Name: Stanley

Web Site:

Bio: Stanley Crane is Chief Innovation Officer for Allscripts. In his more than 30 years of healthcare and consumer-related software experience, he has led the development of award-winning software programs including electronic health record, electronic prescribing, web-based medication sales, online physician education, resource scheduling, financial systems, materials management, medical translation software and voice recognition dictation systems. Previous to his healthcare experience, Stanley was involved in Silicon Valley, where he held positions with many well-known software companies. As the General Manager of Lotus cc:Mail, he created the first remote mail products. He was also the Vice President of Engineering at WordStar International, and Director of Applications at Ashton-Tate, managing their Macintosh products as well as dBase IV. Before that, Stanley was a founder of two Internet startups – MaxMiles, an automated frequent flier mileage aggregator, for whom he built the first versions of the product; and Shopping@Home, a company that was acquired by Allscripts in 1999 to support medication sales.

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    Liberate the data: 3 approaches to advance health care

    February 22nd, 2016

    I love the phrase “liberate the data” and what we are doing to accomplish that lofty goal. But if we liberate the data – with appropriate security and auditing – what problems would it help solve? There are three big reasons to liberate healthcare data:

    #1 – Give patients access to their own healthcare data.

    Of course you want to be able to see what’s in your medical records. For most of us, we have data in multiple physicians’ systems. You should be able to review them just like you can review your credit report. If there is a mistake, such as a missing allergy or discontinued medication, you can fix it.

    If you want to share your information with a relative or trusted friend, or donate data to a clinical repository for research, you should be able to do that. It’s your data.

    #2 – Enable providers to access patient data.

    If you end up in the emergency room, you want that physician to know what medications you’re taking, allergies, blood type, and anything that will help that doctor take better care of you. If you are referred to a specialist, or move to another city, your data should be able to flow freely and directly to your new caregiver.

    It should not be up to you to have to ferry the data around. We should never have to answer the question “What are you allergic to?” or “When was your last tetanus shot?” ever again. Should the physician have to depend on your memory for critical pieces of clinical information?

    #3 – Use combined data for new approaches and technologies.

    If there was some breakthrough in genetics (like the discovery that the BRCA gene mutation predicts breast cancer), wouldn’t you want to be able to use that information to help you decide what you need to do? In some cases, that would put your mind at ease. In other cases, you would know what to watch for. And in other cases, it might suggest a change in direction.

    Why can’t health care simply borrow technology used in other industries? Innovation comes from all kinds of places. If it comes from outside the health information technology company, there needs to be a bridge that enables providers and patients to use that technology to build a healthier world.

    How do you liberate data in a diverse environment?

    One approach in Health IT is to say you accomplish all of these data liberation initiatives “as soon as everyone switches to our software.” The Toyota Camry may be the best-selling car in the U.S., but can any of us imagine a day when everyone drives a Camry? Of course there will continue to be diversity in cars, phones and Health IT.

    So now I’m going to sound a little like a commercial, but I really like the Allscripts strategy and story here, of how we liberate data in a diverse environment:

    Approach #1 – Allscripts FollowMyHealth® was built to give patients access to their data. From its very first installation, it could connect to six different companies’ products, and the list keeps growing. Because as a patient, you should not be required to log in to multiple web sites to examine your medical records. A portal should homogenize and simplify data to help patients understand their information. Because you won’t act on information if you don’t understand it.

    Approach #2 – Allscripts dbMotion™ Solution enables providers to access patient data. Recognizing it is not nearly enough to merely connect to Allscripts products. dbMotion connects across the board to dozens of other company’s products. In fact in Israel, all 8 million citizens’ data is accessible at all points of care through dbMotion, so wherever they go in Israel, their caregivers can see all of their information. Don’t you wish you had that for your family?

    Approach #3 – Open is about working as a team and building bridges to improve health care. We’re doing that now, with more than 130 applications written by our clients and partners. In fact, in 2015 alone, we shared data with partners more than 500,000,000 times. That’s over half-a-billion times that we either sent data to a partner, or they sent data to be stored in the electronic health record (EHR).

    These three approaches address every aspect of letting the healthcare data flow. That’s what we’re doing to help “liberate the data.”


