based manner. Q: Please add a note on the estimated market scenario

Q: What are the newer trends that we could be witnessing with respect to cloud computing in healthcare? A: Today, the largest obstacle to cloud adoption in healthcare is security and privacy. This is due, in part, to the highly regulated nature of the industry. Intel is working very diligently with McAfee and a host of other partners to ensure that cloud environments are just as secure as their in-house enterprise IT counterparts. Over the next several years, you will see security come to be viewed as a significant benefit of adopting cloud solutions rather than a barrier to entry. Even today, for many healthcare organizations (especially organizations that lack a large, dedicated IT staff), there are many security benefits that can be realized by moving to a well-managed cloud environment. Q: We are again in a situation where we observe a large number of distributed and competing cloud platforms that organizations are using. This situation, similar to those faced in legacy, in-house systems has the same challenge of limited interoperability among them. How do you think we will be resolving this challenge in the future? A: Yes, we are seeing vendor lock-in reemerge as a top IT concern with the emergence of cloud. In order to solve this problem, what is needed is a set of open, interoperable standards that can support the key use cases and requirements of enterprise IT departments,

expected in 2020 for cloud computing in the healthcare domain. A: We are already seeing a ’cloud first’ approach for smaller companies and start-ups that don’t see a value proposition in building their own datacenter from the ground up. In this timeframe, healthcare enterprise organizations will be taking the same approach. Hosting and maintaining applications on-premises will start to become the exception rather than the rule. As open, interoperable cloud solutions emerge, there will be many key benefits for healthcare organizations: • Lower cost • Ability to select best in class solution components from multiple vendors • Less complex and more feature rich-solutions for high datacenters and geographic regions However, the highly-distributed nature of future cloud solutions will also introduce some new challenges. For example, I suspect that data sovereignty issues associated with cross-border flow of sensitive information will come to the fore. As a result, there will be an increasing need for solutions that can restrict data and application execution to approved geographic regions to ensure patient privacy and regulatory compliance.

availability and disaster recovery, spanning multiple

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PwC foresees Indian cloud computing market to be $4 billion by 2015
Q: The benefits of cloud computing is being propagated across the industry. What are the factors that a healthcare organization needs to keep in mind before adoption? A: It’s very important for the healthcare fraternity to know what the function of IT is in healthcare: cutting cost or providing better value to the business. This will determine what types of applications need to be moved to cloud, what type of SLAs to be ensured, and what type of security mechanism to be kept in place. Patient data privacy would be critical for hospitals planning to get on cloud. Then there is data integration, where there is a definite need to create a strategy for syncing the data, i.e., data residing in various clouds need to be integrated with the data in the company. Dr Rana Mehta Leader Healthcare PwC India A: The use of the cloud technology brings with it several benefits and these are same for cloud adoption across the healthcare sector as well. These are driving the uptake of cloud in the healthcare sector: • For a large unorganized sector, with small hospitals for whom it is not viable to install in-house hardware and software, cloud solutions are very cost effective. can be taken care of automatically by cloud technology. is easier with cloud. • It is difficult to find qualified staff for maintenance and up-gradation of IT systems which • It is useful in increasing a number of multi-location chain of hospitals because scalability • It facilitates reduced capex on building ones own IT assets, as IT cost is managed as operational cost on ‘pay per use’ basis. • It helps remove cost and complexities of managing sophisticated IT infrastructure in-house, which requires huge capital cost to plan for the peak capacity and skilled manpower to maintain it. Q: Could cloud be the answer to Big Data in healthcare? Do you feel the two can be incorporated for an advantage? A: Definitely! This is a trend to keep a watch on, as cloud-based analytics is already in the market. However Big Data is more core to business than IT, and integrating it with cloud will be a big leap. Q: Data security, interoperability, and regulatory compliance have been identified as the road bumps to widespread adoption of cloud in healthcare. How can a healthcare organization overcome these issues with the use of cloud? A: The regulatory need of privacy and security of the patient record should be a key concern before adopting cloud services. However this can be tackled through proper need assessment and transition planning that will help the healthcare organizations to take the right decisions. Rajesh Ranjan Leader Emerging Technologies PwC India Q: What are the drivers for the adoption of cloud technology in healthcare?

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INTERVIEW

Cloud interoperability standards are evolving by consortiums of standards and definitions. Currently there is a lack of cloud interoperability standards understanding between the cloud providers and platform. However, since healthcare has established standards of HL7 and DICOM protocols, this will continue to be a functional protocol residing on top of the cloud platform. Q: Will there come a time when cloud technology will be advocated by the government for implementation? A: Definitely yes! This is a great opportunity for state governments to extend the reach and provide better heath-related services. Cloud can be used to implement HIS, which will uniquely identify a patient and store its health records across all government hospitals in any state. Our firm is already advising some of the state governments on this. Q: Who are the major cloud players? What are the key differentiators? A: There are big MNCs like Google, Amazon, Microsoft as well as Indian names like Tata, Reliance who provide cloud-based

services. Most of their offerings are similar in nature; however, they can be differentiated on the basis of offerings for large and small enterprises and some also specialize in specific industry domains. Q: What stake does the Indian market have in cloud computing? A: The Indian cloud computing market is currently at 900 million USD and is projected to grow up to 4 billion USD by 2015. The growth potential in the areas such as IaaS and SaaS are huge and the Indian SMBs including healthcare players are poised to move directly to the cloud to reduce cost on infrastructure and manpower to manage applications in-house. Q: What is the future for cloud technology in healthcare? A: The future of cloud will be about integrating patient information across the healthcare providers and payers, and adopting CRM and analytics services on cloud. It will also have great potential for government adoption so as to meet the goal of ‘healthcare for all’.

