Collaborative Opportunities Open Health Tools & Clinical Groupware Collaborative September 2011 Presented by Vince Kuraitis, Better Health Technologies,

Collaborative OpportunitiesOpen Health Tools & Clinical Groupware Collaborative

September 2011Presented by Vince Kuraitis, Better Health Technologies, LLCDr. Adrian Gropper, HealthURL

A Decade of Opening Up Platforms to 3rd Party App Developers

Agenda

CGC Background

CGC Initiatives

OHT/CGC Collaboration

Specific Collaboration Opportunity – P4 (Dr. Adrian Gropper)

Market Openness Model (MOM) for Collaborative CareCGC Goal: Enable Market Competition Between Walled Garden and Open Platforms

1Closed

1Closed

2Walled Garden

2Walled Garden

3Open

Platform & Apps

3Open

Platform & Apps

Technology Architecture

Collaborative Healthcare Business

Ecosystem(Value Network)

Closed Open

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Members/Board of Directors

Members• Alere• Amedisys• American Medical Association• Christus Health• Coto Partners• Covington Associates• Covisint• Epocrates• Intel• McKesson• Medseek• Microlife Corporation• NaviNet• PointClear Solutions• Resilient Networks• VisionTree• + individual members

Board• Steve Adams, SVP, Alere• Mark Blatt MD, MBA, Intel• Hank Fanberg, Christus Health• Michael Fleming, MD, CMO, Amedisys• Vince Kuraitis JD, Better Health Technologies• Tom Morrison JD, SVP & Co-founder, Navinet• Martin Pellinat, CEO, VisionTree

Advisory Board Chair – David Kibbe MD, MBA, American Academy of Family Physicians

Simple

Open

Trusted

Modular

Innovative

Disruptive

Platforms/apps

Internet/web

Affordable

User-centric

“Platform” has many connotations.

Platforms for Collaborative Care

Unified definition of platform elements

Core components

Complementary components

Interface

Unified domain focus

Technological architecture

Business ecosystem

Clinical accountable care

“Platform” used by vendors to describe current offerings

For details see: http://bit.ly/pggz98

Alere Eccentex Medseek SurescriptsAllscripts EMC2 Microsoft TriZettoAMA/Dell Epocrates Navinet Unival-MedAmerican Medical Assoc GE OptumHealth VerizonAT&T Healthcare Health Access Solutions Oracle VitalHealthAxSysExcelicare Intel-GE Ozmosis WellcommBCBS Alabama/ZeOmega Kony Practice Fusion WiproCerner McKesson/Portico Quest DiagnosticsCovisint MEDecision RelayHealthDOD/VA Medicity/Aetna SAP

Long standing debate

Standards are created (cats)1. Create (complex) technical standards

2. Market adopts (hopefully)

Standards are adopted (dogs)1. Market adopts (simple) standards

2. Technical standards evolve

Synthesis

Planning for creation and adoption of standards should occur simultaneously, not sequentially

Significant implications, e.g.,• “Come to the table planning to implement and/or

contribute code• Rethink nature of process

• Technical• AND• Business ecosystem development

• Need for product launch planning• Role for CGC

Health IT Vendors that Want to Bring Disruptive Innovations to the Health IT Market• Technology Infrastructure Vendors• Application developers• EHR vendor community

Healthcare Stakeholders that Want to Enable Health IT Disruptive Innovation• Patients • Payers

• Health plans• Employers• Government

• Population Health• Consumer Health Industry• Financial Industry• Providers• Others

CGC As A Big Tent

CGC Initiatives

CGC “Initiatives”

Advocacy

Direct Project support

Friday Pilots/Collaboration Workgroup webinars. Sign up at http://www.clinicalgroupwarecollaborative.org/events.aspx

HIMSS/CGC conference -- February 23, 2012

P4 (Participatory Patient-Provider Portal)

OHT CGC

OpenSourceSoftware

Modular Software

Privacy

Security System integrity

Functional completeness

Composite licensing

Versioning Code repositories

Support

Integration with NwHIN

Internationalization

P4 -- A Project for Persistent Connectivity Between Systems

Problem and OpportunityHow do software vendors work together toward the “Triple Aim” of better health, better care, and lower costs for the overall population?

Persistent Connectivity Clinical adoption

• Within an institution• Across institutions

Technical adoption• Software Developers• Clinician Innovators

Wanted

Adoption of connectible systems• Lower developer costs• Practical adoption model• Keep it Simple

Rapid impact• Stick to existing standards and accepted policies• Don’t wait for or presume HIE adoption

P4 Project Scope Capture connection authorization by individual users (doctors,

patients, staff) Benefits from Single Sign-On (but SSO itself is out of scope) Agnostic to API and to document formats Useful to both payer and provider institutions Accessible to patients and professionals Open Source Reference Implementation Support for Stage 2 Meaningful Use

Next Steps Identify sponsors of P4 Software vendors Provider Institutions Payers Formalize Governance

Website: www.clinicalgroupwarecollaborative.org

Contact Info:

Vince Kuraitis

208-395-1197

[email protected]

Adrian Gropper

617-571-3857

[email protected]

BACKUP SLIDES

Market Openness Model (MOM) for Collaborative Care

1Closed

1Closed

2Walled Garden

2Walled Garden

3Open

Platform & Apps

3Open

Platform & Apps

Technology Architecture

New Business Ecosystem

(Value Network)

Closed Open

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Illustrative CGC Principles Mapped to Evolution of HIT

• Data portability• Minimize switching costs• Avoid lock-in based on proprietary, non-interoperable technology• Importance of app developers

• Opening API necessary but not sufficient

• Low barriers to entry• Indirect network effects

• Affordable• Value to patients and payers• Collaborative business model• etc.

• Use of Internet and web technologies• Modular/component architecture: platforms + apps• Open standards• Data portability• Open source• Application portability• Private and secure• etc.

Technology Architecture

Closed Open

New Business

Ecosystem(Value Network)

Co

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Fra

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Defining Moments in Platform Evolution

Technology Architecture

New Business Ecosystem

(Value Network)

Closed Open

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Opened API &

Shared Data

Shared

Workflow

Health IT Examples

Technology Architecture

New Business Ecosystem

(Value Network)

Closed Open

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Epic

Cerner

Allscripts Helios

Medicity

Covisint

Alere

Many EMRs

others

Practice Fusion

Kaiser

Value Creation vs. Value Capture

Technology Architecture

New Business Ecosystem

(Value Network)

Closed Open

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Maximum

Value

Creation

Maximum

Value

Capture

CGC Industry Shaping Vision

• Break vicious cycle of “closed/monolithic” HIT• Providers haven’t demanded open, standardized, interoperable EHRs• Vendors build proprietary, non-standardized, non-interoperable EMRs

• Enable sharing of • Health records across providers and with patients• Workflow across care providers and with patients• Accountability for improved patient outcomes, lower costs, improved

quality

• Identify and/or enable high value use cases for health information exchange and clinical workflow enhancement

• Enable competition between walled garden and open HIT platforms• CGC is a catalyst in shaping the technical and business environment• Identify and promote implementation of high value initiatives

Conference Theme Options

1) Technology and Business Ecosystems for Collaborative Care

2) Unified Platforms for Collaborative Care, Technology, and Business Ecosystems

(not yet to the point of suggesting a specific title; needs wordsmithing):