    Making it easier to innovate with Open APIs

    January 13th, 2016

    Meet Steve Buttitta. He’s the president of ByteSized Solutions, a company that has about 30 applications powered by Allscripts Open Application Programming Interfaces (APIs). We have shared data with those products more than 33 million times. Being Open is about utilization, not technology. You have to do it, not just talk about it.

    I asked Steve if he’d be willing to share his thoughts with our blog readers, and he agreed:

    I started consulting in healthcare integration 15 years ago. At the time, it was just me sitting in my basement banging out code. EHR systems were in their infancy and integration was both limited and difficult.

    I struggled a lot in the start, because I spent my time fighting electronic health record (EHR) companies to get access to their systems or information about their systems. In the end, I burned a lot of hours and my clients paid for that time. Additionally, as a result of this lack of willingness to collaborate, I had to shoehorn in many solutions with less-than-graceful executions.

    The adoption of EHRs and IT in general is now a requirement in health care. We’ve come a long way since then, but unfortunately, from a third-party integration perspective, not much has changed.

    My company has developed a niche and expertise. We frequently accomplish tasks that EHR vendors have told their clients aren’t possible. I would think that EHR vendors would see a partnership with us as a net positive. We help their clients and make the EHR a better, more usable product.

    Unfortunately, most EHR vendors, in a very short-sighted manner, see us as antagonists that are stealing their services business. They put up road blocks. They making accessing their APIs difficult.

    As an example, we had one client demanding that its EHR vendor work with us on a project. The EHR vendor dragged its feet so much that it took almost six months just to sign a non-disclosure agreement. Closed EHR vendors routinely use tactics like this, or blocking access to API, to drive consulting services back to the EHR vendor. The truth of the matter is that in general they’re not equipped to do the work, and it will take too long to get the results clients are looking for.

    I’ve found one exception to the rule: Allscripts.

    Allscripts API is readily accessible. The cost of partnership is nominal. Documentation is published and support is available. Instead of hiding documentation, Allscripts strongly encourages innovators to attend open training classes and with people who wrote the API. It’s just that easy.

    In the past 18 months, we’ve written many apps powered by Allscripts Open APIs. Some of the apps we’ve written just wouldn’t be possible without it. The Allscripts team spends a lot of time performance-tuning its API to make it blazingly fast. When we migrated one of our apps from direct database calls to Allscripts, we were able to increase its performance by more than 10 times.

    Another big win is how the API works across multiple Allscripts products. We have a product that we had only sold into the Allscripts Touchworks® EHR space. After converting that product to Allscripts API, instead of taking hundreds of hours to make it work with Allscripts Professional EHR™, we were able to port the solution in less than 20 hours. Clients don’t have to wait as long to get the products they need.

    Having gushed on about the API, I think at its core, the big differentiator between Allscripts and other EHR vendors is this Open philosophy. Allscripts recognizes that when we build products and solutions for clients, those clients are happier. As a company, Allscripts knows that it can’t be everything to everybody. Working with partners like us, together we can help move health care forward.

    Having finally seen what it can look like when an EHR vendor really becomes a true partner, it has me asking the question “Why can’t it always be this easy?”


    Interoperability is as simple as good communication

    October 5th, 2015

    Please don’t trouble yourself with newfangled words like “interoperability” or “bi-directional data exchange” – at the end of the day, it just means “communication.” To communicate, all you need to do is two things: 1. Deliver the message to the recipient and 2. Ensure the recipient can understand it.

    That’s it. If you can get the message from A to B (people or computer systems), in a language they can understand, you have communicated. It’s really that simple.

    If you can’t hear me (or see the page I’ve written), clearly communication did not happen. And beyond that, if you can’t understand me because you only speak English and I am speaking in Latvian, communication did not happen.

    Computer systems work exactly the same way. Can you get the data transmitted from one system to another? And once you get it there, can the receiving system understand what you sent? It’s not more complicated than that.

    Don’t make it harder than it needs to be

    One of the things that bothers me enormously is when other technology types take that simple concept and make it seem much more complicated.