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eHEALTH
eClinicalworks deploys EHR solutions at Ohio Orthopedic Center of Excellence
In an attempt to increase the efficiency and reduce the time lag in delivering services, Ohio Orthopedic Center of Excellence has chosen eClinicalWorks, an ambulatory clinical solution provider, for its electronic health record (EHR) solution to be used by 59 providers, located at various regions. Established in 1965, Upper Arlington, Ohio-based Ohio Orthopedic Center of Excellence offers an array of services such as spine surgery, total joint replacement, hand surgery, ambulatory surgery, sports medicine, and digital imaging. The Center zeroed in on eClinicalWorks for an EHR system in view of the company’s ability to facilitate the provider in complying with the ‘meaningful use’ criteria, aid in R&D, and streamline reporting by using a fully integrated platform. Customized for over 50 specialties and sub-specialties, the EMR will be licensed by the orthopedic center for the following components: • Unified EMR/PM: Embedded with quality measure and registry reporting, and e-prescribing, it enables physicians to seamlessly communicate with peers, access patient-related information, and also qualify for ‘meaningful use’ incentives. Integrated with a practice management (PM) system, it aids in achieving optimized workflow from the time of patient admission until billing. • eClinicalWorks Patient Portal: Allows patients and physicians to exchange various information such as lab reports, reminders, educational material, medical history, appointment schedules, paying bills, refill prescriptions via a secure network, anytime, and anywhere. • eClinicalMessenger®: Uses voice-over-internet protocol (VoIP) technology to promote the sharing of data between provider and patient via voice messages and SMS texts. • Enterprise Business Optimizer (eBO ): A financial and
®

correctional health centers, regional extension centers, and the U.S. Department of Health (DoD). The vendor’s solutions are certified by the Certification Commission for Health Information Technology (CCHIT) Office of the National Coordinator – Authorized Testing and Certification Body (ONC-ATCB; 2011-12), and Child Health (2008 and 2011-12). Reporting revenues of over $200 million for 2011, the company has been featured in Inc. 5000 list of the fastest-growing companies by revenue, and in the 2011 vendor assessment report on US ambulatory EMR/EHR for midsize and large practices by International Data Corporation (IDC), a market research company. Significantly driven by the meaningful use incentives, researchers from Harvard and the University of California at San Francisco (UCSF) have noted that despite the increased rate of EHR use (90% and 71%), functionalities to achieve meaningful use have been utilized to a minimum (2% and 30%, respectively). Also reporting increased acceptance, athenahealth’s recently released annual Physician Sentiment Index (PSI) findings differ on the benefits provided by EHRs. From 2011 to 2012, the survey found that the number of respondents relating the electronic record to better care delivery not only dropped, but a greater association was made to the worsening of patient care. Apart from this, a majority of physicians (44%) felt that EHRs were built not keeping the physician in mind, and achieving meaningful use is a burden (75%). For physicians who choose to differ, as of April 2012, CMS has paid more than $5 billion in incentives to 94,097 providers, and there are currently more than 132,000 primary care providers working towards achieving meaningful use. Frost & Sullivan, in a 2011 report, has predicted the US market to shoot up to $6.5 billion in 2012, a steep increase from $973.2 million of 2009. Furthermore, anticipating a $8.3 billion US market share by 2016, Millennium Research Group has reported over 750 companies that have entered into the market space in a matter of two years, offering solutions that have some form of EMR features. In addition, an estimated average 12% per annum rate in growth through 2016 has questioned the long-term viability of these products in the market. Also suggesting increased market saturation in the near future, Frost analysts opine that vendor displacements will become a natural effect of changes in provider management and ownership.

clinical analytics tool.

The solution’s suite also includes eClinicalWorks Electronic Health eXchange (eEHX), eClinicalWorks P2P, and eClinicalMobile .
®

Headquartered at Westborough, MA and operating at New York City, Pleasanton, Chicago, and Alpharetta, eClinicalWorks caters to more than 370,000 medical professionals, 180,000 providers, in physician groups, health centers, hospitals and communities,

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PARTNERS AND ALLIANCES
Agfa and Dell partner to provide medical image management solution on the cloud
Round Rock, TX’s Dell will provide its cloud platform to host its clinical archive portfolio and Greenville, SC-based Agfa HealthCare’s Imaging Clinical Information System (ICIS). This partnership has been inked in an attempt to enable offsite expansion, facilitating access to archived information, and provide comprehensive electronic medical records (EMR) that supports the management of images. Agfa, a part of Agfa-Gevaert Group, among its many deliverables, focuses on including medical images into EMRs, in accordance with an imaging strategy that outlines both the clinical role of better health outcomes, as well as the business role of streamlining operations and facilitating insurance reimbursements. Its suite of solutions under this vertical, which are included in the current collaboration, include ICIS, a workflow-centric clinical platform that enables a longitudinal imaging record, IMPAX Data Center, a scalable enterprise-wide or regional imaging management solution, and XERO Technology Viewer, a web 2.0-based platform that enables real-time image access. Although ICIS was already accessible on private clouds at client data centers, its current availability as a completely managed service on the cloud, extends the choices of clinical information system for providers, simplifies image viewing, management, and archiving, facilitating the establishment of an image-enabled EMR. According to the agreement, Agfa HealthCare’s US clients can also access Dell Cloud Clinical Archive, a solution to retrieve archived information at times of system downtime or natural calamity, and Dell Cloud Clinical Recovery, which acts as a secondary archive to an existing onsite archive, allowing disaster recovery and business continuity. Healthcare data constitutes 30% of the global data, according to a 2008 survey by Ponemon Institute, an education and research organization. More recently, BridgeHead Software, a provider of healthcare data storage management solutions, found that 63% of the surveyed providers attributed this increasing volume of healthcare data primarily to imaging information. In order to address this, healthcare organizations are deploying disaster recovery and data archival tools for effective information management. Disaster recovery has also been mandated by Health Insurance Portability and Accountability Act (HIPAA) Security. A data management survey by BridgeHead has found disaster recovery as a top area of interest for healthcare IT investments, with 55% planning to have it as one of their top 3 investment areas. In support of data management, the industry has taken to cloud computing technology, which offers healthcare organizations a centralized means to store, exchange and retrieve medical images, while enabling archiving and disaster recovery. Apart from Agfa, Dell has inked similar deals with Siemens Healthcare, and NextGen Healthcare and Puerto Rico Hospital Supply, enabling the presence of healthcare solutions on the cloud. Dell, through its cloud-hosted clinical archives, supports data in more than 800 clinics, 5 billion diagnostic imaging objects, and over 72 million clinical studies. The cloud-based portfolio, by simplifying image archival and management, allows healthcare providers to focus their investments on supporting care, strategic services, and technology development, and its cost predictability helps increase return on investment.

