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Is the ‘Internet of Things’ Health IT’s Next Big Thing?

Posted on October 17, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Gartner Inc. has come out with a bullish report on the “internet of things,” which it predicts will add nearly $2 trillion in value to the economy by 2020 and transform the way all businesses operate.

As many as 30 billion devices with unique IP addresses will be connected, the majority of them being products, according to Gartner. That’s compared with a 2009 figure of 2.5 billion, 80 percent of them being devices such as laptops and phones.

One of the most often quoted descriptions of the internet of things comes from Helen Duce, director of the RFID Technology Auto-ID European Centre at the University of Cambridge: “We have a clear vision: to create a world where every object — from jumbo jets to sewing needles — is linked to the Internet.”

Health care would, of course, be part of the vision, which Gartner, a Stamford, Conn.-based IT research and advisory firm, calls the Digital Industrial Economy. The sector receives prominent billing, along with retail and transportation, in Garner’s latest news release on the topic.

The thinking is that physical objects — “from roadways to pacemakers,” as McKinsey & Co. put it in one report — will produce constant data streams that can be analyzed and acted on. The possibilities for systems such as inventory control are obvious enough, as the inventory would report on itself.

In health care, a major application could be in patient monitoring. Marketplace has quoted Dr. Anthony Jones of Philips Healthcare on the possibilities: “If I now have a continuous monitor, and I have that data going up into a central repository, I can write algorithms and put some intelligence into that repository that allows me to look for trends. So part of what the Internet of things will allow is much more sophisticated, much more continuous monitoring.” Sounds a bit like what John described in his post “Every Organ Will Have an IP Address.”

It sounds promising. But it also sounds much more incremental than it’s being portrayed by Gartner and other consultants.

Consider how Peter Sondergaard, senior vice president at Gartner, explained the future in a recent talk covered by ZDNet:

“The Digital Industrial Economy will be built on the foundations of the Nexus of Forces (which includes a confluence and integration of cloud, social collaboration, mobile and information) and the Internet of Everything by combining the physical world and the virtual.”

The predictions — Sondergaard said every object costing more than $100 will be smart by 2020 — look optimistic. Or pessimistic, depending on how you look at it: Gartner also estimates that one in three knowledge workers will be displaced by the new technologies.

About 60 percent of respondents to Gartner’s own recent CEO survey said the idea that the internet of things would replace millions of workers over the next decade-and-a-half was a “futurist fantasy,” according to SiliconANGLE. In health care, it’s hard to imagine that CIOs have much attention to devote to the internet of things amid the Meaningful Use and ICD-10 requirements they’re up against, although, as Jennifer Dennard wrote, health IT nowadays is much more than that.

The internet of things will get here. But it will probably develop in a piecemeal fashion, not in the dramatic way that Gartner envisions. Lots of “things” will get connected as companies see business reasons to put sensors in and bring them online. It will arise ad hoc from existing projects, with some industries joining the trend earlier than others.

When it does get here, there’s a good chance it won’t even be called the internet of things. In 2005, after all, Gartner was calling it the “real-world web.”

It was also predicting: “By 2015, wirelessly networked sensors in everything we own will form a new Web.”

Is Meaningful Use a Floor or Ceiling?

Posted on June 9, 2011 I Written By

I was witness to an interesting discussion earlier this week at the Wisconsin Technology Network’s Digital Healthcare Conference in Madison, Wis.: Is meaningful use a floor or a ceiling?

One panelist, Judy Murphy, VP of information services at Aurora Health Care in Milwaukee, said Stage 1 meaningful use has caused the health system to alter its own IT plans by activating a patient portal and moving more toward interoperability sooner than intended. “We wouldn’t have decided to give electronic copies of clinical summaries at discharge [without meaningful use],” Murphy said.

But Murphy believes it’s a floor for many of the criteria, such as the requirement that 30 percent of patients have at least one medication order entered electronically. “No one would go into an implementation shooting so low,” she said. As a member of the Health IT Policy Committee as well as the Meaningful Use Workgroup of the Health IT Policy Committee, Murphy actually had a hand in shaping the standards. (Remember, though, the original proposal called for 10 percent for hospitals and 80 percent for physicians. The final Stage 1 rule set the threshold at 30 percent for both.)