    Of course over the decades I’ve seen this play out many times as people make something seem far more difficult and mysterious than it really is. As a contractor, you can convince the client it will take months of extra work. As a junior developer, if you make it seem really hard, imagine the kudos when you finish it? Or managers who want to engorge their staffs because this project is so complex.

    In health care, at times, communication is literally a life and death matter. This is a terrible time to inflate complexity of the problem. And yet that’s what seems to be happening – even more now that there is a small momentum building to demand that Health IT systems simply communicate with each other.

    How Open APIs can open the lines of communication

    Application program interfaces (APIs) should be open. They should give a roadmap for how to communicate with Health IT solutions, and what content will make your message most successful. At Allscripts, we’ve invested years in helping partners efficiently communicate with our solutions through the Allscripts Developer Program, the results of which appear in the Allscripts Application Store.

    There are two tests that you should apply to any IT communication methodology:

    1. How do you make sure the system can transmit the message to the receiving system?
    2. Once it arrives at the receiving system, how can you be sure the receiver understands the message?

    And in the healthcare world, there are two more tests you should apply:

    1. How can you be sure the receiving system has the right security clearance to see that data?
    2. How is that exchange of data audited, giving visibility to who accessed which patient’s records, and by which systems?

    With Allscripts Open APIs, we require a clinical user to be supplied with all calls for patient data. That user defines how we will approach the data. We ask, “Can that user see all of the data, only some of the data, or none of the data?” That’s how we make sure the receiving system has the security clearance to see what we will send them.

    For auditing, that too is taken care of inside our Open APIs. We don’t want our receiving systems to be burdened with having to remember who looked at what, and having to do the auditing manually. That also means the existing audit reports will clearly show all accesses of patient information.

    Do Open APIs make communication simpler?

    Does it really work? The proof is in speed. Typical  interfaces can take about six weeks to create – to establish communication and go through the training process. Using our Open API, we’ve been able to connect ADP partners to clients in under an hour. From the time the client signed a contract, to the time the partner was live in the client environment was under 60 minutes – with our current record being 43 minutes.

    Open APIs make communication easier, faster and cheaper. It’s simple; Send the message in a language the recipient already understands. That’s all communication means.

    And that’s what we all need as patients.

    Editor’s Note: To learn more about Allscripts Open APIs, visit Allscripts Booth #300 at the Health 2.0 9th Annual Fall Conference October 5-7, 2015.

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    How did we get here? The evolution of Open

    November 14th, 2014

    Editor’s Note: The following article originally appeared in CIO Review’s Healthcare Technology Special, October 2014. You can access the article here, pages 42-43.

    Open is a journey, not a destination. Open means you facilitate the exchange of information between programs; you make it easy for your software to talk to other people’s software. The need for Open technologies has shaped standards, which evolve over time to meet new challenges and address shortcomings of previous standards.

    It all started with punch cards, EBCDIC and ASCII

    Back in the ‘60s there were two competing standards for how computers would store data – one was proprietary to IBM main frame computers called EBCDIC. Pretty much everyone else used the other standard, called ASCII.

    EBCDIC can trace its roots back to the punch card standard, invented by Herman Hollerith in 1894 to help tabulate the 1890 U.S. Census. He also founded a business that evolved to be the company we all know today as IBM. EBCDIC represented how card punches used to work – how do you convert those holes in the cards into binary? How about a hole is a one, and a “not hole” is a zero.  Today, computers still store everything in bits of 1’s and 0’s.

    IBM standardized everything they did on EBCDIC. IBM printers expected data coming to them to be in EBCDIC, tape drives, and of course IBM computers. While EBDIC could represent card punch data easily, it wasn’t up to the task of storing data.

    Enter the “new” Open standard of ASCII. Printers made by Data General, Digital Equipment, Unisys, Xerox – they were all interchangeable because they spoke a common language. That common exchange format enabled these companies to innovate and compete against one another.

    In those days of yore, you could say you were Open if you stored data in ASCII. That’s how data was sent from component to component. But soon people wanted to do more; they wanted to share data from system to system.