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Microsoft and GE Healthcare form novel IT company through JV
The shift from sporadic individual patient care to continuous population management has given rise to the need for greater insight into care delivery, integrated care processes, and the engaging of patient experiences. These in turn mandate a transition towards new payment models that require the providers to connect disparate silos of care and integrate data. In an attempt to address this need, IT giants GE Healthcare and Microsoft Corporation have entered into a 50-50 joint venture to form a new company called Caradigm™, which is aimed at providing the healthcare fraternity with real-time intelligence that it can use to enhance the quality of healthcare rendered and patient experience. The idea which was incepted in December 2011, has now reached completion following the establishment of a firm set of goals, and steered by a strong leadership team to enable the company to achieve its outcomes. The leadership team for the new company has been established by constituting a team of executives from GE Healthcare, Microsoft, Care Innovations (an Intel and GE company), and Philips Healthcare. Michael Simpson is spearheading the new establishment as CEO, Neal Singh as CTO, Lauren Salata as CFO, and Michael Willingham as regulatory affairs and quality assurance executive. Obtaining regulatory approvals from the initial list of countries, the company is located at City Center Bellevue, Bellevue, WA, and operates from Andover, MA; Salt Lake City, UT; Chevy Chase, MD; with centers across the globe as well. Through this new venture, Caradigm intends on developing and marketing collaborative clinical applications and an open, interoperable healthcare intelligence platform, which aims to improve population health management systems, thereby reducing costs and enhancing outcomes of care delivery. The new company will serve as a platform for software vendors to develop customized and demand-driven solutions for the industry, and leverage and connect these applications to Microsoft HealthVault, which will remain with Microsoft as a cloud-based service. Caradigm will also host collaborative clinical applications directed towards achieving the long-term goal of developing a healthcare performance management suite aimed at better population health management. Backed by a common vision of a connected, patient-centered health system, the parent companies bring to the table complementary expertise: For Microsoft, many analysts consider this move as an exit from the clinical market, except for HealthVault, with the previous sell-off of its Amalga HIS to Orion Health in 2011. This is augmented by the conditions in this JV, wherein Microsoft contributes through its intellectual property, and the rest of the business is handled by GE. Although, Microsoft has held onto to HealthVault in this JV, analysts, Chilmark Research, wait to see whether it can be converted into revenue generating sustainable business for the company, or ends like the recently closed Google Health. In support of GE chairman and CEO, Jeffrey R Immelt’s belief in the potential of the combination of leading companies with complementary capabilities to meet a common vision, GE Healthcare embarked on a previous JV with Intel Corporation for the establishment of Care Innovations LLC. The combining of Intel’s Digital Health Group and GE Healthcare’s Home Health business, Care Innovations was incepted in January 2011 to cater to home health monitoring and the telehealth sector. Through this collaborative effort, GE Healthcare and Microsoft hope to address pressing concerns of the healthcare sector, such as healthcare-associated infections and chronic disease management, and global challenges to quality care, including access to patient-critical information and healthcare costs. This, they plan to achieve by focusing on interoperability of health systems, accountability and performance of healthcare delivery systems at all levels of care and in every country. • Microsoft’s know-how in creating ecosystems and platforms, and solutions including software » Microsoft Amalga: health intelligence platform for the enterprise » Microsoft expreSSO: single sign-on solution for the enterprise • GE Healthcare, its experience in administrative and clinical workflow solutions including information exchange » Qualibria Quality Management Solution: clinical decision support application » GE Healthcare eHealth Information Exchange: health » Microsoft Vergence: single sign-on, context management