Gartner analyst Vi Shaffer offered a counterpoint. “Meaningful use is not the floor,” she said. “All the existing quality measures that have been out there so long should be considered the floor.” Shaffer expressed frustration that so many 12-year-old National Quality Forum performance measures still haven’t been met.

According to Shaffer, the idea behind meaningful use is to “lift people up,” particularly when it comes to safety-net providers like critical-access hospitals. Shaffer said policymakers didn’t want to see “oligopolies” in local markets because smaller providers were forced to merge with large health systems because of EHR requirements.

Session moderator Dr. Barry Chaiken, chief medical officer at Docs Network Imprivata, and a former HIMSS chair, said he believes health IT will raise the norm for all providers and “lock in” better behaviors, suggesting that in some ways, meaningful use could be a floor.

By holding the conference in Madison, WTN was able to land the publicity-shy Judy Faulkner, CEO of Epic Systems in nearby Verona, Wis. Faulker noted that Epic shows a simpler version of its core EHR in overseas markets because the company had to add some functions for regulation and liability purposes in the U.S.

While plenty of providers are viewing meaningful use as a ceiling right now–perhaps an unattainable one–Murphy believes acceptance will come rapidly. “I think in 2015, we’re gonna look and say, ‘How did we even have healthcare without computers?'” Murphy said. She then said she had heard that HCA would attest this year to meaningful use at all of its U.S. hospitals.

Being the occasionally motivated reporter that I am, I tweeted this statement, asking for verification. Wouldn’t you know, HCA replied with this tweet: “Nearly all HCA facilities should achieve requirements 4 Stage I this yr. An exciting, important step for high-performance hcare!”

So maybe meaningful use is not a floor or ceiling, but the new norm.

What are your thoughts?

CORRECTION, June 13: Chaiken’s one-year contract with Imprivata is over, so he’s no longer affiliated with that company.


Detail’s of Obama’s EMR Stimulus Package

Posted on January 24, 2009 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: Check out more specific details on Obama’s EMR stimulus package.

UPDATE 2: Many of you will find my presentation on the ARRA EMR Simulus money of interest.

Details about Obama’s health care stimulus package are out. I prefer to call it Obama funds EMRs for medical practices. Here’s a summary of some proposed changes via HISTalk and John Glaser, VP and CIO at Partners HealthCare System (and thanks to Chris Paton for linking me there).

  • Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR
  • Creation of HIT Extension Programs that would facilitate regional adoption efforts
  • Provision of funds to states to coordinate and promote interoperable EHRs
  • Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals
  • Creation of HIT grant and loan programs
  • Acceleration of the construction of the National Health Information Network (NHIN)

He also adds. “All of these changes (and more) are accompanied by the infusion of $20B into the healthcare sector. To put this in perspective, in 2007 the HIT industry in the US was $26B (Gartner).”

It’s also important to note like John did that this is still just proposed legislation. In the next 30 days it will be turned upside down. However, what we can guarantee is that the government is going to make a huge investment in health care IT and in particular EMR and EHR software. Man, big EHR and EMR vendors must be licking their chops right now.

The funny thing is that I mentioned this investment in EMR to my wife’s OB/Gyn and she started to laugh. She said, “Like the government’s ever done anything to help the provider.” While I think the response was a bit jaded, you could tell that she sincerely felt like the government wasn’t going to help her get an EMR and honestly I don’t see her ever changing to one.

However, the perspective that the health care IT industry was $26B in 2007 and they’re looking at investing $20B really jumps out at me. It goes back to my thought that there aren’t enough health care IT, EMR, and EHR professionals out there right now. Can the health care IT market really support an infusion of $20B right now? I have my doubts. Of course, I don’t think that’s going to stop anyone in Washington. Plus, I find the possibilities for someone like myself who has experience incredibly exciting.

I’ll save my details response to these points for posts of their own, but it’s going to be a really interesting next couple months as we watch Obama’s investment in health care come to fruition. Of course, this assumes that the money doesn’t just get stuck in the political process and never actually makes it to the doctors who need the money to implement an EMR and EHR.