    Sharing data between systems with EDI and HL7

    In the 1960s, ‘70s and ‘80s EDI (Electronic Data Interchange) was a file-based messaging protocol that enabled grocery stores, banks and others to do business with one another more easily. EDI described a particular file format for requests, placing orders, responding, etc.  There were lots of pipes “|” and carets “^” – making it nearly impossible for humans to read it easily.1

    In the late ‘80s and early ‘90s, healthcare borrowed a lot of the concepts from EDI and started creating its own set of standards that came to be known as HL7.

    HL7 messages look like this (very abbreviated)



    State-of-the-art healthcare data interchange in the ‘90s involved some level of HL7 interface support. In those days, that’s what “Open” meant – it meant we can collaborate with other pieces of software through an EDI-like data waltz. That was as far as the industry and the vendors would allow.

    Then the World Wide Web really caught on

    The web is the ultimate platform for exchanging information. The world needed a better way to view documents on computers, which was the motivation behind HTML.

    HTML is largely a visual standard – how is my web page laid out? Where are the buttons? HTML was the format that web browsers had to understand, and website creators had to be able to produce. HTML gave birth to another standard that better represents data, called XML. Rather than being positional and rigid, like EDI or HL7, XML enables developers to tag data and extend formats on the fly.

    Web services are not going to replace HL7 any time soon. There’s still lots of important data exchanged with HL7. But web services lend themselves to building truly Open, integrated systems. Where EDI and HL7 focus on all of the data for a transaction, web services are far more interactive.

    With web services, you can ask finer-grained questions. For example, if a clinician is writing a prescription, they should be able to engage with other applications to find out “What allergy manifestations are possible?” “What strengths does this medication have?” “Does this medication have any potential reactions with this patient?”

    At Allscripts, we used our award-winning2 web services to build all of our iPad products. You can read and write all areas of clinical information – allergies, vitals, results, orders, clinical documentation and more. It’s not enough to merely look up data, you have to be able to modify it, add to it – and put it back with the patient’s master record.

    The evolving definition of Open

    Standards have evolved from merely representing data, to storing it, to sharing it. In today’s technological landscape, when we say a platform is Open that’s because it offers a rich, comprehensive set of web services to reach deeply into the underlying system.

    Open means we can connect systems more completely than we ever have before, we can exchange data in little, relevant snippets rather than in volumes at a time, and finally build truly collaborative, cooperative, innovative systems.

    1For a complete history about EDI —

    2 North American Frost & Sullivan Award for New Product Innovation Leadership

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    What’s your Innovation Surface?

    October 28th, 2014

    Every healthcare IT company wants to be Open, so every company comes up with a convenient, somewhat self-serving definition of it. As technologies change, the definition of Open also evolves over time. We all need a simple concept we can use to objectively measure how Open a product really is.

    I’ll start by proposing some new language: Innovation Surface.

    In the security and vulnerability space, we talk about “Attack Surface” – that’s “What are the ways hackers can attack you?” You want your Attack Surface to be as small as possible. Don’t expose anything you don’t have to.

    It’s time to coin the phrase “Innovation Surface” – that’s “How many different kinds of technologies are available to a developer?” You want your Innovation Surface to be as BIG as possible, with multiple tools to enable creativity.

    How big is the programmer’s playground?

    In the same way the number of pieces of playground equipment can influence how much your kids like the park, the number of different kinds of technologies can influence how much developers like your platform. More technologies increase the Innovation Surface of the product.

    If you went to a playground and it had a slide, and you were in the mood to slide down a slide, you’re in luck. But what if we want to swing, climb or build a sand castle? It’s good to have more options.

    Allscripts has several different technologies that are available for developers to use. Of course HL7 is one of them. There are also many other tools to help developers customize how our products work, and our latest techniques enable developers to use Internet-like interaction to build cloud-based integrated products using our uniquely Open APIs.

    To help determine the size of a vendor’s Innovation Surface, ask questions like these:

    • Can I add a tab?
    • Could I connect to a different patient portal?
    • Can my developers add vitals data from patient medical devices?
    • Could we build our own patient-caregiver communication module?
    • Could we integrate pharmacogenetics?

    Hopefully your EHR vendor will say “yes” to questions like these, showing they have a large Innovation Surface. Otherwise, you will have to wait for them to invent or re-invent these things.