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PRODUCTS AND SOLUTIONS
3M releases new ICD-10 financial analysis software and service
3M Health Information Systems, a provider of health IT solutions and services, has announced the inclusion of an analysis tool and consulting services into its International Classification of Diseases – Revision 10 (ICD-10) transition planning solutions suite. This has been designed to assist providers in estimating the ICD-10 transition’s financial impact on each, diagnosis related group (DRG), hospital department, and on an organization as a whole. Offered as a component of ICD-10 code translation tool, the financial impact analysis tool evaluates ICD 9-derived DRG claims along with the base payment rate of an organization, and details the probable reimbursement that could be derived if the same DRGs were generated from ICD-10 codes. The financial impact tool also detects the DRGs that will remain as is and those that will change. ICD-10 financial impact analysis consulting service, includes executive-level reports, onsite record review, data analysis, and education to enable providers make informed decisions on educational requirements, and operational and personnel enhancements. Services are also provided for improving clinical documentation, along with a web-based curriculum, the ICD-10 Education Program. According to 3M, by evaluating the financial impact, healthcare organizations can review contracts, project receivables, and incorporate training programs and enhancement of documentation where they are most required. With this, Ray Terrill, the senior vice president at 3M believes that they can transform the transition to ICD-10 as a strategic advantage by purging probable oversight and risks. The latest addition adds to Salt Lake City, UT-based 3M Health Information Systems’ wide array of ICD-10 transition solutions and services that help clients enhance documentation and coding, identify potential risks, map and convert systems, translate codes, and educate employees. For more than 30 years, the company has been catering to over 5,000 hospitals, globally, through more than 100 coding experts. With more than 15 years of expertise in managing ICD-10 products and services, 3M’s code translation In conclusion, it has been suggested that healthcare entities can successfully make this transition by understanding both, the challenges, benefits, and related costs of implementation, and choosing an appropriate adoption strategy. While gearing up for the switch in the coding systems, several concerns related to planning, implementation and cost associated with the process, dearth of skilled coders and trained staff, and reduction in overall productivity daunt the healthcare fraternity, according to a recent article published in the journal Perspectives in Health Information Management. Although the migration to ICD10 may initially offer many challenges, it is anticipated to provide significant benefits over a period of time. The research article finds ICD-10 to reduce cost as it allows for improved cost analyses and data integrity, enhanced monitoring of health outcomes, and reduced fraud and abuse. With the requirement of better documentation, according to Milliman, a consulting and actuarial organization, the new coding system will result in more precise coding and payments in return. The U.S. Department of Health and Human Services (HHS) has proposed a ruling mandating the healthcare industry to shift from ICD-9 to ICD-10 by October 1, 2014. Regarded as a massive task, the implementation of ICD-10 is said to affect almost every operational system and process of the providers’ revenue cycle and payors’ administrative procedures. Apart from 3M, many vendors such as Healthcare Information and Management Systems Society (HIMSS) and Jvion, CSC, and Edifecs have come up with ICD-10 financial impact analysis solutions to aid providers in making the transition. tool was chosen, in 2011 by CMS, to assist in the conversion of applications, systems, and reports from ICD-9 to ICD-10. It was also licensed to Medicare Administrative Contractors (MACs) and carriers, and Fiscal Intermediaries (FIs). 3M’s association with CMS goes way back to 1995, when the company was contracted to provide ICD-10 General Equivalence Mappings (GEMs), Procedure Coding System (PCS), and the initial conversion of MS-DRGs to ICD-10.

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INSIGHTS
IDC reports indicate an evolving HIE market
IDC Health Insights finds the health information exchange (HIE) market landscape to be evolving, through two market reports that have analyzed HIE vendors. Sixteen vendors providing HIE platforms, including tools for development, educational and professional services, an extensive partner network, and published APIs; and 10 vendors for packaged solutions were evaluated through these two studies. While the study finds platform designs advancing over time The ‘IDC MarketScape: U.S. Health Information Exchange Packaged Solutions 2012 Vendor Assessment’ study finds the HIE market to be fragmented, with vendors offering products of varied origins, including composite applications, integration engine platforms, clinical messaging, portals, managed network services, and information management. It was also seen that the enterprise industry forms the fastest growing market, in account of its ability to support collaborative care and demonstrate meaningful use. Released consequently, the ‘IDC MarketScape: U.S. Health Information Exchange Platform Solutions 2012 Vendor Assessment’ found that the HIE market continues to evolve as the attention is shifting towards the conversion of data into ‘actionable information’ for collaborative care or accountable care initiatives, from enabling connectivity for data exchange and using technology meaningfully. As a consequence of this shift, additional vendor consolidations have been reported. This has been demonstrated by seven MnAs and the emergence of new vendors, like telecommunication and payor organizations, since a 2010 analysis by IDC. In view of such activities, the HIE packaged solutions study proposes a dynamic market with continuous change seen in the competitive and technical scenario. The study also reports a major role played by platform-as-a-service in the HIE market; as vendors consider building a strategic collaborative ecosystem with other companies. Lynne A Dunbrack, Program Director, IDC, finds the IT demands, due to changing reimbursement and care delivery models, and health information organizations, to be too big to be fulfilled by a single company. Both surveys show that, vendors are acquiring, partnering, or developing collaborative care, patient engagement, With the healthcare industry quickly entering into the post-EHR era, Clinmark finds that the value of patient data is in a HIE-supported network, and not in disparate EHR data silos. Black Book, a market research company, in their recent survey, also finds evolving reimbursement models and the push to prepare for accountable care organizations as major reasons (85%) for HIE adoption. Further, the research also indicates healthcare organizations’ HIE spending to grow significantly by 2014, as indicated by 8 out of 10 provider participants. The HIE market, despite many challenges, has witnessed remarkable growth (an excess of 40%) in 2011, according to a 2012 Clinmark Research report. In concurrence with the present report, Clinmark finds the enterprise market as a major contributor, and the HITECH Act and statewide HIE contracts as minor factors supporting this growth. Healthcare organizations have been turning towards HIE implementation, not only for complying with meaningful use, but responding to pending reimbursement changes, and shifting from pay-for-services to pay-for-outcomes model. The new reimbursement models would require healthcare organizations to better manage patient care and operations across the continuum of care. Amidst the diverse EHR environment, providers are increasingly adopting HIE technology in an effort to access data in EHR silos across the community. (mostly through self-development) to satisfy the requirements of clients and alliances in the ecosystem, the packaged solutions will be developed to cater to specific requirements. The latter are expected to lower the risks posed by uncertain project timelines, scope, and costs. and analytical technology, apart from just offering primary HIE technology, in an attempt to cater to technical and business demands of accountable care. In addition, the HIE market is expected to witness a dramatic change over the coming 12 to 18 months, with the entrance of dominant vendors into the market, which is flooded with small, private companies.

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INSIGHTS

Healthcare industry experts suggest strategies to address mobile device security and privacy threats
Wireless communication devices are being adopted increasingly in the healthcare industry. A 2012 Dell SecureWorks report finds 2 of 5 US clinicians utilizing tablets or smart phones during patient encounters. Although mobile devices offer several benefits, it brings with it privacy and security risks, with 65% of data breaches occurring on laptops and mobile phones, and 57% because of theft. These have been cited as chief hindrances for mHealth adoption by 41% specialists and one-third primary caregivers. With this, it is imperative for healthcare providers to develop risk assessment and mitigation plans to tackle security and privacy threats posed by mobile devices, and avoid penalties, tarnished reputation, and financial loss. According to the report, the cost for recovering data following breach involving mobile devices is $258. Below is the compilation of suggestions made by the healthcare fraternity, for managing security and privacy with mobile devices. NCCIC, a U.S. Department of Homeland Security (DHS)-led center overlooking nation-wide cyber and communications operations, advocates a layered security mode for securing mobile devices: • Acquire medical devices with fine-grained and well configure on networks • Incorporate ongoing support for vendors to update antivirus, patch, and firmware in the purchase vehicle. Enforcing safe, effective and legal software and patch upgrading regulations. • Have a practical approach for managing network monitoring and internal network segmentation that contain the devices • Forbid unauthorized users via access control lists (ACL), and unsecured and/or unrecognized devices, through the enforcement of stringent laws, from accessing health information network (HIN) • Frame guidelines for periodic review, management, and auditing of network configurations upon change of network • Leverage the principle of least authority in determining the accounts that require access to particular medical device components, instead of the complete network • Password protect personal health information (PHI) authenticating both ends of the channel • Ensure secure communication channels by encrypting and and intrusion detection techniques, external-facing firewalls, documented security functionalities, which are safe to Apart from these, below are a few best practices suggested by various industry leaders, which has been consolidated by ID Experts, a data breach solution provider. • Providers should consider and mitigate risks involved with the use of personal devices for work-related purposes, and facilitate benefits of these devices found lacking in the organization. • With theft and loss of devices being top healthcare data breaches, geolocation tracking software, a low-cost insurance policy, has been suggested as a useful approach to trace and clean data present in devices. • In cases of theft or loss of mobile devices, remote wiping methods need to be used to brick the whole device, rather the personal data stored in the devices have a backup on the cloud. • USB locks can be installed to prevent unauthorized transfer of data. • Encryption is necessary. than just deleting the encrypted corporate data, as most of established models for defining a way forward on mobility and security concerns. The plan, upon considering the needs and important sections of the organization, should give an insight into the areas of opportunity, costs, and expected investment. • Risk assessment: Comprises of recognizing, and assessing the risks. The procedure plays a pivotal role while switching between various ownership models or smart phone platforms, and complying by security and privacy enforcement laws. • Security assessment: Manual and automated approaches of testing should be applied to analyze the security and systems, and flow of data between application and system. • Data encryption and protection for PHI by availing access to only authorized users. compliance risk imposed by an application, connected

• Introduction of ’bring-your-own-device’ (BYOD) and mobile

devices renders electronic PHI vulnerable to data breaches; hence, organizations should implement cyber liability insurance as a part of data breach response strategy.

• While upgrading BYOD, users must ensure that all private devices that go offline.

and sensitive information are successfully deleted from old

In an attempt to ensure secure mobile computing, Dell SecureWorks, provider of information security services, suggests the following steps to healthcare organizations: • Develop a guidepost: Involves the evaluation of different modes employed to secure mobile devices, and utilization of

• Ensure technical safeguards such as data segmentation, encryption, access controls, VPN software remote, data setting. erasure, etc. are installed in mobile devices before use at a

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• It is imperative for employees to shut down the laptops completely as opposed to leaving them in sleep mode, when unattended, to ensure efficient encryption of the device. • Staff should be educated against leaving data unencrypted while at rest or transit, switching off security settings, failing to inform incidents of theft or loss, and downloading free software/applications from unauthorized sites containing malware. • With the growing use of mobile devices in the healthcare for securing PHI. • Companies gathering, exchanging, or storing any personal data need to maintain transparency with user consent for

preserving and promoting brand confidence among its customers. • Conducting risk audition and assessment on new technologies prior to installation is an important step that should be followed consulting with the privacy, legal, and compliance teams in order to eliminate future problems. With mobile devices offering a novel platform to support enhanced patient care, and reduced costs, implementation of policies and solutions to tackle security and privacy concerns becomes vital for healthcare organizations to establish a competitive edge by keeping abreast with latest technology advancements. by the providers. Providers need to develop applications after

industry, it is necessary to have a data management policy

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INSIGHTS

H&HN survey illustrates IT utilization among 2012 ‘Most Wired Hospitals’
Hospitals & Health Networks (H&HN), a publication of the American Hospital Association (AHA), has announced more than 200 Most Wired hospitals, based on a survey that analyzed IT utilization at healthcare organizations across four areas: infrastructure, business and administrative management, clinical integration (ambulatory/physician/patient/community), and clinical safety and quality (outpatient/inpatient hospital). H&HN, in cooperation with McKesson Corporation, CareTech Solutions, AT&T, the College of Healthcare Information Management Executives (CHIME), and AHA, conducted the survey on 1,570 hospitals (~27% of US hospitals); of which, 662 completed the survey. The survey results provide an insight into the types of technology used by these Most Wired hospitals and the rationale behind this recognition. Social media: Moving a step forward in improving patient experience, over 25% of the Most Wired hospitals are providing the facility to interact with physicians through chats and messages. Almost half are also using social media as a means of communicating with patients during a crisis (Figure 1). medical centers also mentioned that CPOE systems are used for entering all lab, radiology and medication orders at inpatient and emergency departments, and alerting care givers on common prescribing mistakes. The use of CPOE has been advocated by the EHR Incentive Program as a means of meaningfully employing IT at a healthcare setting. With government regulations fueling the adoption, the worldwide market for CPOE has been anticipated to reach US$1.5 billion by 2018, according to Global Industry Analysts; with the US represented as the largest regional industry, and expected to emerge as the fastest growing market.