    Estimating a vendor’s Innovation Surface should be part of the evaluation of any product. And the answer you’re looking for is far more than just a list of HL7 interfaces.  It should include a wide (and perhaps fun) range of options on the developer’s playground.

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    Mobile EHR gets nod from Intel

    August 26th, 2014

    When you develop a new product, you can’t help but think it’s great. It’s especially wonderful when someone else agrees and gives you an award for it. Allscripts received an Intel Innovation Award for the development of Allscripts Wand™, powered by Windows. It’s one of the first comprehensive mobile electronic health records (EHR) developed on the Windows 8.1 platform.

    Open: It’s all about choices

    I’ve often talked about the value of Open, and how important it is to connect clinical and financial data across every setting: from the provider to the hospital to post-acute settings and even the patient’s home. An Open approach helps enable the mobile tools needed in an increasingly mobile world.

    It’s all about choosing the right tool for the right clinician to enable the right care at the right time. To make that happen, the healthcare community needs choices. Lots of them.

    Wand for Windows gives several options to healthcare organizations.  Clinicians can use legacy EHRs and new EHRs on the same device. They can choose from several different mobile devices. And they can choose navigation by touch, stylus or mouse. (See other benefits of Windows technology in a recent blog post, Staying on course with Windows 8.)

    My biggest surprise

    Having been on site with a few clients now, I was surprised by the popularity of one Windows 8 feature that has really made a difference. In Win8, if you swipe from the left-hand side of the screen, you can easily flip to the next application.

    So when clinicians are using Wand, if they need to get back to the old product they’ve known for years, they can get to it with a simple swipe. It offers more choices; clients can use features on Wand (e.g., take a picture of a suspicious mole, record vitals, pick a pharmacy with a map) and return to the main product to do other things – instantly and on the same device.

    Certainly that makes the transition to any new product easier for users. It helps their productivity instead of detracting from it.

    Thanks to the team

    It is always satisfying to have a prestigious company like Intel recognize your work, and we are very grateful and humbled by that recognition. And I’d like to express our deepest thanks to the adventurous providers and staff at Resurgens Orthopaedics and Marin Medical Practice Concepts for joining us on a quest to take better advantage of what Win8 has to offer, and most importantly to help healthcare providers practice their art.

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    We’re not the only ones that think Open is important

    August 6th, 2014

    Others agree that embracing Open is critical for the future of health care. Take for example this article: Coalition Calls for Action Against EHRs That Block Interoperability. After a RAND Corporation report found that Open technologies could help lower costs and improve care, calls for interoperability are stronger than ever before.

    A non-technical explanation of Open

    Open means interchangeability. Take car batteries for example. How big are the posts that you connect the battery wires to? And how many volts? These attributes are standard for all car batteries, no matter who makes them.

    In health care, unfortunately, the specifications can be very broad, such as HL7 including “industry standard” Continuity of Care Documents. In a car battery scenario, this breadth might allow the posts to be between 5/8” and 2” and power to be between 5 and 20 volts. So two batteries could comply with these standards, but one may have 1” posts and 5 volts, and the other may have 2” posts and 15 volts.

    Could we easily use our choice of battery? Are the battery cables flexible enough to fit various post sizes? Can the car’s electrical system handle it if the voltage is anywhere between 5 and 20 volts? Probably not; they are not interchangeable. Manufacturers would have to make all sorts of adaptors and interface layers that convert the battery into what your car is expecting.

    When the standard is broad, there are millions of variations possible that all comply with the specification. Building adaptors (like HL7 interfaces in health care) takes both time and money.

    Better standards will lead to more innovation

    Open means, in a sense, that we have much tighter specifications. So all parties can rely on the data coming and going to be a specific flavor. Vendors can create one solution that is relatively simple for clients to install.

    In the olden days, pocket watches were lovingly crafted by hand. No two were alike, even from the same manufacturer. If something broke, it had to go back to the original watchmaker to be fixed or modified. And if you’re the manufacturer, you’re tied to the client until they decide to buy a whole new watch from someone else. That’s a closed system. Pause here: does that sound more or less similar to healthcare information technology today?

    Is that how it should be? Should innovation be limited to the creativity of a single watchmaker? Should innovation be limited to one HIT vendor?