Patient care
Including the existing methods of improving patient care, the survey has found that tech savvy hospitals are venturing into the latest in what technology and media can offer for connecting with patients; improving not only care quality, but also patient satisfaction. Clinical decision support tools: Most Wired providers, according to the survey, have implemented clinical decision support systems for enabling real-time data access, and keeping a tab on drug allergies and interactions to reduce errors and duplication of data. In addition, 63% of these hospitals have in place alert systems that guide them in complying by CMS-mandated quality measures. While, 100% of the most wired hospitals employ drug interaction and drug allergy alert tools, 91%, and 88% of the total respondents use them, respectively. Similarly, a higher usage of clinical decision support for high priority hospital conditions, and drug formula checks was noted in these hospitals (96% and 97%), when compared to all those surveyed (74% and 84%). The ability of decision support tools, such as e-prescribing and e-learning competency, in improving quality care, patient satisfaction, referrals, testing, readmissions and compliance to guidelines, and lowering hospital stay and errors has also been indicated in a whitepaper by Elsevier. Estimations of Frost & Sullivan have indicated that the market for decision support will reach $364.1 million in 2016. Computerized provider order entry (COPE): The survey also found that the utilization of CPOE has aided the organizations in enhancing care quality and lowering expenditure. One of the

This will benefit many social media enthusiasts, who account for one-third of the 1,000 US consumers utilizing this mode of communication for looking up medical data, tracing and exchanging information related to clinical symptoms, and expressing their views about treatments, health plans, physicians, etc (PricewaterhouseCoopers). Analysts at PwC opine that with social media transforming the healthcare fraternity’s means of interaction, healthcare organizations may miss out on engaging patients by not leveraging the potential of this medium of communication. Figure 1: Social media outlets used by the Most Wired hospitals

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Data privacy and security
Protecting sensitive patient data is a major challenge faced by the US healthcare system. In an effort to overcome this challenge the survey found that the most-wired hospitals are more prepared with annual tests and risk assessment, and sophisticated data protection tools (Table 1).

Wired hospitals, as apposed to 58% of all survey respondents, proactively monitor infrastructure and application performance to fix any IT-related problems before it negatively impacts the end-user experience. The different strategies employed by the organizations are shown in Figure 2. Performance monitoring is found to result in increased efficiencies, care delivery, and treatment outcomes. Figure 2: Methods used for monitoring healthcare IT performance

Table 1: Risk assessment and testing results of the survey
Methods conducted Risk analysis to detect gaps in compliance and vulnerabilities in security Penetration testing to detect vulnerabilities in security Wireless security assessment Risk assessment of social media networks/public internet use All survey respondents (%) 87 Most Wired hospitals (%) 87

71 76 63

86 93 82

Among the types of security measures, access controls (biometrics, smart cards and key cards) and intrusion detection systems where the most widely employed for authorized users among both the Most Wired hospitals (94% and 93%, respectively) and other survey respondents (85% and 77%, respectively). Mandated for meaningful use of technology, recent supporting research from a 2011 HIMSS survey suggests that 74% of the respondents conduct risk analysis for estimating potential threat to patient health information. According to the results of a 2011 Healthcare IT News survey, security measures commonly used by the participants include role-based control methods, followed by multi-factor authentication for identity proofing, in-house background checks, knowledge-based authentication, and access controls. In response to the current survey results, Linda Reed, vice president and CIO of Atlantic Health System, states that although tools are vital for maintaining privacy and security of data, they perform only half of the job; the rest can be accomplished by creating in people, a sense of importance, awareness, and vigilance in safeguarding personal health information (PHI). For monitoring the performance of the organization, 90% of the Most Wired hospitals use performance enhancement scorecards, and workforce management tools, when compared to 73% and 72% of all the survey respondents, respectively. Further, automated patient flow systems (74% and 57%, respectively), and web-based, real-time operational budget against financial modeling, budget forecasting and expense monitoring (72% and 53%, respectively) are also being adopted by the Most Wired hospitals, and all survey participants.

Conclusion
According to Rich Umbdenstock, President and CEO, AHA, the survey results not only identify the role of IT in enhancing patient safety and care delivery, but also in increasing hospital efficiency. In order to cope with the changes that the healthcare industry is witnessing lately, it is imperative for IT systems to be robust in providing physicians and executives with actionable, real-time data and support evidence-based care. The healthcare industry, from the past two years, has been focusing on enhancing care quality, efficiencies, in order to

Real-time performance monitoring
With the extensive utilization of IT in care delivery, it becomes essential for healthcare set-ups to have real-time data on the performance of the systems. The benefits that the technology offers can be reversed in episodes of network inaccessibility or system slow-down, which can pose a threat to patients. In an effort to avert such unnecessary risks, the survey found that 75% of the Most

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INSIGHTS

comply with national regulations through the use of clinical applications like COPE, health information exchange (HIE), and clinical decision support tools. However, the Most Wired hospitals have taken their focus to the next level by using IT for not merely adhering to the law, but to also meet the organizations’ definition of ’meaningful use’. This definition, although diverse across the organizations, is focused on value and data. Joe Boyce,

Chief Medical Information Officer, Heartland Health, St. Joseph, opines that access to knowledge and information through patient engagement, actionable alerts, evidence-based care, real-time decision support at bed side, and population health management dashboards is now the center of interest. He further interestingly states a shift in attitude from “‘Why are you making me do this?’ to ‘Can it do that?’”