    With Open, we get interchangeability, and with that comes the opportunity to take advantage of innovation from any direction. If there is a new clinical decision support engine, or a new device, or a new specialty-oriented tool that some clever person invents – Open means that you can have it quickly. You don’t have to wait for the gunsmith to learn how to do it, or wait for the HIT vendor to build that new innovation into the next product.

    Open means interoperability. Open means adaptable. Open provides a platform for innovation.


    Editor’s Note: For more of Stanley’s thoughts on what makes a company truly Open, check out this blog post: 6 traits of a truly Open healthcare IT company.

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    The Power of Open

    March 4th, 2014

    Imagine if a car company said “To control quality, we are going to make every part of the car. We’re going to make our own batteries, mine our own steel, build our own radios…” The cost of that car would skyrocket. Quality and innovation would suffer.

    Continuing with that analogy, Allscripts makes the car (EHR) and will help you customize it in ways that are important to you. If you want a ski rack, we have partners whose racks are safe and fit your roof. If you want a satellite radio, we DO NOT say, “You have to wait until WE invent it ourselves.” With our Open approach, we partner with experts to get the best satellite radios in the hands of our clients faster.

    Open enables innovation. Allscripts Development Partners have used our programmers’ toolkit to connect their great ideas and products to Allscripts products. By working together, we’re able to deliver the best solutions to you.

    Thanks to all of the companies that have joined us on this quest to move healthcare information technology into a collaborative, cooperative team sport – where everyone wins: caregivers, healthcare organizations, partners and patients.

    That’s the Power of Open.

    One company can’t do it all

    We began our journey to Open in 2007, when we taught our first Allscripts Development Program class. We knew then that Open was the right thing for us as a company, as partners and as a society. Most importantly it is the right thing for us to do as patients.

    Healthcare information technology should be a team sport (click to tweet this idea). When we collaborate with each other, we help each other bring solutions to the healthcare providers and patients.

    Open reduces the time from invention to delivery by making it faster for those innovations to plug in to solutions the healthcare organizations already own.

    Open makes it easy for clients to add on to their existing products. They can take advantage of breakthrough technologies and put great ideas into practice.

    What plug-in app for your EHR would you most like to have? (Visit the Allscripts Application Store; it may already be there.)

    Editor’s note: Based on analysis of innovation strategies among leading health information technology vendors, Frost & Sullivan recognized Allscripts with the 2013 North American Frost & Sullivan Award for New Product Innovation Leadership for our Open Application Programming Interfaces (APIs). You can read more in a recent news release.

    Editor’s Note: This post was updated on June 3, 2015 to replace outdated material.


    Staying on course with Windows 8

    February 18th, 2014

    Navigating the choppy seas of health care is not for the faint of heart. A patient’s care can only stay on course if the captain and crew have reliable instruments.

    Electronic health records (EHRs) are at the helm of healthcare delivery. EHRs pull together data to help doctors see trends sooner. To help patients avoid the rocks ahead.

    One of the instruments that is growing in popularity today is Microsoft Windows 8. It’s hard to buy a new (non-Apple) laptop without it. This operating system offers some distinct benefits for healthcare enterprises.

    Smoother sailing with easy-to-deploy technology

    Windows 8 enables enterprises to use the same management tools they have in place today. Why does that matter? Think about a simple update to software. There’s the client side, and then there’s the server side. Both sides have to be in sync for the update to work properly.

    When each part of the application comes from a different source, it can create a problem. If a user goes to an App Store to download the client side, then enterprises have to be prepared for users that make that trip too soon. They also have to be prepared for those users that don’t go at all.

    What happens when the web server is on version 3 and the client devices are on version 2 or 4?

    Windows 8 has solved this issue by enabling your Information Technology (IT) department to use the same tools they use today. They have the ability to push out new versions of the client applications while they are updating the server components of those applications.

    And yes, there are tools that let IT departments manage this issue for Apple and Android – but they are new tools to purchase and learn.

    Canoe or cruise ship? Flexibility is key

    You wouldn’t paddle a canoe across an ocean or attempt to sail a cruise ship down a small river. One boat does not fit all waterways, and the same is true for technology. People are moving away from the “Swiss Army Knife” mindset. Meaning, we don’t expect that one device will do it all.