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NEWS
Indian pharma giant, Piramal Healthcare buys USA’s Decision Resources Group
Piramal Healthcare Ltd has completed the acquisition of Decision Resources Group (DRG) for an approximate amount of US $635 million. Piramal Healthcare has decided to operate DRG as an autonomous business with its headquarters retained at Burlington, MA. The leadership will continue to be driven by Peter Hoenigsberg, CEO, DRG, and its existing senior management team. The acquirer, Piramal Healthcare is ranked 5th among the 10 top Massachusetts-based DRG, a global provider of healthcare data and analysis, is made up of a portfolio of companies that offer insights and information that is of high value to organizations in the healthcare sector to enable them to make knowledgeable and informed decisions. The company has a strong team of 400 employees and leverages a network of 125,000 healthcare professionals across the world to provide analytics services for pharmaceutical, medical devices, financial, managed care and biotechnology industries. With its focus directed towards the biopharma, medical technologies, and market access businesses, DRG has a portfolio of brands offering services that concentrate on the various aspects of healthcare: • Arlington Medical Resources (AMR): provides market intelligence for the diagnostic imaging and pharmaceutical industries • BioTrends Research Group: offers market research to small-midsized pharmaceutical companies • Decision Resources: specialize in research on the emerging developments, market potential, and trends in the pharmaceutical industry • Fingertip Formulary: formulary database on commercial, Medicare, Medicaid and PBM plans, etc. in the US • HealthLeaders-InterStudy: provides analyses reports on regions, and managed Medicaid and Medicare plans • Manhattan Research: healthcare advisory and market research firm • PharmaStrat: providing market research and consulting biopharmaceutical manufacturers • Millennium Research Group: provides focused strategic information on pharmaceutical, medical devices, and biotechnology industries • Pinsonault: delivers solutions for business and training industries From its projects, DRG reported US $160 million in revenues for 2012, and have been reporting a CAGR of 20% for the past 5
Vivimed Labs Ltd Aventis Pharma Ltd Fortis Healthcare Ltd Max India Ltd Super Religare Laboratories Max Healthcare Institute Ltd Universal Medicare Pvt Ltd (Distribution and marketing of neutraceuticals) Orchid Chemicals & Pharmaceuticals Ltd Uquifa SA

years, starting from 2006. With regard to the current acquisition, Peter Hoenigsberg said that Piramal’s participation in DRG will help boost data provided in emerging markets, which has been proven as the primary avenues of growth in the pharmaceutical markets.

pharmaceutical contract manufacturers across the world, and has 115 issued patents and 395 pending applications across the world. The company has placed a larger impetus on its already prevailing acquisition activity towards acquiring global growth businesses that would help achieve sustainable returns, since the 2010 sale of its domestic formulations business to Abbott Laboratories for US $3.72 billion. The DRG buy follows the acquisition of the molecular imaging R&D portfolio of Bayer Pharma AG in April of this year and the injectible anesthetic products businesses of Bharat Serums and Vaccines Limited in 2010. According to a business consulting and advisory company, Grant Thornton, 2011 witnessed 59 M&A deals in the pharma, healthcare and biotech domains in India. The deals were valued at a total of US$ 2.1 billion and accounted for 5% of all the M&A activities that took place across various industry sectors (Table 1). Table 1: Noteworthy biopharma and healthcare MnA of 2011
Acquirer Acquiree Deal value (in US$ millions) 174.57 30.43 114 Deal type

Majority stake Increasing stake Acquisition

health plans, healthcare markets in specific geographical

in the areas of organized customer and reimbursement for
Serum Institute of India Ltd

1.43

Strategic stake

55

Acquisition

specific to managed markets in the biotech and pharmaceutical With the current buy, the chairman of Piramal, Ajay Piramal has expressed that Piramal’s focus and approach has been cemented in investing in businesses with strong intellectual property in the healthcare industry.

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NEWS

Global perspectives on health IT from Harvard Medical School thought leader, Dr Blackford Middleton
Press release Blackford Middleton to deliver keynote at HIMSS AsiaPac12 Conference and Exhibition about clinical decision support and knowledge sharing The Four Conferences in One comprises of HIT X.0, mHIMSS July 10, 2012 Singapore: The HIMSS AsiaPac12 Conference and Exhibition (www.himssasiapac.org/12) in Singapore will begin with a keynote address by Dr. Blackford Middleton, Corporate Director, Clinical Informatics Research & Development, Partners HealthCare System, Clinical Informatics R&D Harvard Medical School, Brigham & Women’s Hospital in Boston. Dr. Middleton will describe research and development efforts at Partners HealthCare System and Harvard Medical School focusing on clinical decision support (CDS) and knowledge sharing. Highlights will be drawn from the multi-national CDS Consortium. Focusing on the central theme of ‘linking people, potential and progress’, the HIMSS AsiaPac12 will connect people and information in new ways that increase patient care and safety, reduce healthcare costs and improve quality of care across the continuum of care in Asia Pacific. This new and unique annual conference will focus on the information technology (IT) needs of healthcare providers and services during the three day-event to be held from September 17-19 at the Marina Bay Sands in Singapore. “HIMSS AsiaPac12 Conference is crucial for IT healthcare providers throughout the Asia Pacific region. No other organization offers the type of IT healthcare information and services that contribute to improving the quality and safety of patient care all in one threeday event. I am privileged to be a part of this conference,” Dr. Middleton said. The HIMSS AsiaPac12 will gather global healthcare leaders and professionals who will be sharing technological advances and innovative best practices for the industry. At the start of the conference on 18 September, Mr. Gan Kim Yong, Minister for Health for the Republic of Singapore, will give an opening address as our guest-of-honour. Dr. Charles Sawyer (MD, FACP), Associate Chief Health Information Officer for the Geisinger Health System, will give the closing keynote, in which he will present some of the tools and data routinely utilized by Geisinger to deliver reliable, high quality medical care to the population we serve. Specific examples will be provided emphasizing improvements in the quality / cost relationship and improved clinical outcomes. A number of education sessions and symposia will be available HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 51 years ago, HIMSS and its related organizations are headquartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents more than 44,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 570 corporate members and more than 170 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. At the HIMSS AsiaPac12, the distinctive expertise of the speakers, the in-depth sessions, and the large exhibition will give attendees exclusive information that will focus on the ‘Continuum of Care’ of information flow for homecare and acute care. The Exhibition will showcase hundreds of products and services for healthcare IT needs. Attendees will experience live demonstrations, technology updates, new products and services in the healthcare IT industry. The Interoperability Showcase, providing an important opportunity for participants to come together with purchasers of clinical technologies to show that interoperable clinical solutions are not far off in the future. The Symposia Programme, which includes the Clinicians IT Leadership Symposium, Nursing Informatics Symposium, and radio-frequency identification (RFID) & real-time location system (RTLS) in Healthcare Symposium. (Mobile Health), Standards and interoperability, and Care in the Community. In order to promote the understanding of the reality of ageing in countries undergoing marked demographic changes, the Care in the Community track will focus on the myriad social and cultural differences in people’s experiences of ageing and health and helps to identify strategic opportunities for appropriate technologies and services for the ageing population. during the conference, reaching out to key target audiences. The HIMSS AsiaPac12 will include:

About HIMSS

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HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote information and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www. himssasiapac.org. For more information about HIMSS AsiaPac12, please visit www. himssasiapac.org/12.

For media enquiries and interviews, please contact: Florence Fang Flame Communications Tel : (65) 6259 3193 Email : florence@flamecomms.com Yvonne Lim Manager, Marketing & Communications HIMSS Asia Pacific Tel : +(65) 6664 1184 Email : ylim@himss.org

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EVENTS
HIMSS AsiaPac12
Organizer: HIMSS Date: September 17 - 19, 2012 Location: Singapore Link: www.himssasiapac.org/12/home/index.aspx

Health 2.0 Europe Fall 2012
Organizer: Health 2.0 Date: November 6 - 7, 2012 Location: Berlin, Germany Link: www.health2con.com/events/conferences/europe-fall-2012

iHT2 Health IT Summit in New York
Organizer: Institute for Health Technology Transformation Date: September 19 - 20, 2012 Location: New York City, NY Link: http://ihealthtran.com/newyorkhome.html

The 8th Annual World Healthcare Innovation & Technology Congress
Organizer: World Congress Date: November 7 - 9, 2012 Location: Arlington, VA Link: www.worldcongress.com/events/HL12010

13 International Conference (IHIC)
th

HL7

Interoperability

Organizer: HL7 Date: September 27 - 28, 2012 Location: Vienna, Austria Link: http://ihic2012.hl7.at

The 9th Annual American Health Care Congress (AHCC)
Organizer: World Congress Date: November 12 - 13, 2012 Location: Anaheim, CA Link: http://worldcongress.com/events/HR12005/index. cfm?confCode=HR12005

IEEE International Conference on Bioinformatics and Biomedicine (BIBM 2012)
Organizer: IEEE Date: October 4 - 7, 2012 Location: Philadelphia, PA Link: www.ischool.drexel.edu/ieeebibm/bibm12

International Telemedicine Conference 2012: Telemedicon 12
Organizer: Telemedicine Society of India Date: Novenber 29 - December 1, 2012 Location: Coimbatore, India Link: www.telemedicon12.com/default.aspx

2012 HIMSS Summit of the Southeast
Organizer: HIMSS Tennessee Chapter Date: October 16, 2012 Location: Nashville, TN Link: www.tnhimss.org/events

2012 mHealth Summit
Organizer: mHIMSS Date: December 3 - 5, 2012 Location: Washington, D.C. Link: www.mhealthsummit.org/index.php

HIMAA 2012 National Conference
Organizer: Health Information Management Association of Australia Limited (HIMAA) Date: October 29 - 31, 2012 Location: Queensland, Australia Link: http://himaa2.org.au/conference

iHT2 Health IT Summit in Austin
Organizer: Institute for Health Technology Transformation Date: December 5 - 6, 2012 Location: Austin, TX Link: http://ihealthtran.com/austinhome.html

Second International Conference on Advances of Information & Communication The Privacy & Security Forum Organizer: Healthcare IT News and HIMSS Technology in Health Care – ICTHC 2012
Organizer: The Association of Computer Electronics and Electrical Engineers (ACEEE) Date: November 1 - 2, 2012 Location: Kuala Lumpur, Malaysia Link: http://icthc.theides.org/2012/index.htm Date: December 12 -13, 2012 Location: Boston, MA Link: www.healthprivacyforum.com

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Advertisement
HIMSS AsiaPac12 will link people and information in new ways that increase patient care and safety, reduce healthcare costs and improve quality of care across the continuum of care in Asia Pacific. FOur HeAltHcAre It cONFereNces IN ONe • HIT X.0 • mHIMSS (Mobile Health) • Care in the Community • Standards and Interoperability sYMpOsIA prOGrAM • Clinicians IT Leadership Symposium • Nursing Informatics Symposium • RFID & RTLS in Healthcare Symposium

Conference & exhibition
17–19 SEPTEMBER 2012 MARINA BAy SANDS WWW.HIMSSASIAPAC.ORG/12

This annual Conference & Exhibition will focus on the information technology (IT) needs of healthcare providers and services during the three day-event.

lINKING PeoPle, Potential and Progress

Diamond sponsors

register today and you stand a chance to win Formula 1 tickets!* Please visit himssasiapac. org/12 for more information. *Terms and conditions apply.

Opening address by Guest-of-Honour Mr GAN Kim Yong Minister for Health, Republic of Singapore

Opening Keynote by Dr Blackford MIDDletON Corporate Director, Clinical Informatics Research & Development, Partners HealthCare System, Harvard Medical School, Brigham & Women’s Hospital

closing Keynote by Dr charles sAWYer MD, FACP Associate Chief Health Information Officer Geisinger Health System

transforming healthcare through IT ™