    We prefer different devices depending on the task at hand. For example, I prefer my laptop over my tablet if I have a lot of typing to do. But I’ll grab my tablet when I have to sort through and delete emails. Personally, I like devices that do what they do very, very well.

    Windows 8 supports this personal choice. It enables new approaches, such as the tablet that clicks into a keyboard when you need it.  It makes it easy to add on functionality with sleeves that hold card readers, RFID readers, barcode readers. You can tailor your device to your needs.

    Staying on course with the right tools

    The reality of the market (and large enterprises) is that users will continue to have iPads, laptops and Windows 8 devices. We’ll never have 100% or 0% in any of those categories.

    Windows 8 is one of many tools that help steer care plans in the right direction. When a ship is off course – even by a single degree – we need to know soon enough to correct it. Or else we might end up in Cuba when we wanted to go to Bermuda. For a patient, early detection could mean the difference between a few simple lifestyle changes and frequent trips to the emergency room.

    Does Windows 8 help you better navigate the choppy seas of health care? If so, how?



    The best of 2013 (and what’s next in 2014)

    December 23rd, 2013

    In 2013 we made progress on the seismic shift from fee-for-service to value-based care models. The industry has taken the first steps so that everyone – patient, provider and payer – has the same agenda. And everyone profits from the same outcomes.

    Some of the best industry trends I’ve seen in 2013 include:

    1. Accountable Care Organizations (ACOs)

    I like this model because everyone’s incentives are aligned. ACOs have to find the patients they should be treating. They need to reach those patients before there’s a problem, before a trip to the ER, or worse.

    2. Population health management

    I like this trend because it means caregivers are being more proactive. They are reaching the patients most likely to need healthcare and aggressively managing their health. Strangely, population health means that we treat the patient more individually.

    3. Open, a more collaborative approach to Health IT

    I think we’re seeing the beginning of the end of closed systems which will mean more innovation, more apps that providers can choose from and more opportunities to apply Health IT to advance healthcare.

    4. Patient engagement

    This has become an area with lots of potential. With the proliferation of devices, the industry is making a lot of progress. We, as patients, are getting much more involved in our own care, which is fundamental to success in population health management.

    It’s too soon to tell if other 2013 trends were good for healthcare. For example, the relaxation of the Stark rules enabled more consolidation of provider groups and hospitals. Or the transition from ICD-9 to ICD-10 codes, which requires a lot more physician time. I hope these are good things for patients, but it’s too early to say for sure.

    3 trends to expect in 2014

    In 2014 I believe the industry will re-focus on physician productivity. There are so many priorities for physicians to manage “administrivia” – when we really need them focused on delivering quality care for patients.

    Other broader trends include:

    1.       Changing financial models

    In general, we’ll see more creative financial models adapted to support value-based care. Technology will play a key role, providing the tools to measure effectiveness, sharing best practices and enabling agility. It’s important for care providers to keep moving forward. The rules keep changing and they need to keep pace or fall behind.

    2.       Increased focus on population health

    All care providers need to reduce preventable readmissions – and the penalties that now come with them. Proactive care management will become increasingly important and will heighten the need of population health data to help identify patients at higher risk up front to drive the most appropriate care plans.

    This focus looks different, depending on the size of the caregiver. Small practices don’t have to be an HIE, but they should join together to share data, best practices, experiment and try new things. They are agile. They can make a decision and implement it quickly. The larger systems can sometimes struggle with that.

    3.        More personalized medicine

    Connecting the dots can unlock a lot of information about our health. For example, think about breakthroughs in genetics and genomics that can help us make better clinical decisions.

    Combine this data stream with a proliferation of apps, and we have powerful possibilities in personalized medicine. Take Genelex, a company that uses the genetic make-up to figure out if the drugs you are taking are working. And, if not, what will work for you? These advances are bringing truly personalized medicine into the mainstream.

    What can care providers do to stay competitive in all three areas? Continue to embrace technology, especially mobility. Those practices that are agile and can adopt new innovations quickly will have the advantage.


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